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Background: Snakebite is an important occupational hazard in India as it is always been a land of poisonous snakes. The isssue which the physician confronts while treating a snake bite patient is assesment of degree of envenomation and requirement of ASV dose. Aims and Objectives: This study was taken to evaluate the optimum dose of anti-snake venom (ASV) required based on the severity of envenomation. Materials and Methods: Patients with a history of snakebite brought to the Department of General Medicine, Hassan, were included in this study. The study was conducted during the period from December 2014 to June 2016. The sample size of 80 patients was included in the study after fulfilling the inclusion criteria. Results: A total of 80 patients were included in the study. The majority of the victims were males (70%), age between 21 and 40 years (47.5%), and agriculture was the main occupation (67.3%). 51.25% did not identify the snake. The most poisonous were viper and cobra types which were 36.5% and 12.5%, respectively. A delay in lag time of 8.99±8.2 h was observed in severe envenomation. Overall, 51 cases (63.75%) had cellulitis, and 3 (3.75%) in the severe group required fasciotomy. Twenty percent had hematologic derangements. Ten percent of patients had developed renal failure and one required dialysis. 8.75% of patients developed respiratory failure and all required mechanical ventilation. The average dose of ASV vials used in mild, moderate, and severe envenomation was 9.04±3.51 vials, 18.5±5.27 vials, and 28.6±7.30 vials, respectively. The overall mortality rate was 5%. Conclusions: The optimum dose of ASV required in mild, moderate, and severe envenomation is 9.04±3.51 vials, 18.5±5.27 vials, and 28.6±7.30 vials, respectively to neutralize the circulating venom and lower the risk of development of serious complications.

Objectives: The SARS-CoV-2-associated pneumonia (COVID-19) infection has spread quickly throughout China and the rest of the world since December 2019. SARS-CoV-2 has been demonstrated to interact with the RAAS and endothelin systems to both initiate "de novo" onset hypertension and exacerbate pre-existing instances. This study described the clinical symptoms, therapeutic outcomes of COVID in 19 patients with hypertension. Methods: Data collection forms were used to gather information on demographics, clinical, laboratory, radiological parameters and treatment outcomes from the medical records provided by 195 Covid-19-infected patients admitted to the KMCH institute of health sciences and research in Coimbatore. The 2019-CoV RNA real-time reverse transcription polymerase chain reaction (RT-PCR) assay was developed to test patients with Covid-19. The patients were split into normotensives (137) and hypertensives (58) with covid infection. Results and Discussion: CORADS score was used to classify the severity of Pneumonia. None of the hypertensives had a severity score of 3. 15.35% had a severity score of 2 and 82.8% had a severity score of 1. When the severity score was compared with normotensives, there was no significant difference among both the groups. None of the patient needed intensive care. The means of various clinical (blood and physical) parameters were compared between hypertensives and non-hypertensives. The mean age of hypertensives was 58.7 compared to 42.44 among normotensives (P

Background: Dengue-induced thrombocytopenia can be life-threatening. However, supportive and symptomatic treatment is the current management protocol. The leaf extract of papaya has shown promising results in improving the platelet count. There are many varieties of Carica papaya such as Washington, Honeydew, Coorg honeydew, Solo, Surya, Red lady, C0-1, CO-3, CO-5, C0-6. Aims and Objectives: The aim is to evaluate the efficacy and safety of two varieties (“Red Lady” and “Solo”) of C. papaya fresh leaf extract in patients diagnosed with dengue-induced thrombocytopenia. Materials and Methods: The study was conducted for 2 months, and 18 dengue-confirmed inpatients with thrombocytopenia (platelet count

