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Bincy Baby, Priya Antony, Walaa Al Halabi, Zahrah Al Homedi, Ranjit Vijayan Department of Biology, College of Science, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates Abstract: Polypharmacology, the discovery or design of drug molecules that can simultaneously interact with multiple targets, is gaining interest in contemporary drug discovery. Serine/threonine kinases are attractive targets for therapeutic intervention in oncology due to their role in cellular phosphorylation and altered expression in cancer. Quercetin, a naturally occurring flavonoid, inhibits multiple cancer cell lines and is used as an anticancer drug in Phase I clinical trial. Quercetin glycosides have also received some attention due to their high bioavailability and activity against various diseases including cancer. However, these have been studied to a lesser extent. In this study, the structural basis of the multitarget inhibitory activity of quercetin and isoquercitrin, a glycoside derivative, on serine/threonine kinases using molecular modeling was explored. Structural analysis showed that both quercetin and isoquercitrin exhibited good binding energies and interacted with aspartate in the highly conserved Asp–Phe–Gly motif. The results indicate that isoquercitrin could be a more potent inhibitor of several members of the serine/threonine kinase family. In summary, the current structural evaluation highlights the multitarget inhibitory property of quercetin and its potential to be a chemical platform for oncological polypharmacology. Keywords: serine/threonine kinases, quercetin, isoquercitrin, docking, polypharmacology

The primary goal of this treatise is to introduce a new kind of generalized closed sets termed as Lgfs-closed sets in the light of fuzzy soft local function in a mixed fuzzy soft ideal topological space. We also define the notion of fuzzy soft ∗-separated set. In addition, we procure the idea of fuzzy soft regularity, normality and fuzzy soft compactness. We also study their behavior in terms of Lgfs-closed sets.

The study determine the utilization and effectiveness of the research-based innovative teaching devices in the Schools Division of Camarines Norte to provide an inventory of available research-based innovative teaching devices developed in the Division as to physical component, special features and mechanics of its utilization; determine the degree of utilization of the said teaching devices as assessed by the teachers along functionality, flexibility, support to teaching, technical considerations, and engagement and interactions of the user; determine the extent of effectiveness of the said teaching devices as assessed by the jurors as to scope, delivery of instruction, appropriateness of the content, and layout and presentation; and determine the experiences and challenges in the utilization of the said teaching devices. The developed research-based innovative teaching devices utilized by the teachers were moderately functional, flexible, supported teaching, considered technical aspects, and ensured the engagement and interaction of the user to a moderate extent only. Along with scope, delivery of instruction, and appropriateness of the content, layout, and presentation, the teaching devices were found to be effective to a moderate extent; thus, their effectiveness moderately contributes to the enhancement of the competencies, skills, and abilities of the students. The inclusion of learning activities suited to the learners that could be utilized by the teachers and students is being suggested. Enhancement training and the allocation of funds to sustain the implementation of the study are necessary to motivate teachers to do research and innovation.

The problem of delay-range-dependent (DRD) stability analysis for continuous time Takagi–Sugeno (T–S) fuzzy time-delay systems (TDSs) is addressed in this paper. An improved DRD stability criterion is proposed in an linear matrix inequality (LMI) framework by constructing an appropriate delay-product-type (DPT) Lyapunov–Krasovskii functional (LKF) to make use of Bessel-Legendre polynomial based relaxed integral inequality. The modification in the proposed LKF along with the judicious choice of integral inequalities helps to obtain a less conservative delay upper bound for a given lower bound. The efficacy of the obtained stability conditions is validated through the solution of three numerical examples.

This paper aims to put forward one more difference between generalized topological space and generalized fuzzy topological space via generalized closed set in the respective fields. Also we claim and prove that to a certain extent, the role of generalized closed set in a fuzzy topological space is not similar in nature with that of generalized closed set in a generalized fuzzy topological space. Generalized closed sets coincide with closed sets under some appropriate restrictions though the implication does not hold in general in a generalized fuzzy topological space.

