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Background: The prevalence and the pattern of birth defects help in devising strategies to reduce the burden of preventable birth defects. The study aimed to find out the pattern of various congenital anomalies in babies born at ESICMC & PGIMSR Hospital, Bangalore and to identify the associated risk factors, if any. Material and Methods: This hospital-based observational study was conducted in the Department of OBG during the period from 2016 to 2019. The data were collected from records and history taken from the antenatal patients with diagnosis of congenital abnormalities delivering at ESICMC & PGIMSR Hospital, Bangalore. Babies born were also assessed for congenital anomalies. Details of maternal age, parity, consanguinity, occupation, and maternal complications like diabetes were collected. The nature and severity of congenital abnormalities were recorded. Results: Out of total 11,469 deliveries in the study period, 77 babies were born with congenital anomalies (Prevalence 0.67%). The most common congenital anomalies involved the craniospinal system (53.2%), followed by the musculoskeletal system (19.5%). Multiple anomalies were present in 14.3% children. Anencephaly was the most common CNS anomaly. A history of abortions was present in 26% of women carrying anomalous fetuses. Majority of the anomalies were detected within 24 weeks of gestation (54.5%). A past h/o anomalous fetus or intrauterine fetal demise was present in 7% women. Conclusions: Our study observed that previous h/o abortions, history of consanguineous marriage, diabetes mellitus, and previous h/o anomalous fetus/IUD are prevalent among the women with anomalous babies in the study setting. Awareness to a large extent needs to be generated regarding the role of consanguinity as a risk factor for congenital anomalies. The importance of folic acid intake and early diagnosis and management of diabetes also needs to be emphasized. Prenatal diagnosis may be recommended to detect malformations early and plan management accordingly.

Abstract Solar energy, a prominent renewable source, has reached an installed capacity of 71.78 GW in India. This research explored the load demands of the computer center at an engineering college in Tanjore, Tamil Nadu, India. The computer center at the engineering college has an annual energy requirement of 260,552 kWh/Year. Consequently, the research focused on the planning and implementation of a standalone photovoltaic (SAPV) system, assessing it against the institution's total annual energy consumption. The performance ratio and losses of the SAPV system with both direct coupling and an MPPT charge controller was compared. This comparative analysis aimed to evaluate the efficacy of two solar photovoltaic control methods—SAPV direct coupling and Maximum Power Point Tracking control—in optimizing energy harvesting from solar panels.

Aims: Diabetes mellitus (DM) is associated with dry mouth, reduced saliva, taste changes, and periodontal disease. This study aimed to evaluate and determine the correlation between oral health status and glycaemic control levels in patients with type 2 DM (T2DM). Methods: This cross-sectional study was conducted on patients with T2DM aged 35-65 years. Glycemic control levels were categorized as good control (≤7% of HbA1c) and poor control (>7% of HbA1c). Full mouth plaque score (FMPS), full mouth bleeding score (FMBS), probing depth (PD), and clinical attachment level (CAL) were determined, along with xerostomia (using a standard questionnaire) and hyposalivation (using modified Schirmer test, MST). Results: This study included 70 individuals with T2DM, comprising 49 males (70%) and 21 females (30%) with a mean age of 55.36±8.3 and 49.36±6.8 years, respectively. Among those with poor glycemic control, a significantly higher prevalence of xerostomia (52.2%), hyposalivation (47.8%), and periodontitis (moderate; 47.8% and severe; 21.7%) was observed compared with those with good control (p=0.027, 0.001, 0.007, respectively). HbA1c exhibited a significant moderate positive correlation with FMPS (r=0.447; p=0.001) and a low correlation with FMBS (r=0.283; p=0.018) and CAL (r=0.301; p=0.011). Conclusions: The study concluded that individuals with poor glycemic control for T2DM have a higher incidence of xerostomia, hyposalivation, and compromised periodontal health, resulting in a decline in their oral health status.

Public health surveillance is described as the ongoing systematic collection, analyzing, and interpreting of the data, closely integrated with the transmission of these data to public health practitioners, doctors, and policymakers responsible to prevent and manage disease as well as injury. Both developed and developing nations are becoming aware of the significance of information from efficient surveillance systems for allocating resources and evaluating programs. Over the past few decades, there was a significant change in oral health profiles around the world. Indicators of oral health have improved in many countries, but not in India. An organized system for providing, monitoring, and evaluating oral health care services is needed in India. Draft National oral health policy 2021 has mentioned specific objectives: (a) by 2025, establish baseline data on the burden of oral diseases in the nation, (b) by 2030, the mortality and morbidity from dental and oro-facial diseases reduce to 15%, (c) By 2025, community-based awareness initiatives and practices for oral health will be covered by the healthcare system by a factor of 50%, and by 2030, by a factor of 70%, (d) the creation of an electronic database at district-level on components of the health system by 2025. A well-defined oral health surveillance system in India will serve the purposes (a) to provide standardized recording procedures, standards, and techniques to collect, analyze and interpret the oral health data at the state and central levels (b) to prioritize oral diseases or conditions that will be the focus of oral health surveillance or disease elimination, (c) to digitally monitor and evaluate the progress of nation’s oral health care programs.