Neonatal jaundice is one of the most common problems encountered in the first week after birth. Neonates who develop significant hyperbilirubinemia require phototherapy. Delay in the diagnosis and management of jaundice may lead to neonatal morbidity and mortality. Total Serum Bilirubin (TSB) estimation is considered the gold standard method. However, this invasive procedure causes pain, anxiety, and may lead to infection and iatrogenic anaemia, especially in preterm neonates. Transcutaneous Bilirubin (TcB) estimation, which measures bilirubin through the skin, has been proposed as an alternative screening method for hyperbilirubinemia in term and near-term neonates. Aim: To compare TcB to TSB in preterm neonates of 30-34 6/7 weeks gestational age before, during, and after phototherapy. Materials and Methods: This hospital-based prospective cohort study was conducted at SDMCMS&H, Dharwad, Karnataka, India, between December 2019 and November 2020. A total of 100 preterm neonates between 30 to 34 6/7 weeks of gestation with clinically suspected jaundice were enrolled in the study. TSB was measured in the laboratory using the Diazo Method, while TcB was measured using the Drager jaundice meter JM 103. TcB and TSB were measured and compared in preterm neonates with clinically suspected jaundice before phototherapy, during phototherapy (8 to 12 hours after initiation), and after 12-18 hours of discontinuation of phototherapy. The collected data was analysed statistically using the mean, standard deviation, dependent t-test, Karl Pearson’s correlation coefficient, and scatter plots. Results: This study enrolled 100 neonates diagnosed with neonatal jaundice, of which 57 were males and 43 were females, resulting in a male-to-female ratio of 1:1.3. Phototherapy was administered to neonates with TSB values, with 79% of the babies between 30-32 weeks and 21% between 32-34 weeks. In the present study, TcB and TSB were compared before, during, and after phototherapy, and the results were analysed, showing statistical significance. The mean TcB levels were 12.05, 9.66, and 7.23 before, during, and after phototherapy, respectively. The mean TSB levels were 11.28, 10.16, and 7.65 before, during, and after phototherapy, respectively. Based on Karl Pearson’s correlation coefficient, a positive correlation was found between TcB and TSB before (r=0.8319, p-value

In recent times, due to increased environmental awareness, the usage of sustainable, eco-friendly textile products has gained momentum. In this respect, the Soya bean protein fiber (SPF) based fabric structure is considered a potential product. Single Jersey and Single Pique knitted structures were developed by changing the yarn count and loop length using Soya bean fiber for next-to-skin applications. Multidimensional moisture management properties were measured using MTT tester to understand the influence of process parameters (fabric structure yarn count and loop length). Further to this, physical properties and wetness comfort properties of the SPF knitted fabrics were also studied. It was found that the OMMC properties of most of the SPF knitted samples were highly rated. The influence of knit structure, yarn count, and loop length on moisture properties was studied through ANOVA. Similarly, the correlation between the physical parameters and moisture properties was also investigated. The Single Pique structure with finer yarn count and higher loop length configuration showed higher moisture management properties. The fabric thickness was correlated with all the moisture management properties. However, the fabric tightness factor was correlated with all the moisture management properties except MWR and AOTI.

Food choice aims to identify the solution totheexiguity of the food. It is possible to do this through diversification. Finding the best selection of food alternatives is the goal of food diversification.. Multi-attribute decision-making (MADM) methods attempt to choose the best alternative from a group of possibilities based on several parameters. This paper provides the description of the entropy process use in the analysis and application of multi attribute decision-making (MADM) for choosing foods.

The method of generating intention with the scope of impact is called the decision making. It is the process which an unique or a group evaluates solutions and alternatives in order to found the most politic option while inspecting the problems or situations.Multi-attribute decision-making (MADM)MADM approaches are designed to discover the most satisfying of numerous comparison choices or to rank possibilities based on their connection to the analysed target. The strategies are utilized to identify the suitable alternative/solution when none of the evaluation parameters are the best.The Multi-attribute decision making theory offers a formal base for the establishment of a model, in which the key criteria is the individual parameters that result in an integrated assessment.MADMis a strategy for evaluating decisions with numerous co-attribute options in a complete and effective manner. The most appropriate options are ranked from most to least, and MADM methods are frequently used to get the best solution.In this paper, the decision-making algorithm is suggested and applied to purchase a new bike with the maximin method.

Background: In this study, we evaluate the predictors of treatment outcomes in drug resistant tuberculosis. Methods: An observational retrospective study was conducted by using the medical records of patients confirmed for TB at Kasturba Medical College from January 2015 to December 2018. Results: Four hundred and sixty-two TB patients were included in this study. Of the total TB-confirmed patients, about 85.1% are diagnosed with pulmonary TB (PTB) (n = 393), 11.7% were extrapulmonary tuberculosis (EPTB) (n = 54), and 3.2% (n = 15) cases had both PTB and EPTB. Among the 462 cases, the frequency of multidrug-resistant TB (MDR-TB) was 25% (n = 117), extensively drug-resistant TB was 1% (n = 3), and non-MDR cases were 74% (n = 342). The frequency of unsuccessful treatment outcome was 92.9% (n = 429) and successful outcome was 7.1% (n = 33). There were 68.2% of new and 31.8% retreatment cases of TB. HIV co-infection was found in 2.3% (n = 14) of TB cases, and among them, 64.3% (n = 9) were found in PTB cases. The major comorbidities found were diabetes (21.2%), weight loss (12.6%), and anemia (12.6%). There was a difference in rate of PTB cases across years decreasing in the year 2017, whereas ETB cases were increasing in the year 2017. The TB treatment success rate was increased from 2015 (4.8%) to 2018 (8.3%). Conclusion: The higher rate of poor treatment outcome emphasizes the need of improvement in TB surveillance, treatment, more stringent follow-up, monitoring, and patient education to ensure complete and successful treatment.

