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With advances in technology that allow for more accurate measurement of ocular biometric characteristics and the availability of sophisticated methods for calculating intraocular lens (IOL) power, cataract surgery has evolved into a refractive operation. Patient expectations have been raised as a result of this, as well as free and simple access to information about the latest technology. After cataract surgery, there is a greater demand than ever for life without spectacles. Newer advances in optical biometry, such as swept-source optical coherence tomography, combined with the availability of highly accurate IOL power calculation formulae, including artificial intelligence-based formulae, have the potential to enable surgeons to achieve near-perfect outcomes in the majority of their patients. Understanding the benefits and limitations of currently available cutting-edge technologies and equations and applying them to the cataract surgical practice is required to hit the bull’s eye in terms of goal refraction.

Bovine coronavirus (BCoV) is a member of pathogenic Betacoronaviruses that has been circulating for several decades in multiple host species. Given the similarity between BCoV and human coronaviruses, the current study aimed to review the complete genomes of 107 BCoV strains available on the GenBank database, collected between 1983 and 2017 from different countries. The maximum-likelihood based phylogenetic analysis revealed three main BCoV genogroups: GI, GII, and GIII. GI is further divided into nine subgenogroups: GI-a to GI-i. The GI-a to GI-d are restricted to Japan, and GI-e to GI-i to the USA. The evolutionary relationships were also inferred using phylogenetic network analysis, revealing two major distinct networks dominated by viruses identified in the USA and Japan, respectively. The USA strains-dominated Network Cluster includes two sub-branches: France/Germany and Japan/China in addition to the United States, while Japan strains-dominated Network Cluster is limited to Japan. Twelve recombination events were determined, including 11 intragenogroup (GI) and one intergenogroup (GII vs. GI-g). The breakpoints of the recombination events were mainly located in ORF1ab and the spike glycoprotein ORF. Interestingly, 10 of 12 recombination events occurred between Japan strains, one between the USA strains, and one from intercontinental recombination (Japan vs. USA). These findings suggest that geographical characteristics, and population density with closer contact, might significantly impact the BCoV infection and co-infection and boost the emergence of more complex virus lineages.

Introduction: Congenital anomaly is a structural or functional defect that occurs during intrauterine life and can beidentifiedprenatally,at birth or sometimelater in infancy. Congenital anomalies may be caused by genetic or environmental factors. Most congenital anomalies, however, show the familial patterns expected of multi-factorial inheritance. Methods:Cross sectional observational hospital based study conducted during the period of august 2020 to august 2021.All new-borns delivered in the hospital with congenital anomalies were included in study. Relevant information regarding maternal age, parity, gestational age, sex and the outcome were documented.Results:Incidence of congenital anomalies are more associated with increasing maternal and paternal age. Higher incidence was found in higher order pregnancy. Maximum cases of congenital anomalies affected musculoskeletal system followed by gastrointestinal system and genitourinary system.Conclusion:With the help of proper antenatal screening,diagnostic modalities and better health care facilities, congenital anomalies can be diagnosed earlier and interventions planned accordingly. Morethan one risk factors can be linked with congenital anomalies. Earlier Central nervous system anomaly was commonly involved but increase folate supplementation in target population reducing the incidence. Keywords: Antenatal scan, Gross congenital malformation, New born

