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Objectives Methods Results Conclusion Our study aimed to evaluate the effect of superior hypogastric nerve plexus (SHNP) block in postoperative pain management in the first 24 h after minimally invasive gynecological (MIG) surgeries.We conducted a double‐blinded, randomized controlled trial in the Department of Obstetrics and Gynecology at a tertiary care centre from May 1, 2023 to September 30, 2023 in women undergoing major MIG surgeries. At the completion of the surgery, women were randomized to the intervention group who received SHNP block with ropivacaine 10 mL (0.75%) before port removal, whereas no intervention was taken in the control group. The extubation time was noted, and the pain score was assessed after 1, 2, 6, 12, and 24 h of extubation in the postoperative period using the visual analog scale (VAS). Statistical analysis was done, with a significance level of 0.05, to test the differences between the two groups.A total of 64 patients were randomly allocated to intervention and control groups. The median pain score was lower at 1 and 2 h post‐extubation and comparable between the two groups at 6, 12, and 24 h. The surrogate markers that is need for additional analgesia and duration of stay did not differ significantly in the two groups, with P‐values of 0.08 and 0.943, respectively.Although the SHNP group experienced considerably lower immediate postoperative pain levels in the initial hours following extubation, the impact of this benefit remains uncertain in the longer postoperative period. The effectiveness of this modality for pain control needs further study, particularly at later postoperative hours. [ABSTRACT FROM AUTHOR]

Microfluidic based sensors are one of the emerging alternatives for bringing solutions studies on paper platforms. Microfluidic paper assisted platform was developed over here through a simple, easy, cost effective and instrument free process. The self‐same method of waxing through crayoning, was estimated thoroughly on different paper platforms. Varied parameter including type of crayoning, way of patterning, color effect, wicking rate and channel optimization was performed on paper milieus. Optimized time of baking for obtaining controlled penetration ranges from 2 min to 8 min depending on the type of paper used. Wax crayoning was preferred over oil pasteling for making hydrophobic barriers uniformly, solid as well fully penetrated within paper inner layers. Fabrication through this easy cost‐effective route allows a formation of hydrophilic reaction or sensing zone of 0.25 cm2 with sufficient reactive area. Further sensing of dopamine on paper platform was carried using paper chip adsorbed with fluorescent modified graphene quantum dots as sensing material. The patterned paper showed advantage as only few microliter (5 μl to 10 μl) range of sample volume was required for testing. Fluorescence quenching with increase of concentration was witnessed where around 25–75 μM dopamine concentration was positively tested through naked eye; which for the first time was demonstrated here via robust wax crayoning method for developing paper based biosensor. [ABSTRACT FROM AUTHOR]

Objective: To measure the anatomical dimensions of the vulva in adult Indian women. To analyze their correlations with age, body mass index (BMI), parity, and mode of delivery. Methods: This cross-sectional study was conducted in a tertiary care university hospital in India, among 400 women aged 18 years and above. Various vulval measurements were taken, and Pearson's correction was applied to variables like age, BMI, parity, and mode of delivery. Results: Mean length of glans of clitoris was 5.2 ± 1.43 mm, the labia minora width was 2.6 ± 0.74 cm, length of introitus was 1.3 ± 0.59 cm, and perineal body length was 2.3 ± 0.60 cm. The range of some measurements was extensive, for example labia minora width ranged from 0.7 to 4.9 cm. Normal centile curves were constructed for vulval measurements according to age groups. Statistically significant positive correlations of age, BMI, and obstetrical history were seen with labia minora width (r = 0.165, P = 0.001; r = 0.284, P < 0.001; r = 0.246, P < 0.001, respectively). Conclusion: The centile curves can be used as a reference for the Indian population of different ages. These can be used when counseling women coming for female genital cosmetic surgery. [ABSTRACT FROM AUTHOR]

Introduction: Hemophilia B is associated with molecular heterogeneity, with more than 1200 unique variants in the F9 gene. We hereby describe the mutational spectrum of severe hemophilia B patients presenting in a tertiary‐care center in India. Method: DNA was extracted from peripheral blood samples of 35 diagnosed severe hemophilia B patients belonging to 32 families, and were subjected to Sanger sequencing. Determination of the effect of novel variants on the protein structure and correlation between genotype and phenotype was attempted using in‐silico tools. Results: Twenty‐seven different mutations were detected in 30 probands, including 20 known and 7 novel variants. Also, we found one suspected case of whole gene deletion. The serine peptidase domain harbored most of the variants (48.1%). Inhibitory antibodies were found in two patients. Conclusions: This study provides a comprehensive mutational spectrum and mutation screening strategy by Sanger sequencing of F9 gene in severe hemophilia B patients, in a resource‐constraint setting. [ABSTRACT FROM AUTHOR]

