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Abstract It is commonly known that a number of variables, including price, supply levels, time, and green level, affect how quickly certain things are in demand. Furthermore, the inventory carrying cost is considered to be a nonlinear representation of time and is subject to variation throughout time. More precisely, it rises with time since longer storage times necessitate more costly warehouse space. This study presents a fully backlogged situation inventory system for a single commodity where the product’s selling price, green level, and time are used to simultaneously compute the demand rate in accordance with a power pattern. Purchase price is determined by the product’s nonlinear green level. Complete backorders are available for shortages. The impact of the product’s selling price, green level and time power function are combined to determine the product’s demand. Moreover, the holding cost also rises as the product is stored for a longer period of time. The primary goal is to determine the best inventory policy to maximise total profit per unit of time. Though the problem is highly nonlinear in nature. Hence, we cannot solve it analytically. To overcome these difficulties, we have applied several well-known popular metaheuristic algorithms (Water Cycle Algorithm (WCA), Artificial Electric Field Algorithm (AEFA), Teaching Learning Based Optimization Algorithm (TLBOA), Grey Wolf Optimizer Algorithm (GWOA), Sparrow Search Algorithm (SSA), Whale Optimizer Algorithm (WOA), Prairie Dog Optimization Algorithm (PDOA), Gazelle Optimization Algorithm (GOA), A Sinh Cosh Optimizer Algorithm (SCHOA) and White Sherk Optimizer Algorithm (WSOA), Archimedes Optimization Paradigm Algorithm (AOPA), Marine Predator Optimization Algorithm (MPOA), Geyser Inspired Algorithm (GIA), Runge Kutta Optimization Algorithm (RKOA), Lungs Performance-based Optimization Algorithm (LPOA) and Dwarf Mongoose Optimization Algorithm (DMOA)). It is observed that WCA perform better than other algorithms with respect to the convergence rate. A numerical example is taken in order to validate the proposed model. Finally, a post optimality analysis is performed in order to make a fruitful conclusion.

Introduction: Endometriosis is a recurring chronic inflammatory condition that affects females of reproductive age. Endometriosis-associated Pelvic Pain (EAPP) adversely impacts physical, mental, and social well-being. Currently, there is no ideal treatment option. Dienogest, a selective progestin, shows a pronounced effect on endometriosis. Aim: To compare the efficacy and safety of Dienogest at doses of 2 mg and 4 mg/day orally in the treatment of endometriosis. Materials and Methods: An observer-blind, parallel-group, randomised clinical trial was conducted in the Department of Obstetrics and Gynaecology at IPGME&R, SSKM Hospital, Kolkata, West Bengal, India, from April 2016 to December 2017. A total of 190 women aged 20-45 years suffering from endometriosis were recruited and divided into two treatment groups, A and B, receiving daily doses of 2 mg and 4 mg, respectively, for 24 weeks. Relief of EAPP was assessed using the Visual Analogue Scale (VAS) score, and improvement in Quality of Life (QoL) was measured. Treatment-related adverse events were also recorded. Numerical variables were compared using Student’s t-test or the Mann-Whitney U Test, and categorical variables were compared using the Chi-square test or Fisher’s-exact test. Results: The absolute reduction in pelvic pain VAS score was 39.71±8.60 at 24 weeks from the initial score of 70.88 (Mean VAS score before treatment with Dienogest) in Group A, compared to 34.80±6.45 from 69.34 (Mean VAS score before treatment with Dienogest) in Group B (p=0.0001). The difference in mean VAS at 24 weeks between the two groups was statistically significant (p=0.0002). At 24 weeks, 18 (24.66%) patients in Group A experienced an irregular bleeding pattern compared to 27 (40.30%) in Group B, with spotting being the most common issue. Adverse effects such as weight gain, acne, alopecia, depression, and decreased libido were observed in both groups, but they were more pronounced in the 4 mg group. Conclusion: The efficacy and safety results from this dose-ranging study of Dienogest indicate that 2 mg/day is the effective dose for treating endometriosis and offers better tolerability compared to the 4 mg dose.

Atherosclerotic plaque formation is a leading cause of arterial thrombosis that significantly impacts global health by instigating major adverse cardiovascular events (MACE) like myocardial infarction (MI) and stroke. Platelets are central to this process, leading to the development of antiplatelet therapies, to mitigate MACE risks. The combination of aspirin with a potent P2Y12 inhibitor known as dual antiplatelet therapy (DAPT) is the standard for post-percutaneous coronary intervention (PCI) aimed at reducing ischemic events. However, DAPT’s associated bleeding risks, particularly in high bleeding risk (HBR) patients, require a balanced approach to optimize therapeutic outcomes. Recent advancements have led to the exploration of ticagrelor monotherapy as a promising strategy after short-term DAPT to reduce bleeding risks while preserving ischemic protection. This review manuscript focuses on ticagrelor monotherapy for HBR patients with discussion on optimal timing, patient selection, and treatment duration. It highlights ticagrelor’s broad efficacy in diverse patient sub-groups and outlines its superiority over aspirin (ASA) and clopidogrel monotherapies. Trials such as TICO, TWILIGHT, GLOBAL LEADERS, and ULTIMATE-DAPT as well as literature meta-analyses validate ticagrelor monotherapy’s role in lowering mortality and clinical adverse events versus conventional DAPT. The review endorses a personalized treatment regimen, beginning with DAPT before moving to ticagrelor monotherapy, as a balanced method for managing both bleeding and ischemic risks in post-PCI acute coronary syndrome (ACS) patients, especially those facing higher bleeding threats.

Introduction: Orthodontic treatment can alter the oral environment, leading to plaque accumulation and changes in microbial colonization. This study aimed to assess microbiological changes in 10 to 16-year-old children undergoing fixed orthodontic treatment. Methodology: The study included children aged 10–16 years, with one group wearing fixed orthodontic appliances and a control group without brackets. Data on salivary pH, buffer capacity, Streptococcus mutans, and Lactobacillus spp were collected at baseline and after 6 months. Logistic regression models evaluated associations between orthodontic treatment and elevated bacterial levels, adjusting for age, gender, pH, and buffer capacity. Results: Wearing fixed orthodontic appliances was significantly associated with elevated Streptococcus mutans (aOR: 6.62, 95% CI: 1.91–21.88) and Lactobacillus spp (aOR: 9.49, 95% CI: 2.57–35.07). Gender showed a significant association with Lactobacillus spp levels (aOR: 0.28, 95% CI: 0.09–0.87). Conclusion: Fixed orthodontic appliances significantly impact oral microbial changes, underscoring the need for proper oral hygiene during orthodontic treatment to reduce dental caries risk.

Several factors affect engine performance, including fuel injection pressure, injection angle, and injector orifice diameter. Any deviation from normal conditions in any of these aspects can disrupt optimal engine performance, resulting in inefficient combustion and increased exhaust emissions. To investigate the effect of injector hole number, injection hole angle, and injection pressure on the performance and emissions of a diesel engine operating on a diesel/hydrogen blend (10 % hydrogen and 90 % diesel), a single-cylinder direct injection diesel engine was used. Three injector nozzle configurations just for diesel injector with different hole diameters (0.6, 0.3, and 0.2 mm) were used at injection angles of 0, 15, and 30 degrees, respectively. Three injection pressures (200, 400, and 600 bar) were tested, with results monitored for brake-specific fuel consumption (BSFC), brake thermal efficiency (BTE), smoke, and NOx emissions.Optimal results were achieved with a maximum injection pressure of 400 bar and a nozzle angle of 15 degrees, resulting in improved engine performance and BTE, along with a 6.5 % reduction in BSFC. Increasing the number of injector holes, injection pressure, and injection angle resulted in reduced BSFC and smoke emissions, but with a significant increase in NOx emissions. Notably, this study deviates from traditional combustion methods by introducing air from a 1.1-atmosphere tank instead of relying solely on natural intake. In addition, hydrogen fuel is introduced into the air manifold via a separate injector with an injection pressure of 20 bar, while diesel fuel is injected directly into the combustion chamber.

