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Abstract Formyl peptide receptors (FPR), part of the G-protein coupled receptor superfamily, are pivotal in directing phagocyte migration towards chemotactic signals from bacteria and host tissues. Although their roles in acute bacterial infections are well-documented, their involvement in immunity against tuberculosis (TB) remains unexplored. Here, we investigate the functions of Fpr1 and Fpr2 in defense against Mycobacterium tuberculosis (Mtb), the causative agent of TB. Elevated levels of Fpr1 and Fpr2 were found in the lungs of mice, rabbits and peripheral blood of humans infected with Mtb, suggesting a crucial role in the immune response. The effects of Fpr1 and Fpr2 deletion on bacterial load, lung damage, and cellular inflammation were assessed in a murine TB model utilizing hypervirulent strain of Mtb from the W-Beijing lineage. While Fpr2 deletion had no impact on disease outcome, Fpr1-deficient mice demonstrated improved bacterial control, especially by macrophages. Bone marrow-derived macrophages from these Fpr1 −/− mice exhibited an enhanced ability to contain bacterial growth over time. Contrarily, treating genetically susceptible mice with Fpr1-specific inhibitors caused impaired early bacterial control, corresponding with increased Mtb persistence in necrotic neutrophils. Furthermore, ex vivo assays revealed that Fpr1 −/− neutrophils were unable to restrain Mtb growth, indicating a differential function of Fpr1 among myeloid cells. These findings highlight the distinct and complex roles of Fpr1 in myeloid cell-mediated immunity against Mtb infection, underscoring the need for further research into these mechanisms for a better understanding of TB immunity.

Abstract Background New daily persistent headache (NDPH) is a continuous, unremitting headache from onset that yields suboptimal results with traditional medicines. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising non-invasive treatment for other headache disorders, such as migraine, and neuromodulation has not been well-studied in NDPH. The objective of the study was to evaluate the efficacy of rTMS in reducing the frequency and severity of headaches, and associated anxiety and depressive symptoms in NDPH patients. Methods This was an open label prospective, single arm, interventional pilot study conducted between October 2022 and September 2023. All eligible participants received 10 Hz rTMS (600 pulses, 10 trains), delivered to the left prefrontal cortex for three consecutive days. The post-rTMS headache severity was recorded weekly for four weeks and headache free days/functional disability, PHQ-9, and GAD-7 scores at the end of four weeks and compared with pre-rTMS parameters. The primary outcome was defined by ≥ 50% reduction in headache severity on Visual Analogue Scale (VAS) score, decrease in headache days from the baseline and secondary outcome was ≥ 6 point reduction in HIT-6 score at 4 weeks. Results Fifty NDPH patients (mean [SD] age, 35.06 [13.91] years; 31 females [62%]) participated in this study. Thirty-five patients (70%) reported ≥ 50% improvement in pain severity (p-value

Most common neuromuscular junction disorder is Myasthenia gravis (MG) which has variable clinical presentations. Diplopia and drooping of eyelids are the peculiarity of myasthenia gravis. Commonly disease manifests as a fluctuating weakness of skeletal muscles. Although respiratory symptoms may be the initial presenting complaint in a few patients, usually it develops during the later part of the disease course. The initial presentation of isolated prominent respiratory distress is a relatively rare presentation of myasthenia gravis unless accompanied by other clinical features. We report a 40-year-old female patient, who visited our hospital with presenting complaints of breathlessness and generalized myalgia and subsequently developed fatigable weakness during hospitalization.

Abstract A 60-day feeding trial was conducted to evaluate the effects of dietary Anabaena blue-green algae (ABGA) meal on the growth performance, digestibility, and physio-metabolic responses of Catla catla fingerlings (initial average weight 9.45 ± 0.15 g). Six iso-nitrogenous (30% crude protein) and iso-caloric (378.09 Kcal. digestible energy/100 g) diets were formulated: a control diet (A0, 0% ABGA) and five experimental diets with varying ABGA inclusion levels (A3: 3%, A6: 6%, A9: 9%, A12: 12%, A15: 15%). The results demonstrated that there were no significant differences (P > 0.05) in percentage weight gain (PWG), specific growth rate (SGR), protein efficiency ratio (PER), and feed conversion ratio (FCR) among the experimental groups. Additionally, dietary ABGA did not significantly affect (P > 0.05) body carcass composition among different groups. However, amylase activity significantly decreased (P 0.05) across all groups. Notably, oxidative stress responses (SOD; superoxide dismutase and CAT; catalase), carbohydrate metabolic enzymes (LDH; lactate dehydrogenase and MDH; malate dehydrogenase), and serum glucose levels increased significantly (P 0.05) observed in serum total protein, albumin/globulin (A/G) ratio, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) activities among the experimental groups. Hematological parameters revealed that RBC (red blood cell) count, hemoglobin (Hb) concentration, and packed cell volume (PCV) significantly decreased (P

Abstract The creation of new alloys with improved qualities has become essential in modern industries for high-performance materials. This work’s main objective is to use vacuum arc melting (VAM) to synthesize two different high-entropy alloys (HEAs): AlCrFeNiCu and AlCrFeNiCo. The mechanical properties, phase composition, grain boundaries, and alloy composition of the HEAs were studied. The predominant crystal structure, the Body-Centred Cubic (BCC) phase was obtained for both alloys. Significantly, the Co-containing HEA showed a smaller particle size than the Cu-containing HEA, which led to a 14.21% increase in microhardness. It indicates that the Co-based HEA will likely perform better than the Cu-based HEA in applications prone to abrasion, and indentation, and requiring high hardness levels based on the observed microstructure and hardness parameters. According to wear surface morphology studies, main effects analysis and ANOVA show that increasing loads and sliding distances increase wear rate, whereas sliding velocity has less effect. The best wear rate-reducing parameters are 10 N, 0.5 m/s, and 500 m for Cu-containing HEAs, and the same can be predicted using regression analysis. The study categorizes the intricate worn surface structure by describing different surface properties and wear mechanisms, such as grooves, delamination, adhesive wear, and pitting.

Abstract The crude leaf extract of Phragmanthera macrosolen L. has been utilized for the first time as an effective reducing, capping and stabilizing agent to synthesize silver oxide nanoparticles (Ag2O NPs) through a green approach. The prepared Ag2O NPs were analyzed by scanning electron-microscopy (SEM), High Resolution Transmission electron microscope (HR-TEM), X-ray diffractions (XRD), Fourier transforms infrared (FTIR) spectroscopy, energy dispersive spectroscopy (EDS), and Ultra-violet visible spectrometry (UV-Vis). The biosynthesized Ag2O NPs applied on gram-positive (S. aureus) and gram-negative (E. coli) bacterial types. FTIR spectral peaks indicate that the phytochemicals in the extract are responsible for the formation of Ag2O nanoparticles. The XRD result shown, poly-crystalline nanoparticles and the average crystalline size calculated was 45.8 nm. UV-Vis analysis shows absorbance existed at 590.5 nm, and the energy band gap calculated through the Tauc relation was 2.1 eV. The SEM images gave a globular and some rod like morphology with diameter of particle obtained between 20.11 and 46.50 nm with some hollow cubic microstructure of Ag2O NPs which makes it suitable for antimicrobial application. The EDS confirms the elemental composition and existence of Ag and O2. The HR-TEM images, specific area electron diffraction (SAED), and XRD patterns confirmed the morphology of Ag2O NPs mean 45.84 nm and polycrystalline nature of the nanoparticles. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were 15 and 30 µl respectively for the samples tested. In this study, it was observed that Ag2O NPs highly sensitive to E. coli than s. aureus. The present study revealed that the possible use of green synthesized Ag2O NPs as potential antibacterial agent.