Although multiparametric magnetic resonance imaging (MRI) has high sensitivity, its lower specificity leads to a high prevalence of false-positive lesions requiring biopsy.To develop and externally validate a scoring system for MRI-detected Prostate Imaging Reporting and Data System (PIRADS)/Likert ≥3 lesions containing clinically significant prostate cancer (csPCa).The multicentre Rapid Access to Prostate Imaging and Diagnosis (RAPID) pathway included 1189 patients referred to urology due to elevated age-specific prostate-specific antigen (PSA) and/or abnormal digital rectal examination (DRE); April 27, 2017 to October 25, 2019.Visual-registration or image-fusion targeted and systematic transperineal biopsies for an MRI score of ≥4 or 3 + PSA density ≥0.12 ng/ml/ml.Fourteen variables were used in multivariable logistic regression for Gleason ≥3 + 4 (primary) and Gleason ≥4 + 3, and PROMIS definition 1 (any ≥4 + 3 or ≥6 mm any grade; secondary). Nomograms were created and a decision curve analysis (DCA) was performed. Models with varying complexity were externally validated in 2374 patients from six international cohorts.The five-item Imperial RAPID risk score used age, PSA density, prior negative biopsy, prostate volume, and highest MRI score (corrected c-index for Gleason ≥3 + 4 of 0.82 and 0.80-0.86 externally). Incorporating family history, DRE, and Black ethnicity within the eight-item Imperial RAPID risk score provided similar outcomes. The DCA showed similar superiority of all models, with net benefit differences increasing in higher threshold probabilities. At 20%, 30%, and 40% of predicted Gleason ≥3 + 4 prostate cancer, the RAPID risk score was able to reduce, respectively, 11%, 21%, and 31% of biopsies against 1.8%, 6.2%, and 14% of missed csPCa (or 9.6%, 17%, and 26% of foregone biopsies, respectively).The Imperial RAPID risk score provides a standardised tool for the prediction of csPCa in patients with an MRI-detected PIRADS/Likert ≥3 lesion and can support the decision for prostate biopsy.In this multinational study, we developed a scoring system incorporating clinical and magnetic resonance imaging characteristics to predict which patients have prostate cancer requiring treatment and which patients can safely forego an invasive prostate biopsy. This model was validated in several other countries.

Microbial fuel cell (MFC) is an emerging technology which has been immensely investigated for wastewater treatment along with electricity generation. In the present study, the treatment efficiency of MFC was investigated for hydrocarbon containing wastewater by optimizing various parameters of MFC. Mediator-less MFC (1·2 l) was constructed, and its performance was compared with mediated MFC with Escherichia coli as a biocatalyst. MFC with electrode having biofilm proved to be better compared with MFC inoculated with suspended cells. Analysis of increasing surface area of electrode by increasing their numbers indicated increase in COD reduction from 55 to 75%. Catholyte volume was optimized to be 750 ml. Sodium benzoate (0·721 g l–1) and actual common effluent treatment plant (CETP) wastewater as anolyte produced 0·8 and 0·6 V voltage and 89 and 50% COD reduction, respectively, when a novel consortium of four bacterial strains were used. Twenty MFC systems with the developed consortium when electrically connected in series-parallel connection were able to generate 2·3 V and 0·5 mA current. This is the first report demonstrating the application of CETP wastewater in the MFC system, which shows potential of the system towards degradation of complex organic components present in industrial wastewater.

BACKGROUND: Accurate reproduction of a preoperative plan is critical in wide resection of bone sarcomas. Recent advances in computer navigation and 3D-custom jigs have increased resection accuracy, although with certain practical drawbacks. METHODS: We developed a novel “projector method” that projects the preoperative osteotomy lines onto the bone. A sawbone study was conducted to evaluate accuracy in reproducing preoperative resection plans. An additional cadaver experiment was conducted to evaluate feasibility in a more realistic operating room setting. RESULTS: Based on the results of experiments conducted on sawbones, the proposed light projector method was more accurate at depicting desired osteotomy lines than a traditional manual method, reducing the corner deviation from 2.53 mm to 0.35 mm, angular deviation from 2.10° to 0.31°, and point deviation from 4.66 mm to 0.48 mm (p

