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Local and illegal exploitation of wildlife is particularly widespread in highly populated and bio-diverse countries such as India. In such countries, illicit utilization practices and how these are perceived among local communities are commonly not well-documented. Due to a lack of data, and environmental education measures to protect ecosystems and biodiversity, the extent of this exploitation appears immense and often goes unnoticed. Therefore, in 2019, a series of awareness workshops targeting the conservation of wildlife focused on monitor lizards (Varanidae) was conducted in five districts of West Bengal, India. The environmental awareness workshops were conducted through PowerPoint slide presentations and questionnaires collecting baseline data from the participants regarding their perceptions and relationships to the three species of Varanus recorded for West Bengal. Our findings reveal specific human attitudes and varying local utilization patterns of monitor lizards. This study was the first to communicate and spread awareness in the study areas about why the conservation of local wildlife such as Varanus species is important for ecosystems and human well-being based on the ‘Nature Contributions to People Concept’.

Abstract Lemierre’s syndrome, a forgotten clinical entity, is characterised by septic thrombophlebitis of the internal jugular vein due to oropharyngeal infection. In the past, it was mainly associated with Fusobacterium necrophorum infections. We present a unique case report of Lemierre’s syndrome due to Klebsiella pneumoniae. Patient reported with progressive swelling involving right side of the neck that eventually increased in size. After confirming the diagnosis through CECT, patient was managed through combined medical and surgical therapy in the form of incision and drainage, targeted antibiotic therapy, glycaemic control and anticoagulation therapy. This case report highlights the association of poor glycaemic control in the pathogenesis and the isolation of Klebsiella pneumoniae as the rare organism of Lemierre’s syndrome.

Pheochromocytoma is a rare neuroendocrine tumor arising from adrenal medulla. Patients usually show classic triad of headache, palpitations and diaphoresis along with persistent or paroxysmal hypertension. Majority of the tumors are solid or mixed solid and cystic. But purely cystic variant is extremely rare with few cases reports available in the published literature. We report a case of purely cystic pheochromocytoma in a male in 30s who presented to our hospital for unrelated symptom of recurrent burning micturition. He was evaluated for causes of recurrent UTI which revealed incidental right adrenal cyst. The patient's blood pressure was raised on clinical examination and imaging showed simple adrenal cyst without solid component or septations. Suspecting possibility of pheochromocytoma, biochemical analysis was done which revealed elevated 24-hour urinary metanephrine. The diagnosis of cystic pheochromocytoma was made. Adrenalectomy was performed showing cystic lesion in the right adrenal region. Histopathology and immunohistochemistry revealed pheochromocytoma with cystic degeneration. Patient's hypertension resolved during the follow up. In conclusion, purely cystic pheochromocytoma must be considered as differential for adrenal cystic lesions, especially when atypical features are present.

Neuroendocrine breast cancers (NEBCs) are a rare and distinct subtype of breast tumors, characterized by their neuroendocrine differentiation. Despite accounting for less than 1% of all breast cancers, NEBCs present unique diagnostic and therapeutic challenges due to their heterogeneous nature and variable prognosis. Accurate imaging plays a crucial role in the diagnosis, treatment planning, and follow-up of NEBCs, yet remains a complex area due to the rarity of these tumors and overlapping features with more common breast cancers. We present a series of 4 cases of primary NEBC, emphasizing the imaging features and their histopathological correlations. All patients presented with breast lump. Diagnostic Mammography followed by Ultrasound was performed in each case. All 4 cases were categorized as Breast Imaging- Reporting and Data System (BI-RADS)-4. Trucut biopsy was performed and histopathological analysis revealed the diagnosis of NEBC. Patients underwent Surgery followed by Chemotherapy, Hormonal Therapy or Radiation therapy alone or in combination with each other depending upon the histopathological characteristics.

Background: Metaverse, the disruptive digital technology, has demonstrated significant effectiveness in the fields of preventive and cognitive therapy, diagnostics, surgical interventions and rehabilitation. Virtual Reality (VR), a part of Metaverse, integrates imaging data and input from users and deliver a 3D graphical output which can be visualised through a wearable headset. Augmented reality (AR) on the other hand, can control the presence of the user in the real world. Methodology: A review was undertaken of peer-reviewed literature on the emerging evidence on the applications of AR and VR in healthcare. Research studies carried out to identify effectiveness of AR and VR technologies were included. Result: AR & VR have been effective in rehabilitation of patients of Autism Spectrum Disorders and Mild Cognitive Impairment by improving motor skills, social skills and various cognitive indices like task learning and attention. In the surgical field, AR head mounted device (HMD) can provide three-dimensional, patient specific anatomic information during surgery. It minimises surgical complications and improves patient satisfaction. AR is of particular interest in complicated spinal surgeries and orthopaedic manoeuvres which require high level of surgical skill. AR has also been used successfully in different types of robotic surgeries as well. In several countries AR technology have been used in basic medical and advanced surgical training. Major challenges in implementing AR and VR in the field of health care persist in the domains of cyber security, ethical issues and cost effectiveness. Conclusion: VR and AR technology can maximise patient outcomes and rapidly develop satisfactory patient management in fields of cognitive research and surgical interventions. More clinical trials with immersive digital technologies are required. Ethical and cyber security challenges are present but there are ways to overcome them. It is our duty as physicians to participate in the development of these innovations to ensure virtual health reality benefits for our patients in real-world setting.

Diversity information mining about a crop for different attributes is an essential step for effective breeding programs. The present investigation evaluates the quantum of genetic variability and determines the relationship among the important agro-economic traits based on two years of phenotypic data of 210 accessions of linseed. The traits, capsule weight per plant, capsule per plant, husk weight per plant, and seed weight per plant exhibited comparatively higher genetic coefficient of variation (GCV) and phenotypic coefficient of variation (PCV). In contrast, oil content and seed per capsule exhibited a lower value. The high magnitude of broad sense heritability was observed for all traits except seeds per capsule and husk weight per plant. The trait, capsules per plant, plant height, and days to 50% flowering showed high genetic advance coupled with high heritability. Hierarchical cluster analysis grouped 210 accessions into six distinct clusters. Out of 210, 144 (68.57%) accessions were grouped into three clusters (I, II, and III), in which cluster-III was the largest, containing 64 accessions followed by cluster II and cluster-I. The highest inter-cluster distance was observed between clusters-I and V (127.85), while the lowest was between clusters-II and IV (27.09). The positive correlation of capsule weight per plant with the seed weight per plant and a negative correlation with the days to 50% flowering indicates that high yielding linseed varieties with early flowering/maturity could be developed through direct and indirect selection. Further, seed yield and oil content could be enhanced together as indicated by ghe positive association among these two important traits. In this study, high yielding accessions with moderate to high oil content such as GP36, GP31, GP14, GP54, GP26, GP24, GP34, GP21, GP37 and GP27 and early flowering (less than 70 days) accessions such as GP2, GP26, GP27, CG33, CG44, CG42, CG132, and CG31 identified as potential genetic materials that could be exploited for developing early maturing varieties with high yield. In addition, information’s on various genetic parameters will help breeders to devise suitable breeding methodology for linseed genetic improvement for targeted traits.

