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AgBiS2 films have recently garnered considerable interest for photovoltaic applications because of their optimal bandgap and high absorption coefficient. Nevertheless, their fabrication has been confined to solution-based processes, which limits their scalability and makes the production of large-area devices challenging. This paper presents the successful fabrication of phase-pure AgBiS2 thin films using a thermal co-evaporation technique and their application in thin-film solar cells. The fabrication process utilized a compositional engineering approach that involved thermal co-evaporation of the precursor powders of Ag2S and Bi2S3. Initial optimization experiments were conducted to determine the optimal Ag/Bi composition and crystallinity. It was found that thin films with a 1 : 1 Ag : Bi ratio post-annealed at 200 °C for 10 minutes exhibited the most favorable microstructure with high crystallinity. Consequently, a notable power conversion efficiency of 1.52% and an open circuit voltage of 346 mV were achieved. These findings pave the way for the production of AgBiS2 thin-film solar cells using the thermal co-evaporation method for both research settings and commercial applications. [ABSTRACT FROM AUTHOR]

Present study employes a picosecond laser (532 nm) for selective P1 laser scribing on the indium tin oxide (ITO) layer and subsequent fine‐tuning of P1 scribing conditions with machine learning (ML) techniques. Initially, the scribing is performed by varying different laser parameters and further evaluate them via an optical microscope and two probe resistivity measurements. The corresponding scribing width and sheet resistance data are used as input databases for ML analysis. The classification and regression tree (CART)‐based ML analysis revealed that median pulse energy <5.7 μJ insufficient to separate the adjacent scribing regions. While pulse energy >5.7 μJ, APL > 35%, LSO > 46%, and processing speed ≥1250 mm s−1 gives ≥16 μm of scribing width. Further, the decision tree (DT) analysis showed that pulse energy of ≥8.1 μJ, and LSO ≥ 37% are required for electrically isolated lines. The feature importance score suggests that laser fluence and pulse energy determined the scribing width, whereas electrical isolation strongly depends on LSO and processing speed. Finally, the ML achieved conditions experimentally validated and reassessed via scanning electron microscope, and atomic force microscopy aligns well with optical microscope measurements. [ABSTRACT FROM AUTHOR]

The study's primary aim is the restoration of native joint line in patients having robotic-assisted unicondylar knee arthroplasty and conventional unicondylar knee arthroplasty. Literature in the past has demonstrated that reducing the joint line can result in greater failure rates. This is a prospective cohort investigation of patients who had medial UKA between March 2017 and March 2022.All patient’s pre-operative and post-operative radiological joint line assessments were examined by two observers by Weber's methods. Robotic-assisted UKA performed with hand-held image-free robots was compared to conventional UKA groups. The distal position of the femoral component was higher in Group B utilizing conventional tools than in Group A employing robotic-assisted UKA. This positional difference was statistically significant. The mean difference among the pre-operative and post-operative joint lines in Group A was 1.6 ± 0.49 (range 0.8 mm–2.4 mm), while it was 2.47 ± 0.51 (range 1.6 mm–3.9 mm) (p 0.005) in Group B. In Group A, a greater percentage of the subjects (64%) attained a femoral component position within two millimeters from the joint line, whereas just 18% in Group B did. When compared with the conventional UKA technique, the meticulous attention to detail and planning for ligament rebalancing when using the robotic-assisted UKA technique not solely enhance surgical precision for implant placing but additionally provides excellent native joint line restoration and balancing. For validation of its longevity and survivability, the cohort must be tracked for a longer period of time. [ABSTRACT FROM AUTHOR]

A strong humoral response against Infectious bursal disease virus (IBDV) in breeder chickens transfers protective maternal immunity in chicks, and protect them from the disease. The present study explains the modulatory effect of silver nanoparticles on humoral immune response against recombinant VP2 (rVP2) protein of IBDV. The hypervariable VP2 gene segment of field IBDV was amplified and cloned into pGEM-T Easy plasmid followed by subcloning into pET32a plasmid vector. Truncated rVP2 protein expressed in E. coli BL32DE3 cells, showed reactivity with specific anti VP2 chicken antibodies. The results of immunoblot revealed its utility in serological diagnosis. The rVP2 protein was evaluated for immunogenic potential by vaccinating the chickens with and without silver nanoparticles (AgNP). The titers induced by rVP2 protein blended with montanide oil were non-significant when compared with titers induced by the conventional vaccines. The IgY response was highly significant in chickens vaccinated with rVP2 protein blended with montanide oil and AgNP than in chickens vaccinated with conventional vaccines or rVP2 protein in montanide oil without AgNP. The results represent Infectious bursal disease virus rVP2 protein as a promising candidate for the differentiation of vaccinated versus infected and sero-diagnostic tools. The current study elucidated the adjuvanticity effect of AgNP on IBDV rVP2 protein potency for the first time. [ABSTRACT FROM AUTHOR]

Germanium selenide (GeSe), a new 2D semiconductor material, is an attractive material due to its excellent optoelectronic properties, which hold tremendous promise in a wide range of applications, including thin‐film solar cells (TFSCs) and photoelectrochemical (PEC) water splitting. Several attempts have been made to date in theoretical studies, high‐quality GeSe material synthesis, evaluating absorber properties, and developing efficient TFSCs and PEC devices. Using existing device topologies for chalcogenide materials, TFSCs with 5.2% efficiency and a PEC device with 3.17% solar‐to‐hydrogen efficiency have been recently developed. To enable its potential in high performances of TFSCs and PEC devices for future large‐scale applications, further improvement in materials quality, device design, and development is required. In this regard, this review provides a comprehensive overview of current advances made in GeSe material development and applications in TFSCs and PEC devices. First, the fundamental properties of GeSe material, theoretical studies, as well as in‐depth synthesis methods, are outlined. Then, key developments in GeSe‐based TFSCs and PEC devices are discussed with an emphasis on device designs. Finally, the most prominent impediments to a fundamental understanding of materials are highlighted, and perspectives on future research directions for improving material quality and device efficiency are provided. [ABSTRACT FROM AUTHOR]

In the Kesterite family, the Cu2ZnSn(S,Se)4 (CZTSSe) thin-film solar cells (TFSCs) have demonstrated the highest device efficiency with non-stoichiometric cation composition ratios. These composition ratios have a strong influence on the structural, optical, and electrical properties of the CZTSSe absorber layer. So, in this work, a machine learning (ML) approach is employed to evaluate effect composition ratio on the device parameters of CZTSSe TFSCs. In particular, the bi-metallic ratios like Cu/Sn, Zn/Sn, Cu/Zn, and overall Cu/(Zn+Sn) cation composition ratio are investigated. To achieve this, different machine learning algorithms, such as decision trees (DTs) and classification and regression trees (CARTs), are used. In addition, the output performance parameters of CZTSSe TFSCs are predicted by both continuous and categorical approaches. Artificial neural networks (ANN) and XGBoost (XGB) algorithms are employed for the continuous approach. On the other hand, support vector machine and k-nearest neighbor's algorithms are also used for the categorical approach. Through the analysis, it is observed that the DT and CART algorithms provided a critical composition range well suited for the fabrication of highly efficient CZTSSe TFSCs, while the XGB and ANN showed better prediction accuracy among the tested algorithms. The present work offers valuable guidance towards the integration of the ML approach with experimental studies in the field of TFSCs. [ABSTRACT FROM AUTHOR]