Abstract With the swift advancement of technology and growing popularity of internet in business and communication, cybersecurity posed a global threat. This research focuses new Deep Learning (DL) model referred as FinSafeNet to secure loose cash transactions over the digital banking channels. FinSafeNet is based on a Bi-Directional Long Short-Term Memory (Bi-LSTM), a Convolutional Neural Network (CNN) and an additional dual attention mechanism to study the transaction data and influence the observation of various security threats. One such aspect is, relying these databases in most of the cases imposes a great technical challenge towards effective real time transaction security. FinSafeNet draws attention to the attack and reproductive phases of Hierarchical Particle Swarm Optimization (HPSO) feature selection technique simulating it in a battle for extreme time performance called the Improved Snow-Lion optimization Algorithm (I-SLOA). Upon that, the model then applies the Multi-Kernel Principal Component Analysis (MKPCA) accompanied by Nyström Approximation for handling the MKPCA features. MKPCA seeks to analyze and understand a non-linear structure of data whereas, Nyström Approximation reduces the burden on computational power hence allows the model to work in situations where large sizes of datasets are available but with no loss of efficiency of the model. This causes FinSafeNet to work easily and still be able to make accurate forecasts. Besides tackling feature selection and dimensionality reduction, the model presents advanced correlation measures as well as Joint Mutual Information Maximization to enhance variable correlation analysis. These improvements further help the model to detect the relevant features in transaction data that may present a threat to the security of the system. When tested on commonly used database for testing banks performance, for instance the Paysim database, FinSafeNet significantly improves upon the previous and fundamental approaches, achieving accuracy of 97.8%.

Abstract The present work proposes a new decision support tool for assessing the sustainable suppliers in the healthcare supply chain. For this purpose, the classical Measurement of Alternatives and Ranking according to Compromise Solution (MARCOS) model is integrated with the Sugeno–Weber weighted averaging operators, modified symmetry point of criterion (SPC) model, rank sum (RS) tool and Fermatean fuzzy sets (FFSs), and named as the ‘FF-SPC-RS-MARCOS’ framework. The developed model firstly determines the decision experts’ weights through RS model. Second, novel Sugeno–Weber weighted operators are introduced to combine the experts’ opinions. Third, a unified weighting procedure is presented based on the combination of modified SPC approach for objective weight and RS method for subjective weight of attributes. To this aim, a novel distance measure is introduced for FFSs and further applied to compute the distance between aggregated Fermatean fuzzy numbers and symmetry point value of an attribute in the modified SPC approach. Further, a hybrid FF-SPC-RS-MARCOS approach is proposed to tackle the decision-making problems on FFSs setting. To elucidate the efficacy of the developed method, it is applied to a case study of sustainable supplier selection problem in the healthcare supply chain. The paper further conducts sensitivity investigation and comparison with existent approaches to test the stability and robustness of the ranking outcomes. This study shows how the proposed MARCOS method in combination with SPC and RS models can be used to prioritize the alternative suppliers in the healthcare supply chain. The introduced work provides a new methodology, which can help the practitioners and academics to evaluate suppliers with uncertain information and can also be employed to other areas facing similar types of decision-making problems.

Abstract Ocean mesoscale eddies, with $$20-300$$ 20 - 300 km size, present in energetic regions of the global ocean, are known to impact local and remote atmospheric weather. The impact of eddies in the Mediterranean Sea on the local weather, however, remains largely unknown. Here, we study this impact during an extreme weather event observed over Israel on January $$8-10$$ 8 - 10 , 2020, resulting in heavy rains and floods. To do so, we designed a set of coupled and forced numerical simulations with a horizontal resolution of 5 km in both ocean and atmosphere. The coupled simulation successfully reproduces the main characteristics of the torrential rains observed during the event, whereas the forced simulations exhibit poorer performance. Our results emphasize the importance of mesoscale air-sea coupling in supplying moisture to the atmosphere, via mechanisms involving both sea surface temperature and surface currents associated with sea eddies. Extreme weather events are intensified by the Mediterranean Sea eddies, especially through atmospheric meso-cyclones.

Abstract Background Phenotypic age (PhenoAge), a widely used marker of biological aging, has been shown to be a robust predictor of all-cause mortality and morbidity in different populations. Existing studies on biological aging have primarily focused on individual domains, resulting in a lack of a comprehensive understanding of the multi-systemic dysregulation that occurs in aging. Methods PhenoAge was evaluated based on a linear combination of chronological age (CA) and 9 clinical biomarkers in 952 multi-ethnic Asian women of reproductive age. Phenotypic age acceleration (PhenoAgeAccel), an aging biomarker, represents PhenoAge after adjusting for CA. This study conducts an in-depth association analysis of PhenoAgeAccel with clinical, nutritional, lipidomic, gut microbiome, and genetic factors. Results Higher adiposity, glycaemia, plasma saturated fatty acids, kynurenine pathway metabolites, GlycA, riboflavin, nicotinamide, and insulin-like growth factor binding proteins were positively associated with PhenoAgeAccel. Conversely, a healthier diet and higher levels of pyridoxal phosphate, all-trans retinol, betaine, tryptophan, glutamine, histidine, apolipoprotein B, and insulin-like growth factors were inversely associated with PhenoAgeAccel. Lipidomic analysis found 132 lipid species linked to PhenoAgeAccel, with PC(O-36:0) showing the strongest positive association and CE(24:5) demonstrating the strongest inverse association. A genome-wide association study identified rs9864994 as the top genetic variant (P = 5.69E-07) from the ZDHHC19 gene. Gut microbiome analysis revealed that Erysipelotrichaceae UCG-003 and Bacteroides vulgatus were inversely associated with PhenoAgeAccel. Integrative network analysis of aging-related factors underscored the intricate links among clinical, nutritional and lipidomic variables, such as positive associations between kynurenine pathway metabolites, amino acids, adiposity, and insulin resistance. Furthermore, potential mediation effects of blood biomarkers related to inflammation, immune response, and nutritional and energy metabolism were observed in the associations of diet, adiposity, genetic variants, and gut microbial species with PhenoAgeAccel. Conclusions Our findings provide a comprehensive analysis of aging-related factors across multiple platforms, delineating their complex interconnections. This study is the first to report novel signatures in lipidomics, gut microbiome and blood biomarkers specifically associated with PhenoAgeAccel. These insights are invaluable in understanding the molecular and metabolic mechanisms underlying biological aging and shed light on potential interventions to mitigate accelerated biological aging by targeting modifiable factors.

Introduction: Diabetic Neuropathy (DN) is a well known difficult to treat microvascular complication of diabetes. Based on Nerve Conduction Velocity (NCV) studies, DN has been classified into various types. Many possible aetiologies have been proposed. C-Reactive Protein (CRP) plays a role in the development of diabetic microvascular complications, while Homocysteine (Hcys) can harm the endothelium by inducing excessive sulfation of connective tissue. Aim: To study the levels of Hcys and CRP in NCV-proven patients with DN and to associate these levels with the type of DN. Materials and Methods: This was a cross-sectional study conducted at a semi-urban medical college hospital in Western Maharashtra, India, between February 2022 and May 2024. The study included 70 patients over 18 years of age with NCV-proven DN in Type 2 Diabetes Mellitus (DM), in whom serum Hcys and CRP levels were evaluated. Data collected were analysed using Statistical Package for Social Sciences (SPSS) software version 26.0. Results: A total of 32 female participants (45.7%) and 38 male participants (54.3%). Among the study participants, 23 (32.9%) had a duration of diabetes of 5-10 years, and 47 (67.1%) had a mixed type of neuropathy. Elevated Hcys levels were observed in 18 (25.7%) participants, while 49 (70%) showed elevated CRP levels. CRP levels were raised in the mixed type of neuropathy, with 35 (71.4%) affected, while elevated Hcys levels were observed among the sensory neuropathies in 6 (33.3%) participants. Conclusion: No significant association was found between elevated Hcys and CRP levels and the type of neuropathy.

Abstract The PIM kinase family, consisting of PIM1, PIM2, and PIM3, is a group of serine/threonine protein kinases crucial for cellular growth, immunoregulation, and oncogenesis. PIM1 kinase is often overexpressed in solid and hematopoietic malignancies, promoting cell survival, proliferation, migration, and senescence by activating key genes. In vitro and in vivo studies have established the oncogenic potential of PIM1 kinases. These kinases have been implicated in tumor progression, metastasis, and resistance to chemotherapy, underscoring their potential as a therapeutic target for cancer therapy. This review delves into the intricate molecular mechanisms through which PIM1 interacts with specific substrates in different tumor tissues, leading to diverse outcomes in various human cancers. Over the past decade, the inhibition of PIM1 in cancers has garnered significant attention as a potential standalone treatment. Various in vitro, in vivo, and early clinical trial data have provided support for this approach to varying extents. Novel compounds that inhibit PIM1 kinase have shown effectiveness and a favorable toxicity profile in preclinical studies. Several of these substances are now being studied in clinical trials due to their promising outcomes. This article provides a thorough examination of the PIM1 kinase pathways and the recent advancements in producing PIM1 kinase inhibitors for the treatment of cancer.

