Search

We sought to determine whether thoracic electrical impedance tomography (EIT) could characterize pulmonary function in amyotrophic lateral sclerosis (ALS) patients, including those with facial weakness. Thoracic EIT is a noninvasive, technology in which a multi-electrode belt is placed across the chest, producing real-time impedance imaging of the chest during breathing. We enrolled 32 ALS patients and 32 age- and sex-matched healthy controls (HCs) without underlying lung disease. All participants had EIT measurements performed simultaneously with standard pulmonary function tests (PFTs), including slow and forced vital capacity (SVC and FVC) in upright and supine positions and maximal inspiratory and expiratory pressures (MIPs and MEPs, respectively). Intraclass correlation coefficients (ICCs) were calculated to assess the immediate reproducibility of EIT measurements and Pearson's correlations were used to explore the relationships between EIT and PFT values. Data from 30 ALS patients and 27 HCs were analyzed. Immediate upright SVC reproducibility was very high (ICC 0.98). Correlations were generally strongest between EIT and spirometry measures, with R values ranging from 0.64 to 0.82 (p < 0.001) in the ALS cohort. There were less robust correlations between EIT values and both MIPs and MEPs in the ALS patients, with R values ranging from 0.33 to 0.44. There was no significant difference for patients with and without facial weakness. There were no reported adverse events. EIT-based pulmonary measures hold the promise of providing an alternative approach for lung function assessment in ALS patients. Based on these early results, further development and study of this technology are warranted. [ABSTRACT FROM AUTHOR]

This study involved the evaluation of the effect of vacuum pasteurization on physicochemical characteristics (pH, total soluble solids, titratable acidity, chroma, tone, IO, vitamin C, 5-hydroxymethylfurfural), microbiological properties (Staphylococcus aureus, Listeria monocytogenes, Escherichia coli, total coliforms, total mesophilic aerobes, molds and yeasts) and sensory characteristics of orange and carrot nectar. The thermal treatments were designed based on the thermal lethality of two heat-resistant microorganisms typical of the product (Neosartorya fischeri and Zygosaccaromyces bailii). The evaluation was carried out on raw nectar and pasteurized nectar. The shelf life was estimated to be 30 days (6 °C). The most favorable results were obtained by applying a heat treatment at 88 °C for 32.68 min, managing to retain 85.87% of vitamin C and a microbiological stability of 12 days (6 ± 0.6 °C) with regard to total mesophilic aerobes. Likewise, the tasters established that this treatment resulted in the best flavor, texture and acceptability characteristics. [ABSTRACT FROM AUTHOR]

Lactobacillus plantarum has beneficial effects on the reduction of symptoms of poor lactose digestion and hypercholesterolemia, removal of the duration and severity of diarrheal processes, improvement of the intestinal permeability barrier, prevention of some types of cancer by adsorption or inactivation of genotoxic agents, increased resistance to intestinal and extraintestinal infections, attenuation of inflammatory bowel disease, and prevention of allergies (especially food). On the other hand, carao (Cassia grandis) has shown remarkable nutritious content with influential dietary applications. As a result, this investigation aimed to explore the effect of Cassia grandis pulp on viability of Lactobacillus plantarum under gastrointestinal conditions, immunomodulatory capacity, and probiotic potential. Adding carao to the medium under different experimental conditions, including rich and minimal culture media and a gastrointestinal digestion process of skimmed milk, did not substantially affect Lactobacillus plantarum's growth but prolonged its viability. The administration of Lactobacillus plantarum with carao in mice did not induce a proinflammatory response at a systemic level. Still, it did cause an increase in the production of immunoregulatory cytokines. Also, the viability of TSB broth was improved by adding carao. Carao improved the growth of acid tolerance, bile tolerance, growth in TSB broth, and NaCl resistance. According to the results, carao may enhance the characteristics of L. plantarum when enriching fermented dairy products. [ABSTRACT FROM AUTHOR]

Surface mould brachytherapy is a conformal radiotherapy technique that can deliver high dose to the target while sparing nearby normal structures, Here, we aim to describe the procedurals details for high-dose rate (HDR) surface mould brachytherapy in sebaceous carcinoma of eyelid in a 54-year old lady. She was hesitant for surgery and any form of invasive intervention like interstitial brachytherapy. So, she was treated with surface mould HDR brachytherapy to a total dose of 52 Gy in 13 fractions at a dose of 4 Gy per fraction delivered twice daily using Iridium-192 isotope with no acute side effects. She was evaluated on a weekly basis for any radiation side effects and now she is disease-free for 6 months post-treatment with only mild dry eye. A detailed step-by-step procedure of surface mould technique, simulation procedure, dose prescription, planning, plan evaluation and treatment has been described in this paper. Surface mould HDR brachytherapy can be safely used as organ preserving modality of treatment for eyelid carcinoma. [ABSTRACT FROM AUTHOR]

Carao (Cassia grandis) contains numerous bioactive substances that contribute to gastrointestinal well-being. The present study assessed the potential impacts of carao on the viability and performance of Streptococcus thermophilus and Lactobacillus bulgaricus under various adverse conditions. These conditions included bile, acid, gastric juice, and lysozyme exposure, simulating the digestive process from the mouth to the intestines. The activity of proteases from cultures was monitored to examine their proteolytic capabilities. To achieve this, the cultures were cultivated in a solution containing plant material, and the results were compared against a control sample after an incubation period. Subsequently, the total phenolic content, total carotenoid content, antioxidant activity, sugar profile, and acid profile of the plant materials were analyzed. These analyses were conducted to explore these compounds' influence on cultures' survival. Seeds contained the highest total phenols (766.87 ± 11.56 µg GAE/mL), total carotenoid content (7.43 ± 0.31 mg Q/mL), and antioxidant activity (40.76 ± 1.87%). Pulp contained the highest moisture (12.55 ± 0.44%), ash (6.45 ± 0.15%), lipid (0.66 ± 0.07%), protein (16.56 ± 0.21%), sucrose (9.07 ± 0.78 g/100 g), and fructose (3.76 ± 0.06 g/ 100 g). The crust had the highest content of ash (85.14 ± 0.27%) and succinic acid (2.01 ± 0.06 g/100 g). Results indicated that seeds negatively affected cultures' survival in the bile tolerance test and had positive effects on Lactobacillus bulgaricus in the protease activity test. Otherwise, the other carao tissues could not change the results significantly (p > 0.05) compared to the control in different tests. The carao crust positively affected cultures' against protease activity, especially in Lactobacillus bulgaricus, and had a negative effect on the growth of S. thermophilus in the lysozyme and gastric acid resistance test. [ABSTRACT FROM AUTHOR]

The current work demonstrates the reversible control of substantial molecular motion in 'nano-sized' molecules, where two structural isomers can 'open' and 'close' their cavities in response to light or heat. The isomers differ widely in their photophysical properties, including colour, polarity, two-photon absorption and π-conjugation, and can easily be separated through column chromatography and thus have wide applicability. [ABSTRACT FROM AUTHOR]

