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We highlight the role of contrast-enhanced ultrasound (CEUS) as a supplementary modality to ultrasound (USG) examination in ovarian torsion in this case report. The reported patient had clinical history suspicious of ovarian torsion; however, USG and Doppler flow study findings were equivocal. CEUS was performed to solve the diagnostic dilemma and to know the status of ovarian parenchymal viability which revealed non-enhancement of the ovarian cyst wall and pedicle throughout the USG examination thus establishing the diagnosis of non-viable or infarcted ovarian parenchyma. The per operative and histopathology findings were consistent with our CEUS findings. CEUS is an emerging promising modality which provides information regarding parenchymal perfusion, resulting in a reliable diagnosis of ovarian torsion along with information on ovarian parenchymal viability. This ability makes CEUS equivalent to contrast-enhanced CT or MRI.

A male patient in his 20s presented with a cough and a small volume of haemoptysis that lasted a year. He had no other constitutional symptoms and a respiratory examination was suggestive of a consolidation. A chronic infection, such as tuberculosis, was suspected. The routine evaluation showed peripheral eosinophilia with raised serum total IgE. Sputum examination for tuberculosis was negative; hence, a high-resolution CT of the thorax was performed, which revealed bilateral bronchiectasis with high-attenuation mucus plugging. The imaging and blood profiles were in favour of allergic bronchopulmonary aspergillosis, but there was no history suggestive of asthma, and the pulmonary function test was normal. The patient underwent a skin prick test and an allergen-specific IgE test forAspergillus fumigatus, and both were positive. His bronchoalveolar lavage cultures also grewA. fumigatus, and he responded well to antifungal therapy. This case illustrates the presentation of a rare entity—allergic bronchopulmonary aspergillosis sans asthma.

Thyroid mucoepidermoid carcinoma (MEC) is a rare thyroid malignancy first documented in 1977. The majority of thyroid MECs are indolent, low-grade tumours with excellent prognosis. A woman in her 60s presented with an ongoing sensation of a lump in the left neck. There were no swallowing, voice or airway concerns. Ultrasound of the neck showed an enlarged thyroid with U5 and U3 features on the right and left lobes, respectively. Right fine needle aspiration cytology (FNAC) demonstrated certain features of Hurthle cell or anaplastic carcinoma (Thy5). Left FNAC showed Hurthle cell changes with atypical cells and prominent nucleoli (Thy3a). Following total thyroidectomy, histopathology revealed synchronous right low-grade MEC and left papillary thyroid microcarcinomas (pT2(m) N0 M0) on a background of Hashimoto’s thyroiditis. This case adds to the literature and details the key histopathological features for a rare but important differential in patients with thyroid carcinoma due to synchronous histological types.

Recurrent episodes of vomiting and diarrhoea in a child can present as a diagnostic dilemma and be easily misdiagnosed as recurrent viral gastroenteritis episodes. Primary adrenal insufficiency can present with recurrent episodes of vomiting and diarrhoea with the presence of metabolic acidosis and can be life-threatening if left undiagnosed and untreated. A high index of suspicion should be kept for diagnosing primary adrenal insufficiency in a child presenting with recurrent episodes of vomiting and diarrhoea with laboratory evidence of metabolic acidosis and hypoglycaemia. Primary adrenal insufficiency, in a male child specifically, should raise alarm for X-linked adrenoleukodystrophy (X-ALD). Very-long-chain fatty acids and confirmatory genetic testing for an ABCD1 gene mutation can help confirm the diagnosis. Addison’s disease often presents prior to the onset of the cerebral form of X-ALD. Early diagnosis of X-ALD allows for MRI screening for the development of cerebral disease in its early stages when treatment with stem cell transplant can halt the disease and be lifesaving.