Abstract Background Hypertrophic olivary degeneration (HOD) is a unique type of neuronal degeneration presenting as hypertrophy, in contrast to atrophy as seen in most cases. It presents with classical characteristic clinical features due to involvement of dentate-rubral-olivary pathway, also described as triangle of Guillain and Mollaret formed in midbrain, pons and cerebellum. It can be idiopathic or secondary to infarction, bleeding, tumours, trauma or demyelination. However, the mechanism is still unclear. Herein, we present a case of HOD that had developed after post-traumatic pontine and midbrain haemorrhagic contusion. Case presentation A young male patient presented with progressively increasing tremors of both hands, inability to walk and multiple cranial nerve palsy. Magnetic resonance imaging demonstrated bilateral inferior olivary nucleus enlargement and signal changes seen as T2 and T2-FLAIR hyperintensities and non-enhancing T1 iso-intensities. Based on these features, diagnosis of HOD was made. Patient was kept on conservative management and his condition improved. Conclusions Hypertrophic olivary degeneration is a unique neuronal degeneration with typical clinical manifestations and distinct imaging features. Proper and early recognition and multidisciplinary treatment approach can result in the best outcomes for the patient.

Reverse transcription-quantitative PCR (RT-qPCR)-based assays are extensively being utilized to detect coronavirus disease 2019 (COVID-19). However, due to a lack of RT-qPCR testing capability, these tests cannot be carried out in community clinics. The intention of our study was to evaluate the specificity and sensitivity of Rapid Antigen Detection (RAT) tests versus those of RT-qPCR using nasopharyngeal and oropharyngeal specimens. Respiratory swab specimens were collected from the COVID-19 patients admitted at Dr. Bhimrao Ambedkar Memorial Hospital, Raipur, CG, India, during March to April 2022. RAT and RT-qPCR were performed using standard methods as per guidebook instructions, and subjects were chosen using a convenience sample technique. 100 swabs from patients, who had earlier verified positive and 100 from who had earlier verified negative for SARS-CoV-2 via RT-qPCR, were taken for study. Study was approved by the institutional ethical committee before data collection and initiation of the study. We evaluated for the sensitivity and specificity of the STANDARD Q COVID-19 Ag test kit (SD Biosensor). On testing, an over-all sensitivity and specificity of the kit was recorded as 74% and 100%, respectively in comparison to the RT-qPCR kit. Further, the assay’s sensitivity was shown to be 100%, 94.87%, 77.27%, and 55.56%, respectively, for samples with cycle thresholds (Ct) of 15-25, 25-30, 30-35, and >35. We draw the conclusion that the RT-qPCR assay has superior sensitivity and specificity to the antigen assay. However, in all situations where RT-qPCR testing is difficult, the antigen assay could serve as a rapid and simple option for separating SARS-CoV-2 contagious from non-contagious patients.

Hepatitis C virus infection is one of the main causes of liver disease that can lead to liver cirrhosis and finally to the chronic development of Hepatocellular Carcinoma (HCC). With 8 different HCV genotypes circulating, it becomes necessary to characterize the pathogenesis caused by each one of the HCV genotypes infecting population of a particular setting. Present study aims to identify the circulating Hepatitis C virus (HCV) genotypes in the different areas of State of Uttar Pradesh, India and understand their clinical etiology and related co-morbidities. The patients reporting to Sharda Hospital, Uttar Pradesh, India who were diagnosed positive for HCV were included in the study. The informed consent was obtained and then blood was drawn. In-house primers, for all the 8 genotypes were prepared and RT-PCR was performed. The amplified product was subjected to Agarose gel electrophoresis to identify the genotypes present in individual samples. Total 30 serum samples were taken. Of these, 21 (70%) showed presence of multiple genotypes, while 7 (23.33%) showed positivity for single genotype and two did not show any bands. Presence of multiple genotypes in individual patient has been reported for the first time. The pathological consequences of multiple genotypes within one host need to be studied further in terms of increased risk of developing a chronic liver disease. Further studies are being undertaken to study association of specific HCV genotype and multiple genotypes, Core, NS3 and NS5 viral proteins with the disease progression to develop predictors of liver cirrhosis and HCC.

Pediatric regional anesthesia (RA) has emerged as a rapidly advancing dimension within pediatric anesthesia, demanding a continual commitment to knowledge acquisition. This review underscores the contemporary significance of this specialty, focusing on its application in neonates and infants. The primary objective of RA is to address perioperative pain effectively while preserving the delicate physiological balance, thereby enhancing overall patient care. This review explores the advantages offered by RA in this age group. Furthermore, conventional, and recently introduced techniques of RA are examined by exploring the advantages and disadvantages of these methods. The aim is to provide clinicians with a nuanced understanding of their applicability in different clinical scenarios. Additionally, the review elucidates the unique considerations associated with pediatric RA, acknowledging pediatric patients’ distinctive anatomical and physiological characteristics. The exceptional cases of congenital anomalies and their implications for the choice of RA are considered. An aspect of the review is its focus on dosages of local anesthetics and the volumes required for various blocks in neonates and infants. The dosages for continuous infusion and practical issues with infusions are considered. Complications associated with RA are described, along with their prevention and treatment. The review offers pragmatic insights into the selection criteria for various regional blocks, aiding anesthesiologists in making informed decisions tailored to individual patient needs.

Bowen's disease is under-recognised, in situ - squamous cell carcinoma usually presenting as a single, well demarcated, slow growing erythematous patch or plaque with a scaly or crusted surface. It has a limited potential of invasion. It mainly occurs over the sun-exposed parts of the body (typical variant). Genitals, back, finger, trunk & thigh are the peculiar sites for pigmented, verrucous, atrophic & hyperkeratotic variants which are considered as atypical variants. A total of 3 patients (2 males and 1 female; average age: 57 years) were noted over a span of one year. Rarity, atypical variants and limited case series on Bowen disease in literature prompt us to report this interesting case series.

Envenomation from snakebites (SBs) is a significant public health hazard globally. The venomous SB is associated with moderate-to-severe pain. Weak opioids such as tramadol or acetaminophen are commonly used for pain management but often provide inadequate analgesia. We hereby report our experience of using ultrasound-guided selective superficial peroneal, sural, and saphenous nerve blocks for pain management following SBs in nine patients. The selective peripheral nerve blocks are achieved with a small amount of local anesthesia and without loss of motor functions.

