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The objective of this study is inspired from the immeasurable difference of COVID-19 incidence data between African & Indian population at peak prevalence month of its pandemic. Raw data analysis of Africa and India was schemed when COVID-19 situation as in peak on pandemic all over the world. The detected data distributions of inter-countries and other countries of Africa were comparatively studied on statistical basis of Correlation coefficient. The evaluation of p-values, ANOVA study with graphical representation on the comparative basis was carried out and interpreted. The screening of the large variation of data distribution has made uniform to get proper variation. The different mean± SD values are 67.142 ±69.91, 76.642± 66.747 & 77.21 ± 67.0215 and CV of these African countries shows 1.080, 0.90377 & 0.90076 respectively. Thus, ANOVA study showed no significance value, p < .05, where P-value is 0.913928 because of least variations. On the other hand, the % distribution of COVID-19 pandemic represents the wide difference of inter-continental difference of Africa from India, specifically of pie-chart. However, due to vast difference in COVID-19 intercontinental cases on restricted travellers interconnectivity tends to focus our attention to examine dietary roles in COVID-19.

Cancer is referred to as a pleiotropic disease-causing approximately 9.6 million deaths in 2018. Among all cancers, lung cancer was the leading cause of death in 2017, and 12% of fatalities were alone due to lung cancer. The associated risk factors in lung cancer include smoking (80-85%), chronic inflammation in the lungs, COPD, pulmonary fibrosis, environmental and occupational exposure to nickel, arsenic, chromates, etc. Early diagnosed patients' treatment plan includes chemotherapy, immunotherapy, radiotherapy, surgery, and tumor ablation. Many sorts of drug delivery carriers have been used in the past, usually in targeted chemotherapy. Liposomes are spherical shape vesicles containing a lipid bilayer and aqueous core, with potency to encapsulate both hydrophobic and hydrophilic drugs with minimal toxicity. These vesicles have a particle size of 0.02-1000 μm allowing selective passive targeting to the tumor's deeper tissues. Current publications on liposomes highlight their acceptance and best choice among all systems to deliver synthetic and herbal drugs to the lungs. This review focuses on many aspects, which include an in-depth analysis of potential anticancer drugs that have utilized the advantages of liposomes for effective lung carcinomatherapy and devices used to deliver the active agents to the pulmonary tissues. Investigations on ongoing, approved, and failed clinical trials and patents on products related to lung cancer have been highlighted to provide a critical review on the subject.

3D printing or additive manufacturing process works on the stereolithographic process. It is based on the x, y and z-axis whereas in 4D printing another dimension is added which is time and with the combination of smart material alteration in shape, properties and function are possible under the corresponding external stimulus. The shape-shifting behaviour of 4D printed objects gives it an edge over 3D printing but it has a limitation of producing objects having curved layers and requiring higher strength. The concepts and applicability of 5D printing (5DP) are discussed. Summarization of the 3D and 4D printing process along with their limitations are also presented. The limitation of 3D and 4D printing of not printing those structures or complex shapes which require higher strength or have a curve layer can be printed with 5D printing. In the case of 5DP, there are two additional axes i.e. rotation of print bed and rotation of extruder head. In this study detailed process, general application and a case study of 5DP in the healthcare and medical industry focussed on dental surgery and orthopaedics is summarized.

Concrete, owing to its brittle nature is weak in tension and therefore, a significant amount of published research has focused on the addition of fibers to improve the flexural performance of concrete. The addition of fibers in a concrete matrix improves its overall performance in terms of strength, ductility, and durability by the mechanism of restraining crack width. Steel fibers are found to be the most efficient in improving the flexural strength of concrete. The design mix for Steel Fiber-Reinforced Concrete (SFRC) is chosen mostly based on the trial mixes. To aid the mix design of SFRC, this study attempts to provide predictive models using machine learning techniques such as non-linear regression on a database of 146 samples, collated from literature. 80% of the randomly chosen samples are used for training the model and the remaining 20% are used to test it. The Root Mean Squared Error (RMSE), Mean Absolute Error (MAE), the statistical significance of the model coefficients, and the coefficient of determination are adopted as criteria to check the performance of the model on both the training and test data. Interaction terms such as fiber factor and number of fibers within a volume were inferred from literature to improve the efficacy of the predictive modeling. Two non-linear models for the prediction of compressive and flexural strength of hooked-end SFRC are proposed and validated. Using the proposed models, the variations in compressive and flexural strength with the key parameters were plotted and discussed. With a decrease in the water-to-binder ratio, there was a significant improvement in compressive strength from 55 MPa to 85 MPa at an aspect ratio of 60. A significant improvement of about 200% to 300% in flexural strength was noted with an increase in fiber factor from 0 to 150.

Study Design: Retrospective observational study.Purpose: To share our experience of multimodal intraoperative neurophysiological monitoring (IONM) used in Sakra World Hospital, Bengaluru in various spine surgeries.Overview of Literature: The development of new onset postoperative neurological deficits can be completely avoided. In order to avoid these, IONM has become a standard of care in recent times for early detection and manipulation of the surgical procedure to prevent postoperative neurological deficits.Methods: This retrospective study was performed on 408 patients who had undergone spine surgeries with IONM during April 2014 to March 2020 at a single center. The operative report, anesthesia record, and IONM were reviewed. All the patients were reassessed for postoperative neurological deficits in the postoperative period and followed up based on the intraoperative findings and neurological deficits for 4 weeks. Signal changes in IONM were reviewed, and the obtained results were further categorized into true positive, true negative, false positive, or false negative. If changes were observed during the IONM, the patients were managed as per the algorithm.Results: Of the 408 patients being monitored continuously during the intraoperative period, 38 showed changes in recordings, 28 developed postoperative neurological deficits, and one developed neurological deficit without any change in the IONM. Nine patients had transient neurological deficits, and the other 20 had permanent neurological deficits. Overall, the multimodal IONM used in our study had a sensitivity of 96.6%, specificity of 97.4%, a positive predictive value of 73.7%, and a negative predictive value of 99.7%.Conclusions: Use of decision algorithm and multimodal neuromonitoring consisting of motor evoked potentials, somatosensory evoked potentials, and electromyography complement each other in the detection of neurological injury during the course the surgery, improve intraoperative care, and prevent further damage and morbidity in patients.