Context Each year, about 21 million girls aged 15–19 in developing regions experience pregnancy, posing significant challenges for their health, well-being, and economic stability due to its vast impact. Aim To identify the risk factors contributing to teenage pregnancy as compared to Pregnancy in pregnant women in the rural area of the Khordha district with the assessment of their knowledge and, health-seeking behaviour (Contraception and STDs) among teenage and adult pregnant women in the study area. Settings and Design Hospital-based case-control study conducted at Bhubaneswar’s Community Health Centre. Material and Methods The study, conducted from April to July 2022, recruited 138 participants using consecutive sampling and interviewed them using a pretested semi-structured questionnaire. Statistical Analysis Chi-square and logistic regression assessed association and strength. Results Factors contributing to teenage pregnancy include education below high school (AOR = 2.46; 95%CI 0.89–6.79), SC and ST caste (AOR = 2.34; 95%CI 0.94–5.82), having more than three siblings (AOR = 4.45; 95%CI 1.53–12.96), and lack of communication about sexual issues (AOR = 2.84; 95%CI 1.25–6.39). Awareness of contraceptive methods was 34.8% among cases and 56.5% among controls (p = 0.02). Regarding STD awareness and symptoms, 15.2% of cases and 42.4% of controls were knowledgeable and experienced symptoms (p < 0.01). Conclusions This study suggests that factors such as lower education, minority caste, having more than three siblings, and lack of communication about sexual issues contribute to early pregnancy. These findings could enhance existing ARSH platforms by integrating regular engagement and sensitization efforts.

Context Tobacco addiction is an important public health problem. Among several theories of addiction proposed, PRIME theory of motivation is found to be a comprehensive one to synthesise prevention strategies. Aims This case study was conducted on the basis of PRIME theory to explain smokeless tobacco (SLT) addiction patterns among slum dwelling female residents of Cuttack district, Odisha. Settings and Design Cuttack district of Odisha state and Qualitative synthesis. Methods and Material Qualitative semistructured face-to-face interviews and framework analysis techniques were employed. The study was conducted over a period of 2 months between February 2020 and March 2020. Face-to-face interviews of 26 participants of Dasha Sahi slum using a semistructured questionnaire assessing responses based on five main themes including P, Plans; R, Responses; I, Impulses And Inhibitory Forces; M, Motives; and E, Evaluations of the said theory. Statistical Analysis Used Verbatim transcripts were analysed using thematic framework analysis. Results A majority of the participants were multiple SLT product users, and they did not have an immediate plan to quit. Most of the participants showed strong emotional attachment with these products and considered them the only source of pleasure (want) in a life full of miseries. The words “Tobacco” and “Nicotine” were medical jargons for them. Though they were aware of the harmful effects, they had a positive evaluative belief about its use because of cognitive dissonance. Most of them were habitual users living in an environment full of physical and social cues. Conclusions This case study is well in line with the PRIME theory in explaining the addictive behaviour; a comprehensive multi-strategic approach was formulated for inculcating quitting behaviour among this disadvantaged section of the population as suggested by the proposer of this theory.

Background The foremost concern and challenge in managing drug-resistant tuberculosis is ensuring a high health-related quality of life (HRQoL). The effectiveness of pre-extensively drug-resistant (Pre-XDR) tuberculosis management hinges on patients adhering to therapy, a crucial factor in averting the development of drug-resistant strains, ultimately enhancing HRQoL. Methodology This analytical longitudinal study spanned two years at a teaching hospital and involved collaboration between the Departments of Pharmacology and Pulmonary Medicine. A case record form was utilized to gather baseline data, encompassing patient demographics, medication details, WHO BREF HRQoL scores, and treatment adherence. Patients were classified as either adherent or nonadherent using three distinct criteria: the guidelines of the Revised National Tuberculosis Programme (RNTCP), the Morisky-Green-Levine Scale (MGLS), and the Batalla test. The sample size was determined based on 30% nonadherence rates from preliminary analysis of prior data, resulting in 86 patients included in the study. The association between the improvement of HRQoL score from the baseline with the predictor variables was assessed with a linear regression model. Comparison of nonadherence with the different predictors of the study population was assessed with binary logistic regression model. Results Analysis of demographic data revealed no notable differences in age and BMI between the Bedaquiline and Delamanid groups. However, there was a gender-related difference in treatment distribution, with more men in the Bedaquiline group. Other factors, such as marital status, socioeconomic status, employment status, stigma/discrimination, comorbidity, and addiction, showed no significant differences between the groups. Comparing HRQoL scores at baseline and after six months showed substantial improvements in all domains, indicating a positive impact of the treatment. Linear regression analysis revealed a strong association between QoL improvement and adherence. Adherence patterns did not significantly differ between the two treatment groups, as assessed by various criteria. The patients with high stigma, newly diagnosed Pre-XDR cases, and the presence of adverse events had higher odds of nonadherence. Conclusion This study highlights the substantial impact of Bedaquiline and Delamanid treatment on the HRQoL of Pre-XDR TB patients in Eastern India. Adherence to treatment plays a crucial role in improving QoL, and factors like stigma, newly diagnosed Pre-XDR patients, and adverse drug reactions influence adherence adversely. The findings emphasize the importance of patient support and education to enhance treatment outcomes.

Medical education plays a pivotal role in ameliorating health-related outcomes by preparing health-care professionals with the desired knowledge, skills, and attitudes necessary to deliver effective patient-centered care. The purpose of the current review is to explore the role of medical education in rural areas, identify the potential challenges in the implementation, and propose suitable measures to overcome these challenges. The delivery of medical education in rural areas is expected to address the disparities in health-care delivery by serving people in underserved areas, thereby reducing the urban–rural divide. This is accomplished by ensuring timely access to medical services, resulting in the promotion of early diagnosis and better management of the disease. The process of delivery of medical education in rural settings has been associated with multiple challenges that must be systematically dealt with to improve the overall outcomes. In conclusion, promoting access to medical education in rural areas is a crucial step to establishing a robust and equitable health-care system that will aid in the attainment of universal health coverage. However, the need of the hour is to overcome the existing challenges to empower aspiring health-care professionals from rural backgrounds and also contribute to the overall health and well-being of underserved communities.

Abstract Antimicrobial peptides have garnered increasing attention as potential alternatives due to their broad-spectrum antimicrobial activity and low propensity for developing resistance. This is for the first time; proteome sequences of Aegle marmelos were subjected to in-silico digestion and AMP prediction were performed using DBAASP server. After screening the peptides on the basis of different physiochemical property, peptide sequence GKEAATKAIKEWGQPKSKITH (AM1) shows the maximum binding affinity with − 10.2 Kcal/mol in comparison with the standard drug (Trimethoprim) with − 7.4 kcal/mol and − 6.8 Kcal/mol for DHFR and SaTrmK enzyme respectively. Molecular dynamics simulation performed for 300ns, it has been found that peptide was able to stabilize the protein more effectively, analysed by RMSD, RMSF, and other statistical analysis. Free binding energy for DHFR and SaTrmK interaction from MMPBSA analysis with peptide was found to be -47.69 and − 44.32 Kcal/mol and for Trimethoprim to be -13.85 Kcal/mol and − 11.67 Kcal/mol respectively. Further in-vitro study was performed against Methicillin Susceptible Staphylococcus aureus (MSSA), Methicillin Resistant Staphylococcus aureus (MRSA), Multi-Drug Resistant Staphylococcus aureus (MDR-SA) strain, where MIC values found to be 2, 4, and 8.5 µg/ml lesser in comparison to trimethoprim which has higher MIC values 2.5, 5, and 9.5 µg/ml respectively. Thus, our study provides the insight for the further in-vivo study of the peptides against multi-drug resistant S. aureus.

Abstract In this study, we examine the third-order fractional nonlinear Schrödinger equation (FNLSE) in $$(1+1)$$ -dimensional, by employing the analytical methodology of the new extended direct algebraic method (NEDAM) alongside optical soliton solutions. In order to better understand high-order nonlinear wave behaviors in such systems, the researched model captures the physical and mathematical properties of nonlinear dispersive waves, with applications in plasma physics and optics. With the aid of above mentioned approach, we rigorously assess the novel optical soliton solutions in the form of dark, bright–dark, dark–bright, periodic, singular, rational, mixed trigonometric and hyperbolic forms. Additionally, stability assessments using conserved quantities, such as Hamiltonian property, and consistency checks were used to validate the solutions. The dynamic structure of the governing model is further examined using chaos, bifurcation, and sensitivity analysis. With the appropriate parameter values, 2D, 3D, and contour plots can all be utilized to graphically show the data. This work advances our knowledge of nonlinear wave propagation in Bose–Einstein condensates, ultrafast fibre optics, and plasma physics, among other areas with higher-order chromatic effects.

