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Abstract Aim To explore the experiences of Nigerian nurses in research and scholarly endeavours. Design Descriptive phenomenological qualitative study design. Method In‐depth interviews were conducted among 30 nurses until data saturation was reached. Data were analysed using the thematic analysis method, and consolidated criteria for reporting qualitative research guidelines (COREQ) were adhered to in reporting this study. Results Three themes emerged: (1) challenges of nurses with research; (2) the state of nursing research in Lagos state; (3) strategies to improve the state of nursing research in Lagos state. Some challenges nurses in Lagos State encounter with research include heavy workload and nursing shortage due to brain drain, faulty research foundation, lack of continuing education in research and the stressful nature of conducting research in Lagos. Conclusion As research is essential in addressing healthcare challenges, policymakers are encouraged to employ more nurses to reduce the workload and provide time for research activities. Training and continuing education in research can be incorporated into professional development programmes. Lagos State will benefit from nursing research units in the hospitals, and a coordinating centre for the units should be provided with adequate funding. Support could be obtained from the Institute of Nursing Research Nigeria in establishing these structures. Hospital management should embrace and welcome research output from nurses and ensure such results are implemented to improve patients' care. Nurses who excel in research might be recognised with awards and other incentives to inspire their peers.

In this article, we deal with mild solution of special random impulsive fractional differential equations. Initially, we present the existence of the mild solution via Leray-Schauder fixed point method. After that, we establish the exponential stability of the system. Finally, we give examples to illustrate the effectiveness of the theoretical results.

Subhasish Pramanik,1,* Chinmay Saha,1,2,* Subhankar Chowdhury,1 Chiranjit Bose,1 Nitai P Bhattacharyya,1 Lakshmi Kanta Mondal3 1Department of Endocrinology & Metabolism, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, 700020, West Bengal, India; 2Genome Science, School of Interdisciplinary Studies, University of Kalyani, Nadia, 741235, West Bengal, India; 3Department of Ophthalmology, Regional Institute of Ophthalmology, Medical College Campus, Kolkata, 700 073, West Bengal, India*These authors contributed equally to this workCorrespondence: Subhankar ChowdhuryDepartment of Endocrinology & Metabolism, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, 700020, West Bengal, India, Email subhankar.chowdhury@gmail.comLakshmi Kanta MondalDepartment of Ophthalmology, Regional Institute of Ophthalmology, Medical College Campus, 88, College Street, Kolkata, 700 073, West Bengal, India, Email lakshmi.mondal62@gmail.comPurpose: Diabetic retinopathy (DR), the leading cause of blindness among working adults, is an urgent public health problem as diabetes mellitus (DM) is increasing at an alarming rate. Hyperglycemia-induced endothelial dysfunction is the principal contributing factor leading to the development of microangiopathy. Altered levels of microRNA (miR), the negative regulator of protein-coding genes, have been observed and considered to be markers for DR. Present study aimed to find out whether miR levels in plasma could be effective biomarkers to differentiate between type 2 diabetes mellitus (T2DM) with non-proliferative retinopathy (NPDR) from T2DM with no-DR (DNR).Methods: We recruited 50 T2DM subjects comprising 31 NPDR and 19 DNR individuals. Surrogate markers of systemic oxidative stress and vascular endothelial growth factor (VEGF) were measured in plasma. Levels of miR-126 and miR-132 were determined in plasma and vitreous fluid using real-time PCR.Results: We observed that levels of miR-126 and miR-132 were decreased in NPDR subjects in comparison to DNR. Plasma levels of miRs were inversely correlated with secreted levels of VEGF and oxidative stress marker. The levels of these miRs showed discriminating ability between NPDR and DNR.Conclusion: Circulating miRs 126 and 132 in plasma or vitreous may serve as biomarkers for early diabetic retinopathy risk prediction, provided validated in a larger cohort and other forms of retinal vasculopathy or retinopathy in the future.Keywords: diabetic retinopathy, microRNA-126, microRNA-132, oxidative stress, malondialdehyde, vascular endothelial growth factor

