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Ankylosing spondylosis (AS) is characterised by bilateral sacroiliitis, asymmetric peripheral oligoarthritis, association with the human leucocyte antigen-B27, enthesitis and dactylitis. The association of IgA vasculitis with AS has been documented in few case reports. We present a rare case of a man in his 40s with AS, who presented with fever, bloody loose stools, abdominal pain, lower limb arthritis, palpable purpura over the lower limbs. He subsequently, also developed renal involvement in the form of proteinuria. His skin biopsy showed evidence of leucocytoclastic vasculitis, while renal biopsy showed focal proliferative, necrotising IgA glomerulonephritis. He was thus diagnosed to have Henoch Schonlein purpura with IgA nephropathy in the background of AS. He was treated with steroids and mycophenolate mofetil with resolution of his symptoms.

Abstract: The tea tree (Melaleuca alternifolia), a member of the Myrtaceae family, is a valuable medicinal and aromatic plant. Tea Tree essential oil (TTO) has many medical applications, including antibacterial, antifungal, antiviral, antiprotozoal, anti-inflammatory, antioxidant, and anticancer properties. Although the concentration of TTO in a microemulsion is of economic interest, very few studies on this product have been conducted. In this study, we look at how different tea tree oil concentrations in microemulsion formulations affect susceptibility to various bacteria and fungi. TTO susceptibility in a diverse range of microbial species has now been studied using data from a previously published literature review survey. Most bacteria are resistant to TTO at concentrations as low as 1.0 percent, but mucosal skin staphylococci and micrococci, Enterococcus faecalis, and Pseudomonas aeruginosa have minimum inhibitory concentrations much higher than 2 percent. TTO susceptibility in fungi has only recently been scrutinized. Fungicidal dosages range from 0.12 to 2 percent, with minimum inhibitory concentrations ranging from 0.03 to 0.5 percent and the only notable exception is Aspergillus niger, which contains fungicidal concentrations of up to 8%. The review emphasizes the importance of new antibacterial and antifungal formulations, as well as the role of natural essential oils in the discovery of new antibacterial and antifungal agents, and discusses, in brief, all constituents derived from the essential oil (tea tree) that are in preclinical and clinical development. This paper summarizes human and food-borne bacteria and fungi susceptibility to tea tree essential oils and their constituents. Among the many tested, essential oils of spices and herbs (Melaleuca alternifolia) were found to have the strongest antimicrobial properties. This review looks at a wide range of scientific literature, including Sci-hub, Google Scholar, Pub, Chem, NCBI, and web books.

Locusts are the most dangerous agricultural pests. They are belonging to family Acrididae. Gregarious locusts travel in swarms from one location to another in adult form. The desert locust, Schistocerca gregaria (Forskal), is one of the grasshopper species that cause crop damage and can fly up to 150 km in the direction of the wind. The present state of knowledge on its biological regulation employing microbes and plant extracts is discussed. Metarhizium flavoviride was among the first fungi to be identified in the laboratory and field as a bio-control agent against desert locust. Following extensive investigation, with integrated pest management stratedies using these bio-controls would be a viable option for controlling desert locust infestations. Against the desert locust, IPM (Integrated Pest Management) approaches that emphasize the successful combination of chemical and biological insecticides with prediction and monitoring technology have been encouraged. Recent experimental investigations and researches are mainly focusing on identifying viable answers through financial collaboration between governmental and non-governmental organizations. The authors highlighted the loss in the agricultural sector due to desert locust infestation, as well as its sophisticated control and management solutions, after evaluating publications from numerous journals, magazines, and symposia.

International audience; Digital data plays a central role in sciences, journalism, environment, digital humanities, etc. Open Data sharing initiatives lead to many large, interesting datasets being shared online. Some of these are RDF graphs, but other formats like CSV, relational, property graphs, JSON or XML documents are also frequent.Practitioners need to understand a dataset to decide whether it is suited to their needs. Datasets may come with a schema and/or may be summarized, however the first is not always provided and the latter is often too technical for non-IT users. To overcome these limitations, we present an end-to-end dataset abstraction approach, which (i) applies on any (semi)structured data model; (ii) computes a description meant for human users, in the form of an Entity- Relationship diagram; (ii) integrates Information Extraction and data profiling to classify dataset entities among a large set of intelligible categories. We implemented our approach in a system called Abstra, and detail its performance on various datasets.

