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Abstract The pursuit of sustainable agriculture has become imperative in addressing global food security challenges while minimizing environmental impacts. Recent innovations in nanotechnology have given rise to a promising solution: nanofertilizers. Research reveals that these nanofertilizers can significantly enhance nutrient use efficiency, reducing environmental consequences, and advancing the cause of cleaner production. With potential increases of up to 30% in nutrient use efficiency and 20% in crop yields compared to traditional fertilizers, nanofertilizers demonstrate the capability to substitute up to 50% of conventional fertilizers, thereby diminishing their ecological footprint. This review paper explores the emerging trends and advancements in the field of nanofertilizers and their potential to revolutionize modern agriculture. We delve into the fundamental concepts of nanofertilizers, including their unique characteristics and controlled-release mechanisms. We analysed the impact of nanofertilizers on crop productivity, quality, and growth through the lens of research findings and case studies. While acknowledging the substantial potential of nanofertilizers, we also address environmental and safety considerations, emphasizing the importance of responsible deployment. In an era prioritizing environmental concerns, nanofertilizers offer a promising solution to meet growing food demands while protecting ecosystems. Graphical Abstract

Microplastics presence in the environment is now a major global issue. Personal care and cosmetic products (PCCPs) contain microbeads and are one of the primary sources of microplastics which contribute to health and ecological risks. The aim of this study was to evaluate the presence of microbeads in a widely used PCCPs (facial scrubs) in the Indian market and the extent to which these microbeads can serve as vectors for toxic compounds like chromium under different environmental conditions. Four of the ten facial scrubs contained microbeads of size ranging from 220 to 600 µm. Based on FTIR analyses, two of the four tested samples (A and B) were made of polypropylene, while the other two samples (C and D) were made of polyethylene. Furthermore, the study revealed that PP microbeads, which are very common, could efficiently adsorb Cr (VI) (3.09 mg Cr/g). Adsorption of Cr (VI) on microbeads was greater in acidic and saline conditions indicating that microbeads can potentially act as vectors for toxic compounds in marine aquatic ecosystems. It was estimated that 4.7 x 1010 microbeads, which amount to 3.8 tonnes of microbeads are released into the environment annually. Based on these results, policy measures for preventing the release of microbeads/microplastics into the environment are suggested.

Abstract The limitations of TB treatment are the long duration and immune-dampening effects of anti-tuberculosis therapy. The Cell wall plays a crucial role in survival and virulence; hence, enzymes involved in its biosynthesis are good therapeutic targets. Here, we identify Mycobacterium tuberculosis (Mtb) GlmM, (GlmM Mtb ) engaged in the UDP-GlcNAc synthesis pathway as an essential enzyme. We generated a conditional knockdown strain, Rv-glmM kD using the CRISPR interference-mediated gene silencing approach. Depletion of GlmM Mtb affects the morphology and thickness of the cell wall. The Rv-glmM kD strain attenuated Mtb survival in vitro, in the host macrophages (ex vivo), and in a murine mice infection model (in vivo). Results suggest that the depletion of GlmM Mtb induces M1 macrophage polarization, prompting a pro-inflammatory cytokine response, apparent from the upregulation of activation markers, including IFNɣ and IL-17 that resists the growth of Mtb. These observations provide a rationale for exploring GlmM Mtb as a potential therapeutic target.

Integration of Interprofessional Education (IPE) into the health sciences curriculum has been recommended over the past several decades to prepare healthcare professionals for future collaborative practice. However, due to the disparity in the adoption of IPE, this literature review attempted to examine the development of IPE and its implementation in global and Indian contexts. IPE has evolved from being fragmented and isolated initiatives to entering into the mainstream of professional education. In terms of IPE implementation, the global scan revealed that IPE was implemented in several countries to varying degrees; however, developing countries lagged behind developed countries in implementing and sustaining IPE. Scarce evidence was found regarding the implementation of IPE in India. The literature review elaborates on the transformation of health professions education from the traditional system to IPE and discusses the gap in the adoption and implementation of IPE in developing countries, including India.