Abstract: Cardiovascular disorders (CVDs) are the leading cause of death worldwide and are accelerated via the low level of low-density lipoprotein-cholesterol (LDL-C). The proprotein convertase subtilis/kexin type9 (PCSK9), a vital regulator and a biomarker, circulates for the LDL-C and has the degradation capability of the low-density lipoprotein receptor (LDLR). PCSK9 has modulated the overall mechanism by transcription, secretion, clearance, or extracellular inactivation in the past few years.PCSK9 has specific pathophysiological roles in many cardiovascular cells. The initial data on the PCSK9 inhibitor, Evolocumab, has a specific reduction in the composite end-point, such as cardiovascular, myocardial, and stroke, while the rest of the data release is still under wait. Furthermore, it is witnessed that the U.S. and the European authorities have approved two humanized antibodies against the LDL-R binding site of PCSK9. This review highlighted the recent data findings on the PCSK9 and its regulation, focusing on cardiovascular disorders, and summarized the current clinical studies. Thus it provides a ray of hope to overcome statin intolerance and alternative approaches for PSCK9 inhibition and significantly reduce cardiovascular complications. This review plays a pivotal role for the researchers and scientists working on PCSK9 inhibitors to treat cardiovascular disorders.

Abstract: Molecular pharmaceutics play a critical role in the drug delivery system, representing the direct interconnection of drug bioavailability with its molecular form. There is a diversity in the molecular structures by which it affects its properties, such as amorphous form, crystalline form, partialamorphous molecular dispersion, and disordered state. The active pharmaceutical ingredient (API) and the excipients utilized in the formulation process contain various divergent modes used in the formulation process. They include better formulations of any type to obtain good quality pharmaceutical products. This review reveals how the molecular states affect the API and are important in maintaining the quality of dosage forms. Furthermore, the physio-chemical properties of the components and various pharmaceutical approaches employed in the formulation of dosage forms are studied from the point of view of molecular pharmaceutics.

Abstract: Nanoparticles are well-established carriers for targeted delivery of bioactive polymeric nanoparticles (PNPs). They have attracted significant attention from pharmaceutical scientists globally due to their wide range of applications in the medical field. The encapsulation of drugs into the nanoparticles offer several unique characteristics leading to prolonged circulation, improved drug localization, and thus enhanced drug efficacy. It also provides a better understanding of the molecular basis of the disease. Nanoparticles allow efficient maintenance of medication cycles at the target site, with less exposure to normal cells and thus decreasing the rehabilitation period. Despite extensive developments in the field of nanotechnology, specifically in drug delivery, only a few nanotechnology-based products are currently available in the market. Thus, further advanced exploration is necessary to make nanoparticles useful for the betterment of mankind. This review is focused on recent advancements in pharmaceutical nanotechnology with special emphasis on polymers used for the preparation of PNPs and their emerging applications in tumor-targeting. This manuscript also highlights on the recent patents disclosing PNPs for tumor targeting.

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.

Enterolith in the Roux limb of hepaticojejunostomy causing jaundice is a rare occurrence. A 40-year-old woman had an extrahepatic biliary obstruction and cholangitis 13 years after the Roux-en-Y repair of postcholecystectomy benign biliary stricture. On evaluation, an enterolith was obstructing the Roux limb, which was successfully managed surgically.

A woman in her 20s presented with chilblains for 2 years and recent-onset photodistributed psoriasiform plaques. She did not have persistent good improvement despite treatment with 1 mg/kg oral prednisolone, along with successive trials with many steroid-sparing adjuvants in adequate dosage and duration, including hydroxychloroquine, methotrexate and cyclosporine, in the following 6 months. The patient had an excellent improvement and went into remission with two doses of injection rituximab, 1 g each, at a 2-week interval. The remission was maintained during the 14-month follow-up.

A patient in his late 40s presented after 1-year following below knee amputation and targeted muscle reinnervation (TMR) with new prosthesis intolerance and pinpoint pain, suspicious for neuroma. X-ray confirmed fibular heterotopic ossification (HO). Operative revision identified HO encompassing a TMR construct with a large neuroma requiring excision and neuroplasty revision. Now approximately 1-year post procedure, the patient remains active, pain-free and ambulating with a prosthetic. Amputated extremities can be at risk for development of HO. Although described in literature, the pathophysiology and timeline for HO development is not well understood. Preventative measures for HO have been described, yet results remain variable. The gold standard for existing HO remains to be operative excision. Due to the unpredictable nature and debilitating presentation, risk of HO should be incorporated into patient–physician discussions. Additionally, new prosthetic intolerance absent of prior trauma should raise suspicion for possible HO development.

