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Background: Several observational studies have reported the prevalence of cerebral microbleeds (CMBs) and their risk factors in an elderly population. Any information in this regard is currently lacking from India. Aim of this study was to estimate the prevalence, risk factors of CMBs, and association with cognition in an Indian urban population aged 50 years and above. Methods: Household surveys were conducted as part of ongoing Longitudinal Cognition and Aging Research on Population of the National Capital Region (LoCARPoN) study in areas of urban Delhi. Magnetic resonance imaging of the brain was performed in 2599 participants. Using standard neuropsychological battery, mean Z-scores for each domain (memory, executive, information) were derived. Binary and stepwise logistic regression models were used to determine associated risk factors for the presence of CMB and its association with cognitive domains. Results: The prevalence of CMBs was 14.42% (95% confidence interval [CI]: 13.06–15.73). Of these, 203 (7.81%) participants had single CMBs and 172 (6.61%) had multiple microbleeds (≥2). Higher prevalence was observed in older age (60–70 years: odds ratio [OR]: 1.25 [95% CI: 0.93–1.67]; 70–80 years: OR: 2.05 [95% CI: 1.48–2.84]; ≥80 years: OR: 3.27 [95% CI: 1.97–5.44]) compared to individuals in the age group 50–60 years. History of stroke (OR: 2.97 [95% CI: 1.56–5.66]), hypertension (OR: 1.36 [95% CI: 1.05–1.75]), and smoking (OR: 1.43 [95% CI: 1.11–1.85]) was associated with at least one CMB. Multiple CMBs were associated with worse scores in memory and executive domains. Conclusion: Older age, hypertension, history of stroke, and history of smoking emerged as important risk factors for the presence of multiple CMBs. Follow-up study is required to determine implications of CMBs.

Dermatomyositis (DM) and polymyositis are idiopathic inflammatory myopathies (IIMs), most associated with solid organ malignancies, and less commonly hematological malignancies. We discuss a case of DM associated with diffuse large B-cell lymphoma, followed by a review of literature on the pathogenesis, clinical course, treatment, and prognosis. Various challenges with the diagnosis and management of underlying lymphoproliferative disorders (LPDs) in patients with IIM are discussed. The case demonstrates the importance of being vigilant of the association between IIM and LPD. Cancer screening in patients with IIM is discussed, including the recently published International Guideline for IIM-Associated Cancer Screening. More research is required to address knowledge gaps in cancer screening in IIM.

Introduction: Acquired angioedema due to C1 esterase inhibitor deficiency (C1INH-AAE) is most associated with lymphoproliferative disorders (LPDs), particularly low-grade B-cell subtypes. The condition remains under-recognized with long diagnostic delays due to various challenges including a lack of awareness of the condition. Case Presentation: We discuss 4 cases of C1INH-AAE associated with low-grade B-cell LPDs, including various diagnostic and management challenges. As our cases illustrate, constitutional symptoms or overt manifestations of LPD at diagnosis are often absent. Hence, a comprehensive multimodal approach to screening for an underlying B-LPD is important when a diagnosis of acquired angioedema is made. Levels of complement C4, C1q, and C1INH are useful for diagnosing C1INH-AAE and for monitoring disease activity. Changes in these parameters may also indicate relapse of the underlying hematological malignancy. Treating the underlying disorder is important as this commonly leads to clinical improvement with decreased episodes of angioedema and normalization of complement studies. Conclusion: Awareness of C1INH-AAE can lead to an early diagnosis of hematological malignancies. The absence of constitutional symptoms emphasizes the need for a comprehensive multimodal approach to screening for LPD in C1INH-AAE. C4, C1INH level, and function are useful for monitoring disease activity.

Dermatomyositis (DM) and polymyositis are idiopathic inflammatory myopathies (IIMs), most associated with solid organ malignancies, and less commonly hematological malignancies. We discuss a case of DM associated with diffuse large B-cell lymphoma, followed by a review of literature on the pathogenesis, clinical course, treatment, and prognosis. Various challenges with the diagnosis and management of underlying lymphoproliferative disorders (LPDs) in patients with IIM are discussed. The case demonstrates the importance of being vigilant of the association between IIM and LPD. Cancer screening in patients with IIM is discussed, including the recently published International Guideline for IIM-Associated Cancer Screening. More research is required to address knowledge gaps in cancer screening in IIM. [ABSTRACT FROM AUTHOR]