Let R be a finite commutative ring with identity. The idempotent graph of R is the simple undirected graph I(R) with vertex set, the set of all nontrivial idempotents of R and two distinct vertices x and y are adjacent if and only if xy = 0. In this paper, we have determined all isomorphism classes of finite commutative rings with identity whose I(R) has genus one or two. Also we have determined all isomorphism classes of finite commutative rings with identity whose I(R) has crosscap one. Also we study the the book embedding of toroidal idempotent graphs and classify finite commutative rings whose I(R) is a ring graph.

In this study, we present a case of Grade IV diabetic foot ulcer (DFU) and its management with Vrana ropana chikitsa along with Ayurvedic precision medicines. A 72-year-old male patient having grade IV DFU was given the Vrana ropana chikitsa with precision medicines. The bacterial profile and antibiotic resistance, and wound characteristics were monitored before and after the treatment. After the treatment, significant progressions were found in the patient. There was a decrease in the growth of Staphylococcus aureus in the wound after the treatment. Doxycycline and erythromycin-resistant isolates were switched to antibiotic sensitive strains with Vrana ropana chikitsa. Progression of Grade IV ulcer to healing wound was found in the patient. A case of Grade IV DFU with drug-resistant S. aureus was managed with the alternative treatment of Vrana ropana chikitsa and showed improved wound healing.

Lignocellulosic biomasses (LCB) are sustainable and abundantly available feedstocks for the production of biofuel and biochemicals via suitable bioconversion processing. The main aim of this review is to focus on strategies needed for the progression of viable lignocellulosic biomass-based biorefineries (integrated approaches) to generate biofuels and biochemicals. Processing biomass in a sustainable manner is a major challenge that demands the accomplishment of basic requirements relating to cost effectiveness and environmental sustainability. The challenges associated with biomass availability and the bioconversion process have been explained in detail in this review. Limitations associated with biomass structural composition can obstruct the feasibility of biofuel production, especially in mono-process approaches. In such cases, biorefinery approaches and integrated systems certainly lead to improved biofuel conversion. This review paper provides a summary of mono and integrated approaches, their limitations and advantages in LCB bioconversion to biofuel and biochemicals.

In geopolymer reactions, with lime rich compound addition, the strength parameter is dependent on the molar ratios of (Si/Al) and (Ca/Si), such that (Si/Al) ratio contributes to short period and (Ca/Si) ratio contributes to long period strength development. In the present study a mathematical model has been proposed to identify the role of each on compressive strength development through exponential mathematical relationship, such that, N1 is an exponent of (Si/Al) ratio and N2 is an exponent of (Ca/Si) ratio indicating short period and long period strength development parameter respectively, while C is the compressive strength developed on keeping the samples for different extended time periods. The values of N1 and N2 can be found out by solving linear equations relating (Si/Al) ratio, (Ca/Si) ratio, and compressive strength values of different experimental batch compositions. Calculated and selected additions of sodium silicate, sodium hydroxide, lime and GGBS in iron ore mine tailing samples indicated that the values of N1 and N2 merged with each other after 7 days reaction period, but after 28 days reaction line due to N1 is found above that of N2. It is concluded that for long period strength development (Si/Al) ratio is more important in comparison to (Ca/Si) ratio.