Abstract Background Friedreich ataxia (FRDA) results in progressive impairment in gait, upper extremity coordination, and speech. Currently, these symptoms are assessed through expert examination at clinical visits. Such in-clinic assessments are time-consuming, subjective, of limited sensitivity, and provide only a limited perspective of the daily disability of patients. Methods In this study, we recruited 39 FRDA patients and remotely monitored their physical activity and upper extremity function using a set of wearable sensors for 7 consecutive days. We compared the sensor-derived metrics of lower and upper extremity function as measured during activities of daily living with FRDA clinical measures (e.g., mFARS and FA-ADL) and biological biomarkers of disease severity (guanine-adenine-adenine (GAA) and frataxin (FXN) levels), using Spearman correlation analyses. Results The results show significant correlations with moderate to high effect sizes between multiple sensor-derived metrics and the FRDA clinical and biological outcomes. In addition, we develop multiple machine learning-based models to predict disease severity in FRDA using demographic, biological, and sensor-derived metrics. When sensor-derived metrics are included, the model performance enhances 1.5-fold and 2-fold in terms of explained variance, R², for predicting FRDA clinical measures and biological biomarkers of disease severity, respectively. Conclusions Our results establish the initial clinical validity of using wearable sensors in assessing disease severity and monitoring motor dysfunction in FRDA.

Abstract In order to improve road safety and offer extra services to cars and their users, vehicular ad hoc networks, or VANETs, are essential parts of intelligent transportation systems (ITS). The primary aim of this research is to suggest and assess a new approach for mitigating network congestion in VANET technology through the implementation of dynamic grouping of vehicles for safety (DGVS). To do this, virtual regions are created around cars using the DBSCAN and K Mean method. This allows vehicles to communicate directly with others within the same DGVS, eliminating the need to broadcast messages across the entire network.The ultimate goal is to drastically decrease traffic while preserving vital data transfer for VANET traffic control and safety. The suggested technique determines the optimal transmission rate in accordance with the existing channel circumstances, yielding a balanced performance concerning both packet delivery and channel congestion. With this novel method, cars may only talk to other vehicles that are in the same DGVS, thus there’s no need to broadcast messages to the whole network. With the use of this technique, the efficacy of DGVS in reducing VANET congestion and enhancing network performance will be thoroughly assessed. The study’s conclusions demonstrate how well the suggested dynamic grouping of vehicles for safety (DGVS) technique works to reduce VANET congestion. It was shown through simulation-based studies that, in comparison to current approaches, DGVS dramatically decrease network congestion, resulting in notable gains in network performance and decreased communication delay. Additionally, the study found a number of possible uses for DGVS in the transportation industry, such as emergency response, traffic management, and accident prevention.

Abstract Medicine recommendation systems are designed to aid healthcare professionals by analysing a patient’s admission data to recommend safe and effective medications. These systems are categorised into two types: instance-based and longitudinal-based. Instance-based models only consider the current admission, while longitudinal models consider the patient’s medical history. Electronic Health Records are used to incorporate medical history into longitudinal models. This project proposes a novel Knowledge Graph-Driven Medicine Recommendation System using Graph Neural Networks, KGDNet, that utilises longitudinal EHR data along with ontologies and Drug-Drug Interaction knowledge to construct admission-wise clinical and medicine Knowledge Graphs for every patient. Recurrent Neural Networks are employed to model a patient’s historical data, and Graph Neural Networks are used to learn embeddings from the Knowledge Graphs. A Transformer-based Attention mechanism is then used to generate medication recommendations for the patient, considering their current clinical state, medication history, and joint medical records. The model is evaluated on the MIMIC-IV EHR data and outperforms existing methods in terms of precision, recall, F1 score, Jaccard score, and Drug-Drug Interaction control. An ablation study on our models various inputs and components to provide evidence for the importance of each component in providing the best performance. Case study is also performed to demonstrate the real-world effectiveness of KGDNet.

Abstract The present study focuses on the green synthesis of a novel Z-scheme SnS₂/HAp photocatalyst using Ocimum tenuiflorum (tulsi) leaf extract as a stabilizing agent. This approach not only emphasizes sustainability but also adds value to waste by extracting hydroxyapatite (HAp) from Labeo rohita fish scales, addressing the challenge of their disposal. The synthesized photocatalyst was thoroughly characterized using a range of analytical techniques to evaluate its crystal structure, optical properties, morphology, and elemental composition. The photocatalytic activity of the SnS₂/HAp composite was assessed through the degradation of gentian violet (GV) dye, a representative organic pollutant. Various reaction parameters were optimized to enhance the degradation efficiency, and the photocatalyst’s performance was further tested across different water matrices. Under optimal conditions, the SnS₂/HAp photocatalyst achieved a maximum photodegradation efficiency of 97.49% with a rate constant of 0.0494 min− 1 for GV dye. Additionally, it exhibited an efficiency greater than 70% against other emerging pollutants via advanced oxidation processes (AOP). The enhanced photocatalytic activity was attributed to the formation of a Z-Scheme heterojunction between SnS2 and HAp, which enhanced the charge separation efficiency and delayed the charge recombination. The study also demonstrated the photocatalyst’s remarkable reusability, maintaining high performance over five cycles and across various water environments. This highlights its potential as a sustainable solution for the removal of organic pollutants from aqueous streams. Finally, a Z-scheme electron transport mechanism is proposed to explain the photodegradation process of GV dye using the SnS₂/HAp photocatalyst.

Abstract The identification of malaria infection using microscope images of blood smears is considered as a ‘gold standard’. The diagnosis of malaria needs expert microscopists which are scarce in remote areas where malaria is endemic. Therefore, it is desirable to automate the repetitive task of pathogen detection in the blood samples received as microscope images. This study provides an easy to use and deploy method for implementing a malaria pathogen detection software- the Intelligent Suite. The Intelligent Suite features a graphical user interface (GUI) implemented using ‘cvui’ library to interact with the OpenVINO’s inference engine for model optimisation and deployment across several inference devices. The intelligent Suite uses a custom YOLO-mp-3l model trained on Darknet framework for detection of malaria pathogen in thick smear microscope images. Moreover, the Intelligent Suite provides user interface for inference device/mode selection, alter model parameters, and generate detection reports along with the model performance metrics. The Intelligent Suite was executed on a CPU computer with model inference running on a plug-and-play Neural Compute Stick (NCS2) and performance reported.

Abstract Among biomimetic strategies shaping engineering designs, molecularly imprinted polymer (MIP) technology stands out, involving chemically synthesised receptors emulating natural antigen-antibody interactions. These versatile ‘designer polymers’ with remarkable stability and low cost, are pivotal for in vitro diagnostics. Amid the recent global health crisis, we probed MIPs’ potential to capture SARS-CoV-2 virions. Large biotemplates complicate MIP design, influencing generated binding site specificity. To precisely structure recognition sites within polymers, we innovated an epitope imprinting method supplemented by in silico polymerization component screening. A viral surface Spike protein informed epitope selection was targeted for MIP development. A novel multi-monomer docking approach (MMSD) was employed to simulate classical receptor-ligand interactions, mimicking binding reinforcement across multiple amino acids. Around 40 monomer combinations were docked to the epitope sequence and top performers experimentally validated via rapid fluorescence binding assays. Notably, high imprinting factor polymers correlated with MMSD predictions, promising rational MIP design applicable to diverse viral pathologies.

Hyperhaemolysis syndrome, often associated with sickle cell disease, can also occur in non sickle cell conditions following viral infections and autoimmune disorders. This case report presents a rare instance of hyperhaemolysis in the context of familial anaemia. A 41-year-old female with a history of unexplained anaemia presented with four episodes of haematemesis, abdominal pain, and headache. She had received a blood transfusion a month prior. Upon admission, she was diagnosed with pancytopenia and hypovolemic shock and was treated with packed cell volume transfusions. The patient had a significant family history of anaemia in her sisters, who also required intermittent blood transfusions. Following admission, she developed thrombocytopenia, a drop in Haemoglobin (Hb), petechiae, and subdural haemorrhage. Further investigations confirmed hyperhaemolysis syndrome. Treatment included blood transfusions, random donor platelet transfusions, and corticosteroids. The patient was discharged on prednisolone and cyclosporine. Over six months, her condition improved significantly, with no further bleeding episodes and stable Hb levels. Diagnosing hyperhaemolysis syndrome is challenging and requires a high index of suspicion. This case underscores the importance of considering hyperhaemolysis in patients with familial anaemia and unexplained haemolytic episodes. Early recognition and appropriate management are crucial for favourable outcomes.