Iron deficiency anemia is a significant health problem in developing countries and this is rising, particularly in children and pregnant women. Several therapeutic properties have been attributed to Cassia grandis (carao), including the treatment against anemia, a laxative effect, and the reduction of bleeding. Yogurt is a vehicle for functional ingredients. As a result, this investigation aims to examine the application of Cassia grandis pulp as an anti-anemic and anti-dyspepsia agent in enriched yogurt. Carao pulp powder was added to milk at 0%, 0.5%, 1%, and 3% to produce yogurt. The bioavailability characteristics of iron deficiency anemia were analyzed in albino rats, which were studied for 4 weeks. Other groups of rats were used to set up the dyspepsia model by being fed a high-fat and high-calorie diet. Intestinal propulsion rate, gastric emptying rate, small intestinal contraction, motilin levels, and intestinal muscle tension were analyzed in rats with dyspepsia. Yogurt with 3% carao pulp powder restored ferritin, hemoglobin, total protein and iron at the end of the 4-week feeding period, with significant competition revealed in calcium and zinc absorbance. Furthermore, yogurt with 3% carao pulp powder improved intestinal propulsion rate, gastric emptying rate, small intestinal contraction, motilin levels, and intestinal muscle tension in dyspepsia rats. Carao can be recommended as an anti-anemia supplement in yogurt fortification. [ABSTRACT FROM AUTHOR]

Solid waste has surfaced as an eminent and critical concern of environmental and social significance on a global scale, and Ethiopia, a developing country with limited income, has also encountered unfavorable outcomes due to substandard waste management practices. When pinpointing a fitting landfill location in the town of Bule Hora, various ecological, economic, and societal aspects must be considered; these may result in discord and exacerbate a multifaceted and lengthy process. Hence, this research aims to identify prospective landfill sites within the town and utilize geospatial methods, such as Multi-Criteria Evaluation and Analytic Hierarchy Process, to accomplish its objectives. The utilization of geospatial technology and multi-criteria evaluation provides an efficient manner to simultaneously address all bottlenecks involved in the selection of an appropriate landfill location. Geospatial technology evaluates and manages environmental constraints, whereas multi-criteria assessment categorizes choices based on their desirability. Furthermore, by employing a restriction map adhering to established standards, seven landfill sites have successfully been identified within the town. The Land Suitability Index assesses site suitability based on ecological factors, while the Total Hauling Distance evaluates sites within an economic framework. AHP determines weightings through 25.4 pairwise comparisons, resulting in a consistency ratio of 1.95%. The cartographic analysis is conducted using ESRI ArcGIS version 10.8 software. The findings of this study reveal that 98.69% of the area under study is subject to restrictions. The study recommends the implementation of geospatial methods for identifying suitable landfill sites, which would aid in the decision-making process and prevent hasty decisions from triggering environmental degradation. Proper waste disposal would augment the quality of life for residents by diminishing health hazards. The study endeavors to serve as a reference for other developing countries in selecting appropriate landfill sites. Implications: The town of Bule Hora also faces the problem of waste disposal; there is no scientifically selected suitable landfill. Residents of the town of Bule Hora practice waste disposal in open fields, near settlements, water bodies, roads, agricultural land, and other places. The main sources of solid waste in the town are homes, shops, hotels, restaurants, open markets, hospitals, educational institutions, private clinics, etc. Water pollution can potentially lead to the spread of waterborne diseases. According to reports from the Bule Horas Health Department, many people are affected by water-related diseases every year. These open landfill systems with no regard for settlement, topography, geology, surface, or groundwater conditions are the consequences of these unsuitable habitats and health problems. To reduce these problems, this study plays an important role in determining the suitability of landfills for the town and proposing alternative measures that can minimize negative environmental impacts from waste. This study aims to apply geospatial-based technology to a multi-criteria assessment technique to select perfectly suitable landfill sites that are environmentally friendly, economically cost-effective, and socially responsible; examine the town's current waste management system; calculate the selected parameter weights for feature ranking; and delineate solid waste landfills. [ABSTRACT FROM AUTHOR]

The gastrointestinal tract is an environment that hosts various microorganisms, including pathogens. Generally, pathogenic bacteria enter the host body through food and the gastrointestinal tract. These pathogenic bacteria can colonize or infiltrate host cells and tissues, causing various infectious diseases. In recent years, the protective role of probiotic bacteria against gastrointestinal pathogens has been carefully investigated. Probiotics have been found to modulate intestinal microbial flora and play a significant role in the gastrointestinal tract's function, especially by inhibiting the growth of pathogenic bacteria. However, the mechanism of action of probiotics has yet to be sufficiently proven and recognized. Several important mechanisms support the antagonistic effects of probiotics on various microorganisms, which is achieved, for example, through the production of different antimicrobial compounds, such as bacteriocins, various organic acids, antibiotics, antimicrobial proteins, and exopolysaccharides; mucosal barriers with mucosa and bacteria binding blockers; competition for nutrient uptake; and strengthening of the immune system. Accordingly, this review summarizes the recent studies that have examined the mechanism of action of probiotic bacteria and their beneficial effects in preventing pathogenic bacterial growth and improving gastrointestinal functions. Comprehending their mechanisms of action allows the selection of appropriate probiotic strains for specific applications in gastrointestinal dysfunction. [ABSTRACT FROM AUTHOR]

Nipple fruit (Solanum mammosum), teosinte (Dioon mejiae), Caesar mushroom (Amanita caesarea), and weevil (Rhynchophorus palmarum) powders have shown great nutritional content with meaningful dietary applications. This study aspired to investigate the impact of nipple fruit, teosinte, Caesar mushroom, and weevil powders on the bile tolerance, acid tolerance, lysozyme tolerance, gastric juice resistance, and protease activity of Lactobacillus casei. Nipple fruit, teosinte, Caesar mushroom, and weevil powders were combined at 2% (wt/vol), whereas the control samples did not include the ingredients. The bile and acid tolerances were analyzed in Difco De Man–Rogosa–Sharpe broth incubated under aerobic conditions at 37 °C. The bile tolerance was investigated by adding 0.3% oxgall, whereas the acid tolerance was studied by modifying the pH to 2.0. The lysozyme tolerance was studied in electrolyte solution containing lysozyme (100 mg/L), while the gastric juice tolerance was analyzed at pH levels of 2, 3, 4, 5, and 7. The protease activity was studied spectrophotometrically at 340 nm in skim milk incubated under aerobic conditions at 37 °C. The results show that nipple fruit increased the counts, whereas Caesar mushroom and weevil powders resulted in lower counts for bile tolerance, acid tolerance, lysozyme resistance, and simulated gastric juice tolerance characteristics. Furthermore, the protease activity increased by adding nipple fruit to skim milk. According to the results, nipple fruit may improve the characteristics of L. casei in cultured dairy by-products. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to describe the clinical, biochemical and etiological profile of patients referred with a provisional diagnosis of rickets in tertiary care centres. In addition, we tried to propose a diagnostic algorithm for the evaluation of such patients. Methods: This was a retrospective cross-sectional study conducted in two tertiary care centres of West Bengal. Data of patients were retrieved between 2014 and 2021. Results: Out of 101 children, 22 had conditions simulating rickets. Renal tubular acidosis (RTA) was the most common (53.2%) etiology of rickets, followed by phosphopenic rickets (PR) (22.8%) and calcipenic rickets (CR) (17.7%). The prevalence of true nutritional rickets (NR) was only 8.9%. Children with RTA had a significantly higher prevalence of chronic ill health (69%) and polyuria (95.2%). Weight standard deviation score (SDS) and body mass index (BMI) SDS scores were significantly lower in the RTA group compared to others. Around 90.5% of children with RTA, and none in the other groups, had hypokalemia. Biochemically, hypophosphatemia and elevated alkaline phosphatase (ALP) were present in all patients with PR and CR. Compared to CR, median serum phosphate was significantly lower in the PR group. A significant difference in ALP values was noticed in patients with hypophosphatemia (815 ± 627 IU/L) compared to those without (279 ± 204 IU/L). Plasma parathyroid hormone (PTH) of 100 pg/ml seemed useful to differentiate CR from other forms. Conclusion: NR is uncommon in tertiary care centres. Children with rickets should be approached systematically with the estimation of ALP, phosphorus, creatinine, calcium, PTH and 25-hydroxy vitamin D to reach an etiological diagnosis. [ABSTRACT FROM AUTHOR]