Correction to Lancet Gastroenterol Hepatol 2022; 7: 627-47. Lancet Gastroenterol Hepatol. 2022 Aug;7(8):704. doi: 10.1016/S2468-1253(22)00210-2. PMID: 35809605. Background: Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. Methods: Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990-2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. Findings: Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408-868 574) to 2·17 million (2·00-2·34), and deaths increased from 518 126 (493 682-537 877) to 1·09 million (1·02-1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3-23·0) per 100 000 to 26·7 (24·6-28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5-14·9) per 100 000 to 13·7 (12·6-14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7-320·7) per 100 000 to 295·5 (275·2-313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9-80·0] per 100 000), Monaco (60·7 [48·5-73·6] per 100 000), and Andorra (56·6 [42·8-71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0-37·1] per 100 000), Brunei (30·3 [26·6-34·1] per 100 000), and Hungary (28·6 [23·6-34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age

Abstracts: The extension of carbon chains, known as homologation, is one of the most fundamental operations of organic synthesis. One and two-carbon homologation reactions are of immense importance because they can be used for synthesizing members of a homologous series by iterative operations. Homologation reactions produce higher analogues of the same functional group, whereas homologation- functional group interconversion (FGI) generates higher analogues with a change in functionality. This general synthesis strategy may be counted for a number of reasons, such as higher accessibility to the successive homologs, a chance for the introduction of additional functionality, or solely to create a regular series of homologs. The advantages of homologation reactions could be measured by the efficiency, technical simplicity, and regio- and/or stereo-selectivity of the overall operations in a synthetic plan. Homologation reactions constitute powerful and versatile tools for preparative chemistry which uses different concepts underpinning the use of homologating reagents in addition to their applications in organic synthesis. A compilation and comparison of diverse methods available for homologation cum functional group interconversion will empower synthetic chemists to undertake studies that require a series of analogues. In this review, we have categorized and summarized such methods and synthetic applications of one and two-carbon homologation-functionalization of various functional groups in organic synthesis.

Background: Stressors have a huge impact on one’s well-being. They affect individual’s mental and physical health, if untreated. The response to these stresses is termed as a stress response. Based on the type and severity of the stimulus, stress can affect the various actions and functioning of the body. This explains how important it becomes to detect the level of stress and treat it well. The best treatment for stress is to identify the factors causing stress and eliminate them in the initial stage. Various methods have been proposed to detect the level of stress. One of the common methods is by using wearable devices to capture EEG signals and use various proposed algorithms to detect the level of stress. However, there are cases where stress cannot be captured by non-invasive technologies. Besides, these technologies cannot determine the stress-causing factors. This paper proposes a methodology to cater to such cases and identify the factors causing stress in the patient. It can also act as a front line methodology to detect if the candidate is suffering from anxiety or stress. The use of fuzzy logic in various healthcare areas has become very evident. This is because it deals with a range of values. While, Petri nets is a network where the arc runs from place to transition and not between places and transitions. It is the best model to use in dynamic and concurrent activities of the system. Thus, a combination of these two logics can provide an extremely competent basis for the implementation of computing reasoning processes and the modeling of systems with uncertainty. Thus, Fuzzy Petri Nets (FPN) have been proposed. This paper proposes the use of FPN in designing a methodology for factors responsible for causing stress and advancing the level of stress in the patient. The methodology is developed by observing the process of food transfer in plants. The authors have also discussed afferent and efferent stress paths. Method: The methodology proposed in this paper uses Fuzzy Petri Net. The algorithm designed in this paper has been named as the Sprouting tree algorithm by the authors. Designing the fault tree is the first and very important step for the correct determination of the level of the stress. The score generated using the Hamilton scale is fed as input to the AND/OR gate system to receive the value of stressor, and thus, drawing a fault tree. The transformation rules are applied to convert the fault tree into the FPN. Then, we derive production rules and reachability matrix. These rules help in normalizing the value obtained via fault tree so that they lie in the range of fuzzy logic. FPN calculates the certainty factor (CF), which represents the state of stress in an individual. Therefore, the values obtained from FPN will finally build a tree, which is named as Sprouting tree. Conclusions: The methodology proposed in this paper is absolutely new to detecting the stress. The future of this work is to observe the accuracy of the proposed algorithm by implementing it with real data, which is under process.

