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Introduction: Understanding the epidemiological and clinical profile of COVID-19 cases and pattern of disease is very much required for future preparedness. Objective: To assess the epidemiological and clinical profile of cases of COVID 19 Method: Cross sectional descriptive study was carried out at a Rural Health Training Centre (RHTC). All cases in the reported in the month of January 2022 were included in the study. The information about the epidemiological and clinical profile was collected from RHTC records by conducting telephonic interview. Results: Total 83 cases were reported. Among them, 43 (54.4%) cases were in age group 20-39 years. Male: Female ratio was 1.37:1. There was one death and patient had ovarian cancer as co-morbidity. Total 71 patients could be contacted for telephonic interview. Fever was most common symptom and was presenting symptom on first day followed by cough/cold and sore throat. None had shortness of breath or chest pain. Hospitalization rate was 5.63% and none required oxygen supplementation or intensive care. Recovery period was 3-5 days. Out of total, 90% cases were fully vaccinated and 95.8% had knowledge of CAB. Diabetes and hypertension were most common co-morbidities and were statistically significantly more in age > 40 years. Conclusions: The COVID-19 cases in the beginning of year 2022 had clinical presentation different than the earlier waves. Periodic situational analysis can guide in policy making for handling this pandemic in future.

In children, adolescents, and young adults (CAYA), non-Hodgkin lymphoma (NHL) is characterized by various age-related dissimilarities in tumor aggressiveness, prevailing pathologic subtypes, and imaging features, as well as potentially different treatment outcomes. Understanding the imaging spectrum of NHL in CAYA with particular attention to children and adolescents is critical for radiologists to support the clinical decision making by the treating physicians and other health care practitioners. The authors discuss the currently performed imaging modalities including radiography, US, CT, MRI, and PET in the diagnosis, staging, and assessment of the treatment response. Familiarity with diagnostic imaging challenges during image acquisition, processing, and interpretation is required when managing patients with NHL. The authors describe potentially problematic and life-threatening scenarios that require prompt management. Moreover, the authors address the unprecedented urge to understand the imaging patterns of possible treatment-related complications of the therapeutic agents used in NHL clinical trials and in practice.

Purpose It is unclear if septal deviation at the insertion points to the nasal cavity is associated with the overall septal deviation. This study aimed to assess septal deviation at the cribriform plate (CP) and maxillary crest (MC) using CT scans and to see if there was any correlation with overall septal deviation.Methods All consecutive CT sinus scans between January 2020 and December 2021 were retrospectively reviewed. Patients were excluded if they had a history of head, nasal or facial trauma, or any previous nasal surgical procedure. Angles between the septum and MC and the septum and CP as well as maximal angle of septal deviation (MSD) were measured.Results A total of 70 scans were included in the final analysis. The mean MSD was 8.14°. The mean septal deviation was 0.89° at the CP and 2.02° at the MC. The correlation coefficient between the deviation at the CP and MSD was 0.025 and between the deviation at the MC and MSD was 0.321.Conclusion Our data reveal a positive correlation between septal deviation at the floor of the nose and overall septal deviation; this was not observed at the septal deviation at the roof. This could be explained due to the inherent tilt in the cribriform plate or by earlier ossification and fixation of the septum during its development at its insertion to the roof, thereby allowing further growth and potential for deviation of the lower part of the septum and its insertion to the floor.

Epiretinal membranes (ERMs) are the result of fibro-cellular proliferation that cause distortion and impairment of central vision. We hypothesized that select microRNAs (miRs) regulate retinal fibro-proliferation and ERM formation. Following IRB approval, a pilot study was performed in patients presenting for retina surgery with and without clinical ERMs. Total RNA was isolated from ERM tissue and controls from non-ERM vitreous and subjected to miR profiling via microarray analysis. MiR-494 was identified as the only miR selectively expressed at significantly greater levels, and in silico analysis identified p27 as a putative fibroproliferative gene target of miR-494. In vitro testing of miR-494 and p27 in fibrotic transformation was assessed in spontaneously immortalized human retinal pigment epithelial (RPE) and human Müller cell lines, stimulated to transform into a fibroproliferative state via transforming growth factor beta (TGFβ). Fibroproliferative transformation was characterized by de novo cellular expression of alpha smooth muscle actin (αSMA). In both RPE and Müller cells, both TGFβ and miR-494 mimic decreased p27 expression. In parallel experiments, transfection with p27 siRNA augmented TGFβ-induced αSMA expression, while only in RPE cells did co-transfection with miR-494 inhibitor decrease αSMA levels. These results demonstrate that miR-494 augments fibrotic transformation in both Müller cells and RPEs, however only in RPEs does miR-494 mediate fibrotic transformation via p27. As p27 is known to regulate cellular proliferation and differentiation, future studies should extend clinical testing of miR-494 and/or p27 as a potential novel non-surgical therapy for ERMs, as well as identify relevant miR-494 targets in Müller cells.