Abstract Background Pongamia (Millettia pinnata syn. Pongamia pinnata), an oilseed legume species, is emerging as potential feedstock for sustainable biodiesel production. Breeding Pongamia for favorable traits in commercial application will rely on a comprehensive understanding of molecular mechanism regulating oil accumulation during its seed development. To date, only limited genomic or transcript sequences are available for Pongamia, while a temporal transcriptome profiling of developing seeds is still lacking in this species. Results In this work, we conducted a time-series analysis of morphological and physiological characters, oil contents and compositions, as well as global gene expression profiles in developing Pongamia seeds. Firstly, three major developmental phases were characterized based on the combined evidences from embryonic shape, seed weight, seed moisture content, and seed color. Then, the gene expression levels at these three phases were quantified by RNA-Seq analyses with three biological replicates from each phase. Nearly 94% of unigenes were expressed at all three phases, whereas only less than 2% of unigenes were exclusively expressed at one of these phases. A total of 8881 differentially expressed genes (DEGs) were identified between phases. Furthermore, the qRT-PCR analyses for 10 DEGs involved in lipid metabolism demonstrated a good reliability of our RNA-Seq data in temporal gene expression profiling. We observed a dramatic increase in seed oil content from the embryogenesis phase to the early seed-filling phase, followed by a steady and moderate increase towards the maximum at the desiccation phase. We proposed that a highly active expression of most genes related to fatty acid (FA) and triacylglycerol (TAG) biosynthesis at the embryogenesis phase might trigger both the substantial oil accumulation and the membrane lipid synthesis for rapid cell proliferation at this phase, while a concerted reactivation of TAG synthesis-related genes at the desiccation phase might further promote storage lipid synthesis to achieve the maximum content of seed oils. Conclusions This study not only built a bridge between gene expression profiles and oil accumulation in developing seeds, but also laid a foundation for future attempts on genetic engineering of Pongamia varieties to acquire higher oil yield or improved oil properties for biofuel applications.

Abstract Background After axon severing, neurons recover function by reinitiating axon outgrowth. New outgrowth often originates from the remaining axon stump. However, in many mammalian neurons, new axons initiate from a dendritic site when the axon is injured close to the cell body. Methods Drosophila sensory neurons are ideal for studying neuronal injury responses because they can be injured reproducibly in a variety of genetic backgrounds. In Drosophila, it has been shown that a complex sensory neuron, ddaC, can regenerate an axon from a stump, and a simple sensory neuron, ddaE, can regenerate an axon from a dendrite. To provide a more complete picture of axon regeneration in these cell types, we performed additional injury types. Results We found that ddaE neurons can initiate regeneration from an axon stump when a stump remains. We also showed that ddaC neurons regenerate from the dendrite when the axon is severed close to the cell body. We next demonstrated if a stump remains, new axons can originate from this site and a dendrite at the same time. Because cutting the axon close to the cell body results in growth of the new axon from a dendrite, and cutting further out may not, we asked whether the initial response in the cell body was similar after both types of injury. A transcriptional reporter for axon injury signaling, puc-GFP, increased with similar timing and levels after proximal and distal axotomy. However, changes in dendritic microtubule polarity differed in response to the two types of injury, and were influenced by the presence of a scar at the distal axotomy site. Conclusions We conclude that both ddaE and ddaC can regenerate axons either from the stump or a dendrite, and that there is some feedback between the two sites that modulates dendritic microtubule polarity.

In this study, the major mastitis pathogen prevalence in the cattle and buffalo of the world was estimated by a meta-analysis. Staphylococcus (S) species, Streptococcus (St) species, and Escherichia coli (Ec) prevalence studies reported during 1979–2019 were collected using online databases, and offline resources. A meta-analysis of these data was done with the meta package in R-Software. The Staphylococcus aureus was the major mastitis pathogen, mostly causing subclinical mastitis, Ec causing clinical mastitis and St causing subclinical and clinical mastitis. The pooled prevalence estimates of S, St, and Ec were 28%, 12%, and 11% in the world from 156, 129, and 92 studies, respectively. The S, St, and Ec prevalences were high in Latin America (51%), Oceania (25%), and Oceania (28%), respectively. Higher S, St, and Ec prevalences were observed by molecular methods, signifying high sensitivity and usefulness for future studies. Among bacterial species, S. aureus (25%) followed by coagulase-negative Staphylococcus species (20%), Escherichia coli (11%), St. agalactiae (9%), St. uberis (9%) were the important pathogens present in the milk of the world. We hypothesize that there is a urgent need to reduce mastitis pathogen prevalence by ensuring scientific farm management practices, proper feeding, therapeutic interventions to augment profits in dairying, and improving animal and human health.