Background: Intertrochanteric fractures are the most frequent fractures of the hip joint. This is attributed to the increase in the elderly population in our country, along with osteoporosis being prevalent in these populations. Aims and Objectives: The aim of the study is to prospectively analyze the functional outcome of unstable intertrochanteric fractures managed with “proximal femoral nail” (PFN). Materials and Methods: The prospective study was conducted on 48 cases of unstable intertrochanteric in Maharani Laxmi Bai Medical College, Jhansi, between June 2022 and December 2023. Results: In our study, the mean age of the patient is 36.16 and the most common age group is 41–60 years, 33.33%, and >60 years, 41.67%. In forty-eight cases, 37 (77.08%) were male patients, and 11 (22.92%) were female patients. The Harris hip score patients follow-up after 3 months 8 (16.67%) patients of excellent outcomes, 18 (37.50%) patients of good outcomes, 12 (25.00%) of fair outcomes, and 10 (20.83%) patients of poor outcomes. The Harris hip score patients follow-up after 6 months 24 (50%) patients of excellent outcomes, 20 (41.67%) patients of good outcomes, 2 (4.17%) of fair outcomes, and 2 (4.17%) patients of poor outcomes. Conclusion: In unstable proximal femur fractures, PFN is a significant advancement in the treatment of unstable trochanteric fractures which has the unique advantages of closed reduction, preservation of fracture hematoma, less tissue damage, early rehabilitation, and early return to work.

Introduction: Injuries to the acromioclavicular (AC) joint can range from modest, transient pain to significant displacement, chronic pain, and shoulder biomechanical changes that result in long-term disability. Aim and Objective: We aimed to evaluate the functional outcome of anatomical reconstruction of ACJ using autologous semitendinosus graft in type III-VI AC joint dislocations. MATERIALS AND METHODS: In this study, 20 patients with AC joint dislocation (Rockwood type III-VI) were managed by surgical fixation using autologous semitendinosus graft from November 01, 2019, to October 31, 2020, at our center. After providing written informed consent, the study enrolled patients who satisfied the inclusion criteria. Preoperative, three-month, and six-month UCLA shoulder scores were assessed. Results: Mean age of participants was 36.5 years (SD: 9.86). Radiological evaluation at each visit suggested a 100.0% success rate of this method. 95% of the participants had no complications, while 5.0% had DVT. No participants had SSI. Conclusions: Autologous semitendinosus graft fixation of type III-VI AC joint injuries is a viable surgical option with the advantages of being a biological fixation, single surgery, and having excellent functional outcomes. However, extensive multicentric comparative studies are required to draw definitive conclusions.

Abstract Herbal medicines are important for ensuring sustainable development goals (SDGs) in healthcare, particularly in developing countries with high rates of antimicrobial resistance (AMR) and little access to medical facilities. Thymus vulgaris is a widely used herbal medicinal plant known for its secondary metabolites and antimicrobial properties. The present study involved a comprehensive examination of the isolation, characterization, and antibacterial activity of Thymus vulgaris obtained from Ethiopia. The aerial part of the plant Thymus vulgaris was successively extracted with hexane, chloroform, and methanol based on differences in polarity. Phytochemical screening tests conducted against hexane, chloroform and MeOH crude extracts indicated the presence of some secondary metabolites. Based on the thin-layer chromatography tests, the chloroform extract was subjected to column chromatography, yielding Tv-2 compounds, namely 5-isopropyl-2-methylphenol. The structures of the compounds were elucidated via spectroscopic methods (UV–Vis, FT-IR and NMR). We investigated the antibacterial properties of hexane crude extract, chloroform crude extract, MeOH crude extract, and isolated fractions derived from T. vulgaris against various bacterial strains. This study contributes to a better understanding of the bioactive components present in Thymus vulgaris crude extracts and their potential role in tackling microbial infections.

Abstract The present study investigates the temporal effects of flaxseed supplementation on boar semen quality, antioxidant status, and in-vivo fertility under high-temperature humidity index (THI) conditions in a sub-tropical climate. Twelve Hampshire crossbreed boars were randomly assigned to control and treatment groups, with the treatment group receiving flaxseed oil supplementation. Semen samples were collected and analyzed for semen quality parameters, sperm kinematics, and antioxidant status. Fertility outcomes were assessed through in-vivo mating trials. Flaxseed supplementation resulted in time dependent significant improvements in semen volume, sperm concentration, total and progressive sperm motility, sperm quality parameters, and antioxidant status. Fertility outcomes, including farrowing rates and litter sizes, were also enhanced in the flaxseed-supplemented group. These findings highlight the potential of flaxseed supplementation to improve boar fertility under high ambient stress conditions, with implications for optimizing reproductive performance in swine production systems.

INTRODUCTION: Renal disorders are becoming increasingly common today. There is a clear correlation between social and economic deprivation and the advancement of many kidney illnesses, as well as premature death. OBJECTIVE: The objective is to reveal trends in the prevalence of renal diseases among the population below the poverty line (BPL) using the Karnataka method. METHODS: The current study is based on the data available on the government-managed website containing details about people who received treatment for several renal diseases under various government health insurance schemes by the BPL population from 2010 to 2020 in Karnataka state, South India. RESULTS: Renal calculi, enlarged prostate, and bladder calculus are the most common renal disorders among BPL communities in the age group of 20–40 years. Regarding renal calculi, there is a consistent increase in cases from 563 in 2010–2011 to a peak of 3901 in 2020–2021, indicating a continuous upward trend. Fluctuations are observed in the case of an enlarged prostate, with variations in the number of cases each passing year. Bladder calculus disease also shows an increasing trend, particularly evident from 2017 to 2018 onward. CONCLUSION: This study found the potential relationship between socioeconomic status and renal diseases among individuals in the BPL segment of Karnataka state. Renal disorders such as calculi, renal failure, and chronic kidney disease exhibit a rising trend over time, whereas diseases such as enlarged prostate and bladder calculus display fluctuations. The findings underscore the urgent necessity for targeted healthcare interventions and awareness programs tailored to BPL communities.

Background: The mitochondrial DNA (mtDNA) G10398A polymorphism has been associated with bipolar disorder (BD). It leads to an amino acid substitution within NADH dehydrogenase subunit, thereby altering the mitochondrial complex I function. This exploratory case–control study assesses the association of mtDNA G10398A with the risk of BD and its relationship to clinical variables in Indian patients. Methods: Cases met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of BD-I in remission and had a family history of BD or recurrent unipolar disorder in biological relatives. The healthy controls (HC) had no known illness and were screened negative for Family Interview for Genetic Studies. Participants were assessed using Clinical Pro forma, NIMH-Life Chart Method and Alda lithium response scale. The mtDNA G10398A was assessed with real-time polymerase chain reaction using TaqMan assay. Results: A total of 82 participants were recruited across cases and controls, with 42 patients (50% with maternal history) and 40 healthy individuals with similar demographic profiles. The mean age of onset was 25.16 (standard deviation [SD] 7.6) years, with illness for 11.59 years (SD: 7.18). Allele A was found in 50% of cases compared to 32.5% HC (odds ratio = 2.08; 95% confidence interval [CI]: 0.85–5.09). Findings remain non-significant for patients with maternal mood disorders (allele A: 38.9%; 21/42). Cases with allele G had significantly higher body mass index (BMI) (P = 0.008) than those with allele A. Conclusion: The study adds information on mtDNA 10398A amongst Indian patient samples and healthy individuals. No significant group difference was found with respect to mtDNA G10398A. The positive association of allele G with higher BMI has potential clinical relevance that can be further investigated in larger samples.