Subhasish Pramanik,1 Lakshmi Kanta Mondal,2 Suman Kalyan Paine,3 Sneha Jain,2 Subhankar Chowdhury,1 Upasana Ganguly,4 Sayantan Ghosh,2 Chiranjit Bose,1 Koena Bhattacharjee,2 Gautam Bhaduri5 1Institute of Post Graduate Medical Education and Research (IPGMER), Kolkata, 700020, India; 2Regional Institute of Ophthalmology (RIO), Medical College and Hospital, Kolkata, 700073, India; 3National Institute of Biomedical Genomics (NIBMG), Kalyani, West Bengal, India; 4Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana, India; 5MGM Medical College, Kishanganj, Bihar, IndiaCorrespondence: Lakshmi Kanta MondalRegional Institute of Ophthalmology, Medical College, Kolkata, IndiaTel +91 9830830216Email Lakshmi.mondal62@gmail.comPurpose: In the present study, we aimed to evaluate the efficacy, safety, and cost-effectiveness of the anti-vascular endothelial growth factor (anti-VEGF), namely ranibizumab (RBZ) or bevacizumab (BVZ), after either focal or grid or scatter laser photocoagulation, for the treatment of diabetic macular edema (DME) in the Indian population.Methods: Retrospective data were collected in the Regional Institute of Ophthalmology, Kolkata, India between January 2018 and June 2019. Seventy-seven eyes received 3 consecutive monthly intravitreal injections of RBZ (0.5 mg) and were followed by prompt laser photocoagulation (within 7– 10 days after the third injection). Similarly, 51 eyes received 3 consecutive monthly intravitreal injections of BVZ (1.25 mg), an off-label drug, and were followed by prompt laser therapy. Safety assessments of the therapy, as well as surrogate markers of biochemical derangements related to diabetic retinopathy (DR), were also investigated at the end of 12 months.Results: Seventy-seven subjects who were given a treatment of RBZ+laser therapy showed average 6.87± 5.53 letters gain in their best-corrected visual acuity (BCVA) score, whereas the ones treated with off-label BVZ+ laser therapy demonstrated improvement in BCVA of an average 6.82± 5.76 letters in “Early Treatment Diabetic Retinopathy Study” (ETDRS) chart. The study also highlights the cost-effectiveness of both RBZ+laser and BVZ+laser therapies for the treatment of DME in DR. The results demonstrated that a subject has to pay 20.951 times more cost (in INR) for RBZ+laser therapy compared to BVZ+laser therapy, to get an almost similar outcome.Conclusion: BVZ is found to be the more attractive option for treating DME in DR for its cost-friendliness over RBZ in terms of BCVA outcome, as well as the safety perspectives, at least for the economically backward population in developing countries, like India.Keywords: diabetic retinopathy, diabetic macular edema, ranibizumab, bevacizumab, laser therapy, cost-effectiveness

Introduction Of the approximately 8.8 million deaths that occur annually in children under 5 years of age, 41% occur in neonates. (1) A child is 45 times more likely to [...], Objective To assess the feasibility of using birth attendants instead of bereaved mothers as perinatal verbal autopsy respondents. Methods Verbal autopsy interviews for early neonatal deaths and stillbirths were conducted separately among mothers (reference standard) and birth attendants in 38 communities in four developing countries. Concordance between maternal and attendant responses was calculated for all questions, for categories of questions and for individual questions. The sensitivity and specificity of individual questions with the birth attendant as respondent were assessed. Findings For early neonatal deaths, concordance across all questions was 94%. Concordance was at least 95% for more than half the questions on maternal medical history, birth attendance and neonate characteristics. Concordance on any given question was never less than 80%. Sensitivity and specificity varied across individual questions, more than 80% of which had a sensitivity of at least 80% and a specificity of at least 90%. For stillbirths, concordance across all questions was 93%. Concordance was 95% or greater more than half the time for questions on birth attendance, site of delivery and stillborn characteristics. Sensitivity and specificity varied across individual questions. Over 60% of the questions had a sensitivity of at least 80% and over 80% of them had a specificity of at least 90%. Overall, the causes of death established through verbal autopsy were similar, regardless of respondent. Conclusion Birth attendants can substitute for bereaved