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Ayurveda has a long-standing tradition of healthcare in Southeast Asia. Swarnaprash, a classical Ayurveda preparation, is commonly given as the pre-lacteal feed to neonates to prevent labor-related complications and infections. It comprises incinerated gold particles (InAuP/Swarna Bhasma), honey (Madhu), and clarified butter oil (CBO/Cow Ghrita). This in vitro study aimed to evaluate the therapeutic potential of the individual ingredients and combinations of Swarnaprash against selected neonatal gut pathobionts and symbionts. The study employed sophisticated instruments, including SEM with EDAX and X-ray diffraction analysis, to investigate the shape and structural disparities in the ingredients of Swarnaprash. The reported size of gold particles in Swarnaprash ranges from 0.6 to 9.5 µm. These particles are relatively smaller than those in Swarna Bhasma but larger than synthetic gold particles. Swarnaprash demonstrated both bactericidal and bacteriostatic activity against selected neonatal gut pathobionts, with the largest inhibition zones observed for P. aeruginosa and S. Typhi. It surpassed the individual efficacy of its components-Prash, InAuPs, honey, or CBO alone. Notably, Swarnaprash did not affect the selected beneficial gut bacteria. The results warrant further in vivo and clinical studies to explore the effects of Swarnaprash on neonatal gut flora, which would provide vital information for research in neonatal healthcare., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Automatic text summarization is a cornerstone of natural language processing, yet existing methods often struggle to maintain contextual integrity and capture nuanced sentence relationships. Introducing the Optimized Auto Encoded Long Short-Term Memory Network (OAELSTM), enhanced by the Whale Optimization Algorithm (WOA), offers a novel approach to this challenge. Existing summarization models frequently produce summaries that are either too generic or disjointed, failing to preserve the essential content. The OAELSTM model, integrating deep LSTM layers and autoencoder mechanisms, focuses on extracting key phrases and concepts, ensuring that summaries are both informative and coherent. WOA fine-tunes the model's parameters, enhancing its precision and efficiency. Evaluation on datasets like CNN/Daily Mail and Gigaword demonstrates the model's superiority over existing approaches. It achieves a ROUGE Score of 0.456, an accuracy rate of 84.47%, and a specificity score of 0.3244, all within an efficient processing time of 4,341.95 s., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Gurusamy, Rangarajan and Altalbe.)

Background and Aims: We provide an overview and data visualization trends of orthopaedic research published by the Journal of Orthopedics (JOO) from 2013 to 2024., Methods: We used Scopus database to retrieve all articles published by the JOO from 2013 to 2024, as of 15.7.2024. Bibliometric analysis and visualization of the global orthopaedic literature were performed using Microsoft Excel and VOSviewer software to explore the research hotspots in this field in the past 12 years., Results: The 2074 publications covered in the JOO published between 2013 and 2024 were identified. The annual average and six-year cumulative publications depicted growth rates of 36.23 % and 147.99 %, respectively. Of the 80 global publications, the main participating countries were from Europe (n = 26), and Asia (n = 13). North America (37.37 %), Europe (34.89 %) and Asia (30.42 %) contributed a significant share of journal output. The most contributing countries were the USA, followed by the U.K., India, and Japan. The visualization and analysis of topical research trends reveal that the JOO covers almost the entire spectrum of orthopaedic research, with the most focus on the Knee (26.38 %), Hip (21.53 %), Shoulder (8.79 %) and Spine (7.09 %) and its subfields, such as arthroplasty (882 papers), surgery (192 papers), radiography (177 papers), osteoarthritis (166), pain (135 papers), fractures (133) and arthroscopy (70). The 68 (3.32 %) of the 2047 publications received 30 and above citations and together received 3466 citations, constituting 51.73 % share of total citations. The Hospital for Special Surgery (USA), and Singapore General Hospital were the most productive organizations, while the most impactful organizations were the University of Toledo Medical Center (USA), and Università degli Studi di Messina (Italy). The most productive authors were R. Vaishya (India), and J.A. Dubin (USA), whereas V. Filardi (Italy) and J.M. Newman (USA) were the most impactful authors of the JOO., Conclusion: The JOO is a destination for global orthopaedic research. It has progressively received an increasing number of manuscripts and depicted high annual average publication growth rates, besides witnessing an increase in the significant number of citations received. It has helped to improve the journal's ranking, impact and reputation., Competing Interests: We wish to confirm that none of the authors have any competing interest related to this manuscript. However, the Authors #1,2,3 are on the editorial board of the Journal of Orthopaedics, but will not have any role in the editorial review and decision making on this article., (© 2024 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Introduction: Evidence on the prevalence of foot problems among people with diabetes in India at a national level is