Introduction Pediatric malignancy represents 5% of total cancer diagnosed in India. Due to delayed diagnosis and inaccessibility to healthcare system, the overall outcome is poor in our country. The clinicodemographic profile of childhood malignancy is well described in the Western world and in certain parts of India. The incidence of pediatric malignancy in Eastern India, especially Odisha, has not yet been reported that has motivated us to conduct such a study. Objective This study aims to evaluate the clinicodemographic profile and pattern of childhood malignancy among pediatric patients who received the treatment at a tertiary cancer institute of Odisha. Materials and Methods It was a retrospective observational study, carried out for a period of 8 years, from January 1, 2013 to December 31, 2020 at a tertiary cancer center in Eastern India. A total of 759 eligible childhood malignancy patients were recruited in the study. IBM SPSS v23 was used for descriptive statistical analysis, that is, number and percentage of various clinicodemographic parameters of the above patients. Result Childhood malignancy accounted for 1.6% of all cancers reported during the above study period. The male to female ratio was 1.8:1. Out of 759 eligible childhood cancer patients, majority of patients were suffering from leukemia (173; 22.8%) followed by malignant bone tumors (137; 18.0%), and lymphoma (122; 16%). Leukemia was predominant in the age group of 0 to 14 years; lymphoma, central nervous system neoplasms, germ cell tumors malignant bone tumors, and soft tissue sarcoma (STS) were common in the age group of 10 to 18 years; neuroblastoma, retinoblastoma, and renal and hepatic tumors were seen commonly in the age group of 0 to 9 years. The most common presentation in leukemia was fever, while lymphadenopathy was the chief complaint in lymphoma. Local swelling and pain were the presenting symptoms in malignant bone tumors, while STS patients had painless swelling. Conclusion This study provides an overview of the burden and pattern of childhood malignancy for the state of Odisha and acts as a roadmap for the clinicians to conduct further research in the field of pediatric oncology. [ABSTRACT FROM AUTHOR]

Patients with osteomalacia have a low bone mineral density (BMD) and are often misdiagnosed as osteoporosis. A marked increase in BMD is noticed following successful treatment of osteomalacia. The biochemical hallmark of tumour-induced osteomalacia (TIO) is hypophosphatemia. Patients with TIO often have severe hypophosphatemic osteomalacia and dualenergy X-ray absorptiometry may demonstrate low BMD. Surgical removal of the phosphatonin-secreting lesion restores serum phosphate, corrects osteomalacia and is associated with a dramatic increase in BMD. We report two patients with TIO and low BMD, who were treated with oral phosphate and calcitriol supplementation. The percentage increase in BMD at 33 months was as high as 94.3% in areas with the lowest BMD at baseline. The BMD at 33 months was higher than the +2SD of the population-specific reference ranges, a finding not reported in surgically treated patients with TIO. An intermittent rise in parathyroid hormone following oral phosphate supplementation might have resulted in such findings. [ABSTRACT FROM AUTHOR]

This study used a mixed research design for several reasons. Firstly, the researchers used longitudinal data from open-source remote sensing satellite imagery dating back at least 30 years to study urban expansion into rural farmland. Then, the researchers used cross-sectional data from household surveys, where data collection tools such as questionnaires and structured interviews were utilized. A simple sampling procedure was used to ensure the representativeness of homogeneous target group households. The survey data was analyzed with SPSS software, and the urban-tofarmland extent was investigated with Landsat satellite images and observation intervals every 10 years for the last 30 years. The key finding of this study was that urban expansion is encroaching onto farmland, negatively impacting household livelihoods. It is recommended that urban expansion should be managed and minimized and that cooperation with the communities in the study area is an important issue. The study emphasizes the significance of comprehending the implications of uncontrolled urban development on rural communities in Ethiopia, using a mixed research approach comprising both longitudinal and cross-sectional data. The research demonstrates that expanding cities are having a considerable impact on agricultural livelihoods and require delicate handling to mitigate their unfavorable influence. [ABSTRACT FROM AUTHOR]

Background: Powered circular saw-related injuries (PCSRIs) are responsible for a sizable proportion of occupational injuries presented to the emergency department (ED). The present study portrays the mechanisms, injury patterns, epidemiological parameters, and outcomes among subjects presenting with PCSRI to the ED. Methods: This retrospective observational study was conducted in the ED of a tertiary care hospital in eastern India. Clinical records of subjects with PCSRI from June 2019 to June 2022 were reviewed. Data pertaining to patients' demographic profiles and the patterns and mechanisms of injury were retrieved. The Modified Hand Injury Severity Score (MHISS) and the Injury Severity Score (ISS) were calculated. Statistical analysis was performed using R version 4.1.0. Results: A total of 175 subjects' data were analyzed. The median age was 34.5 years, and all subjects were men. The mean year of experience of the subjects was 6.2. The most common job category was carpentry (n = 63 [36%]), followed by "do it yourself work" (n = 26 [14.8%]). One hundred twenty-two (69.7%) subjects had hand injuries (HIs), and the left hand was involved in 85 (69.6%) subjects. The index finger was involved in 36 (29.5%) subjects, followed by the thumb (n = 31 [25.4%]). Laceration (n = 155 [88.5%]) was the most common injury pattern. The subjects' mean ISS and mean MHISS were 8.52 and 45, respectively. Conclusion: PCSRI is associated with moderate-to-severe HIs that are most common in occupational settings. Young male carpenters involved in wood and plywood work are more prone to injuries. [ABSTRACT FROM AUTHOR]