The main objective of this paper is to introduce the notion of (i, j)-fuzzy γ -locally closed set in fuzzy bitopological space and to obtain various basic properties of the new notion. Also, we define the dual form of γ -locally closed set which is termed as (i, j)-fuzzy γ -locally open set and show that it is a stronger form of 𝜏𝑖𝜏𝑗 -fuzzy b-locally open set. Finally, we study the notion of (i, j)-fuzzy γ -LC-continuous function and (i, j)-fuzzy γ -LC-irresolute function as an application of the newly defined concept and establish the relationships with some already existing functions.

DNA based steganography plays a vital role in the field of privacy and secure communication. Here, we propose a DNA properties-based mechanism to send data hidden inside a video file. Initially, the video file is converted into image frames. Random frames are then selected and data is hidden in these at random locations by using the Least Significant Bit substitution method. We analyze the proposed architecture in terms of peak signal-to-noise ratio as well as mean squared error measured between the original and steganographic files averaged over all video frames. The results show minimal degradation of the steganographic video file. Keywords: Chaotic map, DNA, Linear congruential generator, Video steganography, Least significant bit

The aim of this paper is to introduce the concept of lambda operator of a fuzzy set in a fuzzy bitopological space. Then we study (i, j)-fuzzy Lembda Gamma- set and its properties. Moreover we define (i, j)-fuzzy Lembda-closed set, (i, j)-fuzzy Lembda Gamma-closed set and (i, j)-fuzzy generalized closed set in fuzzy bitopological space. The concepts (i, j)-fuzzy Lembda-closed set and (i, j)-fuzzy generalized closed set are independent to each other but jointly they gives the taui-fuzzy closed set. To this end as the application of (i, j)-fuzzy Lembda Gamma-closed set we shall study (i, j)-fuzzy Lembda Gamma continuity and (i, j)-fuzzy Lembda Gamma-generalized continuity and their properties.

This paper is a prolongation of the study of fuzzy hyperconnectedness. After studying the characteristic of fuzzy hyperconnectedness concerned with different concepts we ascertain an extension of one essential result of Park et al. (2003). In particular, we obtain one result based on fuzzy hyperconnectedness which points out a comparison between the fuzzy topological spaces and the general topological spaces. A necessary and sufficient condition for a fuzzy semicontinuous function to be a fuzzy almost continuous function is established while the said two continuities are independent to each other shown by Azad (1981).

The aim of this paper is to introduce fuzzy ΛgXr-set and to study some of its generalized forms. The structure constituted by fuzzy Λ g X r -set is also included in the treatise. Moreover we define generalized fuzzy gX -closed set and fuzzy Λ g X r -closed set, which are the weaker forms of fuzzy gX -closed set. The above two weaker forms are independent to each other but jointly they imply fuzzy gX -closed set. Finally, in addition, as the application of fuzzy Λ g X r -closed set, we study fuzzy (Λ , ) g X r Y g - continuity and fuzzy (Λ , ) gf g X r X Y  g g -continuity and a few of their properties. In general, fuzzy contra ( , ) X Y g g -continuity does not imply fuzzy ( , ) X Y g g -continuity, but this paper provides one condition under which the fact is true.

Using the Painlevé property of partial differential equations, the auto-Bäcklund transformation and Lax pairs for a Korteweg–de Vries (KdV) equation with time-dependent coefficients are obtained. The Lax pair criterion also makes it possible for some new models of the variable coefficient KdV equation to be found that can represent nonsoliton dynamical systems. This can explain the wave breaking phenomenon in variable depth shallow water. [ABSTRACT FROM AUTHOR]

A similarity analysis of the Wu-Yang-'t Hooft-Julia-Zee-ansatz-reduced system of nonlinear differential equations of classical SU(2) Yang-Mills-Higgs theory is presented. This yields the similarity group G of the equations. Considering G and one of its subgroups denoted G[sub 1], some previously known time-dependent solutions in the Prasad-Sommerfield limit are generated. Two new time-dependent solutions are also reported. [ABSTRACT FROM AUTHOR]

A Korteweg–de Vries (KdV) equation with time-dependent coefficients is studied in this paper. The similarity transformation for this system is investigated and an exact solution in a particular case is obtained. The Ablowitz–Ramani–Segur (ARS) conjecture is used to identify the integrability of the system. It is found that in some special cases the system may be integrable. [ABSTRACT FROM AUTHOR]