Background: Several observational studies have reported the prevalence of cerebral microbleeds (CMBs) and their risk factors in an elderly population. Any information in this regard is currently lacking from India. Aim of this study was to estimate the prevalence, risk factors of CMBs, and association with cognition in an Indian urban population aged 50 years and above. Methods: Household surveys were conducted as part of ongoing Longitudinal Cognition and Aging Research on Population of the National Capital Region (LoCARPoN) study in areas of urban Delhi. Magnetic resonance imaging of the brain was performed in 2599 participants. Using standard neuropsychological battery, mean Z-scores for each domain (memory, executive, information) were derived. Binary and stepwise logistic regression models were used to determine associated risk factors for the presence of CMB and its association with cognitive domains. Results: The prevalence of CMBs was 14.42% (95% confidence interval [CI]: 13.06-15.73). Of these, 203 (7.81%) participants had single CMBs and 172 (6.61%) had multiple microbleeds (≥2). Higher prevalence was observed in older age (6070 years: odds ratio [OR]: 1.25 [95% CI: 0.93-1.67]; 70-80 years: OR: 2.05 [95% CI: 1.48-2.84]; ≥80 years: OR: 3.27 [95% CI: 1.97-5.44]) compared to individuals in the age group 50-60 years. History of stroke (OR: 2.97 [95% CI: 1.56-5.66]), hypertension (OR: 1.36 [95% CI: 1.05-1.75]), and smoking (OR: 1.43 [95% CI: 1.11-1.85]) was associated with at least one CMB. Multiple CMBs were associated with worse scores in memory and executive domains. Conclusion: Older age, hypertension, history of stroke, and history of smoking emerged as important risk factors for the presence of multiple CMBs. Follow-up study is required to determine implications of CMBs. [ABSTRACT FROM AUTHOR]

Background: Degeneration can occur as a result of moisture loss and decreased flexibility in the neck's spinal discs over time. Cervical spondylosis can also be brought in addition to recurrent neck motions, prior neck injuries, bad posture, and genetic factors and by poor posture. Purpose: The study objective was comparison of the efficiency of interferential therapy and transcutaneous electrical nerve stimulation in construction workers having cervical spondylosis using the short form of the MC Gill pain questionnaire. Methodology: 50 subjects participated in the study from Mars India Builds and selected based on the inclusion and exclusion criteria. Subjects assigned into interferential therapy group (n=25) and transcutaneous electrical nerve stimulation group (n=25). Along with this, static neck exercises were given to both groups. The treatment period was given for 40 mins and 6 days per week and continued for 2 weeks. The entire study process is conducted from November 2022 to April 2023. Result: From the finding of this study interferential therapy group post-test mean was 8.88 and whereas the transcutaneous electrical nerve stimulation group was 11.72. This strongly suggests that interferential therapy in construction workers having cervical spondylosis along with static neck exercises is more effective than transcutaneous electrical nerve stimulation. Conclusion: In this study interferential therapy with static neck exercises among construction workers was found to be more effective than transcutaneous electrical nerve stimulation. [ABSTRACT FROM AUTHOR]

Introduction: Acquired angioedema due to C1 esterase inhibitor deficiency (C1INH-AAE) is most associated with lymphoproliferative disorders (LPDs), particularly low-grade B-cell subtypes. The condition remains under-recognized with long diagnostic delays due to various challenges including a lack of awareness of the condition. Case Presentation: We discuss 4 cases of C1INH-AAE associated with low-grade B-cell LPDs, including various diagnostic and management challenges. As our cases illustrate, constitutional symptoms or overt manifestations of LPD at diagnosis are often absent. Hence, a comprehensive multimodal approach to screening for an underlying B-LPD is important when a diagnosis of acquired angioedema is made. Levels of complement C4, C1q, and C1INH are useful for diagnosing C1INH-AAE and for monitoring disease activity. Changes in these parameters may also indicate relapse of the underlying hematological malignancy. Treating the underlying disorder is important as this commonly leads to clinical improvement with decreased episodes of angioedema and normalization of complement studies. Conclusion: Awareness of C1INH-AAE can lead to an early diagnosis of hematological malignancies. The absence of constitutional symptoms emphasizes the need for a comprehensive multimodal approach to screening for LPD in C1INH-AAE. C4, C1INH level, and function are useful for monitoring disease activity. [ABSTRACT FROM AUTHOR]

The purpose of this study was to prepare and evaluate multiple unit mini tablets (MTs) of prolonged released (PR) bosentan (BSN) and fast release (FR) sildenafil citrate (SDC) on the basis of encapsulation method for the effective management of pulmonary artery hypertension. The system consists of MTs are in the form of uncoated tablets containing the superdisintegrating agents where as the PRMTs contains the polymer with film coating. All the units are prepared by direct compression method and encapsulated using size 1 hard gelatin capsule shells. The formulations were evaluated for differential scanning calorimetry, dissolution test and post compression studies for their quality attributes and it was found that all the parameters were in the acceptable limits. The optimized formulation for BSN PRMTs i.e BS3 which contains 5 % HPMC K15M shows a promising sustained release profile of 82.31 % in 24 h similarly FRMTs of SDC of formulation SD6 that having 3 % of magnesium aluminium silicate shows about 90 % of drug release within 15 min. The in-vivo pharmacokinetic characterization of the system was carried out using wister rats where the AUC value for SDC FRMTs and BSN PRMTs was found to be 94256.88625 ± 123.65 ng h/mL and 142438.084 ± 324.11 ng h/mL respectively. The other pharmacokinetics are also determined and found to be satisfactory. The six months stability samples showed no significant change in the drug content, hardness and uniformity of the content of the optimized formulations.