There is increased awareness of the gendered impacts of outbreaks, including an exacerbation of violence against women and disruptions to essential health service delivery for women. However, there is limited understanding of women’s own experiences of deciding to use the health system after experiencing violence in settings affected by major emergent outbreaks like Ebola and COVID-19. Drawing on data from 37 in-depth interviews and 4 focus group discussions conducted in Sierra Leone we described survivors’ help-seeking pathways and interactions with the health system. Deciding to seek help and selecting a source of support was dependant on how ‘unacceptable’ the type of violence was, women’s needs (be they for physical, psychological or social trauma) and the risk versus benefit anticipated in accessing support. Informal providers such as local mediators were often the first place that survivors sought help. Pre-existing challenges around access and poor-quality service provision were exacerbated by the outbreaks. Fear of infection, quarantine and widespread distrust of the Ebola response shaped women’s help-seeking especially if symptoms like bleeding could resemble the virus. Our findings support the need to re-orientate towards survivor-defined interventions that are flexible in providing a wider range of support choices.

Amaranthus is considered a superfood with high nutraceutical value. It is a functional food composed of bioactive compounds crucial for sports nutrition including secondary metabolites, tocopherols, sterols, squalene, trace elements, polyphenols, peptides, polyunsaturated fatty acids, antioxidants, proteins, fat, carbohydrates, fibers, minerals, and vitamins making it a versatile supplement source. Notably, it is rich in amino acids, including branched-chain amino acids (BCAAs), natural enhancer of nitric oxide levels for improved circulation, endurance, strength, and stamina in athletes. It has been found to improve aerobic capacity, muscle recovery, and improved body composition. It is rich in fiber making it a beneficial prebiotic for athletes to maintain gastrointestinal health after intense training. Being rich in antioxidants and gluten-free, it’s ideal for special diets to reduce fat and increase muscle mass. A comprehensive overview of the ergogenic potential of Amaranthus and further research promises insights into developing Amaranthus-based dietary supplements for enhancing sports performance..

In India, scarcity of ground-based measurements of nitrogen dioxide (NO2) is a major challenge for estimating long-term exposure and associated health impacts. This study aimed to develop and validate a national-scale annual NO2 exposure model for India for 2019 and determine if model cross-validation predictive ability was improved by including non-continuous (manual) measurements along with reference-grade, continuous measurements.We used a supervised forward-addition linear regression method to fit land use regression (LUR) models developed with up to 804 Central Pollution Control Board ground monitoring stations (n = 157 continuous, n = 647 manual) and 209 spatial predictor variables, including satellite-based tropospheric NO2 columns. Two models were developed: one using continuous sites only and one using continuous and manual sites, with standard diagnostics and cross-validation (CV) methods. We also assessed if the kriging of final model residuals reduced spatial autocorrelation and improved model CV results. LUR coefficients for the best-performing model were applied to predictors for 2015–2021 and gridded at 100 m to estimate population-weighted exposure.The continuous sites-only model and combined continuous and manual sites models had CV-R2 values of 0.59 (root-mean-square error [RMSE]: 9.4 μg/m3) and 0.54 (RMSE: 8.3 μg/m3), respectively, and both included the satellite NO2 predictor. Kriging residuals increased the CV-R2 of the combined model to 0.70 (RMSE: 7.2 μg/m3) but offered no improvement for the continuous site model. National population-weighted average NO2 was 22.1 μg/m3 in 2019. We estimated over 92% of the Indian population was exposed to annual NO2 exceeding the WHO air quality guideline (10 μg/m3). In Delhi, Mumbai, and Kolkata, an estimated 45%, 100%, and 100% of the population, respectively, experienced annual NO2 levels that surpassed Indian standards (40 μg/m3). To our knowledge, this is the first such long-term NO2 LUR model specific to India, and predictions are available to interested researchers.

Objective: The severe acute type of respiratory distress caused by Coronavirus disease 2019 (COVID-19) was responsible for the global pandemic of 2019. While most of the focus of vaccine/drug molecules is on the receptor, there are certain enzymes that also need to be checked. Cell surface proteases are one of these. Activation of the virus spike protein becomes more complicated when many host proteases are involved. As many Variants of Concerns have been reported in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), this study aimed to understand the proteolytic function of Furin in each, and its involvement in virus-host interaction. Material and Methods: Spike Protein sequence alignment, furin cleavage site prediction of variants: Wuhan, Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), Delta (B.1.617.2) and Omicron (B.1.1.529), and protein-protein docking studies have been undertaken using appropriate bioinformatics tools. Results: It was observed that when compared to previous variations, the November 2021, outbreak of Omicron variant showed 50 amino acid substitutions in the Spike protein. Thus, in addition to the Angiotensin Converting Enzyme 2 (ACE-2) receptor, the role of virus binding sites to act as “Addition Receptors” for viral entry has been reported here. Conclusion: It was observed that substitution of basic amino acids in the Omicron variant may be responsible for the recognition of furin cleavage sites and the presence of furin cleavage site in the receptor binding domain (RBD) region will thus enhance viral transmission. If these sites are utilized in formulation of new drugs/vaccine molecules to target the furin hydrolyse sites, we may be able to add to the existing course of COVID-19 treatment.

Aims The primary aim of this rapid review was to evaluate the evidence base for the efficacy of ketamine across all formulations and routes of administrations in the treatment of adult patients with treatment resistant depression (TRD). Methods This rapid review retrieved controlled trials on use of ketamine across all of its formulations, including all isomers and across all routes of administration in TRD patients for achieving response and remission. This review included PubMed and PsycINFO databases. The retrieved studies were screened with the help of a screening tool and data were extracted by using data extraction forms by two authors. The studies were evaluated for quality of evidence, ethical issues and critically analyzed. Narrative synthesis was used for data synthesis. Results This review retrieved 10 placebo controlled randomized controlled trials (RCT) on intravenous (IV) ketamine, IV esketamine, intranasal (IN) ketamine and IN esketamine in TRD patients. IV ketamine and esketamine showed higher rates of remission and response in comparison with placebo groups in TRD patients. There was no significant improvement in response and remission rates in TRD patients on IN esketamine in comparison with placebo. The adverse effects in the intervention groups were of mild to moderate severity and short lasting mostly resolving within a day. Conclusion This review recommends IV ketamine and esketamine can help in achieving early response and remission in TRD patients and it seems to be a well-tolerated treatment option. Further studies are needed to assess these issues around safety, ease of administration and potential for dependence.