Neonatal bacterial infection remains a significant cause of neonatal morbidity and mortality. CRP parameter can be the indicator to use the proper antibiotic with certain duration. 60 Neonates < 28 days having/suspicious of bacterial infection (septicaemia) were studied. Blood and Urine culture and sensitivity, routine blood examination, chest x-ray, CRP (serum), were studied. Neonates were classified as per the levels of CRP levels 6 as group 2.Clinical features: 48(80%) born by vaginal delivery, 4(66%) had maternal fever >100.4 F, 6(10%) PROM, 23(38.3%) refusal to feeds, 20(33.3%) were lethargic, 12(20%) had poor cry, 7(11.6%) had jaundice, 8(13.3%) had conjunctivitis, 7(11.6%) had vomiting, 4(6.6%) had excessive cry, 3(5%) abdominal distension, 3(5%) hypothermia, 1(1.6%) had fever, 2(3.3%) diarrhoea, 1(1.6%) umbilical Sepsis. The Gram Negative organismsseen in 20(33.3%). In Group A-28 neonates had CRP value 6, 2 neonates treated for 5 days, 17 for 7 days, 13 for 11 days and 26 neonates had positive blood culture. CRP levels plays vital role to evaluate the duration of antibiotic therapy in neonates of suspected bacterial infection.

Anaemia is a major global health problem; it results in significant morbidity and mortality among children 85 children below 12 years having anaemia were studied. Complete blood count was done to determine PCV, MCV, MCH, MCHC, RDW, Hb %, along with Peripheral smear (PS) study, Reticulocyte count and Serum iron (Fe), Serum B and Folic acid levels were done Types of anaemia were 50(58.8%) Iron deficiency anaemia, 12(14.1%) Thalassemia, 8 (9.41%) Megaloblastic anaemia, 7(8.23%) Anaemia of acute haemorrhage, 5 (5.88%) Sickle cell anaemia, 2(2.35%) Aplastic anaemia, 1(1.17%) Leukemia. The clinical manifestations were 85 (100%) pallor, 71(83.5%) weakness and fatigability, 32(37.6%) fever, 23(27.05%) 17(20%) shortness of breath, 15(17.6%) hepatomegaly, 12(14.1%) cough, 11(12.9%) history of pica, 11 (12.9%) spleenomegaly, 9(10.5%) petechiae, 8(9.4%) Nausea/vomiting, 8(9.4%) koilonychia, 4(4.7%) hyper pigmentation, 5(5.8%) tremors. Out of the total number of patients screened 18(21.1%) had mild, 39(45.8%) moderate and 28(32.9%) had severe anaemia. The present study of anaemia had Iron deficiency as the major cause followed by Thalassemia, Megaloblastic anaemia, acute Haemorrhage, Sickle cell anaemia and Aplastic anaemia. This study will be helpful to paediatricians to treat such patients efficiently to avoid morbidity and mortality.

Thalassaemia is one of the commonest inherited genetic disorders world-wide with around 25,000 births of the most severely affected transfusion dependent children annually. Patients with transfusion dependent thalassaemia require regular blood transfusions to maintain life but because of this will develop iron overload. To remove the excess iron, patients are required to take iron chelation therapy (ICT). ICT requires lifelong adherence to treatment to prevent end organ damage from developing. Many of these preventable complications make adherence to therapy more complex for patients. In this review, we focus on two commonly encountered patient scenarios and discuss how different psychological models and a relational theory can be used to understand and support adherence to treatment.

Seizures are classically described as an epiphenomenon of hyperexcitability and hypersynchronicity across brain regions. However, this view is insufficient to explain the complex, dynamic evolution of focal-onset seizures in the brain. Recent studies have proposed mechanisms involving an evolution of excitability driven specifically by a spatiotemporally progressing seizure wavefront. These mechanisms attempt to align the abnormal propagation of neural activity with well-known neurobiological parameters, such as excitation-inhibition balance and neuronal connectivity patterns. We describe a direct test of these mechanisms by performing real-time,in vivoinvestigations of excitability in the acutely epileptic state and during seizure propagation. We used all-optical interrogation to test single-neuronal and local-circuit excitability in the epileptic brain. We demonstrate a surprising paradox during the acutely epileptic state, wherein the brain becomes susceptible to large synchronous inputs, yet single-cell excitability is largely maintained at baseline levels. At a finer scale, excitability of neurons at the single-cell level is related to their distance from the seizure wavefront. Local circuit excitability is increased in the distal penumbra but, crucially, we find inhibition in close proximity to the seizure wavefront. This is in contrast with previously suggested notions of widespread inhibition outside the direct area of action during a focal-onset seizure. These experimental results provide the first direct,in vivoevidence for the precise spatial scale over which single-cell excitability dynamics evolve during seizure propagation, providing support for local inhibitory restraint of seizure propagation.