The Earth‐abundant element‐based Cu2ZnSn(S,Se)4 (CZTSSe) absorber is considered as a promising material for thin‐film solar cells (TFSCs). The current record power conversion efficiency (PCE) of CZTSSe TFSCs is ≈13%, and it's still lower than CdTe and CIGS‐based TFSCs. A further breakthrough in its PCE mainly relies on deep insights into the various device fabrication conditions; accordingly, the experimental–oriented machine learning (ML) approach can be an effective way to discover key governing factors in improving PCE. The present work aims to identify the key governing factors throughout the device fabrication processes and apply them to break the saturated PCE for CZTSSe TFSCs. For realization, over 25,000 data points were broadly collected by fabricating more than 1300 CZTSSe TFSC devices and analyzed them using various ML techniques. Through extensive ML analysis, the i‐ZnO thickness is found to be the first, while Zn/Sn compositional ratio and sulfo‐selenization temperature are other key governing factors under thin or thick i‐ZnO thickness to achieve over 11% PCE. Based on these key governing factors, the applied random forest ML prediction model for PCE showed Adj. R2 = >0.96. Finally, the best‐predicted ML conditions considered for experimental validation showed well‐matched experimental outcomes with different ML models. [ABSTRACT FROM AUTHOR]

Vulvar carcinoma is a relatively rare malignancy and there is a paucity of data, especially from India and other developing countries regarding the prognostic factors impacting recurrence and survival. A retrospective observational study was conducted in the Department of Gynecologic Oncology at a tertiary care, regional cancer institute, including all patients with carcinoma vulva who underwent surgery between 2009 and 2018. Demographic profile, surgical-pathological information, details of neo-adjuvant chemotherapy, adjuvant radiation and chemotherapy, and peri-operative complications were analyzed. Long-term follow-up data was gathered, with an evaluation of various prognostic factors impacting recurrence and overall survival outcome. Forty-five cases with mean age of 56.2 years (range 29–82) were treated during the study period. Surgery was the initial treatment modality in 41 (91.1%) cases. Neo-adjuvant chemotherapy prior to surgery was given to four cases. After complete surgico-pathological staging, most patients had stage I disease (26 cases, 57.8%) and 22.2% had stage II disease. Owing to microscopic lymph node involvement, seven cases (15.6%) belonged to FIGO stage III disease. Two cases had stage IVA disease with fixed groin nodes. Adjuvant chemotherapy in the form of 5-fluoro uracil and cisplatin was administered to four out of the nine patients with nodal involvement. The remaining five were advised adjuvant groin radiation. At a median follow-up of 34 months (range 2–114 months), 12 cases (26.7%) experienced a recurrence and one case with stage IVA disease progressed during adjuvant chemotherapy. The 5-year overall survival was 76.6% and the 5-year disease-free survival was 69.6%. There were a total number of 10 deaths, of which seven were due to disease recurrence or progression and the remaining 30% of deaths were due to medical co-morbid conditions. Overall survival was negatively impacted by increasing age (age > 60 years), number of positive nodes, presence of perinodal spread, and stage of the disease. Recurrence-free survival was significantly reduced in those with the presence of peri-nodal spread and lympho-vascular space invasion. The incidence of lymph node metastasis was found to be higher in patients with age > 60 years, increasing tumor size, presence of lympho-vascular space invasion and the number of lymph nodes removed. In carcinoma vulva, treatment should be individualized with multidisciplinary cooperation. In our series, we found that the stage of disease, nodal positivity, and nodal positivity with extra-capsular spread were significant prognostic factors impacting survival on analysis. Lymph nodal positivity was associated with increasing tumour size, presence of lympho-vascular invasion, and patient age. [ABSTRACT FROM AUTHOR]

The article discusses chronic limb-threatening ischaemia (CLTI), a complication of peripheral artery disease (PAD) that can lead to high amputation rates and mortality. The authors conducted a study using clinical imaging and gene expression studies to examine the microvasculature in the skeletal muscle of CLTI patients. They found that the capillaries in CLTI muscle were abnormally enlarged and arterialized, leading to decreased oxygen delivery and impaired tissue perfusion. The study suggests that future therapies for CLTI should focus on modulating the function of multiple cell types, not just endothelial cells. [Extracted from the article]

The long‐term stability of kesterite Cu2ZnSn(S,Se)4 (CZTSSe) thin‐film solar cells (TFSCs) is crucial for the sustainable mass production of photovoltaic systems. Herein, the improved long‐term stability of CZTSSe TFSCs with an oxide/metal/oxide (OMO)‐based transparent conducting electrodes (TCEs), i.e., ZnO‐based oxide/Ag/Al‐doped ZnO (AZO), and post heating treatment is reported. The effect of the structural, optical, and electrical properties of the OMO TCEs prepared with various bottom oxide materials on the device performance of the CZTSSe TFSCs is systematically investigated. The CZTSSe TFSCs with Ga‐doped ZnO containing OMO TCEs show excellent long‐term stability with only <1% and <20% power conversion efficiency (PCE) losses, whereas for the TFSCs with conventional AZO TCEs, 12% and 69% PCE losses are observed after 5 and 10 months, respectively, without encapsulation and air atmosphere. Detailed analyses reveal that Ag‐doped ZnO formed at the bottom oxide/Ag interface in OMO TCEs passivates the interface. Accordingly, a passivation mechanism for the Ag‐doped ZnO interfacial layer in the OMO TCEs is demonstrated. Herein, a new pathway to improve the long‐term stability of CZTSSe TFSCs without encapsulation and under air atmosphere is offered. [ABSTRACT FROM AUTHOR]

The temperature‐dependent (25–300 °C) disorder transitions analyzed via Raman spectroscopic technique for the different non‐stoichiometric Cu2ZnSn(S,Se)4 (CZTSSe) thin films are demonstrated. In the thin films prepared with different Zn conditions, i.e., in Zn‐1 (Zn‐poor), the density of the A‐type defect cluster [ZnCu + VCu] increases with temperature; however, it slightly decreases and remains constant for Zn‐rich samples, i.e., Zn‐2 and Zn‐3. At the same time, the density of the B‐type defect cluster [2ZnCu + ZnSn] increases with increasing temperature and Zn content. The observations further reveal that Zn concentration has less impact on VCu formation; therefore, above the optimum Cu‐poor and Zn‐rich conditions, ZnCu shallow donors negatively influence the kesterite device performances. Finally, solar cells based on all the CZTSSe thin‐film samples (Zn‐1, Zn‐2, and Zn‐3) are fabricated in which a device based on Zn‐2 exhibits excellent power conversion efficiency of ≈11.0% with open‐circuit voltage of 478 mV, short‐circuit current of 35.51 mA cm−2, and fill factor of 64%, respectively. [ABSTRACT FROM AUTHOR]