Abstract: Derivatives of 1,3,4-oxadiazole are effective in the treatment and cure of a wide range of diseases in medical chemistry, while industrial development has shown that they can be utilised as corrosion inhibitors and light-emitting diodes. The researchers discovered several promising synthetic strategies that created 1,3,4-oxadiazoles in extraordinarily high yields while using environmentally friendly methods. These compounds can potentially be used in a wide range of lifechanging applications. Stable isomeric oxadiazole forms of pleconaril, raltegravir, butalamine, fasiplon, oxolamine, and several other drugs are among the numerous potent and effective pharmaceuticals that are now on the market. Fasiplon, butalamine, raltegravir, and pleconaril treat HIV/AIDS patients. This article has attempted to bring attention to the chemistry and pharmacology of oxadiazole and its derivatives. Oxadiazole derivatives have been used extensively as prospective therapeutic agents in clinical research, and this has become standard practice. The use of biological and in-silico models has enabled scientists to identify more synthetic analogues of cancer prevention, antifungal, and anti-HIV medications. This article provides recent information regarding procedures for synthesizing 1,3,4-oxadiazoles and their biological actions on the body.

BACKGROUND: We have study the Coulomb drag phenomena for hole-hole static potentials theoretically and measured numerically using the random phase approximation (RPA) method OBJECTIVE: The drag resistivity is evaluated at low temperature, large interlayer separation limit and weakly screening regime, with the geometry of two atomically thin materials, such as, BLG/GaAs based multilayer system, is a promising systems in nanomaterials and technology METHOD: Static local field corrections (LFC) are considered to take into account the Exchange-correlations (XC) and mutual interaction effects with varying concentrations of active and passive layer RESULT: It is found that the drag resistivity is found enhanced on using the LFC effects and increases on increasing the effective mass. In Fermi-Liquid regime, drag resistivity is directly proportional to T^2, n^(-3), d^(-4) and ϵ^2 with respect to temperature (T), density (n), interlayer separation (d~nm) and dielectric constant (ϵ_2), respectively. CONCLUSION: Dependency of drag resistivity is measured and compared to 2D e-e and e-h coupled-layer systems with and without the effect of non-homogeneous dielectric medium.

Abstract: Proteins and peptides possess considerable potential in treating solid tumors because of their unique properties. At present, there are over 100 peptide-based formulations on the market. Today, peptides and proteins are in more demand due to their selective nature and high target-binding efficiency. Targeting solid tumors with compounds of molecular weight less than 10 kDa are much more desirable because they undergo excessive penetration in view of the fact that they are small sized. The solid tumors have thick tissues and possess excessive interstitial fluid pressure, because of which high molecular compounds cannot enter. The properties of proteins and peptides induce low toxic effects and lessen the major side effects caused by chemical-based drugs. However, their delivery is quite challenging as most proteins and peptides stop functioning therapeutically when following a parenteral route of administration. This paper elaborates on the importance of new age formulations of peptides and proteins followed by their recently documented advancements that increase their stability and delay their metabolism, which helps to target solid tumors.

Abstract: In the growing field of heterocyclic compounds, phenothiazine and the associated nucleus are among the most significant potential scaffolds with excellent pharmacological activities. The knowledge of chemistry, synthetic routes, and various physicochemical parameters of these compounds draws particular attention to create a chemical library. Related compounds synthesized by various routes have diverse pharmacological functions. The exhaustive search of phenothiazine literature helps the medicinal chemists who develop the molecules for designing new drugs. A broad view of the synthetic routes has been outlined in this study. This paper includes the chemistry, physiochemical properties, and various biological activities of phenothiazine and related compounds.

Background: As the COVID era unfolds, researchers reveal that rapid changes in viral genetic material allow viruses to circumvent challenges triggered by the host immune system and resist anti-viral drugs, potentially leading to persistent viral manifestations in host cells. Molnupiravir (RNA-dependent RNA polymerase inhibitor) is a novel anti-viral medicine promising a vital role in coming setbacks. Objectives:: This review aims to clarify the safety and efficacy of the molnupiravir molecule in light of existing case studies. As a result, it is intended to explore and discuss the molecular structure, mechanism of action, discovery and development process, preclinical research, clinical investigations, and other subtopics. Methods: A total of 75 publications were searched using multiple engines, such as Google Scholar, PubMed, Web of Science, Embase, Cochrane Library, ClinicalTrials.gov, and others, with a constraint applied to exclude publications published over 11 years ago. Molnupiravir, safety, efficacy, COVID- 19, RdRp, PK-PD, and clinical study were utilized as keywords. Result: Clinical results on molnupiravir are supported by investigations that were recently disclosed in a study on both sex volunteers (male and female) with an age restriction of 19 to 60 years, followed by a Phase-3 Clinical Trial (NCT04575584) with 775 randomly assigned participants and no fatalities reported due to treatment. Conclusion: Molnupiravir proved a high level of safety, allowing it to be tested further. This review supports the safety and efficacy of this molecule based on the established evidence, which claims the most anticipated employment of molnupiravir in COVID protocol.