Abstract Background Although cannabis use incidence, societal acceptance, and legislation all trend positively, cannabis remains federally illegal in the USA. Prior studies have revealed that patients are reluctant to disclose their cannabis use history in the healthcare system, which can negatively impact patient care. This study reports the frequency of cannabis use disclosure with special considerations for stigmatization. To better understand the limitations, providers face in providing collaborative, comprehensive, and informed care, this study evaluated four domains of stigma: perceived, anticipated, enacted, and internalized. Methods This study used a descriptive exploratory design. Data collection occurred using an anonymous, online national survey with a convenience sample in the USA. Recruitment relied on electronic media and occurred between July and December 2022. Participants were adults older than 21 years and self-identified as having used cannabis and accessed the healthcare system within the last five years. The survey measured demographic characteristics, cannabis use, and disclosure patterns. Stigma was measured using the Stigma Use Stigma Mechanism Scale (SU-SMS) and Substance Abuse Use Self-Stigma Scale (SASSS) with language modifications for cannabis. Ordinal logistic regression models were performed to evaluate associations between the frequency of cannabis use disclosure patterns and each stigma category. Associations were assessed using Chi-squared or Fisher’s exact tests. Results Data were available for 249 respondents. Most participants (57.1%) reported initiating a conversation about cannabis with their healthcare provider; 27.8% of the time, cannabis is never discussed, and healthcare providers initiate only 15.1% of related discussions. Anticipated stigma [95% CI 1.045–1.164] and total stigma [95% CI 1.001–1.039] had statistically significant associations with nondisclosure. Annual household income (p = .04), chronicity of cannabis use (p = .03), frequency of cannabis use (p = .02), and a known amount of CBD in products consumed (p = .01) had statistically significant associations with the frequency of cannabis use disclosure. Conclusions Patients who use cannabis experience stigmatization in the healthcare setting that may limit disclosure of cannabis use history. Future studies would be well served to explore anticipated stigma more deeply. Healthcare providers should be knowledgeable to lead such conversations relating to cannabis while maintaining an unbiased perspective.

The emergence of SARS-CoV-2 created a havoc worldwide, causing high morbidity, serious complications and mortality. The ORF1ab of SARS-CoV-2 has 16 non-structural proteins which are required for genome replication and transcription. All of these are druggable targets, of which NSP12 (RNA-dependent RNA polymerase), was selected as a potential target for drug molecules. Remdesivir is a recommended drug for SARS-CoV-2 and it targets the RdRp protein. Although Remdesivir was given to COVID-19 patients based on their clinical manifestations, yet the transmission and spread of the virus continued and to add to its pandemicity, new variants emerged from time to time. This necessitates the need for molecular modification of existing antiviral drugs so that more precise targets for halting viral replication can be selected. For this, the approach used was repurposing of the existing drugs. In the present study, ten FDA-approved drugs were chosen on the basis of their properties of inhibiting the RdRp protein. These drugs were subjected for checking the docking score with the target protein. Of these, Remdesivir, Ribavirin, Favipiravir and Baloxavir were taken for further analysis on the basis of their best scores. These drugs were then modified to check the efficiency to inhibit the RdRp and to stop the replication rate of the virus. We docked the modified drugs with the macrodomain of RdRp by using the CB-Dock web server and checked the binding affinity and amino acid contact residues. The modified drugs were also checked for bioactivity in the Molinspiration cheminformatics online tool. Our results showed increased affinity for RdRp of SARS-CoV-2 when compared to the original compound. We also checked the synthetic accessibility of the drugs using the SwissADME tool. The study showed promising results when modified. The findings reported need further confirmation through wet lab studies.

Complex craniovertebral junction (CVJ) defects account for a considerable proportion of CVJ diseases. Given the heavily assimilated C1, an unfavorable C1–C2 joint orientation, an overriding C2 superior facet, a low-hanging occiput, and an abnormal vertebral artery course with a high-riding vertebral artery, placement of C1 lateral mass screws might be difficult. To address this, a novel technique for placing C1 lateral mass screws that avoid vertebral artery injury, low-hanging occiput, and overriding C2 superior facet was developed in this study. This approach enables firm fixation of C1–C2 even in difficult situations where the placement of the C1 lateral mass is challenging.

Introduction: Ovarian cancer is a common malignancy in women with a high mortality rate, necessitating effective preventive measures. The American Cancer Society and the American College of Obstetricians and Gynaecologists, in their newer guidelines, suggest that patients undergoing tubectomy have an opportunity for the prevention of ovarian carcinoma by undergoing Prophylactic Bilateral Salpingectomy (PBS) instead of tubectomy in average-risk women. However, salpingectomy is not widely accepted as a method of sterilisation over tubectomy during caesarean section due to concerns about its potentially detrimental effect on ovarian reserve. Aim: To determine the effect of Bilateral Salpingectomy (BLS) and Bilateral Tubectomy (BLT) on ovarian reserve over a period of six months from surgery and to compare salpingectomy and tubectomy for their intraoperative and postoperative complications. Materials and Methods: The study is a hospital-based prospective cohort study conducted in the Department of Obstetrics and Gynaecology, Fakhruddin Ali Ahmed Medical College and Hospital (FAAMCH), Barpeta, Assam, India, from Sept 2020 to Aug 2021, over a period of one year, involving women between 32-35 years undergoing sterilisation during caesarean section. Mean Antimullerian Hormone estimation was done preoperatively, at the 3rd month, and at the 6th month to assess changes in ovarian reserve following salpingectomy and tubectomy. Intraoperative blood loss, surgery time, surgical complications, postoperative complications, recovery period, histopathological study of the fallopian tube, etc., were analysed and compared between the two groups. All data were analysed using Statistical Package for Social Sciences (SPSS) version 21.0. A p-value 0.05). However, in each group, the preoperative mean AMH was lower than its 3rd month and 6th month values, which were in the normal range. This was attributed to ovarian suppression during pregnancy, which normalised following delivery and showed an increasing trend thereafter. However, on average, salpingectomy required approximately 10 minutes more than tubectomy. Conclusion: Salpingectomy does not affect ovarian reserve in the short-term of six months. Other than being more timeconsuming compared to tubectomy, salpingectomy is on par with traditional tubectomy. Therefore, it may be adopted as a routine sterilisation method considering its role in the prevention of ovarian cancers.

Introduction: The most crucial factor in improving animal reproduction efficiency is early pregnancy diagnosis. Early diagnosis not only reduces the time interval between two calvings but also aids farmers in identifying open animals, thereby preventing significant milk production losses. Therefore, the objective of this study was to discover circulatory miRNAs that would be useful for early pregnancy diagnosis in buffalo.Material and methods: Blood samples were taken on 0, 6th, 12th, and 18th day after artificial insemination from pregnant animals (n = 30) and non-pregnant animals (n = 20). During these stages of pregnancy, total RNA was extracted, and a small RNA library was subsequently generated and sequenced on the Illumina platform. Subsequently, Real-time PCR was used to validate the findings.Results and discussion: There were 4,022 miRNAs found during the pregnancy, with 15 of those lacking sequences and 4,007 having sequences already in the database. From the beginning of pregnancy until the 18th day, 25 of these miRNAs showed a substantial shift in expression levels in the maternal blood, with a change more than two logs. Furthermore, based on qPCR results, 19 miRNAs were found to be more abundant in pregnant animals than in non-pregnant animals. We used target prediction analysis to learn how maternally expressed miRNAs relate to fetal-maternal communication. In conclusion, miRNA based biomarkers that could be associated with the diagnosis of pregnancy were identified including miR-181a and miR-486 highly upregulated on the 18th day of pregnancy. This study also provides a comprehensive profile of the entire miRNA population in maternal buffalo blood during the early stages of pregnancy.