Abstract There has been a lot of research on pricing and lot-sizing practices for different payment methods; however, the majority has focused on the buyer’s perspective. While accepting buyers’ credit conditions positively impacts sales, requesting advance payments from purchasers tends to have a negative effect. Additionally, requiring a down payment has been found to generate interest revenue for the supplier without introducing default risk. However, extending the credit period, along with offering delayed payment options, has the potential to increase sales volume, albeit with an elevated risk of defaults. Taking these payment schemes into account, this study investigates and compares the per-unit profit for sellers across three distinct payment methods: advance payment, cash payment, and credit payment. The consumption rate of the product varies non-linearly not only with the time duration of different payment options but also with the price and the level of greenness of the product. The utmost objective of this work is to determine the optimal duration associated with payment schemes, selling price, green level, and replenishment period to maximize the seller’s profit. The Teaching Learning Based Optimization Algorithm (TLBOA) is applied to address and solve three numerical examples, each corresponding to a distinct scenario of the considered payment schemes. Sensitivity analyses confirm that the seller’s profit is markedly influenced by the environmental sustainability level of the product. Furthermore, the seller’s profitability is more significantly affected by the selling price index compared to the indices of the payment scheme duration and the green level in the demand structure.

Background: Although fast-track treatment pathways are well established in colorectal surgeries, their role in oesophageal resections has not been well studied. This study aims to prospectively evaluate the short-term outcomes of enhanced recovery after surgery (ERAS) protocol in patients undergoing minimally invasive oesophagectomy (MIE) for oesophageal malignancy. Patients and Methods: We studied a prospective cohort of 46 consecutive patients from January 2019 to June 2022 who underwent MIE for oesophageal malignancy. The ERAS protocol mainly consists of pre-operative counselling, pre-operative carbohydrate loading, multimodal analgesia, early mobilisation, enteral nutrition and initiation oral feed. Principal outcome measures were the length of post-operative hospital stay, complication rate, mortality rate and 30-day readmission rate. Results: The median (interquartile range [IQR]) age of patients was 49.5 (42, 62) years, and 52.2% were female. The median (IQR) post-operative day of intercoastal drain removal and initiation of oral feed was 4 (3, 4) and 4 (4, 6) days, respectively. The median (IQR) length of hospital stay was 6 (6.0, 7.25) days, with a 30-day readmission rate of 6.5%. The overall complication rate was 45.6%, with a major complication (Clavien–Dindo ≥3) rate of 10.9%. Compliance with the ERAS protocol was 86.9%, and the incidence of major complications was associated with failure to follow the protocol (P = 0.000). Conclusions: ERAS protocol in minimally invasive oesophagectomy is feasible and safe. This may result in early recovery with shortened length of hospital stay without an increase in complication and readmission rates.

Quantum information processing leverages the principles of quantum mechanics, utilizing qubits, to improve computational and communicative tasks. In this realm, the quantum channel’s capacity is pivotal in determining the efficiency and accuracy of quantum information handling, with its performance being significantly influenced by channel noise. Our study aims to establish a holistic hybrid quantum noise model to determine the quantum channel capacity. In this paper, we formulated a mathematical expression for this capacity and conducted simulations for both Gaussian and non-Gaussian inputs. A hybrid noise model is constructed by convolution of Poisson-distributed quantum noise with classical additive white Gaussian noise. We characterized the quantum-classical noise and the received signal using Gaussian Mixture Models. The maximum amount of quantum information that can be reliably transmitted over a quantum channel (per use of the channel) is determined by its capacity, and entropy and related quantities like mutual information play a role in calculating this capacity. Our formulation of quantum channel capacity is derived from the mutual information shared between the transmitter and receiver, encompassing the entropies of the signals. The quantum channel presents a higher capacity-to-signal-to-noise ratio for Gaussian inputs than non-Gaussian ones.

Background: Gastrointestinal (GI) bleed is a common cause of medical emergency resulting in significant morbidity and mortality. GI bleeding can be classified as upper (bleeding source proximal to the ligament of Treitz) and lower (bleeding source distal to the ligament of Treitz). Aims and Objectives: The present study was aimed to determine the current clinicoetiological profile of GI bleeding in Kumaon Region of Uttarakhand. Materials and Methods: All patients presented with GI bleed (GIB) to outpatient department and Emergency department or developed the GIB during hospitalization are managed in intensive care unit (preferably) and high-dependency unit. Results: Both upper and lower GI endoscopy were twice normal in 2.7% of patients (obscure bleeding). On upper GI endoscopy findings showing esophageal varices (45.83%), gastroesophageal varices (8.33%), isolated gastric varices (8.33%), gastric ulcer (8.33%), duodenal ulcer (6.25%), Mallory-Weiss tear (6.25%), erosive gastritis (6.25%), gastric antral vascular ectasia (4.16%), gastric carcinoma (4.16%), and Dieulafoy’s lesion (2.08%). Upper GIB (UGIB) had more mortality than lower GIB, among UGIB variceal bleed having higher mortality than non-variceal bleeding. Conclusion: Unlike the evidence from the west that peptic ulcer is the most common cause of upper gastrointestinal bleeding, we found varices as the common cause, followed by peptic ulcer and erosive gastritis. Hence, the variable spectrum of the etiology of the GIB seen in our country could represent either a true epidemiological difference or reflect skewed access to health care.

Inflammation in ulcerative colitis is typically restricted to the mucosal layer of distal gut. Disrupted mucus barrier, coupled with microbial dysbiosis, has been reported to occur prior to the onset of inflammation. Here, we show the involvement of vesicular trafficking protein Rab7 in regulating the colonic mucus system. We identified a lowered Rab7 expression in goblet cells of colon during human and murine colitis. In vivo Rab7 knocked down mice (Rab7KD) displayed a compromised mucus layer, increased microbial permeability, and depleted gut microbiota with enhanced susceptibility to dextran sodium-sulfate induced colitis. These abnormalities emerged owing to altered mucus composition, as revealed by mucus proteomics, with increased expression of mucin protease chloride channel accessory 1 (CLCA1). Mechanistically, Rab7 maintained optimal CLCA1 levels by controlling its lysosomal degradation, a process that was dysregulated during colitis. Overall, our work establishes a role for Rab7-dependent control of CLCA1 secretion required for maintaining mucosal homeostasis.

Introduction Microglia exert a crucial role in homeostasis of white matter integrity and several studies highlight the role of microglial dysfunctions in neurodegeneration. Primary microgliopathy are disorders where the pathogenic abnormality of the microglia causes white matter disorder and leads to a neuropsychiatric diseases. Triggering Receptor Expressed on Myeloid Cells (TREM2), TYRO protein tyrosine kinase binding protein (TYROBP), Colony-stimulating factor 1 receptor (CSF1R) are genes implicated in primary microgliopathy. Clinical manifestations of primary microgliopathy are myriad ranging from neuropsychiatric syndrome, motor disability, gait dysfunction, ataxia, pure dementia, frontotemporal dementia, Alzheimer dementia and so on. It becomes imperative to establish diagnosis of microgliopathy masquerading as degenerative dementia, especially with promising therapies on horizon for the same. We aim to describe a case series of subjects with dementia harboring novel genes of primary microgliopathy, along with their clinical, neuropsychological, and cognitive profile and radiological patterns. Methods: The prospective study was conducted in a university referral hospital in South India, as a part of an ongoing clinic-genetic research on Dementia subjects and was approved by the institutional ethics committee. All patients underwent detailed assessment including socio demographic profile, clinical and cognitive assessment, pedigree analysis and comprehensive neurological examination. Subjects consenting for blood sampling underwent genetic testing by Whole exome sequencing (WES). Results: 100 patients of dementia underwent genetic analysis using whole exome sequencing and three pathogenic variants, one each of TREM2, TYROBP and CSF1R and two variants of uncertain significance in CSF1R were identified as cause of primary microgliopathy .TREM 2 and TYROBP presented as frontotemporal syndrome whereas CSF1R presented as frontotemporal syndrome and Alzheimer dementia. Conclusion :WES has widened the spectrum of underlying neuropathology of degenerative dementias and diagnosing primary microglial dysfunction with emerging therapeutic options is of paramount importance. Cases of primary microgliopathy due to Novel mutations in TREM2, TYROBP and CSF1R with phenotype of degenerative dementia are being first time reported from Indian cohort. Our study enriches the spectrum of genetic variants implicated in degenerative dementia, and provides the basis for exploring complex molecular mechanisms like microglial dysfunction, as underlying cause for neurodegeneration.