lacking. Hence, this study was aimed to assess the burden of high-risk (HR) feet in people with diabetes across India., Research Design and Methods: A cross-sectional national-level project 'Save the Feet and Keep Walking' campaign was conducted by the Research Society for the Study of Diabetes in India (RSSDI) from July 10, 2022 to August 10, 2022. A modified version of 3 min foot examination was used to assess the foot problems. Around 10 000 doctors with RSSDI membership were trained online to conduct foot screening and provided a standardised monofilament for detection of loss of protective sensation. People with diabetes aged >18 years who visited the clinics during the study period were examined for foot problems. Data were collected online using the semi-structured questionnaire. A total of 33 259 participants with complete information were included for the final analysis. The foot at risk was categorised based on International Working Group on the Diabetic Foot guidelines 2023., Results: Nearly 75% of the participants were aged above 45 years. Around 49% had diabetes duration >5 years and uncontrolled diabetes (hemoglobin A1c >8%). Presence of history of foot ulcer (20%), lower limb amputation (15.3%), foot deformities (24.5%) and absence of diminished dorsal pedis and posterior tibial pulses (26.4%) was noted in the study participants. Around 25.2% of them had HR feet and highly prevalent among males. Diabetic kidney and retinal complications were present in 70% and 75.5% of people with HR feet. Presence of heel fissures (OR (95% CI) 4.6 (4.2 to 5.1)) and callus or corns (OR (95% CI) 3.6 (3.3 to 4.0)) were significantly associated with HR feet., Conclusions: One-fourth of people with diabetes were found to have HR feet in India. The findings are suggestive of regular screening of people with diabetes for foot problems and strengthening of primary healthcare., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Aims: Prediabetes and osteoporosis are two commonly prevalent diseases that can have interconnected implications for overall well-being. There is a paucity of literature on "prediabetes and osteoporosis". We aimed to assess the current state of cross-sectional studies involving osteoporosis and prediabetes as well as their bibliometric features., Methods: Publications about prediabetes and osteoporosis between January 1994 and November 2023 were taken from the Scopus database, and VOSviewer and Microsoft Office Excel were used for bibliometric analysis and visualization., Results: We identified 272 documents that were written by 531 authors from 48 countries including 252 organizations. The USA was the leading country with the highest publications (n = 84) and Canada had the largest citation impact per paper (109.0). University of California, San Francisco contributed the most publications (n = 6), while Universita degli Studi di Torino, Italy (275.0 and 5.25), had the highest citation impact. Frontiers in Endocrinology (n = 7), was the most productive journal, while Annals of Internal Medicine (322.0) was the most influential in terms of citation impact per paper. The funded research was 30.5 %, while 17.6 % of research were involved in international collaboration., Conclusion: The number of publications on this topic has increased over three decades. The highest citations per paper were received by the publications which had external funding, followed by those which had international collaboration. All the highly cited papers were published from high-income countries., (© 2024 Delhi Orthopedic Association. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Globally, diabetes mellitus (DM) is a substantial contributor to morbidity and mortality. Comorbidities and intercurrent illnesses in people with diabetes may necessitate the use of steroids. Acute as well as chronic use of steroids contributes substantially to the development of various complications. Despite this, there are no standard guidelines or consensus to provide a unified approach for the rational use of steroids in people with diabetes. Also, there is scant harmonization among clinicians with the use of different steroids in routine practice. To address the inconsistencies in this clinical arena, the consensus working group (CWG) formulated a unified consensus for steroid use in people with diabetes. In people with diabetes, the use of steroids causes hyperglycemia and may precipitate diabetic ketoacidosis (DKA). An increase in weight is directly related to the dose and duration of the steroid therapy. Steroid-related alterations in hyperglycemia, dyslipidemia, and hypertension (HTN) add to the increased risk of cardiovascular (CV) disease. The risk of complications such as infections, osteoporosis, myopathy, acne, cataracts, and glaucoma may increase with the use of steroids. Appropriate and timely monitoring of these complications is necessary for early detection and treatment of such complications. Given the systemic effects of various antihyperglycemic drugs, there is a possibility of aggravating or diminishing the specific complications. Preference to a safer steroid is required matching the steroid dose equivalence and individualizing patient management. In conclusion, short-, intermediate-, or long-term use of steroids in people with diabetes demands their rational use and holistic approach to identify, monitor, and treat the complications induced or aggravated by the steroids., (© Journal of the Association of Physicians of India 2024.)