Diabetes mellitus significantly affects survival in patients with renal cell carcinoma undergoing nephrectomy, requiring personalized care. This case involved a 64-year-old man with type 2 diabetes (T2D) who underwent radical nephrectomy for renal cell carcinoma. He consented to a 1-year intensive lifestyle intervention (ILI), including a vegan diet (to lower calorie intake, reduce uric acid, support renal health, and promote weight loss), intermittent fasting, regular exercise, psychological support, and medical management. Quarterly biochemical assessments and monthly adherence evaluations were conducted. Post intervention, the patient achieved diabetes remission, maintaining glycated hemoglobin A1c (HbA1c) below 6.5% (48 mmol/mol) (reference range, <6.5%; <48 mmol/mol) without medication. He lost 36 kg (79.37 lb), reducing his body mass index from 35.3 to 25.1. His lipid profile normalized (total cholesterol, 175 to 127 mg/dL (4.53 to 3.29 mmol/L) (reference range, <200 mg/dL; <5.18 mmol/L); triglycerides, 155 to 73 mg/dL (1.75 to 0.82 mmol/L) (reference range, <150 mg/dL; <1.69 mmol/L), allowing the discontinuation of statins. Improvements in serum creatinine and high-sensitivity C-reactive protein levels were also observed. The patient exhibited normal glucose tolerance, consecutively passing an oral glucose tolerance test for 2 years. This case highlights the potential of lifestyle modifications in managing T2D in patients with a history of nephrectomy., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)

Background: Hospitalizations and surgical procedures are unpleasant for both children and their parents. Therefore, postoperative pain assessments and management are less commonly performed in younger children than in adults., Purpose: To evaluate the effects of nonpharmacological interventions on postoperative pain and anxiety in children., Methods: In this randomized controlled trial, 160 children were randomly allocated to experimental (n=80) and control (n=80) groups. The children in the experimental group received age-appropriate distraction interventions for 3 postoperative days along with usual care. Children in the control group received standard care only. Each patient's pain was assessed using the EVENDOL pain scale, while their anxiety was measured using the modified Yale Preoperative Anxiety Scale. The data were analyzed using SPSS 23.0. Descriptive statistics (frequency, percentage, mean, and standard deviation) and repeated-measures analysis of variance were used to analyze the data., Results: The children in the experimental group showed significantly decreased pain, anxiety, and physiological parameters (heart rate, respiratory rate, and oxygen saturation) compared to those in the control group. Significant intergroup differences were noted in the mean and standard deviation values of the pain, anxiety, and physiological parameters., Conclusion: The distraction interventions provided by nurses reduced the pain and anxiety levels and improved the postoperative recovery of pediatric surgical patients.

The circadian system plays a crucial role in regulating metabolic homeostasis at both systemic and tissue levels by synchronizing the central and peripheral clocks with exogenous time cues, known as zeitgebers (such as the light/dark cycle). Our body's behavioral rhythms, including sleep-wake cycles and feeding-fasting patterns, align with these extrinsic time cues. The body cannot effectively rest and repair itself when circadian rhythms are frequently disrupted. In many shift workers, the internal rhythms fail to fully synchronize with the end and start times of their shifts. Additionally, exposure to artificial light at night (LAN), irregular eating patterns, and sleep deprivation contribute to circadian disruption and misalignment. Shift work and jet lag disrupt the normal circadian rhythm of liver activity, resulting in a condition known as "circadian disruption". This disturbance adversely affects the metabolism and homeostasis of the liver, contributing to excessive fat accumulation and abnormal liver function. Additionally, extended working hours, such as prolonged night shifts, may worsen the progression of non-alcoholic fatty liver disease (NAFLD) toward non-alcoholic steatohepatitis (NASH) and increase disease severity. Studies have demonstrated a positive correlation between night shift work (NSW) and elevated liver enzymes, indicative of hepatic metabolic dysfunction, potentially increasing the risk of hepatocellular carcinoma (HCC) related to NAFLD. This review consolidates research findings on circadian disruption caused by NSW, late chronotype, jet lag, and social jet lag, drawing insights from studies involving both humans and animal models that investigate the effects of these factors on circadian rhythms in liver metabolism., Competing Interests: Conflicts of interest All authors declared that there are no conflicts of interest.

