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The present study is the first account of physiological poikilocytosis and anisocytosis attained through stained peripheral blood smear in terms of prevalence, types, severity, and association with age, sex, and hemoglobin (Hb) levels in Cholistani cattle blood (n=64). The correlation of these red blood cells (RBC) forms has been made with certain RBC indices attained through a multi-species hematology analyzer. The total poikilocytes (24.7±0.2%) were significantly (p≤0.05) higher than the total anisocytes (8.4±0.1%) with echinocytes being the highest seen cells (5.4±0.5%). There was no statistical difference for poikilocytes and anisocytes between males and females. The spherocytes and schistocytes were significantly (p≤0.05) higher in young cattle as compared to adult cattle. All the animals in the study groups showed slight (13%-20%) to moderate (21%-30%) total poikilocytosis. Young (n=18; 28.1%) and females (n=7; 10.9%) revealed higher marked (˃30%) total poikilocytosis. The severity of total poikilocytosis did not significantly (p≤0.05) affect any of the RBC attributes. Normal cells were significantly higher (p≤0.05) in low Hb group being 68.5±1.5% as compared to 65.09±0.8% for high Hb group. The highest values were attained for the relation between total anisocytes and Hb, and between total anisocytes and Mean Corpuscular Hemoglobin Concentration (r-square=0.159; 15.9% probability). In conclusion, the blood of healthy Cholistani cattle presents physiological peculiarities in terms of the presence of various poikilocytes and anisocytes. Furthermore, the multi-species hematology analyzer failed to predict the level of poikilocytosis and anisocytosis in the present study, whereas the stained PBS provided reliable results.

In today’s information technology age, the issue of cyber Security is a complicated and fascinating area of law. The phenomenal growth and development of e-commerce in India is astounding. However, with the rising dependence on internet commerce, the dangers of fraud and security and trust problems have become severe impediments. Creating robust legal and regulatory frameworks that meet the growing concerns about online fraud, data security, and intellectual property protection in both local and international business contexts is critical. The e-commerce sector, like any expanding business, confronts various obstacles, primarily due to an inadequate and inefficient legal and regulatory framework that fails to guarantee the rights and duties of all players engaged sufficiently. To protect user data, tackle cyber threats, and maintain customer trust, e-commerce enterprises must comply with legal regulations. In India, cybersecurity governance falls under the Information Technology Act of 2000, regulating e-commerce, electronic contracts, data protection, and cybercrimes. The imminent passage of the Personal Data Protection Bill, 2019, is expected after ongoing review. The Indian Penal Code addresses unauthorized access, hacking, identity theft, phishing, and computer virus dissemination. The Reserve Bank of India oversees online payment and financial security, mandating two-factor authentication, encryption, and secure payment channels. CERT-In coordinates national cybersecurity incidents, while electronic signatures and digital certificates hold legal recognition. Intellectual Property Laws regulate online violations of patents, copyrights, and trademarks. The Indian government also enforces cybersecurity standards for enterprises and organizations, covering IT infrastructure and incident response. Nonetheless, further steps must be taken to improve the efficiency of India’s cyber security regulations. This research study uses a doctrinal and analytical approach to examine India’s present Cyber Security Laws and Guidelines. It assesses their effectiveness in addressing legal concerns with Security, privacy, and data protection inside the country. It also evaluates the legal structure that governs the link between e-commerce and Cyber Laws in India. This research will provide a thorough overview of the present condition of cyber security regulations in India, setting the way for prospective reforms and progress in this critical area.

Abstract Fall Armyworm (FAW), Spodoptera frugiperda, is a polyphagous pest capable of feeding over 80 plant species and was indigenous to the Western Hemisphere. Within a span of 4 years, FAW has established itself throughout most of the regions in Africa and Asia causing significant losses in maize production. Owing to its revamped distribution range, it would be prudent to analyze the ensuing genetic changes and study the emerging phylogeographic patterns across the world. In this regard, we would like to provide a current snapshot of genetic diversity of FAW in India 2 years after the initial introduction and compare it with the worldwide diversity in order to trace the origins and evolutionary trajectories of FAW in India. We have investigated around 190 FAW samples from different regions in India for strain identity and polymorphism analysis on the basis of partial mitochondrial cytochrome oxidase I (COI) gene sequences. Apart from the ancestral rice and corn strain haplotype, our study demonstrates the presence of 14 more haplotypes unique to India at a haplotype diversity of 0.356. We were also able to record inter-strain hybrid haplotypes of rice and corn strains in India. Regional heterogeneity within Indian populations seems to be quite low representative of extensive migration of FAW within India. Distribution analysis of pairwise differences and rejection of neutrality tests suggest that the FAW population in India might be undergoing expansion. Our data is consistent with the findings suggesting a recent and common origin for invasive FAW populations in Asia and Africa, and does not indicate multiple introductions to India. This study reports the highest genetic diversity for Indian FAW populations to date and will be useful to track the subsequent evolution of FAW in India. The findings would have important ramifications for FAW behavior and composition throughout the world.

Fertilizer plant waste carbon slurry has been investigated after some processing as an adsorbent for the removal of dyes and phenols using columns. The results show that the carbonaceous adsorbent prepared from carbon slurry being porous and having appreciable surface area (380 m2/g) can remove dyes both cationic (meldola blue, methylene blue, chrysoidine G, crystal violet) as well as anionic (ethyl orange, metanil yellow, acid blue 113), and phenols (phenol, 2-chlorophenol, 4-chlorophenol and 2,4-dichlorophenol) fruitfully from water. The column type continuous flow operations were used to obtain the breakthrough curves. The breakthrough capacity, exhaustion capacity and degree of column utilization were evaluated from the plots. The results shows that the degree of column utilization for dyes lies in the range 60 to 76% while for phenols was in the range 53-58%. The exhaustion capacities were quite high as compared to the breakthrough capacities and were found to be 217, 211, 104, 126, 233, 248, 267 mg/g for meldola blue, crystal violet, chrysoidine G, methylene blue, ethyl orange, metanil yellow, acid blue 113, respectively and 25.6, 72.2, 82.2 and 197.3 mg/g for phenol, 2-chlorophenol, 4-chlorophenol and 2,4-dichlorophenol, respectively