Background: The occurrence of Tuberculosis (TB) has significantly increased worldwide. The extensively drug-resistant tuberculosis (XDR-TB) and multi-drug resistant tuberculosis (MDR-TB) have made it more challenging to treat this mycobacterial infection caused by the Mycobacterium tuberculosis MTB-H37Rv strain. The present treatments for tuberculosis are of long duration and with side effects. Thus, it is necessary to discover new drugs with short-term chemotherapy, fewer health hazards, and cost effectiveness. Objective: The objective of the study was to divulge the antitubercular properties of Betti base scaffolds. Method: Betti bases were designed, synthesized 4a-4h, 6a-6h, and investigated for their in vitro antitubercular activity using Microplate Alamar Blue assay (MABA) against the MTB-H37Rv strain. Their binding affinity with amino acids was studied by performing molecular docking studies using InhA (PDB ID: 2NSD) present in the MTB-H37Rv strain. Cytotoxicity assay and neutrophil function test (NFT) were also performed. Results: The Betti bases (4a-4h, 6d) showed minimum inhibitory concentration (MIC) values ranging from 1.6 μg/mL to 6.25 μg/mL against the MTB-H37Rv strain. The compounds (4a-4h, 6a-6h) were investigated for their ADME properties and good pharmacokinetic profiles were observed. In molecular docking studies, a strong binding affinity between InhA and the compounds (4a-4h, 6a-6h) was observed, which provided theoretical insight into the inhibitory action of the synthesized compounds (4a-4h, 6a-6h) against InhA. NFT of the compounds (4a-4h, 6a-6h) showed no harmful effects on the functions of neutrophils. In vitro cytotoxicity assay against Vero cell lines revealed the non-cytotoxic behavior of the compounds. Conclusion: Betti bases can be considered to be a promising class of molecular entities that can lead to the development of new anti-tubercular leads.

Background: Recently, the construction of a smart city has accelerated due to developing technologies such as 5G and the Internet of things (IoT). The IoT is gaining access day by day in the area of the remote monitoring system. Along with smart city concepts, intelligent patient monitoring systems and intelligent health are being developed. Combining the two, here, patients have a nurse navigation system and a doctor emergency call system. IoT improves the effectiveness of medical equipment by providing real-time monitoring of patient health, in which sensors collect data from patients with less human errors. In IoT, the patient's parameters get transmitted through medical devices via a gateway to the centralized system, where it is stored and analyzed. Objective: In this paper, we have proposed an intelligent patient monitoring system for monitoring the patients' health condition automatically through sensors-based connected links. The system is more intelligent that it can be able to detect the critical condition of a patient by processing sensor data and instantly provides a notification to doctors/nurses as well as hospital in-charge personnel. The doctors and nurses get benefited from this system by observing their corresponding patients remotely without visiting to the particular seat of the patient. Methods: An idea has been proposed to use the centralized processing of IoT devices along with the rigid security and privacy of the classical blockchain to overcome the computation expense challenge with blockchain and the security and privacy threat of the IoT systems. We are developing a system in the field of medical care to enhance the functioning of Medicare systems and provide patients with more ease and hassle-free procedures of the Medicare system, i.e., hospitals, laboratories, dispensaries, chemists, druggists, etc. Results: This model helps in getting rid of this issue faced by all of us. There is a separate blockchain of different verified medical stores linked within the networks, which will be managed by the central hub based on their ratings, reviews, and stock availability. Conclusion: The exponential expansion of blockchain technology in healthcare is also astonishing and has a tremendous impact on the industry. By assessing prior activities, the idea is proposed to use a centralized database system with more privacy and security to gap between the healthcare industry and blockchain technologies has been addressed in this paper.

In the modern era of technology, smart devices are becoming more common in everyday life. To find a free parking slot is the most difficult task in our cities The principal role of this research paper is to analyze smart parking solutions from a technical perspective, underlining the systems and sensors that are available, as documented in the literature. In this paper we have proposed a navigation and reservation based smart car parking system. The proposed system is being controlled by an app so as to reduce human intervention. To book the slot for parking is being done with the help of web application, some amount of charges is deducted through wallet. We can navigate to the reserved slot location by using google map. The proposed method makes our life more easier and hassles free.