Background: The HIV-1 pandemic is undoubtedly the major public-health crisis of our time. The extensive research on HIV has deepened our understanding of its pathogenesis and transmission dynamics. Some new entity molecules have been approved by the FDA for HIV treatment but till now protective vaccine remains elusive. Scientists are targeting many important proteins of HIV-1; gp41, gp120, CCR5 coreceptor, integrase, reverse transcriptase and protease. Few compounds are used as nucleotide analogues to stop HIV replication. Altogether, these compounds and their derivatives specifically block HIV entry and DNA replication. Using ADMET studies, people are working on these compounds to reduce toxicity and increase potency. Objective: Our main aim is to discuss the Pharmacokinetics properties of 23 important FDA antiretroviral drugs used for the treatment of HIV-1 infections. Methods: We have searched literature related to pharmacokinetics properties in PubMed, Google Scholar search engine. Conclusion: Here, we have reviewed the pharmacokinetic properties such as absorption, bioavailability, distribution, metabolism, and excretion, of important 23 FDA approved drugs. The drugs namely Fuzeon, Selzentry, Complera, Epivir, Retrovir, Emtriva, Ziagen, Edurant, Intelence, Pifeltro, Sustiva, Viramune, Isentress, Genvoya, Tivicay, Reyataz, Prezista, Lexiva, Invirase, Aptivus etc. are classified into five major classes: fusion inhibitors, Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs), Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs), Integrase Strand transfer inhibitors (INSTIs) and Protease inhibitors (PIs). This Review may helpful for the future development of potent antiretroviral drugs with improved pharmacokinetic properties.

Aim: The present study aimed to describe the prescribing pattern of topical betamethasone in the outpatient setting in Alkharj. Methodology: This retrospective study that included collecting data from the electronic prescriptions in a public hospital in Alkharj in 2018. Results: During the study period from Jan to Dec 2018 only 46 patients received topical betamethasone. Most of the patients were female (63.04%). About 71.74% of the prescribed betamethasone was in ointment form and 28.26% in lotion form. Most of the prescribers were residents (97.83%). Most of the prescriptions were written by dermatology department (58.70%). Conclusion: The use of topical betamethasone was uncommon and this could be due to the availability of other topical corticosteroids and other alternatives. It is important to increase the knowledge of health care workers and the patients regarding the use of topical corticosteroids.

Objective: Post-operative nausea and vomiting is a frequent complication following anaesthesia. We compared the efficacy and safety of intravenous palonosetron and intravenous dexamethasone as prophylactic antiemetic in patients undergoing laparoscopic cholecystectomy. Methods: After obtaining institutional ethical committee approval, 100 adult female patients undergoing laparoscopic cholecystectomy were randomised to receive 4 mg dexamethasone (group I, n = 50) or 0.075 mg palonosetron (group II, n = 50) intravenously (IV) over 2-5 minutes prior to induction of anaesthesia. Standard anaesthetic technique was followed, and the residual neuromuscular block was antagonised at the end of the procedure. A single anaesthesiologist assessed all the cases for post-operative nausea and vomiting (PONV) for 24 hours. The complete response rate and the overall patient satisfaction were noted. If patient experienced PONV, injection metoclopramide 10 mg was given as rescue antiemetic IV. Results: A total of six patients had vomiting within 6 hours (four patients in groups I and two patients in group II), whereas none had vomiting after 6 hours (P = .39). Complete response rate was 88 and 90% in both group I and group II. Three patients in both group I and group II required rescue antiemetics. Ninety-two percent patients were completely satisfied in group I, while 96% patients were fully satisfied in group II. Conclusion: Intravenous administration of palonosetron (0.075 mg) is as effective as dexamethasone (4 mg) as prophylactic antiemetic without any untoward side effects for female patients undergoing laparoscopic cholecystectomy.

Aim: The present review aimed to describe the rate of different infections, the rate of bacterial resistance and antibiotics use in Al-kharj. Methodology: This was a narrative review that included searching Web of science for the keywords “infections” or “bacterial resistance” or “antibiotics use” and “Al-kharj” from 1st of January 2015 to 14th of October 2021. Results: Searching Web of science for the keywords resulted in 29 papers that was conducted during the study period and investigate the rate of different infections, the rate of bacterial resistance or the use of antibiotics in Al-kharj. So, 29 articles were included in the present review. Conclusion: Most of the studies about infections included only some types of infections and most of the conducted studies about the use of antibiotics focused only on the outpatient setting. More studies are needed to explore the rate of other infections and to describe the prescribing of antibiotics in other hospital settings.