Background: Patients with posterior uveitis can develop vision-threatening complications. Optical coherence tomography (OCT) plays an important role in the diagnosis and management of these complications. Aims: The objectives of this study were to describe different retinal morphological characteristics presenting on OCT in patients with posterior uveitis, with an aim to facilitate early diagnosis to initiate specific treatment and also to observe the response to treatment. Materials and Methods: A cross-sectional prospective non-randomized study was undertaken at a tertiary eye care hospital. The study included 30 eyes of 30 patients with posterior uveitis between the period of May 2016 and May 2018. All subjects underwent a set of systemic investigations for etiological diagnosis and complete ophthalmic examination, including OCT (Zeiss Cirrus machine (model number 5000)] imaging). Data were collected and analyzed. A P value of

Context: The knowledge of fluoride levels and pH in potable water is important for health-care personnel and policymakers in general and dentists in particular, but the data regarding fluoride levels and pH of community drinking water in Pune City are deficient. Aims: The aim of this study was to determine the fluoride levels and pH in community drinking water supply across Pune City, Maharashtra. Subjects and Methods: In an in vitro, experimental study, a total of 30 water samples were collected from one water treatment plant, one water storage reservoir, and three adjoining residential areas of the Pune Municipal Corporation (PMC) and Pimpri Chinchwad Municipal Corporation (PCMC) region. They were analyzed for fluoride content using (2-(parasulfophenylazo)-1,8-dihydroxy-3,6-naphthalene disulfonate) based-spectrophotometric method, and for pH using a digital pH meter. Statistical Analysis Used: Fluoride and pH values were subjected to Mann–Whitney U-test and intragroup comparison of fluoride and pH levels at various levels of water distribution was performed using Kruskal–Wallis test. Results: The mean concentration of fluoride and the pH in water samples from different locations across Pune City were 0.262 and 7.02 mg/L, respectively. Although levels across various sources were different, there was no statistical difference between the fluoride content or the pH of the water from sources across PMC and PCMC regions. Conclusions: The fluoride content of the community water supply of Pune City was below the recommended standards yet within the permissible limits in considering the temperature range in Pune City across different seasons. The pH of the drinking water of Pune City was optimal.

Graft-versus-host disease (GVHD) is a common complication in patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). GVHD is characterized as either acute or chronic based on symptomatology and histopathological findings. Despite advancements in disease-targeting therapeutics, steroid-refractory GVHD remains a significant contributor to mortality in HSCT recipients, highlighting the gaps in our understanding of its pathophysiology and treatment strategies. We present the case of a 46-year-old woman diagnosed with acute undifferentiated leukemia, who exhibited persistently elevated levels of serum total bilirubin (T.Bili), alkaline phosphatase (ALP), and liver function tests (LFTs) beginning on [day +201] post-haploidentical peripheral blood stem cell (PBSC) transplantation. The patient received fludarabine/total body irradiation (Flu/TBI) as a myeloablative conditioning regimen and post-transplant cyclophosphamide/tacrolimus/mycophenolate mofetil (PTCy/Tac/MMF) as GVHD prophylaxis. A liver biopsy confirmed the diagnosis of GVHD, while other possible etiologies were excluded by corresponding tests. Initial treatment with prednisone and tacrolimus, and the later addition of ruxolitinib, all showed poor response indicated by worsening T.Bili, ALP, and LFTs at the same time. Based on a multidisciplinary comprehensive assessment, we decided to administer 1,000 mg/m2 (1,600 mg) of cyclophosphamide (“pulse Cy”), which resulted in a dramatic improvement in T.Bili and transaminases starting from the very next day. A durable response to pulse cyclophosphamide was observed, as all indicators normalized (“complete response”) within 55 days without relapses. The patient remains in good health with no recurrence of hepatic GVHD. To our knowledge, this is the first case in which Grade IV hepatic GVHD, refractory to multiple agents including steroids, tacrolimus, and ruxolitinib, demonstrated a complete response to pulse cyclophosphamide. The success highlights the potential therapeutic role of cyclophosphamide, a potent and cost-effective chemotherapy agent, in treating multi-agent-refractory GVHD. Large-scale clinical trials are warranted to validate its efficacy in this setting.

Background: Sweet Syndrome (SS) is a rare inflammatory skin condition characterized by the sudden appearance of tender, erythematous or violaceous papules, plaques, and nodules typically found on the face, neck, shoulder, upper extremities, and trunk. Often, SS is difficult to diagnose because of its various non-specific manifestations, including fever, arthralgia, myalgia and ocular involvement. In most cases described in literature, cutaneous and pulmonary symptoms of SS present in a concomitant manner. Several reported cases of pulmonary SS have shown that if left untreated, acute respiratory distress syndrome can ensue and progress to fatal respiratory failure. Case report: A 58-year-old female with acute myeloid leukemia (AML) secondary to chronic lymphocytic leukemia (CLL) presented with new nodular lesions, dyspnea, and fevers. Chest X-ray revealed pulmonary infiltrates. The patient developed new facial lesions and worsening hypoxic respiratory failure. Further infectious workup was negative. She was found to have SS with pulmonary involvement and initiated on high-dose intravenous (IV) steroids with marked clinical improvement. Conclusions: Major and minor criteria for the diagnosis of lung-associated SS should be carefully evaluated, especially when a biopsy is unavailable. The following case report describes the clinical course and outcomes from treatment for this patient.

Introduction- Injuries are increasingly recognized as a global public health epidemic. Around the world, almost 16,000 people die every-day from all types of injuries. Injuries represent 12% of the global burden of disease, the third most important cause of overall mortality and the main cause of death among 1-40-year age groups. Methodology- This hospital based cross-sectional study was conducted among the road traffic accident patients admitted in trauma care center of Government Medical College and Hospital Nagpur. Result- Most common type of injury was abrasion in 91.45% followed by laceration in 79.61% of study subjects. Other common injuries were contusion, fracture, internal hemorrhage, crush injury and dislocation. Majority of the study subjects i.e. 67.11% had head injury. Conclusion- Head injury was the most common injury found in the study. Abrasion and laceration was also more commonly found in study subjects. Head injury was found more in non-users of personal protective devices which was statistically significant.