Background: Over the years, several studies have been conducted by utilizing bibliometric techniques to reveal research trends in various sub-fields of medical sciences, including arthritis research. Although no bibliometric study has been conducted Methods:In this study, we examined the publications of Indian scholars on Rheumatoid Arthritis (RA) in the last three decades, using various quantitative and qualitative bibliometric indicators. The publications on RA (from 1994-2023) in the Scopus database were identified, analysed and evaluated using a pre-defined search strategy, and specialised software., Results: 1603 papers were published on RA research that was cited 36814 times (averaging 11.48 citations per paper or CPP). The 18.65% and 16.71% of India's total publications indicated received external funding. The most productive Indian organizations were AIIMS (New Delhi), SGPGIMS (Lucknow) and PGIMER (Chandigarh). The most impactful organizations were AMU (Aligarh), Fortis Healthcare Ltd. (Gurgaon), and Punjab University (Chandigarh). The most productive authors were A. Aggarwal, R. Misra, A. Chopra, and U. Kumar. The most impactful authors were A. Aggarwal, A. Ghosh, S. Shankar, and R. Misra. Medicine (64.2% share), Pharmacology, Toxicology and Pharmaceutics (22.0% share), Biochemistry, Genetics and Molecular Biology (19.8% share) and Immunology and Microbiology (12.8% share) contributed the most publications in this area. Clinical studies (40.9% share), pathophysiology (13.2% share) and the treatment outcome (9.0% share) accounted maximally. The most significant keywords appearing in the area were: "Rheumatoid Arthritis", "Methotrexate", and "Rheumatoid Factor"., Conclusions: This study provides insight into past, present, and future areas of India on research in RA and will help scholars identify the areas of collaboration.

In recent years, medical technological innovators have focused on diverse clinical therapies to find innovative ways to overcome clinical challenges. But still, there emerge certain drawbacks like high computational cost, increased error, less training ability, the requirement of high storage space and degraded accuracy. To conquer these drawbacks, the proposed research article presents an innovative cascaded extreme learning machine for effective heart disease (HD) prediction. Missing data filtering and normalization methods are carried out for data pre-processing. From the pre-processed data, the features are extracted using the Framingham risk factor extraction module, whereas the extracted features are fused to generate a feature vector. The most significant features are selected using Rhino Satin Herd optimization algorithm. Using a linear weight assignment approach, the feature weighting process is undertaken by allocating higher weights to significant features and less weight to unwanted features. Finally, classification is performed through the Cascaded kernel soft plus extreme learning machine with a stacked autoencoder model. The performance is analyzed using PYTHON to evaluate the superiority of the proposed model. The proposed model obtained an overall accuracy of 90%, precision of 94%, recall of 91.3% and F1 measure of 92.6% in the Cleveland-Hungarian dataset, which is comparatively superior to the existing methods. An accuracy of 92.6% is attained for predicting HD in terms of the heart patient dataset. The proposed model attains better performance because of effective accuracy outcome, reduced overfitting issues, fewer error rates, better convergence and training ability.