Background and Purpose: Congenital deformities occur due to abnormal development of limbs in the intrauterine life. The exact cause of this type of defect is not known but can be associated with environmental factors (drug history or exposure of chemical effluents from factory) or genetic predisposition. Cases involving the occurrence of single digits in all four limbs were witnessed, and the aim was to study and trace the cause of such deformities. Knowledge of thalidomide induced phocomelia which has already being published in the literature also contributed to our knowledge and understanding. Objectives: (1) Primary objective was to identify the causative agent or genetic factor for the occurrence of single digits in hands and feet in multiple families. (2) Secondary objective was to create awareness among patients and the general public as well as local government authorities regarding such families of “Divyang” patients. We present a case series of multiple families with complete absence of all fingers and toes except one across villages in Haryana. Materials and Methods: Clinical setting: (1) Study was based on a detailed questionnaire which was taken from multiple villagers (Tarawari Village, Nilokheri Village, etc.) and (2) phenotypic examination. Five affected patients from multiple families for 1 year were taken for study from March 2022 to March 2023. Their habitus, lifestyle, and environmental status were all studied and compared with other studies. Efforts were taken to study the license and toxic effluent treatment plan of a chemical factory present in the near vicinity. Results: A strong genetic association was suggested for the occurrence of single digits in the hands and feet of multiple patients across multiple villages close to a chemical factory. They have well adjusted with writing, eating, riding bikes, and four-wheelers with single fingers and toes. Conclusion: There is a need to establish genetic analysis so that the cause of such deformities could be known and prevented. There is also a need for general and government awareness toward pollutants released from chemical factories and their effects.

Abstract Global crop production is severely affected by environmental factors such as drought, salinity, cold, flood etc. Among these stresses, drought is one of the major abiotic stresses reducing crop productivity. It is expected that drought conditions will further increase because of the increasing global temperature. In general, viruses are seen as a pathogen affecting the crop productivity. However, several researches are showing that viruses can induce drought tolerance in plants. This review explores the mechanisms underlying the interplay between viral infections and the drought response mechanisms in plants. We tried to address the molecular pathways and physiological changes induced by viruses that confer drought tolerance, including alterations in hormone signaling, antioxidant defenses, scavenging the reactive oxygen species, role of RNA silencing and miRNA pathway, change in the expression of several genes including heat shock proteins, cellulose synthase etc. Furthermore, we discuss various viruses implicated in providing drought tolerance and examine the range of plant species exhibiting this phenomenon. By applying current knowledge and identifying gaps in understanding, this review aims to provide valuable insights into the complex dynamics of virus-induced drought tolerance in plants, paving the way for future research directions and practical applications in sustainable agriculture.

Rapid urbanization and the growing tourism industry in the Himalayan region have raised significant concerns about the sustainable handling and management of solid waste in the area. This concern is particularly pronounced in the unique and vulnerable ecosystem of cities nestled in the eastern Indian Himalayas, where geography, ecology, and socio-economic factors converge to create distinctive challenges. This study undertakes a thorough investigation of solid waste management practices and challenges in two smart cities nestled in the eastern Himalayan region of India, specifically Gangtok and Namchi. The primary objective was to unveil the complex challenges confronting these cities by conducting an in-depth exploration of waste management practices. This comprehensive investigation was achieved through the collection of samples, conducting surveys within each ward of the cities, and performing physicochemical characterization analyses. The study also proposes a solution-oriented approach leveraging life cycle analysis. Despite the Himalayan backdrop, waste generation varies significantly, with Gangtok producing substantially more waste (50 tons per day (TPD)) compared to Namchi (4.6 TPD). Both cities excel in waste collection, but Gangtok leads in proactive treatment, with 22% (11 TPD) undergoing composting and recycling. However, shared challenges at riverside disposal sites, including overfilled dumpsites and leachate contamination, pose potential environmental hazards amid the Himalayan allure. Organic waste predominates at 40.9% and 40.01% in both cities, indicating composting potential. Plastic closely at 22.25% (Namchi) and 22.65% (Gangtok) was way above the global (12 %) and national (8.4 %) average respectively, emphasizing the urgency of plastic waste reduction strategy. The 16.95% cardboard in Gangtok highlights potential commerce-related waste. The study also highlights the importance of comprehensive policies for informal sector well-being. The lifecycle assessment of Namchi and Gangtok reveals significant methane emissions (99%) from waste anaerobic decomposition potentially due to poor source segregation. Implementing a futuristic waste strategy reduces emissions by 38% in Namchi and 40% in Gangtok, through biogas utilization and renewable energy adoption. The findings advocate for citizen engagement, improved collection, targeted campaigns, and circular economy principles. To ensure sustainability and resilience in waste management within mountain regions, tailored strategies such as material recycling facilities, community engagement initiatives, and landfill diversion mandates should integrate ecological, socioeconomic, and logistical considerations, fostering awareness and participation among communities.