This article discusses the anesthesia management of two cases of symptomatic aortic stenosis (AS) presenting with neurosurgical emergencies. In both cases, a preoperative valvuloplasty was not feasible, so alternative approaches were used. Bedside Focussed Assessed Transthoracic Echocardiography (FATE) was performed to guide fluid and vasopressor administration. The article emphasizes the importance of FATE in guiding therapeutic interventions and providing an individualized approach to managing uncorrected valvular stenosis conditions in neurosurgical emergencies. [Extracted from the article]

Proximal renal tubular acidosis (pRTA) is characterized by a defect in the ability of the proximal convoluted tubule to reabsorb bicarbonate. The biochemical hallmark of pRTA is hyperchloremic metabolic acidosis with a normal anion gap, accompanied by appropriate acidification of the urine (simultaneous urine pH <5.3). Isolated defects in bicarbonate transport are rare, and pRTA is more often associated with Fanconi syndrome (FS), which is characterized by urinary loss of phosphate, uric acid, glucose, amino acids, low-molecular-weight proteins, and bicarbonate. Children with pRTA may present with rickets, but pRTA is often overlooked as an underlying cause of this condition. We report six children with rickets and short stature due to pRTA. One case was idiopathic, while the remaining five had a specific underlying condition: Fanconi-Bickel syndrome, Dent's disease, nephropathic cystinosis, type 1 tyrosinemia, and sodium-bicarbonate cotransporter 1-A (NBC1-A) defect. Five of these six children had features of FS, while the one with NBC1-A defect had isolated pRTA. [ABSTRACT FROM AUTHOR]

Traditionally, rice leaf disease identification relies on a visual examination of abnormalities or an analytical result obtained by growing bacteria in the research lab. This method of visual evaluation is qualitative and error-prone. On the other hand, an artificial neural network system is fast and more accurate. Several pieces of research using traditional machine learning and deep convolution neural networks (CNN) have been utilized to overcome the issues. Still, these methods need more semantic contextual global and local feature extraction. Due to this, efficiency is less. Hence, in the present study, a multi-scale feature fusion-based RDTNet has been designed. The RDTNet contains two modules, and the first module extracts feature via three scales from the local binary pattern (LBP), gray, and a histogram of orient gradient (HOG) image. The second module extracts semantic global and local features through the transformer and convolution block. Furthermore, the computing cost is reduced by dividing the query into two parts and feeding them to convolution and the transformer block. The results indicate that the proposed method has a very high average precision, f1-score, and accuracy of 99.55%, 99.54%, and 99.53%, respectively. It is suggestive of improved classification accuracy using multi-scale features and the transformer. The model has also been validated on other datasets confirming that the present model can be used for real-time rice disease diagnosis. In the future, such models can be used for monitoring other crops, including wheat, tomato, and potato. [ABSTRACT FROM AUTHOR]

Here, by employing a Barrow entropy and the standard holographic method at a cosmic framework, we formulate Barrow agegraphic dark energy (BADE), taking the Universe age as an IR cutoff scale in a flat FLRW Universe. For evaluation of statefinder parameters in (r , s) and (r , q) planes, trajectories have been plotted for BADE and discovered that for various values of Δ , the model exhibits both the behavior of Chaplygin gas and quintessence. Moreover, as a supplement to the statefinder study, we looked at the BADE model without interaction in the plane (ω D , ω D ′) , which might offer us a dynamic study using the energy density BADE parameter Ω D 0 = 0. 7 0 and H 0 = 6 7 , as per VI- Λ CDM observational data without interaction from Planck 2018 results. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic impacted people's livelihoods worldwide to an unprecedented magnitude, the most affected being the socially and economically disadvantaged and marginalized communities, including the transgender people that constitute one of the most vulnerable sections that are often subjected to discriminated in various sectors such as education, health, housing, and livelihood opportunities. The present study attempts to offer insights into the impact of the pandemic on the livelihood of transgender people in India, given that the pandemic adversely affected their primary sources of livelihood, such as begging, sex-work, singing, and dancing, due mainly to the restrictive measures: lockdown, shutdown, social/physical distancing, etc., imposed by government authorities to curb the spread of the virus, in turn depriving them of their livelihood choices and rendering them even more vulnerable. This study draws from twelve transgender respondents in the city of Bhubaneswar, India recruited through the snowball method and uses thematic analysis of qualitative data obtained through telephonic interviews. The study finds that the pandemic-induced measures have negatively affected the lives and livelihood of transgender people during this time of crisis. Despite the government’s sustained efforts in providing temporary livelihood options and monetary supports during the crisis, the transgender people continued to remain marginalized. Approaches to making them self-sufficient over a longer term and empowering them financially would have been of more significant impact. [ABSTRACT FROM AUTHOR]

Unexpected results and negligence can lead to mishaps in the dental operatory. With the trend of using tooth-colored restorations, mishaps have also increased, which are sometimes ignored due to a lack of knowledge. Although resin-based restorative materials are considered safe, their constituents can leach out and cause allergies in patients as well as dental professionals. Safe-handling of these resin-based materials is critical due to increased risk of occupational health hazards. Most of the allergies caused by resins are related to monomers based on methacrylic acid, which is found in almost all types of dentin bonding agents. Also, it is estimated that 5%–10% of all allergic contact dermatitis reports in dental professionals are due to contact with methacrylate. On the contrary, 37% phosphoric acid in etchant results in necrosis and ulcerative lesions due to vascular nature of the oral cavity. The purpose of this article is to help dentists to become aware of allergies/mishaps that can occur due to bonding agents and phosphoric acid, thereby leading to prevention and their early management. [ABSTRACT FROM AUTHOR]

Objective: This study to evaluate clinicopathological parameters such as age, tumor location, tumor size, grade, depth of invasion (DOI), lymphovascular space invasion (LVSI), lymph node metastasis, and stage that predict peri-neural invasion (PNI) in oral squamous cell carcinoma (OSCC). Material and Methods: A retrospective study on 1716 postoperative OSCC patients who satisfied the eligibility criteria and treated from January 2009 to December 2019 was analyzed using IBM SPSS V23. Mean and percentage were assessed using descriptive statistics. Wilcoxon--Mann--Whitney U-test was used to compare continuous variables, while Chi-square test was used to compare discrete variables between PNI-positive and PNI-negative groups. Two-tailed P < 0.05 was considered to be statistically significant. Results: Out of 1716 patients, 553 were PNI positive. The mean age was 48.76 ± 12.42 years in PNI-positive patients while 51.52 ± 12.51 years in PNI-negative patients. Males outnumbered females. The most common primary was carcinoma buccal mucosa (204, 36.9%), followed by carcinoma of oral tongue (161,29.1%). Maximum tumor size was 3.14 ± 1.20 cm in PNI-positive patients whereas 2.78 ± 1.22 cm in PNI-negative patients. Sixty (10.84%) patients in PNI-positive group and 51 (4.38%) in PNI-negative group had LVSI positive. Lymph node involvement was observed in 305 (55.13%) patients in PNI-positive group whereas 358 (30.78%) patients in PNI-negative group. Maximum number 228 (41.3%) in PNI-positive patients were in Stage IVA disease. Conclusion: PNI is one of the important adverse prognostic factors having a definite correlation with anatomical subsite, tumor size, grade, DOI, LVSI, lymph node involvement, and stage of the disease. PNI should be analyzed in postoperative histopathology report of OSCC that guides the clinician for adjuvant therapy. [ABSTRACT FROM AUTHOR]

