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Purpose: It has been suggested that follow-up visits for pediatric patients after full-mouth dental rehabilitation (FMDR) under general anesthesia (GA) are important to evaluate healing and restorative treatment, review oral hygiene instruction, provide nutritional counseling and address guardians' concerns. The purpose of this study was to evaluate pediatric dentists' current utilization of follow-up visits after GA and to evaluate pediatric dentists' and guardians' perceptions of their purpose and value. Methods: Three separate surveys were administered: (1) pediatric dentist survey, (2) guardian pre-appointment survey and (3) guardian post-appointment survey. The guardian surveys examined their perceptions of a follow-up visit before and after FMDR under GA. The pediatric dentist survey examined current utilization and perception of follow-up appointments. Results: Most clinicians (72 percent) reported scheduling a follow-up visit. Providers generally agreed that the post-operative appointments were important (69 percent). Of the guardians who attended the follow-up visit, 96.3 percent agreed that the post- operative visit was useful. Conclusion: Both pediatric dentists and guardians of patients undergoing FMDR under GA agreed that a follow-up visit after GA was valuable despite low complication rates.

Background The present study aimed to compare the efficacy, safety, and cost-effectiveness of quick penetrating solution (QPS) heparin, QPS diclofenac, and heparin gel in the prevention of superficial thrombophlebitis (ST). Materials and Methods This randomized controlled trial was conducted after approval from the Institutional Ethics Committee and registration to Clinical Trial Registry of India. Patients of 18–60 years age, American Society of Anesthesiologists I/II, and who needed venous cannulation for at least 72 h were included in the study. Patients were randomly divided into three groups receiving study drugs (heparin gel, QPS heparin, and QPS diclofenac) every 8 hourly for a period of 72 h. Venous cannulation site was graded using the Visual Infusion Phlebitis Scale. Patients developing no ST, mean time to reach ST Grade 1 and 2, prevention of ST probability, and cost-effectiveness of interventions during the study period were assessed. Results Out of 219 included patients, development of no ST in the study groups at 72 h of treatment were heparin gel (11%), QPS heparin (9.6%), and QPS diclofenac (2.7%). The mean time (hours) to develop any grade ST in the study arms was heparin gel (36.2 [11.9]), QPS heparin (40.0 [13.4]), and QPS diclofenac (37.0 [13.2]). The Kaplan–Meier analysis did not reveal significant differences for the prevention of any grade ST or severe ST in three treatment arms. The average cost-effectiveness ratio for preventing thrombophlebitis was 14.2 in heparin gel-, 13.2 in QPS heparin-, and 95.6 in QPS diclofenac-treated patients. Conclusion Based on efficacy, safety, and cost-effectiveness, heparin gel or QPS heparin can be used to prevent ST due to intravenous cannulation in surgical patients. QPS diclofenac is not a cost-effective option to prevent ST.

Background There is little information available regarding knowledge and attitudes towards the human papillomavirus (HPV) and its vaccines among the students in mainland India. Furthermore, there has not been much information accessible on how to increase their understanding of and readiness to receive HPV and associated vaccines, which could be crucial for the future success of vaccination campaigns. This study aims to assess the knowledge and attitude of middle- and high-school students towards HPV infection, HPV vaccine and cervical cancer prevention. Method The present study was an observational study conducted from July 2023 to December 2023 in the Gwalior District of Northern India among the 490 students aged 11–16 years. A self-administered questionnaire was used to collect information from the students. The collected data was entered into an Microsoft Excel spreadsheet for easy calculation. Frequency and percentage were calculated and significance in proportion was tested using the chi-square test. P value was judged at a 5% level of significance. Results The average age of the student was 13.67 ± 1.95 years range between 11 years and 16 years with a 0.52:1 sex ratio. Out of the 490 enrolled participants, 41.0% of subjects had previously heard about cervical cancer. About 64.7% of students heard it from the mass media. A total of 181 (36.9%) knew that cervical cancer was caused by HPV infection. Only 168 (34.3%) participants knew the fact that men were also infected by HPV infection. Only 12.4% knew that a healthy-looking person could have an HPV infection. Only 11.6% had shown their willingness for the HPV vaccination. There was a significant difference observed among the males and females regarding knowledge questions. Males (54.76%) heard more about cervical cancer than females (33.85%). Males had more knowledge (60.1%) regarding cervical cancer caused by HPV infection as compared with females (24.8%). Conclusion Students’ awareness of HPV and the HPV vaccine was low. Training that focusses on HPV information in addition to sex education is needed to promote HPV vaccine coverage.

Introduction Forensic odontology plays a pivotal role in identifying individuals in legal contexts. This study analyses the efficacy of lip prints, tongue prints and mandibular canine width in determining gender, aiming to contribute to the evolving field of forensic dentistry. Methods A cross-sectional study was conducted involving 100 participants, analysing lip prints based on Tsuchihashi’s classification, recording tongue shapes and features through the use of alginate impressions and measuring mandibular canine width using a vernier calliper. The findings were reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Results In lip prints, Tsuchihashi’s Type I lip print was predominantly found in females, whereas Tsuchihashi’s Type III prevailed in males. Tongue shapes revealed a predominance of pentagonal shapes in males and ovoid shapes in females. The lingual apex was blunt in males and sharp in females. Mandibular canine width was higher in males than females on both the left and right sides. Conclusion The findings of this study support the use of lip prints, tongue prints and canine width in determining gender as ancillary and supporting methods.

Abstract This article is devoted to the synthesis of a new magnetic palladium catalyst that has been immobilized on A-TT-Pd coated-magnetic Fe3O4 nanoparticles. Such surface functionalization of magnetic particles is a promising method to bridge the gap between heterogeneous and homogeneous catalysis approaches. The structure, morphology, and physicochemical properties of the particles were characterized through different analytical techniques, including TEM, FT-IR, XRD, SEM, EDS, TGA-DTG, ICP, and VSM techniques. The obtained Fe3O4@SiO2@A-TT-Pd performance can show excellent catalytic activity for the synthesis of diaryl ethers and oxidation of sulfides, and the corresponding products were obtained with high yields. The advantages of this catalyst include a simple test method, green reaction conditions, no use of dangerous solvents, short reaction time, low catalyst loading, and reusability. Also, the nanocatalyst was easily separated from the reaction mixture with the help of a bar magnet and recovered and reused several times without loss of stability and activity.

Introduction: Herpes Zoster (HZ) is a very painful and debilitating condition caused by the reactivation of the Varicella Zoster Virus (VZV). HZ is characterised by a maculopapular or vesicular rash, usually accompanied by pain that is unilateral and restricted to dermatomes. Post-herpetic Neuralgia (PHN) is defined as pain that persists for more than 90 days after the onset of the HZ rash. Aim: To evaluate the analgesic efficacy of a lidocaine patch in PHN. Materials and Methods: This prospective interventional study conducted at the Department of Anaesthesiology and Critical Care, Pt. BD Sharma, PGIMS, Rohtak, Haryana, India, from February 2020 to March 2021. The study included a total of 24 patients (single group), with a male-to-female ratio of 11:13, aged between 18 and 75 years, all with a Visual Analogue Scale (VAS) score greater than 4. An evaluation of patient pain scores using the VAS and the total number of lidocaine patches used per week for four weeks or until the VAS declined to four was conducted. After obtaining informed and written consent, a medicated 5% lidocaine patch was applied to cover the appropriate area for a minimum period of 12 hours, followed by removal for the next 12 hours. This application continued until the VAS declined to four or up to a maximum of four weeks. The level of significance was set at p≤0.05. Results: In the present study, a total of 24 patients were included. The mean age was 59.5±12.85 years, with 54.2% being female and 45.8% male. The VAS scores at baseline were 8.71±0.999, which reduced to 7.08±1.349 at the end of one week, 5.67±0.007 at the end of two weeks, 4.25±0.442 at the end of three weeks and 3.58±0.830 at the end of four weeks. The VAS scores were significantly lower in all patients over the four weeks (p=0.001). The total number of patches used was 1.88±0.338 at one week, 1.46±0.509 at two weeks, 1.04±0.204 at three weeks and 1.00 at four weeks. The total amount of patches used was significantly reduced over the four weeks (p=0.001). No side-effects related to the lidocaine patch were noted. Conclusion: The 5% lidocaine patch demonstrated good tolerability with a minimal risk of systemic adverse drug reactions and is an effective modality for relieving moderate to severe pain. It is concluded that the 5% lidocaine patch is very effective in the treatment of PHN.