The study was conducted to standardise the concentration of Moringa leaf aqueous extract (MLE) as a natural antioxidant for applying on Japanese quail carcasses and its effect on the sensory attribute using semi-trained panellists. The concentration of the extract was selected initially on the basis of phytochemical and antioxidant activities of MLE. The total phenolics and flavonoid content of MLE was 72.16 ± 1.80mg GAE/mL and 12.65 ± 0.83 mg QE/mL of MLE. Analysis of the antioxidant activity of MLE was expressed in terms of IC50 (half maximal inhibitory concentration) value and four best concentrations having antioxidant activity greater than that of the IC50 concentration were selected. IC50 concentration obtained for MLE was 4.60 ±0.20 per cent and 5, 10, 15 and 20 per cents of MLE were selected, having antioxidant activities of 52.22± 1.09, 71.50± 2.23, 82.53± 1.84 and 87.30±1.46 per cents, respectively. Freshly prepared cold MLE solutions were used for dipping of quail carcass for five minutes against cold distilled water as negative control and cold water with synthetic antioxidants (BHA and BHT) as positive control. Sensory evaluation of the raw and cooked quail meat was conducted. No significant difference (p>0.05) was observed. between treatments and controls in the sensory parameters of raw quail carcasses. But there was a significant (p<0.05) difference in sensory attributes of cooked quail carcasses. Carcasses treated with 20 per cent MLE had lower flavour values and overall acceptability scores compared to other treatments and controls. The results indicated that dipping of quail carcasses in MLE (upto 15 per cent) had higher sensory scores and it can be used as a natural antioxidant without affecting the sensory quality. [ABSTRACT FROM AUTHOR]

Asymptomatic infection with rotavirus C (RVC) was observed in pigs in India, with a detection rate of 20%. Sequencing of the VP6, VP7, and NSP4 genes of RVC strains identified the genotypes I7/I10, G1, and E5, respectively. Full genome sequencing of one of these strains revealed that the genotypes of the VP4, VP1, VP2, VP3, NSP1, NSP2, NSP3, and NSP5 genes were P1, R1, C1, M3, A1, N5, T5, and H1, respectively. The detection of porcine RVC strains at two different locations in India at different time points strongly suggests that they are circulating continuously in the pig population through asymptomatic infections. [ABSTRACT FROM AUTHOR]

With the growing need for cost-effective and sustainable Internet of things (IoT) technologies, kesterite-based solar cells are gaining popularity. We report the fabrication of an efficient CZTSSe absorber layer with improved Voc loss and its possible use in indoor photovoltaic applications. The double cation incorporation (co-doping) approach is employed with Ag and Ge to achieve this. The devices fabricated and tested under standard illumination (1 sun) and low light intensity conditions showed enhanced device performances and lower Voc losses after co-doping. Under indoor light conditions, Voc of 290 mV with white LED (WLED) and 310 mV with fluorescent lamp (FL-4000K) was achieved at the lowest intensity of 400 lux, while a value exceeding 350 mV was obtained at 1200 lux with FL-4000K for the CZTSSe:Ag–Ge device. Voc recoveries of >60% under all intensity conditions and >70% at 1200 lux with both WLED and FL-4000K were achieved. Moreover, the CZTSSe:Ag–Ge device showed efficiencies of 4.95% and 5.85% under WLED and FL-4000K at 1200 lux, respectively. The prototype device also demonstrated successful test results under indoor conditions. These achievements are attributed to the enhanced carrier density, reduced density of defects, and low carrier recombinations. [ABSTRACT FROM AUTHOR]

The objective of this study is to analyze the impact of clinicopathological and treatment-related factors on survival in patients with malignant ovarian germ cell tumor. A total of 253 patients of ovarian germ cell malignancy were retrospectively reviewed during 2000–2019. Out of these, 111 had primary treatment at our institute, which is a dedicated regional cancer center. The remaining 142 were operated elsewhere and were referred to us for adjuvant chemotherapy or with recurrent disease. The clinicopathological and treatment-related characteristics were analyzed for association with tumor persistence/recurrence or death. Among them, 107 were dysgerminomas; 60 had endodermal sinus tumor, 53 mixed germ cell tumors, and 31 immature teratoma; and one each had embryoma and primitive germ cell tumor. The median follow-up period was 19 months (range 0–214). Median time to recurrence or progression was 5 months. Forty-nine patients (19.4%) had a recurrence and there were 16 (6.3%) deaths. Five-year disease-free-survival was 71.3% and 5-year overall survival rate was 88.1%, for the entire cohort. Disease-free-survival was 90.4% and overall survival was 92.1% for patients entirely treated at the reporting institute. Sub-group analysis based on treatment adequacy showed that survival rate was 91.0% in patients who had timely and complete initial treatment versus 78.3% in patients where treatment was incomplete or delayed (p = 0.032). Factors affecting relapse were tumor histology, absence of surgical staging, presence of residual disease, inadequate response to chemotherapy, treatment outside reporting institute, and incomplete/delayed chemotherapy. Significant factors adversely affecting survival were presence of post-operative residual disease, tumor histology, incomplete response to chemotherapy, and inadequate/delayed treatment at primary setting. There was no statistically significant difference based on disease stage and whether fertility-sparing surgery or non-fertility-sparing surgery was performed. Prognosis of ovarian germ cell malignancies is excellent with timely, optimal treatment. The outcome improves significantly if managed adequately in the primary setting, involving dedicated gynecologic oncologists. [ABSTRACT FROM AUTHOR]

Nitric oxide (NO) is the critical regulator of VEGFR2-induced angiogenesis. Neither VEGF-A over-expression nor L-Arginine (NO-precursor) supplementation has been effective in helping patients with Peripheral Artery Disease (PAD) in clinical trials. One incompletely studied reason may be due to the presence of the less characterized anti-angiogenic VEGF-A (VEGF165b) isoform. We have recently shown that VEGF165b inhibits ischemic angiogenesis by blocking VEGFR1, not VEGFR2 activation. Here we wanted to determine whether VEGF165b inhibition using a monoclonal isoform-specific antibody against VEGF165b vs. control, improved perfusion recovery in preclinical PAD models that have impaired VEGFR2-NO signaling, including (1) type-2 diabetic model, (2) endothelial Nitric oxide synthase-knock out mice, and (3) Myoglobin transgenic mice that have impaired NO bioavailability. In all PAD models, VEGF165b inhibition vs. control enhanced perfusion recovery, increased microvascular density in the ischemic limb, and activated VEGFR1-STAT3 signaling. In vitro, VEGF165b inhibition vs. control enhanced a VEGFR1-dependent endothelial survival/proliferation and angiogenic capacity. These data demonstrate that VEGF165b inhibition induces VEGFR1-STAT3 activation, which does not require increased NO to induce therapeutic angiogenesis in PAD. These results may have implications for advancing therapies for patients with PAD where the VEGFR2-eNOS-NO pathway is impaired. [ABSTRACT FROM AUTHOR]