Introduction: Prevalence of hearing loss is 11.7% of the school going population (5-15 years). Such children fail to develop speech, language and cognitive skills unless proper habilitation is initiated. If detected early and managed suitably, will have a far better chance at a normal life than those who are habilitated late or not at all. Aims & objectives: To detect the age of suspicion, identification, intervention and treatment seeking behavior of children with hearing loss. Materials & methods: This was a cross- sectional study done in Children between 5 and 15 years age-group with hearing loss, coming to an ENT OPD, New Civil Hospital, Surat during the period of 1st August 2011 to 31 July 2012. Results: A total of 246 children were studied. Mean age of the study population was 9±3.46 years. Average age at first suspicion of hearing loss was 2.9±1.7 years, first consultation was 3.5±1.5 years and first intervention was 7.8±3.3 years. There was significant association between age of first suspicion of congenital hearing loss with father’s occupation (p=0.03). There was significant association between delay in diagnosis and gender (p= 0.04). As the level of education of parents and socio- economic status increased, preference for private set ups for first consultation also increased (p< 0.05). In 63.5% cases, advice of general practitioner resulted in the delay in referral to ENT specialist. Conclusion & Recommendations: Even after primary care, an average gap of 4.3 years is observed among parents for receiving intervention. Mother is the first person to suspect hearing loss among their children. Basic training of general practitioner/ MBBS doctors regarding primary ear care is required.

Introduction: Cataract surgery is one of the most commonly performed ophthalmic surgical procedures worldwide, with a high rate of successful and rapid anatomical and functional visual recovery. Goal of cataract surgery is to achieve a desirable induction of refractive outcome with minimal astigmatism after surgery. This brings to interest the question of influence of preoperative and surgically induced corneal astigmatism on the final postoperative unaided visual acuity. Pre-existing corneal astigmatism is an important limiting factor for optimal results of cataract surgery in a significant number of patients. It has been estimated that 15% to 29% of patients with cataract have more than 1.50 dioptres (D) of preexisting astigmatism. Methods: Prospective study was carried out to investigate the prevalence and pattern of pre-existing corneal astigmatism in patients undergoing cataract surgery at B.P. Koirala Lions Center for Ophthalmic Studies, T.U. Teaching Hospital for a period of 2 years. All patients underwent complete ophthalmic examination including visual acuity, refraction, slit lamp examination, applanation tonometry and dilated fundus evaluation, biometry and ultrasound B-scan examination. Corneal astigmatism was measured by Keratometer at least two times for each patient. Astigmatism was calculated from dioptric difference between vertical reading and horizontal reading. With the rule (WTR) astigmatism was considered when steep meridian was at 90° ± 30°. Against the rule (ATR) astigmatism was considered when steep meridian was at 180° ± 30°. Results: Study included 225 eyes of 185 subjects, out of which 38.7% were male eyes and 61.3% were female eyes. The mean age of the subjects was 64.45±12.89 years. Mean amount of corneal astigmatism in our study was 0.84±0.80 D. 16.9% had no significant corneal astigmatism while 65.3% had corneal astigmatism between 0.25 and 1.50 diopter and 17.8% had corneal astigmatism of 1.50D or higher. With-the-rule astigmatism (axis of correcting cylinder 180±30 degrees) was present in 44.4% eyes, 40.04% of the eyes had against-the-rule (ATR) astigmatism (correcting minus cylinder 90±30 degrees), and 12.9% of the eyes had oblique astigmatism. Conclusion: Approximately two thirds of pre-operative cataract patients had 1D or less astigmatism. Corneal astigmatism increases with age. Hence, it is important to analyze the magnitude and pattern of pre-existing corneal astigmatism in aging population due to higher demand for improved vision and use of suitable methods for best visual results. [ABSTRACT FROM AUTHOR]

Introduction: Herpes simplex virus (HSV) is the most common infective cause of blindness in developed countries, with a reported incidence of between 5.9 and 20.7 episodes per 100,000 persons each year. It remains the most common cause of unilateral corneal blindness worldwide. HSV ocular infections include conjunctivitis, blepharitis, epithelial infections like dendritic ulcer, geographic ulcer and punctate epithelial keratitis, stromal infections like disciform and necrotizing stromal keratitis, and iritis .Visual loss usually occurs from the cumulative effect of multiple recurrences. Methodology: Hospital based prospective study was conducted for a period of one year (1st Jan 2015-31st Dec 2015) at B.P.koirala Lions Center for Ophthalmic Studies, IOM, Kathmandu, Nepal. All patients with symptoms and signs suggestive of herpes eye disease having decreased corneal sensation were included. Performa included demographic profile of patients, clinical pattern, presenting symptoms, visual acuity on presentation and treatment received. Results: Incidence of Herpetic Eye Disease was 10.3%. Patients presented with mean age of 36.63 ± 16.94years.59.23% patients presented in productive young adult age group of 16-45 years. Patients presented with chief complain of redness 38%, Diminution of vision 33%, Pain 12%, foreign body sensation 13% and photophobia in (4%) of cases. Clinical pattern was Blepheroconjunctivitis in 26%, Filamentary keratitis in 1%, dendritic ulcer in 22%, Geographical ulcer in 4%, disciform keratitis in 28%, Stromal keratitis in 11% and recurrent keratitis in 3% cases. Treatment received included topical Acyclovir in 54% cases, oral Acyclovir and topical steroids in 43% cases and topical, oral acyclovir with topical steroids in 3%cases. Visual acuity on presentation was 6/6-6/18 in 59.23% of patients and only 8.47%cases had visual acuity >3/60. Conclusion: Herpetic eye disease is a corneal blinding disease with varying clinical presentation. The recurrence rate was low in our study. But, recurrent nature of this disease and the treatment required to decrease this recurrence needs to be further studied. [ABSTRACT FROM AUTHOR]

WAGR syndrome which includes Wilms' tumor, aniridia, genitourinary anomalies and mental retardation is a rare, sporadic, genetic disorder characterized by de nova deletion in the distal band of 11p13chromosome. Here, we report first case of WAGR from Nepal of a 5 year old male child with hypospadias, right Wilms' tumor and bilateral aniridia treated successfully by surgery and chemotherapy. [ABSTRACT FROM AUTHOR]