In this paper, AR based Home Decor App is implemented which uses FAST corner detection. The Proposed System implements Home Decor App for furniture units using concept of Augmented Reality, which changes world of E-commerce by providing best solution to the customers while purchasing online products. The customer buys the product after virtual trial, which is possible through the concept of Augmented Reality. This is just completely new experience to online customers

This study's primary goal is to carry out the design of a sewage treatment facility for Lucknow's Virat Khand Sector 1. due to constant domestic and municipal sewage will be produced at a faster rate as the population grows. All species become sick from the foul stench that sewage produces. To prevent this however, appropriate treatment is required prior to disposal on land in order to utilise the treated water and avoid dumping sewage directly into natural resources, which ultimately lowers the demand for fresh water as a whole. Its goal is to generate solid waste and fluid waste that are safe for the environment and can be recycled or disposed of. In a single day, how much sewage was produced overall, based on the anticipated population of Virat Khand Sector 1 over the following 20 years? As a result, the sewage generation in the Virat Khand area is the main topic of this study, and a sewage treatment plant is constructed in accordance with it. It is suggested that the different parts of the sewage treatment plant be designed taking into account the various standards and allowable limits of treated sewage water. Screening, a grit chamber, a main sedimentation tank, a biological reactor, a secondary clarifier, an activated sludge tank, and drying beds are some of the parts of a sewage treatment plant.

In this paper, an improved high performance energy-efficient leakage-tolerant dual keeper pseudo domino logic circuit is proposed. Circuit design methodologies such as pseudo domino, stacking effect and inverted clock-controlled dual keeper are used in the proposed work for significant reduction of the circuit’s propagation delay and leakage current. Using pseudo-domino logic voltage swing at the output is reduced, stacking effect reduces the leakage current and charge sharing issues in the circuit are reduced by an inverted clock-controlled dual keeper circuit. Leakage current in the proposed circuit is decreased by 21.9%, 20.8%, 71.6%, 52.4% and 57.5% to the conventional logic, DOIND logic, DVT DOIND logic, DFD logic and C3D domino logic, respectively at a 27°C temperature and 1GHz clock frequency. Similarly, delay in the proposed circuit is reduced by 83.3%, 80.1%, 89.8%, 81.3% and 81.5% in comparison to conventional logic, DOIND logic, DVT DOIND logic, DFD logic and C3D domino logic circuit, respectively. Performance metrics like power dissipation, delay, PDP, leakage current, static power, and EDP of the proposed circuit are analysed and compared with the existing domino logics. Monte-Carlo simulation is performed using 1000 samples to analyse the performance of the proposed circuit. The proposed logic circuit is also tested against temperature and process variations. The median values of the proposed buffer circuit’s power and delay are 5.6µW and 1.28ps, respectively and the standard deviation of average power and propagation delay are 633.62nW and 84.37fs, respectively at 27°C and 1GHz clock frequency.

Purpose: Despite promising preclinical studies, toxicities have precluded combinations of chemotherapy and DNA damage response (DDR) inhibitors. We hypothesized that tumor-targeted chemotherapy delivery might enable clinical translation of such combinations. Patients and Methods: In a phase I trial, we combined sacituzumab govitecan, antibody–drug conjugate (ADC) that delivers topoisomerase-1 inhibitor SN-38 to tumors expressing Trop-2, with ataxia telangiectasia and Rad3-related (ATR) inhibitor berzosertib. Twelve patients were enrolled across three dose levels. Results: Treatment was well tolerated, with improved safety over conventional chemotherapy-based combinations, allowing escalation to the highest dose. No dose-limiting toxicities or clinically relevant ≥grade 4 adverse events occurred. Tumor regressions were observed in 2 patients with neuroendocrine prostate cancer, and a patient with small cell lung cancer transformed from EGFR-mutant non–small cell lung cancer. Conclusions: ADC-based delivery of cytotoxic payloads represents a new paradigm to increase efficacy of DDR inhibitors.

In this report, the catalytic potential of chalcogen-stabilized iron carbonyl clusters [Fe3E2(CO)9 (E = S, Se, Te)] for the photolytic hydration of alkynes has been explored. The iron chalcogenide clusters bring excellent transformations of terminal and internal alkynes to their respective keto products in just 25 min photolysis at −5 °C in inert free and aqueous conditions. After the completion of the reaction, the product can be extracted from organic solvent, and due to the lower solubility of the catalyst in water, it can also be isolated and further reused several times prior to any activation. The catalyst was also found to be active in thermal conditions and bring about the desired transformations with average to good catalytic efficiency. Moreover, during the thermal reaction, the catalyst decomposed and formed the nanoparticles of iron selenides, which worked as a single-source precursor for FeSe nanomaterials. The presented photolysis methodology was found to be most feasible, economical, instantly produce the desired product, and work for a wide range of internal and terminal alkynes; hence, all these features made this method superior to the other reported ones. This report also serves as the first catalytic report of chalcogen-stabilized iron carbonyl clusters for alkyne hydrations.