This study is the first study to incorporate a novel approach to single-implant-retained mandibular overdenture with a bar attachment on a single implant in the symphysis region. The use of a single-implant-retained bar overdenture significantly improved patients' chewing efficiency, indicating enhanced overdenture retention and stability. Materials and Methods: Ten maxillary and mandibular completely edentulous patients were enrolled in the study. A complete denture was fabricated for them. On completion, bite force, retention force, and bone change were recorded. Bite force was recorded with the strain gauge, retention force with the force measurement gauge, and bone changes with radiographs. Conclusion: Single-implant-supported bar mandibular overdenture (SISBOD) can be a suitable standard economic option for edentulous mandible and can greatly improve the quality of life of patients.

Background: Despite a huge number of advancements in the medical field, periodontitis still remains one of the most prevalent oral diseases worldwide. Aim: Thus, the primary aim of our study was to evaluate the prevalence of periodontal diseases in patients reporting to the tertiary healthcare setup in Ranchi. Materials and Methods: Based on inclusion criteria, subjects aged 18–60 years were selected and a per forma was filled by the observer. The prevalence of periodontal disease was measured using the community periodontal index, simplified oral hygiene index, and stage of periodontitis. Results: Descriptive variables were assessed using frequency, percentage, mean, and standard deviations, while the categorical analysis was performed using the Chi-square tests. Conclusion: General awareness about periodontal health and regular dental visits should be given utmost importance among the rural populations of every developing country.

Introduction Worldwide nearly 70 million populations are affected by glaucoma, a leading cause of irreversible blindness. Awareness and knowledge about glaucoma is the key to early diagnosis and effective management to prevent debilitating blindness. In India, the literature has shown that the level of awareness ranges from 0.32 to 13.5%, much lower than developed countries. Previous studies found higher levels of education and socioeconomic status along with positive family history of ocular diseases were directly related to improved levels of awareness and knowledge about glaucoma. Considering the improvement in literacy standards, socioeconomic status, and better utilization of medical care in the past few years, we aimed to assess the current trends in levels of awareness and knowledge about glaucoma in the North Indian population.

Background: Persons with intellectual and developmental disabilities (IDD) suffer from stark, well-documented health and healthcare disparities, despite data indicating that the majority see a healthcare provider at least annually. Multiple surveys have indicated that over 90% of physicians feel they have inadequate knowledge and skill in caring for those with IDD. This has been recognized as a key barrier to health equity. Objective: To evaluate the content of high-impact clinical literature for a potential cause of clinician knowledge deficits. Methods: We performed a bibliometric analysis of publications within major, high-impact general, and specialty clinical journals from 1946 to 2020 to determine the relative frequency of publications regarding IDD and publication rate. Results: We observed a significant decline in articles regarding IDD over the past 20 years within high-impact general medical journals, and a significant decline over the past 15 years within high-impact, specialty society-published journals of Psychiatry, Psychology, and Neurology. Furthermore, we observed that high-impact general medical journals devoted a significantly smaller proportion of publication space to articles regarding IDD than they did for conditions with similar prevalence such as HIV/AIDS, breast cancer, and drug abuse. Conclusion: The declining rate and low frequency of clinical publications regarding IDD within the major, respected clinical literature may be contributing to physicians’ ability to source evidence-based information, thereby impacting perceptions of skill and knowledge deficits, and therefore may be contributing to healthcare disparities in this population. Well-designed clinical studies that engage persons with IDD may lead to an evidence base within the clinical literature that will improve physician confidence and care quality.

In India and other affected countries, Omicron variant of SARS-CoV-2 has shown faster transmission but less clinical severities when compared to Delta strain. Present study was aimed to investigate how molecular changes in the spike proteins of Omicron variant has increased its transmission but reduced the disease severity. We report molecular interactions of Spike proteins of Delta and Omicron variants with ACE-2 receptor to explain how change in chemical and physical nature of mutated amino acids of Omicron variant has affected the internalization competence of virus into host cell. The Research Collaboratory Structural Bioinformatics (RCSB) and Protein Data Bank (PDB) were used to construct ACE2-Spike Protein interaction. The binding affinity of both omicron and delta variant spike proteins with human ACE2 receptor was observed. Spike protein of Omicron variants has revealed total number of 93 dissimilarities of amino acids from Delta strain,15 of which are in its Receptor Binding Domain (RBD). Our study showed that RBD of Delta variant contained only one hydrophobic amino acid whereas there were 6 hydrophobic amino acids in the RBD of Omicron variant. We report that increased number of Hydrophobic Amino Acids in RBD of Omicron variant affects its binding with ACE2 receptor to enter into the cell. The failure of internalization of virus has increased concentration of extracellular virions at nasopharyngeal region leading to faster expulsion of infective droplets during coughing or sneezing to increase transmission but has reduced the severity of infection. The reported observations could prove to be of public health and therapeutic significance.

Biopolymers are highly desirable alternatives to petrochemical-based plastics owing to their biodegradable nature. The production of bioplastics, such as polyhydroxyalkanoates (PHAs), has been widely reported using various bacterial cultures with substrates ranging from pure to biowaste-derived sugars. However, large-scale production and economic feasibility are major limiting factors. Now, using algal biomass for PHA production offers a potential solution to these challenges with a significant environmental benefit. Algae, with their unique ability to utilize carbon dioxide as a greenhouse gas (GHG) and wastewater as feed for growth, can produce value-added products in the process and, thereby, play a crucial role in promoting environmental sustainability. The sugar recovery efficiency from algal biomass is highly variable depending on pretreatment procedures due to inherent compositional variability among their cell walls. Additionally, the yields, composition, and properties of synthesized PHA vary significantly among various microbial PHA producers from algal-derived sugars. Therefore, the microalgal biomass pretreatments and synthesis of PHA copolymers still require considerable investigation to develop an efficient commercial-scale process. This review provides an overview of the microbial potential for PHA production from algal biomass and discusses strategies to enhance PHA production and its properties, focusing on managing GHGs and promoting a sustainable future.