Chikungunya fever is an important arboviral infection prevalent through out Africa and Southeast Asia. Recently, in 2006, it has reemerged in many parts of India, affecting more than a million persons. A detail serological, virological, and molecular investigation of this unprecedented outbreak was carried out by collecting and studying 540 samples from all the affected regions of India during this epidemic. An in-depth investigation revealed the presence of anti-Chikungunya antibodies in 68 of the samples and genomic RNA in 49 of them. In addition 32 Chikungunya viruses were isolated from 45 representative polymerase chain reaction-positive samples. The nucleotide sequences of partial E1 gene of 25 representative Chikungunya viruses were deciphered. The sequence analysis indicated that all the isolates of this epidemic belonged to the new Indian Ocean island clade of East Central South (ECS) African genotype. Phylogenetic analysis also revealed that earlier Indian isolates were clustered into the Asian genotype. This study conclusively proved the genotype shift from Asian to ECS African as the major factor in the reemergence of Chikungunya in an unprecedented outbreak in India after a gap of 32 years. [ABSTRACT FROM AUTHOR]

Abstract Background The Argus II Retinal Prosthesis System (Second Sight Medical Products, Sylmar, California) is an epiretinal prosthesis that serves to provide useful vision to people who are affected by retinal degenerative diseases such as retinitis pigmentosa (RP). The purpose of this study was to analyze postoperative movement of the electrode array. Methods Five patients diagnosed with profound retinal dystrophy who have undergone implantation of retinal prosthesis at Stony Brook University Hospital. Fundoscopy was performed at postoperative month 1 (M1), month 3 (M3), month 6 (M6), month 12 (M12), and month 24 (M24) visits. Fundoscopy was extracted and analyzed via NIH ImageJ. Data analysis was completed using IBM SPSS. Various lengths and angles were measured each postoperative month using ImageJ. Results There was no significant change in distance between the optic disc and the surgical handle (length AB) over the two-year span (F = 0.196, p = 0.705). There was a significant change in distance of length AB over time between patients between M3 and M6 (p = 0.025). A repeated measures ANOVA revealed that there was statistically significant change of the optic disc-tack-surgical handle angle (𝛾) (M1 to M24) (F = 3.527, p = 0.030). There was no significant change in angle 𝜟 (the angle to the horizontal of the image), angle 𝜶 (tack-optic disc-surgical handle), and angle 𝜷 (optic-disc-surgical handle-tack). Conclusion Our results demonstrate that there may be postoperative movement of the retinal prosthesis over time, as a statistically significant downward rotation is reported over the 2 years span. It is important, moving forward, to further study this movement and to take into consideration such movement when designing retinal implants. It is important to note that this study is limited by the small sample size, and therefore, the conclusions drawn are limited.

Background: Spinal cutaneous inclusion tumors are extremely rare, accounting for less than 1% of intraspinal tumors. The existing literature is scarce; in last two decades, only eight case series have documented more than 10 patients. We tried to figure out if intramedullary and extramedullary locations have an impact on outcomes in terms of extent of resection and neurological recovery. Materials and Methods: A retrospective review of intraspinal epidermoid and dermoid tumors operated at our Neurosurgical Department, between May 2006 and May 2021, was made. McCormick grading was used to evaluate the neurological status of all patients at presentation, after surgery, and at the follow-up visit in the outpatient clinic. The neurological status at the last follow-up was taken as final. Results: Of 15 cases, eight (53.3%) were males with the age at presentation ranging from 7 to 60 years (mean = 24.4 years). Spinal dysraphism was associated in four patients. The proportion of region involved in descending order was lumbar (46.6%), thoracic/thoracolumbar/lumbosacral (13.3% each) and cervicothoracic/sacrococcygeal (6.6% each) with 11 gross total resections (73.3%) and four subtotal resections (all intramedullary). Two-tailed Fischer’s exact test showed a significant correlation between location, extent of resection, and neurological recovery, whereas histological subtype and region had no significant impact on the outcome. Conclusions: To the best of our knowledge, this is the eighth largest study in the last two decades, reporting 15 cases with long-term follow-up. We attempt to bring clarity to the notion of location having no effect on resectablity by specifying location in terms of spinal compartment involved and describing spinal level as region. Overall, our gross total resection rate was lower (73.3%) than other contemporary studies (86.6%–92%), but a subgroup analysis with regard to the location of tumor revealed the intramedullary location to be the primary determinant of the extent of resection.

Context: The existing situation of the coronavirus disease 2019 (COVID-19) pandemic has created enormous pressure and anxiety among dental students practicing in dental institutions. Aim: The aim of this sentence was to evaluate the awareness and knowledge of safety measures and disinfection protocol during the COVID-19 pandemic among dental students. Materials and Methods: Institutional ethical committee cleared the questionnaire format for the survey then this Google Forms was forwarded to dental students all over Maharashtra. The questionnaire was divided into four sections: Section A recorded sociodemographic details. Section B recorded knowledge about COVID-19. Section C recorded awareness of measures. Section D recorded awareness of disinfection protocols in the dental setup. Results: A total of 707 dental students from different colleges in Maharashtra participated in the study. A total of 200 postgraduate (PG) students (95.2%) and 458 (92.2%) undergraduate (UG) students correctly marked the incubation period for COVID-19 as 7–14 days. Ninety-nine percent of students are aware of personal protective equipment (PPE) kit to be used while treating patients as well as they are well known for the components of the PPE kit. Most of the PG (93.8%) and UG (82.9%) students understand the need for an oral rinse with mouthwash by the patient before treatment. Awareness and knowledge regarding safety measures and disinfection protocols were adequate among PG students. Conclusion: COVID-19 pandemic brought new challenges and responsibilities to institutions providing dental education. Upliftment of knowledge can lead to a positive attitude in resuming back to the dental practice in the respective institute.