Abstract Stroke remains a critical global health issue, significantly impacting India with substantial contributions to mortality and disability. This study comprehensively analyses stroke incidence, mortality, and disability-adjusted life years (DALYs) across India from 1990 to 2021, using the latest Global Burden of Disease (GBD) 2021 data. We evaluate how Universal Health Coverage (UHC), health expenditure, human development index (HDI), and gross national income (GNI) influence stroke outcomes. Our findings reveal significant regional disparities, with higher stroke rates in urban areas and states like Goa and Kerala. Higher health expenditure and HDI are linked to lower stroke rates, while higher GNI per capita correlates with increased stroke incidence, likely due to lifestyle changes. Risk factors include air pollution, tobacco use, dietary risks, and high blood pressure. Air pollution notably impacts stroke mortality in Bihar and Jharkhand, while tobacco use is a major risk factor in Mizoram and Manipur. Dietary risks and hypertension are prevalent in Maharashtra and Jammu & Kashmir. The study highlights the need for targeted public health strategies addressing regional disparities and socioeconomic factors. Policymakers should focus on lifestyle modification programs, public awareness campaigns, and enhanced access to quality stroke care to reduce stroke-related morbidity and mortality effectively.

Abstract Background Tenosynovial giant cell tumor is a rare soft tissue tumor of the synovium of joint, bursae, or tendon sheath. It is divided into localized or diffuse types on the basis of the growth pattern. Localized tenosynovial giant cell tumors are usually benign and treated successfully by excision. Diffuse tenosynovial giant cell tumors, in contrast to localized type, can destroy bone and cartilage and are associated with frequent local recurrences and distant metastasis. Localized type tenosynovial giant cell tumors rarely metastasize to distant organs. Here, we report a case of localized tenosynovial giant cell tumor presenting with lung metastases and systematically review literature. Case presentation A 55-year-old Asian male presented with a dry cough, right-sided chest pain and progressive dyspnea for 1 month. At 18 months before this presentation, he had undergone excision of a painless swelling on his right index finger. The swelling recurred within 3 months of excision, and a biopsy was then suggestive of a giant cell tumor. Given the suspicion of a giant cell tumor, a wide excision of the lesion was performed and the excisional biopsy was consistent with a diagnosis of tenosynovial giant cell tumor, localized type. At admission to our hospital, the patient had tachypnoea and absent breath sounds on the right side. A chest radiograph showed a right-sided pleural effusion with a homogenous opacity in the left mid-zone. A contrast-enhanced computed tomography of the chest and abdomen showed right massive pleural effusion and bilateral multiple lobulated heterogeneously enhancing pleural-based masses with areas of internal calcification. Pleural fluid analysis revealed an exudate with no malignant cells on cytology. A lung biopsy showed osteoclast-like giant cells and mononuclear spindle cells with areas of hemorrhage and necrosis, suggesting tenosynovial giant cell tumor metastasis. A final diagnosis of localized type tenosynovial giant cell tumor of the right index finger with metastases to the lungs and pleura was made. The patient passed away after receiving three cycles of denosumab injection owing to progressive disease. Conclusion Lung metastasis is extremely rare in patients with localized tenosynovial giant cell tumor. The survival is usually poor in patients with lung metastasis. A close follow-up of patients with localized type tenosynovial giant cell tumor is necessary for early detection of pleuropulmonary complications.

Abstract DNA characterisation in people with tuberculosis (TB) is critical for diagnostic and microbiome evaluations. However, extracellular DNA, more frequent in people on chemotherapy, confounds results. We evaluated whether nucleic acid dyes [propidium monoazide (PMA), PEMAX] and DNaseI could reduce this. PCR [16S Mycobacterium tuberculosis complex (Mtb) qPCR, Xpert MTB/RIF] was done on dilution series of untreated and treated (PMA, PEMAX, DNaseI) Mtb. Separately, 16S rRNA gene qPCR and sequencing were done on untreated and treated sputa before (Cohort A: 11 TB-negatives, 9 TB-positives; Cohort B: 19 TB-positives, PEMAX only) and 24-weeks after chemotherapy (Cohort B). PMA and PEMAX reduced PCR-detected Mtb DNA for dilution series and Cohort A sputum versus untreated controls, suggesting non-intact Mtb is present before treatment-start. PEMAX enabled sequencing-based Mycobacterium-detection in 7/12 (58%) TB-positive sputa where no such reads otherwise occurred. In Cohort A, PMA- and PEMAX-treated versus untreated sputa had decreased α- and increased β-diversities. In Cohort B, β-diversity differences between timepoints were only detected with PEMAX. DNaseI had negligible effects. PMA and PEMAX (but not DNaseI) reduced extracellular DNA in PCR and improved pathogen detection by sequencing. PEMAX additionally detected chemotherapy-associated taxonomic changes that would otherwise be missed. Dyes enhance microbiome evaluations especially during chemotherapy.

Introduction: Prescription patterns significantly impact healthcare quality and patient outcomes. Evaluating these patterns using World Health Organisation (WHO) indicators helps identify areas for improvement and ensures rational drug use. The present study was conducted to evaluate prescription patterns via WHO indicators, aiming to uncover insights, identify discrepancies and enhance prescription quality within the institute for improved healthcare outcomes. Aim: To evaluate drug prescription patterns using WHO prescription indicators in the prescriptions of outdoor patients at a tertiary care teaching hospital in Chhattisgarh, India. Materials and Methods: A cross-sectional study was conducted in the Department of Pharmacology at Department of Pharmacology, Pt. J.N.M. Medical College, Raipur, Chhattisgarh, India, from July 15, 2023, to October 15, 2023 (a duration of 3 months), involving 1,000 outpatient prescriptions at Dr. Bhimrao Ambedkar Memorial Hospital (BRAM), Raipur, Chhattisgarh. Ethical clearance was obtained from the Institutional Ethics Committee (IEC) (No./MCI/Ethics/2023/45 Raipur, dated 12/07/2023). Data were collected using a digital form and analysed statistically. Parameters evaluated included the average number of medicines per prescription, the percentage of drugs prescribed by generic name, the percentage of prescriptions containing antibiotics, the percentage of prescriptions containing injections, and the percentage of drugs prescribed from the Essential Drug List (EDL). Descriptive statistics were used to summarise the data, and analysis was performed using Microsoft (MS) Excel 2021. Results: The present study included 1,000 prescriptions. A total of 4,320 medicines were prescribed across these prescriptions, with 2,853 (66.04%) prescribed by their generic name. Injections accounted for 483 (11.18%) prescriptions, while antibiotics were included in 663 (15.34%) prescriptions. Additionally, 2,973 (68.81%) medicines were prescribed from the EDL. The average number of medicines prescribed per prescription was 4.3. Conclusion: The study revealed that while certain aspects of prescription practices aligned with WHO indicators, notable discrepancies persisted. The percentage of antibiotics prescribed per prescription was in accordance with WHO guidelines. Strategic measures are needed to enhance prescription practices and align them more closely with WHO guidelines.

Abstract Soil contamination with heavy metals presents a substantial environmental peril, necessitating the exploration of innovative remediation approaches. This research aimed to investigate the efficiency of nano-silica in stabilizing heavy metals in a calcareous heavy metal-contaminated soil. The soil was treated with five nano-silica levels of 0, 100, 200, 500, and 1000 mg/kg and incubated for two months. The results showed that nano-silica had a specific surface area of 179.68 $${\text{m}}^{2}/\text{g}$$ m 2 / g . At 1000 mg/kg, the DTPA-extractable concentrations of Pb, Zn, Cu, Ni, and Cr decreased by 12%, 11%, 11.6%, 10%, and 9.5% compared to the controls, respectively. Additionally, as the nano-silica application rate increased, both soil pH and specific surface area increased. The augmentation of nano-silica adsorbent in the soil led to a decline in the exchangeable (EX) and carbonate-bound fractions of Pb, Cu, Zn, Ni, and Cr, while the distribution of heavy metals in fractions bonded with Fe–Mn oxides, organic matter, and residue increased. The use of 1000 mg/kg nano-silica resulted in an 8.0% reduction in EX Pb, 4.5% in EX Cu, 7.3% in EX Zn, 7.1% in EX Ni, and 7.9% in EX Cr compared to the control treatment. Overall, our study highlights the potential of nano silica as a promising remediation strategy for addressing heavy metal pollution in contaminated soils, offering sustainable solutions for environmental restoration and ecosystem protection.