‘9 out of 10 online’ indicates that Malaysia’s e-commerce industry has risen steadily throughout Southeast Asia. The increase in the number of Shopee apps in the second quarter of 2021, marks Shopee as a leading Malaysian e-commerce market. Shopee provides a good value, the best quality, convenience and security when consumers experience the app. This paper aims to look into factors that influence consumers' behaviours towards online shopping using the Shopee app. This paper also assesses customer satisfaction regarding the service that had been provided. A total of 100 respondents of Shopee users participated in the online survey via Google Form. From the analysis, the results depict the necessity of quality products, reliability, convenience and product price as good indicators of customer satisfaction that may lead to behavioural intention. These findings provide new insight into consumer behaviour towards Shopee.

Nepal is an English as a Foreign Language (EFL) country where teaching and learning of English was disallowed under the Ranas for political reason while English took root in the rest of South Asia under the British colonial dispensation for over two centuries. English was adopted as a useful tool to enhance Nepal’s standing and to strengthen its relations with the outside world after the Ranas were removed from ower in 1951. This research paper dwells on how choosing English for use in a nation for education, business and foreign relations constitutes a political act and how Nepal’s political history guided the resistance to use English in the nation and how the changed political scenario pushed the country to adopt teaching and learning of English in a big way. Political thinking even determines how the choice of English is described at the official level to camouflage it as a purely nationalistic invention dubbing it as one of the U.N. languages which Nepal as a member must master to play its role in the world body. This research paper seeks to highlight the context of EFL in Nepal in the past fifty years, describes the modes of teaching and learning of English in the country and tries to demonstrate that English in Nepal does not fall under the nstitutionalized variety of English such as Indian or South Asian English.

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, and its global health burden is increasing. COPD is characterized by emphysema, mucus hypersecretion, and persistent lung inflammation, and clinically by chronic airflow obstruction and symptoms of dyspnea, cough, and fatigue in patients. A cluster of pathologies including chronic bronchitis, emphysema, asthma, and cardiovascular disease in the form of hypertension and atherosclerosis variably coexist in COPD patients. Underlying causes for COPD include primarily tobacco use but may also be driven by exposure to air pollutants, biomass burning, and workplace related fumes and chemicals. While no single animal model might mimic all features of human COPD, a wide variety of published models have collectively helped to improve our understanding of disease processes involved in the genesis and persistence of COPD. In this review, the pathogenesis and associated risk factors of COPD are examined in different mammalian models of the disease. Each animal model included in this review is exclusively created by tobacco smoke (TS) exposure. As animal models continue to aid in defining the pathobiological mechanisms of and possible novel therapeutic interventions for COPD, the advantages and disadvantages of each animal model are discussed.

Sterilization is a critical aspect of the medical device industry, as the use of improperly sterilized devices can have serious consequences for patients. This article provides an overview of the risks of inadequate sterilization, the methods of sterilization commonly used in the industry, and best practices for ensuring safe and effective sterilization. The article also explores emerging sterilization technologies and their potential impact on the industry. The importance of quality assurance and control procedures, validation, and testing in the sterilization process is emphasized. By following best practices and staying up-to-date with technological advancements, the medical device industry can continue to ensure that sterilization is performed safely and effectively to protect patients and maintain industry standards.

A study was carried out after harvest of rabi season crop during 2020-2021 to find out the vertical variability in status of physical properties in Vertisol and Inceptisol under different land uses. Samples were collected in triplicate from six different land use practices (forest, uncultivated, soybean-wheat, rice-wheat, soybean - chickpea and maize-wheat) at four depths (0-15, 15-30 30-45 and 45-60 cm) Gwalior and Jabalpur regions. For statistical analysis of data in factorial RBD different soil type were considered as factor A ,land use practices as factor B and three replications. Physical properties significantly affected by soil type. It was observed in different land use practices significantly affected in WHC. Under different soil type content of sand, silt and bulk density were higher in Inceptisol as compared to vertisol, however content of clay, porosity and (water holding capacity) WHC were higher Vertisol as compare to Inceptisol. WHC, bulk density and clay was found increased down the depth except porosity, sand in Vertisol while content of sand and bulk density was found increased down to depth except WHC, porosity and clay in Inceptisol.