Abstract The inhibition of tumor necrosis factor (TNF)-α trimer formation renders it inactive for binding to its receptors, thus mitigating the vicious cycle of inflammation. We designed a peptide (PIYLGGVFQ) that simulates a sequence strand of human TNFα monomer using a series of in silico methods, such as active site finding (Acsite), protein–protein interaction (PPI), docking studies (GOLD and Flex-X) followed by molecular dynamics (MD) simulation studies. The MD studies confirmed the intermolecular interaction of the peptide with the TNFα. Fluorescence-activated cell sorting and fluorescence microscopy revealed that the peptide effectively inhibited the binding of TNF to the cell surface receptors. The cell culture assays showed that the peptide significantly inhibited the TNFα-mediated cell death. In addition, the nuclear translocation of the nuclear factor kappa B (NFκB) was significantly suppressed in the peptide-treated A549 cells, as observed in immunofluorescence and gel mobility-shift assays. Furthermore, the peptide protected against joint damage in the collagen-induced arthritis (CIA) mouse model, as revealed in the micro focal-CT scans. In conclusion, this TNFα antagonist would be helpful for the prevention and repair of inflammatory bone destruction and subsequent loss in the mouse model of CIA as well as human rheumatoid arthritis (RA) patients. This calls upon further clinical investigation to utilize its potential effect as an antiarthritic drug.

We report a case of a 46-year-old female – a postrenal transplant patient, having developed rhabdomyolysis and neuroleptic malignant syndrome (NMS), after 2.5 months of desidustat initiation – for anemia. Post renal transplant anemia (PTA) is common among renal transplant recipients. Apart from treating it with iron supplements, folic acid, andrecombinant human erythropoietin (EPO), novel agents like hypoxia-inducible factor–prolyl hydroxylase domain (HIF–PHI) are also used, with a very few studies available on its efficacy and safety in PTA patients. Anemia occurring in the first 6 months is called early PTA – occurring most commonly due to iron deficiency, while anemia occurring after 6 months is called late PTA – associated with impaired graft function. The optimal target of hemoglobin in transplant recipients is 12.5–13 gm/dl, which is higher than targets in chronic kidney disease patients. NMS is a life-threatening emergency – mainly seen in patients on antipsychotic medications. It needs to be differentiated from other closely related conditions such as central nervous system infections (meningitis and encephalitis), tetanus, heatstroke, serotonin syndrome, and thyrotoxicosis. Desidustat is an oral HIF–PHI that stimulates erythropoiesis by preventing EPO degradation. Its adverse effects include high blood pressure, myocardial infarction, heart failure, high potassium, and dizziness; however, there is only one case report of rhabdomyolysis associated with desidustat, and none of NMS. It is, therefore, important to be aware of this potential severe side effect of the drug that was not known earlier so that practicing physicians can be vigilant of the same.

In this paper, a fractional food chain system consisting of a Holling type Ⅱ functional response was studied in view of a fractional derivative operator. The considered fractional derivative operator provided nonsingular as well as a nonlocal kernel which was significantly better than other derivative operators. Fractional order modeling of a model was also useful to model the behavior of real systems and in the investigation of dynamical systems. This model depicted the relationship among four types of species: prey, susceptible intermediate predators (IP), infected intermediate predators, and apex predators. One of the significant aspects of this model was the inclusion of Michaelis-Menten type or Holling type Ⅱ functional response to represent the predator-prey link. A functional response depicted the rate at which the normal predator consumed the prey. The qualitative property and assumptions of the model were discussed in detail. The present work discussed the dynamics and analytical behavior of the food chain model in the context of fractional modeling. This study also examined the existence and uniqueness related analysis of solutions to the food chain system. In addition, the Ulam-Hyers stability approach was also discussed for the model. Moreover, the present work examined the numerical approach for the solution and simulation for the model with the help of graphical presentations.

