Search

Introduction: Primary spinal cord tumors are rare tumors that are usually heterogeneous having variable histopathological subtypes. Rapidly, growing space-occupying lesions in the spinal canal cause severe loss of function. This study aimed to analyze all adult patients diagnosed with primary spinal cord tumors and to describe their location, symptoms, histopathological types, surgical outcome, complications, recurrence in a single institution, and prognostic factors. Materials and Methods: The study was a retrospective study of 178 patients with spinal tumor who underwent surgical intervention at the department of neurosurgery at a tertiary care institute from 2014 to 2021. Patient demographic characteristics, symptoms, radiological features, spinal level of tumor, spinal compartment, preoperative and postoperative McCormick grade, and complications were recorded, and a comparison of outcomes after surgical intervention was done. Results: In our study, 97 patients were males and the rest of the 81 patients were females. The mean age at the time of surgery was 43.5 years. The thoracic region of the spinal canal was the most involved with 67 (37.64%) cases, whereas intradural extramedullary was the most common (65.73%). Schwannoma was the most common histopathological subtype (46.06%). Total excision was achieved in 154 cases. A total of 37 patients were in Grades 4 and 5 of modified McCormick’s grade preoperatively. However, postoperatively, there were only 17 patients in this group. Two patients with cervical intramedullary tumor expired in the postoperative period. Conclusion: Early surgical intervention with sound microneurosurgical skills gives good outcomes independent of the type and location of tumor. Better outcomes are seen in extradural tumors, early surgical intervention, tumors better amenable to total resection, and in patients with better preoperative neurological status.

Background and Aims: The quality of recovery (QoR)-40 score has been used worldwide and validated in many surgical cohorts to assess global patient recovery. We aim to translate and culturally adapt the QoR-40 score into Hindi and test the validity and reliability of the translated version in patients undergoing cancer surgery. Methods: The translation of the QoR-40 questionnaire was based on the forward and backward translation methods. Patients filled out the translated version of the QoR-40 preoperatively, on the third postoperative day in the morning (POD3) and the evening. The reliability of the translated questionnaire was checked for internal consistency, test-retest reliability and split-half reliability. Construct validity was assessed with a correlation coefficient value between the total QoR-40 score, visual analogue scale (VAS) for pain and total length of hospital stay. Content validity was evaluated for feasibility and understanding. Results: The questionnaire was completed by 350 patients. The correlation coefficient r for repeatability was 0.21, the split-half test was 0.92, and Cronbach’s alpha was 0.82. The correlation between QoR-40 on POD3 with VAS score and length of stay was -0.35 and -0.67, respectively. The average time to complete the questionnaire was 3.8 minutes; 90% of the respondents found the translated questionnaire easy to understand, and 92% of the patients related the questions to their recovery. Conclusion: The Hindi translation of the QoR-40 questionnaire is a valid and reliable version of the original questionnaire in English to assess the QoR in Hindi-speaking patients after cancer surgery.

Abstract Background Knee osteoarthritis (KOA) progression is often influenced by biomechanical factors. Biomechanical interventions, such as Trunk stabilization exercise (TSE) and Mulligan joint mobilization (MWM), may offer relief from KOA symptoms and potentially slow disease progression. However, the comparative efficacy of these therapies remains uncertain. This study aimed to compare the efficacy of TSE, Mulligan joint mobilization, and isometric knee strengthening (KSE) on disability, pain severity, and aerobic exercise capacity in patients with KOA. Methodology A randomized controlled trial (RCT) with three intervention groups was conducted between September 2020 to February 2021. The study enrolled adults aged between 40 and 60 years with a confirmed KOA diagnosis recruited from the physical therapy clinic of the Sindh Institute of Physical Medicine and Rehabilitation, Pakistan. Participants were randomly assigned to receive 24 sessions of either TSE, MWM, or KSE. The knee’s functionality was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), pain on a visual analogue scale (VAS), and two objective functional tests—the 6-minute walk test (6MWT) and the 11-stair climb test (SCT). These assessments were conducted at baseline, the third week, and the sixth week. Changes in outcome measures were analyzed using a mixed-design ANOVA with Bonferroni post-hoc analysis, with statistical significance set at a p-value