Aims Ablative therapy, such as focal therapy, cryotherapy or electroporation, aims to treat clinically significant prostate cancer with reduced treatment-related toxicity. Up to a third of patients may require further local salvage treatment after ablative therapy failure. Limited descriptive, but no comparative, evidence exists between different salvage treatment outcomes. The aim of this study was to compare oncological and functional outcomes after salvage robot-assisted radical prostatectomy (SRARP) and salvage radiotherapy (SRT). Materials and methods Data were collected prospectively and retrospectively on 100 consecutive SRARP cases and 100 consecutive SRT cases after ablative therapy failure in a high-volume tertiary centre. Results High-risk patients were over-represented in the SRARP group (66.0%) compared with the SRT group (48.0%) (P = 0.013). The median (interquartile range) follow-up after SRARP was 16.5 (10.0–30.0) months and 37.0 (18.5–64.0) months after SRT. SRT appeared to confer greater biochemical recurrence-free survival at 1, 2 and 3 years compared with SRARP in high-risk patients (year 3: 86.3% versus 66.0%), but biochemical recurrence-free survival was similar for intermediate-risk patients (year 3: 90.0% versus 75.6%). There was no statistical difference in pad-free continence at 12 and 24 months between SRARP (77.2 and 84.7%) and SRT (75.0 and 74.0%) (P = 0.724, 0.114). Erectile function was more likely to be preserved in men who underwent SRT. After SRT, cumulative bowel and urinary Radiation Therapy Oncology Group toxicity grade I were 25.0 and 45.0%, grade II were 11.0 and 11.0% and grade III or IV complications were 4.0 and 5.0%, respectively. Conclusion We report the first comparative analyses of salvage prostatectomy and radiotherapy following ablative therapy. Men with high-risk disease appear to have superior oncological outcomes after SRT; however, treatment allocation does not appear to influence oncological outcomes for men with intermediate-risk disease. Treatment allocation was associated with a different spectrum of toxicity profile. Our data may inform shared decision-making when considering salvage treatment following focal or whole-gland ablative therapy.

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Blockchain is the invention that permits digitally generated information to be allocated without being copied. Blockchain technology is the heart of the new internet (i.e., virtual currency). Emerging clever settlement structures over decentralized cryptocurrencies permit jointly suspicious events to transact competently without relying on third parties (i.e., the reason to provide wide security to blockchain technology). Cryptography has so many algorithms to provide security such as MD5, AES, RSA, SHA family, etc. Hash functions are extremely useful and appear in almost all information security applications, so hashing techniques are more secure among them. The authors are designing a new approach (i.e., SHA-512) in a local blockchain application. SHA-512 is a very secure algorithm that uses 64-bit words and operates on 1024-bit blocks. They are proving that SHA-512 is more collision-resistant than its predecessor with a few mathematical models.

Objectives: To assess the safety and clinical impact of a novel, kit-based formulation of 68Ga‐THP PSMA positron emission tomography/computed tomography (PET/CT) when used to guide the management of patients with prostate cancer (PCa). Methods: Patients were prospectively recruited in to one of: Group A: high-risk untreated prostate cancer; Gleason score >4+3, or PSA >20 ng/mL or clinical stage >T2c. Group B: biochemical recurrence (BCR) and eligible for salvage treatment after radical prostatectomy with two consecutive rises in prostate specific antigen (PSA) with a three month interval in between reads and final PSA >0.1 ng/mL or a PSA level >0.5 ng/mL. Group C: BCR with radical curative radiotherapy or brachytherapy at least three months prior to enrolment, and an increase in PSA level >2.0 ng/mL above the nadir level after radiotherapy or brachytherapy. Patients underwent evaluation with PET/CT 60 minutes following intravenous administration of 160±30 MBq of 68Ga-THP PSMA. Safety was assessed by means including vital signs, cardiovascular profile, serum haematology, biochemistry, urinalysis, PSA, and Adverse Events (AEs). A change in management was reported when the predefined clinical management of the patient altered as a result of 68Ga-THP PSMA PET/CT findings. Results: Forty-nine patients were evaluated with PET/CT; 20 in Group A, 21 in Group B and 8 in Group C. No patients experienced serious AEs discontinued the study due to AEs, or died during the study. Two patients had Treatment Emergent AEs attributed to 68Ga-THP-PSMA (pruritus in one patient and intravenous catheter site rash in another). Management change secondary to PET/CT occurred in 42.9% of all patients; 30% in Group A, 42.9% in Group B and 75% in Group C. Conclusion:68Ga-THP PSMA was safe to use with no serious AE and no AE resulting in withdrawal from the study. 68Ga-THP PSMA PET/CT changed the management of patients in 42.9% of the study population, comparable to studies using other PSMA tracers. These data form the basis of a planned Phase III study of 68Ga-THP PSMA in patients with prostate cancer.