Abstract Protein kinases are critical components of a myriad biological processes and strongly associated with various diseases. While kinase research has been a point of focus in biomedical research for several decades, a large portion of the kinome is still considered understudied or “dark,” because prior research is targeted towards a subset of kinases with well-established roles in cellular processes. We present an empirical and in-silico hybrid workflow to extend the functional knowledge of understudied kinases. Utilizing multiplex peptide activity arrays and robust in-silico analyses, we extended the functional knowledge of five dark tyrosine kinases (AATK, EPHA6, INSRR, LTK, TNK1) and explored their roles in schizophrenia, Alzheimer’s dementia (AD), and major depressive disorder (MDD). Using this hybrid approach, we identified 195 novel kinase-substrate interactions with variable degrees of affinity and linked extended functional networks for these kinases to biological processes that are impaired in psychiatric and neurological disorders. Biochemical assays and mass spectrometry were used to confirm a putative substrate of EPHA6, an understudied dark tyrosine kinase. We examined the EPHA6 network and knowledgebase in schizophrenia using reporter peptides identified and validated from the multi-plex array with high affinity for phosphorylation by EPHA6. Identification and confirmation of putative substrates for understudied kinases provides a wealth of actionable information for the development of new drug treatments as well as exploration of the pathophysiology of disease states using signaling network approaches.

Abstract Diffusion-weighted imaging (DWI) is a technique used to probe the random microscopic motion of water protons in living tissue, represented by a parameter measurement of apparent diffusion coefficient (ADC) values. This study aimed to measure the ADC values of various fetal organs and placenta using 3T at various gestational ages. This was a prospective observational study. A total of 103 singleton pregnancies from 20 to 38 weeks of gestational age were included. Diffusion-weighted imaging was performed in the axial plane from the fetal head to the trunk with the following parameters: TR: 2000–2500 ms; TE: 88 ms; FOV: 250 mm; 256 matrix; slice thickness: 4 mm with a 0 mm gap; acquisition time: 1 min, 18 s. Diffusion gradient values were b = 0 and b = 700 s/mm2. ADC was measured in fetal brain regions (frontal white matter, occipital white matter, centrum semiovale, pons, thalamus, cerebellum, and fetal organs (lungs, kidney, and placenta). ANOVA was used to calculate the mean ADC values. Karl Pearson’s coefficient of correlation was used to evaluate the correlation between ADC values and increasing gestational age. The mean ADC values of brain regions were: frontal white matter (1.64 ± 0.08 × 10− 3 mm2 /s, F-39.10,p-

Abstract The work report on architecture of integrated frequency selective meta-surface (IFSMS) absorbers for aerospace stealth applications. Fabricated IFSMS comprised of a pattern metasurface integrated with dielectric interlayer and conducting ground. Initially, a supercell (2 × 2-unit cell: 24 × 24 mm2) was designed with a fourfold topological symmetry. Supercell produces impedances (R), inductances (L), and capacitances (C) in tune with design on its interaction with microwave. RC performance was tested at variable incident transverse electric/magnetic (TE/TM) modes over, Θ, 0°–60° and at the normal incidence (TE), against a planer, clockwise rotation over, Φ, 0°–90°. The mode stability and rotational invariance was analyzed for displacement current- and power-density distributions. The impedance behavior and phase reversal S11 reflection coefficient studies revealed the emergence of mid-band Fabry–Perot mode distinguishing LC behavior of the circuit. The meta-pattern was manufactured by mask lithography using a customized resistive micro-carbon ink and imprinted onto dielectric/ground tile (dimension: 30 × 30 cm2). Structure–property relationship of the ink material was investigated using SEM, XRD, FTIR, UV–visible spectroscopy to reveled surface properties of imprinted material. The absorber was subjected to the free space measurements over C (4–8), X (8–12), and Ku (12–18 GHz) bands, including pristine interlayer dielectrics. The simulated and experimental RC data was found to be in excellent agreement. The proposed IFSMS design is a potential candidate for the stealth application.

Objective: Public spitting attributable to Smokeless Tobacco (SLT) use not only causes a threat to public cleanliness but also to the people exposed around them. An electronic search on various anti-spitting laws and ban in India was done using Google search engine for duration of three months (November 2018 to January 2019). Material and Methods: The original state gazettes were reviewed to extract the data on spit ban and penalty. Renewals of Acts were also thoroughly checked for recent updates of penalty or severity of the act. The law implementing bodies were broadly classified as National, State, Municipal, Village councils (Gram Panchayat), Airports, Metro Railway, and Company Law Tribunal. Results: A total of 42 Anti-spitting laws were identified in this search and 16 states had anti spitting law under different sectors. Discussion: Under these laws, sign boards and warnings are placed commonly at Airports, Railway stations, and metro stations. States with high rates of SLT users like Tripura, Arunachal Pradesh and Mizoram did not have any policy on spitting. Conclusion: Strong enforcement of anti-spitting laws in India will not only reduce spread of communicable diseases but also indirectly will reduce the act of using SLT also.

Introduction: In modern times, endodontic intervention is preferred and tooth extraction is becoming increasingly rare. Root Canal Therapy (RCT) is well-established, with success rates exceeding 90%. A key contributor to post-endodontic pain is the extrusion of debris into the periapical region, which causes inflammation and nerve compression. The amount of debris extruded varies with instrumentation techniques and no current technology completely prevents it. Rotary and reciprocating Nickel-Titanium (NiTi) instruments, each with distinct designs and kinematics, play a critical role in managing this complication. Aim: To evaluate postoperative pain using rotary and reciprocating file systems in single visit endodontics. Materials and Methods: This prospective, parallel-group, single-centre, double-blinded, equivalence, randomised clinical study was conducted at the Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed To be University), Karad, Maharashtra, India, from October 2023 to March 2024, with the aim of comparing postoperative pain following endodontic therapy using two reciprocating systems, WaveOne Gold (WOG) and E-Flex Rec, versus two rotary systems, Mtwo and XP Endo Shaper (XPES). A total of 80 patients with symptomatic irreversible pulpitis were enrolled and randomly assigned to four groups, each treated with one of the four endodontic file systems. Patients were randomised into four groups: 1A-Mtwo (Dentsply-Maillefer, Ballaigues, Switzerland); 1B-XP Endo Shaper (XPS; FKG Dentaire SA, La Chaux-de-Fonds, Switzerland); 2A-Eighteeth E-Flex Rec File; and 2B-WOG (Dentsply Sirona, York, PA). Postoperative pain scores were measured using the Visual Analogue Scale (VAS) at 24, 48 and 72 hours and seven days post-treatment. Statistical analysis was conducted using One-way Analysis of Variance (ANOVA) with Tukey’s post-hoc test and Chi-square tests for categorical data using Statistical Package for Social Sciences (SPSS) software version 21.0, with p-values

Introduction: When there is significant furcation involvement, mechanical debridement without surgery can cause the disease to progressively worsen. To halt the disease process, surgery allows for odontoplasty, root debridement, osseous recontouring, and periodontal regeneration while preserving periodontal attachment. Need of the Study: In cases of furcation deficiencies, periodontal regeneration with different bone grafts is an effective method to both replace lost bone tissue and slow down the progression of the disease. In osseous abnormalities, the additive actions and features of Cissus Quadrangularis (CQ) demonstrate improved healing. Thus, the purpose of present clinical trial is to determine whether the combination of CQ, when utilised locally and systemically, is efficacious for the management of Class II furcation defects. Aim: To evaluate and compare the efficacy of CQ (Hadjod) used locally, systemically, and in combination as an adjunct to osteon II with Platelet Rich Fibrin (PRF) for the management of Class II furcation defects. Methodology: A randomised clinical trial will be conducted in the Department of Periodontics at Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, Maharashtra, India from April 2024 to March 2026. A total 60 systemically healthy individuals with Class II furcation invasions, either buccal or lingual, and moderate to severe chronic periodontitis will be selected. The study population will be categorised into three interventional groups and one control group as follows: Group A: Control group (n=15) will be treated with osteon II + PRF membrane + antibiotic coverage for Class II furcation defects, Group B: (n=15) will be treated with osteon II + PRF membrane + CQ graft (locally) for Class II furcation defects + antibiotic coverage, Group C: (n=15) will be treated with osteon II + PRF membrane + systemic dosage of CQ for Class II furcation defects + antibiotic coverage, Group D: (n=15) will be treated with osteon II + PRF membrane + CQ graft (locally) + systemic dosage of CQ for Class II furcation defects + antibiotic coverage. The data will be analysed and calculated using the Student’s t-test, with a significance level of less than 0.05.