Background: Methotrexate is an antimetabolite anticancer drug frequently used in the treatment of extensive chronic plaque psoriasis. Psoriasis patients on treatment with immunosuppressants have an increased risk of developing malignancies. Objective: To present a rare case of Oral Squamous Cell Carcinoma (OSCC) in a psoriasis patient postacute methotrexate toxicity. Case Report: A 47-year-old female, a known case of chronic plaque psoriasis for which she was on 15 mg/ week methotrexate therapy and accidentally consumed 15 mg for 7 consecutive days. She was successfully treated for methotrexate toxicity and 45 days later she presented with exophytic growth on the tongue. Histopathology confirmed the diagnosis of squamous cell carcinoma and the patient underwent surgical resection. Conclusion: There could be a causal association between psoriasis and OSCC in the setting of acute methotrexate toxicity, as in the present case.

Background: Polysaccharides are a type of natural macromolecular polymer that can be found in plants, animals, fungi, algae, and marine organisms. Its activities have piqued the interest of researchers. The internal structure, as well as their chemical and physical properties, dictate how they work. Polysaccharide functionalities are progressively being chemically changed. Using this approach, polysaccharides' structural, physicochemical, and biological properties can all be altered. Aim and Methods: The review sought to provide an overview of polysaccharide modification but also biological use. Recent research has shown that chemically modifying polysaccharides may increase their immunological function as well as their antiviral, antibacterial, antioxidant, as well as other characteristics. There are several chemical modifications, including sulfation, carboxymethylation, acetylation, phosphorylation, and others. Modified polysaccharide recent developments are reviewed. Discussion and Result: Polysaccharide physiochemical properties and biological activity can change as their structural properties change. The structural modifications that occur depend on the source of the polysaccharides. Chemical modification has enormous promise for enhancing biomedical applications. These modified polysaccharides have made significant contributions to tissue engineering and drug delivery applications. Modification of polysaccharides induces therapeutic benefits. The immunomodulation of polysaccharides and their derivatives, as well as their chemical modification, has been studied and discussed. Conclusion: These modified polysaccharides have the potential to be used for wound dressing, gene delivery, drug delivery, etc.

Abstract: Metastases result from a complicated process in which malignant cells detach from the initial cancerous cells and disseminate to other locations. Few therapy options are available that aim to prevent or counteract metastatic disorders. Identifying novel molecular targets and medications, developing techniques to distribute preexisting chemicals, and combining resources to supervise individualized treatment are all part of this process. Because of its improved sensitivity, accuracy, and multiplexed measurement capacity, nanotechnology has been investigated to recognize extracellular cancer biomarkers, cancer cells, and bioimaging. Nanotechnology is a vast and rapidly expanding field with enormous potential in cancer treatment. Nanoparticles can treat resistant cancers with minimal harm to healthy tissues and organs by targeting cancer stem cells. Nanoparticles can also trigger immune cells, which can help to destroy malignancies. The potential of herbal-based nano formulation as a specialized and high-efficacy therapeutic method opens the path for future research into the screening and use of herbal nanoparticles for cancer treatment. The possible impacts of nanoparticles in the therapy of metastatic cancer, specifically on cell stability, proliferation suppression, eventual interaction with adhesion molecules, and antiangiogenic activity, are discussed in this paper.

Chronic renal failure (CRF) is a progressive and irreversible deterioration of renal functions. Diabetes, hypertension, indiscriminate use of antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) are major contributory factors of chronic kidney disease (CKD) or end stage renal disease (ESRD). (1,2) In modern system, the role of medicinal treatment is very limited while haemo or peritoneal dialysis is cumbersome and expensive. Economic and legal issues limit the possibility of renal transplant and depends on the availability of donor.(3) On the other hand, homoeopathic treatment, if sought at an early stage, can help in maintaining or to some extent reviving renal functions by lowering serum creatinine thereby improving GFR. Gupta et. al. has done some work on the medicinal treatment of this difficult disease and have published the results.(4)