Background: The research field of stem cell-based therapies in orthopaedics has witnessed significant growth in the recent past. We aimed to identify and analyze the bibliometric characteristics of the global highly cited papers (HCPs) in stem cell research in orthopaedics., Methods: This study relied on secondary data extracted from Scopus, Elsevier's abstract and citation database. An advanced search string was employed, for the period from 1995 to 2020. For each paper, the extracted information included the number of citations, title, authors (name, number, authorship position, and country), year of publication, title of the journals, study design, and thematic field. The VOSviewer (1.6.20) was used to uncover relationships between authors, institutions, keywords, and publications., Results: There were a total of 1427 publications and out of these 186 papers had 100 or more citations (range 100-2644) and were considered as HCPs. The average citation per paper (CPP) was 265.8. Only 4% of the top HCPs contributed 20% of the total citations of all HCPs. All the HCPs were published from high-income countries, and the USA was the leading country in all aspects of publication on stem cell research. Méndez-Ferrer S registered the highest citation ( n  = 2644), Prockop DJ was the most prolific author ( n  = 8 papers), and Harvard Medical School, USA emerged as the most prolific organization with 12 HCPs., Conclusion: Global research in stem cell therapies for orthopaedic problems is making strides, and is an emerging field of research. Stem cell research offers the potential for improved treatment outcomes for various musculoskeletal conditions., Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-024-01160-0., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest., (© Indian Orthopaedics Association 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

A barrier to meeting the goal of universal health coverage in India is the inequality in utilisation of health services between indigenous and non-indigenous people. This study aimed to explore the determinants of utilisation, or non-utilisation, of public healthcare services among the Santals, an indigenous community living in West Bengal, India. The study holistically explored the utilisation of public healthcare facilities using a framework that conceptualised service coverage to be dependent on a set of determinants - viz. the nature and severity of the ailment, availability, accessibility (geographical and financial), and acceptability of the healthcare options and decision-making around these further depends on background characteristics of the individual or their family/household. This cross-sectional study adopts ethnographic approach for detailed insight into the issue and interviewed 422 adult members of Santals living in both rural (Bankura) and urban (Howrah) areas of West Bengal for demographic, socio-economic characteristics and healthcare utilisation behaviour using pre-tested data collection schedule. The findings revealed that utilisation of the public healthcare facilities was low, especially in urban areas. Residence in urban areas, being female, having higher education, engaging in salaried occupation and having availability of private allopathic and homoeopathic doctors in the locality had higher odds of not utilising public healthcare services. Issues like misbehaviour from the health personnel, unavailability of medicine, poor quality of care, and high patient load were reported as the major reasons for non-utilisation of public health services. The finding highlights the importance of improving the availability and quality of care of healthcare services for marginalised populations because these communities live in geographically isolated places and have low affordability of private healthcare. The health programme needs to address these issues to improve the utilisation and reduce the inequality in healthcare utilisation, which would be beneficial for all segments of Indian population.