Background: Type 2 diabetes (T2D) is a chronic metabolic disorder that has a notable influence on mental well-being, contributing to elevated morbidity and mortality rates. Depression and anxiety disorders are the most common mental health concerns among patients with T2D worldwide. Therefore, the present study aimed to assess the impact of an online intensive lifestyle intervention (ILI) on mental health outcomes (depression and anxiety) in patients with T2D in India., Materials and Methods: This retrospective pre-post analysis included adult patients (aged > 18 years) diagnosed with T2D who were enrolled in a diabetes management program in India between June 2021 and June 2023. The intervention consisted of lifestyle modifications such as a customized plant-based diet, regular physical activity, psychological support through group and individual therapy, and medical management. Data were extracted from the electronic database of the clinic, including anthropometry, medical history, biochemical parameters, symptoms of depression, and anxiety (assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7) scale) at the start and end of the six-month intervention period., Results: Of the 1061 eligible patients (177 with prediabetes), 40.3% were female. The mean age, duration of diabetes, and HbA1c levels were 52 ± 10.4 years, 9.8 ± 7.8 years, and 8 ± 1.7%, respectively. The prevalence of symptoms of depression and anxiety (ranging from mild to severe) was 46% and 44.3%, respectively, which reduced to 28.7% and 29.2%, respectively, post-intervention., Conclusion: Integrated ILI successfully improved the symptoms of anxiety and depression, highlighting the importance of a multidisciplinary approach that includes diet, physical activity, psychological support, and medical management in enhancing mental health outcomes among patients with T2D. Future prospective studies are needed to explore the long-term effects of such interventions and develop effective strategies for promoting mental health in diverse populations., Trial Registration: The study was approved by the Freedom from Diabetes Research Foundation Institutional Ethics Committee (approval number FFDRF/IEC/2024/7) and registered in the Clinical Trials Registry of India (CTRI/2024/03/064596, registered on March 21, 2024)., (© 2024. The Author(s).)

Background: Lung cancer ranks as one of the most rapidly growing malignancies. Which is characterized by its poor prognosis and a low survival rate due to late diagnosis and limited efficacy of conventional treatments. In recent years nanotechnology has emerged as a promising frontier in the management of lung cancer, presenting novel strategies to enhance drug administration, improve therapeutic efficiency, and mitigate side effects. This research comprehensively evaluates the current state and research trends concerning the application of nanomaterials in lung cancer through bibliometric analysis., Materials and Methods: We employed a systematic approach by retrieving studies from the Scopus database that focused on nanomaterials and lung cancer between 2003 and 2023. Subsequently, we carefully selected relevant articles based on predetermined inclusion criteria. The selected publications were then subjected to bibliometric and visual analysis using softwares such as VOSviewer and Biblioshiny., Results: A total of 3523 studies that meet inclusion criteria were selected for bibliometric analysis. We observed a progressive increase in the number of annual publications from 2003 to 2023, indicating the growing interest in this field. According to our analysis, China is the primary contributor to publication output among the countries. The "Ministry of Education of the People's Republic of China" was the most influential institution. Among the authors, "Dr. Jack A. Roth" and "Dr. Huang Leaf" had the highest number of publications and cited publications, respectively. The "International Journal of Nanomedicine" was found to be the most prolific journal in this field. Additionally, "Biomaterials" emerged as the most cited journal. Through keyword analysis, we identified five main research themes and future research directions; nono-immunotherapy and green synthesis are the hot topics in this research field., Conclusion: Our study summarized the key characteristics of publications in this field and identified the most influential countries, institutions, authors, journals, hot topics, and trends related to the application of nanomaterials in lung cancer. These findings contribute to the existing body of knowledge and serve as a foundation for future research endeavors in this area. More effective efforts are needed in this field to reduce the burden of lung cancer and help achieve the United Nation's Sustainable Development Goals., (© 2024. The Author(s).)