Objective: Mastalgia, a common complaint among women, denotes breast discomfort that can manifest as cyclical or non-cyclical. Reassurance, mechanical support and various non-pharmacological treatments, like flaxseeds, have been seen to have a good effect in treating mastalgia. Thus, the aim of this study was to investigates the efficacy of flaxseed in alleviating pain associated with mastalgia and its impact on the overall health-related quality of life among female patients. Materials and Methods: Conducted at a tertiary care center in Northern India over 18 months, it employed a single-arm interventional design. The participants included females aged 18 years and older presenting with breast pain at the Department of General Surgery. The intervention involved daily consumption of 30 g of milled flaxseed for each participant, administered over a period of six months. Pain severity was assessed using the visual analogue scale (VAS) before supplementation and at follow-up intervals up to six months. Concurrently, the Short Form-12 (SF-12) items Health Survey measured health-related quality of life, encompassing both physical and mental health domains. Statistical analysis employed parametric (paired t-test) and non-parametric tests (chi-square, McNemar) where appropriate, with statistical significance set at p

Introduction: This study was conducted to determine total and neutralizing antibody (nAb) titer in individuals at an interval of 2 and 6 months after primary vaccination and after 1 month after administration of booster dose. MATERIALS AND METHODS: A serum sample was collected from 72 volunteers who were vaccinated with either the Covishield or CovaxinTM vaccine for quantitative estimation of human anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike immunoglobulin G (IgG) antibodies and nAb. nAb against SARS-CoV-2 was detected by GenScript (New Jersey, USA) and was quantitatively estimated by in-house developed enzyme-linked immunosorbent assay (ELISA). Results: Out of 72 study participants, 62.5% and 37.5% were male and female, respectively, and were in the age group of 21–83 years. About 94.44% of study volunteers were vaccinated with the CovishieldTM vaccine. Diabetes mellitus and hypertension were observed in 7.5% of volunteers. The average time interval between two doses of study vaccination was 37 days. Sixty-seven (93.18%), 50 (69.3%), and 69 (96.8%) (N = 72) volunteers elicited good nAb response at the end of 2 months, 6 months, and 1 month post-booster dose vaccination, respectively. Conclusion: Rapid nAb reaction to Spike protein development correlates with viral immunity for Covishield vaccine recipients. Due to the availability of limited data for the CovaxinTM vaccine, we are unable to compare the effectiveness of the two vaccinations, and we are also unable to analyze the vaccine’s efficacy.

Background: Iron deficiency anemia (IDA) has been the main cause of the health burden in India over the past decade. The aim of the present study was to examine the iron status and prevalence of iron deficiency anemia using biochemical markers among sanitation workers working at a tertiary healthcare center. Methodology: This hospital-based cross-sectional observational study was conducted on 80 sanitation workers for a period of 18 months (age 31–40 years). Dietary intake patterns were collected through the structured questionnaires. Blood samples were analyzed for complete blood count, serum iron level and unsaturated iron binding capacity, and ferritin. Total iron binding capacity and percentage transferrin saturation were calculated. Stool samples were screened for intestinal helminthic ova and cysts of intestinal protozoa. Results: Of the 80 sanitation workers, IDA was found in 38.7%; out of this, mild anemia was found in 16 (20%) participants, while 11.3% and 7.5% participants had moderate and severe anemia, respectively. Higher plasma sTfR levels were observed in women with severe iron depletion than in those with iron sufficiency (median 17.6 versus 15.5 nmol/L; P = 0.001). A statistically significant positive correlation between hemoglobin and serum iron, serum ferritin, and transferrin saturation was found. Hemoglobin was positively correlated with white blood cells, red blood cells, hematocrit, and mean corpuscular hemoglobin. Conclusion: This study highlights the presence of mild IDA among sanitary workers and lower levels of iron intake than the recommended dietary allowance.

Introduction: The Siddha system of medicine (SSM) is one of the Indian Systems of Medicine (ISM). In recent times, it has received adequate support from the Indian Ministry of Ayush. Like many such indigenous systems of medicine globally, the SSM is based on its own theoretical principles, philosophy, and methods of practice. Nevertheless, SSM conducts and needs basic and applied research using scientific methods. Such research is evidenced by research publications. In the absence of a review, we did a bibliometric analysis of research publications from SSM for the period of 1972–2019. MATERIALS AND METHODS: We used the term “Siddha” to retrieve the data from the PubMed database. We retrieved data from the National AYUSH research portal and homepages of institutions mandated to do research in SSM. We abstracted bibliometric information and used Epi info (Version 7.2) for analysis. We described the trends and key characteristics. Results: Of a total of 2009 retrieved articles, we included 1457 (73%) for analysis. Between 1972 and 2001, the median number of publications per year was three (range: 0–13). Beyond 2012, the publications increased exponentially with an annual growth of 23%. The maximum number of publications (n = 224) was in 2019. Among 43 countries that produced the papers, India topped it (88%). Of 1457, 1.7% (n = 25) of publications from Siddha institutions were indexed in PubMed. Conclusion: A bibliometric review of research output from SSM suggests that the publications have increased in the last two decades. The review recommends improving research output from SSM in terms of quantity and quality.

Background: Early initiation of breastfeeding reduces infant mortality and morbidity and prolongs the duration of breastfeeding. OBJECTIVE: The present study was conducted to assess the prevalence of early initiation of breastfeeding and factors associated with early initiation of breastfeeding in the urban area of Jabalpur district of Madhya Pradesh. Methodology: The present community-based cross-sectional study was conducted in an urban area of Jabalpur district of Madhya Pradesh from March 2017 to July 2018 on 370 recently delivered mothers. Data were collected by interview, using the pretested structured questionnaire and analyzed using SPSS, version 20. Significance was set at the value of P < 0.05. Results: The prevalence of early initiation of breastfeeding was found to be 45.4%. The percentage of mothers initiating breastfeeding earlier increased when they belonged to the higher age group, nuclear family, were educated, employed, counseled during antenatal visits, non-primigravida and delivered in health institutions. It was also observed that type of delivery, socioeconomic status of mothers, birth weight of baby and occupation of husband are not significantly associated with the early initiation of breastfeeding. Conclusion: Increasing literacy amongst the population, promoting marriages at an appropriate age, counseling pregnant women regarding early initiation of breastfeeding during antenatal care visits and institutional deliveries can significantly increase the prevalence of early initiation of breastfeeding in the mothers of urban areas of Jabalpur district, Madhya Pradesh.

Introduction: Hypothyroidism is among the most prevalent endocrine disorders worldwide. Its risk increases with menopause. The prevalence of hypothyroidism among menopausal women in India is unknown, as conclusive data are scarce. The present study was conducted to find out the prevalence of hypothyroidism among menopausal women in Delhi, India, and study the socio-demographic factors associated with it. Methods: This was a cross-sectional community-based study done among 282 menopausal women in an urbanised village in Delhi, India. Women with a previously known history of diagnosed thyroid disorders were also included in the study. Informed written consent was obtained from all participants. A socio-demographic profile was gathered by questionnaire and blood samples were collected and analysed for thyroid hormone levels. Results: The mean age of study participants was 51.1 years. The prevalence of hypothyroidism among postmenopausal women was 27.3% (77) with 19.9% (56) previously diagnosed and 7.3% (21) diagnosed by the present study. Out of 56 previously diagnosed hypothyroid study participants, only 26 (46.4%) participants had thyroid hormones in a normal range. Age, socio-economic status and literacy status were found to be significantly associated with hypothyroidism. Conclusion: About three postmenopausal women out of 10 were found to be hypothyroid. Nation-wide data were required to estimate the true burden of thyroid disorders in this population. The prevalence increased with age underscoring the need for further research to have conclusive evidence regarding this association. Hypothyroid women who are on treatment should undergo regular evaluation of thyroid hormones so that appropriate dose adjustments can be made for pharmacological therapies.

Abstract Chronic lumbopelvic pain (CLPP) and its associated disabilities significantly affect women's social, professional, and personal lives. However, the specific factors contributing to CLPP in women remain unclear. To address this gap, this prospective cross-sectional study aims to identify the risk factors predicting CLPP in women and develop a prediction model that can predict CLPP in women. The study was conducted across Delhi, India, where free health camps were held, and 2400 women were assessed. Among the assessed individuals, the study revealed a high prevalence rate of CLPP among Indian women, standing at 70.4%. Seven risk factors namely, hamstring muscle tightness (> 20° on passive knee extension test), increased lumbar lordosis (> 11.5 cm of the lumbar lordotic index), reduced hip flexibility (> 15 cm on bent knee fallout test), altered foot posture (≥ 20 on foot posture index score), increased perception of psychological stress (> 25 on cohen’s perceived stress scale-10 score), reduced physical activity level (