Manisha Khandelwal,1 Sunita Choudhary,2 Harish,2 Ashok Kumawat,3 Kamakhya Prakash Misra,3 Yogeshwari Vyas,1 Bhavya Singh,4 Devendra Singh Rathore,4 Kanchan Soni,3 Ashima Bagaria,3 Rama Kanwar Khangarot1 1Department of Chemistry, University College of Science, Mohanlal Sukhadia University, Udaipur, Rajasthan, 313001, India; 2Department of Botany, University College of Science, Mohanlal Sukhadia University, Udaipur, Rajasthan, 313001, India; 3Department of Physics, School of Basic Sciences, Manipal University Jaipur, Jaipur, Rajasthan, 303007, India; 4Department of Environmental Sciences, Mohanlal Sukhadia University, Udaipur, Rajasthan, 313001, IndiaCorrespondence: Rama Kanwar Khangarot, Department of Chemistry, University College of Science, Mohanlal Sukhadia University, Udaipur, Rajasthan, 313001, India, Email ramakanwar@mlsu.ac.inBackground: In the current scenario, the synthesis of nanoparticles (NPs) using environmentally benign methods has gained significant attention due to their facile processes, cost-effectiveness, and eco-friendly nature.Methods: In the present study, copper oxide nanoparticles (CuO NPs) were synthesized using aqueous extract of Coelastrella terrestris algae as a reducing, stabilizing, and capping agent. The synthesized CuO NPs were characterized by X-ray diffraction (XRD), UV-visible spectroscopy (UV-Vis), Fourier transform infrared spectroscopy (FTIR), dynamic light scattering (DLS), and field emission scanning electron microscopy (FE-SEM) coupled with energy-dispersive X-ray spectroscopy (EDS).Results: XRD investigation revealed that the biosynthesized CuO NPs were nanocrystalline with high-phase purity and size in the range of 4.26 nm to 28.51 nm. FTIR spectra confirmed the existence of secondary metabolites on the surface of the synthesized CuO NPs, with characteristic Cu–O vibrations being identified around 600 cm− 1, 496 cm− 1, and 440 cm− 1. The FE-SEM images predicted that the enhancement of the algal extract amount converted the flattened rice-like structures of CuO NPs into flower petal-like structures. Furthermore, the degradation ability of biosynthesized CuO NPs was investigated against Amido black 10B (AB10B) dye. The results displayed that the optimal degradation efficacy of AB10B dye was 94.19%, obtained at 6 pH, 50 ppm concentration of dye, and 0.05 g dosage of CuO NPs in 90 min with a pseudo-first-order rate constant of 0.0296 min− 1. The CuO-1 NPs synthesized through algae exhibited notable antibacterial efficacy against S. aureus with a zone of inhibition (ZOI) of 22 mm and against P. aeruginosa with a ZOI of 17 mm.Conclusion: Based on the findings of this study, it can be concluded that utilizing Coelastrella terrestris algae for the synthesis of CuO NPs presents a promising solution for addressing environmental contamination. Keywords: green synthesis, CuO NPs, photocatalysis, antibacterial activity, wastewater treatment

Abstract Background District Residency Programme (DRP) was introduced by National Medical Commission as mandatory three-months training program for postgraduate residents. The program was for the first time implemented in April 2023 in Rajasthan. However, it ran into several teething problems, especially for residents. With a lack of any precedence, this study was planned to explore experiences and challenges of residents posted in DRP. Methods Cross-sectional study was conducted at 12 DRP sites attached to SMS Medical College, Jaipur between August-October 2023. A self-administered questionnaire was used to collect information from residents who had completed DRP. Questions were scored on a five-point Likert scale. Mann-Whitney U test and Kruskal-Wallis H test was used to show association. Results Only around 17% residents felt that the learning objectives of DRP were fulfilled and nearly 60% residents felt isolated from academic activities and parent department. Over half of the residents were never posted with their concerned specialty services. Around four-fifth residents felt concerned about safety at least sometimes and more than three-fourth residents were dissatisfied with basic amenities. Kruskal-Wallis and Mann-Whitney tests showed significant association of gender and specialisation strata with multiple outcome variables. Conclusion The study finds high degree of dissatisfaction among residents towards learning objectives, academic learning, and basic amenities during DRP. There was also a clear lack of specialty-exposure and high concerns of safety, especially for female residents. The study findings should alarm and inform policymakers and administrators to improve DRP implementation so as to better achieve laid objectives.

Titanium is widely acknowledged as a challenging metal due to its inherent characteristics. Manufacturers often encounter challenges such as tool wear, reduced tool lifecycle, and increased cutting heat when working with Ti64. This research investigates the cutting characteristics of additively manufactured (AMed) Ti64 under dry cutting, Minimum Quantity Lubrication (MQL), Cryogenic Carbon dioxide (CO2), and a hybrid approach combining MQL and CO2 conditions. Surface roughness, flank wear, temperature, chip morphology, and microhardness were analyzed to assess the impact of cooling strategies. Results indicate that the hybrid approach outperforms individual methods, showing superior surface finish and reduced tool wear. Machined Surface roughness (Ra) measurements reveal a substantial improvement in the hybrid condition, reducing Ra values by 62.44–67.02%, 35.65–41.38%, and 18.68–27.59% compared to dry, MQL, and CO2. Tool wear assessments exhibit significantly lower flank wear values in the hybrid condition, emphasizing the synergistic benefits of lubrication and cryogenic cooling. This research provides valuable insights into tailoring cooling strategies for optimal precision in machining AMed-Ti64 material, which is crucial for achieving high-quality manufacturing outcomes.