Hypoparathyroidism is a common encounter in endocrinology practice. A thorough search for the etiology is generally futile, and most cases are labeled as idiopathic. Familial idiopathic hypoparathyroidism is a large chunk of these idiopathic cases. Here we present 2 cases who presented with features of hypocalcemia and were eventually diagnosed with hypoparathyroidism. Our first case is that of a middle-age woman who presented with spontaneous tetany and perioral numbness. She had very low serum calcium values, low serum magnesium, hypokalemia, hypercalciuria, and undetectable parathormone levels. She was initially managed with parenteral calcium, magnesium, and oral potassium chloride, which was shifted to oral replacements once stabilized. Focused exome sequencing for causes of hypoparathyroidism and hypocalcemia revealed a frameshift mutation in glial cell missing homolog 2 (GCM2) (NM_004752.4) on chromosome 6, c737dupA variant (p. Asp246Glufs*25) located at exon 5. The second case presented is that of a 1-month-old infant presenting with hypocalcemic seizures, severe hypocalcemia, hyperphosphatemia, and low parathormone levels. The infant was stabilized with parenteral calcium and trial of subcutaneous teriparatide for further improvement. Oral calcium and calcitriol were instituted once stabilized, and teriparatide was tapered off. Focused exome sequencing revealed a homozygous mutation involving GCM2 (ENST0000379491.5) on chromosome 6, variant CM2 chr6:10876558_10877139insT located on exon1-2. Both of these mutations are novel and underscore the profound effect of GCM2 on parathyroid gland development in infants and maintenance in adults. [ABSTRACT FROM AUTHOR]

Background: It is difficult to ascertain reliably the overall incidence and prevalence of the various cutaneous infections in different parts of the world because studies of one region of the country may not be a true representation of the overall disease pattern of that country; furthermore, incidence and prevalence figures may only will be representative of the population sampling, which may have associated risk factors for infection. Most of the studies done in this field are dealt with adults or with a specific clinical form of dermatophytosis. Only few surveys were performed in pediatric age group. Aim: To study clinical presentation of superficial dermatophytic infection in paediatric patients in tertiary health care centre. Methods: It is an observational type of study. The present study was conducted in Department of Dermatology, Rajshree Medical & Research Institute, Bareilly, from 1st march 2021 to 28th February 2022. Results: Majority of the study population belonged to 11-15 years (48.7%) followed by 15-18 years (24.1%), 0-5 years (16.6%) and 5-10 years (10.6%). The mean age of the study population was 9.16±4.241 (0-18) years. There were 47.7% males and 52.3% females. Itching was present among most of the patients that is 226 patients had this complaint (95.3%). The most commonly affected sites was Groin (47.2%) followed by Trunk (29.9%), buttocks (29.1%), upper limbs (24.0%), Face (6.7%), Scalp (4.6%), lower limbs (4.6%) and Nails (0.4%). The predominant lesion type was Plaque (43.5%) followed by Others like Pustules, erosions, excoriation, crusting (29.5%), Plaque with papules (16.5%), Plaque, Others (4.6%), Papules, Others (4.6%) and Macule being the least lesion type (1.3%). The most common lesion feature found in most of the study group was discoloration (94.1%). The most common diagnosis was T. corporis (29.1%) followed by T. corporis+ T. cruris (28.3%), T. cruris (22.4%). Limitations: The study was an observational study done at the first visit of the patient in OPD with no follow-up. This was major limitation of the study, since the further change of course of presentation was not noted. Also the patients undergoing any other treatment with dermatophytosis were not studied. Conclusion: Total 237 patients of superficial dermatophytosis were included in the study, out of which mean age was 9.16 ± 4.241 with female predominance (52.3%). Maximum patients were from middle school (48.9%) corresponding to age and belonged to middle class (70.5%) socioeconomic status. Common presenting complaints were itching (95.3%), affected site was groin (47.2%) and annular plaque was predominant type of lesion. The most common made in our study was T. Cruris (47.2%). More studies should be carried out in future on large scale so that this study can be corroborated to evidence. Along with that, alternation in dosage for pediatric age group should be studied. [ABSTRACT FROM AUTHOR]

Shock is a state of acute circulatory failure leading to decreased organ perfusion, inadequate delivery of oxygenated blood to tissues, and resultant end-organ dysfunction. A 45-year-old male patient a known case of Diabetes Mellitus (DM) presented to the Emergency Room (ER) with a complaint of fever for four days and shortness of breath for one day. The patient had a wound discharging pus over the dorsum of the right foot for two weeks following trauma. On examination, the patient's vitals were: pulse rate-88 Beats Per Minute (bpm), respiratory rate-26 breaths per minute, SpO2-78% room air, Blood Pressure (BP)-82/40 mmHg mean arterial pressure-54 mmHg. As a protocol of shock evaluation, Point Of Care Ultrasonography (POCUS) showed a distended Inferior Vena Cava (IVC), dilated right atrium and ventricle, and good left ventricular systolic function. Given the presence of right leg swelling, ultrasound was done, which showed a thrombus in the popliteal vein. Noradrenaline infusion was started to maintain a mean arterial blood pressure of 70 mmHg. A diagnosis of obstructive shock due to pulmonary embolism was strongly suspected, and thrombolysis with injection streptokinase was done. After two hours of thrombolysis, Two-Dimensional (2D) Echocardiography (ECHO) revealed normal right atrium and ventricle size and IVC collapsibility index of 70%, but the patient's blood pressure didn't improve significantly. So, adequate intravenous fluid was given as per the septic shock protocol. But, the noradrenalin requirement didn't improve. The patient was put on broad-spectrum antibiotics. Blood culture showed growth of Pseudomonas aeruginosa. So, a diagnosis of co-existing septic shock with obstructive shock was made. The patient improved and discharged in stable condition. The present case report highlights the co-existence of septic shock and obstructive shock and the usefulness of POCUS in differentiating and managing various shocks. [ABSTRACT FROM AUTHOR]

Brain metastasis is seen in 10% to 20% of all adult cancer patients. One of the main modalities of treatment is stereotactic radiosurgery (SRS). Here, we describe the step by step procedure for stereotactic planning of brain metastasis by using a clinical scenario. The management of brain metastasis starts with the clinical evaluation of the patient followed by imaging and SRS treatment in the present case. The paper highlights the sequential process of radiation planning for SRS—starting from simulation, planning, evaluation of plan, and treatment. [ABSTRACT FROM AUTHOR]