TiN films with different thicknesses (17.9–102.8 nm) were prepared using rf magnetron sputtering to study the effect thickness on the plasmonic, electrical, and optical properties. X-ray diffraction revealed the amorphous-like structure for thinner films with thicknesses lower than 50.3 nm, whereas polycrystalline of face-centered cubic TiN structure was observed for thicker films. Scanning electron microscopy observations revealed rounded nano-crystallites morphology for TiN films. The EDAX depicted oxygen in the TiN films which attributed to the residual oxygen inside the sputtering chamber and to the partial surface oxidation resulted from the exposure to atmospheric air. As the thickness increased from 17.9 to 102.8 nm, the carrier concentration increases from 1.47 × 1022 to 3.51 × 1022 cm−3 and the carrier mobility increased from 0.091 to 0.489 cm2/V.s, which resulted in a resistivity decrease from 4.65 × 10–3 to 3.64 × 10–4 Ω cm. Two absorption bands around 250 and 1000 nm were observed. The band around 1000 nm was ascribed to the localized surface plasmon resonance (LSPR) and increased with increasing the film thickness. The optical band gap and refractive index values decreased monotonically with increasing the film thickness. It is also inferred that the thickness has a strong influence on the values of real and imaginary parts of the dielectric function. Applying various figures of merit indicated that the prepared TiN films are probably not practical for LSPR device fabrication however they are probably suitable for practical transformation optics and superlens device applications.

Background & aim Diabetic patients are susceptible for surgical site infections, periprosthetic infections, and increased hospital stay. Present study was aimed to determine the influence of HBA1c level on perioperative hemodynamic, recovery room stay and postoperative discharge times in patient undergoing total hip arthroplasty. Methods After institutional ethical clearance, this prospective, observational, study was conducted on 70 diabetic patients aged 18–65 years of either sex. Patients under study were enrolled into either group A ( Results Association of hypertension (p value 0.001), gm intake (p value 0.003), post-operative blood glucose levels (p value Conclusion Diabetic patients, not on insulin therapy, with no renal impairment, with ASA grading II-III, and with no other contraindication for spinal anaesthesia; 7.5% can be used as a new cut-off for level of HbA1c for total hip arthroplasty.

A technique is implemented for altering the multimodal resonance generated in an ultrathin silicon ring resonator-based terahertz (THz) absorber. The absorber provides the dual-band resonance with the excitation of magnetic and electric dipole in the lower and upper band, respectively. The field of magnetic and electric dipoles is altered using a non-resonant graphene ring placed in the center of the generated dipolar arrangement and the tunability and perfect absorption is achieved. A circuit model is prepared using transmission line method and absorber operation is verified. The proposed absorber can be utilized as a biosensor for the detection of malaria virus and glucose percentage in water. The sensor offers highest sensitivity as 0.29 and 0.27 THz per thickness unit change and quality factor as 117.53 and 245 in the lower and upper band, respectively during the sensing of analyte thickness. Also, it offers the sensitivity as 0.20 and 0.10 THz per refractive index unit change and quality factor as 105.28 and 211.84 in the lower and upper band, respectively during refractive index sensing. Moreover, the structure remains insensitive to polarization angle of the incident electromagnetic wave.

Stock markets worldwide have witnessed high volatility during the year 2020 owing to the eruption of Covid-19. Due to the world’s unprecedented economic challenges, this study could potentially guide financial advisors and individual investors in dealing with pandemics. An association between investors’ perception toward the intensity of Covid-19 and heuristic biases is analyzed using the responses of 290 stock investors of National Capital Region (NCR), India. The data are validated through Cronbach’s alpha, and the model fit is analyzed using EFA. Confirmatory factor analysis (CFA) is employed to investigate the relationship between Covid-19 and heuristic biases. Covid-19 does not have any influence on the overconfidence of investors. A significant positive relationship is found between Covid-19 and the remaining three heuristics, i.e., availability, anchoring, and representativeness. The present study analyzes the association between Covid-19 and specific investors’ bias only and should not be interpreted for causality. The study has the potential to guide investors in understanding the errors they are making while investing during the pandemic and the ways to deal with them. The study could provide insights to the financial advisors in understanding their customers. The implications of the study may include inputs of the errors committed by them during the pandemic. Despite the fact that an enormous amount of literature exists in the field of investors’ sentiment, a scarcity of literature is available that measures the relationship between heuristic biases and the perceived impact of the pandemic. The current study attempts to fill this gap in the literature.

This piece of research aims to explain the drivers of early-stage entrepreneurship in factor-driven economies and how these are affected by several cognitive factors. This study covers literature on several driving factors of entrepreneurial activity, trying to formulate a framework of determinants of early-stage agricultural entrepreneurial activity. For this purpose, the adult population survey (APS) data of factor-driven economies published by GEM has been used. The selected respondents (848) include those individuals who, alone or with other individuals, presently involved in venture creation, including any self-employment in the agricultural sector. The impact of cognitive and social capital factors on early-stage entrepreneurial activity is measured using logistic regression. The findings suggest that its opportunity perception and self-efficacy, which are the major motivators of early-stage entrepreneurship in developing nations. Also, there are gender biases and age-related negativity with respect to new agri-business creation in developing countries.

This study explores the potential of the Deep Learning (DL) approach to develop a model for basin-scale drought assessment using information from a set of primary hydrometeorological precursors, namely air temperature, surface pressure, wind speed, relative humidity, evaporation, soil moisture and geopotential height. The novelty of the study lies in extracting the information from the hydrometeorological precursors through the efficacy of the DL algorithm, based on a one-dimensional convolutional neural network. Drought-prone regions, from where our study basins are selected, often suffer from the vagaries of rainfall that leads to drought-like situations. It is established that the proposed DL-based model is able to capture the underlying complex relationship between rainfall and the set of aforementioned hydrometeorological variables and, subsequently, shows its promise for the basin-scale meteorological drought assessment as revealed through different performance metrics and skill scores. The accuracy of simulating the correct drought category, among the seven categories, is also high (>70%). Moreover, in general, the skill of any climate model is much higher for the primary meteorological variables as compared with other secondary or tertiary variables/phenomena, like droughts. Thus, the novelty of the proposed DL-based model also lies in the improved assessment of ensuing basin-scale meteorological droughts using the projected meteorological precursors and may lead to new research directions. HIGHLIGHTS This study explores the potential of Deep Learning (DL) approach to capture the hidden complex hydrometeorological association.; A DL-based model is developed for basin-scale drought assessment using the hidden complex relationship from a set of primary hydrometeorological precursors.; DL may be effective to use simulated primary hydrometeorological variables from climate models to assess more complex phenomena.