Abstract Much debate exists concerning the factorial dimensionality of student well-being. We contribute to this debate by drawing on PISA 2018 data from a total of 61,722 students, 2528 schools, and nine countries. For our investigation, we test multiple associated measurement models for convergent, discriminant, and concurrent validity, model fit, and measurement invariance. For the PISA 2018 sample, we found very little variation in student well-being both between schools and between countries suggesting that variation in student well-being exists predominantly within respective school contexts. In addition, our findings support the notion that student life-satisfaction should be split into separate general and school-based factors in a Bi-Dimensional Life-Satisfaction Model. Moreover, results suggest that PISA 2018 data can be used to successfully measure a Four-Factor Hedonic Model of Student Well-being, tackling both cognitive (general life-satisfaction and satisfaction with school factors) and affective features (positive and negative affect). Finally, we propose a Five-Factor Integrative Model of Student Well-being that supports a broader conceptualization of student well-being that includes life-satisfaction, both positive and negative affect, and eudaemonia. We tested this model and found that it met the requirements for scalar invariance across male and female gender groups. However, for all 36 inter-country tests of measurement invariance, metric invariance was only reached nine times (25%), and scalar invariance was reached once (2.8%). Implications and recommendations for follow up research are provided.

Ovarian steroid cell tumors are rare, representing less than 0.1% of all ovarian neoplasms. Among the myriad causes of hirsutism, ovarian tumors account for 1% of the reported cases. We present the case of a 49-year-old parous postmenopausal woman who sought medical attention for hirsutism for 2 years. This case illustrates the unusual and interesting connection between rare ovarian pathology and the clinical manifestation of hirsutism in a postmenopausal patient. Her ultrasonography and MRI showed a right adnexal mass of solid-cystic consistency with thin septations. Her laboratory workup revealed high levels of total testosterone of 256 ng/ml (8.4-48.1ng/ml) and free testosterone of 7.36 pg/ml (0.2-4.1 pg/ml), while DHEAS - 234 µg/dl (35.4-256 µg/dl) and CA125 - 15.8U/L (0.0-35 U/L) were in the normal range. She underwent exploratory laparotomy with a total abdominal hysterectomy and oophorectomy. Histopathological examination and immunohistochemistry conclusively established the presence of a steroid cell tumor, specifically classified as "Not Otherwise Specified"(NOS), in the right ovary.

The emergence of hypervirulent strains of Acinetobacter baumannii poses a significant threat in intensive care units (ICU). This study aimed to molecularly characterize hypervirulent A. baumannii strains isolated from ICU patients with respiratory infections. Six strains were isolated from ICU patients over one month. Isolates were identified by phenotypic characterization biochemical properties and 16s RNA sequencing. Antibiotic susceptibility testing was conducted followed by resistance genes detection by PCR. MLST, and PFGE were employed to analyse clonal relationships among strains. Plasmid replicon typing and plasmid transmission frequencies were determined. The isolated strains exhibited diverse clinical manifestations, including acute respiratory distress syndrome (ARDS). Antibiotic susceptibility testing revealed multidrug-resistance phenotype. Molecular analysis revealed a complex genetic landscape of antibiotic resistance genes, including ESBLs and carbapenemases, as well as virulence genes such as ompA, csuE, and exoS. The multiple sequence types indicating genetic diversity among the strains as ST1512, ST622, and ST149 (each type two isolates). Plasmid characterization revealed the presence of diverse replicon types associated with multidrug resistance. This study provides comprehensive insights into the phenotypic, molecular, and epidemiological characteristics of hypervirulent A. baumannii outbark in ICU.

Background: People living in settings affected by conflicts face insecurity and live in fragmented social systems. Conducting research in these settings is essential, however integrating results into practices is complex. Implementation science tools are not used often in such environments. In this paper we explore how a convenience sample of interviewees experienced implementation in these settings, through the lens of the adapted Extended Normalization Process Theory (a-ENPT). Methods: We conducted in-depth interviews with 26 participants (donors, academics, and humanitarian actors). We assessed what key issues interviewees met and how they negotiated them. We combined an inductive thematic analysis to identify implementation issues, and we applied the a-ENPT deductively to question power imbalances, engaging a group of humanitarian actors as co-authors along the way. Results: The main challenges met by interviewees related to a) engaging frontline actors to produce knowledge; b) discussing the results critically; c) integrating research results in constrained learning spaces; and d) managing contextual instabilities in settings affected by conflicts. Interviewees negotiated these constraints through an early involvement of frontline actors, an institutional support, a meaningful engagement of communities, and balanced partnerships. Based on these findings we propose a tool to anticipate the power imbalances embedded in the implementation of research results in settings affected by conflicts, rooted in the a-ENPT constructs. Conclusion: We identified mechanisms that allowed for the negotiation of important challenges and power imbalances, through an implementation science tool. Further research should focus on the perspectives of communities affected themselves.

Primary progressive aphasia (PPA) variants present with distinct disruptions in speech-language functions with little known about the interplay between affected and spared regions within the speech-language network and their interaction with other functional networks.The Neurodegenerative Research Group, Mayo Clinic, recruited 123 patients with PPA (55 logopenic (lvPPA), 44 non-fluent (nfvPPA) and 24 semantic (svPPA)) who were matched to 60 healthy controls. We investigated functional connectivity disruptions between regions within the left-speech-language network (Broca, Wernicke, anterior middle temporal gyrus (aMTG), supplementary motor area (SMA), planum temporale (PT) and parietal operculum (PO)), and disruptions to other networks (visual association, dorsal-attention, frontoparietal and default mode networks (DMN)).Within the speech-language network, multivariate linear regression models showed reduced aMTG-Broca connectivity in all variants, with lvPPA and nfvPPA findings remaining significant after Bonferroni correction. Additional loss in Wernicke-Broca connectivity in nfvPPA, Wernicke-PT connectivity in lvPPA and greater aMTG-PT connectivity in svPPA were also noted. Between-network connectivity findings in all variants showed reduced aMTG-DMN and increased aMTG-dorsal-attention connectivity, with additional disruptions between aMTG-visual association in both lvPPA and svPPA, aMTG-frontoparietal in lvPPA, and Wernicke-DMN breakdown in svPPA.These findings suggest that aMTG connectivity breakdown is a shared feature in all PPA variants, with lvPPA showing more extensive connectivity disruptions with other networks.

Background: Coronavirus disease 2019 (COVID-19) pandemic raised an immediate demand for skilled workforce in hospitals. There is limited literature related to perspectives of trainers in this unprecedented situation. This study aimed to examine lived experience of trainers while delivering training to a large number of participants in a challenging situation with the fear of contracting the infection themselves. Methods: A qualitative, phenomenological research was conducted in a tertiary care training centre among 21 trainers who trained 8417 healthcare personnel. Data was collected through Google Forms, which consisted of open-ended questions. Thematic analysis was done using MAXQDA software. Three themes and nine subthemes related to the teaching–learning method, administrative support, and challenges faced by the trainers were extracted. Results: Participants included nurses, nursing tutors, resident doctors, and faculty from nursing and medical specialities. Classroom teaching strategies with demonstration, simulation & hands-on training, and even virtual demonstrations were favoured as the effective teaching methods and modes. Well-planned modules, availability of infrastructure and advanced supporting software facilitated training sessions. Hands-on skill assessment was favoured as the best evaluation method. Trainers also expressed various challenges faced in planning and executing the training. Conclusion: A meticulous planning of preparedness training based on the understanding level of participants and their scope of work led to feasible and fast large-scale capacity building of healthcare professionals during COVID-19 pandemic. Diverse educational methods, as per demand of situations, online training, and in-person hands-on techniques via simulation lead to more responsive delivery of training and learning than a single method.