Abstract Tuberculosis (TB) is the leading cause of mortality among infectious diseases globally. Effectively managing TB requires early identification of individuals with TB disease. Resource-constrained settings often lack skilled professionals for interpreting chest X-rays (CXRs) used in TB diagnosis. To address this challenge, we developed “DecXpert” a novel Computer-Aided Detection (CAD) software solution based on deep neural networks for early TB diagnosis from CXRs, aiming to detect subtle abnormalities that may be overlooked by human interpretation alone. This study was conducted on the largest cohort size to date, where the performance of a CAD software (DecXpert version 1.4) was validated against the gold standard molecular diagnostic technique, GeneXpert MTB/RIF, analyzing data from 4363 individuals across 12 primary health care centers and one tertiary hospital in North India. DecXpert demonstrated 88% sensitivity (95% CI 0.85–0.93) and 85% specificity (95% CI 0.82–0.91) for active TB detection. Incorporating demographics, DecXpert achieved an area under the curve of 0.91 (95% CI 0.88–0.94), indicating robust diagnostic performance. Our findings establish DecXpert's potential as an accurate, efficient AI solution for early identification of active TB cases. Deployed as a screening tool in resource-limited settings, DecXpert could enable early identification of individuals with TB disease and facilitate effective TB management where skilled radiological interpretation is limited.

Abstract The research introduces a novel method for creating drug-loaded hydrogel beads that target anti-aging, anti-oxidative, and anti-inflammatory effects, addressing the interconnected processes underlying various pathological conditions. The study focuses on the development of hydrogel beads containing anti-aging compounds, antioxidants, and anti-inflammatory drugs to effectively mitigate various processes. The synthesis, characterization and in vitro evaluations, and potential applications of these multifunctional hydrogel beads are discussed. A polymeric alginate-orange peel extract (1:1) hydrogel was synthesized for encapsulating fish oil. Beads prepared with variable fish oil concentrations (0.1, 0.3, and 0.5 ml) were characterized, showing no significant decrease in size i.e., 0.5 mm and a reduction in pore size from 23 to 12 µm. Encapsulation efficiency reached up to 98% within 2 min, with controlled release achieved upto 45 to 120 min with increasing oil concentration, indicating potential for sustained delivery. Fourier-transform infrared spectroscopy confirmed successful encapsulation by revealing peak shifting, interaction between constituents. In vitro degradation studies showed the hydrogel's biodegradability improved from 30 to 120 min, alongside anti-inflammatory, anti-oxidative, anti-collagenase and anti-elastase activities, cell proliferation rate enhanced after entrapping fish oil. In conclusion, the synthesized hydrogel beads are a promising drug delivery vehicle because they provide stable and effective oil encapsulation with controlled release for notable anti-aging and regenerative potential. Targeted delivery for inflammatory and oxidative stress-related illnesses is one set of potential uses. Further research may optimize this system for broader applications in drug delivery and tissue engineering.

Background: Fibromyalgia (FM) is a chronic disorder characterized by widespread pain associated with fatigue, stiffness, sleep disturbance, cognitive dysfunction, anxiety, and depression. The role of Vitamin D in the pathophysiology of FM is poorly known. Studies available to establish the association between Vitamin D and FM have inconsistent results. Some of the studies reported a positive association and others found no relation. It is not clear whether the pain is due to and/or associated with low levels of Vitamin D. Aims and Objectives: The objective of the current study is to estimate Vitamin D levels in FM patients and to find the association between Vitamin D levels and severity of FM. Materials and Methods: In this cross-sectional study, seventy patients who fulfilled the inclusion (American College of Rheumatology 2016 criteria) and exclusion criteria as has been considered for the study were enrolled and their serum 25 hydroxy-vitamin D level has been measured by enzyme-linked immunosorbent assay reader. Pre-designed questionnaires were prepared to measure FM severity. Pain intensity was measured by the Visual Analog Scale (VAS). Results: A total of 70 patients who were diagnosed with FM were included in our study. The majority of them (80%) were female and the rest (20%) were male. The mean age is 48.2±9.2 years. Their mean body mass index (BMI) is 23.7±3.82. The mean Vitamin D serum level was 22.4±9.2 ng/dL. Vitamin D deficiency (VDD) was defined as patients with a serum level of 20 ng/mL and below. In our study, 62.8% (44) of the study population had VDD. According to VAS (0–10) pain scale, 15 (21.4%) subjects suffered from moderate pain and 55 (78.6%) subjects suffered from severe pain. The severity of FM was measured by the Fibromyalgia Severity Scale (FSS). The mean score of FSS was 22.7. To find the association between VDD and severity of FM, several covariates were identified and a multivariable logistic regression was done. Conclusion: VDD increases with an increase in age, BMI, VAS, and FSS, all of which are predicators of FM syndrome.

Purpose Orbital cellulitis is an acute post-septal orbital infection caused mostly by bacteria. This may result in serious complications including blindness, meningitis, cavernous sinus thrombosis, brain abscess, and even death. The delay in treatment increases morbidity and mortality. The purpose of present study was to review cases of orbital cellulitis in recent years regarding its clinical presentation, diagnostic evaluation, treatment policy, complications, and disabilities. The outcome of study will help in early diagnosis and better management of orbital cellulitis cases. Materials and Method Total 20 cases of orbital cellulitis in children from March 2021 to February 2024 were evaluated and analyzed in department of ophthalmology, Patna Medical College and Hospital, Patna. Result Total 20 children with ages

Introduction: The cornea of the eye is the most vulnerable organ to external insult. Contact lens is no exception. Changes in corneal epithelium, stroma, and loss of hexagonal shape in the endothelium have been taught in contact lens classes. We wanted to understand the cell density of endothelium in prolonged contact lens wear. Methods: It was a prospective, observational, cross-sectional study. The volunteers were divided into two groups: group 1 wore their contact lenses for over 5 years and group 2 never wore contact lenses. Specular microscopy was performed using Topcon SP-3000P. Computerized morphometry was used to evaluate the mean cell density of the corneal endothelial cells. Result: A statistically significant decrease in corneal endothelial cell density was observed in contact lens wearers. Conclusion: The use of contact lenses for a prolonged period significantly decreases corneal endothelial cell density. Suitable intervention may prevent such changes in the cornea.

Arthroscopic shoulder surgeries are routinely practiced in many orthopedic centers for diagnostic and therapeutic purposes. The patient is commonly made to lie in a lateral position to carry out the procedure. We had a 71-year-old patient who underwent right shoulder arthroscopy for rotator cuff injury; the duration of surgery was 300 min. The patient developed subcutaneous edema over the neck and anterior chest. Further evaluation revealed airway edema as well. The patient was shifted to ICU for monitoring and overnight ventilation. Other radiological investigations confirmed the edema in subcutaneous and deep tissues of the neck and chest. The patient was extubated the next day morning after the edema improved. She was shifted to the ward for further management. Airway edema after shoulder arthroscopy, though uncommon, can be predicted in susceptible patients with prolonged surgeries and excess fluid irrigation. Timely diagnosis and intervention with coordination among the treating teams can result in positive outcomes.

Purpose: The COVID-19 pandemic was caused by severe acute respiratory syndrome coronavirus-2 (SARS-COV2). The impact of the pandemic is becoming more apparent now on various tissues and body organs. Limited knowledge is present about the characteristics, duration, and long-term sequelae of ocular problems post-COVID-19 infection. The purpose of the present study was to evaluate and analyze the ocular problems occurring in healthcare workers after COVID-19 infection. Material and Method: This was a cross-sectional survey study conducted in the Department of Ophthalmology, Patna Medical College and Hospital, Patna. The participants were healthcare workers who were exposed to COVID-19 infection ≥6 months back. A questionnaire was prepared. Responses were evaluated and analyzed. Patient consent and institutional committee permission were taken as per norms. Result: A total of 210 healthcare workers who were infected with COVID-19 >6 months back responded with complete answers. The maximum number of respondents was between the ages of 31 and 60 (73.3%). The pre-covid ocular problems were present in 25% of the participants, especially in those having chronic diseases (such as diabetes, hypertension, or both). Post-ocular problems were faced by 60% of the participants, which was significant (P < 0.01). Dry eye, itching, and foreign body sensations were present in 60% of those facing ocular problems (P < 0.01). Ocular surface manifestations were more common. Conclusion: A knowledge, understanding, and awareness about ocular problems and their long-term sequelae in post-COVID-19-infected patients will help in early diagnosis and better management of such patients.