Background: Research and clinical studies on multiligamentous knee injuries (MLKI) have recently gained interest with several clinical studies reported recently. This study aims to identify, visualize, and characterize the MLKI research, to analyze the knowledge structure of MLKI during 2008-2023 and to identify the emerging research trends from a bibliometric perspective., Methods: All articles reporting MLKI from 2008 to 2023 were curated from the Scopus database, on 1st January 2024. VOS viewer and Microsoft Excel were used to analyze the publications including the participating countries, authors, organizations, journals and research focus. These data were used to generate visual knowledge maps of the outputs., Results: 406 papers on MLKI were published in 115 journals by 483 authors. There has been a slow publication growth in the past 16 years. The United States had more than 50% share in global publications. Knee Surgery Sports Traumatology Arthroscopy, Orthopaedic Journal of Sports Medicine and American Journal of Sports Medicine published the most papers. The three USA institutions, namely Mayo Clinic, Hospital for Special Surgery-New York and Twin Cities Orthopedics contributed the largest number of publications. B.A. Levy (Mayo Clinic, USA) (n = 66) and M.J. Stuart (Mayo Clinic, USA) (n = 63) have registered the highest collaborative links with other authors., Conclusions: This study is the first comprehensive bibliometric study to analyze MLKI. The findings shed light on the growth trajectory of publications, the extent of international collaborations, the influence of highly cited articles, and the key countries, institutions, journals, and authors contributing to the field., Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-024-01149-9., Competing Interests: Conflict of interestNone of the authors have any competing interests to disclose., (© Indian Orthopaedics Association 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Heavy metals (HMs) enter waterbodies through various means, which, when exceeding a threshold limit, cause toxic effects both on the environment and in humans upon entering their systems. Recent times have seen an increase in such HM influx incident rates. This requires an instant response in this regard to review the challenges in the available classical methods for HM detection and removal. As well as provide an opportunity to explore the applications of artificial intelligence (AI) and machine learning (ML) for the identification and further redemption of water and wastewater from the HMs. This review of research focuses on such applications in conjunction with the available in-silico models producing worldwide data for HM levels. Furthermore, the effect of HMs on various disease progressions has been provided, along with a brief account of prediction models analysing the health impact of HM intoxication. Also discussing the ethical and other challenges associated with the use of AI and ML in this field is the futuristic approach intended to follow, opening a wide scope of possibilities for improvement in wastewater treatment methodologies., 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. Published by Elsevier Ltd.)

Objective: To evaluate the efficacy and adverse events of fezolinetant for treating vasomotor symptoms (VMS) of menopause., Data Sources: PubMed/MEDLINE, ClinicalTrials.gov , EMBASE, Cochrane Database, Scopus, and WHO International Clinical Trials Registry Platform were searched through June 2023 for publications and randomized controlled trials on fezolinetant compared with placebo in menopausal women who experienced moderate-to-severe VMS., Methods of Study Selection: Our literature search identified 330 articles, of which five studies with six reports were included in our meta-analysis per our eligibility criteria., Tabulation, Integration, and Results: The risk of bias was evaluated using Cochrane's RoB 2 (Risk of Bias version 2) tool, quality of evidence was graded using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach, and outcome measures data for effect size were pooled in random-effects model and rated. A total of 2,168 participants from five randomized clinical trials (six reports) were included. Fezolinetant significantly lowered VMS frequency, with pooled mean difference of 2.62 (95% CI, 1.84-3.41). The pooled mean difference for fezolinetant compared with placebo for the MENQOL (Menopause-Specific Quality of Life) measure was -0.60 (95% CI, -0.92 to -0.28), and the mean percentage improvement in VMS frequency was 22.51% (95% CI, 15.35-29.67). Fezolinetant was associated with improvement in sleep quality when compared with placebo., Conclusion: Fezolinetant is effective in lowering moderate-to-severe VMS frequency and sleep disturbances in postmenopausal women., Systematic Review Registration: PROSPERO, CRD42023427616., Competing Interests: Financial Disclosure The authors did not report any potential conflicts of interest., (Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: This study presents a global research scenario in the broad domain of osteoarthritis (OA) research, using quantitative and qualitative publication and citation indicators., Methods: The study is based on 45,368 global publications, sourced from the Scopus bibliographical database, covering three decades (1994-2023). We studied the performance of the top 12 developed and top 12 developing countries. The key countries, organizations and authors at national and international levels were identified. The broad subject areas and key journals contributing to global OA research were delineated, besides