Although autoimmune lymphoproliferative syndrome (ALPS) is an unusual and fatal disorder to which no absolute cure stands, there also remains substantial diversity with majority of subjects exhibit...

The present study identifies the prevalence, pattern & geographical distribution of pregnancy loss and its various determinants. The choropleth equal interval maps and local indicators of spatial association maps were used to investigate the locations requiring attention. Spatial regression techniques were used to investigate the factors associated with pregnancy losses across India using data derived from the fourth round of National Family Health Survey. A decision tree was constructed to investigate the interaction effect of the significant factors.The percentage of pregnancy loss in India is noted to be 14.3% (95% BCa confidence interval: 13.47, 14.79). The spatial autocorrelation coefficient ( $$\rho = 0.61,~p < 0.001$$ ) indicated the spatial dependence in the data. Hotspots of response variable were observed in districts of Uttar Pradesh, Manipur, and Odisha. Locations, with high percentage of women who have attained education upto high school and above, women who did not want the pregnancy, and women whose family did not want more child, were likely to have increased percentage of pregnancy loss. Struggles in a womens life, family’s pressure and own desire to have child coupled with their education status are related to the pregnancy loss. Preventing the unplanned pregnancies will play a pivotal role in decreasing the pregnancy loss which further prevents maternal mortality and morbidity. Timely and adequate supplies of contraception in public health institutions particulary sub-centre, primary health centre should be ensured.

Nanotechnology has transformed the world with its diverse applications, ranging from industrial developments to impacting our daily lives. It has multiple applications throughout financial sectors and enables the development of facilitating scientific endeavors with extensive commercial potentials. Nanomaterials, especially the ones which have shown biomedical and other health-related properties, have added new dimensions to the field of nanotechnology. Recently, the use of bioresources in nanotechnology has gained significant attention from the scientific community due to its 100 % eco-friendly features, availability, and low costs. In this context, jute offers a considerable potential. Globally, its plant produces the second most common natural cellulose fibers and a large amount of jute sticks as a byproduct. The main chemical compositions of jute fibers and sticks, which have a trace amount of ash content, are cellulose, hemicellulose, and lignin. This makes jute as an ideal source of pure nanocellulose, nano-lignin, and nanocarbon preparation. It has also been used as a source in the evolution of nanomaterials used in various applications. In addition, hemicellulose and lignin, which are extractable from jute fibers and sticks, could be utilized as a reductant/stabilizer for preparing other nanomaterials. This review highlights the status and prospects of jute in nanotechnology. Different research areas in which jute can be applied, such as in nanocellulose preparation, as scaffolds for other nanomaterials, catalysis, carbon preparation, life sciences, coatings, polymers, energy storage, drug delivery, fertilizer delivery, electrochemistry, reductant, and stabilizer for synthesizing other nanomaterials, petroleum industry, paper industry, polymeric nanocomposites, sensors, coatings, and electronics, have been summarized in detail. We hope that these prospects will serve as a precursor of jute-based nanotechnology research in the future.

Background and objectives: Radiofrequency ablation (RFA) is a recent modality of treatment of the affected varicose vein. In the present study, the outcome of great saphenous varicose vein disease treated byradiofrequency ablation technique was analyzed. Methods: Patients with varicosities of the lower limb affecting mainly the great saphenous vein were (GSV) included. The procedures were carried out under spinal anesthesia. The target varicose vein was accessed by Seldinger technique and the RFA catheter advanced 2 to 3 cm below sapheno-femoral junction under ultrasonography (USG) guidance. A tumescent anesthetic infiltration was given in a solution of normal saline and sodium bicarbonate before the vein being ablated. Results: The success rate of RFA was 97.5 % (39 out of 40). One patient showed episodic recanalisation of vein at one year duplex colour scan. Though the complications related to procedure were negligible, one patient developed endovenous heat induced thrombosis (EHIT) and non-fatal pulmonary thromboembolism (PTE) which was managed adequately. Conclusion: Endovenous RFA is a useful treatment modality for varicose vein disease primarily due to great saphenous insufficiency with marked symptomatic improvement and least recurrence. Although the complications are minimal, EHIT is a potential and serious complication of heat ablation. IMC J Med Sci 2021; 15(1): 006 *Correspondence: Farooq Ahmad Gganie, Department of Cardiovascular and Thoracic Surgery, Sheri-I-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, Kashmir, India. Email ID: farooq.ganie@ymail.com

PurposeHalal supply chain management (HSCM) is an emerging research area and is in the early stage of evolution. This study aims to identify 11 critical factors towards effective management of a Halal supply chain (HSC) and provides a framework for the HSCM by evaluating Halal practices' impact on sustainability performance measures empirically.Design/methodology/approachA structured questionnaire-based survey has been carried out to collect data for analysis. The statistical analysis is accomplished by exploiting merits of factor analysis and structural equation modelling (SEM).FindingsThe results imply that out of 11 critical factors, nine factors on effective management of the HSC are statistically significant, and impacts of two critical factors are positive but statistically insignificant. In the structural model, the path coefficient of all success indicators are positive and statistically significant. In terms of the path coefficient of sustainable performance measures of HSC, all three dimensions, economic, environmental and social, are positive and statistically significant.Research limitations/implicationsThe research extends Halal and supply chain management's literature by proposing Halal as a standard quality control system, as it focuses on wholesome consumption. Effective management of the HSC is positively related to the firms' sustainable performance, thus helping managers make the organisation sustainable in the long term.Practical implicationsThe research extends the literature of Halal and supply chain management by proposing Halal as a standard quality control system, which focuses on wholesome consumption. Effective management of the HSC is positively related to the sustainable performance of the firms, thus helps managers in making the organisation sustainable in the long term.Originality/valueThe result of the study underlines that sustainable performance measures are embedded in HSCM. This research develops a new paradigm in the research of HSCM and sustainability.