The main causes of the large open-circuit voltage (Voc)-deficit in kesterite-based thin-film solar cells (TFSCs) are the high concentration of defects, related defect clusters, and poor band tailing characteristics. We report thorough investigations of defects, defect clusters, and band tailing characteristics in Cu2ZnSn(S,Se)4 (CZTSSe) thin films as well as their impact on device performance. Through detailed analyses, we find that (i) the relative concentration of the ZnCu and SnCu defects and B-type [2ZnCu + ZnSn] and C-type [2CuZn + SnZn] defect clusters plays a critical role in determining the kesterite device parameters such as the Voc, fill factor, and power conversion efficiency (PCE) under Cu-poor and Zn-rich conditions; in particular, we observed that the higher Zn content has minimal impact on VCu formation; though, ZnCu shallow donors over the optimal concentration cause the electron sink/electron localization to facilitate carrier recombination and induce Voc loss in the device. (ii) the trend in short circuit current densities (Jsc) is independent of defects and defect cluster concentrations; (iii) band tailing characteristics calculated from the energy difference between bandgap energy (Eg) from external quantum efficiency (EQE) and photoluminescence (PL) spectra can also be affected by the existence of minor secondary phases on the kesterite surface. This work offers new insights and correlations between defects, defect clusters, band tailing characteristics, and device performance, which will help further improve the performance of kesterite-based TFSCs. [ABSTRACT FROM AUTHOR]

In this study, the nanocomposite of manganese oxide (Mn2O3)/graphene oxide (GO) is deposited on a current collector using the single-nozzle electrospinning method. The effects of the GO concentration (volume %) of the Mn2O3 nanofibers (NFs) on the structural, morphological, and electrochemical properties are investigated systematically. The presence of GO in the Mn2O3 NF samples is confirmed using X-ray diffraction patterns, Raman spectroscopy, and X-ray photoelectron spectroscopy, where sp2 hybridization can be observed. The influence of the GO (volume %) in the Mn2O3 NF samples on the contribution of the capacitive and diffusion-controlled process has been calculated mathematically. GO at 5 vol% in the Mn2O3 sample exhibited a high specific capacitance of 588 Fg−1 at a current density of 0.5 mAcm−2 (2.5 Ag−1) in 1 M aqueous electrolyte with 98% cyclic stability up to 1000 cycles. Furthermore, a coin cell hybrid device was assembled using Mn2O3/GO and a Li-chip as an electrode, 1 M LiPF6 as an electrolyte, and a polypropylene sheet as a separator. This device exhibited a capacitance, an energy density, and a power density of 0.33 F (specific capacitance of 740 Fg−1), 925 Whkg−1, and 3.3 kWkg−1, respectively at a current density of 1 mAcm−2 (2.5 Ag−1) along with 90% retention in capacitance measured till 5000 cycles. [ABSTRACT FROM AUTHOR]

Background: Traditional principles for successful outcomes in Total Hip Arthroplasty (THA) have relied largely on placing the socket in the native position and trying to restore static anatomical femoral parameters gauged on X-rays or intra-operative measurement. Stability is conventionally achieved by making appropriate changes during the time of trial reduction. Post-operative complications of dislocation and significant Limb Length Discrepancy (LLD) requiring foot wear modification represents opposite ends of the spectrum from a biomechanical perspective and these continue to be relatively high. A move towards giving more importance to functional dynamic parameters rather than static anatomical parameters and less reliance on stability testing at trial reduction is warranted. Methods: Intraoperative 3D functional balancing of THA without stability testing at trial reduction was practiced in all subjects undergoing THA in our unit from April 2014. To date 1019 patients have had their hips replaced with the same technique. They were followed up till April 2020 for post-operative complications of dislocation and significant LLD needing footwear modification. A secondary cohort of 114 patients from 1st January to December 31st 2017 within this primary group were analyzed clinically and radiologically to ascertain the implications of functional 3D balancing on X-ray parameters, clinical outcome scores (Harris Hip Score and Oxford Hip Score), ability to squat, and subtle subjective post-operative perception of limb lengthening (POPLL). Results: In the primary group of 1019 patients, there were only two dislocations and no patient needed footwear modification for LLD. In the detailed analysis of the secondary cohort of 114 patients, the correlation with restoration of static radiological parameters was inconsistent. 40 patients could not squat and 4 patients had subtle subjective post-operative perceived limb lengthening (POPLL). Measured outcomes such as HHS and OHS were improved in all patients with significant statistical significance (P < 0.001). Conclusion: This study underlines the fact that more importance must be given to functional dynamic parameters by 3D balancing of the THA and not on static anatomical X-rays parameters and stability testing during trial reduction. This represents a paradigm shift in the evolution of total hip arthroplasty. Level of Evidence: A Level II study. (Data collected from the ongoing prospective study) (http://www.spine.org/Documents/LevelsofEvidenceFinal.pdf). [ABSTRACT FROM AUTHOR]

Background: Total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) are already proven good for end-stage arthritis in the older populations but it is challenging in young teenage patients. The primary aim was to assess Hip Disability and Osteoarthritis Outcome Score (HOSS), Harris Hip Score (HHS) and secondary aim for implant survival rate. Materials and Methods: The details of 33 teenage patients (forty hips) who underwent HRA (21) and THA (19) at our institution (January 2002 to December 2013) with a mean follow-up period of 11.00 years (range 7.00–18.40) were included. The study group had 25 males and eight females. Results: The overall median HOOSs with interquartile range were 89.00 (87.63–0.00). The median HOOSs at follow-up were as follows: 95.00 (90.00–95.00) for symptoms, 92.00 (90.00–95.00) pain, 87.00 (85.00–90.00) for functions, 81.00 (75.00–85.00) for sports and 94.00 (88.00–95.00) for QOL. HHS improved significantly from 36.88 ± 6.14 to 90.12 ± 6.56 (p < 0.001). The HHS of HRA group improved from 36.29 ± 5.83 to 89.38 ± 5.23 and THA group improved from 37.26 ± 6.22 to 90.94 ± 7.84. The 5-year radiological follow-up X-rays did not show any radiolucent line wider than 2 mm in all three zones of the acetabulum and no progressive subsidence or migration of > 1 mm and divergent radiopaque line in femur. The Implant survival rate for HRA was 100% at 5 years, 100% at 10 years, 92% at 15 years and THA group was 100% at 5 years and 90% at 10 years. Conclusion: Our study showed a disability rate of zero with improved HOSS and HHS. The overall implant survival rate was good with 100% at 5 years, 97% at 10 years and 89.9% at 15 years in contrast to the previous studies with the use of modern implants and newer standard surgical techniques. Level of Evidence: A Level II study http://www.spine.org/Documents/LevelsofEvidenceFinal.pdf. [ABSTRACT FROM AUTHOR]