Abstract Many drugs were recommended as antiviral agents for infection control and effective therapy to reduce the mortality rate for COVID-19 patients. Hydroxychloroquine (HCQ), an antimalarial drug, has been controversially recommended for prophylactic use in many countries, including India, to control SARS-CoV-2 infections. We have explored the effect of prophylactic HCQ from the cells of bronchoalveolar lavage fluids from COVID-19-induced acute respiratory distress syndrome patients to determine the level of infection and ultrastructural alterations in the ciliated epithelium, type II pneumocytes, alveolar macrophages, neutrophils, and enucleated granulocytes. Ultrastructural investigation of ciliated epithelium and type II pneumocytes showed lesser infections and cellular impairment in the prophylactic HCQ+ group than HCQ− group. However, macrophages and neutrophils displayed similar infection and ultrastructural alterations in both patient groups. The enucleated fragments of granulocytes showed phagocytosis of the matured virus in HCQ+ groups. The present report unveils the ultrastructural proof to complement the paradox regarding the role of prophylactic HCQ in COVID-19 patients.

Background: Upper gastrointestinal (GI) bleeding refers to blood loss within the intraluminal GI tract from any location between the upper esophagi to the duodenum at the level of the ligament of Treitz. Bleeding from the upper GI tract may present as hematemesis, melena, hematochezia, occult GI bleeding, and anemia. Aims and Objectives: The aims of this study were to study the risk factors and outcome in upper GI bleed patients presenting to a tertiary care center in Kumaon region of Uttarakhand. The primary objective was to estimate the proportion of mortality in upper GI bleed patients attending a tertiary care center. The secondary objective was to study the risk factors associated with upper GI bleed and their effect on mortality. Materials and Methods: This was a hospital-based observational prospective clinical study, carried out in the Department of General medicine, Dr. Susheela Tiwari Memorial Hospital and associated Government Medical College, Haldwani, from January 2020 to September 2021 after obtaining ethical clearance from the Institutional Review Committee and informed consent from the patient or patient relatives. Statistical testing has been conducted with the Statistical Package for the Social Science software (SPSS version 20.0). Results: The factors associated with mortality using multivariate analysis were high international normalized ratio (INR), low albumin, raised serum glutamic oxaloacetic transaminas, high Child Pugh Score, and high model for end stage liver disease (MELD) score found to be significant. Conclusion: The mortality rate in our patients was 18% and factors associated with increased mortality were high INR, low Albumin, raised creatinine, high Child Pugh Score, high MELD score, and presence of spontaneous bacterial peritonitis.

Tuberculosis (TB) remains a significant public health challenge in Low- and Middle-Income Countries (LMIC). Inappropriate use of Anti-Tubercular Treatment (ATT) undermines treatment efficacy and could contribute to drug resistance. While antimicrobial stewardship programs (AMSP) are well established, anti-tubercular treatment stewardship programs (ATTSP) in private hospitals do not have an established model. An AMSP model in a private tertiary care hospital in South India was repurposed to monitor the prescription appropriateness of ATT. A multidisciplinary team evaluated the ATT prescription appropriateness among inpatients over a one-year period with the 4R's criteria: Right Indication, Right Drug, Right Dose, and Right Frequency. The ATTSP team filed recommendations for inappropriate prescriptions to the primary clinical care team, and compliance to the recommendations was documented within 48 hours. During the study period, 172 ATT prescriptions were evaluated. Inappropriate dose and drug prescriptions were found in 16% and 7%, respectively. The primary clinical care teams complied with 83% of the recommendations within 48 hours. The potential impact of implementing the ATTSP model nationwide was assessed using published data, suggesting that the opportunities to correct inappropriate prescriptions could reach a quarter million. The study provides a proof of concept that an ATTSP can be successfully implemented in a TB endemic, resource-constrained setting. Extrapolation for implementing ATTSP across the country has the potential for huge public health benefits.

IntroductionNoninvasive High-Frequency Oscillatory Ventilation (NHFOV) is increasingly being adopted to reduce the need for invasive ventilation after extubation.ObjectivesTo evaluate the benefits and harms of NHFOV as post-extubation respiratory support in newborns compared to other non-invasive respiratory support modes.Material & methodsWe included randomized controlled trials comparing NHFOV with other non-invasive modes post-extubation in newborns. Data sources were MEDLINE (via Pubmed), Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, WHO international clinical trials registry platform and Clinical Trial Registry, forward and backward citation search. Methodological quality of studies was assessed by Cochrane's Risk of Bias tool 1.0.ResultsThis systematic review included 21 studies and 3294 participants, the majority of whom were preterm. NHFOV compared to nasal continuous positive airway pressure (NCPAP) reduced reintubation within seven days (RR 0.34, 95% CI 0.22 to 0.53) after extubation. It also reduced extubation failure (RR 0.39, 95% CI 0.30 to 0.51) and reintubation within 72 hrs (RR 0.40, 95% CI 0.31 to 0.53), bronchopulmonary dysplasia (RR 0.59, 95% CI 0.37 to 0.94) and pulmonary air leak (RR 0.46, 95% CI 0.27 to 0.79) compared to NCPAP. The rate of reintubation within seven days (RR 0.62, 95% CI 0.18 to 2.14) was similar whereas extubation failure (RR 0.65, 95% CI 0.50 to 0.83) and reintubation (RR 0.68, 95% CI 0.52 to 0.89) within 72 hrs were lower in NHFOV group compared to nasal intermittent positive pressure ventilation. There was no effect on other outcomes. Overall quality of the evidence was low to very low in both comparisons.ConclusionsNHFOV may reduce the rate of reintubation and extubation failure post-extubation without increasing complications. Majority of the trials were exclusively done in preterm neonates. Further research with high methodological quality is warranted.

Interspecific feeding is recorded in numerous bird species across the world, however, there are limited published observations from India. We provide the first documentation of a non-brood parasitic interspecific feeding between an Indian Robin (Copsychus fulicatus) and a Brown Rock Chat (Oenanthe fusca) fledgling from the Central Aravalli hill region of Ajmer, Rajasthan, India.