Hematopoietic stem cell transplantation (HSCT), including bone marrow transplantation, is the treatment of choice for many hematologic diseases, including hematologic malignancies and different types of anemia. The use of HSCT is increasing annually, mainly because advanced research that has been conducted in this area has exponentially expanded the indications for HSCT and significantly improved transplantation techniques and supportive care practices. Collectively, these improvements have led to an increase in the overall survival of HSCT patients. However, as post-HSCT survival is increasing, awareness of the potential late complications of HSCT is also growing. Unpredictable bone loss is one of the major post-HSCT complications that can cause significant morbidity and impair the quality of life of survivors. Although the exact mechanism of post-HSCT bone loss is not yet known, previous studies have suggested that numerous factors, including destructive preparative regimens (eg, high-dose chemotherapy, total body irradiation), treatment-related complications (eg, graft-versus-host disease), endocrine abnormalities (eg, diabetes mellitus, thyroid dysfunction, adrenal insufficiency), lack of physical activity, and the underlying disease itself are responsible for HSCT-associated bone loss. Sufficient data have been collected to suggest that post-HSCT bone loss can be prevented and treated using the same preventive and treatment modalities as used for the general population. Various guidelines have been formulated to help keep a check on HSCT recipients' deteriorating bone health.

Evidence from real-world studies have suggested a reduced rate of macrovascular complications following bariatric surgery. We undertook this meta-analysis to investigate the impact of bariatric surgery on macrovascular disease outcomes in severely obese type 2 diabetes mellitus (T2DM) patients. An extensive literature search was performed in PubMed from inception until March 2020. All cohort studies assessing the association between bariatric surgery and macrovascular complications in severely obese T2DM patients were included. Two independent reviewers screened the articles, extracted data, and assessed the quality using the Newcastle-Ottawa Scale. The primary outcome was to assess the impact of bariatric surgery and the risk of macrovascular complications. Statistical analysis was performed using Review Manager 5.3. This meta-analysis comprised of five studies including 49,211 participants (75% female), of which 14,434 underwent bariatric surgery and 34,777 underwent usual care. Participants who underwent bariatric surgery had a significantly lower risk of macrovascular complications as compared to those with non-surgical interventions (RR: 0.50 [95% CI: 0.35–0.73], p = 0.0003). In the subgroup analysis, based on the geographical regions, studies conducted in the USA showed a higher reduction (RR: 0.41 [95% CI: 0.32–0.53], p

Some of the anti-tuberculosis (TB) drugs used for drug-resistant tuberculosis (DR-TB) are ototoxic and can result in hearing loss with extended use. Hearing loss can be present in individuals with ...

The race to decarbonize our energy systems has led to significant advancement in technologies for harvesting renewable energy, carbon capture and conversion. Future scenarios are being envisioned where CO2 is captured from air and converted to valuable fuels and chemicals, with methanol (MeOH) being the most coveted product. Here we assess transition pathways for the sustainable production of MeOH using CO2 via direct air capture (DAC) and hybrid power via renewable photovoltaic (PV) and grid electricity. Specifically, we perform techno-economic and life-cycle analysis on technologically mature 1st generation (water electrolysis coupled to CO2 hydrogenation) and emerging 2nd generation air-to-MeOH (direct CO2-to-MeOH electrolysis) routes. Our results indicate that the two transition pathways would be economically compelling only in jurisdictions where low-cost ($0.02 per kWh) grid electricity is available. Furthermore, the economic feasibility of the 1st generation route will also depend on a drastic reduction in Si-PV ($300 per kW) and DAC ($280 per ton-CO2 per year) capital costs. On the other hand, the 2nd generation route will additionally need drastic performance improvement to be economically competitive, with required CO2 electrolysis current densities >300 mA cm−2, energy efficiency >50% and stack stability >2 years. The envisioned air-to-MeOH routes could lead to zero or negative CO2 emissions in jurisdictions with clean grid electricity (

Despite significant accomplishments in developing efficient rapid sensing systems and nano-therapeutics of higher efficacy, the recent coronavirus disease (COVID-19) pandemic is not under control successfully because the severe acute respiratory syndrome virus (SARS-CoV-2, original and mutated) transmits easily from human to -human and causes life-threatening respiratory disorders. Thus, it has become crucial to avoid this transmission through precautions and keep premises hygienic using high-performance anti-viral nanomaterials to trap and eradicate SARS-CoV-2. Such an antiviral nano-system has successfully demonstrated useful significant contribution in COVID-19 pandemic/endemic management effectively. However, their projection with potential sustainable prospects still requires considerable attention and efforts. With this aim, the presented review highlights various severe life-threatening viral infections and the role of multi-functional anti-viral nanostructures with manipulative properties investigated as an efficient precative shielding agent against viral infection progression. The salient features of such various nanostructures, antiviral mechanisms, and high impact multi-dimensional roles are systematically discussed in this review. Additionally, the challenges associated with the projection of alternative approaches also support the demand and significance of this selected scientific topic. The outcomes of this review will certainly be useful to motivate scholars of various expertise who are planning future research in the field of investigating sustainable and affordable high-performance nano-systems of desired antiviral performance to manage not only COVID-19 infection but other targeted viral infections as well.