Abstract The global crisis of the COVID-19 pandemic has highlighted the need for mathematical models to inform public health strategies. The present study introduces a novel six-compartment epidemiological model that uniquely incorporates a higher isolation rate for unreported symptomatic cases of COVID-19 compared to reported cases, aiming to enhance prediction accuracy and address the challenge of initial underreporting. Additionally, we employ optimal control theory to assess the cost-effectiveness of interventions and adapt these strategies to specific epidemiological scenarios, such as varying transmission rates and the presence of asymptomatic carriers. By applying this model to COVID-19 data from India (30 January 2020 to 24 November 2020), chosen to capture the initial outbreak and subsequent waves, we calculate a basic reproduction number of 2.147, indicating the high transmissibility of the virus during this period in India. A sensitivity analysis reveals the critical impact of detection rates and isolation measures on disease progression, showing the robustness of our model in estimating the basic reproduction number. Through optimal control simulations, we demonstrate that increasing isolation rates for unreported cases and enhancing detection reduces the spread of COVID-19. Furthermore, our cost-effectiveness analysis establishes that a combined strategy of isolation and treatment is both more effective and economically viable. This research offers novel insights into the efficacy of non-pharmaceutical interventions, providing a tool for strategizing public health interventions and advancing our understanding of infectious disease dynamics.

Introduction: Leptospirosis is an acute treponemal infection with high mortality and morbidity. Due to varied presentations in different geographical areas and unexpected seasonal patterns, clinical diagnosis is difficult. The present study aims to analyze the varied clinical presentations and epidemiological factors in correlation with laboratory diagnosis. Materials and Methods: A retrospective study was conducted among the clinically suspected cases of leptospirosis at R. L. Jalappa Hospital, Kolar, from January 2023 to December 2023. A total of 750 blood samples were tested for IgM ELISA leptospira test. All patient samples that tested positive for IgM antibodies were considered seropositive for Leptospira. The clinical history, laboratory parameters, management, course, and outcome of these patients were recorded. Results: The majority of the affected population were in the 41-60 year age group. Males were more affected than females. Due to unexpected rains, cases peaked in March. Thrombocytopenia was observed in 32 patients (34%), hyperbilirubinemia in 28 patients (30%), raised transaminases in 27 patients (29%), followed by low hemoglobin levels in 27 patients (28%). Severe acute respiratory illness (SARI) was the most common complication, seen in 24 patients (26%), followed by renal failure in 11 patients (12%). Conclusion: The morbidity and mortality due to leptospirosis can be reduced by better understanding environmental factors, by early detection through rapid tests, and predicting the severity of illness using laboratory parameters.

Background: Substance use disorders have profound implications for individuals, their families, and society as a whole. At present, drug trafficking and addiction have ensnared every corner of the globe, impacting millions of individuals worldwide. This pressing issue of drug abuse is concerning due to the underlying conditions fueling it, including shifting cultural values, increasing economic stress, and weakened social support networks. Aims and Objectives: This study aimed to identify the trends in drug abuse and its influencing factors among patients undergoing treatment for addiction in rehabilitation centers in Telangana. Materials and Methods: The study, a descriptive cross-sectional analysis, involved 222 individuals grappling with drug addiction at the primary rehabilitation center for drug addiction treatment in Telangana. Information was gathered using a pre-tested, structured questionnaire between September and December 2022 under the Department of Pharmacology. Results: Among the respondents, 95% were male and 5% were female, with a majority falling in the 21–30 age brackets. The religious breakdown comprised 151 Hindus, 32 Muslims, and 30 Christians, while 41% hailed from tribal regions. Injection emerged as the most prevalent method of substance abuse among 194 participants. The onset of drug abuse mostly occurred between ages 11 and 20, primarily driven by self or peer pressure. Notably, 89% of participants reported being compelled to consume substances. Conclusion: The study found a significant correlation between male gender and drug consumption (P

Abstract Background Tuberculosis remains a major challenge in India, with an estimated 2.69 million cases each year. Although men are more affected than women, gender differences and related factors affect awareness of tuberculosis and thus impact tuberculosis diagnosis and access to treatment. Understanding the gender-specific needs and complexities when diagnosing and treating tuberculosis is essential to manage cases in India. Methods We undertook a comparative study using data from three National Family and Health Surveys (NFHS), specifically NFHS-3, NFHS-4 and NFHS-5. We investigated the prevalence and gender disparity in awareness about tuberculosis, and associated factors, using regression analysis. Results Most men and women surveyed are between the ages of 15 and 19. Across the surveys, the proportion of men and women who are unaware of spreading of tuberculosis decreases from 44.9% during NFHS 3 to 29.6% during NFHS 5. However, the prevalence ratio of men to women with no knowledge about modes of transmission of Tuberculosis increases from 0.92 during NFHS 3 to 0.98 during NFHS 5. Higher odds with younger age (NFHS 5, aOR: 1.07 (1.01–1.13)) and rural residency (NFHS 5, aOR: 1.12 (1.06–1.18)), and lower odds with unmarried marital status (NFHS 5, aOR: 0.92 (0.86–0.98)) are noteworthy associations. Women and men have differences in knowledge. Conclusions Gender disparity associated with awareness about tuberculosis in India is observed across all three nationwide surveys. Being aged fifteen to nineteen years and residing in rural area are risk factors. Being unmarried is a protective factor for women, but not for men.