Overgrowth, defined as height and/or OFC ≥ +2SD, characterizes a subset of patients with syndromic intellectual disability (ID). Many of the disorders with overgrowth and ID (OGID) are rare and the full phenotypic and genotypic spectra have not been unraveled. This study was undertaken to characterize the phenotypic and genotypic profile of patients with OGID. Patients with OGID were ascertained from the cohort of patients who underwent cytogenetic microarray (CMA) and/or exome sequencing (ES) at our center over a period of 6 years. Thirty‐one subjects (six females) formed the study group with ages between 3.5 months and 13 years. CMA identified pathogenic deletions in two patients. In another 11 patients, a disease causing variant was detected by ES. The spectrum of disorders encompassed aberrations in genes involved in the two main pathways associated with OGID. These were genes involved in epigenetic regulation like NSD1, NFIX, FOXP1, and those in the PI3K‐AKT pathway like PTEN, AKT3, TSC2, PPP2R5D. Five novel pathogenic variants were added by this study. NSD1‐related Sotos syndrome was the most common disorder, seen in five patients. A causative variant was identified in 61.5% of patients who underwent only ES compared to the low yield of 11.1% in the CMA group. The molecular etiology could be confirmed in 13 subjects with OGID giving a diagnostic yield of 42%. The major burden was formed by autosomal dominant monogenic disorders. Hence, ES maybe a better first‐tier genomic test rather than CMA in OGID. [ABSTRACT FROM AUTHOR]

Summary: Cloud computing technology provides flexibility to Cloud Service Provider (CSP) for providing the cloud resources based on the users' requirements. In on‐demand pricing model, the attackers exploit this feature and cause unwanted scaling‐up of the cloud resources without any intent to pay for them. The associated cost for the unpaid malicious usage burdens the CSP, and over a long period, economic losses occur at the CSP end. Thus, the resources and services offered by the CSP become unsustainable, and the attack is termed as Economic Denial‐of‐Sustainability (EDoS) attack. The existing defense approaches for EDoS attacks are reactive. Thus, the associated attack detection/mitigation cost is high; consequently, the approaches are not suitable for the Small and Medium Enterprises (SMEs). The aim of this paper is to detect and mitigate, internal and external, stealthy EDoS attacks proactively. The attack is detected using average CPU utilization threshold and utility function (in terms of cost for the utilized cloud computing resources) and mitigated using virtual firewalls. Amazon Elastic Compute Cloud (Amazon EC2) is used to evaluate the performance of the proposed approach. The proposed approach accurately detects the EDoS attack and mitigates its effect as well with reduced cost. It is observed that the approach provides competitive response time, victim service downtime, and attack reporting time. Thus, the overall performance is improved. [ABSTRACT FROM AUTHOR]

Synthesis of multifunctional fabrics with long‐lasting durability remains a quest for researchers in the past decade. In this work, robust coatings on cotton fabrics for superhydrophobic, antibacterial, and UV‐blocking functionalities by a dual‐stage silanization technique are reported. Aminopropyltriethoxysilane is utilized as a silane cross‐linker to anchor zinc oxide nanoparticles to the pristine cotton fabric surface, followed by modification with a silane hydrophobe, hexadecyltrimethoxysilane. This dual‐silanization approach results in highly functional fabrics displaying superhydrophobicity with a water contact angle of 154°, water shedding angle of 2°, antibacterial activity of up to 98%, and UV‐blocking ability more than 200 times of pristine cotton. The as‐prepared fabrics display excellent durability against abrasion, ultrasonic washing, immersion in different pH solutions, and UV irradiation. Moreover, the air permeability and flexural rigidity of the fabrics are still within the required breathability and wearer comfortability for clothing applications. The reported process is simple, cost‐effective, and green, showing great promise for large‐scale production of multifunctional fabrics. [ABSTRACT FROM AUTHOR]

Pulmonary agenesis, a rare congenital condition, is incompatible with life when present bilateral, while unilateral agenesis is usually detected in infancy or early childhood. Rare asymptomatic patients may reach adulthood undiagnosed, with signs mimicking common conditions presenting as radiopaque hemithorax with ipsilateral mediastinal shift. Here, we describe a case of a young lady, with history of consanguinity, who presented with complaints, suggestive of lower respiratory tract infection, and was investigated and diagnosed to be a case of right-side pulmonary agenesis with large ostium secondum atrial septal defect. Our present case emphasizes the importance of presence of pulmonary agenesis with cardiac congenital anomaly, remaining asymptomatic until adulthood, particularly in patients born of parents with consanguineous marriages. [ABSTRACT FROM AUTHOR]