Abstract Background SARS-CoV-2 was reported to induce cell fusions to form multinuclear syncytia that might facilitate viral replication, dissemination, immune evasion, and inflammatory responses. In this study, we have reported the types of cells involved in syncytia formation at different stages of COVID-19 disease through electron microscopy. Methods Bronchoalveolar fluids from the mild (n = 8, SpO2 > 95%, no hypoxia, within 2–8 days of infection), moderate (n = 8, SpO2 90% to ≤ 93% on room air, respiratory rate ≥ 24/min, breathlessness, within 9–16 days of infection), and severe (n = 8, SpO2 30/min, external oxygen support, after 17th days of infection) COVID-19 patients were examined by PAP (cell type identification), immunofluorescence (for the level of viral infection), scanning (SEM), and transmission (TEM) electron microscopy to identify the syncytia. Results Immunofluorescence studies (S protein-specific antibodies) from each syncytium indicate a very high infection level. We could not find any syncytial cells in mildly infected patients. However, identical (neutrophils or type 2 pneumocytes) and heterotypic (neutrophils-monocytes) plasma membrane initial fusion (indicating initiation of fusion) was observed under TEM in moderately infected patients. Fully matured large-size (20–100 μm) syncytial cells were found in severe acute respiratory distress syndrome (ARDS-like) patients of neutrophils, monocytes, and macrophage origin under SEM. Conclusions This ultrastructural study on the syncytial cells from COVID-19 patients sheds light on the disease’s stages and types of cells involved in the syncytia formations. Syncytia formation was first induced in type II pneumocytes by homotypic fusion and later with haematopoetic cells (monocyte and neutrophils) by heterotypic fusion in the moderate stage (9–16 days) of the disease. Matured syncytia were reported in the late phase of the disease and formed large giant cells of 20 to 100 μm.

Pangasius catfish (Pangasianodon hypophthalmus) is popularly cultured in Bangladesh but the farmers usually suffer financial losses due to their low market price. Development of new value-added products will enhance its popularity and acceptability to the consumers. This study was conducted to develop smoked products from pangasius catfish, to evaluate their quality and shelf-life at ambient (30-35°C) and refrigeration temperatures (4°C). Two treatments, dipped for 15 min in 10% (T1) and 15% (T2) salt solutions, and one untreated control were maintained. The smoking was conducted at 70-75°C in an improved traditional smoking kiln. The products were then sealed in polybags and stored separately at ambient and refrigeration temperatures. The sensory quality, proximate composition, salt content, total volatile base nitrogen (TVB-N) values, and viable bacterial counts were determined. The products stored at ambient temperature were rejected on day 5, 7 and 9; and those kept at refrigeration temperature, on day 28, 35, and 42, respectively for control, T1, and T2. Significant difference in proximate composition was observed between the treatments, storage conditions and periods. The TVB-N values were increased rapidly in control followed by the T1 samples, compare to T2 samples. Viable bacterial counts of the smoked products were gradually increased with the increasing storage periods. Considering all the assessed parameters, the T2 products were better in quality with longer shelf-life than those of control and T1. As consumers' preference towards new fishery products has been changing, smoked products from pangasius catfish will be preferred for their taste, less bones, and higher shelf-life. [ J Adv Biotechnol Exp Ther 2023; 6(1.000): 184-197]

Abstract Background Successful pregnancy outcome in women with synchronous ovarian and endometrial cancers is very rare. We report successful pregnancy outcome in a young woman managed conservatively for synchronous endometrial and ovarian cancer. Case presentation Thirty years old nulliparous lady presented following exploratory laparotomy, left salpingo-oophorectomy and hysteroscopic polypectomy for left adnexal mass. Histology revealed endometrioid carcinoma of left ovary and moderately differentiated adenocarcinoma in the resected polyp. She underwent staging laparotomy along with hysteroscopy which confirmed above findings without any evidence of further tumor spread. She was treated conservatively with high dose oral progestin (megestrol acetate, 160 mg) and leuprolide acetate 3.75 mg monthly injections for three months along with four cycles of carboplatin and paclitaxel based chemotherapy followed by monthly injection of leuprolide for further three months. After failure of spontaneous conception, she underwent ovulation induction for six cycles along with intrauterine insemination which failed. She underwent in vitro fertilization with donor egg followed by elective cesarean section at 37 weeks of gestation. She delivered a healthy baby of weight 2.7 kg. Intraoperatively 5 × 6 cm right ovarian cyst was found which drained chocolate coloured fluid on puncture and cystectomy was carried out. Histological examination revealed endometrioid cyst of right ovary. Uterus was spared as she wanted to preserve her fertility. She is being followed periodically and is normal nine months following delivery. She is on injection Depot medroxy progesterone acetate once every three months.

Cancer being a life treating ailment is the second reason of death universally. The growing threats of medication-resistant cancers indicates an crucial need for the improvement of more effective anticancer agents. Herbal medication offers very reasonable alternate to modern medicine against cancer. The investigation of natural products is a valued method for the detection and expansion of newer biologically dynamic compounds having exclusive assemblies and pathways. This work reviews certain medicinal plant with active phytochemicals, methodology of researches and their pharmacological characteristics. This work is created after careful literature review directed through relevant exploration of keywords in Clarivate Analytical, Web of Science, Scopus, Google Scholar, Science Direct, PubMed, MDPI, and Google Academic. This study was planned to accumulate the record of plants having anticancer activity and the evidences supporting their usage in cancer treatment. Fifty plants were selected based on their potenty as anticancer compounds. The thorough research studies exposed that plants and its phytochemicals can play a crucial role against oral, breast, lung, cervical, colon, stomach, hepatic cancers. The in vitro researches displayed that the plant secondary metabolites in extracts causes inhibition of cancer cell through DNA mutilation as well as stimulation of apoptosis-tempting enzymes in different models.

Background: Youth are considered to be most vulnerable to health and lifestyle issues (HLS) in India. The current study aims to investigate the factors that contribute to health and lifestyle issues among youth attending mental health promotion clinics (YMHP) in Karnataka. Method: Three-year first-visit data from beneficiaries (aged 15–35 years) attending YMHP clinics in Karnataka between 2017 and 2020 were analyzed. Multivariable logistic regression analysis included beneficiaries reporting any HLS issue as the outcome and a host of 57 hypothesized variables as exposures. Results: Overall, 2,615 (25%) beneficiaries reported HLS issues. Years of schooling (AOR 5–7 years = 0.89; 95% confidence interval [CI] =0.60–1.31), (AOR 8–10 years = 0.65; 95% CI = 0.46–0.91), (AOR >10 years = 0.67; 95% CI = 0.49–0.93)], unemployed youth (AOR = 0.52; 95% CI = 0.45–0.61) business and salaried workers (AOR = 1.69; 95% CI = 1.33–2.13), and other occupations (AOR = 2.11; 95% CI = 1.73–2.56), junk food consumption (AOR = 0.76;95% CI = 0.68–0.84), having issues related to relationships with parents (AOR = 3.01; 95% CI = 2.47–3.68) and intergenerational issues (AOR = 1.71; 95% CI = 1.19–2.45), self-development issues (AOR low-self-awareness = 1.57; 95% CI = 1.33–1.85), (AOR low-self-esteem = 1.29; 95% CI = 1.062–1.57), (AOR emotional issues = 1.57; 95% CI = 1.31–1.89), education and academics (AOR = 1.23; 95% CI = 1.09–1.39), safety issues (AOR = 4.11; 95% CI = 3.07–5.50), gender sex and sexuality issues (AOR = 2.44; 95% CI = 1.43–4.15), suicidal ideation (AOR = 1.91; 95% CI = 1.44–2.54), substance use (AOR tobacco chewing = 1.45; 95% CI = 1.09–1.93), (AOR tobacco-smoking = 1.66; 95% CI = 1.18–2.32), (AOR smoking = 4.94; 95% CI = 3.52–6.93) and experiencing emotions (AOR feel anxious = 1.63; 95% CI = 1.41–1.88), (AOR forgetfulness = 1.50; 95% CI = 1.41–1.98), (AOR difficulty in concentration = 1.37; 95% CI = 1.035–1.81), (AOR anger = 1.61; 95% CI = 1.25–2.07), (AOR feel worthless = 2.21; 95% CI = 1.71–2.86) were associated with HLS issues among beneficiaries. Conclusion: This analysis addresses an important but neglected component of HLS issues among youth highlighting the importance of early intervention among youth to prevent the development of diseases later in life. The study has important implications for youth health promotion in India and countries such as India. Health and Lifestyle Issues Among Youth: A record analysis of contributing factors among beneficiaries attending Youth Mental Health promotion clinics (Yuva Spandana Kendras) in Karnataka, India.