Concept of Mission Command is not new, however, dynamics of present and requirements of future battle fields have further enhanced the relevance and importance of its right adaptation and execution. With mixed results of low intensity battles and stabilizing operations as a result of Armed conflicts during last two decades or so, this paper explores aspects in addition to the debate of mere centralized and decentralized control normally linked with Mission Command concept. Previous researches have correctly identified training aspects required in a Military set up during peace time to bleed less during operations under Mission Command environment. This paper inquires whether we are ready to accept our vulnerabilities and preparing towards a directional training while keeping in view various myths as a case in point. Through results of recent conflicts and experience of officers involved in such operations, this paper identifies a gap in previous researches pertaining to importance of International Relations knowledge and aspects of Psychological domain for officers, especially during low intensity battles and stabilizing operations in the twenty first century Battlefield environment. This paper concludes by identifying that transformation of Commanders at Strategic, Operational and Tactical level coupled with threat spectrum at Strategic/ Operational level if identified correctly will have a trickle down effect for Tactical level commanders being good students of International Relations. This will increase the Morale and Motivation level of subordinates enabling them to assess Political sensitivities, understand and address the complexities involved in low intensity and stabilizing operations and value the conflict in today’s environment of continous chaos.

Abstract Triple-negative breast cancer (TNBC) is a metastatic disease and a formidable treatment challenge as it does not respond to existing therapies. Epigenetic regulators play a crucial role in the progression and metastasis by modulating the expression of anti-apoptotic, pro-apoptotic markers and related miRNAs in TNBC cells. We have investigated the anti-TNBC potential of dietary flavonoid ‘Apigenin’ and its combination with Vorinostat on MDA-MB-231 cells. At Apigenin generated ROS, inhibited cell migration, arrested the cell cycle at subG0/G1 phases, and induced apoptotic-mediated cell death. Apigenin reduced the expression of the class-I HDACs at the transcriptomic and proteomic levels. In the immunoblotting study, Apigenin has upregulated pro-apoptotic markers and downregulated anti-apoptotic proteins. Apigenin inhibited the enzymatic activity of HDAC/DNMT and increased HAT activity. Apigenin has manifested its effect on miRNA expression by upregulating the tumor-suppressor miR-200b and downregulation oncomiR-21. Combination study reduced the growth of TNBC cells synergistically by modulating the expression of epigenetic and apoptotic regulators. Molecular docking and MD simulations explored the mechanism of catalytic inhibition of HDAC1 and HDAC3 and supported the in-vitro studies. The overall studies demonstrated an anti-TNBC potential of Apigenin and may help to design an effective strategy to treat metastatic phenotype of TNBC.

Abstract Rapid placement of electric vehicle charging stations (EVCSs) is essential for the transportation industry in response to the growing electric vehicle (EV) fleet. The widespread usage of EVs is an essential strategy for reducing greenhouse gas emissions from traditional vehicles. The focus of this study is the challenge of smoothly integrating Plug-in EV Charging Stations (PEVCS) into distribution networks, especially when distributed photovoltaic (PV) systems are involved. A hybrid Genetic Algorithm and Simulated Annealing method (GA-SAA) are used in the research to strategically find the optimal locations for PEVCS in order to overcome this integration difficulty. This paper investigates PV system situations, presenting the problem as a multicriteria task with two primary objectives: reducing power losses and maintaining acceptable voltage levels. By optimizing the placement of EVCS and balancing their integration with distributed generation, this approach enhances the sustainability and reliability of distribution networks.

Bartholin gland carcinoma is one of the less common histology accounting for 0.1 – 5 % of all vulvar malignancies and is mostly seen in postmenopausal women. It accounts for 0.001 % of all female malignancies. Clinical presentation is delayed to its deep-seated position in vulva. It has a propensity for frequent recurrences and distant metastases. Owing to the disease rarity, there are no well-defined management guidelines. We describe here the challenges in diagnosis and management of a case of adeno-squamous carcinoma of bartholin gland in a postmenopausal woman. Unlike the usual presentation, our case presented in an early stage with symptom of itching per vaginum. Radical surgery was the primary treatment modality with no requirement for adjuvant treatment and the patient is disease free at two years post treatment. However, adeno-squamous carcinoma of vulva has a propensity for perineural invasion and early nodal metastases and a dismal five-year survival.