Background: Extracapsular cataract extraction (ECCE) with implantation of posterior chamber intraocular lens (PC IOL) is currently the surgery of choice for cataract, with the success rate of over 95%. Objectives: To earmark clinical superiority of either of the drugs given prophylactically in managing intraocular pressure spikes following Nd:YAG laser posterior capsulotomy. Method: The present study was conducted on 100 patients, who had developed posterior capsule opacification following successful cataract surgery with intraocular lens implantation and underwent Nd:YAG laser posterior capsulotomy in the Outpatient Department of Ophthalmology, RMCH. Results: In Apraclonidine group, pressure differences with control group were evident at 3 hours (ΔP3) & at 24 hours (ΔP24) that were highly statistically significant; (p=0.0078 & 0.0045 for ΔP3 & ΔP24 respectively). The same were not significantly different (p> 0.05) at 1 hour or day 7 following laser application. The Briminodine group demonstrated significant differences in pressure fluctuations compared with control group at all recorded times with maximum variation noted at 3 hours post capsulotomy (p=0.000015). Conclusion: It was concluded Both Apraclonidine & Briminodine are found useful drug interventions in laser therapy, but Briminodine clearly scores over former in dampening the IOP rise.

As the price of renewable electricity continues to plummet, hydrogen (H2) production via water electrolysis is gaining momentum globally as a route to decarbonize our energy systems. The requirement of high purity water for electrolysis as well as the widespread availability of seawater have led significant research efforts in developing direct seawater electrolysis technology for H2 production. In this Perspective, we critically assess the broad-brush arguments on the research and development (R&D) needs for direct seawater electrolysis from energy, cost and environmental aspects. We focus in particular on a process consisting of sea water reverse osmosis (SWRO) coupled to proton exchange membrane (PEM) electrolysis. Our analysis reveals there are limited economic and environmental incentives of pursuing R&D on today’s nascent direct seawater electrolysis technology. As commercial water electrolysis requires significant amount of energy compared to SWRO, the capital and operating costs of SWRO are found to be negligible. This leads to an insignificant increase in levelized cost of H2 (2) and CO2 emissions (

EDM is an electrical discharge machining, used in machining of those constituents which are not machined by traditional machining process. This machining method is more advanced than conventional. In this experimental study, cylindrical copper material is used as an electrode, and die-steel is used as workpiece material. In this empirical work, results were found for the erosion of copper electrodes concerning to die steel workpiece material at various current and constant depth of machining by varying time-on and time-off parameters. In this work input parameters are current, voltage, T-on, and T-off, and output parameters are erosion of electrode material in terms of weight (grams) and length (mm). The eroded metal on the surface of both workpieces and the electrode is flush out by the dielectric fluid. This study mainly concentrates on the copper electrode and output parameters such as rate of wear of the electrode. Electrode wear rate have increased with an increase in pulse on time. More wear is occurred due to increasing of duration of sparking time. The production of the high rate of material removal is increased by pulse on time (T-on).

As renewable electricity prices continue to decline, interest grows in alternative routes for the synthesis of sustainable fuels and chemicals, including ammonia. Considering demand for fertilizers, as well as its future potential as a dispatchable energy vector, sustainable synthesis of ammonia is being explored as an alternative to the capital- and carbon-intensive fossil-fuel-driven Haber–Bosch process. Here we assess stages along a transition to the sustainable synthesis of ammonia, looking at economic feasibility and climate impacts compared to the incumbent Haber–Bosch without and with CO2 capture. This analysis enables us to suggest technological thresholds for sustainable synthesis of ammonia to become economically and environmentally favourable. When driven by renewable energy sources, the water electrolyzer (near $400 per kW) coupled Haber–Bosch process will reach cost parity near 2.5 cents per kWh electricity. In the case of direct electrochemical ammonia synthesis, achieving cost-parity using the same 2.5 cents per kWh electricity will rely on achieving major advances in performance: an electrolysis full-cell energy efficiency exceeding 40% at a current density of 0.5 A cm−2. Once this operating performance is reached, electrically-powered ammonia synthesis will bring climate benefits when coupled with low-carbon electricity (

In recent years, increasing demand for biodegradable lubricants has been observed in precision machining owing to ISO 14000, which draws more attention toward the operator’s health and environmenta...

Background: Stroke is one of the causes of death and disability globally. Brain attack is because of the acute presentation of stroke, which highlights the requirement for decisive action to treat it. Objective: The mechanism and in-vivo experimental models of stroke with various neuroprotective agents are highlighted in this review. Method: The damaging mechanisms may proceed by rapid, nonspecific cell lysis (necrosis) or by the active form of cell death (apoptosis or necroptosis), depending upon the duration and severity and of the ischemic insult. Results: Identification of injury mediators and pathways in a variety of experimental animal models of global cerebral ischemia has directed to explore the target-specific cytoprotective strategies, which are critical to clinical brain injury outcomes. Conclusion: The injury mechanism, available encouraging medicaments thereof, and outcomes of natural and modern medicines for ischemia have been summarized. In spite of available therapeutic agents (thrombolytics, calcium channel blockers, NMDA receptor antagonists and antioxidants), there is a need for an ideal drug for strokes.