Background: Oral cancer (OC), which happens to be one of the leading causes of death in the Indian population, is caused primarily by tobacco use, although other factors are also responsible. Serum vitamin B12 is important in maintaining the immune system and also repairing the damaged deoxyribonucleic acid (DNA) of cells. The aim of our study was to evaluate the serum B12 levels in patients with OC and look for any association between the two. Methods: One hundred subjects were selected for the study and divided into two groups: group A having OC (including cases of oral squamous cell carcinoma (OSCC), verrucous carcinoma and oropharyngeal carcinoma; 50 patients) and group B had age- and gender-matched healthy controls (50 healthy volunteers). Patients diagnosed clinically and histopathologically confirmed as OC were selected for the study. All the patients were subjected to haematological investigation to assess serum vitamin B12. Results: Males subjects in the 4th and 5th decades of life were predominantly affected. Serum vitamin B12 was significantly increased in OC patients when compared with controls, which was statistically significant. The mean serum vitamin B12 was slightly higher in males than in females, which was statistically non-significant. Conclusion: Our study found increased vitamin B12 levels in OC patients, and it was statistically significant.

Aim: To find out the prevalence of OSMF and its Co-relation of clinical grading to various habit factors (time span of habit practiced in years, repetition of habit practiced per day, time of habit practiced in minutes per use). Method: This descriptive, cross-sectional survey was carried out and close ended questionnaire was used for data collection. Demographic details like gender & age and different tissue exploiting habits like, chewing gutkha, chewing areca nut, chewing panmasala with or without tobacco, plain tobacco, mawa, smoking, alcohol was recorded. Also, duration of habit in years, repetition of habit per day, time of habit per use & site of involvement was recorded. Results: Among 5297 patients examined at OPD, 120 were diagnosed with OSMF. The present study found no statistical relation between age, gender & OSMF. The present study concluded that majority 83 (69.17%) of the OSMF patients are guthka user and buccal mucosa was most affected site. OSMF was more prevalent in patients who practiced the habit for more than 15 years. Conclusion: Among the OSMF patients, guthka was most commonly practiced & buccal mucosa was most commonly involved. Duration and frequency of consumption were significantly associated with severity of OSMF.

Introduction: The position of the canine has a key role in facial harmony, dental aesthetics, functional occlusion, and health of temperomandibular joint. Maxillary canine impaction is the second most common tooth after third molars impaction. Maxillary canines are more prone to impaction due to longer path of eruption. Settings and Design: All the patients were examined in the Dental Chair light and referred to the department of Oral Radiology for Orthopantomogram. Yamamoto's classification was used to classify maxillary canine impaction. Position of mandibular canine from cement-enamel junction was used for mandibular canine impaction. Materials and Methods: The study was performed on 2300 patients who consulted the orthodontic department from January 2018 to July 2022. Orthopantomogram of each patient was examined for canine impaction, retained deciduous teeth, cyst, and other anomalies. The incidence and pattern of canine impaction was assessed. Statistical Analysis: The data was then statistically analyzed using Graph Pad Prism software. The incidence of impacted canine was evaluated. The effect of gender was evaluated using a t-test. Results: A total of 2300 subjects were examined out of which 52 individuals were diagnosed with canine impaction. The incidence of canine impaction among orthodontic patients is 2.26%. The amount of canine impaction in females (60%) is higher than males (40%). The ratio of canine impaction of the maxilla and mandible is 2.5. Conclusion: The incidence of canine impaction was found to be 2.26 percent in the tribal dominant population of Jharkhand. Type II (50%) pattern in the maxilla and Level A (57%) impaction in the mandible was found to be the highest.

Background: Diabetes enhances the risk of stroke which is one of the leading causes of morbidity and mortality. Aims and Objectives: The study was done to analyze the clinical profile and pattern of stroke in diabetic and non-diabetic patients. Materials and Methods: This was a hospital-based cross-sectional study done in 130 stroke patients (with/without diabetes – 65 each) presenting to outpatient department\inpatient department general medicine department, Dr. Sushila Tiwari Hospital of Government Medical College, Haldwani during January 2020–September 2021. A detailed history, neurological examination along with assessment of risk factors, pattern, and subtype were done. Results: The mean age was significantly higher among stroke patients with diabetes (66.38±11.99 years). The proportion of systemic hypertension was significantly higher in stroke patients without diabetes (89.2%). Abnormal ECG was significantly more reported in stroke patients without diabetes (73.8%). The mean hemoglobin and mean random blood sugar were significantly higher in stroke patients with diabetes (8.82±1.72 and 291.17±107.39, respectively). The mean high-density lipoprotein was significantly higher in stroke patients without diabetes (43.06±5.1), whereas mean low-density lipoprotein, mean triglycerides, and mean total cholesterol were significantly higher in stroke patients with diabetes (126.28±33.19; 186.97±45.91; and 229.31±39.83, respectively). The presenting complaints observed were altered consciousness (67.7%) right hemiparesis (55.4%), left hemiparesis (41.5%), abnormal body movement (28.5%), etc. Ischemic stroke was significantly higher in patients with diabetes (90.8%). Lacunar (34%), basal ganglia (27%), cortical (23%), etc., were stroke subtypes seen among study patients. Conclusion: Significant difference was observed between stroke patients with/without diabetes in terms of age, several risk factors, presenting symptoms, pattern, and its subtype.

Background and aim: The ingredients viz., Artemisia roxburghiana, Cissampelos pareira, Stephania glabra, Drimia indica, Roylea cinerea, Tinospora sinensis and Curcuma longa of the present formulation are used to treat diabetes in the Indian traditional medical system. Adopting the concept of multiple herbal mixtures for better therapeutic effects from the ancient Ayurvedic text Sarangdhar Samhita, the present study aimed to develop a polyherbal formulation (PHF) of seven herbs and to evaluate its sodium-glucose cotransporter protein-2 (SGLT2) inhibitory effect on type 2 diabetic rats. Experimental procedure: Streptozotocin (STZ) (60 mg/kg) and nicotinamide (NAM) (120 mg/kg) were intraperitoneally administered to induce type 2 diabetes in Wistar rats. The animals were divided into 5 groups viz. normal control, diabetic control, positive control (dapagliflozin at 0.1 mg/kg) and two test groups (PHF at 250 and 500 mg/kg). Various parameters including blood glucose, serum glutamic pyruvic transaminase (SGPT), serum glutamic-oxaloacetic transaminase (SGOT), bilirubin, triglycerides and creatinine were measured. Results and conclusion: The treatment with PHF (250 and 500 mg/kg) showed a significant (p