identifying the broad characteristics of highly cited papers in the field., Results: The United States and China were the most productive countries, while the Netherlands and Canada made the largest citation impact. Harvard Medical School and the University of Sydney made the most contribution, while Boston University and Pfizer Inc., USA registered the highest citation impact. Hunter DJ and Guermazi A were the most productive authors, while Lohmander LS, and Hochberg MC registered the highest citation impact. Osteoarthritis and Cartilage ( n  = 4879) and Annals of the Rheumatic Diseases ( n  = 786) published the maximum papers, while Arthritis and Rheumatism and Nature Reviews Rheumatology registered the largest citation impact. The highly cited papers with 100 or more citations constituted 6.25% of the total publications., Conclusions: There has been a systematic growth of publications on OA. The research on OA was mainly done in developed countries, with the maximum publications coming from the United States of America, China and Canada. The most impactful publications on OA were from the Netherlands, Canada and the United States of America., Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-024-01111-9., Competing Interests: Conflict of interestNone., (© Indian Orthopaedics Association 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Backgroundand Aims: Prosthetic Joint Infection (PJI) is a serious clinical problem after Arthroplasty. The research field on PJI is emerging, but there is a paucity of information on the most impactful publications on it. This prompted us to conduct a bibliometric analysis of the global research output, from 2003 to 2022, to identify the growth of publications, the key players in this research field and to evaluate the characteristics of highly-cited publications (HCPs) on the PJI., Methods: Publications related to PJI research were identified globally from the Scopus database, using specific keywords, covering the literature from 2003 to 2022. The HCPs were considered those with 100 or more citations. Information on publication year, citation count, funding sources, title, author, journal, country, institution, research area, and strategic keywords were collected from these HCPs. Publication data was imported into Microsoft Excel and analyzed further using VOSviewer and R software., Results: There were 182 HCPs (3.12%), which received a total citation of 124701 (average CPP of 21.41), with the citation range from 100 to 1921. Research articles were the most predominant publications (69.2%), but their average citations per paper (CPP) of 189.78 was lower than that of Review articles (average CPP: 253.17). The USA has been the leading country in terms of total publications (31.58%), and HCPs (36.99%), followed by Switzerland, Spain, UK and China. There were no HCPs from developing countries. J. Parvizi of Thomas Jefferson University, USA (with a total publications of 31 and an average CPP of 315.7), and W. Zimmerli of Basel University, Switzerland (with a TP of 11 and an average CPP of 341.9), were the most productive and impactful authors in PJI global research output., Conclusion: This bibliometric analysis identified the most productive and impactful authors, organizations, countries, and journals in the research of PJI, of the last two decades., Competing Interests: None of the authors of the present study have declared any competing interests., (© 2024 Delhi Orthopedic Association. All rights reserved.)

Background: Medical management of adenomyosis is an emerging perspective in modern gynecology. Though levonorgestrel intrauterine system (LNG-IUS) and dienogest (DNG) effectively relieve symptoms in adenomyosis, neither has been approved for the same indication. Our study aims to compare the efficacy and safety of these progestins in treating adenomyosis., Objective: To study the efficacy and safety of LNG-IUS versus DNG in patients with symptomatic adenomyosis., Design: Open-labeled, parallel, single-centered, randomized clinical trial., Methods: Patients with adenomyosis-associated pain with or without abnormal uterine bleeding were randomly allocated to either LNG-IUS group or DNG group. The primary outcome was a reduction in painful symptoms after 12 weeks of treatment measured by visual analog scale (VAS) score. Changes in menstrual blood loss (MBL), improvement in quality of life (QoL), and adverse drug reactions were also analyzed., Results: The VAS score significantly decreased from baseline in both groups. The baseline and post-treatment VAS scores in the LNG-IUS group were 6.41 ± 1.07 and 3.41 ± 1.04 ( p  = <0.001) and in the DNG group, were 6.41 ± 0.95 and 3.12 ± 1.40 ( p  = <0.001), respectively. A significantly greater proportion of patients in the LNG-IUS group experienced lighter MBL as compared to the DNG group [27/30 (90%) in the LNG-IUS group versus 17/22 (77.2%) in the DNG group ( p  = 0.006)]. Both the groups had improvement in QOL scores calculated by the World Heath Organisation QOL scale (WHOQOL BREF) questionnaire; however, it was more pronounced in the DNG group [(28.76 ± 30.47 in the LNG-IUS group versus 48.26 ± 44.91 in the DNG group ( p  = 0.04)]. Both the agents were safe as there were no reported major adverse drug reactions., Conclusion: DNG can be an effective and safe alternative to LNG-IUS for the medical management of adenomyosis., Trial Registration: The trial was prospectively registered at the clinical trial registry - India (CTRI) vide CTRI number CTRI/2020/05/025186., Competing Interests: The authors declare that there is no conflict of interest., (© The Author(s), 2024.)