With the advancement of technology, equipment, and airway management knowledge, anticipated difficult airway (DA) management has come a long way towards excellence. Usually, anticipated difficulties are related to bag-mask ventilation (BMV), laryngoscopy, intubation, or supraglottic airway placement; all in a single patient pose exceptionally challenging airway management. We may electively plan a surgical airway, but the option may not be available, especially when the patient provides tracheostomy permission only for emergency airway management, not for an elective. A 48-year-old male patient with a probable diagnosis of midline lethal granuloma presented with right-side nasal blockade, deformity, and near-total blockade of the left nasal cavity with right-sided mid-facial swelling, pain, and foul-smelling discharge and an ulcerated hard palate and was scheduled for an endoscopic biopsy. The airway examination predicted difficult bag-mask ventilation, pre-intubation oxygenation, risky laryngoscopy, and supraglottic airway insertion. Even airway topicalization, sedation, and preparation for awake intubation were challenging. Resource limitations and unexpected desaturation while attempting awake intubation led to an emergent situation; i-gel came as a rescue, and ultimately, the definitive airway was secured using a 6.5 mm cuffed endotracheal tube (ETT), railroaded over a fibreoptic bronchoscope (FOB), and inserted through i-gel. We present the case to highlight the challenges and discuss the possible remedies where our technique can be an alternative for cases with difficult mask ventilation, intubation, and supraglottic airway insertion., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institute Ethics Committee, All India Institute of Medical Sciences, Guwahati issued approval Not applicable. Case reports and letters do not require ethical approvals for publication in our institute. We declare that we have obtained permission to take clinical images and for publishing them in journals and presenting them in other academic platforms as de-identified images. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Atlapure et al.)

Eucalyptus oil consumption is well known to cause adverse effects on central nervous system like seizures, ataxia and unconsciousness. No antidote is available and treatment is largely supportive. We report a case of rhabdomyolysis with pigment cast nephropathy and acute kidney injury in a young female following eucalyptus oil consumption and its successful management., Competing Interests: There are no conflicts of interest., (© 2024 Indian Journal of Nephrology | Published by Scientific Scholar.)

Identification of novel subgroups of type 2 diabetes (T2D) has helped improve its management. Most classification techniques focus on clustering or subphenotyping but not on both. This study aimed to compare both these methods and examine the rate of T2D remission in these subgroups in the Indian population. K-means clustering (using age at onset, HbA1C, BMI, HOMA2 IR and HOMA2%B) and subphenotyping (using homeostatic model assessment (HOMA) estimates) analysis was done on the baseline data of 281 patients with recently diagnosed T2D who participated in a 1-year online diabetes management program. Cluster analysis revealed three distinct clusters: severe insulin-deficient diabetes (SIDD), severe insulin-resistant diabetes (SIRD), and mild obesity-related diabetes (MOD) while subphenotyping showed four distinct categories: hyperinsulinemic, insulinopenic, classical, and nascent T2D. Comparison of the two approaches revealed that the clusters aligned with phenotypes based on shared characteristics of insulin sensitivity (IS) and beta cell function (BCF). Clustering correctly identified individuals in nascent group (high IS and BCF) as having mild obesity related diabetes which subphenotyping did not. Post-one-year intervention, higher remission rates were observed in the MOD cluster (p = 0.383) and the nascent phenotype showing high IS and BCF (p = 0.061, Chi-Square test). In conclusion, clustering based on a comprehensive set of parameters appears to be a superior method for classifying T2D compared with pathophysiological subphenotyping. Personalized interventions may be highly effective for newly diagnosed individuals with high IS and BCF and may result in higher remission rates in these individuals. Further large-scale studies are required to validate these findings., (© 2024. The Author(s).)