The status of DTPA extractable micronutrient (Zn, Cu, Fe and Mn) in response of continuous application of different inorganic and organic fertilizer combination in a 48 years old ongoing long-term fertilizer experiment (AICRP-LTFE) were investigated in Vertisol at Department of Soil Science, and Agricultural Chemistry, JNKVV, Jabalpur under intensive cultivation of soybean- wheat cropping system in 2021. The treatments selected for the study were: control (T1); 100% NP(T2); 100% NPK (T3); 100% NPK+FYM (T4); 100% N(T5); 50% NPK (T6); 150% NPK (T7). Application of FYM along with balance fertilizer (100% NPK) significantly increased the micronutrients availability in soil. On contrast, Imbalance fertilization caused a lower level of micronutrients in soil even below to the critical limit in case of zinc. A decreasing trend with increase in soil depth irrespective of type of nutrient management and micronutrient type was evident in the study. Findings of the present study emphasized the application of balance fertilization along with organic sources like FYM for sustaining micronutrients availability in Vertisol under soybean-wheat cropping system.

For long time various types of communicable diseases were biggest killer diseases globally. But now a days trend become changing towards increased prevalence of chronic diseases due to changing their diet pattern, lifestyle and behavioral pattern. In these chronic diseases Gastro Esophageal Reflux Disease (GERD) is the Gastro-intestinal disorder defined by recurrent troublesome heart-burn and regurgitation. Patient with GERD can be medicated empirically with Antacids and proton pump Inhibitor’s but in most of the cases patient do not respond to such treatment absolutely and several adverse effects arises after prolonged use. Ayurvedic texts classifies the broad spectrum of Amlapitta into Urdhwag and Adhog Amlapitta in which GERD shows similarity with Urdhwag Amlapitta on the basis of causes and symptoms. Aim and Objectives: The current review article illustrates the mode of action of Ayurvedic procedures (Shodhana Chikitsa) and formulations (Shamana Chikitsa) which is safe and effective for GERD (Urdhwag Amlapitta) Material and Methods: Ayurvedic texts referred are Charak Samhita, Yog Ratnakar, Bhaisjya ratnavali and contemporary modern texts and published manuscripts. Discussion: Detailed protocol treatment for Amlapitta in the form of Shodhana and Shamana Chikitsa discussed in terms of drugs and diet, should be applied considering the association of Dosha. Conclusion: This review article will helpful to Ayurveda scholars, academicians, clinicians and researchers for the future prospect to plan the research work on same topics.

Background: Prenatal detection of genetic abnormalities is one of the biggest challenges of current fetal medicine. Prenatal screening for chromosomal abnormalities can be done using biochemical tests. The screening is a risk estimation test and not a diagnostic test. Methods: Statistical data treatment had been performed on a sample of 362 pregnant women for prenatal screening. This was a retrospective data analysis study undertaken at the National Reference Laboratory, Redcliffe Labs. Results: Nine (2.48%) women out of 362 were screen positive for chromosomopathy. The point biserial correlation between variables (Free β-hCG - Free Beta Human Chorionic Gonadotrophin, PAPP-A- pregnancy associated plasma protein-A and NT-(nuchal translucency) amongst patients with positive and negative screen test was statistically significant. There was a positive correlation between positive screen for chromosomopathy and hCG, MoM, NT MoM whereas a negative correlation between them and PAPP-A. This study indicates that higher values of hCG and lower values of PAPP-A MoM as seen in the positive screen patients is associated with a significant risk of chromosomopathy. A positive correlation between age and screen positive cases was seen. The McNemar’s test indicated a significant reduction in screen positive cases when biomarkers were added to screen for Trisomy 21 in women aged >35 years (n=86). 81 women eventually screened negative. Conclusions: The analyses stresses on the importance of using state-of-the-art, prenatal noninvasive screening software to help provide a predictive outcome, individualized for that pregnant woman.

In this era infectious diseases are posing problems for human beings. In order to avoid various infections, production and use of antibiotics is on rise. The widespread misuse of antimicrobials is responsible for emerging microbial resistance. Numbers of Ayurvedic classical preparations were being used in cases of infections, and they were found to be effective clinically. Therefore, to make our treatment scientifically more validated, we can assess the antimicrobial activity of such preparations in vitro (i.e., culture and sensitivity tests). The development of bacterial resistance to known antibiotics and adverse effect to presently available antibiotics has necessitated the search for new antibacterial agents in different systems of medicine. So Hinguleshwar rasa, a known traditional medicine, has been selected for this study. The antibacterial activity of the Hinguleshwar rasa was tested against pathogenic bacteria strain Streptococcus pyogenes, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Salmonella typhi. In order to study antibacterial action of Hinguleshwar rasa in vitro well diffusion method. During this study Hinguleshwar rasa was trailed with bacteria at different concentrations. To correlate the result, control solutions were prepared by streptomycin. Experimental groups were compared with control groups and observations were noted.