In recent years, herbal nanomedicines have gained tremendous popularity for novel drug discovery. Nanotechnology has provided several advances in the healthcare sector, emerging several novel nanocarriers that potentiate the bioavailability and therapeutic efficacy of the herbal drug. The recent advances in nanotechnology with accelerated strategies of ophthalmic nanosystems have paved a new path for overcoming the limitations associated with ocular drug delivery systems, such as low bioavailability, poor absorption, stability, and precorneal drug loss. Ophthalmic drug delivery is challenging due to anatomical and physiological barriers. Due to the presence of these barriers, the herbal drug entry into the eyes can be affected when administered by following multiple routes, i.e., topical, injectables, or systemic. However, the advancement of nanotechnology with intelligent systems enables the herbal active constituent to successfully entrap within the system, which is usually difficult to reach employing conventional herbal formulations. Herbal-loaded nanocarrier drug delivery systems demonstrated enhanced herbal drug permeation and prolonged herbal drug delivery. In this current manuscript, an extensive search is conducted for original research papers using databases Viz. , PubMed, Google Scholar, Science Direct, Web of Science, etc. Further painstaking efforts are made to compile and update the novel herbal nanocarriers such as liposomes, polymeric nanoparticles, solid lipid nanoparticles, nanostructure lipid carriers, micelles, niosomes, nanoemulsions, dendrimers, etc., which are mostly used for ophthalmic drug delivery system. This article presents a comprehensive survey of diverse applications used for the preventative measures and treatment therapy of varied eye disorders. Further, this article highlights the recent findings that the innovators are exclusively working on ophthalmic nanosystems for herbal drug delivery systems. The nanocarriers are promising drug delivery systems that enable an effective and supreme therapeutic potential circumventing the limitations associated with conventional ocular drug delivery systems. The nanotechnology-based approach is useful to encapsulate the herbal bioactive and prevent them from degradation and therefore providing them for controlled and sustained release with enhanced herbal drug permeation. Extensive research is still being carried out in the field of herbal nanotechnology to design an ophthalmic nanosystem with improved biopharmaceutical properties., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

COVID-19 is an RNA virus that attacks the targeting organs, which express angiotensin- converting enzyme-2 (ACE-2), such as the lungs, heart, renal system, and gastrointestinal tract. The virus that enters the cell by endocytosis triggers ROS production within the confines of endosomes via a NOX-2 containing NADPH-oxidase. Various isoforms of NADPH oxidase are expressed in airways and alveolar epithelial cells, endothelial and vascular smooth muscle cells, and inflammatory cells, such as alveolar macrophages, monocytes, neutrophils, and Tlymphocytes. The key NOX isoform expressed in macrophages and neutrophils is the NOX-2 oxidase, whereas, in airways and alveolar epithelial cells, it appears to be NOX-1 and NOX-2. The respiratory RNA viruses induce NOX-2-mediated ROS production in the endosomes of alveolar macrophages. The mitochondrial and NADPH oxidase (NOX) generated ROS can enhance TGF-β signaling to promote fibrosis of the lungs. The endothelium-derived ROS and platelet-derived ROS, due to activation of the NADPH-oxidase enzyme, play a crucial role in platelet activation. It has been observed that NOX-2 is generally activated in COVID-19 patients. The post-COVID complications like pulmonary fibrosis and platelet aggregation may be due to the activation of NOX-2. NOX-2 inhibitors may be a useful drug candidate to prevent COVID-19 complications like pulmonary fibrosis and platelet aggregation., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)