Background: Cardiotocography is the most common method for assessing fetal health and reveals brain oxygenation. This study is done for admission and intrapartum cardiotocography in high- and low-risk pregnancies and its correlation with neonatal outcome. Methods: All high-risk and normal antenatal women with more than 34 weeks of pregnancy and vertex presentation who came to the labor room were included in the study. 200 cases were taken, 100 were in the "high risk group," and the remaining 100 were in the "low risk group." On admission CTG and intrapartum CTG tracing were taken after written and informed consent, neonatal outcomes were observed, and adverse neonatal outcomes were noted. Results: Admission CTG results were unsatisfactory for 9% of women in the high-risk group and none in the low-risk group. Intrapartum NST was non reassuring in 51% of high-risk women and 6% of the low-risk group. Of the total number of neonates admitted to the NICU, 14 were from the low-risk group, while 50 were from the high-risk group. Conclusions: On admission NST in both low and high-risk women, the absence of category III NST predicted the absence of an adverse neonatal outcome most accurately. Even during labor in both high-risk and low-risk women, the absence of category III reassured the fetal well-being most precisely.

Background: Preterm labor remains one of the major cause of neonatal morbidity and mortality. Different tocolytics have been studied for prolongation of pregnancy, role of progesterone in increasing latency period remains controversial. Aim of the study was to compare efficacy of nifedipine with nifedipine along with dydrogesterone as a tocolytic agent in case of preterm labor and find its impact on maternal and neonatal outcome. Methods: This study was conducted in 100 women who presented with symptoms of preterm labor, patients were then randomized to nifedipine plus dydrogesterone therapy or nifedipine treatment. Group I received Nifedipine plus dydrogesterone 10 mg and group II received only nifedipine. Results: There was significant difference in latency period between group I and group II polongation beyond 1 week was observed in 58% in group I and 32% in group II. There is significant difference in APGAR score at 1 minute and 5 minute between patients of group I and group II. In group I, 57.4% neonates have APGAR >7 whereas in group II 31.9% neonates have APGAR >7 at 1 minute. In Group I, 89.4 % neonates have APGAR >7 whereas in group II 68.1% neonates have APGAR >7 at 5 minutes. The mean birth weight in group I was 1.86 with SD 0.35 whereas in group II it was 1.72 with SD 0.34 which is statistically significant. However, no significant difference was found between admission in neonatal intensive care unit or neonatal complications and adverse effects between 2 groups. Conclusions: This study found dydrogesterone along with nifedipine is more effective as tocolytic in comparison to nifedipine alone.

The use of therapeutic herbs for healing is as old as humanity itself. There is substantial proof that man and his hunt for natural remedies have a long history, including written records, surviving monuments, and even the first plant medicines. The knowledge of using medicinal plants came about as a result of man's long-standing battles with disease, which taught him to look for pharmaceuticals in the barks, seeds, fruit bodies, and other parts of plants. Modern pharmacology includes various plant-based medications that have been used for centuries and were known to ancient cultures. Modern science has recognized their active effect. Kantakari, also known as Yellow Berried Nightshade, is a medicinal plant that is mostly found in India's arid areas. This plant, which is a member of the Solanaceae family, has a range of pharmacological and phytochemical traits. Studies and research conducted over the years have revealed that the plant's medicinal benefit includes anti-inflammatory, bronchodilator, anti-microbial, wound-healing, anti-cancer, and insecticidal properties. The review that follows provides a critical analysis of the existing literature while integrating details on Kantakari, including a mention of its botanical description, chemical composition, and Ayurvedic medicine applications.

Water is the major constituent of life for the growth of animals and flora species. Water is available around the world with different Total Dissolved Solids (TDS) levels and minerals. On the basis of TDS, the hardness and softness of water are determined. (Underground water and oceanic water are found to have higher TDS than fresh water). Aim: To understand the effect of TDS on the growth of plant. Objectives: A study was conducted on the basis of the TDS of water to observe the effect of TDS on the growth of phaseolus vulgaris (kidney bean) plants and to check whether the water TDS is responsible for the growth of the plants or not. Methods: Water of different TDS levels was collected from Gwalior district (Gwalior, Gwalior fresh water Takenpur, and distilled water). Water has different TDS levels ranging from 95ppm (Parts Per Million), 750ppm, 2000ppm, distilled water with 0ppm TDS, and acidic distilled water (pH 3.5–4, by adding HCl acid). The kidney beans (phaseolus vulgaris) were purchased from a local mart and sowed into the washed sand with a neutral pH of 7, and the growth was observed under sunlight. (Each pot containing 7 beans). Results: The result of the experiment was positive as required, as the water TDS level affects the growth of plants. It has been observed that distilled water with a TDS of 0 ppm shows almost no growth, but a TDS of 750 ppm shows the maximum growth. Therefore, it has been concluded that TDS is also responsible for the growth of plants, and this practice can be done on a large scale also for the best result of growth.