Background: Recent advances in radiation technology has allowed to significantly reduce toxicity and improve the efficacy of radical radiotherapy in head and neck and oral squamous cell cancers. Insights into molecular biology of carcinogenesis has opened a window for identifying aggressive clinical situations that may benefit with larger clinical target volume (CTV ) margin, broader levels of nodal coverage, or alternative radiation sensitizers.Aim: To evaluate the potential role of eukaryotic translation initiation factor 4E (elF4E) and p53 as predictive biomarkers in resected margins of head and neck and oral cancers.Material and Methods: Forty patients with oral cancers and 26 patients with head and neck cancers were evaluated for p53 and eIF4E in their negative surgical margins, for pattern of distribution and outcome.Results: In oral cancers, 27 patients (67.5%) were positive for p53 and 10 (25%) for eIF4E in surgically negative margins. For head and neck cancer, the values were 13 (50%) for p53 and 9 (34.6%) for eIF4E. Twelve patients with oral cancers and 8 patients with head and neck cancers had local failure or death. The association with these biomarkers did not achieve statistical significance. However, adjuvant radiotherapy had a significant protective value. It improved median survival from 15 to 21 months in patients positive for p53 (P = 0.018) and from 12 to 20 months (P = 0.03) in those with eIF4E. There was no predictive association of subsite, tumor size, or nodal status.Conclusion: The overexpression of p53 and eIF4E in pathologically negative margins may represent a subset of patients who would benefit from early initiation of adjuvant radiation and tailored intensity-modulated radiotherapy (IMRT). [ABSTRACT FROM AUTHOR]

The objectives of this study are to assess the role of non-chemotherapeutic combination of drugs as maintenance therapy, after standard treatment, for advanced epithelial ovarian cancers (EOC) and to determine the recurrence-free survival (RFS) and cancer-specific survival (CSS). One hundred women with advanced high-grade EOC who had completed standard treatment by primary/interval debulking surgery followed by adjuvant chemotherapy were randomised to either receive (study group) or not to receive (control group) the non-chemotherapeutic maintenance therapy (oral metformin, anastrozole, aspirin, atorvastatin, vitamin D, injection zoledronic acid). Both groups were followed up, and trends of RFS and CSS were analysed. One hundred patients were analysed. Median RFS was 18 months (95% CI: 13–24) in study group versus 16 (95% CI: 14–20) in the control group (P value = 0.57). Median CSS in the study group was lesser than that in the control group (47 months (95% CI: 31–68) versus 51 (95% CI: 32–66), P value = 0.76). Five-year CSS was not significantly different between the groups (47% study vs 40% control, P value = 0.51). The use of combination of non-chemotherapeutic drugs as maintenance therapy was found to have no significant impact on the survival or reduction of recurrences in patients with advanced epithelial ovarian cancer. [ABSTRACT FROM AUTHOR]

To study the clinical, biochemical, radiological, pathological characteristics, surgical treatment details, and follow-up of growing teratoma syndrome (GTS) patients. This is a retrospective study of GTS treated in the Department of Gynaecological Oncology at a regional cancer institute from March 2000 to March 2020. A total of 303 cases of germ cell ovarian cancers were treated, and 8 (2.6%) of 303 cases recurred as GTS during this period. The patients presenting with recurrent GTS were studied for clinical, radiological, tumor markers, surgical management, histopathology, and post-operative follow-up details that were analyzed retrospectively. The Kaplan-Meier curve was used for the survival analysis. The 8 out of 303 cases of germ cell ovarian cancers recurred as GTS and the incidence rate is 2.6% during this period. In the six (75%) of eight cases, the histopathology report was immature teratoma ovaries. The five cases (62.5%) were in advanced stage. All the eight recurrent GTS cases received optimal surgical cytoreduction. The overall disease-free survival is 85.7% and one patient has recurrence after the surgery for GTS at 23rd month of follow-up visit. All the patients are alive till date. The GTS represents a rare clinical and pathological phenomenon. Nevertheless, GTS should be considered as one of the differential diagnosis in young patients having normal tumor markers with recurrent carcinomatosis following the primary treatment germ cell tumors of ovaries. The optimal cytoreduction of recurrent GTS leads to prolonged survival and possible cure in young patients. [ABSTRACT FROM AUTHOR]

Background: National Mental Health Program (NMHP) was launched by the government with an aim to improve mental health of the society through precise and focused interventions and policies. In order to provide reliable data and evidence for NMHP, there is a strong requirement of a comprehensive system for integrative collection, storage, and analysis of data generated by this program. Methods: Data collection tools, questionnaires, instruments, and scales provided by the National Coordinating Unit were digitized using the District Health Information Software 2 (DHIS2) framework (version 2.30). The rules for data validation and automated scoring were implemented as per the scales. The developed system (i-MANN, ICMR-Mental Health Assessment National Network) is based on modular architecture with role-based access to data input forms and dashboards. Results: The data are stored on a centralized server at ICMR. i-MANN captures data on basic and advanced demographic details followed by category specific forms from 15 multicentric ICMR-funded projects. Data collection module is divided into 12 categories containing 93 scales/instruments with built-in validation rules, scoring patterns, and indicators. As of August 2020, the system contains 17,690 records. Conclusions: i-MANN is the first web-based, modular, robust, and extendable system for collection, integration, management, and analysis of data on mental health in India. [ABSTRACT FROM AUTHOR]

Background: Uncemented total hip arthroplasty (THA) with large size femoral heads have shown greater advantage with good stability, range of motion and decreased dislocation rate in ankylosing spondylitis (AS). Meticulous planning is needed to address the unique surgical challenges in such patients with fused hip and spinal deformity. Materials and Methods: Thirty fivefused hip joints in twenty-five AS patients who underwent uncemented THA (April 2014 to December 2016) were included in our prospective study and were followed up for a minimum period of 36 months. Pain relief, functional improvement and patient satisfaction were statistically assessed using "Visual Analogue Score" (VAS), "Harris Hip Score" (HHS) and "AJRI 10-Point Satisfaction Score" (A10PSS), respectively. Results: The overall mean preoperative VAS improved from 6.9 ± 1.5 to 1.5 ± 1, HHS improved from 50.0 ± 12 to 88.4 ± 7.8 and A10PSS improved from 2.2 ± 1.2 to 7.6 ± 0.8. Our study results were significant with zero dislocation and good functional score in comparison to the other available studies in literature. First subdivision study in AS patients with bilateral THA performed better than unilateral THA. Second subdivision study showed no significant statistical difference in terms of VAS, HHS, A10PSS and dislocation rate in relation to femoral head size between 32 mm, 36 mm and 40 mm. Conclusion: Uncemented THA with large size femoral head equal or greater than 32 mm provides better stability and good functional outcome with less dislocation rate in comparison to older studies of literature with femoral head size less than 32 mm. Level of Evidence: A Level II study. (Data collected from the ongoing prospective study) (https://www.spine.org/Documents/LevelsofEvidenceFinal.pdf). [ABSTRACT FROM AUTHOR]