Introduction: Gerotranscendence represents a shift in meta-perspective, transitioning from a materialistic and rational outlook to a more cosmic and transcendent one. This phase fosters resilience in older individuals, enabling them to overcome the challenges and despondency associated with ageing, thereby promoting a positive embrace of the ageing process. Remarkably, individuals with high levels of gerotranscendence, even in the presence of poor oral health, demonstrate the capacity to cope and adapt to their circumstances. This adaptive capability may contribute to an enhancement in their self-reported Oral Health-Related Quality of Life (OHRQoL). Aim: To evaluate the relationship between gerotranscendence and OHRQoL among the elderly population in the Vidarbha region. Materials and Methods: This cross-sectional study was conducted over a 6-month period from March 2023 to August 2023 in collaboration with the Department of Prosthodontics and the Department of Public Health Dentistry at the Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra on 350 participants. The study included volunteers aged ≥70 years, residing in homes or old age homes, and those visiting tertiary healthcare centers. Methodologically, data collection employed a self-made organised proforma. Oral examinations were conducted using Type III inspections with a mouth mirror. Gerotranscendence was assessed using the Gerotranscendence Scale Type 2 (GST2), which was validated and translated into Marathi. The Geriatric OHRQoL was evaluated using the Geriatric Oral Health Assessment Index (GOHAI), also translated into Marathi. The study used Chi-square tests for categorical variables and Pearson’s and Spearman’s tests for correlation analyses. Results: The average gerotranscendence score was 23.45 (95% confidence interval [CI]: 22.96, 23.94), reflecting a mid-level of gerotranscendence, indicating that the gerotranscendence score was neither low nor high. According to Pearson’s and Spearman’s correlation tests, the gerotranscendence score was significantly positively correlated with age and self-perceived need for treatment. The mean GOHAI score was 40.16 (95% CI: 39.55, 40.76). A substantial positive association between the GOHAI and self-perceived need for treatment was found using Pearson’s and Spearman’s correlation tests. When comparing gerotranscendence and GOHAI, Pearson and Spearman correlation tests revealed a significant positive association (p

Background: Neoadjuvant chemotherapy (NACT) affects the tumor protein marker’s expression and status. Changes in the expression of biomarkers during NACT may influence the clinical decision of adjuvant molecular and hormonal therapy. Hence, re-evaluation of receptor status has to be done after NACT to give a specific adjuvant therapy for patient benefit. Aims and Objectives: The aim of this study was to study the status of hormone receptors (HRs) – estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (Her-2/Neu), and Ki-67 in patients with locally advanced breast cancer (LABC) in both core needle biopsies and post-mastectomy specimens after administering neoadjuvant chemotherapy. Materials and Methods: The present study was conducted in the Department of Pathology in collaboration with the Department of Surgery, Pt B D Sharma PGIMS, Rohtak, for a period of 1 year. The study comprised 52 patients with LABC who received neoadjuvant chemotherapy and 20 control cases who did not receive neoadjuvant chemotherapy. Each case comprised two specimens: Trucut biopsy and a mastectomy specimen. Results: ER changed from positive to negative in 15.4% of the cases and from negative to positive in 1.9% of the cases. The overall change in ER was statistically significant (P=0.020). For PR, 9.6% of the cases changed from positive to negative while none of the cases showed change from negative to positive. The overall change in PR was statistically significant (P=0.025). For HER2/Neu, 19.2% of the cases changed from positive to negative, and 11.5% of the cases changed from negative to positive. The overall change in HER2/Neu was not statistically significant (P=0.317). For Ki-67, 30% of patients changed from positive to negative while 11.5% of patients changed from negative to positive. The overall change in Ki-67 was statistically significant (P=0.024). Conclusion: There was discordance in the HR status and proliferation marker after NACT in patients with breast cancer. The administration of NACT might be the main reason for the change in receptor status thus understanding the chemotherapy-induced biological conversion in the tumor cell behavior is strategically important in planning adjuvant endocrine therapy and for disease follow-up.

Purpose: To estimate levels of serum vitamin D in patients of retinal vein occlusion (RVO) and compare with age- and sex-matched controls. Methods: A prospective case-control study of 54 patients of RVO and 54 age- and sex-matched attendants of patients presenting to a tertiary care hospital in Delhi was performed. Patients on vitamin D supplementations and RVO due to infective or immunological causes or patients of glaucoma were excluded. Serum vitamin D levels of all the study participants along with relevant blood investigations with history and examination were documented. Vitamin D deficiency was defined as

Introduction: Optimal space closure is a pivotal aspect of orthodontic treatment, particularly challenging in patients with bimaxillary protrusions and Angle’s class II division 1 malocclusion. Two primary methods, friction, and frictionless mechanisms, are employed for anterior teeth retraction. However, concerns over prolonged treatment duration and increased anchorage demands have prompted exploration into non-frictional approaches. Biomechanical properties significantly influence the efficacy of retraction loops, with ideal loops exhibiting high Moment-to-Force (M/F) ratios and low Force-to-Deflection (F/D) ratios. The “PRP loop” was developed inspired by existing designs, showing promising biomechanical characteristics in a finite element study. However, its clinical efficacy remains unexplored. Need of the study: More research is required to assess the clinical efficacy of the recently created PRP loop in promoting retraction. This trial attempts to evaluate the effectiveness of the PRP loop compared to current techniques, focusing on attaining effective anterior en-masse retraction. Through an analysis of the benefits and limitations of both methods, the research aims to shed light on which loop provides the best space closure. Aim: This study aims to evaluate and compare the PRP loop with the Opus loop for anterior en-masse retraction in Angle’s class I Dewey’s Type 2 malocclusion. Materials and Methods: A prospective single-blinded randomised clinical trial will be conducted in the Department of Orthodontics and Dentofacial Orthopedics at Sharad Pawar Dental College and Hospital, Sawangi, Wardha, Maharastra from September 2024 to April 2026. Thirty patients between the age of 15-30 years having Angle’s Class I Dewey’s type 2 malocclusion requiring maxillary premolar extraction will be included and divided into two groups (PRP and Opus loop groups) with the exclusion of Angle’s Class II and III cases. Treatment procedures include initial alignment, maxillary premolar extractions, and retraction using respective loops. Evaluation criteria encompass retraction rate, efficacy, and anchorage loss measured through study models and radiographic assessments. Statistical analysis will employ Student’s paired and unpaired t-test and Chi-square test with GraphPad Prism 7.0 and SPSS 27.0 software and a significance level of p

Introduction: Mixed dentition analyses are used to determine possible tooth-size and arch-length discrepancies during the transition from primary to permanent dentition. Prediction methods using a probability table or linear regression equation use the sum of the mesiodistal widths of mandibular permanent incisors to predict the mesiodistal width of unerupted permanent teeth. Racial and sexual variations and sexual dimorphism in tooth size have been reported. The objective of this study is to validate Moyer’s and Tanaka Johnston’s mixed dentition analyses in a contemporary South Indian population. Materials and methods: 100 pairs of permanent dentition models belonging equally to both sexes with an age range of 12–21 years comprised the sample in which both analyses were done. The predicted width of permanent canines and premolars was compared to the actual width in the study models. Results: There was a statistically significant difference between the two values for Moyer’s analysis in the mandibular teeth of females (p=0.04), 95% CI −0.605 to −0.969. There was a statistically significant difference between the two values for Tanaka Johnston’s analysis of maxillary teeth (p=0.001), 95% CI 0.863 to 1.370. Conclusions: Moyer’s analysis shows a statistically significant underestimation in the mandibular arch of females. Tanaka Johston’s analysis shows a statistically highly significant overestimation in the maxilla. Both analyses cannot be reliably applied to the South Indian population.

Abstract Kindlin-2 is a cytoskeletal adapter protein that is present in many different cell types. By virtue of its interaction with multiple binding partners, Kindlin-2 intercalates into numerous signaling pathways and cytoskeletal nodes. A specific interaction of Kindlin-2 that is of paramount importance in many cellular responses is its direct binding to the cytoplasmic tails of integrins, an interaction that controls many of the adhesive, migratory and signaling responses mediated by members of the integrin family of cell-surface heterodimers. Kindlin-2 is highly expressed in many cancers and is particularly prominent in prostate cancer cells. CRISPR/cas9 was used as a primary approach to knockout expression of Kindlin-2 in both androgen-independent and dependent prostate cancer cell lines, and the effects of Kindlin-2 suppression on oncogenic properties of these prostate cancer cell lines was examined. Adhesion to extracellular matrix proteins was markedly blunted, consistent with the control of integrin function by Kindlin-2. Migration across matrices was also affected. Anchorage independent growth was markedly suppressed. These observations indicate that Kindlin-2 regulates hallmark features of prostate cancer cells. In androgen expressing cells, testosterone-stimulated adhesion was Kindlin-2-dependent. Furthermore, tumor growth of a prostate cancer cell line lacking Kindlin-2 and implanted into the prostate gland of immunocompromised mice was markedly blunted and was associated with suppression of angiogenesis in the developing tumor. These results establish a key role of Kindlin-2 in prostate cancer progression and suggest that Kindlin-2 represents an interesting therapeutic target for treatment of prostate cancer.