Microfinance is an economic means designed to encourage financial inclusion to reach poor people that traditional formal financial institutions like banks are unable to reach. In recent decades, the microfinance sector has experienced remarkable expansion. The aim of this study is to review the existing literature in order to ascertain how financial risk impacts MFIs' capacity to maintain their financial viability. Numerous research on efficiency, the twin goal of achieving sustainability and social performance, and financial sustainability have been carried out in the past and few have been conducted on analyzing the financial risk’s effect on the financial performance of MFIs. Liquidity risk and credit risk are potentially serious risks for the financial system’s stability and the long-term viability of financial institution management.

Chitin is one of the most common biopolymers found in both marine and terrestrial habitats. Chitinase enzyme has gained popularity due to its diverse biotechnological applications, particularly in agriculture for the biocontrol of phytopathogenic fungi and harmful insects. In this work bacteria producing chitinase enzyme were isolated from soil and water samples. Three bacterial isolates C2, C3, and C4 were found to be Gram-negative coccobacilli while bacterial isolate C9 was found to be Gram-positive cocci. The optimum pH and temperature for all the isolates were studied. The effect of pH, temperature, substrate variation, and incubation period on enzyme activity was studied. The activity of the chitinase enzyme for all the bacterial isolates increased with an increase in temperature up to 37°C. However, a further rise in reaction temperature caused a loss of chitinase activity. Michaelis-Menten plot and Line weaver Burk plot were constructed to calculate the Km and Vmax values. Partial Purification of the chitinase enzyme was carried out and the enzyme activity, protein content, specific activity, and purification fold were estimated. It was observed that the enzyme activity of the crude sample was less than the fractionated sample. The highest enzyme activity was found to be at a 40% fraction. Of the four isolates, C2 was the best in its enzyme activity. The future prospect is the production of chitinases at an industrial scale for various biotechnological applications. Chitinase-producing isolates have the ability to produce chitinase between temperatures 22ºC and 40ºC which is the field temperature for the cultivation of most the crop, so it may be applicable to field conditions against plant pathogenic fungi which is the major problem for agricultural food production. The management of seafood waste businesses may potentially benefit from the usage of this enzyme.

Herbs have wide range of pharmacological activities including antibacterial, anti-inflammatory, anticancer, antioxidant, and anti-HIV gives them great potential as treatments for a wide variety of infectious disorders. The present review was emphasized on the evaluation of diverse pharmacological potentials of Betula utilis that have been confirmed by the researchers. Studies were analysed and extracted from the publications done at Scopus, PubMed, Web of Science, and other reputed journals. The bark of the betula utilis tree has antiseptic and carminative properties. Betula utilis, a common medicinal plant, is just one of the more than a thousand plant species known to contain significant pharmacological characteristics. Betula utilis belongs to Betulaceae family that can be found on the moraines around Bhojbasa in Uttarakhand, India, not far from the mouth of the Gangotri glacier. A moderate-sized tree that can reach heights of up to 20 metres. Bark has shown different chemical constituents i.e., acetylo-heanolic acid, lupeol, oleanolic acid, lupenone etc. Traditional use shows that bark has been used in treating a wide range of conditions, including bronchitis, convulsions, leprosy, blood disorders, contraceptive, antibacterial, fragrant, carminative, ear infections etc. It has been shown to have potent anticancer effects. Because to its many beneficial pharmacological properties, including antibacterial, anticancer, anti-obesity, antihyperglycemic, anti-inflammatory, antioxidant, and anti-HIV properties. In conclusion, Betula utilis is a promising research-oriented plant that might be effective in the cure and management of numerous medical conditions/ ailments through incorporating in different suitable dosage forms.