Patients who undergo solid organ transplantation are at risk of opportunistic infection associated with immunosuppression. We report a case of confirmed donor derived visceral leishmaniasis (VL), in a patient following liver transplantation causing fever and pancytopenia. The diagnosis was confirmed by bone marrow biopsy, with confirmed positive donor serology, with no other route of transmission. To our knowledge, this is the first case report in the United Kingdom and Europe, of confirmed organ donor transmission of VL. This case report highlights an important consideration of donor derived infections, in the context of solid organ transplantation.

Background: Vitiligo is an acquired, multifactorial disorder of depigmentation and is overwhelming and distressing to the patients and the care givers. Childhood vitiligo has different characteristics as compared to adult-onset vitiligo. Every parent wants to know if the disease will progress or regress. Aims and Objectives: To study the epidemiological, clinical and hematological patterns of children with vitiligo. Materials and Methods: First 50 patients with vitiligo, younger than 12 years of age, who visited the Dermatology outpatient department of Vinayaka Missions Hospital, a tertiary care center in Karaikal, between January 2015 and January 2020 were included. They were assessed for the natural history, clinical features, family history and associated abnormalities of vitiligo. Results: There were 19 boys and 31 girls (boys: girls 1:1.63) out of 50 patients. Mean age of onset of vitiligo was 5.8 years and mean duration was 1.4 years. The most common site was the head and the neck, followed by the extremities, trunk and genitalia and the most prevalent type was vitiligo vulgaris (60%). Then, it was acrofacial vitiligo (26.5%), focal vitiligo (23.7%) and segmental vitiligo (2.6%). 5 patients had a positive family history. Involvement of mucosa in 12%, Leukotrichia in 11% and Koebnerization was seen in 10% children. Body involvement is bilateral in 72% and unilateral in 28% children. Majority of patients (49%) had multiple lesions (more than 5) and most (96%) had Conclusion: In children, any depigmented/hypopigmented lesion should be evaluated and followed up properly to rule out vitiligo. The patterns and characteristics of childhood-onset vitiligo should be understood properly by Dermatologists as it presents in a different manner from adult-onset disease and its management should take several factors into consideration like extension, psychological effects on children and parents, avoidance of treatment side effects and probable association with other autoim

Background: Polycystic ovary syndrome (PCOS) is one of the most common heterogeneous, endocrine and metabolic disorders in women and studies have shown that 10% of the women are affected by PCOS in India. This study aims at assessing knowledge, attitude, and practice of exercise as a treatment option in young females diagnosed with PCOS. Materials and Methods: A cross-sectional study included 100 participants diagnosed with PCOS and were asked to fill a self-made questionnaire that was face validated. Results: 93% of the respondents are aware of PCOS being one of the most common lifestyle disorders. 22.5% were aware of obesity being a complication of PCOS and only 23.1% were aware of weight reduction as a benefit of exercise. 5.4% consulted a Physiotherapist to treat the condition. 70% reported that health care professionals were their main source of information about PCOS. 74% strongly agreed to the importance of treating PCOS to prevent its future complications and 66% agreed to take some time out of their daily schedule to indulge in an exercise program. 84% were aware that exercise is a treatment option in the management of PCOS but only 67% practiced exercise regularly. 34.8% of the population chose a lack of time as the main reason for not exercising regularly. Conclusion: Efforts need to intensify in creating awareness about the complications of PCOS and therefore the importance of exercise as the first line of treatment option to cure the condition along with a healthy diet. A multidisciplinary approach in tackling PCOS has to be emphasized. Keywords: Polycystic ovary disease, Awareness, Exercise, Physiotherapy.

A young Indian man presented elsewhere with a short history of haematuria and cough. Investigations revealed renal and pulmonary lesions. Histopathology of these lesions was reported as mucormycosis. He consulted us two months after onset of symptoms, asymptomatic and clinically well, having received no treatment. In view of clinico-histopathological discordance, a review of the biopsy slides was advised but the patient refused further work-up at that time. One week later, however, he was admitted with left hemiparesis. Brain imaging showed an abscess. He underwent surgical excision of the brain abscess and nephrectomy. Review of previous slides showed septate fungal filaments with granulomatous inflammation. Intraoperative cultures grew Aspergillus flavus. He received voriconazole for one year and is well at his two-year follow-up. His immunological work-up was negative for immunodeficiency. This case illustrates that granulomatous aspergillosis may be an indolent infection in apparently normal individuals and reiterates the importance of interpreting diagnostic reports in conjunction with clinical features.

Background - Many dental professionals are now completing higher degrees that involve a research project. However, many of those research projects, although worthwhile, are not written up for publication in a peer reviewed journal.Aim - To encourage and assist novice authors in transferring their project report into a paper to submit for publication.Discussion - The relationship between the authors and contributors is considered and advice is given on how to focus on the specific research question and produce a succinct paper within the target Journal’s word limit. Emphasis is placed on choosing the right journal for submission and the need to follow the ‘instructions to authors’ as well as what happens post submission, acceptance and publication. Further some of the difficulties that the authors have encountered on their publication journeys’ are highlighted.Conclusion - Great satisfaction will be derived if the novice researcher makes the most of their opportunity of undertaking a research project and subsequently getting it published in a peer reviewed journal. Publishing gives the author recognition within their professional community, a feeling of personal achievement, can create better career perspectives and allows others to build on the work.