Designing sustainable agricultural models is imperative to enhance farm productivity, and soil health with minimum ecological footprints. Therefore, three cropping systems viz., maize-mustard (M-Mus), maize + cowpea-mustard (M + C-Mus), pigeon pea-wheat (PP-W) were tested under four production scenarios viz., integrated organic management (IOM), integrated crop management (ICM), conventional system (CS), and conservation agriculture (CA) for three consecutive years (2018–2021) to find out the productive, soil supportive, and eco-efficient production model. The ICM recorded significantly higher system productivity i.e. 12107, 12889, and 12866 kg ha−1 during 2018–19, 2019–20, and 20–21 over other production system, respectively. Among the cropping systems, the PP-W system registered the maximum system productivity of 12007.0 kg ha−1 during 2018–19, 11899 kg ha−1 in 2019–20, and 12247 kg ha−1 during 20–21. This led to ∼15% higher average system productivity over the maize-mustard system. Nutrient (N, P, and K) acquisition was the highest by the M + C-Mus system followed by the PP-W system. All soil biological indicators considerably improved under IOM followed by ICM across the soil profile after three years. Cultivation of the PP-W system under IOM registered the highest energy use efficiency (73.24). Concerning the eco-efficiency index (EEI), cultivation of PP-W under the IOM production scenario registered ∼ 2.85 times higher EEI (0.20 US$ MJ−1) over the M-Mus cropping under CS. Thus, findings inferred that legume-embedded systems under either IOM or ICM production scenarios are sustainable production models for fetching higher profitability with minimum environmental impact under semi-arid regions.

The US corn area footprint has changed significantly since the 20th century, declining in the southeastern states while exhibiting an increase or stable variations in the Midwest. As harvested acreage directly impacts the total corn production, understanding the influencing factors is crucial. This study assesses the role of potential drivers on the contrasting trajectories of harvested corn acreage between midwestern and southeastern US. Profit-acreage analysis reveals that antecedent profits/losses have a statistically significant influence on corn acreage changes, with southeastern US, which experienced more loss-making years, also experiencing more frequent reductions in corn acreage. The high number of loss-making years in the Southeast is primarily attributed to the region's low corn yield, influenced by climate and other agro-environmental factors. Using a panel regression model, we find that the loss-making years in the Southeast could have reduced to fewer than 26 out of the considered 45 years, or almost similar to the average in the Midwest, by just increasing the irrigated corn area to 50 %, a realistic irrigated corn area fraction already achieved in several Georgia counties. This underscores the potential for early policy interventions like irrigation facilitation to sustain and expand cropped acreage. However, we also find that this would only be economically feasible with incentives for both the installation and sustained operation of irrigation infrastructure.

The evolution of the steep unstable slopes is influenced by landslides as a major geomorphological feature in the Kashmir region. The NW-SE–oriented landslide has affected the village of Birpani and the main Sudhan Gali Road. The Lower Sudhan Gali (LSG) landslide was studied using a combined use of ground-based remote sensing (Electrical Resistivity Tomography (ERT)) and space-borne remote sensing (Persistent Scatterer Interferometric Synthetic Aperture Radar (PSInSAR)) measurements, geotechnical and field surveys. PSInSAR data highlighted the parts of the landslide that are currently active as well as the immediate surrounding area experiencing uplift and subsidence phenomenon. ERT imaging has delineated the geometry and subsurface structural features of the LSGL. Geotechnical results indicated that the landslide material had a low to medium plasticity index, with a higher clay fraction that may have reduced its shear strength. Finally, the characteristics of this mass movement were observed during the geological field by analyzing the geomorphological features and the lithological units. The interplay among rainfall and close proximity of a major fault may have contributed to the landslide kinematics. The results provided important on- and near-ground surface information for effective planning interventions that can help with hazard mitigation.