Background: ESKAPE “(Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter sp.)” pathogens are commonly found in infections affecting the skin and underlying tissues. ESKAPE pathogens often exhibit widespread multidrug resistance in hospitals, contributing significantly to Hospital-acquired infections. ESKAPE pathogen prevalence can combat the vast challenge of Antibiotic Resistance (ABR). Materials and Methods: “The microbiological statistics of ESKAPE infections and sensitivity between January 2020 and October 2022 were extracted from the laboratory records and analysed for the bacterial profile and antibiotic sensitivity pattern”. Results: Out of the 2037 pathogens isolated from Skin and soft tissue infection, 1308 were ESKAPE pathogens accounting for a prevalence of 64.2%. Staphylococcus aureus (n=340/1308; 25.99%) was the predominant pathogen followed by Pseudomonas aeruginosa (n=332/1308; 25.38%). Among Gram-negative isolates, 29.43% exhibited multidrug resistance (MDR). Carbapenemase was found to be a frequent mechanism of resistance, highest among Acinetobacter species (n=99; 64.7%), followed by Klebsiella pneumoniae (n=109; 37.07%). Amp C production was seen most commonly in Enterobacter species (n=93; 61.2%), followed by Klebsiella pneumoniae (n=172; 58.5%) whereas ESBL production was seen in Enterobacter species (n=46; 30.03%). Conclusion: ESKAPE pathogens are critical etiologic agents of Skin and soft infections. Regular studies are vital for evaluating bacterial susceptibility and highlighting the importance of policies to reduce hospital infections and enhance antibiotic prescription oversight. Understanding virulence and resistance markers is critical for tailoring treatment strategies based on local antibiograms and managing related infections.

COVID-19 is an infectious disease that is caused by SARS-CoV-2 which affects the respiratory framework of the body and continues to devastate the world's health as well as economy. This disease is said to adversely affect the nutritional status of the people. Healthy eating habits as well as lifestyle changes are essential to protect us from this virus. Now, there is a gradual increase in researches and nutritional recommendations on immunity boosting diets for COVID-19. However, there is still no such food pyramid has been specifically designed for COVID-19 period. Therefore, this study aimed to develop a COVID-19 specific food pyramid to illustrate the foods to be consumed on daily basis by a person to maintain health during this pandemic. Such visual representation of the nutritional guideline will help common people also to easily understand and adapt it to their day to day healthy eating behavior.

Introduction: Tuberculosis is one of the major health problems in developing countries like India. Among various types of presentations of extrapulmonary tuberculosis, lymphadenitis is the most common presentation. Aim: "To evaluate the efficacy of Modified bleach concentration method in detection of Acid Fast Bacilli (AFB) over conventional Ziehl-Neelsen (ZN) staining" Objectives: To apply modified bleach concentration method in detecting AFB and to evaluate its sensitivity over conventional ZN method in association with the CBNAAT for the diagnosis of TB lymphadenopathy. Material and methods: A cross-sectional and observational study carried out for a period of six months. 146 cases of suspected clinical TB with lymphadenopathy referred for FNAC. Aspirates by FNAC were processed for direct microscopy using conventional ZN staining and routine cytology and compared with the findings of the modified bleach method, remaining material was subjected to CBNAAT assay. Results: Among 146 cases, 44 cases were positive for AFB stain on conventional ZN staining and 49 cases by modified bleach method were positive for AFB. Sensitivity (98%), Specificity (98%), Positive predictive value (96%), Negative predictive value (99%) were calculated for modified bleach method in comparison with CBNAAT.

Background: ChatGPT holds promise in oral health education, provided valid concerns are proactively examined and addressed. Hence, this study was conducted to evaluate ChatGPT responses to patients’ most common queries about their oral health. Methods: A cross-sectional study was conducted to gather a dataset of oral health-related queries from patients attending a dental institution. The dataset was preprocessed and formatted to remove any irrelevant or duplicate queries. Then, we supplied the dataset to ChatGPT to generate responses. We asked two dental public health experts to independently review the ChatGPT responses for clarity, accuracy, relevance, comprehensiveness, consistency, acceptance, and bias using a 5-point Likert scale. The intraclass correlation coefficient (ICC) was used to evaluate interrater reliability. Scores were summarized using descriptive statistics. Results: A total of 563 oral health-related queries were gathered from 120 patients. After removing the irrelevant or duplicate queries, 105 were included in the final dataset. The ICC value of 0.878 (95% confidence interval range from 0.841 to 0.910) showed good reliability between the reviewers. The majority of ChatGPT responses had a clear understanding (95.24%), were scientifically accurate and relevant to the query (87.62%), were comprehensive (83.81%), were consistent (84.76%), and were acceptable without any edits (86.67%). The reviewers strongly agreed that only 40.96% of the responses had no bias. The overall score was high with a mean value of 4.72 ± 0.30. The qualitative analysis of comments on ChatGPT responses revealed that the responses were rather long and more comprehensive. Conclusions: ChatGPT generated clear, scientifically accurate and relevant, comprehensive, and consistent responses to diverse oral health-related queries despite some significant limitations.

