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Objective: To quantify and compare respiratory functions and further screen the oral mucosa of tobacco and non-tobacco users. Material and Methods: First control group, non-tobacco users (n=55); Second group, smokers’ group (n=168) who currently smoked cigarettes; Third group smokeless/chewing type, tobacco group (n=81); Fourth group, both smokeless and smoking type tobacco users (n=46). Fagerstrom Test for Nicotine Dependences (FTND) and Fagerström Test for Nicotine Dependence-Smokeless Tobacco (FTND-ST) instruments were used to assess nicotine dependence. Subsequently, spirometry and Toluidine Blue (TB) vital staining were performed. Chi-squared and one-way analysis of variance (ANOVA) were used for statistical analysis. Results: Fagerstrom test resulted in 48.8% of subjects with low dependency, followed by an increase in nicotine dependency from low to moderate (29.2%), moderate (15.6%), and highly dependent (6.4%) groups. All respiratory function tests and oral screening confirmed significant changes amongst tobacco and non-tobacco users. The forced vital capacity of non-smoker group was significantly different from other tobacco users’ group (p

Rates of Blount disease and childhood obesity have increased in parallel, although the co-management of this acquired comorbidity and obesity is not well described. This report shares the course of a toddler with severe obesity who experienced rapid and persistent weight gain without success from nutrition and behavior changes. After repeat subspeciality evaluation, the patient was ultimately diagnosed with signs of early-onset Blount disease, urging the need for adjunct medical therapy. Initiation of topiramate was shown to achieve weight neutrality and improve the patient's body mass index (BMI), appearing to halt the progression of Blount disease and avoiding escalation to surgical treatment. This report suggests topiramate can be an effective and well-tolerated medication in young patients with a pressing need for weight intervention.

Purpose We aimed to develop a predictive tool for anastomotic leakage (AL) following colon cancer surgery by combining a clinical early warning score (EWS) with the C-reactive protein (CRP) level. Methods The records of 1,855 patients who underwent colon cancer surgery at the Oxford University Hospitals NHS Foundation Trust between January 2013 and December 2018, with or without AL, were retrospectively reviewed. EWS and CRP levels were assessed daily from the first postoperative day until discharge. AL was defined as an anastomotic defect observed at reoperation, the presence of feculent fluid in a pelvic drain, or evidence of AL on computed tomography. The tool incorporated postoperative EWS and CRP levels for the accurate early detection of AL. Results From postoperative days 3 to 7, the mean CRP level exceeded 200 mg/L in patients with AL and was under 200 mg/L in those without AL (P

Background: Generalized anxiety disorder (GAD) affects up to 6% of the population, which if not detected early and adequately treated will continue as a hidden impairment resulting in disability. Aim: The primary objective of the study is to assess the hair cortisol levels (HairF) in persons with GAD with and without alcohol dependence syndrome (ADS), and the secondary objective is to assess whether HairF can be used as a biomarker for assessment of GAD. Materials and Methods: This comparative study was done on 94 subjects (68 persons with GAD with or without ADS and 26 healthy controls) who were divided into three groups. Hamilton Anxiety Rating Scale (HAM-A) and Patient Health Questionnaire-4 (PHQ4) were also used to assess severity of anxiety symptoms. These scores were compared with HairF. Diagnostic accuracy of the HairF analysis test was done. Statistical analysis was done using SPSS version 20. Results: The study found higher levels of HairF in persons with GAD (mean 189.4 ± 33.1) and GAD with ADS (164.2 ± 47.6) compared to healthy controls (mean 45.34 ± 40.7), which were statistically significant. Correlation of HAM-A and PHQ4 scores and HairF also showed positive correlation. The receiver operating characteristic curve suggested the best cutoff point at 88.4 pg/mg with a sensitivity of 98.5% and a specificity of 92.5%, clearly differentiating GAD from healthy controls. Conclusion: HairF were found to be higher in patients with GAD irrespective of ADS as comorbidity. The study supports the possibility of the HairF as a possible biomarker to detect GAD and play a complementary role in a multidimensional approach for management of chronic stress and anxiety.

OBJECTIVE: The objective of the study was to evaluate the role of spinoplasty in the surgical management of intervertebral disc prolapse by midline decompression and discectomy. MATERIALS AND METHODS: Our study included 30 patients diagnosed with lumbar intervertebral disc prolapse at one level between July 2018 and October 2021. The patients belonged to the age group 18–45 years and comprised both males and females. All the patients in our study were operated by fenestration and discectomy of the involved level. Intraoperatively, the spinous process was not removed at the involved level. The spinous process was cut at the base, at the insertion of interspinous ligament, retracted along with the ligament complex, and the lamina was exposed. After the decompression of neural tissues, the spinous process was anatomically restored by performing a spinoplasty. All patients were followed up postoperatively and evaluated by the Oswestry Disability Index (ODI), Visual Analog Scale (VAS), and patient satisfaction. Results: In our study, most patients had involvement of L4–5 disc (70%). Intraoperatively, satisfactory neurological decompression was achieved and all patients had relief of symptoms immediately. The mean ODI and VAS scores were 58% and 8.2 preoperatively which reduced significantly to 15.5% and 0.8 during 6 months postoperative follow-up. The patients were mobilized on the 2nd day after surgery and had a faster recovery time with good functional outcomes. Conclusion: The goal of treatment of intervertebral disc prolapse is to improve the quality of living and reduce the economic burden of the disease. Spinous process osteotomy carried out and restorative spinoplasty done after nerve decompression provided satisfactory functional outcomes.