Abstract Background Betulinic acid (BA) has been well investigated for its antiproliferative and mitochondrial pathway-mediated apoptosis-inducing effects on various cancers. However, its poor solubility and off-target activity have limited its utility in clinical trials. Additionally, the immune modulatory role of betulinic acid analogue in the tumor microenvironment (TME) is largely unknown. Here, we designed a potential nanotherapy for colorectal cancer (CRC) with a lead betulinic acid analogue, named as 2c, carrying a 1,2,3-triazole-moiety attached to BA through a linker, found more effective than BA for inhibiting CRC cell lines, and was chosen here for this investigation. Epithelial cell adhesion molecule (EpCAM) is highly overexpressed on the CRC cell membrane. A single-stranded short oligonucleotide sequence, aptamer (Apt), that folds into a 3D-defined architecture can be used as a targeting ligand for its specific binding to a target protein. EpCAM targeting aptamer was designed for site-specific homing of aptamer-conjugated-2c-loaded nanoparticles (Apt-2cNP) at the CRC tumor site to enhance therapeutic potential and reduce off-target toxicity in normal cells. We investigated the in vitro and in vivo therapeutic efficacy and anti-tumorigenic immune response of aptamer conjugated nanotherapy in CRC-TME. Methods After the characterization of nanoengineered aptamer conjugated betulinic acid nanotherapy, we evaluated therapeutic efficacy, tumor targeting efficiency, and anti-tumorigenic immune response using cell-based assays and mouse and rat models. Results We found that Apt-2cNP improved drug bioavailability, enhanced its biological half-life, improved antiproliferative activity, and minimized off-target cytotoxicity. Importantly, in an in vivo TME, Apt-2cNP showed promising signs of anti-tumorigenic immune response (increased mDC/pDC ratio, enhanced M1 macrophage population, and CD8 T-cells). Furthermore, in vivo upregulation of pro-apoptotic while downregulation of anti-apoptotic genes and significant healing efficacy on cancer tissue histopathology suggest that Apt-2cNP had predominantly greater therapeutic potential than the non-aptamer-conjugated nanoparticles and free drug. Moreover, we observed greater tumor accumulation of the radiolabeled Apt-2cNP by live imaging in the CRC rat model. Conclusions Enhanced therapeutic efficacy and robust anti-tumorigenic immune response of Apt-2cNP in the CRC-TME are promising indicators of its potential as a prospective therapeutic agent for managing CRC. However, further studies are warranted. Graphical abstract

Abstract Background Mechanical ventilation (MV) in intensive care units (ICUs) is a stressful experience for patients. However, these experiences have not been systematically explored in low- and lower-middle-income countries (LLMICs). This systematic review (SR) aims to explore the patients’ experiences of MV in ICUs in LLMICs and the factors influencing their experiences. Methods The PICO framework will be used to operationalize the review question into key concepts: population (mechanically ventilated adult patients in ICUs), phenomenon of interest (experiences) and context (LLMICs). PubMed, Embase, PsycINFO, CINAHL, Cochrane Library, Scopus and Web of Science will be systematically searched since database inception. Citation, reference list and PubMed-related article searching of included studies will be done to ensure literature saturation. Empirical peer-reviewed literature exploring adult patients’ (aged ≥ 18 years) experiences of MV in ICUs in LLMIC will be included. All study designs (quantitative, qualitative and mixed methods) will be included. Two independent reviewers will perform screening, data extraction and critical appraisal. The mixed-methods appraisal tool (MMAT) and Popay’s narrative synthesis will be used for critical appraisal and data synthesis, respectively. Discussion This SR aims to bridge a gap in knowledge as previous evidence synthesis has described this phenomenon in developed countries. The review design, with the inclusion of quantitative, qualitative and mixed-methods studies, intends to provide a rich and in-depth exploration of the issue. The findings will be presented as themes, subthemes and their explanatory narratives. The gaps in available literature will be identified, and implications of SR findings on policy, practice and future research will be presented. The strength of this SR lies in its systematic, comprehensive, transparent, robust and explicit methodology of identifying, collating, assessing and synthesizing available evidence. By prior registration and reporting of this SR protocol, we aim to ensure transparency and accountability and minimize bias. Systematic review registration PROSPERO CRD42024507187

Integration of Interprofessional Education (IPE) into the health sciences curriculum has been recommended over the past several decades to prepare healthcare professionals for future collaborative practice. However, due to the disparity in the adoption of IPE, this literature review attempted to examine the development of IPE and its implementation in global and Indian contexts. IPE has evolved from being fragmented and isolated initiatives to entering into the mainstream of professional education. In terms of IPE implementation, the global scan revealed that IPE was implemented in several countries to varying degrees; however, developing countries lagged behind developed countries in implementing and sustaining IPE. Scarce evidence was found regarding the implementation of IPE in India. The literature review elaborates on the transformation of health professions education from the traditional system to IPE and discusses the gap in the adoption and implementation of IPE in developing countries, including India.

Introduction: Knee Osteoarthritis (OA) is a significant cause of disability globally and is rapidly becoming a major health issue. The part of the knee most affected by OA is the patellofemoral joint. This type of arthritis poses challenges for both patients and healthcare providers in managing symptoms and improving the quality of life for those affected. However, there’s a lack of data on specific therapies for the patellofemoral joint. Aim: To investigate if a varied frequency treadmill exercises protocol involving retro-walking has a greater impact on musculoskeletal responses, leading to better improvements in individuals with symptomatic Patellofemoral Joint Osteoarthritis (PFOA). Materials and Methods: The present study was an experimental research design i.e., between -subjects experimental design in which 60 participants with patellofemoral arthritis were enrolled based on the inclusion criteria. The study was conducted in the Department of Orthopaedics, SGT Medical College Hospital and Research Institute in Gurugram, Haryana, India for a duration of one year (May 2022- May 2023). Participants were randomly randomised to three distinct exercise program groups with varying intensity levels for retro-walking on a treadmill for six weeks, and all three groups received conventional treatment six days/week for six weeks. All participants were evaluated at three-time intervals of baseline, at the end of the third week, and after intervention (end of the sixth week) for the evaluation of several musculoskeletal parameters affecting patellofemoral arthritis. Statistical analysis was carried out using the IBM Statistical Package for the Social Sciences (SPSS) version 26.0. Comparison for within group differences between various outcome measures at various intervals of time was done using repeated measures of Analysis of Variance (ANOVA) and post-hoc analysis for mean values with Least Significant Difference (LSD) whereas for between group analysis One-way ANOVA and post-hoc Analysis for mean values was done with p-value set at

A less common puerperal complication following a caesarean section is a bladder flap haematoma, characterised by the accumulation of blood in the vesico-uterine space. A young, unregistered primigravida was referred from a peripheral facility with preeclampsia and obstructed labour. Signs of obstructed labour were observed both before and intraoperatively, like dehydration, foetal distress, a stretched lower uterine segment, and oedematous bladder. The uterus was sutured in two layers to control bleeding, and the patient was closely monitored postoperatively. The diagnosis of haematoma was made by the increasing height of the uterus and a suprapubic bulge anterior to the uterus, along with postoperative haematuria. Imaging with ultrasonography and Computed Tomography (CT) helped to decide the management. The patient improved after exploratory laparotomy with haematoma drainage. No bladder injury was found during the cystoscopy. Early diagnosis and treatment were important in preventing complications such as haemodynamic instability, abscess formation, and sepsis. Authors present their experience in this patient with postcaesarean vesico-uterine haematoma, with frank haematuria, without an obvious bladder injury, who required re-exploration. The clinical presentation, course, and sonographic findings of this patient form the basis of this report.

Background: Gestational trophoblastic disease (GTD) represents a diverse group of conditions characterized by abnormal trophoblastic proliferation within the placenta. GTD includes benign and malignant lesions, ranging from complete and partial hydatidiform moles to more severe forms like invasive moles, choriocarcinoma, placental site trophoblastic tumors (PSTTs), and epithelioid trophoblastic tumors. Given that neoplastic GTD lesions respond remarkably well to chemotherapy, early and accurate histopathological diagnosis is crucial as it directly influences treatment and prognosis. Aim and Objectives: This study examined the histomorphological features of various types of GTD alongside key clinical factors such as age, parity, and gestational period. Materials and Methods: The study was conducted in the Department of Pathology over the course of10 years, from January 2014 to January 2024. All cases of GTD confirmed through histopathological examination of hematoxylin and eosin-stained slides were included in the analysis. Results: Out of 60 diagnosed cases of GTD, 34 (56.66%) were complete hydatidiform moles, 22 (36.67%) were partial hydatidiform moles, 1 (1.67%) was an invasive mole, 1 (1.67%) was choriocarcinoma, and 2 (3.33%) were PSTTs. The age of the affected patients ranged from 18 to 45 years, with the highest incidence observed in the 20–25 year age group (30 cases, 50%). Most cases (33, 55%) occurred during the first trimester, with a predominance among primigravida patients (28 cases, 46.66%). The most common clinical presentation was per vaginal bleeding, reported in 56 cases (93.33%). Conclusion: Although GTD can lead to serious complications, including metastasis, it is treatable. In this study, the complete hydatidiform mole was the most frequently encountered lesion and is associated with a higher risk of severe complications such as persistent GTD, invasive moles, and choriocarcinoma. Thus, early and accurate histopathological diagnosis is vital for the timely initiation of therapy, ultimately reducing the mortality rate. This study highlights the various categories and histomorphological features of GTD, emphasizing the importance of understanding its clinical presentation to mitigate disease burden and complications.