Health of any soil is influenced by its physical properties to greater extent which has been more prominent in Vertisols due to their self-till behavior. Differential application of nutrients in long-term may alter the soil properties at temporal and spatial scales. Inventory on effect of different long-term nutrient management practices on physical properties across the soil depths, especially on Vertisols of central India, is insufficient. Present study examined the long-term (48 years) effect of different combinations of organic and inorganic nutrient management practices under soybean-wheat cropping system on various physical properties (Bulk density, Particle density, Porosity and Water holding capacity) of a Vertisol in of central India. In the present study, soil sample were collected at four depths (0-15, 15-30, 30-45 and 45-60 cm) in triplicate from seven treatments (Control, 100% NP, 100% NPK, 100% NPK+FYM, 100% N, 50% NPK and 150% NPK) of permanent plots of AICRP on LTFE (initiated in 1972), Jabalpur. By differential nutrient management practices the bulk density and porosity affected significantly up to 30 cm soil depth and beyond that up to 60 cm non-significantly. At all selected soil depths, water holding capacity were significantly affected. On contrary, a non-significant effect was observed on particle density by various nutrient managements. This study indicated a positive impact of balance fertilizer application and integrated approach of nutrient management on physical properties of soil.

IntroductionMenstruation, also known as a period, is a natural process that occurs in the female body as apart of the menstrual cycle. The menstrual cycle is the monthly hormonal cycle that preparesthe female body for pregnancy. The objective of this research is to find the prevalence andassociated factors of menstruation pattern among schools adolescents. MethodsA descriptive cross sectional study was conducted among 355 adolescent girls of (10-19 years) in five boarding and government school of Bharatpur municipality, Chitwan. Self- structure questionnaire was then distributed to those students who had already attended their menstruation. Data was entered and analyse by using descriptive and inferential statistical tools in SPSS 20. P-value

Introduction The posterior approach to liver resection is technically difficult, especially when there is a bulky tumor or dense adhesion of right lobe of liver with the risk of tumor dissemination and hepatic vein avulsion. To prevent this, anterior approach of liver resection was used; however, it is technically challenging and can lead to a false line of transection and difficulty in controlling bleeding in deeper parenchymal plane. These technical difficulties are overcome by hanging maneuver liver resection which eases the process of anterior approach. The Objectives of our study were to observe the technical safety, operative duration, operative blood loss, and perioperative complications of hanging maneuver in liver resection. Methods This is a cross-sectional study on the patients who underwent hanging maneuver of liver resection at our center. The perioperative data were analyzed. Descriptive variables were described using frequency and percentage; continuous variables were described using mean and standard deviation. Results A total of 15 patients underwent hanging maneuver of liver resection, majority were male (66.6%) with Child-Pugh score-A of 80%. The most common indication was complex hydatid cyst of liver (33%) and biliocutaneous fistula (13%) that occurred after previous intervention for hydatid cyst of liver (13%). Intraoperative blood loss was 750±343.2 ml and complications grade IIIA were up to 20% as per Clavien Dindo grading system. Conclusions Hanging maneuver of liver resection is a technique that facilitates in elevating liver parenchyma away from IVC and helps in an easier anterior approach. A learning curve and assessment of background liver disease is necessary for its safety.

IntroductionMastoid process is one of the most important landmark of the skull. It is a part of temporal boneand contains air filled space which is called mastoid air cells. It is also an attachment of differentneck muscles. Normal measurement of the mastoid process is very important for surgeons' pointof view. This study was aimed to assess the normal dimension of mastoid process. MethodsThe study was a descriptive cross-sectional study conducted on 104 patients, at Department ofRadiology and Imaging, College of medical sciences, Bharatpur, Nepal. All CT examinations wereperformed using Toshiba 160 slice CT scanner. The data was analyzed using Statistical Packagefor the Social Sciences (SPSS) version 16 (SPSS, Inc., an IBM Company, Chicago, IL). Descriptivestatistics was used to analyze the data. ResultsAmong the 104 patients who participated in the study, 38 (36.5%) were male and 66 (63.5%) werefemale. All the measurements of mastoid process taken in males were higher than in femalesexcept the anterior inclination angle which was more in female on both right and left side. Thevolume of mastoid process in males was 14.16±5.3 and 14.69±6.6 on right and left side respectivelywhile in female it was less. ConclusionsThe present study estimated the normal dimension of mastoid process. The normal dimension ofmastoid process in male is larger than in females.