Introduction: Fractures of the clavicle are common injuries with an incidence of 5%–10% of all fractures. The most common site of fracture in clavicle is the middle third and accounts for approximately 70%–80% of all clavicle fractures. Clavicle fractures are usually associated with some degree of displacement. Displaced midshaft clavicle fractures can cause significant persistent disability, even if they heal uneventfully when treated conservatively. Surgery is required in case of significant fracture displacement and associated neurovascular injuries. Fractures that require internal fixation are usually treated by plate osteosynthesis as the standard procedure. Intramedullary fixation with titanium elastic nailing system (TENS) is an increasingly popular technique for the internal fixation of displaced mid-clavicular fractures. It is a better fixation device for simple displaced midshaft clavicle fractures. Methodology: A prospective study was conducted with a sample size of 20 patients for 18 months. After obtaining approval and clearance from the institutional ethics committee, the patients fulfilling the inclusion criteria were enrolled for the study after obtaining informed consent. A thorough clinical examination of the patient was done. The diagnosis was made based on X-ray findings. All patients underwent routine preoperative investigations, and their fitness for surgery was taken. The surgery was performed under general or regional anesthesia. Constant–Murley score was used to evaluate the outcome of the study. The cases were followed for a minimum period of 6 months following surgery at the regular intervals of 6, 12, and 24 weeks. Results: The functional outcome in 17 patients was excellent with the union of the fracture site. In one case, there was fixation failure and it had to be converted into plate fixation and was excluded from the study. In four patients, there was hardware prominence at the entry site. Conclusion: TENS is a good internal fixation option for simple displaced midshaft clavicle fractures to reduce the duration of the surgery, decrease the surgical site morbidity, and early mobilization.

Microbial diseases remain a leading cause of death worldwide, and the emergence of new infections underscores the need for innovative treatments. Plant-based sources for antimicrobial drugs are gaining popularity due to their fewer side effects compared to synthetic drugs. Corn silk (CS), an ancient medicinal plant, has been used for thousands of years to treat ailments such as edema and cystitis. It is a rich source of vitamins and minerals and acts as an anti-hypertensive, anti-diabetic, anti-cancerous, antioxidant, and antimicrobial agent. Its bioactive components, which include phenolic acids, flavonoids, tannins, alkaloids, terpenes, and saponins, are responsible for these therapeutic benefits. Numerous studies have examined the antibacterial effectiveness of diverse CS extracts, unveiling several methods by which CS demonstrates its antimicrobial properties. These mechanisms include the inhibition of energy production within microbial cells, interference with DNA and protein synthesis, prevention of biofilm formation, disruption of cell wall synthesis, and direct disruption of the cell wall structure. CS effectively blocks microbial growth and multiplication by focusing on these vital processes. Therefore, the purpose of this review is to provide a comprehensive summary of the different bioactive compounds found in CS, as well as their mechanisms of action against microbes. Understanding these mechanisms highlights CS’s potential as a potent source for developing new antimicrobial medications and supplements, offering a natural and effective alternative in the fight against infectious diseases.

The Aurora family of kinases orchestrates chromosome segregation and cytokinesis during cell division, with precise spatiotemporal regulation of its catalytic activities by distinct protein scaffolds. Plasmodium spp., the causative agents of malaria, are unicellular eukaryotes with three unique and highly divergent aurora-related kinases (ARK1-3) that are essential for asexual cellular proliferation but lack most canonical scaffolds/activators. Here we investigate the role of ARK2 during sexual proliferation of the rodent malaria Plasmodium berghei, using a combination of super-resolution microscopy, mass spectrometry, and live-cell fluorescence imaging. We find that ARK2 is primarily located at spindle microtubules in the vicinity of kinetochores during both mitosis and meiosis. Interactomic and co-localisation studies reveal several putative ARK2-associated interactors including the microtubule-interacting protein EB1, together with MISFIT and Myosin-K, but no conserved eukaryotic scaffold proteins. Gene function studies indicate that ARK2 and EB1 are complementary in driving endomitotic division and thereby parasite transmission through the mosquito. This discovery underlines the flexibility of molecular networks to rewire and drive unconventional mechanisms of chromosome segregation in the malaria parasite.