Background: Statins are widely prescribed for the management of hyperlipidemia and the prevention of cardiovascular diseases. Atorvastatin and rosuvastatin are among the most commonly used statins, with varying impacts on lipid profiles, side effect profiles, patient adherence, and health-care costs. Understanding these differences within specific populations can inform more tailored and cost-effective treatment strategies. Aims and Objectives: This study aimed to evaluate the differences in side effect management, patient outcomes, and health-care costs between atorvastatin and rosuvastatin therapies in a cohort from Coimbatore, Tamil Nadu, India. Materials and Methods: An observational study was conducted with 100 patients at the Karpagam Faculty of Medical Sciences and Research, evenly split between atorvastatin (n=50) and rosuvastatin (n=50) groups. Data on demographic characteristics, side effects, low-density lipoprotein (LDL) cholesterol reduction, medication adherence, and health-care costs were collected and analyzed. Results: The cohort had an average age of 62 years, with a higher prevalence of males (57%). Socioeconomic analysis showed 30% from low-income, 50% from middle-income, and 20% from high-income backgrounds. Side effects were more common in the atorvastatin group (35%) compared to the rosuvastatin group (28%), with muscle pain and gastrointestinal issues being predominant. Rosuvastatin treatment resulted in higher adherence rates (90%) and more significant LDL cholesterol reduction but incurred higher annual health-care costs (INR 28,000) versus atorvastatin (INR 25,000) (P=0.04). Conclusion: Both statins effectively reduced LDL cholesterol; however, rosuvastatin demonstrated higher patient adherence but at an increased cost. These findings underscore the need for individualized statin therapy that considers both clinical outcomes and economic constraints, particularly in settings with limited health-care resources.

Abstract The beet armyworm, Spodoptera exigua (Hubner) (Lepidoptera: Noctuidae), has become a significant pest of chickpea in recent years. The polyphagous nature allows it to survive on various hosts during the off-season, creating a great menace to the crop in the following season. To assess the incidence and document the alternate hosts of S. exigua, a rapid roving survey was conducted in 11 chickpea-growing areas of Prakasam district, Andhra Pradesh, India. Additionally, the life history traits of S. exigua were studied on major alternate host plants under laboratory conditions (27 ± 1 °C and 70 ± 2% RH) to understand the survival, life expectancy and potential contribution to future populations. The results show that, among the different crops surveyed, the maximum larval incidence was noticed in maize (1.93 larvae/plant), cowpea (1.73 larvae/plant), and sunflower (1.68 larvae/plant) during the off-season. Life history studies of S. exigua showed that highest larval survival percentage was observed on chickpea (83.6%), while the lowest was on maize (44.5%). The mean developmental time for larvae was longest on maize (27.1 days) and shortest on chickpea (14.9 days). Larvae did not develop beyond the third instar when fed with chilli. The growth index statistics showed chickpea (9.2) was the most suitable host plant, whereas maize (0.9) was the least suitable host. The age-stage-specific survival rate (Sxj) varied across developmental stages, and the survival curves overlapped, indicating different growth rates among individuals. The life expectancy (exj) at age zero was highest on groundnut (37.06 days). The intrinsic rate of increase (r) of S. exigua was lowest on maize (0.10 ± 0.0013) and highest on chickpea (0.22 ± 0.0010). Similarly, the net reproductive rate (R0) was highest on chickpea (846.39 ± 18.22) and lowest on maize (59.50 ± 2.06). The population doubled every 3.08 ± 0.011 days on chickpea compared to 7.22 ± 0.80 days on maize. The study conclusively indicates that chickpea and sunflower, primarily cultivated during the rabi season in India, are the most preferred hosts for S. exigua. In contrast, maize and cotton, mainly grown during the kharif season, are less preferred and merely support the pest's survival. Consequently, S. exigua switches hosts between different crops growing seasons, so effective management of S. exigua during the kharif season can help prevent pest outbreaks during the rabi season.

An isolated fallopian tube torsion is a rare, often difficult to diagnose, but significant cause of acute lower abdominal pain in women of the reproductive age group. It is rare in the perimenopausal age group. We are presenting a literature review and the case of a 47 years old woman who presented with a sudden onset of acute lower abdominal pain . Her clinical examination revealed an 8x8 cm, tender, cystic mass in the left lower quadrant, with positive cervical movement tenderness. MRI revealed a gross hydrosalpinx with a small left ovarian cyst. With a diagnosis of left adnexal torsion, an emergency laparotomy was performed, which revealed an isolated left fallopian tube torsion which necessitated a left salpingo-oophorectomy. A tubal torsion should be suspected in females with acute lower abdominal pain, of any age group, especially in those with predisposing factors like pelvic infections, tumours and surgeries which include tubal ligation. Laparoscopy is the preferred modality for the diagnosis and treatment of a tubal torsion.

In recent years, a multitude of studies have been conducted to investigate the assessment of quality of life (QoL) among individuals affected by thalassemia. This scoping review aimed to examine the existing knowledge regarding the QoL and its associated factors among individuals with thalassemia in India. Databases, such as PubMed, SCOPUS, Web of Science, and the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines, were searched. A total of nine articles were included in the review. The included studies mainly investigated children. The Pediatric Quality of Life Inventory (PedsQL) is the most common instrument used most often. Overall, the research findings indicate that individuals who underwent blood transfusion exhibited a lower QoL than those who did not receive blood transfusion. Additionally, it was observed that children diagnosed with thalassemia reported a lower QoL than adults. Nevertheless, the studies exhibited notable methodological deficiencies that constrained the validity and generalizability of the results. Hence, it is imperative to undertake comprehensive QoL research encompassing all regions of India and various thalassemia populations within the country to bridge this evidentiary void.