Recent studies have shown that microtransplant (MST) could improve outcome of patients with elderly acute myeloid leukemia (EAML). To further standardize the MST therapy and improve outcomes in EAML patients, based on analysis of the literature on MST, especially MST with EAML from January 1st, 2011 to November 30th, 2022, the International Microtransplant Interest Group provides recommendations and considerations for MST in the treatment of EAML. Four major issues related to MST for treating EAML were addressed: therapeutic principle of MST (1), candidates for MST (2), induction chemotherapy regimens (3), and post-remission therapy based on MST (4). Others included donor screening, infusion of donor cells, laboratory examinations, and complications of treatment.

The Ponseti method has revolutionized clubfoot treatment. Though completely neglected clubfeet are now rare, partially or incompletely and improperly treated feet are not uncommon. Relapses after successful correction may occur due to non-compliance with bracing. In scarred soft tissues due to previous surgery, soft tissue distraction using external fixation helps achieve correction. The Ilizarov fixator permits us to follow the Ponseti protocol, using correction methods that may either be constrained or unconstrained by hinges. Applying force vectors perpendicular to the moment arm allows us to correct the еquinus without damaging the ankle joint. All of the above is possible when the talus is round. Full correction of the deformity is possible. However, longterm follow-up of these patients has revealed stiffness of the ankle setting and frequently with tibio-talar osteophytes anteriorly. They are probably a reaction to excessive pressure developed in the joint due to the tight soft tissues. Hence the author has now added a mild shortening of the tibia and fibula to reduce soft tissue tension, rather than resorting to further soft tissue releases through scarred tissues. This allows faster correction with the Ponseti-Ilizarov protocol and allows good ankle range of motion to persist.

Abstract Cytotoxicity assays are essential for the testing and development of novel immunotherapies for the treatment of cancer. We recently described a novel cytotoxicity assay, termed the Matador assay, which was based on marine luciferases and their engineered derivatives. In this study, we describe the development of a new cytotoxicity assay termed ‘Matador-Glo assay’ which takes advantage of a thermostable variant of Click Beetle Luciferase (Luc146-1H2). Matador-Glo assay utilizes Luc146-1H2 and D-luciferin as the luciferase-substrate pair for luminescence detection. The assay involves ectopic over-expression of Luc146-1H2 in the cytosol of target cells of interest. Upon damage to the membrane integrity, the Luc146-1H2 is either released from the dead and dying cells or its activity is preferentially measured in dead and dying cells. We demonstrate that this assay is simple, fast, specific, sensitive, cost-efficient, and not labor-intensive. We further demonstrate that the Matador-Glo assay can be combined with the marine luciferase-based Matador assay to develop a dual luciferase assay for cell death detection. Finally, we demonstrate that the Luc146-1H2 expressing target cells can also be used for in vivo bioluminescence imaging applications.

Purpose: To assess the outcome of 2 weeks phacoemulsification training program that is a unique collaboration between premier ophthalmic training institutes of India and Alcon Inc. initiated 10 years ago. Methods: Cataract surgeons eager to adopt phacoemulsification surgery as the primary treatment modality were enrolled in an intensive 2 weeks training program across seven premier ophthalmic institutes in India. These surgeons performed supervised phacoemulsification surgery under the guidance of expert faculty. Simultaneously didactic lectures, postoperative video discussions, and wet laboratory training were conducted. To assess improvement in the surgical skills each surgery was scored using the International Council of Ophthalmology-Ophthalmology Surgical Competency Assessment Rubrics (ICO-OSCAR). Phaco Development Specialist supported these surgeons for minimum duration of 1 year and maximum of 9 years and 2 months. In this multicentric study, surgical data of the participants enrolled between June 2010 to August 2018 was retrospectively analyzed. Results: Nine hundred 89 ophthalmologists across 27 Indian states and 4 Union Territories were trained between June 2010 and August 2018. The mean age of participants was 40.6 (+ 8.2 years) and 64.8% were males. After completing their training they performed 1,022,508 phacoemulsification surgeries in 9 years and 2 months. At follow-up, 92.11% and 88.77% of the surgeons were performing phacoemulsification at the end of 1 year and final follow-up, respectively. Conclusion: This program highlights how partnership model between industry and ophthalmologists can go hand in hand for training and skill development of doctors contributing to much-needed improvement in patient care across societies.

ABSTRACT A cross-sectional study was conducted to investigate seroprevalence and virus prevalence of the H9 subtype of avian influenza virus in non-vaccinated broiler farms of dense poultry-populated districts, Lahore and Sheikhupura of Punjab-Pakistan. A convenient sampling method was adopted for collection of blood (n=500) and oropharyngeal swab (n=500) samples from 25 broiler farms of each district for hemagglutination inhibition assay and RT-PCR test, respectively. Proportional estimates were calculated using R software and overall seroprevalence of H9 was estimated at 36.3% (95% CI 33.3-39), with no significant difference (p>0.05) between Lahore (37.2 %, 95% CI=31.2-39.59) and Sheikhupura (35.4%, 95% CI= 29.64-39.76). RT-PCR identified 2% (4/200) pool level viral prevalence. None of the farms from Lahore districts were RT-PCR positive for H9. Simple logistic regression followed by multivariable analysis, identified the presence of foot bath/dipping area at the entrance (OR=0.7, 95% CI=0.52-0.93) and availability of rubber shoes for visitors (OR=0.36, 95% CI 0.26-0.48) as protective factors. History of respiratory signs (OR=1.51, 95%=CI 1.12-2.04), history of sudden death in past flocks (OR=3.26, 95% CI=2.41-4.41), and birds previously infected with avian influenza virus (OR=1.33, 95% CI=1-1.76) were significant risk factors. Negligence in preventive measures at farms level was associated with the spread of H9 infection between the farms. To control future outbreaks, biosecurity and continuous monitoring of non-vaccinated flocks are suggested.

Microtransplantation (MST), a type of HLA-mismatched allogeneic cellular therapy, is a promising, cellular therapy for acute myeloid leukemia (AML). MST transfuses granulocyte colony-stimulating factor (G-CSF)-mobilized, HLA-mismatched donor peripheral blood stem cells into patients undergoing conventional chemotherapy. MST, using haploidentical donors, has been shown to yield clinical benefit without any permanent marrow engraftment in AML. Consequently, graft-versus-host disease concerns are rendered irrelevant with no need for immunosuppression. We describe the first reported patient with refractory AML who underwent salvage MST from an unrelated, complete HLA-mismatched donor. The patient achieved remission without complication, warranting further study of unrelated HLA-mismatched donor MST in AML.