Abstract Skin cancer is one of the most life-threatening diseases caused by the abnormal growth of the skin cells, when exposed to ultraviolet radiation. Early detection seems to be more crucial for reducing aberrant cell proliferation because the mortality rate is rapidly rising. Although multiple researches are available based on the skin cancer detection, there still exists challenges in improving the accuracy, reducing the computational time and so on. In this research, a novel skin cancer detection is performed using a modified falcon finch deep Convolutional neural network classifier (Modified Falcon finch deep CNN) that efficiently detects the disease with higher efficiency. The usage of modified falcon finch deep CNN classifier effectively analyzed the information relevant to the skin cancer and the errors are also minimized. The inclusion of the falcon finch optimization in the deep CNN classifier is necessary for efficient parameter tuning. This tuning enhanced the robustness and boosted the convergence of the classifier that detects the skin cancer in less stipulated time. The modified falcon finch deep CNN classifier achieved accuracy, sensitivity, and specificity values of 93.59%, 92.14%, and 95.22% regarding k-fold and 96.52%, 96.69%, and 96.54% regarding training percentage, proving more effective than literary works.

Bilobed or duplicate gallbladders are the rare anomalies of the biliary system occurring between the 5th and 6th weeks of embryonic life, of which Type 2 ductular variant is the commonest. Patients may be asymptomatic or symptomatic, with majority of the cases being detected intraoperatively or during re-operation. Once suspected a detailed preoperative evaluation is a must to avoid both intraoperative and postoperative complications. We report a case of a 34-year-old female who presented with acute onset of abdominal pain and was detected with symptomatic bilobed gallbladder (H Type) with cholelithiasis, with a resolution of symptoms after a successful laparoscopic cholecystectomy. The case emphasizes the importance of detailed preoperative evaluation in the form of ultrasound and magnetic resonance cholangiopancreatography to be considered during the management of biliary pathologies to avoid any intra- and post-operative complications.

Aim: To analyze the potential predisposing factors and clinical presentation of mucormycosis in patients with COVID-19. Material and Methods: Medical records of 141 patients with COVID-19-associated mucormycosis (CAM) treated at a tertiary care center in Bihar were reviewed. The predisposing factors, clinical features, and imaging findings of mucormycosis were analyzed. Results: The median age was 48 years (IQR, 43-60). A total of 58 patients developed concurrent CAM and 83 post-CAM. The median interval between COVID-19 and onset of CAM symptoms was 15 days (IQR, 9–16). A total of 80 patients received at-home treatment for COVID-19, and 73 had mild-to-moderate disease. While 61 patients received in-hospital treatment, 57 had severe disease. At presentation, 131 patients had hyperglycemia: 64 type 2 diabetes mellitus (DM) and 67 new-onset DM. The history of glucocorticoid use for COVID-19 was present in 125 patients; 47% were administered at home without monitoring plasma glucose. The common presenting features were toothache, periocular or facial pain, and edema. Rhino-orbital mucormycosis was the most common. Imaging revealed rhinosinusitis in all patients, including pansinusitis (68%), pterygopalatine fossa involvement (21%), cavernous sinus thrombosis (38%), brain abscess (8%), and infarct (4%). All patients received intravenous liposomal amphotericin B, and surgical debridement was performed in 113. Conclusion: COVID-19 patients with hyperglycemia are at risk of developing CAM, irrespective of the severity. Timely recognition of symptoms and prompt initiation of therapy by primary healthcare physicians are imperative for enhancing outcomes. Additionally, glucocorticoid overuse should be avoided, and close monitoring for hyperglycemia development is warranted.

Background: A novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) was the causative agent of coronavirus disease 2019 (COVID-19) pandemic 2019. SARS-CoV-2 affects respiratory tract and damages the tissue resulting in generation of inflammatory cells such as cytokines and chemokines such as IFN that damage the lung alveoli, causing severe acute respiratory syndrome. Aims and Objectives: The aims and objectives of the study are to analyze the blood inflammatory markers of COVID-19 patients and association between clinical outcomes in COVID-19-positive patients with serum inflammatory markers during the second wave of COVID-19 pandemic in 100 bedded dedicated COVID MCH Raigarh CG. Materials and Methods: In this hospital-based cross-sectional observational study, 90 patients with COVID-19 were enrolled and categorized into three groups: mild, moderate, and severe. Blood inflammatory markers such as C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, CK-Nac as well as hemogram total leukocyte count (TLC), differential leukocyte count, and neutrophil: lymphocyte (N:L) were determined and analyzed. Results: The results of the oxygen saturation (SpO2) severity strength of association with multiple variables taken in the study through logistic regression analysis of COVID-19 patient’s inflammatory markers serum levels of LDH (P