Agriculture provides basic livelihood for a large section of world's population. It is the oldest economic activity in India, with two third of Indian population involved in crop production. India is second largest producer of rice and biggest exporter globally, with rice which is most common staple crop consumed in country. However, there are several challenges for paddy production including small production yield, soil quality, seed quality, huge volume of water needed and biotic stress. Of these, biotic stress drastically affects yield and susceptibility to other diseases in paddy production. It is caused by pathogens such as bacteria, viruses, fungi, nematodes, all of which severely affect growth and productivity of paddy crop. To mitigate these challenges, infected crops are identified, detected, classified, categorized, and prevented according to their respective suffering disease by using conventional methods which are not effective and efficient for growth of paddy crop. Thus, use of artificial intelligence (AI) and a smart agriculture-based Internet of Things (IoT) platform could be effective for detecting the biotic stresses in very less time or online mode. For this, deep learning, and convolutional neural networks (CNN) multi-structured layer approach were used for diagnosing disease in rice plants. Different models and classifiers of CNN were used for detecting disease by processing high-spectral images and using logistic and mathematical formulation methods for classification of biotic paddy crop stresses. Continuous monitoring of stages of infection in paddy crop can be achieved using real-time data. Thus, use of AI has made diagnosing paddy crop diseases much easier and more efficient.

Abstract Multistate memory systems have the ability to store and process more data in the same physical space as binary memory systems, making them a potential alternative to existing binary memory systems. In the past, it has been demonstrated that voltage-controlled magnetic anisotropy (VCMA) based writing is highly energy-efficient compared to other writing methods used in non-volatile nano-magnetic binary memory systems. In this study, we introduce a new, VCMA-based and skyrmion-mediated non-volatile ternary memory system using a perpendicular magnetic tunnel junction (p-MTJ) in the presence of room temperature thermal perturbation. We have also shown that ternary states {− 1, 0, + 1} can be implemented with three magnetoresistance values obtained from a p-MTJ corresponding to ferromagnetic up, down, and skyrmion state, with 99% switching probability in the presence of room temperature thermal noise in an energy-efficient way, requiring ~ 2 fJ energy on an average for each switching operation. Additionally, we show that our proposed ternary memory demonstrates an improvement in area and energy by at least 2X and ~ 104X respectively, compared to state-of-the-art spin-transfer torque (STT)-based non-volatile magnetic multistate memories. Furthermore, these three states can be potentially utilized for energy-efficient, high-density in-memory quantized deep neural network implementation.

Tuberculosis (TB) is a serious disease that has been observed since ancient times. In the mid-to late-20th century, the main clinical approach to this disease involved focusing on its diagnosis, prevention, and treatment. However, in the 21st century, the focus has shifted toward the diagnosis and treatment of drug-resistant TB. With the use of the Xpert MTB/RIF assay at the frontlines in India, interpreting indeterminate results to treatment with rifampicin, an antitubercular drug, can be challenging. This is further exacerbated by a lack of knowledge regarding mutation frequency in antitubercular drug-resistant genes in this region. Among antitubercular drugs, rifampicin is the most potent and effective drug for the treatment of tuberculosis; hence, understanding the pattern of rifampicin resistance (rpoB) gene mutations will provide insights into the genetic basis of this resistance, which may help in the prevention and treatment of TB. This retrospective observational study presents sociodemographic details, sample types, Mycobacterium tuberculosis load, types of probe mutations detected, and rifampicin indeterminate results from the Xpert MTB/RIF assay. Of the 314 samples analyzed, 258 showed rifampicin resistance as detected by MTB, with 56 samples of MTB-detected rifampicin indeterminate results. Type E probe mutation (58.9%) was the most common type, while the least frequent mutation was Type C probe (1.5%). No missing probe was observed in approximately 8.9% of samples. Among the 56 rifampicin indeterminate results, the maximum Cycle threshold value did not cross 34.5 in six samples.

The confinement of electrons in gold nanoparticles results in Surface Plasmon Resonance (SPR), which is characterized by electric field enhancement in the vicinity of these nanoparticles. This property has been extensively studied and applied in various fields. In our research, we conduct a detailed investigation of plasmonic coupling in spherical gold nanoparticles. Specifically, we use the Discrete Dipole Approximation (DDA) method implemented in DDSCAT to simulate the coupling of electric fields in a doublet of nanoparticles as a function of the distance between them. Our simulations show that the coupling of SPR between two nanoparticles occurs up to a separation of 12 nm. Moreover, we extend our simulations to study the coupling of nanoparticles in linear chains consisting of up to five nanoparticles and in clustered forms. Our results indicate that the SPR coupling in a linear chain occurs, and as the number of nanoparticles increases, the field enhancement also increases. However, we observe that this effect saturates after four nanoparticles in a line. Our study provides insights into the plasmonic coupling in gold nanoparticles, which can aid in the design and optimization of plasmonic devices for various applications.