BACKGROUND: Diabetic patients are at higher risk of cardiovascular morbidity and mortality. NT-proBNP levels measurements are useful for the assessment of risk in heart failure patients in emergency condition and give the faster result. Further, it also offers lower cost and unnecessary hospitalization and follow-up cost. The studies have shown that NT-proBNP levels are a direct predictor of outcome risk in diabetic patients with heart failure. The objective of this research was to study the role of NT-proBNP levels to determine the severity of heart failure in diabetic patients. MATERIALS AND METHODS: In this study 150 patients diagnosed with symptomatic heart failure admitted to the emergency department of a tertiary care center from January 2021 to January 2022 have been included in Saraswati Institute Of Medical Sciences, Hapur, India. N-terminal pro-B-type natriuretic peptide (NT-Pro-BNP) levels were measured using an automated analyzer ranging between 60 and 3000 pg/ml. According to the European society of cardiology (ESC) guidelines, it has been defined as NT-Pro-BNP level above 125 pg/ml indicates a high possibility of heart failure and NT-Pro-BNP level below 125 pg/ml excludes the high possibility of heart failure. All the patients underwent an echocardiographic study and ejection fraction was calculated and recorded. RESULTS: In diabetic patients ejection fraction was significantly lower in diabetic patients: 47.15 ± 8.75% vs. 43.24 ± 9.54%, P = 0.002). We have observed statistically significant lower HDL values (40.10 ± vs. 35.94 mg/dL, P = 0.0004), however, significant higher triglycerides values were found (101.43 ± 41.7 mg/dL vs. 151.37 ± 78.85, P = 0.001). No significant difference was observed in LDL level (97.8 ± 31.23 vs. 92.35 ± 314.2, P ≥ 0.05) and total cholesterol level (161.49 ± 41.38 vs. 159.97 ± 41.12, P ≥ 0.05). CONCLUSION: We concluded that the measurement of NT-proBNP in heart failure and diabetic patients could be an economic marker for the evaluation of morbidity and mortality, facilitating better management and follow-up.

Background: Late Vitamin K deficiency bleeding, is a disease of exclusively breast-fed infants attributable to poor content of Vitamin K in breast milk. We aimed to estimate the prevalence of subclinical Vitamin K deficiency, at 3 months of age in exclusively breast-fed term infants who were administered routine Vitamin K 1 mg intramuscular at birth. Methods: This prospective observational study was conducted between June 2018 and June 2020 in a Tertiary Care Teaching Hospital in Western India. Consecutive inborn infants, having received Injection Vitamin K at birth and on exclusive breast feeds attending immunization at 3 months of age were included. Half milliliter of venous blood was withdrawn for the estimation of Proteins Induced by Vitamin K Absence or Antagonist-II (PIVKA-II). Subclinical Vitamin K deficiency was defined as PIVKA-II level of more than 2 ng/mL. Results: The mean age of infants was 3.2 ± 0.2 months and the PIVKA II levels ranged from 0.19 to 10.07 ng/ml. Subclinical Vitamin K deficiency was present in 62 (32.63%) out of 190 infants. Conclusion: Significantly raised PIVKA II levels (>2 ng/mL) were detectable in 32.6% of infants after 3 months of age who had received 1 mg of Vitamin K at birth.

Abstract The use of selective serotonin reuptake inhibitors (SSRIs) can increase the risk of gastrointestinal (GI) bleeding. Similarly, it is well known that the use of NSAIDs predisposes patients to upper GI bleeding. The aim of this study was to explore if the addition of SSRIs in patients already taking NSAIDs significantly increases their risk for upper GI bleeding. An electronic literature search was conducted using the SCOPUS and MEDLINE databases from inception through September 2020. Cohort and case–control trials that reported patients with upper GI bleeding on NSAIDs with SSRIs, compared to controls on NSAIDs only were included. Newcastle–Ottawa checklist was used to ensure inclusion of high-quality studies. Data was extracted by the lead investigator and cross-checked by the second author. Dichotomous data was pooled to obtain an odds ratio (OR) of the risk of upper GI bleeding in patients on NSAIDs with concomitant SSRI use. The primary endpoint of the study was the risk of upper GI bleeding with SSRIs and NSAIDs compared to NSAIDs alone. A total of 366 citations were reviewed, and 21 were selected for full-text evaluation. 1 cohort and 9 case–control studies were eligible. There was an additional increased risk of upper GI bleeding in patients on NSAIDs with concomitant SSRI use (OR 1.75, 95% CI = 1.32–2.33). In patients already on NSAID therapy, the concomitant use of SSRIs can significantly increase the risk of upper of GI bleeding.

Background: SARS-CoV-2 virus can affect the lungs and other organs of our body, including the brain. Studies from various parts of the world have started reporting a high prevalence of anxiety disorder in COVID-19 patients. This study aims to estimate the prevalence of generalized anxiety disorder in patients admitted with COVID-19 infection in a tertiary care medical college in South India. Methods: All COVID positive patients admitted to a tertiary care medical college during the study period were evaluated by a psychiatrist, and diagnosis was made based on ICD-10. GAD-7scale was used to assess the severity of anxiety disorder. Results: Hundred and eighty-four COVID-19 patients were studied. Generalized anxiety disorder was detected in 34.8% of the patients. Conclusions: Generalized anxiety disorder is highly prevalent in COVID-19 patients. Proper screening and treating generalized anxiety disorder in them will help in the care of these patients.

Abstract Background Pericardial cysts are rare, with the most common etiology being congenital. Ventricular septal defect is the most common congenital heart disease in children. However, the combination of pericardial cyst, ventricular septal defect, and patent ductus arteriosus is extremely rare. Case presentation A one-year-old boy with ventricular septal defect and patent ductus arteriosus was planned for surgical correction. Intraoperatively, we made an additional diagnosis of a large pericardial cyst; and the cyst was excised along with ventricular septal defect closure and patent ductus arteriosus ligation. Conclusions Pericardial cysts can sometimes be missed with transthoracic echocardiography. Excision of the cyst can safely be done during concomitant cardiac surgery.

Background and Aim: The morbidity and mortality caused by COVID-19, the economic crisis brought about by the pandemic, and the health policies laid down for the containment of the virus, have a negative effect on the mental health of the people. Pregnant women represent a high-risk group, being particularly susceptible to stress and emotional instability. This study aims to estimate the prevalence of psychological distress in pregnant women during the COVID-19 pandemic. Materials and Methods: This is a cross-sectional observational study done in a tertiary care center in Kerala between June and July 2021. All the pregnant women attending the obstetric department, after taking their informed consent were assessed with a pro forma to collect their sociodemographic details and Kessler Psychological Distress Scale was used to assess their psychological distress. The association between sociodemographic variables and distress was assessed using the Chi-square test. Results: A total of 66 pregnant women were studied. Fourteen (21.2%) were noted to have psychological distress. Three (4.5%) and 6 (9.1%) were in moderate and severe distress, respectively. None of these women were known to have any psychiatric illness. Psychological distress was more prevalent among homemakers compared to employed pregnant women (P = 0.134), more in primi, compared to second and third gravida (P = 0.825) and more in pregnant women in the second trimester compared to women in the first and third trimesters (P = 0.296). Conclusion: Psychological distress is highly prevalent in pregnant women during the COVID-19 pandemic. There is an urgent need for health policies to decrease its negative impact on the health of pregnant women, mothers, and children.

Background and Objectives: Coronary artery disease (CAD) has been associated with increased stress both etiologically and as a consequence. The current pandemic of COVID-19 infection has impacted the personal, social, and occupational spheres of people's lives and has negatively affected mental health. People with existing chronic medical illnesses may be more vulnerable to the stressful effects of the ongoing pandemic. This study was conducted on patients with CAD during the COVID-19 pandemic to estimate the prevalence of psychological distress, the factors associated with distress, and their coping mechanisms. Materials and Methods: A cross-sectional study was conducted at a tertiary care teaching hospital in Kerala in the cardiology department. After informed consent was obtained from the patients with CAD, sociodemographic details were collected, Kessler Psychological Distress Scale (K-10 scale) was administered to assess psychological distress and the Brief COPE scale was administered to assess their coping mechanisms. Results: Among 50 patients who participated, the prevalence of psychological distress was 50%. The factors associated with distress were female gender, semiskilled occupation, incomplete COVID-19 vaccination status, exposure of family to COVID-19, experiencing financial difficulties, and experiencing difficulty acquiring medications prescribed for CAD. Religion and acceptance were the most common coping strategies applied by the patients and acceptance was found to be a better coping strategy than religion. Conclusion: There is a high prevalence of psychological distress among patients with CAD during the pandemic, owing to the emotional, financial, and familial instability faced during the pandemic.