Background: Microbial secondary metabolites have shown promise as a source of novel antimicrobial agents. In this study, we aimed to isolate, characterize, and evaluate the antimicrobial activity of compound from a novel Streptomyces albofaciens strain MS38. The objective was to identify a potential bioactive compound with broad-spectrum antimicrobial properties.Methods: The isolated strain MS38 on starch casein agar was characterized using morphological, physiological, and molecular identification techniques. The compound was obtained from the fermented broth through extraction with n-butanol and further purification using silica gel column chromatography and high-performance liquid chromatography (HPLC). Structural elucidation was conducted using Ultraviolet (UV), Infrared (IR), nuclear magnetic resonance (NMR), and mass spectrometry (MS) techniques. The antimicrobial activity was evaluated using the agar well diffusion method and the microplate Alamar blue assay (MABA).Results: The isolated strain MS38 was identified as novel S. albofaciens based on morphological characteristics and confirmed by 16S sequences analysis and MALDI-TOF MS. The compound obtained from the fermented broth exhibited substantial antimicrobial activity against a variety of pathogenic bacteria and fungi. Structural analysis revealed a complex chemical structure with characteristic functional groups indicative of potential antimicrobial properties. The compound demonstrated strong activity against both Gram-positive (Staphylococcus Spp.) and Gram-negative (Klebsiella pneumoniae and Escherichia coli) bacteria, as well as fungi, including Candida albicans and Trichophyton rubrum.Conclusion: This study successfully isolated and characterized a bioactive compound from a novel S. albofaciens MS38. The compound exhibited significant antimicrobial activity against a range of pathogenic microorganisms. These findings underscore the importance of exploring microbial biodiversity for the discovery of novel antimicrobial agents. This study contributes to the growing knowledge of microbial secondary metabolites with potential therapeutic value.

Sustainable agriculture faces major challenges under abiotic stress conditions owing to extensive application of chemical fertilizers which pollute water, soil and atmosphere. Biostimulants (BSs), comprising of naturally derived complex mixtures of uncharacterized biomolecules, pure biochemicals and nanomaterials, enhance nutrient use efficiency (NUE) and trigger crop’s natural defense mechanisms. While it is difficult to specify the metabolic effects of uncharacterized natural mixtures (seaweed extract, protein hydrolyzates, etc.), exogenous application of pure biochemicals and nanomaterials offers an edge as BSs since their physiological roles and mechanisms of action are decipherable. Foliar application or seed treatment of some amino acids, polyamines and biopolymers (chitosan, lipochitin oligosaccharides and thuricin 17) enable plants to overcome drought and salinity stress via activation of mechanisms for reactive oxygen species (ROS) scavenging, osmolyte regulation and chlorophyll accumulation. Interaction of nitric oxide (NO) with some vitamins and melatonin exhibits potential significance as BSs for mitigating stress by ROS scavenging and maintenance of intracellular ionic balance and membrane integrity. Near future is likely to see wide applications of nanoparticles (NPs) and nanomaterials (NMs) as BSs in view of their biphasic mode of action (bio-physical activation of membrane receptors followed by gradual release of BS into the plant cells).

The article aims to estimate the relationship between synergy gains and deal size of mergers & acquisitions for Indian firms by examining deals that took place between 2005 and 2015. The paper employs principal component analysis to create a composite variable representing operating and financial synergy, followed by instrument variable 2SLS regression to estimate the relationship. The results suggest that small dealsize transactions do considerably better than large deals. The magnitude of financial synergy increases with deal size . However, large companies suffer substantial operating synergistic erosion.

Objective: The aim of this research study is to emphasize the necessity to train neurosurgeons in both endovascular procedures as well as microsurgical clipping in the management of intracranial vascular lesions. Material and methods: In this study, the retrospective data collected from our institution from 2021-2022 is presented. Here we present six cases of intracranial vascular lesions that were initially planned for endovascular procedure and later ended up being managed by microsurgical clipping/ excision. Written informed consent was obtained from relevant individuals for publishing the data. Results: All six patients recovered well in the postoperative period. Therefore, a neurosurgeon who is adequately trained in vascular neurosurgery along with endovascular tutoring shall have an extensive grasp of cerebral vascular diseases and all the available treatment alternatives. Since we live in a result-oriented scenario - patients shall be best served by a hybrid neurosurgeon in the long run. Conclusion: This study provides the intra-operative difficulties faced during endovascular management of intracranial vascular lesions. These difficulties require real-time management. Any delay in the process of intra-procedural decision-making making, the non-availability of trained neurosurgeons can have devastating consequences. Hence, this study further fortifies the want for a dual-trained neurosurgeon to handle cerebrovascular lesions.

AbstractPancreatic cancer is a malignant disease associated with poor survival and nearly 80% present with unresectable tumors. Treatments such as chemotherapy and radiation therapy have shown overall improved survival benefits, albeit limited. Histotripsy is a noninvasive, non-ionizing, and non-thermal focused ultrasound ablation modality that has shown efficacy in treating hepatic tumors and other malignancies. In this novel study, we investigate histotripsy for noninvasive pancreas ablation in a pig model. In two studies, histotripsy was applied to the healthy pancreas in 11 pigs using a custom 32-element, 500 kHz histotripsy transducer attached to a clinical histotripsy system, with treatments guided by real-time ultrasound imaging. A pilot study was conducted in 3 fasted pigs with histotripsy applied at a pulse repetition frequency (PRF) of 500 Hz. Results showed no pancreas visualization on coaxial ultrasound imaging due to overlying intestinal gas, resulting in off-target injury and no pancreas damage. To minimize gas, a second group of pigs (n = 8) were fed a custard diet containing simethicone and bisacodyl. Pigs were euthanized immediately (n = 4) or survived for 1 week (n = 4) post-treatment. Damage to the pancreas and surrounding tissue was characterized using gross morphology, histological analysis, and CT imaging. Results showed histotripsy bubble clouds were generated inside pancreases that were visually maintained on coaxial ultrasound (n = 4), with 2 pigs exhibiting off-target damage. For chronic animals, results showed the treatments were well-tolerated with no complication signs or changes in blood markers. This study provides initial evidence suggesting histotripsy’s potential for noninvasive pancreas ablation and warrants further evaluation in more comprehensive studies.