Aims: To retrospectively study infected distal tibial nonunions which have deformity, bone gaps and a small size of distal fragment for union and eradication of infection using staged Ilizarov treatment. Patients and Methods: Thirty seven distal infected tibial nonunions were treated over 11 years. Twelve presented without active discharge and were treated with Ilizarov fixator. Twenty five presented with draining infection and were treated with debridement, Antibiotic Cement Coated (ACC) rods and beads. Five healed without further intervention. Twenty were treated by Ilizarov fixator secondarily. Monofocal compression was used in 16 patients. Ten had a bone transport to fill gaps of 2 to 17.3 cm. Six had bifocal simultaneous treatment. Twenty three had a foot frame applied for stability. None had Iliac Crest bone grafting to achieve union at Nonunion site. Bone Marrow aspirate was injected in 5 patients to hasten union. Results: Five patients united without application of fixator. Twenty nine of 32 nonunions healed with first application of Ilizarov fixator. Three needed repeat fixation to achieve 100% union. Infection was eradicated in all patients. Thirteen (40%) were excellent, 14 good (43%), two were fair and three poor by ASAMI criteria. Mean ex-fix duration was 393.4 days (132-720). Mean 7.6 cm length was achieved in the regenerate. Conclusions: Infected Distal tibial nonunions have a small distal fragment, deformity, bone gap causing difficulties in treatment. Debridement, ACC beads and rods and Ilizarov fixator reliably achieves union and eradicates infection. Residual deformity and prolonged fixator duration were the main problems in our series.

Kaposi's sarcoma associated herpesvirus encoded viral FLICE inhibitory protein (vFLIP) K13 activates the NF-κB pathway by binding to the NEMO/IKKγ subunit of the IκB kinase (IKK) complex. However, it has remained enigmatic how K13-NEMO interaction results in the activation of the IKK complex. Recent studies have implicated TRAF6, TAK1 and linear ubiquitin chains assembled by a linear ubiquitin chain assembly complex (LUBAC) consisting of HOIL-1, HOIP and SHARPIN in IKK activation by proinflammatory cytokines.Here we demonstrate that K13-induced NF-κB DNA binding and transcriptional activities are not impaired in cells derived from mice with targeted disruption of TRAF6, TAK1 and HOIL-1 genes and in cells derived from mice with chronic proliferative dermatitis (cpdm), which have mutation in the Sharpin gene (Sharpin(cpdm/cpdm)). Furthermore, reconstitution of NEMO-deficient murine embryonic fibroblast cells with NEMO mutants that are incapable of binding to linear ubiquitin chains supported K13-induced NF-κB activity. K13-induced NF-κB activity was not blocked by CYLD, a deubiquitylating enzyme that can cleave linear and Lys63-linked ubiquitin chains. On the other hand, NEMO was required for interaction of K13 with IKK1/IKKα and IKK2/IKKβ, which resulted in their activation by "T Loop" phosphorylation.Our results demonstrate that K13 activates the NF-κB pathway by binding to NEMO which results in the recruitment of IKK1/IKKα and IKK2/IKKβ and their subsequent activation by phosphorylation. Thus, K13 activates NF-κB via a mechanism distinct from that utilized by inflammatory cytokines. These results have important implications for the development of therapeutic agents targeting K13-induced NF-κB for the treatment of KSHV-associated malignancies.

Infection with Kaposi's sarcoma associated herpesvirus (KSHV) has been linked to the development of primary effusion lymphoma (PEL), a rare lymphoproliferative disorder that is characterized by loss of expression of most B cell markers and effusions in the body cavities. This unique clinical presentation of PEL has been attributed to their distinctive plasmablastic gene expression profile that shows overexpression of genes involved in inflammation, adhesion and invasion. KSHV-encoded latent protein vFLIP K13 has been previously shown to promote the survival and proliferation of PEL cells. In this study, we employed gene array analysis to characterize the effect of K13 on global gene expression in PEL-derived BCBL1 cells, which express negligible K13 endogenously. We demonstrate that K13 upregulates the expression of a number of NF-κB responsive genes involved in cytokine signaling, cell death, adhesion, inflammation and immune response, including two NF-κB subunits involved in the alternate NF-κB pathway, RELB and NFKB2. In contrast, CD19, a B cell marker, was one of the genes downregulated by K13. A comparison with K13-induced genes in human vascular endothelial cells revealed that although there was a considerable overlap among the genes induced by K13 in the two cell types, chemokines genes were preferentially induced in HUVEC with few exceptions, such as RANTES/CCL5, which was induced in both cell types. Functional studies confirmed that K13 activated the RANTES/CCL5 promoter through the NF-κB pathway. Taken collectively, our results suggest that K13 may contribute to the unique gene expression profile, immunophenotype and clinical presentation that are characteristics of KSHV-associated PEL.

Accumulating evidence suggests that dysregulated expression of lytic genes plays an important role in KSHV (Kaposi's sarcoma associated herpesvirus) tumorigenesis. However, the molecular events leading to the dysregulation of KSHV lytic gene expression program are incompletely understood.We have studied the effect of KSHV-encoded latent protein vFLIP K13, a potent activator of the NF-kappaB pathway, on lytic reactivation of the virus. We demonstrate that K13 antagonizes RTA, the KSHV lytic-regulator, and effectively blocks the expression of lytic proteins, production of infectious virions and death of the infected cells. Induction of lytic replication selects for clones with increased K13 expression and NF-kappaB activity, while siRNA-mediated silencing of K13 induces the expression of lytic genes. However, the suppressive effect of K13 on RTA-induced lytic genes is not uniform and it fails to block RTA-induced viral IL6 secretion and cooperates with RTA to enhance cellular IL-6 production, thereby dysregulating the lytic gene expression program.Our results support a model in which ongoing KSHV lytic replication selects for clones with progressively higher levels of K13 expression and NF-kappaB activity, which in turn drive KSHV tumorigenesis by not only directly stimulating cellular survival and proliferation, but also indirectly by dysregulating the viral lytic gene program and allowing non-lytic production of growth-promoting viral and cellular genes. Lytic Replication-Induced Clonal Selection (LyRICS) may represent a general mechanism in viral oncogenesis.