Background: Activation and regulation of androgen receptor (AR) signaling and the DNA damage response impact the prostate cancer (PCa) treatment modalities of androgen deprivation therapy (ADT) and radiotherapy. Here, we have evaluated a role for human single-strand binding protein 1 (hSSB1/NABP2) in modulation of the cellular response to androgens and ionizing radiation (IR). hSSB1 has defined roles in transcription and maintenance of genome stability, yet little is known about this protein in PCa. Methods: We correlated hSSB1 with measures of genomic instability across available PCa cases from The Cancer Genome Atlas (TCGA). Microarray and subsequent pathway and transcription factor enrichment analysis were performed on LNCaP and DU145 prostate cancer cells. Results: Our data demonstrate that hSSB1 expression in PCa correlates with measures of genomic instability including multigene signatures and genomic scars that are reflective of defects in the repair of DNA double-strand breaks via homologous recombination. In response to IR-induced DNA damage, we demonstrate that hSSB1 regulates cellular pathways that control cell cycle progression and the associated checkpoints. In keeping with a role for hSSB1 in transcription, our analysis revealed that hSSB1 negatively modulates p53 and RNA polymerase II transcription in PCa. Of relevance to PCa pathology, our findings highlight a transcriptional role for hSSB1 in regulating the androgen response. We identified that AR function is predicted to be impacted by hSSB1 depletion, whereby this protein is required to modulate AR gene activity in PCa. Conclusions: Our findings point to a key role for hSSB1 in mediating the cellular response to androgen and DNA damage via modulation of transcription. Exploiting hSSB1 in PCa might yield benefits as a strategy to ensure a durable response to ADT and/or radiotherapy and improved patient outcomes. Refereed/Peer-reviewed

Context Acute testicular torsion is a common urological emergency. Accepted practice is surgical exploration, detorsion, and orchidopexy for a salvageable testis. Objective To critically evaluate the methods of orchidopexy and their outcomes with a view to determining the optimal surgical technique. Evidence acquisition This review protocol was published via PROSPERO [CRD42016043165] and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). EMBASE, MEDLINE, and CENTRAL databases were searched using the following terms: “orchidopexy”, “fixation”, “exploration”, “torsion”, “scrotum”, and variants. Article screening was performed by two reviewers independently. The primary outcome was retorsion rate of the ipsilateral testis following orchidopexy. Secondary outcomes included testicular atrophy and fertility. Evidence synthesis To our knowledge, this is the first systematic review on this topic. The search yielded 2257 abstracts. Five studies (n = 138 patients) were included. All five techniques differed in incision and/or type of suture and/or point(s) of fixation. Postoperative complications were reported in one study, and included scrotal abscess in 9.1% and stitch abscess in 4.5%. The contralateral testis was fixed in 57.6% of cases. Three studies reported follow-up duration (range 6–31 wk). No study reported any episodes of ipsilateral retorsion. In the studies reporting ipsilateral atrophy rate, this ranged from 9.1% to 47.5%. Fertility outcomes and patient-reported outcome measures were not reported in any studies. Conclusions There is limited evidence in favour of any one surgical technique for acute testicular torsion. During the consent process for scrotal exploration, uncertainties in long-term harms should be discussed. This review highlights the need for an interim consensus on surgical approach until robust studies examining the effects of an operative approach on clinical and fertility outcomes are available. Patient summary Twisting of blood supply to the testis, termed testicular torsion, is a urological emergency. Testicular torsion is treated using an operation to untwist the cord that contains the blood vessels. If the testis is still salvageable, surgery can be performed to prevent further torsion. The method that is used to prevent further torsion varies. We reviewed the literature to assess the outcomes of using various surgical techniques to fix the twisting of the testis. Our review shows that there is limited evidence in favour of any one technique.