ABSTRACTBackground Pharmacists can play an important role in the fight against tuberculosis (TB) through optimising medication use and safety, promoting adherence to anti-TB drugs, and providing patient education. Limited evidence is available on the effectiveness of pharmacist’s interventions on health outcomes in patients with pulmonary TB. This systematic review aims to assess the effectiveness of pharmaceutical care interventions in the management of pulmonary TB.Methods English language studies assessing the impact of pharmaceutical care interventions in TB management were searched across three electronic databases (PubMed, Embase, Cochrane), a RCT registry ClinicalTrial.gov, a peer-reviewed journal ‘The Lancet Infectious Diseases’, and the references of retrieved articles. Interventions delivered by pharmacists alone or as part of multidisciplinary teams were included in the review. Data were extracted using the modified Cochrane EPOC standardised data collection tool. The Cochrane Risk of Bias 2 and the NIH quality assessment tools were used to assess the risk of bias among included studies. Data were synthesised narratively. (PROSPERO Protocol Registration CRD42022325771).Results Thirteen studies, including two randomised controlled trials (RCTs) with a total of 3886 patients were included. Many of the included studies had a high risk of bias and lacked cohert reporting of treatment outcomes. The most common pharmaceutical care interventions were education and counselling regarding adverse drug reactions and resolution of drug-related problems. Five studies showed a relatively high TB completion rate yet only one study reached the targeted treatment success goal of (>90%).Conclusion The current evidence suggests that pharmaceutical care interventions can potentially improve treatment outcomes among patients with pulmonary TB. However, no definitive conclusion can be drawn given the low methodological quality of the included studies and lack of long-term follow-up data. Well-designed RCTs with careful attention to study methodology, standardised outcomes assessment aligned with the World Health Organization’s guidelines are warranted to guide future practice and policy.

Aerial imagery and video recordings of animals are used for many areas of research such as animal behaviour, behavioural neuroscience and field biology. Many automated methods are being developed to extract data from such high-resolution videos. Most of the available tools are developed for videos taken under idealised laboratory conditions. Therefore, the task of animal detection and tracking for videos taken in natural settings remains challenging due to heterogeneous environments. Methods that are useful for field conditions are often difficult to implement and thus remain inaccessible to empirical researchers. To address this gap, we present an open-source package called Multi-Object Tracking in Heterogeneous environments (MOTHe), a Python-based application that uses a basic convolutional neural network for object detection. MOTHe offers a graphical interface to automate the various steps related to animal tracking such as training data generation, animal detection in complex backgrounds and visually tracking animals in the videos. Users can also generate training data and train a new model which can be used for object detection tasks for a completely new dataset. MOTHe doesn't require any sophisticated infrastructure and can be run on basic desktop computing units. We demonstrate MOTHe on six video clips in varying background conditions. These videos are from two species in their natural habitat-wasp colonies on their nests (up to 12 individuals per colony) and antelope herds in four different habitats (up to 156 individuals in a herd). Using MOTHe, we are able to detect and track individuals in all these videos. MOTHe is available as an open-source GitHub repository with a detailed user guide and demonstrations at: https://github.com/tee-lab/MOTHe-GUI.

The aim of the present study was to assess the stigma in patients with schizophrenia attending a tertiary referral government hospital. This was a cross-sectional research involving 60 schizophrenia patients at a government tertiary referral hospital. ICD-10 research diagnostic criteria were used for mental assessment. Statistics were analyzed using relevant tests. Of the 30 males, 21 (70%) experienced moderate stigma, two (6.67%) had mild stigma, and seven (23.33%) had severe stigma. The 30 females got 20 (66.67%) moderate ratings, one (3.33%) got a light grade, and nine (30%) had severe stigma grades associated with stigma disclosure. Twenty of 30 males (66.67%) reported moderate stigma, eight (26.67%) reported mild stigma, and two (6.66%) had severe stigma. With respect to positive stigma, 25 (83.33%) of 30 females exhibited moderate stigma. Also, four (13.33%) girls exhibited moderate stigma and one (3.33%) had severe stigma. Significant proportion of patients with schizophrenia experience stigma and stigma is associated with lower level of functioning. Better knowledge about illness is associated with a lower level of stigma.

Objective: The purpose of this study was to compare the efficacy of various remineralizing agents in stopping the early enamel lesions surrounding orthodontic brackets from progressing. Techniques: Four groups were randomly allocated to a total of 100 participants: the control group (no treatment), calcium phosphate, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and fluoride varnish. Remineralizing chemicals were administered in accordance with manufacturer recommendations, and enamel lesions were created around orthodontic brackets. At baseline and follow-up visits, enamel lesion development was evaluated by visual inspection, quantitative light-induced fluorescence, and microhardness tests. Results: All treatment groups showed significant improvements in microhardness and decreases in lesion size compared to the control group (P < 0.05). Of all the treatment groups, CPP-ACP showed the most notable improvement in microhardness. Regarding the reduction of lesion size, there were no notable variations between the therapy groups (P > 0.05). Conclusion: Initial enamel lesions surrounding orthodontic brackets can be effectively prevented from progressing with the use of fluoride varnish, calcium phosphate, and CPP-ACP. Promising improvements in microhardness indicate that CPP-ACP may be a better treatment choice. Larger sample sizes and longer follow-up times are needed for future studies to validate these results and clarify the best strategy for maintaining the health of enamel throughout orthodontic treatment.