Objective: To investigate whether the application of thyroid collars (TCs) affects the results of cephalometric study. Study Design: The Steiner cephalometric analysis of the patients was performed using lateral cephalometric radiographs, which were taken twice for each patient: Once using TCs (TC group; n0 = 50) and once without using TCs (NTC group; n = 50). A randomized and observer-blinded diagnostic study with head films taken from the two aforementioned groups was performed and results were evaluated with the t-test and Z-test, using GraphPad® Prism 4 software. Results : Statistical analysis using t-test was performed. The values of the line angles used in Steiner cephalometric analysis were compared for which values of each angle remained unchanged when done using TCs and without TC to the same samples. Conclusions : Lead shielding of the thyroid gland does not affect landmark identification or the specific measurements of the angulations traced during cephalometric analysis. TCs should be routinely applied during cephalometric radiography if cephalometric analyses are limited to the structures above the second cervical vertebra.

A radiopaque hydrogel-in-liposome (RHL) system was developed for micro-computed tomography (μCT) imaging of tumor tissue and simultaneous delivery of a cytotoxic agent. Iopamidol (IPD) and doxorubicin (DOX) were incorporated as the CT contrast and anti-cancer agents, respectively. The presence of a polyethylene glycol hydrogel core in the liposomes was confirmed via attenuated total reflectance Fourier transform infrared, proton nuclear magnetic resonance, and selective solvent extraction. Nano-sized (∼160 nm) spherical DOX/IPD-loaded RHLs with a narrow size distribution and negative zeta potential were successfully fabricated. The RHLs demonstrated enhanced cellular uptake of DOX in SCCVII cells compared to conventional radiopaque liposomes, likely due to clathrin-mediated endocytosis. Additionally, pH-dependent DOX release and reduced IPD leakage were observed. In vivo studies using SCCVII tumor-xenografted mice showed that RHLs exhibited improved CT contrast efficiency and anti-tumor efficacy, along with systemic biocompatibility, attributed to enhanced tumor-targeting properties. These findings suggest that the RHL system could serve as a promising nano-platform for tumor theranostics., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Lassa fever is a serious epidemic viral disease in West Africa affecting an estimated 2 million people annually with about 5000-10,000 deaths, although supporting data is sparse. Lassa fever significantly affects neonates, children, and pregnant women, however, comprehensive data on its impact in these populations are lacking. We reviewed the available literature on Lassa fever to assess its prevalence and impact in these populations and implications for vaccine development. Clinical features in children were similar to those observed in adults, with complications such as bleeding. Altered mental status, anasarca (swollen baby syndrome), bleeding, and poor urine output were risk factors for death. The case fatality rate (CFR) in 16 paediatric studies ranged from 6 % to 63 % and was 66.7 % and 75.0 % in two neonatal studies. In a systematic review of studies on pregnant women the CFR was 33.73 %. The adverse foetal outcomes included miscarriage, stillbirth, and intrauterine death associated with maternal death. Since Lassa fever significantly affects neonates, children, and pregnant women, developing a safe and effective, single-dose vaccine for these high-risk populations is vital. Currently, there are four clinical trials assessing Lassa virus vaccines. Only one of these trials is enrolling children aged ≥18 months, and exclude pregnant and breast-feeding women. It is essential that pregnant and breast-feeding women and young children are included in clinical trials that incorporate robust safety surveillance and risk mitigation measures. In our review, potential approaches to address the specific gaps in the areas of diagnosis, management, and prevention of Lassa fever in these specific populations, such as disease surveillance systems and vaccine development, were identified. A comprehensive strategy with investment focused on addressing specific knowledge gaps will be essential in protecting the health of these specific populations in Lassa virus endemic regions., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Flor M Munoz reports financial support, administrative support, article publishing charges, and writing assistance were provided by Coalition for Epidemic Preparedness Innovations. Clare L Cutland reports a relationship with Pfizer that includes: funding grants. Clare L Cutland reports a relationship with BMGF that includes: funding grants. Clare L Cutland reports a relationship with GIZ that includes: funding grants. Flor M. Munoz is an associate editor for Vaccine. Helen Marshall declared being an investigator on vaccine clinical trials with institutional funding by pharmaceutic industry with no personal payments If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Purpose: Nosocomial bloodstream infections with multidrug-resistant microorganisms have become a common health threat in intensive care settings worldwide. Understanding antimicrobial resistance and the outcomes of these infections is crucial for addressing this issue. This study aimed to investigate the burden, antimicrobial resistance, and 28-day outcomes of nosocomial bloodstream infections in the intensive care unit. Materials and Methods: This retrospective study was conducted in a multispecialty intensive care unit at a tertiary care hospital in western India. Adult patients aged ≥18 years with bloodstream infections acquired after 48 h of admission were included in the analysis. Results: A total of 245 patients suspected of having nosocomial infections in the intensive care unit were evaluated, and 179 were included in the study. Gram-negative bacteremia was identified in the majority of cases, affecting 111 (62%) patients. Carbapenem-resistant Acinetobacter baumannii was the most prevalent pathogen, found in 21.2% (38/179) of patients. Candida species were detected in 37 (20.6%) cases, and gram-positive cocci were identified in 31 (17.3%) patients, with vancomycin-sensitive Enterococci being the most common gram-positive cocci isolated from blood. The central venous catheter was the most frequent source of bloodstream infection, identified in 66 (36.9%) patients. Among all patients, 28-day mortality was observed in 102 (57%) patients. Higher quick sepsis-related organ failure (qSOFA) scores at the onset of bloodstream infection, central venous catheters as a source of infection, inability to initiate early appropriate therapy and septic shock at the onset of bloodstream infection were identified as independent predictors of mortality in patients with nosocomial bloodstream infections. Conclusion: An increased burden of gram-negative bacilli and Candida was found to cause nosocomial bloodstream infections, with very high rates of antimicrobial resistance. Early appropriate diagnosis and treatment play a critical role in improving survival. Additionally, enhanced infection prevention and control practices are necessary to mitigate the heavy burden of infections caused by multidrug-resistant organisms in critical care settings., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study presents a unique, fast, and environmentally friendly approach for synthesizing MnO 2 nanoparticles (MnO 2 NPs) utilizing Withania somnifera (Ashwagandha) extract. The formation of nanoparticles was indicated by a color change from dark purple to dark brown within 10 min and validated through techniques including UV-Vis spectroscopy, Field Emission Scanning Electron Microscopy (FESEM), Fourier Transform Infrared Spectroscopy (FTIR), and Energy Dispersive X-ray (EDX). Bromocresol green and Bromothymol blue were established as standards for assessing the photocatalytic efficiency of the synthesized nanoparticles. The synthesized nanocatalyst exhibited remarkable removal efficiency upon sunlight exposure, achieving 92% for Bromothymol blue and 95% for Bromocresol green within a duration of 1 h. The influence of variables including duration, photocatalyst dosage, and photodegradation kinetics was carefully examined to assess the efficacy of the created photocatalyst. The devised procedure is environmentally benign, facile to execute, and does not necessitate any chemical agents or advanced instrumentation for synthesis. This presents a new opportunity for the advancement of green photocatalysts, which may serve as an outstanding nanomaterial for wastewater clean-up., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