Laparotomy is one of the most common surgical procedures done by a surgeon. It is performed both as elective and an emergency procedure. Laparotomy procedures are prone to post-operative complications such as pain, fever, wound infection, wound dehiscence, incisional hernia, etc. The rate of these complications depends on preoperative antibiotic prophylaxis, skin antisepsis, control of contamination and surgical skills. SSI is the most common health-care-associated infection and is a cause of one-third of post-operative deaths. A prudent antibiotic prophylaxis and post-operative antibiotic management should be done. For successful management knowledge is necessary regarding the possible pathogens and their antibiotic resistance patterns. The aim of the study is to find out the incidence of SSI in elective laparotomies and to find out the type of pathogenic organism causing wound infection. This prospective observational study was conducted on 180 patients who had undergone elective laparotomy after taking an informed consent.Asterile swab for culture and sensitivity was taken Pre-operatively from incision site and sent to laboratory for assessment with normal culture technique. Repeat swabs for culture and sensitivity was done for patients with post-operative wound infection. Patients were followed up for 1 month. Out of 180 cases incidence of the SSI was seen in 17 cases of elective laparotomy (9.4%). Out of 17 SSI swab specimens 2 (11.8%) were Gram positive involving CONS pathogen, 13 (64.7%) were Gram negative involving E. coli, K.pneumoniae and Pseudomonas (41.2%, 29.4%, 5.9%) while no growth was observed in 11.8% specimens. SSIs were unaffected by demographic or operative variables. Surgical site infections were instrumental in prolonging the duration of hospital stay. Tigecycline and colistin were found to be 100 % sensitive for all the pathogens.

To compare the outcome of patients undergoing conservative management versus ultrasound guided aspiration of small amoebic liver abscess (=

With the increase in the labour supply and the labour market imbalances globally, a notable increase is witnessed in the number of temporary employments as well as flexible arrangement in employment. This new development coupled with technological advancement create opportunity for flexible work through digital platforms, and the emergence of a new term in employment – the “gig” employment. Examples of gig workers are ‘independent contractors’, ‘consultants’, or ‘contract professor’, which are working only to complete a task for specific time and specific payment, with no work connection with their hiring institution once the contract ends. In the meantime, digitalisation has created more opportunities for individuals to engage in gig employment for income generation. The rise of the gig workers calls for new initiatives in human resource development policy as they continue to play important roles in employment creation, production and income generation. From this study, a total of 218 occupations were identified as gig works which offered flexible working hours, flexible workplace and with or without digital presence. This study attempts to measure the gig workers in Malaysia using Labour Force Survey to gauge sociodemographic profiles of this new group of employment.

Background: Hair coloring, or hair coloring, is the follow of fixing the hair color. The most reasons for this area unit cosmetic: to hide gray or white hair, to alter to a color thought to be additional modern or fascinating, or to revive the initial hair color once, it's been stained by hairdressing process or sun bleaching. Hair coloring is often done professionally by a stylist or severally reception. Celtic folks colored their hair blonde; they bleach it by laundry them in lime and brushing it back from their foreheads. The coloring of hair is associate ancient art that involves treatment of the hair with varied chemical compounds. In history, the dyes were obtained from plants. The event of artificial dyes for hair is derived from the legendary discovery of the reactivity of para-phenylenediamine (PPD) with air. Results: Hair dyes are cosmetic compounds that make contact with the skin throughout application. As a result of this skin contact, there exists some health risk related to use of hair dyes. People allergic to protein as an example, can have to be compelled to take care once buying hair color since bound dye includes protein. Protein doesn't have to be compelled to be eaten for it to cause associate hypersensitivity reaction. Skin contact with protein might cause a reaction; thus, resulting in associate hypersensitivity reaction. Symptoms of those reactions will embody redness, sores, itching, burning sensation, and discomfort. Symptoms can typically not be apparent instantly following the appliance and process of the tint, however may arise once hours or maybe daily later. Conclusion: Pigments of the hair got colored by the tactic of removing, replacing, or covering up. Employment of those chemicals may cause varied adverse effects, at the facet of temporary skin irritation and hypersensitivity, hair breakage, skin discoloration, and explosive hair color results. The ultimate color of every strand of hair can depend upon its original color and body. As a result of hair's color and body across the pinnacle and on the length of a hair strand, there'll be delicate variations in shade across the complete head. This provides an additional natural-looking result than the solid, everywhere color of a permanent color. Thus, hair dyes area unit regulated within the industrial marketplace and, as new toxicity knowledge is generated for a few hair dye, and health risks area unit discovered, in a controlled people, employment of hair coloring may end up in aversions and/or skin irritation.

The research was supported by the project of the National First-class Disciplines (PNFD) and the Priority Academic Program Development (PAPD) of Jiangsu Higher Education Institutions. This research is also undertaken thanks to funding from the Canada First Research Excellence Fund (CFREF).