In the current scenario, medical concern is fundamental for everyone’s existence in addition to well-being, but the waste produced as of healthcare facilities signifies an actual concern in our surroundings. One of the healthcare workers (HCWs) most crucial duties is to handle biomedical waste (BMW) created in a healthcare institution properly since inappropriate management of BMW not only puts both individuals and the environment at risk but might also lead to lawful act opposed to healthcare workers and hospital authority. Current research plan is intended to assess biomedical waste management in a tertiary care hospital in Raipur, Chhattisgarh. A facility-based cross-sectional observational study was conducted at Dr. Bhimrao Ambedkar Memorial Hospital, Raipur; Chhattisgarh from July 2021 to August 2021. Assessment of knowledge, attitude, and observation was done by interviewing 105 healthcare workers, selected by simple random sampling, using a predesigned, semi-structured questionnaire. The analysis revealed that medical staff had good knowledge, attitude and practice of biomedical waste management than the paramedical professionals or non-medical workers. There is an imperative need for orientation training to protect themselves, and citizens visiting this healthcare facility and close by communities.

Basal cell carcinoma (BCC) is the most common malignant skin tumor, constituting 80% of nonmelanocytic skin tumors. Intermittent exposure to ultraviolet radiation is considered a major risk factor for BCC. This study was done in 2023 at a tertiary care cancer centre in North India. Pigmented BCC is a rare entity, a histopathological and clinical variant of BCC. This entity belongs to the category of nonmelanocytic skin tumors but exhibits increased pigmentation. Increased pigmentation also creates suspicion of melanocytic tumors, seborrheic keratosis, and Discoid Lupus Erythematosus DLE. However, this diagnostic dilemma can be elicited with histopathological analysis and clinical correlation. However, to prevent basal cell carcinoma, the best is to avoid direct sunlight; if it cannot be avoided, use sunscreen.

Introduction: The fifth edition of WHO classification of myeloid neoplasms has introduced major changes in the defining criteria and grouping of MDS, MDS/MPNs and MPNs. Recently published literature has also cited the importance of new risk-scoring systems by integrating genomic profiling with hematologic and cytogenetic characteristics, in order to improve the prognostic discrimination of patients and represents a valuable tool for clinical decision-making. Aim: To find out the prevalence and molecular spectrum of Philadelphia-negative MPNs, MDS/MPNs and MDS in our subset of patients and henceforth to evaluate the impact on diagnosis, risk stratification and treatment decision-making of patients. Methods: This retrospective observational study included all newly diagnosed patients of non-Philadelphia positive MPNs, MDS, and MPN/MDS, in whom complete baseline diagnostic work-up was available including complete blood counts, bone marrow morphology and biopsy, cytogenetic and molecular studies. Results: The most frequent entities in our cohort of patients were primary myelofibrosis (32.8%), MDS (32.8%) and CMML (16.4%). In PIMF, 50% patients were JAK2- mutated while 30% were triple negative (JAK-, CALR-, MPL-). The commoner epigenetic modifiers among MPNs were ASXL1, TET2 and IDH2. The predominant CMML molecular signatures in our patients were NRAS, U2AF2, SETBP1, ASXL and SH2B3. There was no significant effect of WHO changes and recently introduced molecular scoring models on the diagnosis and risk stratification of all these MPN and MDS/MPN patients However, in MDS and PIMF patients, recent WHO subtyping plus IPSS-M & GIPSS scoring respectively enabled refining of risk groups. Conclusion: Molecular profiling helps in better risk stratification of patients across all groups as well as in making therapeutic decisions. However, in resource constrained settings, it is not always possible to stratify patients on the basis of molecular signatures and hence, scoring models such as DIPSS and IPSS-R holds their ground strongly even today for offering appropriate therapy to patients without compromising on quality care.

Introduction: Hemoglobin D Punjab is a common hemoglobin D variant, which is essentially known to cause a mild disease even in homozygous state. Heterozygous state of hemoglobin D Punjab with sickle cell is the only presentation when a severe disease may be expected. We aim to study the spectrum of clinical and haematological profile of all case of haemoglobin D, reported at an apex referral centre of the country. Material and Methods: This is a record based retrospective study of cases of hemoglobin D Punjab from hematology OPD of a apex medical care centre. The clinical and hematological findings of 30 cases with genotype/phenotype of hemoglobin D Punjab were recorded from physical records and electronic data maintained at the institute. The cases were divided into homozygous Hb D Punjab, Double heterozygous hemoglobin S and D, Hemoglobin D-β-thalassemia, and Hemoglobin D trait. Results: The reported 30 cases consisted of 3 cases of homozygous Hb D Punjab, 8 cases of co-mutation of Hb D and beta thalassemia, 6 cases of co-mutation of Hb D with sickle cell and 13 cases of Hb D trait. All three cases of Hb D disease were mild to moderately symptomatic with co-existent splenomegaly. Out of the 8 cases reported of Hb D-β-thalassemia, three cases were found to have moderate anemia and one with severe anemia. The MCV of all participants were reduced, while, MCHC of all cases was within normal range. Among the 6 cases of compound heterozygous Hb D and S Disease two had hemolytic faces and three cases had splenomegaly. Blood transfusion was required by four out of six cases at varied frequency. Conclusion: We find the spectrum of symptoms presented by the cases of hemoglobin D Punjab is varied and few cases may require blood transfusion and medical care with follow up even in absence of heterozygous hemoglobin S inheritance.

Background: Era's one of the utmost scourges is air pollution, owing to not only its impact on climate change but also its impact on public and individual's health due to combined morbidity and mortality. Objectives: The current study was intended to monitor the air quality data from two districts of Chhattisgarh, namely Raipur and Korba, so that policymakers will be able to take corrective measures to control individual's health-related issues associated with polluted air. Methods: All air samples were collected from around Raipur and Korba city of Chhattisgarh and submitted to the Chester LabNet, a laboratory based in 3 Oregon, USA, for analysis. Particulate matter (PM2.5) was determined by using the gravimetry technique and used the X-ray fluorescence 4 technique to detect the presence of heavy metals. Results: PM2.5 levels in all samples in Raipur and Korba ranged from 131.4–653.8 μg/m3 to 150.3–1699.2 μg/m3 which is 2.18–10.88 and 2.5–28.3 times higher than standards prescribed by the Ministry of Environment, Forest and Climate Change (MoEFCC) of 60 μg/m3. Heavy metals such as silica (Si), lead (Pb), nickel (Ni), and manganese (Mn) levels were recorded higher than the standard level reported by the National Ambient Air Quality Standards in locations of Raipur and Korba, Chhattisgarh. Conclusion: Although Chhattisgarh, a state in Central India covered with 45% forest, but it is suffering from low air quality due to developing township and industrial area, which is causing a lot of commotion in the local community. At this time, the government should approach to take immediate action and measures to control air pollution and to reduce the terrible impact on the health of local citizens.