This case series describes the endovascular management of three patients with catheter-associated superior vena cava (SVC) syndrome. SVC syndrome can result from malignant (60%) or benign (40%) etiologies. The most common causes of benign SVC syndrome are indwelling central venous catheters (CVCs) with 1%-3% and 0.2%-3.3% of patients being affected. In all cases, a mechanical thrombectomy device was used to evacuate the chronic and acute thrombus, followed by a balloon angioplasty and stenting of the SVC. Anterograde flow and rapid symptom resolution was achieved following the procedure. No peri- or postprocedural complications occurred. These cases demonstrate the feasibility of endovascular management of catheter-associated SVC syndrome., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Target protein degradation (TPD) is an emerging approach to mitigate disease-causing proteins. TPD contains several strategies, and one of the strategies that gained immersive importance in recent times is Proteolysis Targeting Chimeras (PROTACs); the PROTACs recruit small molecules to induce the poly-ubiquitination of disease-causing protein by hijacking the ubiquitin-proteasome system (UPS) by bringing the E3 ligase and protein of interest (POI) into appropriate proximity. The steps involved in designing and evaluating the PROTACs remain critical in optimising the PROTACs to degrade the POI. It is observed that using in-silico and biochemical methods to study the ternary complexes (TCs) of the POI-PROTAC-E3 ligase is essential to understanding the structural activity, cooperativity, and stability of formed TCs. A better understanding of the above-mentioned leads to an appropriate rationale for designing the PROTACs targeting the disease-causing proteins. In this review, we tried to summarise the approaches used to design the ternary complexes, i.e., in-silico and in-vitro methods, to understand the behaviour of the PROTAC-induced ternary complexes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

The need for targeted pest control strategies has led to the development of juvenile hormone (JH) mimics that selectively disrupt the life cycles of harmful insect species. Present study focuses on the synthesis, characterization and evaluation of sulfonyl-acetohydrazide derivatives (H1-H8) as novel JH mimics on two different insect species, with an emphasis on their insect-specific action. The yellow fever mosquito, Aedes aegypti and cabbage leaf borer, Spodoptera litura, were selected for this investigation. Our results indicate that while these compounds exhibit negligible effects on the development of Aedes aegypti, they demonstrate a potent and specific action against Spodoptera litura. The sulfonyl-acetohydrazide derivatives induced significant developmental abnormalities and increased mortality rates in Spodoptera litura larvae, leading to a marked disruption in their life cycle. Additionally, Density Functional Theory methods were employed to elucidate the electronic structure and corelate the reactivity of the synthesized compounds with the insect growth regulating activity (IGR). The DNA-binding study of synthesized JH analogs has been carried out using UV-vis spectroscopy for toxicity assessment against biomolecule DNA. All the synthesized JH analogs (H1-H8) show IGR action and exhibit better reactivity and reduced toxicity as compared to the commercial in use IGR, pyriproxyfen., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

In this study, the novel activated carbon developed from Phyllanthus emblica fruit stone, through hydrothermal treatment at low pressure and temperature, was utilized for the removal of 4-nitrophenol, 4-chlorophenol, and phenol from water. The activated carbon produced (AC-HTPEFS) showed a well-developed porosity with a surface area of 569 m 2 g -1 and a total pore volume of 0.342 cm 3 g -1 . The adsorption process was explored and efficiently applied regarding the removal of phenols and substituted phenols from wastewater. Thermodynamic analyses indicated that the adsorption process was endothermic and spontaneous. To analyze the equilibrium data, different isotherm models were employed. The Langmuir model applied best, with maximum adsorption capacities of 0.463, 0.434, and 0.387 mmol g -1 at 25 °C for 4-nitrophenol (4-NP), 4-chlorophenol (4-CP), and phenol, respectively, regarding the AC-HTPEFS. The adsorption was mainly an endothermic process, and the results achieved were slightly higher than those obtained with a commercial activated carbon commonly used for this purpose.

Abnormal Toxicity Test (ATT) is performed as quality control test by manufacturers and National Control Laboratory (NCL) to ensure safety of biologicals. However, stakeholders are in general consensus that extraneous toxic contaminations are extremely unlikely where Good Manufacturing Practices (GMPs) and consistent production have been established. This test requiring mice and guinea pigs is still a regulatory requirement for the batch release of biologicals in several countries although it has been deleted by some National Regulatory Authorities (NRAs) and Pharmacopoeias while some are still working on its elimination. Therefore, ten years historic data of ATT performed at National Institute of Biologicals (NIB), India on 4813 batches of biologicals including blood and related products, enzymes, hormones and vaccines by using 33637 animals was analyzed. As per Indian Pharmacopeia (IP), 4783 batches of these biologicals passed the test. The test had to be repeated in 30 batches, all of which were blood products and the repetition rate was 0.62 %. Further, after repeat testing, all these 30 batches also passed the test. This data will help the regulatory authorities of countries where ATT is still a requirement, take appropriate decision regarding its deletion. The elimination of ATT from specific monographs of these biologicals will help save many thousands of animals being used globally for this test., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)