Background: Scrub typhus is one of the most covert diseases of present era. Diagnosis is often missed, and tools for confirming diagnosis are often not available in resource-poor setups. The aim of the study was to investigate an outbreak investigation and suggests methods of containment. Methods: An epidemiological investigation of Scrub typhus outbreak though active and passive surveillance. Time, Place and person distribution, mean, median stand deviation were used during analysis. Results: Cases presented with high grade fever (100%), bodyache (91%) and headache (81%). Nearly, 22% cases presented with Eschar, 16% of blood samples were positive for OX-19 antigens, 9% blood samples were sent for enzyme linked immunosorbent assay (ELISA) and were positive for IgM antibodies. Conclusions: An outbreak of Scrub Typhus infection was successfully contained without any mortality by effectively using Chemoprophylaxis, judicial use of chemicals and personal protective measures.

Virtual worlds are progressing toward a holistic abstraction of the metaverse. While there is abundant literature and synthesis on virtual worlds and related constructs, the linkages between above scholarly work and the “metaverse” are scarce. This research study addresses this gap by focusing on three specific research pursuits: a comprehensive definition of the metaverse that subsumes virtual world literature and looks at the metaverse as a sociotechnical stack, exploring the design elements of the metaverse, and a synthesis of future research direction associated with metaverse. For achieving the above goals, a hybrid research methodology comprising bibliometric analysis and a rigorous qualitative analysis of case studies across four major metaverse players with varied end goals was employed. The interpretive qualitative analysis was further distilled by mapping the emergent themes to the theoretical lens of affordances. This work presents a novel framework of metaverse design, establishing theoretical linkages between the sociotechnical fabric and applications of the metaverse.

Background: Despite the well-established potent benefit of mechanical thrombectomy (MT) for large vessel occlusion (LVO) stroke, access to MT has not been studied globally. We conducted a worldwide survey of countries on 6 continents to define MT access (MTA), the disparities in MTA, and its determinants on a global scale. Methods: Our survey was conducted in 75 countries through the Mission Thrombectomy 2020+ global network between November 22, 2020, and February 28, 2021. The primary end points were the current annual MTA, MT operator availability, and MT center availability. MTA was defined as the estimated proportion of patients with LVO receiving MT in a given region annually. The availability metrics were defined as ([current MT operators×50/current annual number of estimated thrombectomy-eligible LVOs]×100 = MT operator availability) and ([current MT centers×150/current annual number of estimated thrombectomy-eligible LVOs]×100= MT center availability). The metrics used optimal MT volume per operator as 50 and an optimal MT volume per center as 150. Multivariable-adjusted generalized linear models were used to evaluate factors associated with MTA. Results: We received 887 responses from 67 countries. The median global MTA was 2.79% (interquartile range, 0.70–11.74). MTA was Conclusions: Access to MT on a global level is extremely low, with enormous disparities between countries by income level. The significant determinants of MT access are the country’s per capita gross national income, prehospital LVO triage policy, and MT operator and center availability.

Male sexual disorders remain taboo, particularly in a developing country like India. The affected census is under-depicted as of privacy issues, unawareness about the disease complex, a phobia about being affected, and many more counting on it, with advancing digitalization and many friendly social media platform, the affected individual logs onto the cybernet for perception, and here comes the role of content reliability.: In April 2022, we seek the most accountable social media platforms - with keywords of "Male Sexual Disorders", "Erectile Dysfunction", "Premature Ejaculation" and "Male sex Problems" using BuzzSumo, an online analytic tool. The collected content was evaluated by two urology residents on ground of European Association of Urology(EAU) Guidelines 2022, and for discrepancies, the final decision was established by a senior specialist.: Out of 191 included videos, 62.3% were videos uploaded by specialist and their mean duration was 7.2 minutes. 67.53% of uploaded videos explained general information (n=129, 67.53%) and provide information about diagnosis (28.7%) and treatment (78.01%), among which maximum videos favored medical management (97.9%). 158 inclusion videos (82.72%) were following EAU guidelines. In excluded videos, videos on alternative medicines shared maximum number (45.63%). Videos with animation and sound were more appealing based on views and likes, although the contribution of animated videos was rather less in number (25.65%). : The content with delusive information, small size samples, and individual opinion are having more luring appeasement. so, this study firms its ground by stressing verity of content and need for scrutiny by medical community.