Background: The COVID-19 pandemic has forced the world to change its approach to medical education with most of the undergraduate (UG) teaching shifting to online mode. As in other colleges in India, we also switched to online classes for both UG and postgraduate (PG) students in April 2020. We intend to share our preliminary experience about the acceptance and performance of these online classes in Pediatrics. Methodology: For UGs, we studied the attendance and marks of term ending summative assessment of batch of 2020 who attended online classes and compared them to the attendance and marks of the term ending summative assessment of the previous three batches (2017, 2018, and 2019). We also obtained a feedback on a prevalidated questionnaire from the UG as well as PG students. Results: The mean ± standard deviation (SD) attendance of the batch of 2020 was 81.6 ± 16.2%, while that of the 2017, 2018, and 2019 batch during the same period was 84.9 ± 10.9%, 92.6 ± 4.8%, and 83.0 ± 7.6% respectively. Similarly, the mean ± SD marks for the batch of 2020 was 74.8 ± 6.5% while it was 66.9 ± 9.4%, 58.6 ± 10.1%, and 60.9 ± 9.7% for 2017, 2018, and 2019 batches, respectively. The feedback obtained from both UGs and PGs was satisfactory in relation to the acceptance of the online mode. Conclusion: The online classes in Pediatrics are a reasonable alternative to the onsite classes in the prevailing situation.

Objective: Cirrhotic cardiomyopathy (CCM) is associated with increased morbidity and mortality in patients with liver cirrhosis. Yet, it remains an under-diagnosed entity. Further, its relation to the severity of cirrhosis is contradictory. We conducted this study on an Indian population to determine the cardiac dysfunctions in cirrhosis of the liver and correlations with etiologies and cirrhosis severity. Methods: This study enrolled patients with diagnosed liver cirrhosis without any cardiac disease or conditions affecting cardiac function. All participants were evaluated clinically, electrocardiographically, and echocardiographically. Cirrhosis severity was assessed by scores from the Model for End-stage Liver Disease (MELD) and Child–Turcotte–Pugh (CTP) tests. Cirrhotic cardiomyopathy was defined as diastolic dysfunction and/or systolic dysfunction with QT prolongation. Results: Ninety-six patients were evaluated, and CTP-A stage of cirrhosis was found in 23 (24%), CTP-B in 42 (43.8%), and CTP-C in 31 (32.3%) cases. Systolic dysfunction was most frequent (P=0.014), and left ventricular ejection fraction was significantly reduced (P=0.001) in CTP-C stage of cirrhosis. Cirrhotic cardiomyopathy was found in 39.6% (n=38) of patients; CCM patients had significantly higher CTP scores (9.6±2.6 versus 8.3±2.3, P=0.012) as well as MELD scores (19.72±4.9 versus 17.41±4.1, P=0.015) in comparison to patients without CCM. Conclusion: Cirrhotic cardiomyopathy has a positive relationship with the severity of cirrhosis. Systolic function declines with the severity of cirrhosis, and overt systolic dysfunction can be present, particularly in the advanced stage of cirrhosis of the liver.

Abstract Breeding for higher yield and wider adaptability are major objectives of soybean crop improvement. In the present study, 68 advanced breeding lines along with seven best checks were evaluated for yield and attributing traits by following group balanced block design. Three blocks were constituted based on the maturity duration of the breeding lines. High genetic variability for the twelve quantitative traits was found within and across the three blocks. Several genotypes were found to outperform check varieties for yield and attributing traits. During the same crop season, one of the promising entries, NRC 128,was evaluated across seven locations for its wider adaptability and it has shown stable performance in Northern plain Zone with > 20% higher yield superiority over best check PS 1347. However, it produced 9.8% yield superiority over best check in Eastern Zone. Screening for waterlogging tolerance under artificial conditions revealed that NRC 128 was on par with the tolerant variety JS 97–52. Based on the yield superiority, wider adaptability and waterlogging tolerance, NRC 128 was released and notified by Central Varietal Release Committee (CVRC) of India, for its cultivation across Eastern and Northern Plain Zones of India.

Promoting positive identity and seeking early support for gender, sex and sexuality (GSS) issues among youth is vital. Understanding and addressing factors associated withGSS among them is critical. We assessed four-year case records (January 2017–December 2020) of all first visit youth mental health promotion clinic (YMHPC) clients (15–35 years) for factors associated with GSS issues in Karnataka. Overall, prevalence of GSS issues was 1.8% (189/10,340). Increased risk of GSS issues was observed among clients reporting suicidality (AOR = 4.27, 95% CI = 2.70–6.74) and relationship issues (AOR = 3.63, 95% CI = 2.36–5.57), followed by issues of safety (AOR = 2.56, 95% CI = 1.72–3.81), personality (AOR = 2.48, 95% CI = 1.60–3.85), health and lifestyle (AOR = 2.27, 95% CI = 1.77–4.19), smokers (AOR = 2.30, 95% CI = 1.24–4.27), and those who felt depressed (AOR = 2.10, 95% CI = 1.43–3.09) and worthless (AOR = 2.08, 95% CI = 1.28–3.39). Clients aged 21–25 years (AOR = 1.80,95% CI = 1.27–2.54), male (AOR = 1.72, 95% CI = 1.20–2.46) and who had been married (AOR = 2.32, 95% CI = 1.51–3.57) had a higher risk of GSS issues than those aged 15–20 years and other counterparts, respectively. Clients who drank alcohol (AOR = 0.49, 95% CI = 0.30–0.81) had reduced risk of GSS issues. The findings re-iterate the importance of early recognition of factors (essential precursors) of GSS issues among youth. The study highlights the importance of promoting awareness and improving primordial prevention of possible GSS issues in later life. This study has important implications on youth mental health promotion programs, especially in countries like India.

Background: Cissampelos pareira L. (Menispermaceae) has been used in Indian traditional medicine for a variety of human ailments including diabetes mellitus. Although its anti-hyperglycemic activity has been validated by previous studies, a detailed mechanism of action and the responsible components are still unknown. Purpose: The present study aimed to evaluate the antidiabetic effect of aqueous-ethanolic extract of C. pareira roots in streptozotocin-nicotinamide (STZ-NAM)-induced diabetic rats via targeting SGLT2 inhibition. Methods: In vitro α-amylase and α-glucosidase inhibitory assays were conducted using Epoch Microplate Spectrophotometer. A-498 cells viability assay and SGLT2 protein expression study were conducted using MTT assay and western blot respectively. STZ-NAM-induced diabetic rats were used as a model to evaluate the antidiabetic effect of the extract. Selected bioactive compounds reported earlier from the plant were studied for their in silico SGLT2 inhibitory activity. Results: The extract showed α-amylase and α-glucosidase inhibitory effects with IC50 values of 18.0 ± 1.01 and 4.87±0.54 mg/mL, respectively. A-498 cells viability assay showed its CC50 value of 0.8 mg/mL. The extract showed a notable effect on SGLT2 protein expression. The in vivo study revealed that the extract significantly (p

Soybean is one of the largest sources of protein and oil in the world and is also considered a “super crop” due to several industrial advantages. However, enhanced acreage and adoption of monoculture practices rendered the crop vulnerable to several diseases. Phytophthora root and stem rot (PRSR) caused by Phytophthora sojae is one of the most prevalent diseases adversely affecting soybean production globally. Deployment of genetic resistance is the most sustainable approach for avoiding yield losses due to this disease. PRSR resistance is complex in nature and difficult to address by conventional breeding alone. Genetic mapping through a cost-effective sequencing platform facilitates identification of candidate genes and associated molecular markers for genetic improvement against PRSR. Furthermore, with the help of novel genomic approaches, identification and functional characterization of Rps (resistance to Phytophthora sojae) have also progressed in the recent past, and more than 30 Rps genes imparting complete resistance to different PRSR pathotypes have been reported. In addition, many genomic regions imparting partial resistance have also been identified. Furthermore, the adoption of emerging approaches like genome editing, genomic-assisted breeding, and genomic selection can assist in the functional characterization of novel genes and their rapid introgression for PRSR resistance. Hence, in the near future, soybean growers will likely witness an increase in production by adopting PRSR-resistant cultivars. This review highlights the progress made in deciphering the genetic architecture of PRSR resistance, genomic advances, and future perspectives for the deployment of PRSR resistance in soybean for the sustainable management of PRSR disease.