Worldwide, peritoneal dialysis (PD) is the preferred renal replacement therapy option for children with end-stage renal disease who are awaiting transplantation. PD involves the instillation of a specifically formulated solution into the peritoneal cavity via a PD catheter, with two-way exchange of solutes and waste products along a concentration gradient. This exchange occurs across the peritoneal membrane. The PD catheter has intraperitoneal, abdominal wall, and external components. Enormous efforts have been directed to augment the efficiency and longevity of the peritoneum as a dialysis system by preventing PD-related infectious and noninfectious complications, which may otherwise result in technique failure and a subsequent temporary or permanent switch to hemodialysis. Imaging has an instrumental role in prompt diagnosis of PD complications and in guiding the management of these complications. The main imaging techniques used in the setting of PD complications-namely, conventional radiography, US, CT, MRI, and peritoneal scintigraphy-as well as the benefits and limitations of these modalities are reviewed. The authors also describe the frequently encountered radiologic findings of each complication. Familiarity with these features enables the radiologist to play a crucial role in early diagnosis of PD complications and aids the pediatric nephrologist in tailoring or discontinuing PD and transitioning to hemodialysis if necessary.

Introduction Regulatory processes for Oral health care professionals are considered essential for patient safety and to ensure health workforce quality. The global variation in their registration and regulation is under-reported in the literature. Regulatory systems could become a barrier to their national and international movement, leading to loss of skilled human resources. The General Dental Council is the regulatory authority in the UK, one of the nine regulators of health care overseen by the Professional Standards Authority. Aim The aim of this paper is to present the professional integration experiences of internationally qualified dentists (IQDs) working in the UK, against the background of regulation and accreditation nationally. Methods Registration data were obtained from the General Dental Council to inform the sampling and recruitment of research participants. Semi-structured interviews of 38 internationally qualified dentists working in the United Kingdom were conducted between August 2014 and October 2017. The topic guide which explored professional integration experiences of the dentists was informed by the literature, with new themes added inductively. A phenomenological approach involving an epistemological stance of interpretivism, was used with framework analysis to detect themes. Results Internationally qualified dentist’s professional integration was influenced by factors that could be broadly classified as structural (source country training; registration and employment; variation in practising dentistry) and relational (experiences of discrimination; value of networks and support; and personal attributes). The routes to register for work as a dentist were perceived to favour UK dental graduates and those qualifying from the European Economic Area. Dentists from the rest of the world reported experiencing major hurdles including succeeding in the licensing examinations, English tests, proving immigration status and succeeding in obtaining a National Health Service performer number, all prior to being able to practice within state funded dental care. Conclusion The pathways for dentists to register and work in state funded dental care in UK differ by geographic type of registrant, creating significant inconsistencies in their professional integration. Professional integration is perceived by an individual IQD as a continuum dictated by host countries health care systems, workforce recruitment policies, access to training, together with their professional and personal skills. The reliance of the UK on internationally qualified dentists has increased in the past two decades, however, it is not known how these trends will be affected by UK’s exit from the European Union and the COVID-19 pandemic.

Additional file 1. Subthemes and main themes from the qualitative data.

316 Background: The impact of molecular imaging (MI) on patient management after biochemical recurrence (BCR) following radical prostatectomy has been described in many studies. However, it is not known if MI-induced management changes are appropriate. This study aimed to determine if androgen deprivation therapy (ADT) management plan is improved by MI in patients who are candidates for salvage radiation therapy. Methods: Data were analyzed from the multicenter prospective PROPS trial evaluating PSMA/Choline PET in patients being considered for salvage radiotherapy (sRT) with BCR after prostatectomy. We compared the pre- and post-MI ADT management plans for each patient and cancer outcomes as predicted by the MSKCC nomogram. A higher percentage of predicted BCR associated with ADT treatment intensification after MI was considered as an improvement in a patient’s management. Results: Seventy-three patients with a median PSA of 0.38 ng/mL were included. In bivariate analysis, a positive finding on MI (local or metastatic) was associated with decision to use ADT with an odds ratio of 3.67 (95% CI, 1.25 to 10.71; p=0.02). No factor included in the nomogram was associated with decision to use ADT. Also, MI improved selection of patients to receive ADT based on predicted BCR after sRT: the predicted nomogram 5-year biochemical-free survivals were 52.5 % and 43.3%, (mean difference, 9.2%; 95% CI 0.8 to 17.6; p=0.03) for sRT alone and ADT±sRT subgroups, while there was no statistically significant difference between subgroups before MI. Conclusions: PSMA and/or Choline PET/CT before sRT can potentially improve patient ADT management by directing clinicians towards more appropriate intensification.