Lower respiratory tract infection is a common cause of morbidity and mortality worldwide. A cross-sectional study was carried out with an objective to assess the antibiogram pattern of the Gram-negative bacterial isolates from LRTI suspected patients visiting tertiary care hospitals. The study was carried out in a tertiary care hospital laboratory from January 2022 to March 2022. A total of 108 sputum samples from LRTI suspected patients were processed for Gram-negative bacteria isolation. Out of 108 sputum samples, 17 (15.74%) showed significant growth for Gram- negative bacteria and 91 (84.26%) showed insignificant growth. Male suspected patients were more predominant over female suspected patients, showing (11)10% and (6)6% significant growth respectively. The most common bacterial pathogens among Lower respiratory tract infection (LRTI) suspected patients are Mycobacterium tuberculosis (47.05%) followed by Pseudomonas aeruginosa (17.64%), Klebsiella pneumoniae (17.64%), Escherichia coli (11.76%), and Klebsiella oxytoca (5.88%). Antibiotic susceptibility tests (AST) were done by the KirbyBauer disc diffusion method. The antibiotic susceptibility patterns of isolates revealed high resistivity against most of the used antibiotics whereas the isolates showed good in vitro activity against amikacin, ofloxacin and ceftriaxone. Therefore, Culture and Susceptibility tests are important for management of LRTI in patients.

ABSTRACT The host immune responses play a pivotal role in the establishment of long-term memory responses, which effectively aids in infection clearance. However, the prevailing anti-tuberculosis therapy, while aiming to combat tuberculosis (TB), also debilitates innate and adaptive immune components of the host. In this study, we explored how the front-line anti-TB drugs impact the host immune cells by modulating multiple signaling pathways and subsequently leading to disease relapse. Administration of these drugs led to a reduction in innate immune activation and also the cytokines required to trigger protective T cell responses. Moreover, these drugs led to activation-induced cell death in the mycobacterial-specific T cell leading to a reduced killing capacity. Furthermore, these drugs stalled the T cell differentiation into memory subsets by modulating the activation of STAT3, STAT4, FOXO1, and NFκB transcription factors and hampering the Th1 and Th17-mediated long-term host protective memory responses. These findings suggest the urgent need to augment directly observed treatment, short-course (DOTS) therapy with immunomodulatory agents to mitigate the adverse effects linked to the treatment.IMPORTANCEAs a central component of TB eradication initiatives, directly observed treatment, short-course (DOTS) therapy imparts immune-dampening effects during the course of treatment. This approach undermines the host immune system by delaying the activation process and lowering the immune response. In our investigation, we have unveiled the impact of DOTS on specific immune cell populations. Notably, the signaling pathways involving STAT3 and STAT4 critical for memory responses and NFκβ associated with pro-inflammation were substantially declined due to the therapy. Consequently, these drugs exhibit limited effectiveness in preventing recurrence of the disease. These observations highlight the imperative integration of immunomodulators to manage TB infection.