Primary testicular lymphoma (PTL) is a rare variant of non-Hodgkin's lymphoma that is predominant in old age group. Painless testicular swelling is the most common presentation. The standard of care is surgery in the form of radical orchiectomy followed by adjuvant chemotherapy and central nervous system prophylaxis. Because of blood-testis barrier, contralateral testis acts as a sanctuary site for chemotherapy to act and hence scrototesticular radiation is advocated in order to reduce the chance of testicular relapse. Due to lack of any consensus simulation procedure, we propose here a step-by-step procedure for simulation of a case of PTL using a case scenario. [ABSTRACT FROM AUTHOR]

Background: Glomus jugulare is a rare, slow-growing tumor that arise within the jugular foramen of the temporal bone. In the past, surgery was the primary modality of treatment for glomus Jugulare, but it leads to many complications and increased mortality. Radiotherapy was indicated in adjuvant setting in post-operative residual disease. But, with the advent of highly conformal radiation planning, stereotactic radiosurgery (SRS), is now one of the main modalities of radiation treatment in glomus jugulare. Objective: To describe the procedural steps for radiation planning of SRS of glomus jugulare. Methods: The step-by-step procedure for stereotactic planning of glomus jugulare has been described using a clinical scenario of glomus jugulare. Results: The stereotactic radiation planning of glomus jugulare starts with the basic history and relevant clinical evaluation, that is, visual testing. Computed tomography (CT) scan and magnetic resonance imaging (MRI) of the brain is the imaging modality of choice. The radiation planning of glomus jugulare starts with CT simulation. MRI of brain should be done in the prescribed format to achieve uniformity in radiation planning. After CT and MRI image fusion, contouring of target, organs at risk (OAR) and radiation planning should be done. The plan evaluation includes target and OAR coverage index, conformity, homogeneity and gradient index, and beam arrangement. After radiation plan evaluation, treatment is delivered after quality assurance and dry run. Conclusion: The paper highlights the sequential process of radiation planning for SRS in glomus jugulare—starting from simulation, planning, evaluation of plan, and treatment. [ABSTRACT FROM AUTHOR]

Road hazards such as jaywalking pedestrians, stray animals, unmarked speed bumps, vehicles, and road damage can pose a significant threat in poor visibility conditions. Vehicles are fitted with safety technologies like advanced driver assistance systems (ADAS) and AW (automatic warning) systems to tackle these issues. However, these safety systems are complex and expensive, and these proprietary systems are exclusive to high-end models. The majority of the existing vehicles on the road lacks these systems. The YOLO model (You Only Look Once Architecture) was chosen owing to its lightweight architecture and low inference latency. Since YOLO is an open-source architecture, it can enhance interoperability and feasibility of aftermarket/retrofit ADAS devices, which helps in reducing road fatalities. An ADAS which implements a YOLO-based object detection algorithm to detect and mark obstacles (pedestrians, vehicles, animals, speed breakers, and road damage) using a visual bounding box was proposed. The performance of YOLOv3 and YOLOv5 has been evaluated on the Traffic in the Tamil Nadu Roads dataset. The YOLOv3 model has performed exceptionally well with an F1-Score of 76.3% and an mAP (mean average precision) of 0.755, whereas the YOLOv5 has achieved an F1-Score of 73.7% and an mAP of 0.7263. [ABSTRACT FROM AUTHOR]

Nowadays, in a world full of uncertainties and the threat of digital and cyber-attacks, blockchain technology is one of the major critical developments playing a vital role in the creative professional world. Along with energy, finance, governance, etc., the healthcare sector is one of the most prominent areas where blockchain technology is being used. We all are aware that data constitute our wealth and our currency; vulnerability and security become even more significant and a vital point of concern for healthcare. Recent cyberattacks have raised the questions of planning, requirement, and implementation to develop more cyber-secure models. This paper is based on a blockchain that classifies network participants into clusters and preserves a single copy of the blockchain for every cluster. The paper introduces a novel blockchain mechanism for secure healthcare sector data management, which reduces the communicational and computational overhead costs compared to the existing bitcoin network and the lightweight blockchain architecture. The paper also discusses how the proposed design can be utilized to address the recognized threats. The experimental results show that, as the number of nodes rises, the suggested architecture speeds up ledger updates by 63% and reduces network traffic by 10 times. [ABSTRACT FROM AUTHOR]

Tile-based architecture is broadly utilized in the structuring of the system-on-chip by different vendors. Nevertheless, the performance of the system-on-chip (SoC) is incredibly influenced by the performance of the network hidden on a chip named network-on-chip (NoC). Routing of network-on-chip network chips plays a crucial role in the overall performance of the NoC. In this paper, we have proposed a routing algorithm that utilizes the neural network to perform the routing. This routing algorithm updates the route dependent on the port execution of the switch. From the outcome, the execution of the directing has worked successfully and has the option to deal with the enormous burden viably. The result obtained shows that the performance metric for the uniform traffic is slightly better in comparison to XY routing at the higher loads of 80%. In the case of neighbor traffic, bit complement traffic, and tornado traffic, these values are higher on 80% of the load. The reason for better handling of the loads is due to the parallelization due to the pipeline created by the neural network routing decision. [ABSTRACT FROM AUTHOR]

White light‐emitting diodes (LEDs) are the most promising alternative to the conventional lighting sources due to their high efficacy and energy saving in illumination. Silicon carbide (SiC) has a wide optical bandgap and could be tailored to emit light at different wavelengths across the entire visible spectrum by introducing different dopants. Donor and acceptor (DA) co‐doped fluorescent SiC (f‐SiC) is a potential candidate for replacing phosphor material in white LEDs, as it has been observed as a good wavelength converter overcoming the disadvantages of rare earth‐containing phosphors, such as poor color‐rendering index (CRI), short lifetime, and short degradation time. The current study attempts to present an overview on the available approaches to fabricate f‐SiC for generating the white light emission and challenges in fundamental research issues to enhance quantum efficiency, color rendering performance, stability, reproducibility of color quality, and lifetime of f‐SiC. [ABSTRACT FROM AUTHOR]