Context: Despite the advances in orthodontic material and treatment mechanics, the placement of fixed appliances increases the risk of enamel demineralization. The development of fluoride release adhesives has attracted considerable interests because the combined use of antimicrobials and fluoride enhances the cariostatic effect. Aim: To compare the shear bond strength (SBS) of fluoride release adhesives with established orthodontic adhesives and assess failure mode using adhesive remnant index (ARI). Settings and Design: The present study included 80 maxillary premolars which were randomly divided into four groups (n = 20) and were further subdivided into two subgroups A - Pumice prophylaxis (PP) and subgroup B - No PP (n = 10). Materials and Methods: Stainless steel brackets were bonded with Transbond XT, Transbond plus (TP) color change adhesive, Light Bond, and Clearfil protect bond. After debonding, the ARI was used to assess the mode of bracket failure. Statistical Analysis: The data were analyzed using two-way analysis of variance, Post-hoc Tukey Honest significant differences test, and Chi-square test. Results: The mean SBS of Group 4 was comparably higher regardless of PP. Brackets bonded with TP showed a comparable SBS to conventional Transbond XT. The ARI scores were predominately 2. Conclusions: Fluoride releasing adhesives combined with antibacterial monomer can play a vital role in reducing white spot lesions by enhancing the cariostatic effect especially in noncompliant\medically compromised patients.

The efficacy of a novel topical combination of fipronil 9.8% (w/v) and (S)-methoprene 8.8% (w/v) (Fiprofort® Plus) was tested against ticks and fleas in naturally infested dogs. A total of fifty dogs were allocated in the study with ticks infestation (n=35) and fleas infestation (n=15). On day 0, thirty-five tick and fifteen flea infested dogs received the test formulation, a combination of fipronil 9.8% (w/v) and (S)-methoprene 8.8% (w/v) spot-on solution. Ticks and flea counts were taken on days 0 (pretreatment) and 3, 7, 14, 21, 28, and 35 after treatment. Blood samples were collected for evaluation of haematological parameters on days 0 (pretreatment) and 7, 21, and 35 after treatment. All the adult ticks and fleas collected were identified as Rhipicephalus sanguineus and Ctenocephalides felis, respectively. The efficacy of spot-on formulation against ticks was 34.00% (day 3), 53.14% (day 7), 62.71% (day 14), 65.48% (day 21), 59.80% (day 28), and 58.82% (day 35), whereas against fleas it was 38.00% (day 3), 64.34% (day 7), 89.67% (day 14), 95.40% (day 21), 100.00% (day 28), and 100.00% (day 35). Haematological parameters for ticks and fleas infested dogs were statistically nonsignificant as compared to control. The combination of fipronil and (S)-methoprene eliminated the existing ticks and fleas infestation and prevented the dogs from flea and tick infestation for four weeks.

The aim of this study was to determine the degree of conversion and residual stress of resin composite preheated to different temperatures and to compare it to room-temperature composite. The composite resin was preheated to 40°C, 50°C, and 60°C and packed into brass rings and light-cured. The degree of conversion and residual stress were analysed using Fourier transform infra-red spectroscopy and X-ray diffraction, respectively. The results obtained were tabulated and statistically analyzed using Kruskal-Wallis test and Tukey′s honestly significantly different test. The results showed significant increase in the degree of conversion and residual stress with increase in preheating temperature.

Wilms tumour or nephroblastoma is the most common renal tumour of in children. It accounts for 6% of all pediatric tumours and is the second most frequent intrabdominal solid organ tumour in children. Inferior vena cava (IVC) involvement by Wilms tumour occurs in 4-10% of patients and right atrium thrombus extension in less than 1%. Using a multidisciplinary approach, overall survival is excellent in Wilms tumour. We are presenting this case because Wilms tumour with right atrial thrombus is relatively rare and continues to remain a challenge for treating physicians

Background: Inborn metabolic disorders (IMDs) form a large group of rare, but often serious, metabolic disorders. Aims: Our objective was to construct a decision tree, based on classification algorithm for the data on three metabolic disorders, enabling us to take decisions on the screening and clinical diagnosis of a patient. Settings and Design: A non-incremental concept learning classification algorithm was applied to a set of patient data and the procedure followed to obtain a decision on a patient’s disorder. Materials and Methods: Initially a training set containing 13 cases was investigated for three inborn errors of metabolism. Results: A total of thirty test cases were investigated for the three inborn errors of metabolism. The program identified 10 cases with galactosemia, another 10 cases with fructosemia and the remaining 10 with propionic acidemia. The program successfully identified all the 30 cases. Conclusions: This kind of decision support systems can help the healthcare delivery personnel immensely for early screening of IMDs.