Introduction: Post-dural puncture headache (PDPH) is an iatrogenic complication associated with spinal anaesthesia. The occurrence of PDPH is determined by different factors. They are sex, age, pregnancy, past PDPH history, needle tip shape and needle size, bevel orientation, number of attempts, and approach used for lumbar puncture. We conducted the present study to find the incidence of PDPH. Material and Method: After ethics committee approval, we observed 500 patients who had undergone surgery for lower abdomen and lower limb. Patients were randomly divided in Group A and Group B 250 patients in each group and received spinal anaesthesia via 23 and 25 quincke spinal needle respectively. They were followed post operatively regularly for development of any signs and symptoms of post dual puncture headache, which was end point of study. Results: Out of 500 patients 6 patient developed PDPH. The incidence was 1.2%. There was no statistically significance with sex, number of attempts and guage of spinal needle. Conclusion: In our series the incidence was 1.2% which is far less than other studies. Taking into consideration cost effectiveness & success rate we feel that in our setup we can continue with use of 23 & 25-gauge quincke needle. [ABSTRACT FROM AUTHOR]

Background: Empyema thoracis is an entity seen across all age groups. This study aims at reporting a detailed microbiological profile of "pus and pleural tissue" in patients operated for empyema thoracis and also correlating it with perioperative clinical outcomes. Materials and Methods: Patients operated for empyema thoracis between 2012 and 2016 were included in the study. Patients were taken up for surgery after thorough preoperative evaluation. Perioperative outcomes were correlated with the results of microbiological analysis to evaluate their effect on clinical outcomes. Results: In the study, 285 patients were operated. There were 215 males (75.4%) and 70 females (24.6%). Tuberculosis (TB) was responsible for 58.2% of the cases (n = 166). Of 166, 32 patients were mycobacterial culture positive, suggesting 19.28% mycobacterial culture positivity rate. 21.8% of the total mycobacterial cultures were multidrug resistant. TB culture-positive patients had a significantly higher incidence of air leak (P = 0.03), inter-costal drain (ICD) duration (P = 0.03), and higher rates of recurrence (P = 0.03). Nontubercular empyema constituted 119 cases (41.8%). Forty-seven (39.5%) cases were culture positive. Gram-negative organisms were cultured in 30 (63.8%). Pseudomonas aeruginosa was the predominant isolate. Bacterial culture-positive patients had significantly higher conversions (P = 0.03), prolonged postoperative air leak (P = 0.04), and postoperative wound infections. Conclusions: This study highlights the emergence of Gram-negative organisms in bacterial empyema and emergence of multidrug resistance in tubercular empyema. Clinical outcome correlation revealed increased complications in culture-positive cases in both tubercular and nontubercular empyemas. [ABSTRACT FROM AUTHOR]

The impact of socioeconomic status on health has been established via a broad body of literature, largely from high-income countries. Investigative efforts in low- and middle-income countries have suffered from a lack of reporting standardization required to draw comparisons across countries of varying economic strata. In this study we aimed to evaluate the impact of socioeconomic status on emergency department outcomes in a low-income African country using international data classification systems. This was a retrospective cohort study was conducted at a tertiary care center in northern Madagascar. Data were abstracted from paper charts into an electronic registry using Integrated Public Use Microdata Series codes for occupation, Nam-Powers-Boyd (NPB) scores for socioeconomic status, and Clinical Classifications Software ICD-9 equivalents for diagnosis. Outcome was dichotomized to the combined disposition of death or transfer directly to operating theater (OT) versus discharge. We used t-tests to compare baseline characteristics between these groups. We used chi-square analysis to test the association between occupational class and diagnosis. Finally, multivariate logistic regression analysis was performed examining the impact of NPB score on death/OT outcome, adjusting for age, gender, diagnosis and occupation. 5271 patients were seen during the 21-month study period with a death/OT rate of 9.7%. Older age and male gender were more common in death/OT patients (both p<0.001), and were shown to have positive odds ratios for this outcome in multivariate modeling (p<0.006 and <0.001). Occupational class was found to influence diagnosis for all classes (p<0.001) except Sales and Office. Adjusting for these 3 factors, we found a strong independent association between NPB quartile and death/OT outcome. Relative to the 1st quartile, the odds ratio in the 4th quartile was 2.9 (p = 0.004), the 3rd quartile 1.8 (p = 0.094), and the 2nd quartile 3.1 (p<0.001). To our knowledge, this is the first Malagasy study describing the relationship between socioeconomic status on emergency care outcomes. We found a stronger effect on health in this setting than in high-income countries, highlighting an important healthcare disparity. By using standardized classification systems we hope this study will serve as a model to facilitate future comparative efforts. [ABSTRACT FROM AUTHOR]

Introduction: The fear of pleural adhesions and densely stuck lymph nodes in India, a country where tuberculosis is endemic, is one major factor keeping our surgeons away from video-assisted thoracoscopic surgery (VATS) lobectomy. In this paper, we aim to report our experience with performing VATS lobectomy in 102 cases using a standardised three-port anterior approach. Materials and Methods: Between March 2012 and September 2016, we performed 102 VATS lobectomies. Sixty patients (58.8%) were males and 42 females (41.2%), with a mean age of 42.02 years. Diagnoses were as follows: benign disease (72), lung cancer (27) and pulmonary metastases (3). Among the cases with primary lung cancer, twenty out of 27 (74%) were adenocarcinoma and 7 cases of squamous carcinoma (25.92%). All patients underwent lobectomy by a standardised three-port anterior approach. Results: The overall conversion rate was 8.82% (n = 9). We observed no postoperative complications in 82 (80.4%) patients. The average blood loss was 211.37 ml. Mean operative time was 173 min. Median length of hospital stay was 5 with median chest tube duration of 4.9 days. There was no in hospital or 30-day mortality. The most common complication was prolonged air leak. Conclusion: From this first Indian series, it is clear that VATS lobectomy is feasible in both benign and malignant cases. It also shows that the fear of adhesions is unwarranted and properly selected benign cases can also undergo VATS lobectomy safely. [ABSTRACT FROM AUTHOR]