We present a microscopic study of waterâ€"dimethyl sulfoxide (DMSO) binary mixtures using optical tweezers and thermal lens techniques. Binary mixtures of DMSO with water show anomalous behavior due to the specific hydrogen bonding ability of DMSO. We use a tightly focused femtosecond laser at a low average power to optically trap microspheres with diameters of 1 micron for use as probes. The binary mixture exhibits various viscosities, depending on its composition ratio, and hence different trapped particle characteristic frequencies (corner frequencies) due to Brownian motion. The power spectrum density method is used to obtain the corner frequency from forward-scattered data. Thus, using low-power optical tweezer experiments, we find that the maximum viscosity occurs at a DMSO mole fraction of 0.276. At higher powers, the propensity for trapping is highly diminished. It may be surprising to note that these viscosity values obtained from the corner frequencies do not exactly match those published in the literature. However, this deviation can be attributed to the thermal behavior of the binary mixture, which affects the Brownian motion and hence the obtained viscosity values. Studies at the microscopic level can thus provide a newer perspective on these already important binary mixtures. Intensity-dependent measurements further confirm the contribution of thermal effects in this study. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease. Gastrointestinal manifesting as nausea, vomiting, and pain abdomen are not so uncommon in SLE flare. However, gastrointestinal intestinal vasculitis as an initial presenter of SLE is very rare. This case report narrated gastrointestinal vasculitis as an initial presentation of systemic lupus erythematous, which mimicked lithium toxicity in a patient of preexisting bipolar disorder who was on long-term lithium therapy. A 26-year-old female presented with abdominal pain and persistent vomiting for 2 months. On further workup, she was antinuclear, anti-Smith, and anti-ds-DNA antibody positive. The serum lithium level was found to be normal computed tomography angiogram of the abdomen suggestive of vasculitis. A final diagnosis of SLE with gastrointestinal vasculitis as an initial presenter was made. She was treated with high-dose corticosteroid, cyclophosphamide, and other supportive care. She improved dramatically and was discharged with an oral corticosteroid, hydroxychloroquine, and ramipril. [ABSTRACT FROM AUTHOR]

Education, since times immemorial, has always required in-person interactions between teachers and students. In recent times, however, Massive open online courses (MOOCs) have become popular with the goal of democratizing education. COVID-19 accelerated the pace of such online learning. However, the completion rates in the self-driven MOOC courses have been low, and learning outcomes depend strongly on the learners' motivation. The pandemic enabled faculty to adapt quickly to the black swan event, and the teaching-learning process resumed online. To comparethe impact of offline, online learning and teaching on student performances, perceptions and class feedback, structured student surveys were conducted, and student performances were analyzed in higher education settings. Statistical analyses were conducted using descriptive statistics and two-sample ttests. We observed that while the perceptions were overwhelmingly in favour of offline education, the students performed equally well in both settings, and their feedback was equally good for both learning modes. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the dosimetry and practice feasibility in patients of breast carcinoma undergoing postoperative radiotherapy (RT) to the whole breast (WB) as per the FAST-Forward trial protocol. Materials and Methods: A total of 10 patients aged more than 18 years with histopathology proved early stage invasive carcinoma of breast after breast conservation surgery (BCS) were considered for receiving adjuvant RT to the WB with a total dose of 26 Gy in five fractions at a rate of 5.2 Gy per fraction delivered over 5 days. Boost to the tumor bed with a dose of 10 Gy in four fractions was delivered to the BCS cavity with adequate margin as per protocol. Targets were contoured according to the ESTRO guidelines. Heart and ipsilateral lung were considered as organs at risk. Target coverage and dose to the heart and ipsilateral lung were evaluated by dose–volume histograms. All patients were evaluated clinically for acute toxicity such as skin reaction and breast pain weekly once during RT, at the completion of RT, and at 3 months of follow-up. Results: Out of 10 patients, eight patients had right-sided breast carcinoma. As per protocol, we were able to achieve a dose constraint to ipsilateral lung in only three patients (V30%(7.8Gy) ≤ 17%). The range of excess dose variations in remaining seven patients was between 0.4% and 4.5%. Dose constraint to the heart has been achieved in all right-sided breast cancer patients (V25%(6.5Gy) ≤ 5). In left-sided breast cancer patients, an excess range of dose variation was between 0.8% and 2%. Only one patient developed grade III skin reaction at the end of RT (Common Toxicology Criteria for Acute Effects Grade 1). Conclusion: The FAST-Forward trial protocol (26 Gy in five fractions) can be effectively delivered in patients with postoperative invasive early stage breast cancer. The hurdle we faced was lung dose constraint, which was difficult to achieve in certain patients. [ABSTRACT FROM AUTHOR]

Background: A major parameter in the workflow of radiation treatment is the plan evaluation. In order to achieve high dose to target, minimum dose to the critical structures and accurate delivery of treatment, various qualitative and quantitative parameters need to be assessed during plan evaluation. Material and Methods: Here we propose an acronym COSID to describe the five major indices that need to be evaluated during a stereotactic treatment plan. Results: The stereotactic radiation plan evaluation include good target coverage, minimum dose to the organs at risk (OAR), homogeneity and conformity of dose to the target. As very high dose is being delivered in stereotactic radiotherapy in one or small number of fractions, certain other parameters such as the dose fall of beyond the target and the complexity of plan must to be addressed. The proposed COSID index is an acronym for these parameters such as Coverage Index, OAR Index, Spillage Index, Imaging Index and Delivery Index. Conclusion: The paper highlights the five important parameters that need to be assessed while evaluating a Stereotactic Radiosurgery (SRS) or Stereotactic Radiotherapy (SRT) plan. [ABSTRACT FROM AUTHOR]

Background: Surgical resection of brain metastasis is followed by adjuvant radiation in order to reduce the risk of local recurrence. Traditionally, adjuvant radiation was practiced in the form of whole brain radiation therapy that was associated with adverse neurocognitive outcomes and poor quality of life of the patients. In the recent times, stereotactic radiosurgery (SRS) is being practiced as the standard of care for treating brain metastasis cavity with good local control and improved the patient's quality of life by sparing the normal tissues of adverse effects of radiation. Here, we describe procedure details for stereotactic planning of surgically resected brain metastasis. Materials and Methods: The step-by-step procedure for stereotactic planning of brain metastasis cavity has been described using a clinical scenario of brain metastasis. Results: The stereotactic radiation planning of brain metastasis cavity starts with the basic history and relevant evaluation of symptoms. Magnetic resonance imaging (MRI) of the brain is the imaging modality of choice. The radiation planning of brain metastasis cavity starts with computed tomography (CT) simulation and MRI of brain that should be done in a prescribed format to achieve uniformity in radiation planning. After CT and MRI image fusion, contouring of target, organs at risk (OAR), and radiation planning should be done. The plan evaluation includes target and OAR coverage index, conformity, homogeneity and gradient index, and beam arrangement. After radiation plan evaluation, treatment is delivered after quality assurance and dry run. Conclusion: The paper highlights the sequential process of radiation planning for SRT of brain metastasis cavity, starting from simulation, planning, evaluation of plan, and treatment. [ABSTRACT FROM AUTHOR]