Objective: To determine the correlation between SARS-CoV-2 antibody titers and viral load in vaccine breakthrough infections. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Virology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Nov 2021 to May 2022. Methodology: Three hundred and thirty-seven patients admitted at the Pak Emirates Military Hospital, who had completed the entire course of the inactivated SARS-CoV-2 vaccination and developed COVID-19, at least 14 days from the second dose were selected. Specimens for the viral load of SARS-CoV-2 were taken from posterior nasopharyngeal swabs and serum for anti-Spike antibodies. Viral load in the specimens were estimated using reverse transcriptase polymerase chain reaction. Meanwhile, antibodies level against the SARS-CoV-2 surface spike protein receptor binding domain were assessed using COBAS e411 Electrochemiluminescence. Results: Two hundred and thirty-two (69%) patients were male, while 104(31%) were female. Age, Cycle Threshold value and antibody titers data were normally distributed. Mean age (in years) of participants was 41.83±15.35 (range 18-65). Mean Cycle Threshold value was 23.79±5.49 (range 13.3–35), while mean anti-Spike IgG titers was 165.29±84.62 (range 12–250). Pearson’s correlation coefficient (r) was 0.023 with a 95% CI [-0.08, 0.13] and p-value >0.05, indicating no correlation between Cycle Threshold values and antibody titers. Conclusion: No correlation was found between viral load and anti-spike antibody among patients presenting with breakthrough infections following vaccination with an inactivated vaccine.

Objective: To compare the efficacy of Platelet Rich Plasma versus Steroids among patients managed for Tennis elbow at our Orthopaedic unit. Study Design: Quasi-experimental study. Place and Duration of Study: Orthopaedic Department, Combined Military Hospital, Rawalpindi Pakistan, from Jan 2021 to Jul 2022. Methodology: Patients with Tennis Elbow diagnosed by a consultant orthopaedic surgeon were included in the study. They were randomly allocated treatment with platelet-rich plasma and steroid injections. The team assessed them after three months of treatment using the Disabilities of Arm, Shoulder, and Hand score. Different factors, including mode of treatment, were associated with significant improvement in these patients at the end of three months. Results: Out of 250 patients with tennis elbow included in the final analysis, 193(77.2%) were male, and 57(22.3%) were female. Patients were divided into two groups for comparison, and Group-1 had significant improvement, while Group-2 had no improvement. Out of the total, 117(46.8%) patients received platelet-rich plasma, while 133(53.2%) patients were managed with corticosteroids. The presence of comorbid illnesses and the use of platelet-rich plasma was statistically significantly found in a group with significant improvement in Disabilities of Arm, Shoulder, and Hand score (p-value

IntroductionEarly detection of pancreatic cancer continues to be a challenge due to the difficulty in accurately identifying specific signs or symptoms that might correlate with the onset of pancreatic cancer. Unlike breast or colon or prostate cancer where screening tests are often useful in identifying cancerous development, there are no tests to diagnose pancreatic cancers. As a result, most pancreatic cancers are diagnosed at an advanced stage, where treatment options, whether systemic therapy, radiation, or surgical interventions, offer limited efficacy.MethodsA two-stage weakly supervised deep learning-based model has been proposed to identify pancreatic tumors using computed tomography (CT) images from Henry Ford Health (HFH) and publicly available Memorial Sloan Kettering Cancer Center (MSKCC) data sets. In the first stage, the nnU-Net supervised segmentation model was used to crop an area in the location of the pancreas, which was trained on the MSKCC repository of 281 patient image sets with established pancreatic tumors. In the second stage, a multi-instance learning-based weakly supervised classification model was applied on the cropped pancreas region to segregate pancreatic tumors from normal appearing pancreas. The model was trained, tested, and validated on images obtained from an HFH repository with 463 cases and 2,882 controls.ResultsThe proposed deep learning model, the two-stage architecture, offers an accuracy of 0.907 ± 0.01, sensitivity of 0.905 ± 0.01, specificity of 0.908 ± 0.02, and AUC (ROC) 0.903 ± 0.01. The two-stage framework can automatically differentiate pancreatic tumor from non-tumor pancreas with improved accuracy on the HFH dataset.DiscussionThe proposed two-stage deep learning architecture shows significantly enhanced performance for predicting the presence of a tumor in the pancreas using CT images compared with other reported studies in the literature.