Context: Acute lymphoblastic leukemia (ALL) shows substantial differences in clinical and laboratory features and treatment responsiveness in different subgroups. Pediatric ALL <2 years is associated with worse outcome. Infantile ALL is characterized by high white blood cell (WBC) counts, bulky extramedullary disease, translocations of 11q23 locus. There is paucity of data on ALL under 2 years of age. Aims: This study aims to analyze clinical, hematological, biochemical, immunophenotypical parameters, and treatment responsiveness of ALL under 2 years. Settings and Designs: It is a retrospective data analysis conducted at a Tertiary Care Cancer Centre in South India. The study population includes all pediatric ALL, registered at this institute during January 2009 to December 2013, who were under 2 years at the time of presentation. Materials and Methods: There were 122 cases of ALL under 2 years of age of whom 48 refused treatment, and four were lost to follow-up. Thus, 70 cases are eligible for analysis. Details on clinical, hematological, biochemical, radiological, immunophenotypical, and cytogenetic features were collected from case records, hospital cancer registry, and analysis done using SPSS version 20. Kaplan-Meier curves plotted for survival analysis. Results: Male:female ratio was 1.26:1 (infants - 1:1; 1-2 years group - 1.3:1). The most common clinical features were hepatomegaly (95%) and fever (89%). Hemoglobin level >11 gm% was seen in 12%, WBC counts above 50,000 in 26% and platelets below 20,000 in 20%. Elevated lactate dehydrogenase presents in 64% and uric acid in 12%. Immunophenotype done in 44 children; precursor-B ALL-41, precursor-T ALL-3. Central nervous system-positive disease and 11q23 translocation were noted in one infant each. Conclusions: Infants with ALL are associated with poor prognosis. Children in the 1-2 years are associated with significantly better outcome. WBC counts >50,000 are associated with poor prognosis among infants. Treatment refusal/abandonment rate is 43% in the study population which is comparable to that in literature. [ABSTRACT FROM AUTHOR]

We built a whole-body computational model to study the role of the poorly understood vascular endothelial growth factor (VEGF)165b splice isoform in peripheral artery disease (PAD). This model was built and validated using published and new experimental data from cells, mice, and humans, and explicitly accounts for known properties of VEGF165b: lack of extracellular matrix (ECM)-binding and weak phosphorylation of vascular endothelial growth factor receptor-2 (VEGFR2) in vitro. The resulting model captures all known information about VEGF165b distribution and signaling in human PAD, and provides novel, nonintuitive insight into VEGF165b mechanism of action in vivo. Although VEGF165a and VEGF165b compete for VEGFR2 in vitro, simulations show that these isoforms do not compete for VEGFR2 at much lower physiological concentrations. Instead, reduced VEGF165a may drive impaired VEGFR2 signaling. The model predicts that VEGF165b does compete for binding to VEGFR1, supporting a VEGFR1-mediated response to anti-VEGF165b. The model predicts a key role for VEGF165b in PAD, but in a different way than previously hypothesized. [ABSTRACT FROM AUTHOR]

Introduction: Surgical management of pulmonary aspergilloma in symptomatic patients offers a significant chance of cure. Video-assisted thoracic surgery is a valid alternative for properly selected cases. We herein report our experience with thoracoscopic management of pulmonary aspergilloma. Patient and Methods: This retrospective analysis was performed on 41 patients operated between 2012 to 2015. The patient records were thoroughly analyzed for demography, clinical presentation, computed tomography, the procedure performed, post-operative complications and course during 6 month's follow up. Results: Out of total 41 patients, 23 (56%) were treated by VATS and 18 (44%) by thoracotomy. Average intraoperative blood loss was 214 ml (±106) in VATS group and 461 ml (±167) in thoracotomy. Mean operative time was 162 (±14) minutes in VATS and 239 (±12) minutes in thoracotomy group. In VATS group, postoperative complications were found in 5 patients and in 11 patients in the thoracotomy group. Average duration of chest tube was 5.43 () days in VATS group and 8.94 () days in thoracotomy group. Average length of hospital stay was 5.04 in VATS group and 6.55 days in thoracotomy group. Conclusions: VATS for pulmonary aspergilloma, if applicable, may be a safe and efficacious option in experienced hands. Simple aspergilloma, in particular, is considered to be a good indication for VATS. Some cases of complex aspergilloma may also be amenable to VATS. However, the long term results need to be further analyzed using a larger study group. [ABSTRACT FROM AUTHOR]

Context (Background): We report our experience with robotic thymectomy in patients with myasthenia gravis (MG)and provide data on the surgical results and neurologic outcomes, as per the Myasthenia Gravis Foundation of America (MGFA) recommendations for MG clinical research standards.Objective: The study aims at reporting the surgical and neurological outcomes of patients of Myasthenia gravis treated by robotic thymectomy.Materials and Methods: Prospective data was collected from 71 patients with myasthenia gravis (in the age range 15-67 years) with or without thymoma, who had completed a minimum follow up of one year. All patients were treated with robotic radical thymectomy. The clinical classification, status of preoperative and postoperative therapy, evaluation of post-interventional clinical status, and descriptions of morbidity/mortality were done as per the MGFA recommendations. Univariate and multivariate analysis was done to assess the factors associated with achievement of complete stable remission(CSR).Results: A total of 71 patients were included in this study. Twenty-one out of 71 patients (29.6%) with myasthenia gravis had thymoma. At the last follow up, 70 patients were alive. No evidence of tumour recurrence was found in patients with thymoma. The overall CSR rate was 38% with the median time to CSR of 17.5 months (range 11-48 months). The CSR rate for patient of MG with thymoma was 19 % (n=4/21). Factor found to be significantly predicting CSR were young age, lesser severity of MG and non-thymomatous histology.Conclusions: Robotic thymectomy is a technically feasible and safe operation with a low morbidity and short hospitalization. It is associated with good neurological long-term results in terms of both CSR and clinical improvement. [ABSTRACT FROM AUTHOR]

The perennial grasses are considered as a rich source of lignocellulosic biomass, making it a second generation alternative energy source and can diminish the use of fossil fuels. In this work, four perennial grasses Saccharum arundinaceum, Panicum antidotale, Thysanolaena latifolia, and Neyraudia reynaudiana were selected to verify their potential as a substrate to produce hydrolytic enzymes and to evaluate them as second generation energy biomass. Here, cellulase and hemi-cellulase producing three endophytic bacteria (Burkholderia cepacia BPS-GB3, Alcaligenes faecalis BPS-GB5 and Enterobacter hormaechei BPS-GB8) recovered from N. reynaudiana and S. arundinaceum were selected to develop a triculture (CC3) consortium. During 12 days of submerged cultivation, a 55-70% loss in dry weight was observed and the maximum activity of b-glucosidase (5.36-12.34 IU) and Xylanase (4.33 to 10.91 IU) were observed on 2nd and 6th day respectively, whereas FPase (0.26 to 0.53 IU) and CMCase (2.31 to 4.65 IU) showed maximum activity on 4th day. Around 15-30% more enzyme activity was produced in CC3 as compared to monoculture (CC1) and coculture (CC2) treatments, suggested synergetic interaction among the selected three bacterial strains. Further, the biomass was assessed using Fourier-transform infrared spectroscopy (FTIR) and Scanning electron microscopy (SEM). The FTIR analysis provides important insights into the reduction of cellulose and hemicellulose moieties in CC3 treated biomass and SEM studies shed light into the disruption of surface structure leading to access of cellulose or hemicelluloses microtubules. The hydrolytic potential of the CC3 system was further enhanced due to reduction in lignin as evidenced by 1-4% lignin reduction in biomass compositional analysis. Additionally, laccase gene was detected from A. faecalis and E. hormaechei which further shows the laccase production potential of the isolates. To our knowledge, first time we develop an effective endophytic endogenous bacterial triculture system having potential for the production of extracellular enzymes utilizing S. arundinaceum and N. reynaudiana as lignocellulosic feedstock. [ABSTRACT FROM AUTHOR]