Inborn errors of metabolism (IEM) are a rare and complex group of inherited disorders, typically observed in infants as autosomal recessive or, less commonly, as X-linked recessive conditions. Newborn screening (NBS) for IEMs can significantly improve prognosis and quality of life through early diagnosis and intervention, marking a significant public health achievement. NBS programs vary by country, but generally include tests for a range of metabolic errors, endocrine disorders, primary immunodeficiency disorders, congenital deafness, congenital heart defects, and cystic fibrosis. Integrating mass spectrometry (MS/MS), genetic sequencing, and emerging technologies such as next-generation sequencing into NBS programs represents a substantial advancement in the field of healthcare. These technologies enable early detection, intervention, and the possibility of personalized treatments through gene therapies. Such advancements are poised to shape the future of NBS, potentially enhancing healthcare outcomes for newborns on a global scale. Neonatal screening is the most well-known and widely implemented proactive and preventative pediatric public health initiative worldwide. It encompasses a comprehensive education system, screening, diagnostic confirmation, management, follow-up, and counseling. This article reviews recent advances in newborn metabolic screening, drawing on the results of various clinical trials and pilot studies.

Taking into account the availability of numerous clinical trials on the effects of Aloe vera gel on the prevention and healing of skin wounds, as well as its popularity among people and widespread use in the cosmetic industry, the current study compares the healing efficacy of Aloe vera gel vs. 1% silver sulfadiazine (SSD) in burn patients. We searched PubMed, Medline, Embase, and ClinicalKey database from January 1, 1990, to January 1, 2023 period. Our study included a patient who were having first- and second-degree burns. The intervention group received Aloe vera gel, while the control group received 1% SSD. The outcome variables assessed were tissue healing. Randomized controlled trials (RCTs) and non-RCTs were included to ensure a comprehensive evaluation of the intervention effects. Studies had to be available in English and published in full text to be eligible for inclusion. Initially, the search strategy’s flow diagram, which reported, screened, excluded, and eventually included studies, was created using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 principles. Using the population, intervention, control, and outcome format (PubMed-65, Embase-52, and ClinicalKey-131), 248 studies were included, while 220 studies were eliminated. As a result, 18 full-text RCTs were evaluated, and 7 studies that satisfied all of the meta-analysis’s eligibility requirements were eventually qualified. In comparison to the control group, the mean healing (in days) for first- and second-degree burn wounds was significantly lower in the total pooled result from the four RCTs. The mean difference was −2.73 [95% confidence interval (CI) −3.85 to −1.62; P ≤ 0.0001*]. When comparing the area of recovery in percentage for first- and second-degree burn wounds to the control group, the total pooled result from the four RCTs revealed a significant decrease, with odds ratio of 0.20 (95% CI 0.08–0.53; P ≤ 0.001*). Thus, the results of this meta-analysis demonstrate that Aloe vera gel is far more beneficial for first- and second-degree burn wound healing and patient recovery than 1% SSD.

Abstract Methods to quantify cortical hyperexcitability are of enormous interest for mapping epileptic networks in patients with focal epilepsy. We hypothesize that, in the resting state, cortical hyperexcitability increases firing-rate correlations between neuronal populations within seizure onset zones (SOZs). This hypothesis predicts that in the gamma frequency band (40–200 Hz), amplitude envelope correlations (AECs), a relatively straightforward measure of functional connectivity, should be elevated within SOZs compared to other areas. To test this prediction, we analyzed archived samples of interictal electrocorticographic (ECoG) signals recorded from patients who became seizure-free after surgery targeting SOZs identified by multiday intracranial recordings. We show that in the gamma band, AECs between nodes within SOZs are markedly elevated relative to those elsewhere. AEC-based node strength, eigencentrality, and clustering coefficient are also robustly increased within the SOZ with maxima in the low-gamma band (permutation test Z-scores > 8) and yield moderate discriminability of the SOZ using ROC analysis (maximal mean AUC ~ 0.73). By contrast to AECs, phase locking values (PLVs), a measure of narrow-band phase coupling across sites, and PLV-based graph metrics discriminate the seizure onset nodes weakly. Our results suggest that gamma band AECs may provide a clinically useful marker of cortical hyperexcitability in focal epilepsy.

Abstract Long noncoding RNAs (lncRNAs) are RNA molecules with a length greater than 200 nucleotides that do not code for functional proteins. Although, genes play a vital role in immune response against a disease, it is less known that lncRNAs also contribute through gene regulation. Bovine tuberculosis is a significant zoonotic disease caused by Mycobacterium bovis (M. bovis) in cattle. Here, we report the in-silico analysis of the publicly available transcriptomic data of calves infected with M. bovis. A total of 51,812 lncRNAs were extracted across all the samples. A total of 216 genes and 260 lncRNAs were found to be differentially expressed across all the 4 conditions—infected vs uninfected at 8- and 20-week post-infection (WPI), 8 vs 20-WPI of both infected and uninfected. Gene Ontology and Functional annotation showed that 8 DEGs were annotated with immune system GOs and 2 DEGs with REACTOME immune system pathways. Co-expression analysis of DElncRNAs with DEGs revealed the involvement of lncRNAs with the genes annotated with Immune related GOs and pathways. Overall, our study sheds light on the dynamic transcriptomic changes in response to M. bovis infection, particularly highlighting the involvement of lncRNAs with immune-related genes. The identified immune pathways and gene–lncRNA interactions offer valuable insights for further research in understanding host–pathogen interactions and potential avenues for genetic improvement strategies in cattle.

Abstract In response to the escalating global threat of antimicrobial resistance, our laboratory has established a phagemid packaging system for the generation of CRISPR-Cas13a-antimicrobial capsids targeting methicillin-resistant Staphylococcus aureus (MRSA). However, a significant challenge arose during the packaging process: the unintentional production of wild-type phages alongside the antimicrobial capsids. To address this issue, the phagemid packaging system was optimized by strategically incorporated silent mutations. This approach effectively minimized contamination risks without compromising packaging efficiency. The study identified the indispensable role of phage packaging genes, particularly terL-terS, in efficient phagemid packaging. Additionally, the elimination of homologous sequences between the phagemid and wild-type phage genome was crucial in preventing wild-type phage contamination. The optimized phagemid-LSAB(mosaic) demonstrated sequence-specific killing, efficiently eliminating MRSA strains carrying target antibiotic-resistant genes. While acknowledging the need for further exploration across bacterial species and in vivo validation, this refined phagemid packaging system offers a valuable advancement in the development of CRISPR-Cas13a-based antimicrobials, shedding light on potential solutions in the ongoing battle against bacterial infections.

Abstract High-altitude (HA) environment presents immense physiological adversities for humans that have been overcome by supplementing bio-active phytochemicals from functional foods that support and accelerate acclimatization under these extreme environmental conditions. Several agricultural interventions have been investigated to enhance the phytochemical content in vegetables however; these studies have been limited to low-altitude (LA) regions only. In view of an existing knowledge gap, current work is designed to compare the phytochemical compositions of HA and LA-grown Brassicaceae vegetables (cabbage, cauliflower, knol-khol, and radish) using organic treatments via farm yard manure (FYM) and Azotobacter. The open field study was conducted as a two-factorial randomized block design. The first factor was treatment (T1-FYM, T2-Azotobacter, T3-FYM + Azotobacter, and T4-control) while the second was locations (HA and LA). Among all these treatments, the application of treatment T3 in HA-grown cabbage showed the highest total phenolic content (TPC; 9.56 μg/mg), total flavonoids content (TFC; 14.48 μg/mg), and antioxidant potential using 2,2-diphenyl-1-picrylhydrazyl (DPPH; 85.97%) and ferric reducing antioxidant power (FRAP; 30.77 μg/mg) compared to LA grown samples. Reverse Phase high performance liquid chromatography (RP-HPLC) analysis showed that treatment T3 at HA led to significantly high kaempferol (0.92 μg/mg) and sulforaphane (8.94 μg/mg) contents in cabbage whereas, indole-3-carbinol (1.31 μg/mg) was higher in HA grown cauliflower. The present study provides scientific evidence for the enrichment of health-promoting phytochemical compounds in Brassicaceae vegetables grown with T3 treatment specifically at HA.