Background: Blood loss is often a major complication of neurosurgery; and adversely impacts postoperative outcomes. Primary objective of our study was to assess the effect of tranexamic acid (TXA) on total perioperative blood loss and the need for packed red blood cell (PRBC) transfusion in patients. Secondary objective was to assess and compare the effect of TXA on haemoglobin (Hb) , packed cell volume (PCV), coagulation profile, crystalloid and PRBC requirement, neurological outcomes; and the quality of surgical field peri-operatively. Materials and Methods: 60 adult patients, undergoing elective craniotomy for tumor resection were recruited. 30 patients each, received either a bolus of TXA , followed by an infusion (TXA group); or normal saline in the same dose (Placebo group). Crystalloid and PRBC transfusion, blood loss, Hb, PCV, platelet count, fibrinogen levels, international normalized ratio were recorded. Mean intensive care unit (ICU) stay and Glasgow Outcome Extended (GOSE) score were also measured. Results: There was no significant difference in blood loss, PRBC requirement, Hb, PCV, fibrinogen levels , INR, duration of ICU stay or the quality of the operative field; between the TXA and placebo groups. GOSE scores were better and platelet count decrease was significantly higher in the TXA group. Conclusion: Low-dose TXA did not significantly reduce blood loss or improve outcomes in patients undergoing intracranial tumor resection. GOSE score was better; and the platelet decrease post- operatively was significantly higher in the TXA group. Keywords: Intracranial Tumours, Tranexamic Acid ( TXA), Glasgow Outcome Extended (GOSE) Score

Background: Despite the enactment of Sustainable Development Goal (SDG) and National Food Security Act, food insecurity in India has been growing. Objectives: This study aimed to estimate the current magnitude of food insecurity in a rural setting of West Bengal; to find out the association of food insecurity with the health and socio-demographic profile of the study population, if any; to explore their food situation and its various impacts on the study population; and to integrate the findings from the qualitative and quantitative strands. Methods: An observational study with a cross-sectional design using a mixed-methods approach was conducted in Muchisa. Two hundred and twelve households were selected through cluster random sampling for the quantitative strand. The participants were interviewed using a predesigned, pretested, and structured schedule from February 6–March 26, 2021. Qualitative data were collected from 10% of food-insecure households employing an in-depth interview guide. Statistical evaluation was done using Microsoft Office Excel 2007 and Statistical Package for the Social Sciences (SPSS) Version 25.0. The data were analyzed using Pearson’s Chi-square test, Cochran–Armitage trend test, ordinal logistic regression, and thematic analysis. A P value of

Background: Unmet healthcare need among elderly is the want for essential healthcare which is not fulfilled. Health needs of the elderly often go unrecognized. Functional limitation is one of the contributors in this unmet health need. The situation is worse in rural areas due to lack of awareness and lower socio-economic status. The study aimed to estimate the burden of unmet health needs among the elderly of Budge-Budge II block in West Bengal, to assess their morbidity pattern and to evaluate the predictors of this unmet health need. Materials and Methods: A community-based descriptive study, cross-sectional in design was conducted for a period of 3 months in selected villages of Budge-Budge II block, West Bengal. Data on unmet need were collected by face-to-face interview of 396 participants selected by simple random sampling using EASYCare standard (2010) questionnaire. Results: The most prevalent unmet health need was for preventive care (87.37%), followed by mental health and wellbeing (84.09%). Hypertension was the most common morbidity (52.02%) reported among the study population. Belonging to the age group of 60-69 years had a lower odds of experiencing unmet health needs, whereas being a homemaker or engagement in agricultural work had higher odds of facing unmet health needs among the study participants. Conclusions: The unmet health need of the elderly is a major public health problem that is influenced by age, marital status, and nature of work.

Abstract This research addresses the scalable and inexpensive synthesis of α-Fe2O3via hydrothermal method without any precipitating agent as well as the enhancement of solar driven photocatalytic and H2 production through doping different chromium proportions. Competency of α-Fe2O3, both pure and doped with chromium, to function as photocatalyst was evaluated by its interaction with multiple dyes, which was real-time monitored utilizing (Internet of Things) IoT technique. By adding chromium, the rate of deterioration increased substantially from 15 to 94% for TB under sunlight in a remarkably brief 20 min by employing a very small amount of Cr0.8Fe1.2O3 (0.3 g/L), as evidenced by high degree of mineralization i.e. 85% and LC-HRMS. Also, the rapid breakdown of Trypan Blue (TB) was indicated by BOD5/COD ratio. Moreover, Cr-doped α-Fe2O3 displays excellent H2 production (~ 132 μmol h−1 g−1) as compared to α-Fe2O3. This work highlights the potential utilization of Cr-doped α-Fe2O3 for the purification of industrial waste water and green energy harvesting.

Abstract COVID-19 has resulted in a significant global impact on health, the economy, education, and daily life. The disease can range from mild to severe, with individuals over 65 or those with underlying medical conditions being more susceptible to severe illness. Early testing and isolation are vital due to the virus’s variable incubation period. Chest radiographs (CXR) have gained importance as a diagnostic tool due to their efficiency and reduced radiation exposure compared to CT scans. However, the sensitivity of CXR in detecting COVID-19 may be lower. This paper introduces a deep learning framework for accurate COVID-19 classification and severity prediction using CXR images. U-Net is used for lung segmentation, achieving a precision of 0.9924. Classification is performed using a Convulation-capsule network, with high true positive rates of 86% for COVID-19, 93% for pneumonia, and 85% for normal cases. Severity assessment employs ResNet50, VGG-16, and DenseNet201, with DenseNet201 showing superior accuracy. Empirical results, validated with 95% confidence intervals, confirm the framework’s reliability and robustness. This integration of advanced deep learning techniques with radiological imaging enhances early detection and severity assessment, improving patient management and resource allocation in clinical settings.

Introduction: Although H3N2 outbreaks were once rare, they have become more common in recent years. With a significant toll on health-care resources and the ability to cripple any society, the epidemiological significance of this disease is paramount. While most of the previous studies on influenza outbreaks have reported H1N1 disease, there is a scarcity of literature regarding the H3N2 clinicoradiological profile. Hereby, we present the clinicoradiological profile of a series of H3N2 cases from western India. Materials and Methods: This is a retrospective chart-based review of clinicoradiological profile of a series of cases that were reported to a tertiary care center in western India between February 2023 and March 2023. Results: A total of 10 patients had tested positive for H3N2. All patients had a history of fever lasting an average of 4.7 days, and six had varying degrees of dyspnea. One patient had gastrointestinal symptoms, and six developed tachypnea with hypoxemia requiring oxygen supplementation. One patient with multiple comorbidities required invasive mechanical ventilation and had a complicated course with a superadded bacterial infection. Out of the four patients with radiographic findings, two had atypical pneumonia/acute infective etiology. Conclusion: This study provides valuable insights into the clinical presentation and management of H3N2 infections. The findings highlight the importance of influenza vaccination and early detection of H3N2 infections to prevent severe complications. The successful outcomes of the patients in this study demonstrate the effectiveness of prompt intervention and appropriate treatment in managing H3N2 infections.

Abstract Background Oral cancer poses a significant health challenge due to limited treatment protocols and therapeutic targets. We aimed to investigate the invasive margins of gingivo-buccal oral squamous cell carcinoma (GB-OSCC) tumors in terms of the localization of genes and cell types within the margins at various distances that could lead to nodal metastasis. Methods We collected tumor tissues from 23 resected GB-OSCC samples for gene expression profiling using digital spatial transcriptomics. We monitored differential gene expression at varying distances between the tumor and its microenvironvent (TME), and performed a deconvulation study and immunohistochemistry to identify the cells and genes regulating the TME. Results We found that the tumor–stromal interface (a distance up to 200 µm between tumor and immune cells) is the most active region for disease progression in GB-OSCC. The most differentially expressed apex genes, such as FN1 and COL5A1, were located at the stromal ends of the margins, and together with enrichment of the extracellular matrix (ECM) and an immune-suppressed microenvironment, were associated with lymph node metastasis. Intermediate fibroblasts, myocytes, and neutrophils were enriched at the tumor ends, while cancer-associated fibroblasts (CAFs) were enriched at the stromal ends. The intermediate fibroblasts transformed into CAFs and relocated to the adjacent stromal ends where they participated in FN1-mediated ECM modulation. Conclusion We have generated a functional organization of the tumor–stromal interface in GB-OSCC and identified spatially located genes that contribute to nodal metastasis and disease progression. Our dataset might now be mined to discover suitable molecular targets in oral cancer.