Clostridium difficile infection (CDI) is characterized by dysbiosis of the intestinal microbiota and a profound derangement in the fecal metabolome. However, the contribution of specific gut microbes to fecal metabolites in C. difficile-associated gut microbiome remains poorly understood. Using gas-chromatography mass spectrometry (GC-MS) and 16S rRNA deep sequencing, we analyzed the metabolome and microbiome of fecal samples obtained longitudinally from subjects with Clostridium difficile infection (n = 7) and healthy controls (n = 6). From 155 fecal metabolites, we identified two sterol metabolites at >95% match to cholesterol and coprostanol that significantly discriminated C. difficile-associated gut microbiome from healthy microbiota. By correlating the levels of cholesterol and coprostanol in fecal extracts with 2,395 bacterial operational taxonomic units (OTUs) determined by 16S rRNA sequencing, we identified 63 OTUs associated with high levels of coprostanol and 2 OTUs correlated with low coprostanol levels. Using indicator species analysis (ISA), 31 of the 63 coprostanol-associated bacteria correlated with health, and two Veillonella species were associated with low coprostanol levels that correlated strongly with CDI. These 65 bacterial taxa could be clustered into 12 sub-communities, with each community containing a consortium of organisms that co-occurred with one another. Our studies identified 63 human gut microbes associated with cholesterol-reducing activities. Given the importance of gut bacteria in reducing and eliminating cholesterol from the GI tract, these results support the recent finding that gut microbiome may play an important role in host lipid metabolism. [ABSTRACT FROM AUTHOR]

Aims and objectives of the study was to determine the genetic mutations responsible for CNS mutation and tubulinopathies and to determine the mode of investigation and associated features seen on non-invasive antenatal modalities. Patients with CNS genetic syndromes or tubulinopathies in fetus of the present pregnancy or previous pregnancy who presented themselves only for genetic counseling with the genetic analysis report done at an outside diagnostic centre were selected. [Extracted from the article]

To investigate the gastro protective and antioxidant activities of methanolic extract ofTaverniera cuneifolia(Roth) Arn. Gastric ulcers were produced by administration of ethanol and pylorus ligation in albino Wister rats. Free radical scavenging activity was evaluated by using DPPH, Nitric oxide, DNA Damage Scavenging methods.Taverniera cuneifoliaextract treated group decreased the dose dependently gastric content, acidity, ulcer index and TBARS of gastric content. In this study the DPPH and Nitric oxide radical is significantly reduced by solvent extract and standard with increasing concentration. The maximum prevention of DNA damage was found at 4 µg/ml concentration. The gastro protective property of methanolic extract ofTaverniera cuneifoliain pylorus ligation model has been demonstrated to reduce the number of ulcer and ulcer index. The present study suggests that methanolic extract ofTaverniera cuneifoliaroots are beneficial in the treatment of gastric ulcer. [ABSTRACT FROM PUBLISHER]

Background: Efforts to develop effective and regionally-appropriate emergency care systems in sub-Saharan Africa are hindered by a lack of data on both the burden of disease in the region and on the state of existing care delivery mechanisms. This study describes the burden of acute disease presenting to an emergency unit in Mahajanga, Madagascar. Methods and Findings: Handwritten patient registries on all emergency department patients presenting between 1 January 2011 and 30 September 2012 were reviewed and data entered into a database. Data included age, sex, diagnosis, and disposition. We classified diagnoses into Clinical Classifications Software (CCS) multi-level categories. The population was 53.5% male, with a median age of 31 years. The five most common presenting conditions were 1) Superficial injury; contusion, 2) Open wounds of head; neck; and trunk, 3) Open wounds of extremities, 4) Intracranial injury, and 5) Unspecified injury and poisoning. Trauma accounted for 48%, Infectious Disease for 15%, Mental Health 6.1%, Noncommunicable 29%, and Neoplasms 1.2%. The acuity seen was high, with an admission rate of 43%. Trauma was the most common reason for admission, representing 19% of admitted patients. Conclusions: This study describes the burden of acute disease at a large referral center in northern Madagascar. The Centre Hôpitalier Universitaire de Mahajanga sees a high volume of acutely ill and injured patients. Similar to other reports from the region, trauma is the most common pathology observed, though infectious disease was responsible for the majority of adult mortality. Typhoid fever other intestinal infections were the most lethal CCS-coded pathologies. By utilizing a widely understood classification system, we are able to highlight contrasts between Mahajanga’s acute and overall disease burden as well as make comparisons between this region and the rest of the globe. We hope this study will serve to guide the development of context-appropriate emergency medicine systems in the region. [ABSTRACT FROM AUTHOR]

Introduction: We retrospectively evaluated our experience with modified Cantwell--Ransley epispadias repair at our center to determine the complications and long-term results. Materials and Methods: We retrospectively reviewed the case records of 43 male children with a mean age of 9.13 ± 1.94 years who underwent primary epispadias repair at our center. The results of epispadias repair were assessed by both physical and endoscopic examination. All children who were old enough to opine as well as all parents/guardians were interviewed during the follow-up visits. Results: Urethrocutaneous fistulae occurred in 17.85% (5/28) children of the classic bladder exstrophy group and in 13.33% (2/15) children with penopubic epispadias. Postoperative cystoscopy done 12 weeks after repair revealed a smooth urethral tube in 81.39% (35/43) of children. With the patient in a standing position, the penis was dangling downward or in a horizontal position in 88.37% (38) of children, 85% of the patients ≥18 years of age were satisfied with both the functional and cosmetic outcome, as assessed by short form 36 and 93.02% (40/43) of the patients were continent during the daytime with voided volumes of more than 200 ml. Conclusion: In our experience, Cantwell--Ransley repair creates a functionally and cosmetically acceptable penis and produces a reliably tubularized neourethra with acceptable complication rates. [ABSTRACT FROM AUTHOR]