Introduction Post infectious glomerulonephritis (PIGN) is the most common renal disease in children causing significant morbidity. The affected children present with features of acute nephric syndrome (hematuria, hypertension, edema and oliguria. The objective of this study was to determine the prevalence, clinical characteristics, complications, and outcomes of children presenting with post infectious glomerulonephritis in paediatric ward of tertiary care hospital. Methods This was a prospective observational study conducted at a tertiary care hospital in Chitwan, Nepal from March 1st 2020 to February 28th 2021. Children aged 4 – 15 years satisfying 2 out of 4 features of acute nephritic syndrome were included in the study. After discharge, patients were followed up at 4 weeks and 8 weeks. Data entry was done in statistical packages for the social science version 20. Results Among 63 children recruited with acute nephritic syndrome, 73% had Post infectious glomerulonephritis. The most common etiology of PIGN was Post streptococcal glomerulonephritis (63%). The mean age of children was 11.2 (±3.2) years. Males to females’ ratio was 1.5:1. The most common presenting feature was edema (100%). The most common complication was acute kidney injury (41.3%). Conclusion Post infectious glomerulonephritis was the most common cause of acute nephritic syndrome in children. High incidence of life-threatening complications like CCF, retinopathy, encephalopathy and renal insufficiency occur that require close monitoring and timely intervention to prevent morbidity and mortality.

Introduction Postoperative pain management is essential post-extraction for early mobilization and rehabilitation to enhance recovery and to reduce morbidity. Diclofenac and Ibuprofen and Paracetamol combination are two most common NSAIDs used in the postoperative pain control. Methods Two hundred fifteen patients (n=215) of age group 20-60 years who underwent extraction of upper or lower third molar impacted teeth were divided randomly into two groups (T1 and T2). T1 group (n=105) received Tab. Diclofenac 100mg and T2 group (n=110) received Tab Ibuprofen and Paracetamol combination. Analgesic efficacy of Diclofenac was compared with that of Ibuprofen and Paracetamol combination at post-op day 1, day 3 and day 5. Analgesic efficacy was measured using Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Results Pain intensity decreased significantly at all the time points in both the groups. The analgesic efficacy of Diclofenac was significantly higher than Ibuprofen and paracetamol combination as estimated by VAS mean score at day 1 and day 3 post-operative period (p

IntroductionMoraxella catarrhalis is a gram negative, oxidase positive, cocci mainly causing upper and lowerrespiratory tract infections. The RND family efflux pumps lead to multidrug resistance in most ofthe gram negative bacteria. One of the well- known pumps in M. catarrhalis is arcAB and oprMsystem. The objective of this study was to investigate the antibiotic resistance in M. catarrhalis andto determine its resistance dependence on the efflux pump. MethodsIn this study, 283 different respiratory tract infection samples processed out of that 73 were confirmedby biotyping and molecular characterization as a M. catarrhalis. The antibiotic susceptibility testswere performed by disc diffusion method according to CLSI. Molecular characterization formultidrug resistance isolates was also done along with genes responsible for efflux pumps. PCRwas done M. catarrhalis and acrAB and oprM genes. The factor for association of efflux pump withantibiotic resistance was investigated using phenylalanine argine β-naphthylamide. ResultsThe antibiotics susceptibility result showed 12 out of 73 isolates were MDR, selectively takenfor PCR using 16SrRNA specific primer. The MDR isolates were further confirmed by PCR. Theamplification results of acra, acrb and oprm genes for the M. catarrhalis having multidrug resistancegenes by PCR band size products seen on 2% agrose gel. The highest resistance towards the drugsviz penicillin, ampicillin, amoxicillin, amoxiclave, cotrimoxazole, cefazolin, cefuroxime, ceftrixoneand cefepime were seen in M. catarrhalis. ConclusionsThe result showed that Moraxella catarrhalis is one of the major causes for respiratory tract infection.The drug resistance in this species is increasing day by day. The 90% of isolates have acrAB andoprM genes for efflux pump responsible for multiple drug resistance. The efflux pump inhibitorhas important clinical significance for the proper treatment.

Background: Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. Methods: We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. Findings: From an estimated 13·7 million (95% UI 10·9–17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7–10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2–18·1) of all global deaths and 56·2% (52·1–60·1) of all sepsis-related deaths in 2019. Five leading pathogens—Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa—were responsible for 54·9% (52·9–56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185–285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4–71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. Interpretation: The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development. Funding: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care, using UK aid funding managed by the Fleming Fund.