Background: Pre-operative anxiety is unpleasant state of tension or uneasiness that results from patient doubt and fear before an operation. This study aims at assessing level of state and trait anxiety and other associated factors among preoperative patient. Methods: A descriptive cross-sectional study was done among 195 patients above 18 years of age planned for elective surgery the following day in different departments in tertiary care center. State and Trait Anxiety Inventory and self-designed semi structured pro-forma was used to assess anxiety and patient particulars respectively. Results: There were 195 patients in study among which 93(47.7%) underwent major surgery and 102 (52.3%) underwent minor surgery. The mean State Anxiety Score was 45.89±12.502. The mean Trait Anxiety Score was 43.17±9.342. State and Trait anxiety differed significantly in male and female patients. Trait Anxiety was associated with education and marital status. Conclusions: There was no significant difference in anxiety level in patient undergoing major and minor surgery. Male and female patients differed significantly in both State and Trait Anxiety. Keywords: Preoperative anxiety; state anxiety; trait anxiety

Given the greater penetration of wind power, the impact of wind generators on grid electricity reliability imposes additional requirements. One of the most common technologies in wind power generating schemes is the permanent magnet synchronous generator (PMSG) converter. However, the controller calculation is difficult due to the nonlinear dynamical and time-varying characteristics of this type of conversion system. This study develops a unique intelligent controller approach based on the passivity notion that tracks velocity and maintains it functioning at the optimum torque. To address the robustness issues encountered by traditional generator-side converter (MSC) strategies such as proportional-integral (PI), this suggested scheme integrates a passivity-based procedure with a fuzzy logic control (FLC) methodology for a PMSG-based wind power converter. The suggested controller is distinguished by the fact that the nonlinear features are compensated in a damped manner rather than canceled. To achieve the required dynamic, the fuzzy controller is used, which ensures quick convergence and global stability of the closed loop system. The development of the maximum power collected, the lowered fixed gains, and the real-time application of the control method are the primary contributions and novelties. The primary objectives of this project are to manage DC voltage and attain adequate reactive power levels in order to provide dependable and efficient electricity to the grid. The proposed scheme is being used to regulate the MSC, while the grid-side employs a traditional proportional-integral method. The efficiency of the suggested technique is investigated numerically using MATLAB/Simulink software. Furthermore, the processor-in-the-loop (PIL) tests are carried out to demonstrate that the suggested regulator is practically implementable.

A 22-year-old male presented with borderline intelligence, visual and auditory hallucinations, and an obsessive urge to bite. He was investigated for organic pathology in view of visual hallucinations and his magnetic resonance imaging study showed enlarged Virchow-Robin Space, which are fluid-filled spaces that surround small blood vessels and capillaries in the brain. He had no facial dysmorphic features or autistic features. Literature reports that this finding is associated with dementias in elderly, obsessions, and auditory hallucinations, but there is little data on its association with visual hallucinations, or intellectual impairment in the young. He responded well to a combination of medications and psychosocial approaches. Neuroimaging offers a noninvasive, reproducible method to better understand the clinical associations and accumulate evidence base in young patients presenting with intellectual impairment and behavioral problems.

Epiphrenic diverticulum is a rare abnormality of the distal oesophagus. Both thoracic and abdominal approaches are suitable for this diverticulum. A 46-year-old male presented with complaints of regurgitation and chest pain for 2 years. Contrast-enhanced computed tomography of the neck, thorax, abdomen and oesophageal endoscopy revealed 12 cm × 10 cm size large intrathoracic oesophageal diverticulum. He underwent an elective laparoscopic transabdominal oesophageal diverticulectomy. Gastrograffin study on the first post-operative day did not reveal any leak. In this case report, we are sharing our experience in the management of large epiphrenic oesophageal diverticulum through a laparoscopic approach. The benefits of the laparoscopic approach include decreased morbidity because we can avoid large thoracotomy or laparotomy incision.

The paper presents a modified Constant Envelope Multiplexing with Intermodulation Construction (CEMIC) technique for multiplexing signals within a single frequency band. A constant envelope signal is necessary to operate a transponder at maximum efficiency. This paper proposes a novel scheme to incorporate backwards compatibility constraints into the cost function of the existing CEMIC scheme to minimize changes in the onboard navigation system and ground receivers. The proposed scheme maximizes multiplexing efficiency by optimizing signal power sharing as per system requirements. Simulation results indicate that the proposed scheme provides 0.1% to 13.7% better efficiency than the existing CEMIC scheme, depending upon the case severity. Furthermore, the power distribution and phasing of the individual intermodulation constituent signals are optimized to minimize intra-system and inter-system interference. As a result, the proposed scheme facilitates frequency coordination with GNSS service providers. The paper also discusses the hardware performance of the proposed scheme’s composite signal.

Introduction: Chronic kidney disease is a global public health problem with psychological issues and other adverse issues like renal failure, cardiovascular disease, and premature deaths. This study aimed to find out the prevalence of anxiety and depression among patients with chronic kidney disease undergoing haemodialysis in a tertiary care centre. Methods: A descriptive cross-sectional study was done among patients with chronic kidney disease undergoing haemodialysis in the Department of Medicine, Nephrology unit of a tertiary care centre from December 2020 to June 2021. Ethical approval was taken from the Institutional Review Committee (Reference number: 1712202003). The whole sampling method was used. The diagnosis of anxiety and depression was made using the Nepali version of the Hospital Anxiety and Depression Scale with a cut-off of ≥8 scores. Results: Among 96 patients, the prevalence of anxiety was 66 (68.75%) and that of depression was 74 (77.08%) patients. Conclusions: The prevalence of anxiety and depression was similar to other studies done in similar settings.

Using direct-fed microbials to mitigate enteric methane emissions could be sustainable and acceptable to both consumers and producers. Forty lactating, multiparous, Holstein-Friesian cows were randomly allocated one of two treatments: (1) a base of ad libitum vetch (Vicia sativa) hay and 7.0 kg DM/d of a grain mix, or (2) the basal diet plus 10 mL of MYLO® (Terragen Biotech Pty Ltd., Coolum Beach, Queensland, Australia) delivering 4.17 × 108 cfu of Lactobacillus per mL. Neither feed intake (25.4 kg/d vs. 24.8 kg/d) nor milk yield (29.9 vs. 30.3 kg/d) were affected by treatment. Feed conversion efficiency was not affected by treatment when expressed on an energy-corrected milk basis (1.15 vs. 1.18 kg/kg DMI). Neither methane yield (31.6 vs. 31.1 g/kg DMI) nor methane intensity (27.1 vs. 25.2 g/kg energy corrected milk) were affected by treatments. While these results are contrary to our expectations and not significant, all were numerically in a favorable direction. Given there are reports that diet and dose rate may impact the size of any effect, we recommend a dose–response study be undertaken using a basal diet that is commonly used in pasture-based dairy systems.