Background: Massive Open Online Course (MOOC) modules are deemed to be novel educational models to optimize learning. They can be useful in delivering oral health education to primary health care workers to strengthen the oral health care delivery system. Therefore, the aim of this study is to analyze the current oral health situation analysis of the South East Asia region countries and to assess areas where the MOOC modules can be integrated as oral health training material. Methodology: A focus group discussion was held virtually with 70 participants from SEAR. The MOOC modules were developed as learning activities to facilitate the application of the material learned, in public settings. The themes for the situation analysis were based on oral health policy, barriers to dental treatment needs and action plan for implementation of the MOOC modules in each SEAR country. Results: Results highlighted the importance of formulating and implementing oral health policy at the national level among the participating countries. Nepal, Maldives, Timor–Leste reported on existing gaps regarding the unmet dental treatment needs. The inclusion of helath care workers in conducting dental procedures was observed in Bhutan. Global school health promoting initiatives were recorded in Maldives. The participating SEAR countries reported on the sensitization of primary healthcare workers through the developed MOOC modules. Conclusion: The developed massive open online course module was acknowledged to be an improved and interactive tool for primary health care workers by the country's oral health officers for oral health promotion and networking.

Abstract Infections by multidrug resistant bacteria (MDR) are becoming increasingly difficult to treat and alternative approaches like phage therapy, which is unhindered by drug resistance, are urgently needed to tackle MDR bacterial infections. During phage therapy phage cocktails targeting different receptors are likely to be more effective than monophages. In the present study, phages targeting carbapenem resistant clinical isolate of E. coli U1007 was isolated from Ganges River (U1G), Cooum River (CR) and Hospital waste water (M). Capsid architecture discerned using TEM identified the phage families as Podoviridae for U1G, Myoviridae for CR and Siphoviridae for M phage. Genome sequencing showed the phage genomes varied in size U1G (73,275 bp) CR (45,236 bp) and M (45,294 bp). All three genomes lacked genes encoding tRNA sequence, antibiotic resistant or virulent genes. A machine learning (ML) based multi-class classification model using Random Forest, Logistic Regression, and Decision Tree were employed to predict the host receptor targeted by receptor binding protein of all 3 phages and the best performing algorithm Random Forest predicted LPS O antigen, LamB or OmpC for U1G; FhuA, OmpC for CR phage; and FhuA, LamB, TonB or OmpF for the M phage. OmpC was validated as receptor for U1G by physiological experiments. In vivo intramuscular infection study in zebrafish showed that cocktail of dual phages (U1G + M) along with colsitin resulted in a significant 3.5 log decline in cell counts. Our study highlights the potential of ML tool to predict host receptor and proves the utility of phage cocktail to restrict E. coli U1007 in vivo.

Background: Antimicrobial peptides are an important component of host defense against Mycobacterium tuberculosis. However, the ability of BCG to induce AMPs as part of its mechanism of action has not been investigated in detail. Methods: We investigated the impact of Bacillus Calmette–Guerin (BCG) vaccination on circulating plasma levels and TB-antigen stimulated plasma levels of AMPs in a healthy elderly population. We assessed the association of AMPs, including Human Beta Defensin 2 (HBD-2), Human Neutrophil Peptide 1-3 (HNP1-3), Granulysin, and Cathelicidin (LL37), in circulating plasma and TB-antigen stimulated plasma (using IGRA supernatants) at baseline (pre-vaccination) and at Month 1 and Month 6 post vaccination. Results: Post BCG vaccination, both circulating plasma levels and TB-antigen stimulated plasma levels of AMPs significantly increased at Month 1 and Month 6 compared to pre-vaccination levels in the elderly population. However, the association of AMP levels with latent TB (LTB) status did not exhibit statistical significance. Conclusion: Our findings indicate that BCG vaccination is linked to heightened circulating levels of AMPs in the elderly population, which are also TB-antigen-specific. This suggests a potential mechanism underlying the immune effects of BCG in enhancing host defense against TB.

Background The mortality and morbidity due to secondary peritonitis is high. Timely surgical intervention of secondary peritonitis due to Gastrointestinal (GI) perforation and appropriate empirical antibiotic therapy are prerequisites for a good outcome in these cases. The study aims to investigate the bacterial profile and the antibiotic susceptibility pattern of bacterial isolates in cases of secondary peritonitis following GI perforation and the correlation of bacterial spectrum with the different anatomical sites of GI perforation. Methods The retrospective study includes 44 patients operated on for secondary peritonitis following GI perforation between Jan 2019 to March 2020. The peritoneal fluid samples from these patients were subjected to bacterial culture and sensitivity. The bacterial isolates were identified by standard microbiological techniques and antibiotic susceptibility pattern was determined by the Kirby Bauer disk diffusion method and E test. The clinical data about the anatomical site of gastrointestinal perforation was collected from the medical records of these patients and were analyzed. Results Out of 44 peritoneal fluid samples obtained from secondary peritonitis cases due to GI perforation, 58 bacterial strains were isolated. The majority of the bacterial isolates were Gram-negative bacilli; Escherichia coli 31/58 (53.44%), Klebsiella pneumoniae 16/58 (27.58%) and Enterobacter spp. 5/58 (8.62%). The Gram-positive bacteria accounted for 10.33% of the infections; Enterococcus spp. 4/58 (6.89%) and Staphylococcus aureus 2/58 (3.44%). The most common anatomical site of GI perforation was Appendix in 63% of the cases, followed by the stomach in 16% and the small intestine in 14% of the study cases. Meropenem was found to have the highest susceptibility rate among all Gram-negative bacteria. Vancomycin and Linezolid were effective in all localizations with a sensitivity rate of 100%. Conclusion By evaluating the microbial flora and its antibiotic susceptibility pattern in relation to the location of perforation and microbial flora, we recommend Meropenem and Linezolid as the choice for empirical antibiotic therapy in cases of secondary peritonitis following GI perforation.