Digoxin, a cardiac glycoside, functions by inhibiting the sodium potassium ATPase pump. It's crucial to note that digoxin has a very narrow therapeutic range. Its serum level vary due to changes in body weight, age, renal function, hepatic impairment and concomitant drug therapy. Chronic toxicity can lead to different types of arrrythmia,which span from heart blocks to ventricular tachycardia. This report present a case of an elderly male, where Digoxin toxicity resulted in syncope and mild traumatic brain injury. Initially upon patient's presentation ECG indicated myocardial infarction, subsequently bradycardia and complete heart block. The patient had a known history of chronic kidney disease and was prescribed 0.25mg of digoxin regularly without dose adjustment, which might have resulted in reduced digoxin elimination, leading to toxicity. Thus this case demonstrates a classic presentation of digoxin toxicity. Multiple risk factor such as old age, impaired renal function with continued digoxin treatment without dose adjustment was likely the cause of toxicity., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Rice brown spot is an important disease of rice worldwide that inflicts substantial yield losses. The antimicrobial potential of methanol, acetone and dimethyl sulfoxide (DMSO) extracts of different medicinal plants, viz., Syzygium aromaticum, Saussurea costus, Acorus calamus, Bergenia ciliate, Geranium pratense, Mentha longifolia, Inula racemosa, Podophyllum hexandrum, Heracleum candicans and Picrorhiza kurroa, against the brown spot pathogen Bipolaris oryzae in vitro was evaluated via mycelial growth inhibition and spore germination inhibition assays. Among the plant extracts tested, 100% mycelial inhibition was observed for the methanol extract of Syzygium aromaticum at all three concentrations (2000 ppm, 3000 ppm and 4000 ppm), followed by the methanol extract of Inula racemosa (90.33%) at 4000 ppm. A maximum conidial germination inhibition of 83.54% was exhibited by the Heracleum candicans leaf extract. Phytochemical profiling of Syzygium aromaticum and Inula racemosa through liquid chromatography and mass spectrometry (HR-LCMS) revealed the presence of several compounds, such as eugenol, ursolic acid, quercetin, chlorogenic acid, and noscapine. A molecular docking approach was used to identify key inhibitory molecules against B. oryzae. Among the compounds detected in S. aromaticum and Inula racemosa, ursolic acid and noscapine were found to have the greatest binding affinity for the Big Mitogen Activated Protein Kinase (BMK-1) enzyme present in B. oryzae. In conclusion, S. aromaticum and Inula racemosa are potent compounds that could serve as lead compounds for drug discovery in the future., (© 2024. The Author(s).)

Background: The microbiota in the intestine is made up of trillions of living bacteria that coexist with the host. Administration of antibiotics during neonatal infection causes depletion of gut flora resulting in gut dysbiosis. Over the last few decades, probiotics have been created and promoted as microbiota management agents to enrich gut flora. Probiotics decrease the overgrowth of pathogenic bacteria in the gut of preterm neonates, reducing the frequency of nosocomial infections in the Neonatal Intensive Care Unit (NICUs). Methods: The systematic review will include randomized control trials (RCTs) of premier neonates with sepsis. Studies will be retrieved from global databases like Cochrane CENTRAL, CINAHL Plus via EBSCO host, MEDLINE via PubMed, EMBASE, SCOPUS, Ovid, Web of Science, ProQuest Medical Library, Microsoft academic, and DOAJ by utilizing database-specific keywords. Screening, data extraction, and critical appraisal of included research will be carried out separately by two review writers. Findings will be reported in accordance with the PRISMS-P 2020 guidelines. Conclusions: The findings of this systematic review will help to translate the evidence-based information needed to encourage the implementation of potential research output in the field of neonatal intensive care, guide best clinical practise, assist policy making and implementation to prevent gut dysbiosis in neonates with sepsis by summarising and communicating the evidence on the topic. PROSPERO registration number: This systematic review protocol has been registered in PROSPERO (Prospective Register of Systematic Reviews) on 10 th March 2022. The registration number is CRD42022315980., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Iqbal F et al.)

Introduction: Spine fixation surgery for traumatic vertebral fractures is associated with severe pain and is often difficult to control. Traditionally systemic opioids have been the mainstay of analgesia for these procedures, which can lead to hyperalgesia, nausea, ileus, sedation, cognitive impairment, dependence, etc., limiting usage of opioids. The Erector spinae plane block (ESPB) is a novel ultrasound-guided procedure with easily identifiable sonoanatomy. We hypothesized that a multimodal approach involving ESPB to a conventional analgesic regimen with local infiltration for patients undergoing major traumatic spine surgeries might provide better perioperative analgesia and reduce the need for postoperative opioid requirements., Material and Methods: A randomized control prospective trial was conducted on 34 ASA grade I -II patients aged 18 to 65 years who were scheduled to undergo elective posterior spine fixation surgery with ASIA B to E after traumatic spine fracture under general anesthesia. Patients were randomized to Group A which included patients who received general anesthesia with ESPB, and Group B, or the control group, included patients who received general anesthesia with systemic analgesics and postoperative local infiltration without ESPB. Intraoperative total fentanyl consumption, VAS score at 0, 3, 6, 12, 18, and 24 hours, time to activate patient-controlled analgesia (PCA) pump, total morphine consumption, and opioid-related side effects were monitored and compared in both groups., Results: Postoperative PCA morphine consumption was significantly lower in group A patients who received ESPB than those in the control group (17.06 ± 9.59 vs 37.82 ± 9.88 P value = <0.0001). VAS scores at rest and movement at 0, 3, 6, 9, 12, 18, and 24 hours were significantly lower ( P value = 0.05) in the ESPB group compared with the control group at all time points., Conclusion: Bilateral ultrasound-guided Erector spinae plane block, when administered in traumatic spine patients undergoing spine fixation surgery, provides better analgesia with statistically decreased VAS scores and less postoperative opioid requirement., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Saudi Journal of Anesthesia.)