Vitamin D has multifaceted roles in brain function beyond its traditional role in bone health, impacting neurotransmitters, inflammation, and mood-regulating brain areas where its receptors are present. Conversely, Vitamin D deficiency is often observed in obese individuals. Metreleptin, a synthetic form of human leptin, has demonstrated efficacy in promoting weight loss and alleviating depression among obese patients. However, there is limited direct evidence linking metreleptin to depression reduction or establishing an interaction between metreleptin and Vitamin D in this context. Vitamin D’s neurotrophic and immunomodulatory properties influence neurotransmitter regulation, including serotonin, dopamine, and norepinephrine, vital for mood stability. The presence of Vitamin D Receptors (VDR) in regions of the brain linked to depression further supports its role in mood regulation. Moreover, Vitamin D’s anti-inflammatory effects contribute to mitigating brain inflammation associated with depression. Given the inverse relationship between obesity and Vitamin D levels, obese individuals are at higher risk of Vitamin D deficiency. Metreleptin, as a synthetic leptin analogue, has demonstrated significant efficacy in reducing obesity. Thus, the plausible combination of Vitamin D and metreleptin presents a potential novel strategy for managing depression in obese individuals. Though these therapies may address the intricate interplay of depression in the context of obesity, rigorous research is essential to validate their efficacy and safety in tandem.

Class III malocclusion is always a challenging treatment and has been the subject of interest in many investigations due to the challenges it poses. It can be caused by maxillary retrognathism, mandibular prognathism, or a combination of the two. In around 40% of Class III patients, the cause is maxillary retrognathia. The condition can be treated either by camouflage or by surgery to correct the skeletal disharmony. However, camouflage treatment doesn’t result in a drastic change to the facial profile when it involves skeletal disharmony and may recur after treatment is completed. To increase the stability of this treatment, the patient’s growth and age phase are decisive factors. In young children, the circumaxillary sutures are patent, and protraction of the maxilla can be aided by opening these sutures with orthopaedic force. Protraction appliances like face masks are used to support the growth of a deficient maxilla in cases of maxillary retrognathism. The current case report of a 13-year-six-month-old male presented the correction of class III skeletal malocclusion with an anterior crossbite in a growing patient using the “Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) protocol” and face-mask treatment with the Hyrax appliance. Skeletal class III can be due to mandibular excess, maxillary deficiency, or a combination of both. The treatment time was 18 months, and a notable improvement was observed in the soft tissue profile when assessed through cephalometric measurements and photographs.

Introduction: Essential herbs such as garlic, ginger, and cardamom have shown antimicrobial activity with no potential adverse effects and are cost-effective. Despite these advantages, the efficacy of these agents needs to be tested against common oral pathogenic microorganisms to ensure that if found effective, they can be used in clinical settings. Aim: To evaluate and compare the effectiveness of garlic, ginger, and cardamom oils on Streptococcus mutans (S. mutans) against chlorhexidine. Materials and Methods: An in-vitro study was conducted at Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, in the Department of Microbiology and Bharati Vidyapeeth College of Pharmacy, Navi Mumbai, Maharashtra, India from January 2023 to September 2023. Oil extracts of garlic, ginger, and cardamom were loaded onto sterile filter paper discs measuring 6 mm in diameter in concentrations of 50 μL, 100 μL, and 200 μL. Additionally, 2% chlorhexidine (control group) was loaded onto similar sterile paper discs. The discs were dried and placed aseptically on culture media plates inoculated with S. mutans, and the plates were then incubated at 37°C overnight. Subsequently, the zones of inhibition were measured in millimeters. Results: Ginger oil exhibited the highest zone of inhibition, measuring 25 mm, followed by cardamom oil and garlic oil measuring 18 mm and 12 mm, respectively, at a concentration of 200 μL. The zone of inhibition measured for 100 μL concentrations of garlic, ginger, and cardamom oils were 7 mm, 16 mm, and 13 mm, respectively. For 50 μL concentrations of the oils, the zones of inhibition for garlic, ginger, and cardamom were 0 mm, 13 mm, and 9 mm, respectively. The zone of inhibition shown by chlorhexidine was 22 mm for concentrations of 50 μL, 100 μL, and 200 μL. Conclusion: Essential oil extracts from ginger, cardamom, and garlic were found to have antimicrobial activity against S. mutans, with ginger oil showing the highest effectiveness, followed by cardamom oil and garlic oil.

Background: Retinal vein occlusion (RVO) is one of the most common causes of retinal vascular disease, second to diabetic retinopathy. We aimed to compare the lamina cribrosa thickness (LCT) of patients with unilateral branch RVO (BRVO) versus healthy individuals. Materials and Methods: This was a hospital-based, prospective, cross-sectional, and comparative study. Participants were newly diagnosed RVO cases (n = 25) and apparently normal age-matched healthy controls (n = 25). All the participants underwent systemic and comprehensive ophthalmic examination, including refraction and enhanced depth imaging optical coherence tomography. Relevant parameters were compared between the groups using the independent t-test. Statistical significance thresholds were set at a P < 0.05. Results: The mean age of cases (66.7% female) and controls (52% female) was 55.9 ± 7.4 and 59.4 ± 7.0 years, respectively, (P = 0.089). The mean LCT of the affected eyes in cases (176.6 ± 28.3 μm) was significantly lower compared to the unaffected eyes of cases (200.6 ± 33.1 μm, P = 0.008) and control eye (230.9 ± 36.9 μm, P = 0.001). Conclusions: A thinner lamina cribrosa (LC) was observed in both eyes of unilateral RVO patients compared with healthy, nonglaucomatous subjects’ eyes. The role of LCT as a local mechanical factor in the pathogenesis of BRVO and their relationship to systemic factors merits further investigation.

Background: A healthy child can make way for a healthy adult. Some of the factors that can be used to determine the health of a young child are nutritional status of the child, the developmental milestones achieved, and frequency of illness. Objectives: The health status of children and associated factors are determined. Methods: This is a community-based cross-sectional study with 271 participants. The height and weight of the child were measured; questions were asked regarding developmental milestones achieved and frequent illnesses. An interview schedule was used to enquire about the determinants of health status. Descriptive statistics were done; Chi-square test and regression were used to determine association between the health status of children and determinants. Results: A total of 127 (46.86%) were found to have a good health status. Family type (Chi square value 9.568; P value = 0.002), birth spacing (Chi square 20.540; P value < 0.001), term or pre-term birth (Chi square 4.598; P value = 0.032), chronic medical problem in the child (Chi square 11.074; P value = 0.001), and immunization status of the child (Chi square 5.666; P value = 0.017) were found to have significant association with the health status of the child. By logistic regression, pre-term child birth and family type were found to have higher odds. Conclusion: For better health of the child, specific focus on birth spacing, term birth of baby, better care of the ill, and complete immunization play vital roles.

Introduction: Adolescent health is itself a neglected topic so as the bullying, the young fragile adolescents who are already going through physical, psychological and hormonal changes have to pay a toll by bullying and its associated violence. Objective: The purpose of this study is to ind the proportion of school going adolescents with Bullying and Violence related behavior and its associated variables. Method: Total 900 students of both government and private schools having co-education facility and having all the three streams i.e., science, commerce, and arts were included. Indianized version, of YRBS questionnaire was used, the questionnaire was modiied by three senior Professors of the department and made suitable for the use in Indian context. Results: Most of the participants were in age group 13-16 years and majorities were Hindu. Out of 900 adolescent 33.34 % belongs to high risk of Violence and bullying behaviour. Students of commerce stream (48%) break into more ight than art stream (16.80%). Approximately six percent were threatened or injured with a weapon such as gun, knife or sticks on school campus in past 12 months, majority for their selfdefence only 2% did it to harm someone. Only 48 adolescents (05.30%) reported to be sexually abused and majority of abused were males (60.41%) and maximum number(68.75%) of times the Perpetrator were their dates followed by relatives. Conclusion: The risk of violence and bullying is relatively more in this budding generation which can be entertained by proper guidance and support by parents, teachers and friends.