Objectives Given the increasing prevalence of obesity and need for effective interventions, there is a growing interest in understanding how an individual’s body image can inform obesity prevention and management. This study’s objective was to examine the use of silhouette showcards to measure body size perception compared with measured body mass index, and assess body size dissatisfaction, in three different African-origin populations spanning the epidemiological transition. An ancillary objective was to investigate associations between body size perception and dissatisfaction with diabetes and hypertension.Setting Research visits were completed in local research clinics in respective countries.Participants Seven hundred and fifty-one African-origin participants from the USA and the Republic of Seychelles (both high-income countries), and Ghana (low/middle-income country).Primary and secondary outcome measures Silhouette showcards were used to measure perceived body size and body size dissatisfaction. Objectively measured body size was measured using a scale and stadiometer. Diabetes was defined as fasting blood glucose ≥126 mg/dL and hypertension was defined as ≥130 mm Hg/80 mm Hg.Results Most women and men from the USA and Seychelles had ‘Perceived minus Actual weight status Discrepancy’ scores less than 0, meaning they underestimated their actual body size. Similarly, most overweight or obese men and women also underestimated their body size, while normal weight men and women were accurately able to estimate their body size. Finally, participants with diabetes were able to accurately estimate their body size and similarly desired a smaller body size.Conclusions This study highlights that overweight and obese women and men from countries spanning the epidemiological transition were unable to accurately perceive their actual body size. Understanding people’s perception of their body size is critical to implementing successful obesity prevention programmes across the epidemiological transition.

Periodontitis and metabolic syndrome (MetS) are concerning issues affecting well-being and are prevalent. The MetS comprises a conglomerate of numerous physical conditions that occur concurrently, as well as intensifying the likeli-hood of heart disease and type 2 diabetes mellitus (T2DM). Periodontitis is a microbial oral condition that causes the loss of tooth attachment and can proceed to edentulism if left untreated. Epidemiologic, experimental, and interven-tional studies have documented that periodontitis could have a consequence on systemic health and share a com-mon pathway with several chronic noncommunicable diseases, namely DM, cardiovascular disease, and MetS. Cur-rent data suggest that periodontitis may promote the onset or acceleration of MetS. The overall oxidative load and overactive inflammatory repercussions could be responsible for this interaction. As a result, it is crucial to compre-hend the current condition of the association as well as the prospective contribution of periodontitis to MetS. The findings of published studies that provide consistent data on the varied outcomes of periodontitis on MetS are en-capsulated in this review. Systematic reviews, meta-analyses, original studies, and review articles were appraised in synthesizing this review, using PubMed and Google Scholar search engines.

Background: Medicinal plants have played crucial roles in the traditional health care system since the origin of mankind. Among them, cinnamon is used not only as a spice in food but also as a substance with many health-beneficial effects. The aim of the present study was to identify the antibacterial activity of cinnamon bark extract against bacterial isolates from patient pus samples that might help treat infections. Methods: The antibacterial potential of cinnamon bark extract in both ethanol and methanol against 6 bacterial isolates obtained from pus samples received in the Microbiology Laboratory was identified by agar well diffusion, minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) using standard techniques. Results: By agar well diffusion, the highest inhibitory activity of ethanol and methanol extracts of cinnamon was shown by Staphylococcus aureus, followed by coagulase-negative Staphylococci. The lowest inhibitory effect was shown by Proteus mirabilis. The ethanol extract of cinnamon MIC and MBC ranged from 6.25 mg/mL to 12.5 mg/mL and 12.5 mg/mL to 50 mg/mL. The methanol extract of cinnamon MIC showed a value of 12.5 mg/mL, and the methanol extract of MBC ranged from 12.5 mg/mL to 50 mg/mL against all bacterial isolates of the present study. Conclusion: Staphylococcus aureus is sensitive to the alcoholic extract of cinnamon bark, but its effect is less than that of the selected antibiotic.

Children are at a high risk for many of the medical conditions as their immune system in not completely matured. Children exposed to life-threatening illnesses like HIVAIDS may face a range of potential psychological changes. Psychosocial issues are common among families with any of the family member suffering from HIVAIDS. This paper provides a thorough analysis of the psychological and psychosocial challenges faced by children living with HIVAIDS along with possible suggestions to deal with these issues.

It is well recognized that young individuals with neurological impairments such as epilepsy receive less suitable assistance than young people with other chronic diseases. The period between the ages of 13 and 19 surrounding the transition to adult services is particularly crucial for promoting young peoples continued control and self-care. Epilepsy-specific biological psychosocial and biological variables can both hinder and facilitate the sharing of information and the development of self-care behaviors. The goals of the present review were to explain how young people with epilepsy aged 13 to 19 years and their parents experienced sharing information in healthcare settings to identify characteristics that affect both good and negative healthcare communication and identify what is known to be beneficial in doing so. Seizures which are frequent bursts of electrical activity in the brain are brought on by epilepsy. By the time they are adolescents almost two-thirds of all children with epilepsy outgrow their seizures. Epilepsy however maybe a lifelong condition for certain people. To better comprehend their childs condition and treatment parents should work together with their medical professionals.