Background: Pediatric posterior fossa tumors (pPFTs) may present acutely with features of increased intracranial pressure that need urgent intervention or with stable symptoms requiring elective management. In this article, we have analyzed the outcomes of pPFTs managed under three arms: (1) emergency tumor resection (A), (2) elective tumor resection (B), and (3) pre-resection cerebrospinal spinal fluid (CSF) diversion followed by elective tumor resection (C). Materials and Methods: We retrospectively reviewed our database from July 2012 to March 2020 for pediatric patients (age ≤16 years) with PFTs. The patients were classified into three groups based on the timing and type of intervention. Their result was assessed as the primary (postoperative complications) and secondary outcomes (post-resection CSF diversion, CSF diversion failure, residual tumor, and survival). A P value < 0.05 was considered significant (SPSS version 22.0, IBM, New York). Results: A total of 154 patients (M:F 2.42:1) were included with a mean age of 8.1 (SD ± 4.2)-years (range 1-16). Group B (n 72/46.8%) had a significantly higher number of patients as compared to the group A (n 40/26%) and group C (n 42/27.3%) (χ[sup.2] test, P value 0.02). The primary outcomes were comparable between group A and group B. A higher incidence of preoperative external ventricular drain insertion and post-resection CSF diversion failure was noted in group A as compared to group B (P value < 0.01). Group C had a significantly higher proportion of patients with residual tumor (n 19/48.7%) as compared to group A (n 11/29.7%, P value 0.09) and group B (n 20/ 29.4%,P value < 0.05). The post-resection CSF diversion failure rate was significantly higher in group C than in the other two groups (P value < 0.05). Conclusion: The pre-resection CSF diversion subgroup had a poorer outcome as compared to elective and emergency tumor resection. The outcomes of elective and emergency resection of pPFTs were comparable, except for the higher risk of shunt failure in the emergency cohort. Keywords: Elective, emergency, external ventricular drain, pediatric posterior fossa tumors, pre-resection CSF diversion, Author(s): Ashutosh Kumar [1]; Suyash Singh [2]; Aanchal Datta [1]; Kamlesh Singh Bhaisora [1]; Jayesh Sardhara [1]; Priyadarshi Dikshit [1]; Ved Prakash Maurya [1]; Pawan Kumar Verma [1]; Kuntal Kanti [...]

Background and Aim: Dengue is one of the most severe mosquito-borne viral infection. In the absence of specific treatments and vaccines for dengue fever (DF), vector control is the only method by which the spread of dengue can be prevented. This study investigates the seroprevalence of DF cases by detecting NS1 antigen and immunoglobulin (Ig)-G and IgM antibody by enzyme-linked immunosorbent assay (ELISA) test. Materials and Methods: This study was carried out in the Department of Microbiology, at a Tertiary Care Hospital, Jaipur (Rajasthan), done between 6 months. Blood samples from clinically suspected cases of dengue were tested immediately for qualitative detection of NS1 Ag, IgM, and IgG antibodies by ELISA. Results: One thousand seven hundred and sixty-three serum samples were tested for dengue NS1 antigen, IgM, and IgG, out of which 1066 were positive for one or more serological parameters. Dengue cases for the NS1 infection are 52.53%, for the IgM infection is 33.39%, and for the IgG infection is 14.07%. Sixty-two percentage positive samples were of male patients and 57% of positive samples were from 19 to 40 years of age group (adult population) (59%). The seasonal trend showed a gradual increase in dengue-positive cases that started in September with a peak in October (46.24%). Conclusion: The monsoon and postmonsoon seasons are times of high virus activity and enhanced vector breeding. The population must thus be constantly monitored to prevent the virus from spreading further, and serological tests are crucial for making an early diagnosis. ELISA is advised for all suspected dengue patients to initiate therapy and decrease the morbidity and fatality rate.

Purpose: To assess the accuracy of freehand cervical C1 C2 screws placement by knock and drill (K and D) technique in craniovertebral anomalous bony anatomy. Materials and Methods: From January 2017 to December 2022, 682 consecutive C1 C2 screws in 215 patients with craniovertebral junction (CVJ) anomalies were enrolled. All patients underwent posterior fixation with K and D technique without any fluoroscopic guidance. The patient's demographic details, clinical details, radiological details, major intraoperative events, and postoperative complications were noted. The screws malposition grades and direction on CT images in the axial and sagittal plane were defined as new per proposed “SGPGI accuracy criteria.” All patients had a clinical evaluation at 3-month follow-up. Results: Total 682 C1, C2 screws were placed in 215 patients for CVJ anomalies using K and D technique. The accuracy of screws placement by freehand technique was 84.46% (576/682). So with technique explained the rate of malplacement in simple (16.35%) and complex (15.19%) groups were almost comparable and comparison difference was not significant (P = 0.7005). Conclusion: The freehand technique, as described, is effective in cases of anomalous bony anatomy, and it is mandatory in complex CVJ anomalies. The accuracy of screw placement and VA injury is comparable with major studies. This technique is supposedly cost-effective and less hazardous to both health-care workers and patients.