mothers as verbal autopsy respondents. The questions in existing harmonized verbal autopsy questionnaires need further refinement, as their sensitivity and specificity differ widely. [TEXT NOT REPRODUCIBLE IN ASCII.] Objectif Evaluer la faisabilite du recours aux sages-femmes (au lieu des meres endeuillees) pour repondre aux questions de l'autopsie verbale perinatale. Methodes Des entretiens d'autopsie verbale en cas de deces neonataux precoces et de mort a la naissance ont ete menes separement chez des meres (norme de reference) et chez des sages-femmes dans 38 communautes de 4 pays en voie de developpement. La concordance entre les reponses des meres et des sages-femmes a ete calculee pour l'ensemble des questions, pour les categories de questions et pour les questions individuelles. On a evalue la sensibilite et la specificite des questions individuelles aux sages-femmes en tant que personnes interrogees. Resultats Pour les deces neonataux precoces, la concordance sur toutes les questions a atteint 94%. Elle etait d'au moins 95% pour plus de la moitie des questions sur les antecedents medicaux maternels, l'accouchement et les caracteristiques du nouveau-ne. La concordance sur une question donnee n'a jamais ete inferieure a 80%. La sensibilite et la specificite variaient selon les questions individuelles, et 80% d'entre elles presentaient une sensibilite d'au moins 80% et une specificite d'au moins 90%. Pour les enfants morts-nes, la concordance sur l'ensemble des questions etait de 93%. Elle etait superieure ou egale a 95%, plus de la moitie du temps, pour les questions sur l'accouchement, le lieu de la naissance et les caracteristiques de l'enfant mort-ne. La sensibilite et la specificite variaient selon les questions individuelles. Plus de 60% des questions presentaient une sensibilite d'au moins 80%, et plus de 80% d'entre elles une specificite d'au moins 90%. Dans l'ensemble, les causes de la mort etablies par autopsie verbale etaient similaires, quelle que soit la personne interrogee. Conclusion Les sages-femmes peuvent replacer les meres endeuillees et repondre aux questions de l'autopsie verbale. Les questions des questionnaires d'autopsie verbale harmonises existants necessitent une amelioration supplementaire, car generalement, leur sensibilite et leur specificite different grandement. [TEXT NOT REPRODUCIBLE IN ASCII.] Objetivo Evaluar la viabilidad de utilizar matronas como encuestadas en autopsias verbales perinatales en lugar de madres que han perdido un-hijo/a. Metodos Las entrevistas para las autopsias verbales de muertes neonatales prematuras y alumbramientos mortinatos se realizaron por separado entre madres (estandar de referencia) y matronas en 38 comunidades de cuatro paises en desarrollo. Se calculo la concordancia entre las respuestas maternas y las respuestas de las matronas para todas las preguntas, tanto para las categorias de preguntas como para las preguntas individuales. Se evaluaron la sensibilidad y especificidad de las preguntas individuales con la matrona como encuestada. Resultados En las muertes neonatales prematuras, la concordancia en todas las preguntas fue del 94%. La concordancia fue de al menos el 95% para mas de la mitad de las preguntas sobre el historial medico materno, atencion en el parto y caracteristicas neonatales. La concordancia de cualquier pregunta determinada no fue en ningun caso inferior al 80%. La sensibilidad y la especificidad variaron en las preguntas individuales. En este caso, mas del 80% de las preguntas presentaron una sensibilidad de al menos el 80% y una especificidad de al menos el 90%. En cuanto a los alumbramientos mortinatos, la concordancia en todas las preguntas fue del 93%. La concordancia fue del 95% o mas durante mas de la mitad del tiempo para preguntas relacionadas con la atencion en el parto, el centro de parto y las caracteristicas de la mortinatalidad. La sensibilidad y especificidad variaron en las preguntas individuales. Mas del 60% de las preguntas presentaron una sensibilidad de al menos el 80%. En este caso, mas del 80% de las preguntas presentaron una especificidad de al menos el 90%. Globalmente, las causas de muerte establecidas mediante autopsia verbal fueron similares, independientemente de la persona encuestada. Conclusion Las matronas pueden sustituir a las madres que han perdido un hijo/a como encuestadas en autopsias verbales. Es necesario perfeccionar las preguntas de los cuestionarios de autopsia verbal armonizados existentes, ya que su sensibilidad y especificidad difieren ampliamente.