The most commonly encountered disorders with microcytic anemia are iron deficiency anemia (IDA) and β-thalassemia trait (BTT).It is important to distinguish between IDA and BTT to avoid unnecessary iron therapy and the development of hemosiderosis.Various parameters obtained on automated haematology analyser by calculating discriminant functions have been helpful to differentiate iron deficiency anemia and β-thalassemia trait. Materials and Methods: This study was carried out in the pathology department of Gujarat Adani Institute Of Medical Science.We had studied 100 cases of differentiating Iron deficiency anaemia and β-Thalassaemia trait from patient's case records and laboratory reports irrespective of age and sex over a period of one year (January 2020 to December 2020).Tests for serum iron and ferritin were carried out in individuals showing low hemoglobin (Hb). All the selected subjects' samples were subjected to blood morphology, comparison of mean cell volume (MCV), RBC count, red cell distribution width (RDW), Red cell distribution width Index (RDWI),Srivastav Index(SI),Green and king Index (GI) and Mentzer's Index(MI). Results: Out of 100 cases seventy five were diagnosed having iron deficiency anaemia, whereas twenty five were having βthalassemia trait. The RBC count was higher and MCV was much lower in β-thalassemia trait as compared to iron deficiency anaemia.Both groups were subjected to RDW,RDWI,SI,MI and GI. Conclusion:Among various discriminant function calculated from different haematological parameters and blood indices,Mentzer index and Srivasta index are more sensitive and specific for differentiating iron deficiency anaemia and β-thalassemia trait.

Information poverty is widely recognised as having a negative impact upon peoples’ health and wellbeing, and socioeconomic prosperity; however, whilst an issue of significant societal concern evidenced across a wide variety of adult groups and socioeconomic contexts, no studies have been previously undertaken with children. This appears a significant oversight given that many children across the globe are considered multi-dimensionally poor. This study thus sought to explore the possibility of information poverty amongst children. One hundred fifty-six children (aged 6–8) from five UK primary schools participated in a series of practical exercises exploring their information behaviours, and 34 parents and teachers were interviewed to provide further insights. Finding’s evidence self-protective information behaviours and unmet information needs amongst children aged 6–8; both characteristics of an impoverished information state. Whilst much can be explained in developmental terms (i.e. in relation to child age and emergent literacies), much can also be explained in information poverty terms encompassing issues of both information access and use. Notably, approximately half of our child participants considered themselves to be, in general, unsuccessful information seekers; and contrasts with the views of our adult participants who majority believed that children are, in general, successful information seekers. This paper provides the first evidence of information poverty in young children, and provides further insights into the role of parents in supporting their children’s information needs and shaping their developing information behaviours, with parental mediation of child media use appearing particularly problematic. Enduring inequalities in information access are also highlighted. Beyond call for further global research, a public communication campaign to increase awareness of child information poverty and contributory factors is recommended as an immediate priority.

Medical education and training of health professionals are linked with their recruitment and retention. Practising as a competent health professional requires life-long continuous training and therefore training structures in health systems appear to influence doctors job satisfaction, their well-being and their intentions to remain in that health system. The commentary critiques aspects of the paper on doctors retention in Ireland, while drawing some parallels with the United Kingdom. There appears to be an emerging type of health professional migrants ‘education tourists’ who travel to other countries to obtain medical education creating new routes of migration and this presents new challenges to source and destination countries. The global shortage of doctors and other health professionals further exacerbates health inequalities as seen in the present pandemic and therefore the increased need for research into health professionals’ migration and their integration.

Introduction: Kikuchi - Fujimoto disease (KFD), also known as Histiocytic necrotizing lymphadenitis is a benign, uncommon, self-limited disease of unknown etiology. Young females are primarily affected and it manifests primarily as cervical lymphadenopathy with tenderness at times. Kikuchi and Fujimoto, way back in 1972, reported it from Japan, independently and simultaneously, as a type of lymphadenitis associated with numerous histiocytes and extensive nuclear debris. The present study aims to study the key cytomorphological features of KFD along with its clinicopathological correlation. Materials and Methods: This present study was carried out in a tertiary care hospital for a period of one year. The cases that were diagnosed as KFD on Fine needle aspiration cytology (FNAC) and whose follow up histopathology was confirmatory were included in the present study. Papanicolaou stain (PAP stain), Hematoxylin and eosin stain (H&E), and May-Grunwald Giemsa stain (MGG stain) was done on smears. Following cytological features were evaluated; cellularity, crescentic histiocytes, plasmocytoid monocytes, karyorrhectic debris and intra and extra cytoplasm apoptotic bodies. Result: Females in the age group of 31-40 years were most commonly affected with cervical lymphadenopathy as the presenting feature. The most common clinical diagnosis rendered by clinicians was tuberculosis. Karyorrhexis, crescentic histiocytes and plasmacytoid monocytes were the key cytological features. Conclusion: This study emphasizes on the key cytological features of the rare entity of KFD and its clinicopathological correlation. Knowledge and timely diagnosis of this rare entity avoids unnecessary surgical intervention and helps in timely management. Keywords: Cervical lymphadenopathy, Crescentic histiocytes, Karyorrhexis.