Yellow mosaic disease (YMD) caused by several begomoviruses is one of the major constraints of over a dozen leguminous crops worldwide, particularly in Asian and Southeast Asian countries. The present study aimed to investigate the distribution, diversity and prevalence of begomoviruses associated with YMD in leguminous hosts in five agro-climatic zones of India, to assess the extent of their geographical presence and develop location and crop-specific distribution maps. One hundred and seventy-four leguminous plant samples were tested from 32 locations in India to detect YMD-causing viruses. Additionally, publicly available data were incorporated into this study to provide a comprehensive overview of their distribution in India. This resulted in 581 reports on the DNA-A component representing 119 locations, which were also utilized to depict the distribution of YMD-causing viruses on a map of India. In this study, 117 full-length DNA-A and 103 DNA-B components were successfully characterized, representing the detected mungbean yellow mosaic India virus (MYMIV), mungbean yellow mosaic virus (MYMV), and horsegram yellow mosaic virus in the collected samples. Phylogenetic analysis of isolates of these species showed no differentiation based on location in India. Diversity indices revealed the abundance (55.9%) and dominance (0.56) of MYMIV across 119 locations. These findings hold significant implications for legume researchers, offering insights into disease prevalence and geographic distribution. Furthermore, the distribution of YMD-causing viruses in different agro-climatic zones will help researchers in developing zone-specific YMD-resistant cultivars of the legume crops and would facilitate effective disease management options.

Background: Protozoal pathogens pose a considerable threat, leading to notable mortality rates and the ongoing challenge of developing resistance to drugs. This situation underscores the urgent need for alternative therapeutic approaches. Antimicrobial peptides stand out as promising candidates for drug development. However, there is a lack of published research focusing on predicting antimicrobial peptides specifically targeting protozoal pathogens. In this study, we introduce a successful machine learning-based framework designed to predict potential antiprotozoal peptides effective against protozoal pathogens. Objective: The primary objective of this study is to classify and predict antiprotozoal peptides using diverse negative datasets. Methods: A comprehensive literature review was conducted to gather experimentally validated antiprotozoal peptides, forming the positive dataset for our study. To construct a robust machine learning classifier, multiple negative datasets were incorporated, including (i) non-antimicrobial, (ii) antiviral, (iii) antibacterial, (iv) antifungal, and (v) antimicrobial peptides excluding those targeting protozoal pathogens. Various compositional features of the peptides were extracted using the pfeature algorithm. Two feature selection methods, SVC-L1 and mRMR, were employed to identify highly relevant features crucial for distinguishing between the positive and negative datasets. Additionally, five popular classifiers i.e. Decision Tree, Random Forest, Support Vector Machine, Logistic Regression, and XGBoost were used to build efficient decision models. Results: XGBoost was the most effective in classifying antiprotozoal peptides from each negative dataset based on the features selected by the mRMR feature selection method. The proposed machine learning framework efficiently differentiate the antiprotozoal peptides from (i) non-antimicrobial (ii) antiviral (iii) antibacterial (iv) antifungal and (v) antimicrobial with accuracy of 97.27 %, 93.64 %, 86.36 %, 90.91 %, and 89.09 % respectively on the validation dataset. Conclusion: The models are incorporated in a user-friendly web server (www.soodlab.com/appred) to predict the antiprotozoal activity of given peptides.

ABSTRACT: Background: Ischemia-modified albumin (IMA) has gained attention as an important biochemical marker of oxidative stress in acute myocardial ischemia. This study assessed the screening ability of IMA in acute coronary syndrome and its correlation with the severity of obesity, arterial blood pressure, and lipid profile. Methods: A cross-sectional study using a non-probability sampling technique with 200 patients was conducted at the Physiology Department of Liaquat University of Medical and Health Science (LUMHS) from 1st September 2021 to 1 May 2022. Obese patients from the general population who had a positive family history of cardiovascular disorders were recruited and a biophysical examination was conducted. Afterward, 5cc of blood was drawn and sent for laboratory assessment of IMA and Lipid profile by using ELISA-based assay kits. Using SPSS v.25, ANOVA and student's T-test were used to assess the quantitative data. The Chi-Square Test was employed to assess the qualitative data, and a p