Polyherbal formulation (PHF) enhances therapeutic efficacy and minimizes side effects by reducing individual herb dosages. Allopolyherbal formulation (APHF) combines polyherbal extracts with allopathic medication, effectively reducing the latter’s required dose and mitigating associated adverse effects. The current study intends to assess the anti-diabetic effects of PHF and APHF in-vivo. Dried raw powders of Cassia auriculata leaf, Centella asiatica leaf, and Zingiber officinale rhizome were extracted by cold maceration process using 70% ethanol. These extracts were combined in three different ratios to make PHF. PHF was subjected to qualitative and quantitative phytochemical investigations. APHF has been prepared by combining a potent ratio of PHF with metformin in three different ratios. The compatibility of APHF has been confirmed by differential scanning calorimetry (DSC). In vivo activity was also evaluated in streptozotocin-induced diabetic albino rats. PHF (3 different ratios at a dose of 200–400 mg/kg b.w), APHF (combination of PHF and metformin in 3 different ratios, 200 + 22.5, 200 + 45, and 200 + 67.5 mg/kg b.w), and metformin (90 mg/kg b.w) were administered to albino rats for 21 consecutive days. Blood glucose levels were estimated on the 1st, 7th, 14th, and 21st days of treatment. On the 21st day, blood was collected by cardiac puncture for biochemical analysis. The liver and pancreas were isolated and subjected to histopathological analysis. PHF and APHF showed significant anti-diabetic and antihyperlipidemic efficacy. In comparison to PHF, APHF had the most promising action. The current study demonstrated that PHF and APHF are safe and efficacious drugs in the treatment of diabetes mellitus as they help to replace or lower the dose of metformin, thereby decreasing the risks of metformin.

Introduction Otorhinolaryngologic manifestations account for almost 80% of the various manifestations of Human Immunodeficiency Virus (HIV) infection, of which Human Papilloma Virus (HPV) associated laryngeal papilloma and laryngeal malignancy are the most common pertaining to larynx. Case Report A 55year old male patient on Antiretroviral treatment since 10 years who was a chronic smoker, presented with difficulty in breathing and hoarseness of voice. Flexible laryngoscopy revealed a white, horny, wide based keratotic lesion completely covering rima glottidis resulting in obstruction of airway and stridor. Tracheostomy was done followed by endoscopic excision of the lesion. Histopathologic examination showed features of hyperkeratotic papilloma and lesion was tested negative for HPV. Discussion We report this case to emphasize on the differential diagnosis of laryngeal papillomatous lesion. A hyperkeratotic papilloma, with a dual aetiology of retroviral disease and smoking, presenting with stridor, the lesion being negative for HPV infection makes it uncommon from other laryngeal lesions.

Type 2 diabetes mellitus (T2DM) is one of the most highly prevalent metabolic disorders worldwide. Uncontrolled T2DM can lead to other health threats such as cardiac arrest, lower-limb amputation, blindness, stroke, impaired kidney function, and microvascular and macrovascular complications. Many studies have demonstrated the association between gut microbiota and diabetes development and probiotic supplementation in improving glycemic properties in T2DM. The study aimed to evaluate the influence of Bifidobacterium breve supplementation on glycemic control, lipid profile, and microbiome of T2DM subjects. Forty participants were randomly divided into two groups, and they received probiotics (50 × 109 CFU/day) or placebo interventions (corn starch; 10 mg/day) for 12 weeks. The changes in the blood-urea nitrogen (BUN), aspartate aminotransferase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), fasting blood sugar (FBS), glycated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), creatinine levels, and other factors such as body-mass index, visceral fat, body fat, and body weight were assessed at baseline and after 12 weeks. B. breve supplementation significantly reduced BUN, creatinine, LDL, TG, and HbA1c levels compared to the placebo group. Significant changes were observed in the microbiome of the probiotic-treated group compared to the placebo group. Firmicutes and proteobacteria were predominant in the placebo and probiotic-treated groups. Genera Streptococcus, Butyricicoccus, and species Eubacterium hallii were significantly reduced in the probiotic-treated group compared to the placebo. Overall results suggested that B. breve supplementation could prevent worsening of representative clinical parameters in T2DM subjects. The current study has limitations, including fewer subjects, a single probiotic strain, and fewer metagenomic samples for microbiome analysis. Therefore, the results of the current study require further validation using more experimental subjects.

Lipid-based vaccine delivery systems such as the conventional liposomes, virosomes, bilosomes, vesosomes, pH-fusogenic liposomes, transferosomes, immuno-liposomes, ethosomes, and lipid nanoparticles have gained a remarkable interest in vaccine delivery due to their ability to render antigens in vesicular structures, that in turn prevents its enzymatic degradation in vivo. The particulate form of lipid-based nanocarriers confers immunostimulatory potential, making them ideal antigen carriers. Facilitation in the uptake of antigen-loaded nanocarriers, by the antigen-presenting cells and its subsequent presentation through the major histocompatibility complex molecules, leads to the activation of a cascade of immune responses. Further, such nanocarriers can be tailored to achieve the desired characteristics such as charge, size, size distribution, entrapment, and site-specificity through modifications in the composition of lipids and the selection of the appropriate method of preparation. This ultimately adds to its versatility as an effective vaccine delivery carrier. The current review focuses on the various lipid-based carriers that have been investigated to date as potential vaccine delivery systems, the factors that affect their efficacy, and their various methods of preparation. The emerging trends in lipid-based mRNA vaccines and lipid-based DNA vaccines have also been summarized.