The pyridinophane molecule L2 (3,6,9,15-tetraazabicyclo[9.3.1]penta-deca-1(15),11,13-trien-13-ol) has shown promise as a therapuetic for neurodegenerative diseases involving oxidative stress and metal ion misregulation. Protonation and metal binding stability constants with Mg(2+), Ca(2+), Cu(2+), and Zn(2+) ions were determined to further explore the therapeutic and pharmacological potential of this water soluble small molecule. These studies show that incorporation of an –OH group in position 4 of the pyridine ring decreases the pI values compared to cyclen and L1 (3,6,9,15-tetraazabicyclo[9.3.1]penta-deca-1(15),11,13-triene). Furthermore, this approach tunes the basicity of the tetra-aza macrocyclic ligand through the enhanced resonance stabilization of the –OH in position 4 and rigidity of the pyridine ring such that L2 has increased basicity compared to previously reported tetra-aza macrocycles. A metal binding preference for Cu(2+), a redox cycling agent known to produce oxidative stress, indicates that this would be the in vivo metal target of L2. However, the binding constant of L2 with Cu(2+) is moderated compared to cyclen due to the rigidity of the ligand and shows how ligand design can be used to tune metal selectivity. An IC(50)=298.0 µM in HT-22 neuronal cells was observed. Low metabolic liability was determined in both Phase I and II in vitro models. Throughout these studies other metal binding systems were used for comparison and as appropriate controls. The reactivity reported to date and pharmacological features described herein warrant further studies in vivo and the pursuit of L2 congeners using the knowledge that pyridine substitution in a pyridinophane can be used to tune the structure of the ligand and retain the positive therapeutic outcomes.

Genetic diversity among 24 genotypes of sorghum was studied by using 20 random primers. The total number of amplified PCR bands was 591 of which 495 (83.75%) were polymorphic displaying PIC values ranging from 0.27 to 0.69 with an average of 0.52. Similarity coefficients among the genotypes were ranged from 0.33 to 0.89. The similarity coefficient was used to construct a UPGMA based dendrogram using average linkage between groups. The analysis illustrates considerable potential of RAPD markers for estimating genetic diversity among 24 genotypes of sorghum.

Background: The Coronavirus disease (COVID-19) pandemic has contributed to over 1,000,000 deaths worldwide. Hospitals responded by expanding services to accommodate the forecasted rise in COVID-19-related admissions. We describe the effects these changes had on management of orthopaedic trauma and patient outcomes at a district general hospital in Southern England.Methods: Data were extrapolated retrospectively from two separate six-week periods in 2019 and 2020 (1st April - 13th May) using electronic records of patients referred to the orthopaedic team. Soft tissue injuries were included where a confirmed diagnosis was made with radiological evidence. Patients were excluded if no orthopaedic intervention was required. Data were compared between the two time periods. Results: There were fewer attendances to hospital in 2020 compared with 2019 (178 vs 328), but time from presentation to surgery significantly increased in 2020 (2.94 days vs 4.91 days, p=0.009). There were fewer operative complications in 2020 (36/145 vs 11/88, p). However, ordinal logistic regression analysis found a significantly greater complication severity in 2020 including death (p=0.039). Complication severity was unrelated to COVID-19 status.Conclusions: Restructuring of orthopaedic services in response to the COVID-19 pandemic has been associated with significant delays to surgery and higher post-operative complication severity. Our results demonstrate the need for fast-track emergency operative orthopaedic services in UK district general hospitals whilst the COVID-19 pandemic continues.

Perhaps the most important lesson learned from the COVID-19 pandemic is that of preparedness. Enhanced surveillance systems for early threat detection will be crucial to maximizing response time for implementation of public health measures and mobilization of resources in containing an emerging pandemic. Recent outbreaks have been dominated by viral pathogens, with RNA respiratory viruses being the most likely to have pandemic potential. These should therefore be a preparedness priority. Tools in the areas of virology, drug discovery, clinical pharmacology, translational medicine and pharmacometrics should be considered key components in the rapid identification and development of existing and novel interventions for a pandemic response. Prioritization of therapeutics should be based on in vitro activity, likelihood of achieving effective drug concentrations at the site of action, and safety profile at the doses that will be required for clinical efficacy. Deployment strategies must be tailored to the epidemiology of the disease, and the adequacy of the response should be re-evaluated in view of evolving epidemiological factors. An interdisciplinary framework integrating drug pharmacology, viral kinetics, epidemiology and health economics could help optimize the deployment strategy by improving decision-making around who to treat, when to treat, and with what type of intervention for optimal outcomes. Lastly, while an effective vaccine will ultimately end a pandemic, antiviral drug intervention guided by clinical pharmacology principles will continue to play a critical role in any pandemic response.