Background: Minimally invasive injectable aesthetic treatments have seen a surge in popularity, particularly in the post-COVID era. However, our understanding of the psychological and social factors that influence patients’ choices when seeking these treatments is still lacking. Objective: This study explored whether the COVID-19 pandemic influenced patients’ motivations and perceptions regarding the above-mentioned treatments. Methods: A comprehensive survey was conducted among 147 patients who had received injectable aesthetic interventions at Acquisition Aesthetics, a leading UK training academy in aesthetic medicine. The survey included questions regarding motivation for treatment initiation, ongoing drivers for continuing treatment, desired outcomes, main concerns about treatment, post-treatment feelings, and the psychological impact of skin aging. Descriptive analysis was performed to explore the patterns of patient responses. Results: This findings revealed that the primary motivation for seeking aesthetic treatment was to improve confidence and address concerns about aging. Patients expressed a strong desire for natural-looking results and reported the significant psychological effects of skin aging, including feelings of self-consciousness and anxiety. After treatment, patients reported increased confidence and satisfaction with their appearance, and reduced self-consciousness. Conclusion: This study revealed that although the core motivations for improving confidence and addressing aging remain central to patients seeking aesthetic treatments, the post-COVID era saw a subtle shift toward heightened concerns about social acceptance and maintaining appearances. Understanding these subtle shifts can allow aesthetic practitioners to tailor their approaches to meet patients’ holistic needs. Level of Evidence: Level V, descriptive study

Abstract Milk is a good source of nutrition but is also a source of allergenic proteins such as α-lactalbumin, β-lactoglobulin (BLG), casein, and immunoglobulins. The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/Cas technology has the potential to edit any gene, including milk allergens. Previously, CRISPR/Cas has been successfully employed in dairy cows and goats, but buffaloes remain unexplored for any milk trait. In this study, we utilized the CRISPR/Cas9 system to edit the major milk allergen BLG gene in buffaloes. First, the editing efficiency of designed sgRNAs was tested in fibroblast cells using the T7E assay and Sanger sequencing. The most effective sgRNA was selected to generate clonal lines of BLG-edited cells. Analysis of 15 single-cell clones, through TA cloning and Sanger sequencing, revealed that 7 clones exhibited bi-allelic (−/−) heterozygous, bi-allelic (−/−) homozygous, and mono-allelic (−/+) disruptions in BLG. Bioinformatics prediction analysis confirmed that non-multiple-of-3 edited nucleotide cell clones have frame shifts and early truncation of BLG protein, while multiple-of-3 edited nucleotides resulted in slightly disoriented protein structures. Somatic cell nuclear transfer (SCNT) method was used to produce blastocyst-stage embryos that have similar developmental rates and quality with wild-type embryos. This study demonstrated the successful bi-allelic editing (−/−) of BLG in buffalo cells through CRISPR/Cas, followed by the production of BLG-edited blastocyst stage embryos using SCNT. With CRISPR and SCNT methods described herein, our long-term goal is to generate gene-edited buffaloes with BLG-free milk.

Abstract Background Pseudomyxoma peritonei is an infrequent condition with a global annual incidence of only one to two cases per million people. Mucinous neoplasms, widespread intraperitoneal implants, and mucinous ascites characterize it. Currently, most clinicians misdiagnose this condition, which leads to delayed management. Case presentation A 44-year-old North Indian female presented with a 1.5-month history of an abdominal lump. Physical examination revealed a sizeable abdominopelvic mass at 36 weeks. Contrast-enhanced computed tomography showed a massive multiloculated right ovarian cystic mass measuring 28 × 23 × 13 cm with mild ascites and elevated carcinoembryonic antigen levels (113.75 ng/ml). A provisional diagnosis of ovarian mucinous neoplasm was made, for which the patient underwent laparotomy. Intraoperatively, there were gross mucinous ascites, along with a large, circumscribed, ruptured right ovarian tumor filled with gelatinous material. The appendicular lump was also filled with mucinous material along with the omentum, ascending colon, right lateral aspect of the rectum, splenic surface, and small bowel mesentery. Cytoreductive surgery was performed along with an oncosurgeon, including total abdominal hysterectomy with bilateral salpingoophorectomy, omentectomy, right hemicolectomy, lower anterior resection, ileo-transverse stapled anastomosis with proximal ileal loop diversion stoma, excision of multiple peritoneal gelatinous implants, and peritoneal lavage. Histopathology and immunohistochemistry confirmed the presence of intestinal-type mucinous carcinoma. Postoperatively, the patient was given six cycles of chemotherapy. She tolerated it without any specific morbidity and had an uneventful recovery. Postoperative follow-up at 15 months revealed normal tumor marker levels and abdominal computed tomography findings and no signs suggestive of local recurrence or distal metastases. Conclusions Pseudomyxoma peritonei is a rare disease that is frequently misdiagnosed in the preoperative phase. Therefore, radiologists and clinicians should maintain a high index of suspicion for accurate diagnosis and multidisciplinary management.

Abstract In quantum computing there are quite a few universal gate sets, each having their own characteristics. In this paper we study the Clifford+CS universal fault-tolerant gate set. The CS gate is used is many applications and this gate set is an important alternative to Clifford+T. We introduce a generating set in order to represent any unitary implementable by this gate set and with this we derive a bound on the CS-count of arbitrary multi-qubit unitaries. Analysing the channel representation of the generating set elements, we infer $${\mathcal {J}}_n^{CS}\subset {\mathcal {J}}_n^T$$ J n CS ⊂ J n T , where $${\mathcal {J}}_n^{CS}$$ J n CS and $${\mathcal {J}}_n^T$$ J n T are the set of unitaries exactly implementable by the Clifford+CS and Clifford+T gate sets, respectively. We develop CS-count optimal synthesis algorithms for both approximately and exactly implementable multi-qubit unitaries. With the help of these we derive a CS-count-optimal circuit for Toffoli, implying $${\mathcal {J}}_n^{Tof}={\mathcal {J}}_n^{CS}$$ J n Tof = J n CS , where $${\mathcal {J}}_n^{Tof}$$ J n Tof is the set of unitaries exactly implementable by the Clifford+Toffoli gate set. Such conclusions can have an important impact on resource estimates of quantum algorithms.

Abstract Background It is a requirement that medical students are educated in emergencies and feel well prepared for practice as a doctor, yet national surveys show that many students feel underprepared. Virtual reality (VR), combined with 360-degree filming, provides an immersive, realistic, and interactive simulation experience. Unlike conventional in-person simulation, it is scalable with reduced workforce demands. We sought to compare students’ engagement and enjoyment of VR simulation to desktop computer-based simulation. Methods We conducted a prospective, interventional, evaluation study. The study was carried out on final year medical students undertaking their Pre-Foundation Assistantship (n = 116) at Imperial College School of Medicine (ICSM) in London. We compared objective engagement, subjective engagement, and subjective enjoyment of VR simulation to desktop computer-based simulation using cardiac arrest and life-threatening asthma scenarios. Engagement was measured objectively using students’ physiological parameters, including heart rate and eye tracking, and facilitator observations using the validated ‘Behavioural Engagement Related to Instruction’ (BERI) protocol. Students’ subjective engagement and enjoyment levels were measured using a post-session survey. Results Students’ maximum heart rates were significantly higher during VR simulation with a mean difference of 4.2 beats per minute (3.2 to 5.2, p

Introduction: Postoperative Sore Throat (POST) is a known complication after general anaesthesia with an endotracheal tube (14.4% to 50%) and less so with Supraglottic Airway (SGA) devices (5.8% to 34%). Various modalities and drugs can decrease POST. Zinc possesses anti-inflammatory and antioxidant properties and is utilised in oral mucositis and xerostomia. Aim: To evaluate the effect of preoperative administration of a zinc lozenge on POST after the removal of the Proseal Laryngeal Mask Airway (PLMA). Materials and Methods: In this randomised, double-blinded controlled study was conducted at the Department of Anaesthesia at Pt. BD Sharma PGIMS, Rohtak, Haryana, India, over a period of five months from August 2020 to December 2020. 100 patients aged 18-60 years of either sex belonging to American Association of Anesthesiologists (ASA) I and II undergoing elective surgery under general anaesthesia with PLMA placement were randomly allocated into two groups to receive a 40 mg zinc lozenge (Group-I) or placebo (Group-II) and were asked to chew it 30 minutes preoperatively. Patients with upper respiratory tract infections, at risk of aspiration, or with anticipated difficult intubation were excluded from the study. The incidence and severity of POST were assessed on a 4-point scale (0-3) at 30 minutes, 2, 4, and 24 hours postoperatively. The primary outcome of the study was the incidence of POST at four hours postoperatively, and the secondary outcome was the severity of POST at 30 minutes, two hours, and 24 hours postoperatively. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 20.0 (IBM SPSS Statistics Inc., Chicago, Illinois, USA) Windows software programme. The Chi-square test and unpaired t-test were used for statistical analysis. Results: The mean age in Group-I was 38.6±12.32 years and in Group-II was 37.90±14.84 years (p-value 0.79). Data regarding the distribution of patients according to sex were comparable with a p-value of 0.31. There was a significantly lower incidence of POST in Group-I (zinc group) than in Group-II (placebo group) at four hours with a p-value of 0.004. Conclusion: The present study has shown that the preoperative administration of a 40 mg zinc lozenge effectively reduces the incidence and severity of POST in the postoperative period, peaking at four hours after general anaesthesia. Zinc lozenges are easy, convenient, non invasive, and successfully prevent POST.