Improvements in productivity are the mainstay of manufacturing companies. These companies face the challenge of identifying suitable groups of customers to present their offerings and hence are on a constant lookout for innovations either in their product, ways to market the product, or to influence other stages in their value chain. Given the emergence of diversified purchase platforms, a new insight is the emerging segment of 'virtually erudite' customers that emerges out of this research. This segment promises a range of gains for both companies and customers in the given group. Frameworks for segmentation are evolving, and the most significant evolution in recent times is the departure from existing frameworks due to technological interventions. This piece of research establishes how there is a shift from the traditional brick and mortar purchase considerations to the behaviour of the virtually erudite segment. The research finds out how humans of different age groups exhibit different purchase behaviour (this is true for the year 2021). Differences in purchase behaviour have evolved due to technological exposure and technology adaptation which gives rise to technological rationality. The result of complete interaction between the abovementioned variables is the virtual erudite segment. Segmentation as we all know is the classification of a group of customers with different needs into sub-groups with similar needs and preferences. This has its own ramifications at the production level also. The STP model which consists of segmentation, targeting, and positioning is well accepted in modern marketing. It is important to create a clear segmentation strategy to successfully implement STP practices in the current dynamic environment. The approach falters if the right criteria have for segmentation are not set. The following work looks at how technology has influenced the understanding of the prospects of customer groups and has changed their perception, process of purchase, and post purchase behaviour. This work has been addressed to four different groups consisting of students, businessmen, servicemen, and executives of the e-commerce platforms, through unstructured questionnaires. The work introduces virtual erudite as a new category of segmentation, and presents a detailed discussion on how this category has evolved and is applicable to most parts of the globe. [ABSTRACT FROM AUTHOR]

Introduction: Head and Neck cancer is most common cancer in developing countries like India. Oral Squamous Cell Carcinoma (OSCC) is the most common site of head and neck malignancy. Various histopathological factors prognosticates the therapeutic outcome. Clinicopathological characteristics of OSCC in Asian countries somehow differ from Western countries. Aim: To report the different clinicopathological characteristics of OSCC due to paucity of the literature even though it is one of the most common malignancy in India. Materials and Methods: In this retrospective observational study, the medical records of 1753 patients of OSCC who satisfied the eligibility criteria and were treated at a tertiary cancer centre at Cuttack, Odisha, India, from January 2009 to December 2019. Clinicopathological profile of the included subjects were noted. The data was analysed in the month of March 2021 using descriptive statistics such as mean, median, maximum, minimum value and percentage using International Business Machine (IBM) Statistical Package for the Social Sciences (SPSS) version 23.0. Results: Total of 1753 patients were analysed with the mean age of 50.55±12.56 years, however, majority 492 (28.1%) were in the age of 40-49 years. Male predominance was observed in 1379 (78.7%) patients. Buccal mucosa was the most common primary 731 (41.7%) followed by the tongue 359 (20.5%). Left side lesion was seen in 1008 (57.5%) patients while 734 (41.9%) patients had lesion at right side. Morphologically, ulceroinfiltrative lesion was the most common presentation constituting in 897 (51.2%) patients. Maximum tumour size was 2.91±1.25 cm. Maximum number of patients i.e., 1529 (87.2%) had grade I disease. Mean Depth of Invasion (DOI) was 8.67±4.50 mm. Lymphovascular Space Invasion (LVI) was positive in 123 (7%) patients and Perineural Invasion (PNI) was observed in 565 (32.2%) patients. Resected margin was positive in 203 (11.6%) patients. Cervical lymph node involvement was found in 691 (39.4%) patients and 28(1.6%) had extracapsular extension. In this study, most of the patients presented in advanced stage of the disease i.e., stage III 380(21.7%) and stage IV 506(28.9%). Conclusion: The present study highlights that majority of OSCC presents in younger age groups, as left side buccal mucosal lesion with advanced stages of disease. This scenario is due to poor lifestyle pattern which can be prevented by avoidance of tobacco consumption, active screening, public awareness and early diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Critical hand ischemia with advancing gangrene of digits requires urgent intervention to salvage as much tissue as possible. The purpose of this study was to evaluate the efficacy of "palmar arch loop" technique for endovascular management of critical hand ischemia by establishing inline flow to the palmar arch via both radial artery and ulnar artery, in patients with failed antegrade recanalization. To the best of our knowledge, this is the first case series evaluating the efficacy of "palmar arch loop" technique, with retrograde percutaneous transluminal angioplasty of the involved radial artery and/or ulnar artery. Material and methods: We retrospectively investigated 10 patients (60% female; mean age 42 ± 18 years; mean time of presentation post-acute event 24 ± 11 days) with critical hand ischemia undergoing endovascular intervention using "palmar arch loop" technique at a single center in northern India between April 2017 and March 2019. All patients were followed up at regular intervals (weekly for a month, fortnightly for 3 months, and then at 6 and 12 months) with clinical assessment and SpO2 measurement. Study end points were technical success rate, hand healing, and primary patency rate at one year. Results: Causes for critical hand ischemia were iatrogenic injuries due to inadvertent intra-arterial injection in 50% (n = 5) and thromboembolic events in 50% patients (n = 5). Vessels involved were: both radial artery and ulnar artery along with the PA in 50%; radial artery and palmar arch in 30%; ulnar artery and palmar arch in 20%. All of them had total occlusion of the involved vessel (>2/3rd of total length) with occlusion/diffuse disease of palmar arch as well; 70% technical success rate was achieved ensuring inflow to palmar arch via both the arteries with improved flow distally to the common and proper digital arteries. Retrograde percutaneous transluminal angioplasty of radial artery in 50% (n = 5) and ulnar artery in 20% (n = 2) was done successfully by looping the guidewire across the palmar arch; 90% showed subjective improvement in pain with healing of the lesions and/or formation of clear line of demarcation with reversal of pregangrenous changes proximally. Out of the eight patients with gangrene of fingers, three underwent minor amputation of the gangrenous digits and five underwent auto-amputation of the gangrenous tissue with complete healing of the stump. Primary patency rate was 85.7% at one year. There was no access site-related complication or mortality in the follow-up period. Conclusions: Endovascular management of critical hand ischemia by "palmar arch loop" technique is an efficient technique to deal with occluded forearm vessels, particularly when antegrade recanalization fails. This technique, with good technical success and patency rates, is potentially a unique tool in the endovascular armamentarium for salvaging hand. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) barrier box is being used by health-care workers for protection against aerosol-transmitted infection. Usually, a Macintosh laryngoscope (MC) or a video laryngoscope (VL) is used for endotracheal intubation (ETI). We aimed to determine the most suitable laryngoscope blade in terms of time to ETI, ease of ETI, and the first-pass success rate. Methods: American Society of Anesthesiologists Grade I and II patients undergoing surgery under general anesthesia were randomized into the MC and the King Vision VL groups in a 1:1 ratio. ETI was performed using either the MC (the MC group) or the King Vision VL (the VL group) with a COVID-19 barrier box. The first-pass intubation success rate, intubation time, and ease of ETI were analyzed. Results: The first-pass success rate was higher in the MC group (P = 0.43). The mean duration of ETI was 33 s and 47 s in the MC group and VL group, respectively. The difference was statistically significant between the groups (P = 0.002). The ease of ETI was comparable between the groups (P = 0.57), and the Cormack–Lehane grade was significantly different between the groups (P = 0.0025). Conclusion: ETI duration was shorter in the MC group than in the VL group. Hence, a MC can be used along with a COVID-19 barrier box by experienced operators for the prevention of aerosol spread. [ABSTRACT FROM AUTHOR]