With the increase in content being uploaded daily on video sharing platforms, the need to moderate the material uploaded becomes mandatory. Traditional profane removal mechanisms follow a prolonged approach. This is not recommended since the audience already had access to the media before it was identified of having potential profane content. There has been extensive work in the domain focusing on profanity removal from text. There arises a need for automated video moderation technique to handle the media which is being uploaded at the initial stage itself so as to provide a profane free platform to the viewers which ranges from kids to the adults. With a view to detect and remove profanity from the video-sharing platforms, this paper suggests an approach to silence the audio and pixelate the lips present if any in the video-segments containing profanity using machine learning.

Using whole genome sequencing (WGS) as a diagnostic tool allows for faster and more accurate diagnosis of TB strains. WGS predictions on drug susceptibility mean that patients can be treated with the right medication more quickly than with previous methods.

Health has always been a major concern with the magnification of human race and advancement in technology. It has enabled healthcare to be taken solemnly in adverse and non-adverse situations. Internet of Things plays a consequential role in epidemic situations and enables all contrivances to communicate with each other, regardless of the company or brand they belong to. IOT has made quite paramount researches in the healthcare industry and thus results its applications in sundry scenarios. This IOT paper focuses mainly on developing a keen real time health monitoring system that can monitor a patient’s basic health signs as well as the room condition, where the patients are now in authentic-time. A remote healthcare monitoring system is enabled so that the sanctioned utilizer can access the data recorded and thereby the diseases can be diagnosed by the doctors from a distance.

BackgroundJoint replacement is an effective intervention and prosthetic joint infection (PJI) is one of the most serious complications of such surgery. Diagnosis of PJI is often complex and requires multiple modalities of investigation. We describe a rare cause of PJI which highlights these challenges and the role of whole-genome sequencing to achieve a rapid microbiological diagnosis to facilitate prompt and appropriate management.Case presentationA 79-year-old man developed chronic hip pain associated with a soft-tissue mass, fluid collection and sinus adjacent to his eight-year-old hip prosthesis. His symptoms started after intravesical Bacillus Calmette-Guerin (BCG) therapy for bladder cancer. Synovasure™ and 16S polymerase chain reaction (PCR) tests were negative, but culture of the periarticular mass and genome sequencing diagnosed BCG infection. He underwent a two-stage joint revision and a prolonged duration of antibiotic therapy which was curative.ConclusionsBCG PJI after therapeutic exposure can have serious consequences, and awareness of this potential complication, identified from patient history, is essential. In addition, requesting appropriate testing is required, together with recognition that traditional diagnostics may be negative in non-pyogenic PJI. Advanced molecular techniques have a role to enhance the timely management of these infections.

Objectives\ud To establish current uro‐oncology practice in the management of sexual dysfunction (SD) following radiotherapy (RT) and/or androgen deprivation therapy (ADT) to treat prostate cancer. To identify differences in approach to the management of SD according to disease stage.\ud \ud Subjects and methods\ud A 14‐question mixed methods survey was designed to assess the current UK practice. Closed‐ and open‐ended questions were used to quantify results while allowing participants to expand on answers. The survey was distributed to members of the British Uro‐Oncology Group at the 2019 annual meeting.\ud \ud Results\ud Surveys were completed by 63 uro‐oncologists attending the annual meeting of the British Uro‐Oncology Group (response rate 66%). The major issue highlighted was a difference in approach to managing SD according to disease stage. More than half of the participants (56%) said ‘advanced stage of disease’ was a barrier to discussing SD. Clinicians were less likely to discuss SD, take baseline assessments, refer to a specialist clinic or offer rehabilitation when dealing with patients with advanced disease. Only a minority said that the management of SD was primarily their responsibility (11%). Nearly all clinicians (92%) had access to SD clinics; however, the majority of clinicians did not routinely refer patients.\ud \ud Conclusions\ud This study shows that men with advanced prostate cancer need better support in managing SD. Patients receiving long‐term ADT are less likely to be offered any kind of help or intervention. Specific guidance on managing SD in this cohort may result in improvements in sexual function, emotional well‐being, quality of life, mental health and confidence.

In today's world, one of the major environmental problems is the collection, management and disposal of the garbage. The current process of garbage collection does not consider real-time garbage level in dustbins while generating routes for garbage trucks. Collecting garbage in an unordered way leads to overfilling of bins, rotting garbage smell, more fuel consumption of trucks and hence has adverse effects on the environment. Moreover, the capacity of garbage trucks is not utilized. With the development of smart cities around the globe, there is an increasing need for IoT based technological solutions for solid waste management which will help in promoting a clean and sustainable environment. The proposed system gathers the real-time garbage level of every bin with the help of ultrasonic sensors. This data is then used to generate dynamic routes for garbage trucks while considering several factors like capacity of trucks and bins, the distance between bins, and the level of garbage.