The aim of the present research work was to investigate the variation in nutritional potential, phenolic profile, antioxidant, and free radical scavenging activities of four wildly grown accessions of Cucumis melo var. Agrestis. The accessions of Cucumis melo var. Agrestis were collected from different areas of the district Faisalabad and Layyah of Punjab province (Pakistan). Mineral profile and amino acid analysis were examined using inductively coupled plasma optical emission spectroscopy (ICP-OES) and an amino acid analyzer. High-pressure liquid chromatography (HPLC) was used for the separation and quantification of polyphenols from chloroform and methanol fractions of Cucumis melo. ICP-OES was used for quantitative and qualitative evaluation of elements, and results showed that magnesium (533.6–663.2 ppm) and iron (308.1–590.8 ppm) were the most abundant minerals. Amino acids analyzer showed that valine (0.03–45.58 mmol/L) and taurine (0.03–2.34 mmol/L) were present in the highest concentration. The methanol extract yield of the accessions was in the range of 14.00–17.03 g/100 g of plant material. HPLC analysis showed the detection of eleven phenolic compounds, and the most abundant compound was chlorogenic acid (1120.53–1237.52 µg/g), followed by gallic acid (188.14–930.74 µg/g) and vanillic acid (6.35–298.81 µg/g). Chloroform and methanol fractions were analyzed for antioxidant activity, and results showed that all the fractions were rich in total phenolic content (TPC) (26.6–112.00 mg/100 g) and total flavonoid content (TFC) (20.5–77.9 mg/100 g). Methanol fraction of accession-1 showed the best free radical scavenging capacity (82.2 %) and % inhibition of linoleic acid peroxidation activity (84.4 %) than other fractions. Statistical analysis revealed significant variation among the nutritional potential and antioxidant activity of all the accessions.

Background: Vitamin D deficiency is a worldwide epidemic health problem. Variable results are available with few studies favouring and others denying the association of Vit D deficiency and Hypertension. Material and Methods: An Epidemiological prospective Cross-sectional 3 year observational study was conducted to determine the point prevalence of vitamin D deficiency among hypertensive patients in comparison to age , sex matched, healthy controls among urban and rural population of the Jammu region and also to evaluate the correlation between vitamin D deficiency and hypertension.Group1 ( n = 856) patients of Hypertension with any co-morbid profile with or without complications presenting in tertiary care Medical college. Group 2 (n= 1006) healthy subjects. Results: The study included 1862 patients (856 cases and 1006 controls) with male-to-female ratios of 1.62:1 and 1.13:1, respectively, Prevalence rates of vitamin D sufficiency (>30 ng/mL), insufficiency (20-30 ng/mL), and the deficiency (

Interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD) are chronic respiratory diseases that affect the lungs and airways. ILD encompasses approximately 200 different conditions with known and unknown causes. Various comorbidities, such as cardiovascular, psychological, obstructive sleep apnea, and gastrointestinal disorders, are often associated with them. However, little is known about the relationship and prevalence of hypothyroidism and diabetes mellitus (DM) in ILD and COPD. Therefore, understanding these connections is crucial for proper treatment. This cross-sectional, prospective observational study was conducted at a tertiary care hospital in North India. After obtaining informed consent, we consecutively enrolled 100 patients with ILD and 100 patients with COPD who reported to the Respiratory Medicine Outpatient Department. We collected demographic, clinical, and medical data from the patients and conducted appropriate statistical analysis to determine the prevalence of hypothyroidism and DM in patients with ILD. ILD patients exhibit a significantly higher prevalence of hypothyroidism (24% versus 4%) and DM (24% versus 4%) compared to those with COPD (p

Objective To investigate the views, hopes and concerns of patients living with glaucoma and age-related macular degeneration (AMD) regarding vision home-monitoring.Design Qualitative study using focus groups and questionnaires. Participants were given three disease-relevant home-monitoring tests to try. The tests consisted of three visual field tests for the glaucoma groups (Melbourne Rapid Fields, Eyecatcher, Visual Fields Fast) and three acuity and/or contrast-sensitivity tests for AMD groups (Alleye, PopCSF, SpotChecks). Focus group data were thematically analysed.Setting University meeting rooms in London, UK.Participants Eight people with glaucoma (five women, median age 74) and seven people with AMD (four women, median age 77) volunteered through two UK-based charities. Participants were excluded if they did not self-report a diagnosis of glaucoma or AMD or if they lived further than a 1-hour travel distance from the university (to ensure minimal travel burden on participants).Results Six themes emerged from focus groups, the two most frequently referenced being: ‘concerns about home-monitoring’ and ‘patient and practitioner access to results’. Overall, participants believed home-monitoring could provide patients with a greater sense of control, but also expressed concerns, including: the possibility of home-monitoring replacing face-to-face appointments; the burden placed on clinicians by the need to process additional data; struggles to keep up with requisite technologies; and potential anxiety from seeing worrying results. Most devices were scored highly for usability, though several practical improvements were suggested.Conclusion Patients with mild-to-moderate glaucoma/AMD expect vision home-monitoring to be beneficial, but have significant concerns about its potential implementation.