Hair health is associated with personal distress and psychological well-being. Even though hair loss (alopecia) does not affect humans’ biological health, it affects an individual’s social well-being. So, treatment for hair problems and improving hair health are obligatory. Several pharmacological and cosmeceutical treatment procedures are available to manage hair loss and promote growth. Several factors associated with hair health include genetics, disease or disorder, drugs, lifestyle, chemical exposure, and unhealthy habits such as smoking, diet, and stress. Synthetic and chemical formulations have side effects, so people are moving towards natural compounds-based remedies for their hair problems. The history of using phytochemicals for hair health has been documented anciently. However, scientific studies on hair loss have accelerated in recent decades. The current review summarizes the type of alopecia, the factor affecting hair health, alopecia treatments, phytochemicals’ role in managing hair loss, and the mechanisms of hair growth-stimulating properties of phytochemicals. The literature survey suggested that phytochemicals are potent candidates for developing treatment procedures for different hair problems. Further detailed studies are needed to bring the scientific evidence to market.

Introduction Tonsillectomy is one of the most commonly performed surgical procedures worldwide, with the major drawback of significant post operative pain.There is no consensus regarding topical application or local infiltration of anesthetics post operatively to reduce pain. The present study was performed to evaluate the effect of bupivacaine infiltration in the tonsillar fossae after tonsillectomy. Materials and Methods A double-blinded clinical trial was performed on 75 patients undergoing tonsillectomy between January 2019 and January 2020. All patients underwent tonsillectomy under general anesthesia and were then randomly divided into 3 groups of 25 patients each. For Group I, a swab soaked in normal saline was applied to the tonsillar fossae for 5 minutes just before extubation. In Group II, a swab soaked in 5 ml of 0.5% bupivacaine was placed for 5 minutes, while in Group III, 5ml of 0.5% bupivacaine was infiltrated in the tonsillar fossae. The intensity of pain for each group was measured in the immediate post op period, at6 hours, 24 hours and 1 week by Wong Baker Faces Pain Rating Scale. Results There was a significant difference in the mean level of pain between groups I and III in the immediate post op period, at 6 hours and 24 hours. Although the average pain scores of group III were better than those of group II, the results were significant only in the 6 hour post op period. Conclusion To reduce post-tonsillectomy pain,0.5% bupivacaine can be infiltrated into the tonsillar fossa.

Introduction Cornu cutaneum is a nodule of dense keratin, resembling the horn of animals, an uncommon clinical condition predominantly seen in elderly men, and even rare to be seen on the pinna. Case Report A 70 year old man, presented with a horn like swelling on the left pinna for 2 years. The lesion was excised and histopathological examination did not show any underlying or associated conditions. Discussion The cause of worry here is not the disfigurement, but the probability of underlying premalignant or malignant condition. Exposure to sunlight is considered as the etiology. Ours being a tropical country where exposure to sunlight could not be avoided, a high clinical vigil and early intervention is recommended to reduce the mortality and morbidity from the spectrum of diseases resembling this condition.

Penile strangulation is one of the less frequently encountered cases in emergency room. Sexual pleasure leads the list of factors acting as impetus. In this case report, a case of penile strangulation presenting to Surgery outpatient after two months of insertion of metal ring (key chain ring) is discussed. After careful consideration of patient's condition, the ring was removed with help of K wire cutter.

To probe how non-human primates (NHPs) decode temporal dynamic stimuli, we used a two-alternative forced choice task (2AFC), where the cue was dynamic: a movie snippet drawn from an animation that transforms one image into another. When the cue was drawn from either the beginning or end of the animation, thus heavily weighted towards one (the target) of both images (the choice pair), then primates performed at high levels of accuracy. For a subset of trials, however, the cue was ambiguous, drawn from the middle of the animation, containing information that could be associated to either image. Those trials, rewarded randomly and independent of choice, offered an opportunity to study the strategy the animals used trying to decode the cue. Despite being ambiguous, the primates exhibited a clear strategy, suggesting they were not aware that reward was given non-differentially. More specifically, they relied more on information provided at the end than at the beginning of those cues, consistent with the recency effect reported by numerous serial position studies. Interestingly and counterintuitively, this effect became stronger for sessions where the primates were already familiar with the stimuli. In other words, despite having rehearsed with the same stimuli in a previous session, the animals relied even more on a decision strategy that did not yield any benefits during a previous session. In the discussion section we speculate on what might cause this behavioral shift towards stronger bias, as well as why this behavior shows similarities with a repetition bias in humans known as the illusory truth effect.

In this prospective, interventional case-control study, 58 patients with unilateral acute central serous chorioretinopathy (CSCR) were recruited. Patients ≥ 18 years age, presenting with first episodes of acute CSCR, were included. Acute CSCR was defined by the presence of subretinal fluid (SRF) and symptoms for p < 0.001) and SFCT (p < 0.001) reduction was noted in the affected eye of both groups. SFCT was reduced in the fellow eye after treatment (p = 0.005) compared to the observation group (p = 0.276). In conclusion, oral eplerenone achieves faster SRF resolution and vision improvement in acute CSCR. Additionally, it shows beneficial effects on the fellow eye.