Background In oncology practice, eliciting the patient’s perspective on their quality of life (QOL) adds important information and value to their treatment and care. The European Organization for Research and Treatment of Cancer QOL questionnaire (EORTC QLQ-C30) is the most commonly used tool for this purpose but has not been validated in Kenya. The present study aimed to conduct a preliminary assessment of the QOL among Kenyan cancer patients and examine the psychometric properties of the tool in this population. One hundred patients with heterogeneous types of cancer were enrolled in this cross-sectional study between July and August 2019. The EORTC QLQ-C30 questionnaire was administered to patients using either the English or Kiswahili official version. Descriptive statistics were used to assess patient demographics and clinical characteristics. The psychometric properties of the EORTC QLQ-C30 were evaluated in terms of acceptability, internal consistency, and construct validity using statistical software packages, STATA and SPSS. Results The EORTC QLQ-C30 was found to be acceptable for use in our patient population as indicated by high compliance and low missing responses. Of the 100 patients, 66 were able to self-administer the questionnaire. The average time for completion was 13 min. Preliminary QOL assessment indicated an average QOL in Kenyan cancer patients (53 ± 27). Among the function scales, participants scored the lowest on the social function scale (51 ± 36) whereas among the symptom scales, participants scored the highest on the financial difficulties scale (79 ± 31). Cronbach’s alpha coefficient values ranged from 0.72–0.95, illustrating the reliability of the scales measured. Interscale correlations were statistically significant (p Conclusion The results from this study provide important first insights into using EORTC QLQ-C30 in the Kenyan population. We conclude that the questionnaire is an acceptable, reliable, and valid instrument for measuring the QOL in cancer patients in Kenya and recommend its use in clinical practice.

Our objectives were to assess the safety and clinical impact of a novel, kit-based formulation of (68)Ga-tris(hydroxypyridinone) ((68)Ga-THP) prostate-specific membrane antigen (PSMA) for PET/CT in guiding the management of patients with prostate cancer. Methods: Patients were prospectively recruited to group A (high-risk untreated prostate cancer; Gleason score ≥ 4 + 3, or prostate-specific antigen (PSA) level > 20 ng/mL or clinical stage > T2c), group B (biochemical recurrence and eligible for salvage treatment after radical prostatectomy with 2 consecutive rises in PSA with a 3-mo interval between reads and a final PSA level > 0.1 ng/mL or a PSA level ≥ 0.5 ng/mL), or group C (biochemical recurrence with radical curative radiotherapy or brachytherapy at least 3 mo before enrollment, and an increase in PSA level > 2.0 ng/mL above the nadir level after radiotherapy or brachytherapy). Patients underwent evaluation with PET/CT 60 min after intravenous administration of 160 ± 30 MBq of (68)Ga-THP PSMA. Safety was assessed through vital signs, cardiovascular profile, serum hematology, biochemistry, urinalysis, PSA, and adverse events (AEs). A change in management was reported when the predefined clinical management of the patient was altered as a result of the (68)Ga-THP PSMA PET/CT findings. Results: Forty-nine patients were evaluated with PET/CT: 20 in group A, 21 in group B, and 8 in group C. No patients experienced serious AEs, discontinued the study because of AEs, or died during the study. Two patients had treatment-emergent AEs attributed to (68)Ga-THP PSMA (pruritus in one patient and a rash at the intravenous catheter site in another). A management change secondary to the PET/CT findings occurred in 42.9% of all patients: 30% in group A, 42.9% in group B, and 75% in group C. Conclusion: (68)Ga-THP PSMA was safe to use, with no serious AEs and no AEs resulting in withdrawal from the study. (68)Ga-THP PSMA PET/CT changed the management of 42.9% of the study population, comparable to studies using other PSMA tracers. These data form the basis of a planned phase III study of (68)Ga-THP PSMA in patients with prostate cancer.

Introduction The National Health Service’s reliance on overseas doctors and nurses, unlike dentists, has been widely reported. As the United Kingdom (UK) leaves the European Union, an understanding of the migration trends and possible influences are important to inform future planning. Aim To examine trends in the profile of UK registered dentists in the context of key events and policy changes from 2000 to 2020. Method Data were obtained from the General Dental Council via annual reports, and under ‘freedom of information’ communications; details of policy initiatives were obtained from the government and professional websites. Results Over a 20-year period (2000–2019), the number of registered dentists increased from 31,325 to 42,469, a net increase of 36% (11,144 dentists), the majority of whom were international graduates (58%; n = 6,416) such that by December 2019, 28% of all registered dentists had qualified outside of the UK. Similarly, regarding new registrants, there were increases of graduates from UK (18%), EEA countries (214%) and, via the Overseas Registration Examination route (621%); and a decrease from countries with bilateral agreements for recognition (43%), in line with changes in health and immigration policies. Conclusions International dental graduates increasingly contribute to the UK dental workforce and there is an urgent need for research into dentist migration and retention in the UK in support of patient access to dental care. Impact The United Kingdom (UK) dental workforce is increasingly reliant on international dental graduates representing 28% of current registrants compared with 18% in 2000. Health policies and immigration policies were the main drivers that influenced dental workforce migration to the UK along with wider events, such as EU expansions, global recession and Brexit. Pre-existing lack of research into dental workforce could add to the uncertainties of post COVID-19 oral health care access and delivery.