Surgical missions are often conducted in outreach areas where facilities are often not as advanced as in an institution. Excellent team coordination, detailed planning, and good communication are necessary for a successful outcome. Unfamiliar work environment, new acquaintances within the team, and language barriers at the mission site are some of the challenges often faced. Careful patient selection is crucial in a mission setup as most complications can be traced back to the preanaesthetic check and preoperative preparedness. We describe airway management strategies (airway assessment, mask ventilation, intubation options, and the postoperative airway plan) contrived by our anaesthesia team at one such surgical mission where four children with Pierre Robin Syndrome and incomplete cleft palate (involving posterior hard palate and complete soft palate)were successfully operated.

Abstract The growing popularity of nano-fertilization around the world for enhancing yield and nutrient use efficiency has been realized, however its influence on soil microbial structure is not fully understood. The purpose of carrying out this study was to assess the combined effect of nano and conventional fertilizers on the soil biological indicators and crop yield in a wheat–maize system. The results indicate that the at par grain yield of wheat and maize was obtained with application of 75% of recommended nitrogen (N) with full dose of phosphorus (P) and potassium (K) through conventional fertilizers along with nano-N (nano-urea) or nano-N plus nano-Zn sprays and N100PK i.e. business as usual (recommended dose of fertilizer). Important soil microbial property like microbial biomass carbon was found statistically similar with nano fertilizer-based management (N75PK + nano-N, and N75PK + nano-N + nano-Zn) and conventional management (N100PK), during both wheat and maize seasons. The experimental data indicated that the application of foliar spray of nano-fertilizers along with 75% N as basal is a sustainable nutrient management approach with respect to growth, yield and rhizosphere biological activity. Furthermore, two foliar sprays of nano-N or nano-N + nano-Zn curtailed N requirement by 25%, furthermore enhanced soil microbial diversity and the microbial community structure. The specific microbial groups, including Actinobacteria, Bacteroidia, and Proteobacteria, were present in abundance and were positively correlated with wheat and maize yield and soil microbial biomass carbon. Thus, one of the best nutrient management approaches for sustaining productivity and maintaining sound microbial diversity in wheat–maize rotation is the combined use of nano-fertilizers and conventional fertilizers.

The malignant transformation of chronic fistula in ano is rare, accounting for 3% to 11% of all anal canal malignancies. It results from long-standing inflammation and chronic irritation. No guidelines are available for the management of these cases. We herein present a case report of a 55-year-old man who presented with a history of constipation, perianal pain, and discharging fistula in ano of 4-year duration and underwent fistula surgery with recurrence. Biopsy of the fistulous tract revealed adenocarcinoma. He received neoadjuvant chemoradiotherapy, followed by abdominoperineal excision including excision of the fistulous tract. After 18 months of follow-up, he is free of recurrence. We present this case with a review of the literature, highlighting the management strategies.

One of the cancers that affect men, prostate cancer considerably raises mortality rates for males around the world. Patients with prostate cancer can have a localized or advanced form of the illness. Digital rectal examinations, prostate-specific antigen analyses, and prostate biopsies are all used to identify prostate cancer. The onset, development, and spread of cancer are all correlated with mutations in specific genes. Radical prostatectomy, ablative radiation, and active surveillance are all forms of treatment for localized prostate cancer. Androgen deprivation therapy (ADT), radiation, and chemotherapy are given to men who have metastatic prostate cancer or have experienced a relapse. When compared to traditional cancer chemotherapeutic methods, the liposome-based drug delivery technology offers less toxic, biodegradable, and biocompatible nanomedicine. Liposomes offer great advantages for use in nanomedicines by improving the sensitivity, specificity, and persistence of these anti-malignant cell agents in the body. Liposomal formulations are undergoing clinical trials of variety of cancers including prostate cancer. The present narrative review describes the composition and types of liposomes, its advantages, disadvantages, and the methods of preparation, research studies, clinical applications, drug repurposing and administration.

A thorough literature search is a key feature of scoping reviews. We investigated the search practices used by social science researchers as reported in their scoping reviews. We collected scoping reviews published between 2015 and 2021 from Social Science Citation Index. In the 2484 included studies, we observed a 58% average annual increase in published reviews, primarily from clinical and applied social science disciplines. Bibliographic databases comprised most of the information sources in the primary search strategy (n = 9565, 75%), although reporting practices varied. Most scoping reviews (n = 1805, 73%) included at least one supplementary search strategy. A minority of studies (n = 713, 29%) acknowledged an LIS professional and few listed one as a co‐author (n = 194, 8%). We conclude that to improve reporting and strengthen the impact of the scoping review method in the social sciences, researchers should consider (1) adhering to PRISMA‐S reporting guidelines, (2) employing more supplementary search strategies, and (3) collaborating with LIS professionals. [ABSTRACT FROM AUTHOR]