This study aimed to investigate the dissipation pattern, risk assessment, and waiting period of myclobutanil on apple fruit (Malus domestica Borkh.) under temperate conditions in Kashmir, India. The study involved the application of myclobutanil 10 WP at a single recommended dosage (125 g a.i. ha -1 ) and double dosage (250 g a.i. ha -1 ) on Red Velox apple trees, 2 months before harvest. GC equipped with an electron capture detector was used to analyze myclobutanil residues in fruit samples. The study revealed that myclobutanil, at both recommended and double recommended doses, dissipated rapidly and became nondetectable after 55 and 60 days, respectively. The waiting period for myclobutanil application was determined to be 12.41 days for the single dose and 25.58 days for the double dose, respectively. These waiting periods were based on the maximum residue limit of 0.6 ppm as prescribed by the Codex Alimentarius Commission, Food Safety and Standards Authority of India, and European Commission. The study concludes that myclobutanil 10 WP is safe for consumers at both recommended and double recommended doses when applied 2 months before harvest. Risk assessment, considering the average daily apple consumption in India and theoretical maximum residue contributions (TMRCs), indicates negligible health hazards even at double the recommended dosage. The calculated TMRC values at Day 0 were significantly below the maximum permissible intake. For average and maximum myclobutanil residues at single and double doses, the TMRC values were found to be 0.0069 and 0.0070 mg day -1 person -1 and 0.0105 and 0.0106 mg day -1 person -1 , respectively. These results indicate that myclobutanil, when used according to recommended dosages and waiting periods, poses minimal health risks to consumers. The study emphasizes the importance of prudent fungicide use to minimize fungicide residues on fruits, thereby ensuring their safety for consumption., (© 2024 John Wiley & Sons Ltd.)

Background: The global rise in diabetes, particularly in India, poses a significant public health challenge, with factors such as limited awareness, financial strain, and cultural considerations hindering its effective management. Although lifestyle changes have shown promising results, their consistent implementation and maintenance continue to pose challenges. Most studies have focused primarily on dietary modifications, overlooking other essential aspects of lifestyle intervention. The DiRemI study aims to address these gaps by evaluating the efficacy of a comprehensive one-year program that combines diet, exercise, psychological support, and medical management to achieve weight loss, diabetes remission, and improved glycemic control among patients with type 2 diabetes (T2D) in India, while also considering the unique needs of the Indian population., Methods: The DiRemI study is a prospective, open-label, matched-group trial aimed at assessing the impact of a one-year online integrated intensive lifestyle intervention (ILI) comprising dietary modifications, physical activity, psychological support, and medical management on weight loss and remission in adult T2D patients (aged 30-70 years), with a body mass index (BMI) between 25 and 35 kg/m2, and disease duration of <15 years. ILI will be compared with routine medical care (RMC). Participants will be recruited from three clinics: one providing ILI and two others providing RMC. The co-primary outcome will be weight loss and remission at 12 months, with a follow-up at 18 months. The proposed sample size is 360 participants (180 each in intervention and control group)., Discussion: The DiRemI study represents the first large-scale remission study in India to show the effectiveness of an integrated approach in the remission and management of T2D and its complications. The findings of this study hold the potential to report evidence-based strategies for managing T2D both in India and globally, thus alleviating the substantial burden of diabetes on public health systems., Trial Registration: Clinical Trials Registry, India (Registered Number: CTRI/2023/06/053885)., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Tripathi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)