Background: The oral cavity is a mirror of the body, entry point to food, antigens, and microorganisms. Oral cavity with mastication and speech, also have a role play in immunological defense. The Oral mucous membrane is in link with skin, oropharynx, and nasopharynx. The oral cavity and anterior two-thirds of the tongue are formed by the ectoderm and that is why from a dermatologist's viewpoint, an oral opening is especially imperative and involved in a range of systemic and skin disease, also affect teeth and gums. The body's natural protection is in good quality oral care. Oral problems when associated with skin conditions require oral care as it affects the quality of life and enable dermatologist and dentist in the identification and diagnosing of systemic disease. Oral illness can bring into being from infection, inflammation or neoplastic, immunological, benign, or malignant. Results: The oral cavity is a mirror to a variety of systemic and cutaneous diseases. Interpretation of the symptom and signs of systemic diseases help early diagnosis. However, while not correct oral hygiene, microorganisms will reach levels that may result in oral infections and decay. The health status of our oral cavity can give us a strong signal of the health of our bodies. It proceeds as a premature warning system. That's why the oral cavity should be examined in one piece from the buccal mucosa to the oropharynx. Conclusion: The mouth is a straightforwardly available window of the body. In contemplation with development, composition, and utility oral cavity is only one of its kind. It is a two-way road as systemic skin disease has oral manifestation. Interpretation of the symptom and signs help in identification and early diagnosis of systemic diseases. Oral illness can bring into being from infection, inflammation or neoplastic, immunological, benign, or malignant. That's why the oral cavity should be examined in one piece from buccal mucosa, lips, tongue, gum, teeth, palate to the oropharynx. Knowledge of systemic diseases is vital in day to day clinical practice, often oral manifestation is the most significant or first sign of systemic illness. So dermatologists and dental surgeons are conscious of oral complaints and their association with systemic disease.

Background: A drug-drug interaction arises when the pharmacologic effect of a medication is changed by the action of other medication causing unexpected clinical effects. Drug-drug interactions are widely known but the identification of the consequences of food and drug interactions has been growing slowly. Aim: The present study aims to describe the occurrence of drug –food and drug-drug interactions in the outpatient settings in Riyadh city. Methodology: A retrospective study was piloted in Riyadh city. The prescriptions were reviewed to identify potential drug - food and drug–drug interactions using Drug Interactions Checker. Results: About 16.16% of the prescriptions included a drug - drug interaction. The most frequent interaction was the interaction between ciprofloxacin and metronidazole (25.00%) that is a minor interaction. Regarding drug – food interactions there were 40 interactions, the majority of these interactions were moderate. The most common drug - food interactions were metronidazole with food (20.00%) that is a major interaction. Conclusion: Drug interactions with other drugs or with foods are common. These interactions could have a beneficial or a harmful effect. Physicians and pharmacists should use programs that detects the drug interactions.

Background Ambulance Services are vital in providing pre-hospital treatment and care to help regain life. Timely and safe transport of patients from the emergency scene to the appropriate healthcare facility for further care is a complex process. Administering emergency services in minimal time is a challenge in a country with basic lacunae in infrastructure", making the role of EMTs (emergency medical technicians) and ambulance quality vital in saving lives. Methods A descriptive cross-sectional study using a structured questionnaire for the emergency medical technicians and ten parameters to inspect the quality of ambulances was used. Emergency medical technicians in 150 ambulances were interviewed and ambulance was inspected through convenience sampling. Chi-squared test was applied to investigate the association between quality of ambulance & emergency medical technicians' knowledge. Logistic regression was used to obtain the measure of association adjusted for confounders. SPSS (Statistical Package for Social Sciences) version 25, (Licensed software of IIHMR University, Jaipur) was used for analysis. Results Majority of the ambulances 68% (n = 102) were found to have met the standards. Almost 71% (n = 107) of the EMTs were observed to have below average knowledge. Among ambulances not meeting the standards, 66.7% (n = 101) had EMT with below average knowledge. Ambulance quality was found to be independent of the knowledge of EMTs after adjusting for the effects of years of experience and age of the EMTs. Conclusion Majority of the ambulances were found to have met the standards however public health workers should work towards improving the emergency medical technicians' knowledge on transportation of emergency cases.

Cancer and autoimmune diseases are the two devastating conditions that together constitute a leading health problem worldwide. The rising burden of these disorders in the developing world demands a multifaceted approach to address the challenges it poses. Understanding the root causes and specific molecular mechanisms by which the progression of the diseases takes place is need of the hour. A strong inflammatory background and common developmental pathways, such as activation of immune cells, proliferation, increased cell survival and migration which are controlled by growth factors and inflammatory cytokines have been considered as the critical culprits in the progression and complications of these disorders. Enzymes are the potential immune modulators which regulate various inflammatory events and can break the circulating immune complexes via macrophages production. In the current manuscript, we have uncovered the possible role of proteolytic enzymes in the pathogenesis and progression of cancer and autoimmune diseases. In the light of the available scientific literature, we advocate in-depth comprehensive studies which will shed light towards the role of proteolytic enzymes in the modulation of inflammatory responses in cancer and autoimmune diseases together.

Background: Frenum that encroaches on the margin of the gingiva may interfere with plaque removal and can lead to gingival recession and midline diastema. Thus, to maintain proper oral hygiene and prevent gingival recession, frenectomy is done. Frenectomy can be accomplished by conventional frenectomy technique, which has certain disadvantages. To overcome those drawbacks, paralleling technique of frenectomy has been introduced. Both the techniques can be performed by using various treatment modalities. Aim: The purpose of this clinical study was to compare the bleeding during surgery, post-operative wound healing and patient's perception towards the conventional frenectomy technique with scalpel, paralleling frenectomy technique with scalpel and paralleling technique with electrocautery. Materials and method: A total of 30 subjects with gingival or papillary frenal attachment were selected and equally divided into three groups. Group 1 was treated by conventional technique with scalpel, Group 2 by paralleling technique with scalpel and Group 3 by paralleling technique with electrocautery. Various parameters such as bleeding during surgery, patient's perception towards the various techniques and post-operative wound healing were evaluated. Results: The results showed that bleeding during surgery was minimum in group 3 as compared to other two groups. Patient's perception towards paralleling technique with scalpel, was found better than the other groups. At 7th day, though there was a difference in the healing but at 21st day wound healing was almost similar in all the three groups. Conclusion: Based on our findings and clinical outcome, paralleling technique with scalpel provided better patient's perception and an efficient and satisfactory option for frenectomy.