Search

Introduction: The perspective of airway management has undergone a considerable transformation since the advent of Video Laryngoscopes (VL). VL has rapidly been accepted as an intubation tool in a variety of clinical scenarios. This heralds a wide array of VL models with their own strengths and weaknesses. The C-MAC D blade® is one such VL with an angulated blade that provides an excellent glottis view, but negotiating the Endotracheal Tube (ETT) past the glottis opening and into the trachea might be difficult. No study till date was done on the C-MAC D blade® with different glottis views for intubation. Aim: To compare the Total Time of Intubation (TTI) with restricted glottis view and full glottis view with C-MAC D blade® as the primary aim, along with the first attempt intubation rate and complications during intubation. Materials and Methods: The present prospective single-centre randomised controlled trial was conducted in the Department of Anaesthesiology, Shree Krishna Hospital, PSMC, Karamsad, Gujarat, India, from September 2021 to August 2022. A total of 42 patients were randomly divided into two groups: group-F (n=21), which had a full glottis view, and group-R (n=21), which had a restricted glottis view. Randomised glottis views were achieved with the C-MAC D blade® VL during oral endotracheal intubation in both groups. Video recordings of the intubations were made, and TTI, first attempt success rate and complications during intubation were noted. Statistical analysis was done with an independent sample t-test to compare the two groups of continuous variables using STATA version 14.2. Results: The mean age in group-F was 45.86±10.83 years and in group-R was 47.76±9.14 years. The male-to-female ratio in group-F was 10:11 and in group-R was 9:12. Overall, the first-attempt successful intubation rate with the C-MAC D blade® in both groups was 90.48%. However, it was higher in group-R (95.24%) compared to group-F (85.71%). TTI was less in group-R compared to group-F (36.19±11.11 vs 45±15.89 seconds, p-value=0.0438). Group-R had lower incidence of postoperative sore throat (14.29% vs 57.14%, p-value=0.004) compared to group-F. Conclusion: Total time of intubation was less with a restricted glottis view compared to a full glottis view with C-MAC D blade® VL. Additionally, the restricted view had a higher first attempt intubation rate. Postoperative sore throat was significantly lower in the restricted view, with a lesser incidence of oropharyngeal trauma compared to the full glottis view.

Abstract Background Thyroid dysfunction in pregnancy can adversely impact maternal and fetal outcomes. However, the association between thyroid status and specific adverse outcomes needs clarity, especially in understudied regions. Objective This prospective cohort study aimed to illuminate the multifaceted associations between maternal thyroid dysfunction and feto-maternal outcomes in Gujarat, India. Methods This hospital-based cohort study recruited and monitored 500 euthyroid, 250 hypothyroid, and 150 hyperthyroid pregnant women until delivery. Maternal thyroid status was determined by serum thyroid stimulating hormone (TSH) and free thyroxine (fT4) levels. Adverse fetal outcomes included preterm birth, neonatal intensive care unit (NICU) admission, respiratory issues, and low APGAR scores. Maternal outcomes included preeclampsia, haemorrhage, hypertension, postpartum thyroiditis, and thromboembolism. Relative risks quantified associations between thyroid dysfunction and outcomes. Results Compared to euthyroid women, hypothyroid women had a higher RR for preterm birth (RR 1.8, 95% CI 1.1–3.0), low APGAR score (RR 2.5, 95% CI 1.5–4.1), preeclampsia (RR 3.0, 95% CI 1.9–4.8), postpartum haemorrhage (RR 1.6, 95% CI 1.2–2.1), and venous thromboembolism (RR 3.1, 95% CI 1.7–5.7). Hyperthyroid women had over twice the risk of low APGAR score (RR 1.8, 95% CI 0.9–3.5), neonatal hypoglycemia (RR 1.5, 95% CI 0.5–4.3), respiratory distress (RR 1.4, 95% CI 0.7–2.8), and postpartum thyroiditis (RR 2.3, 95% CI 1.1–4.8). Conclusion Maternal thyroid dysfunction escalates risks for adverse fetal and maternal outcomes. Thyroid monitoring and management during pregnancy are critical to mitigate complications.

Background: Antibiotic resistance is a silent pandemic disease that is growing and causing a global threat. Existing antibiotics are less effective against infectious diseases, so we must discover more potent and effective drugs. The latest report from the World Health Organization (WHO) underscores the global nature of the situation, revealing that high levels of antibiotic resistance in bacteria worldwide lead to life-threatening bloodstream infections and resistance to treatment. Methods: This study focuses on the Molecular Docking and Pharmacophore Modeling of Ciprofloxacin and its analogs to explore ligand-protein interactions and identify potent drugs against AMR. Twenty ciprofloxacin analogs, designed using ChemDraw Pro12.0, were docked with the 2XE1 protein. Molecular docking assessed the binding affinity, with Arguslab 4.0 scoring the lowest docking scores to indicate strong interactions and biological activity. Pharmacophore modeling identified essential molecular features like HBA, HBD, and AI for optimal biological activity. Results: The computational screening identified several compounds with improved binding properties, showing greater affinity towards ALA129, TYR149, and PHE88 amino acids, essential for biological activity. Conclusion: The study identifies the best analog of ciprofloxacin, which can effectively combat antibiotic resistance. Compound 13 showed promising docking scores and relevant pharmacophoric features, outperforming the parent ciprofloxacin in binding affinity, suggesting it could be a potent drug candidate against AMR.

Psychotropic medications, particularly antipsychotics, are known to elicit various adverse effects, with ocular complications being underreported yet significant. This case series presents three instances where atypical antipsychotics, namely Risperidone, Cariprazine, and Olanzapine, led to ocular dystonias and nystagmus. These adverse effects occurred at relatively low doses, highlighting the need for vigilant monitoring even with second-generation antipsychotics. Case descriptions delineate patients experiencing acute dystonic reactions and nystagmus following initiation or dose adjustment of atypical antipsychotics, leading to upward deviation of the eyes, involuntary movements, and nystagmus. Prompt recognition and management were crucial, with cessation of the offending medication resulting in symptom remission and subsequent stabilization with alternative treatments. Factors contributing to these adverse effects, such as dopamine receptor blockade and individual susceptibility, are explored, emphasizing the importance of comprehensive evaluation and open patient–physician communication. The present case series underscores the necessity of vigilant monitoring for ocular adverse effects, even with atypical antipsychotics, given their potential to induce acute dystonias and nystagmus. The presented cases advocate for heightened awareness among clinicians to promptly recognize and manage such rare complications, ensuring optimal patient care and treatment outcomes.

Background: Dissatisfaction with body image is common both among adolescents and young adults, especially females, which leads to an increased risk of various psychiatric disorders such as depression, anxiety, substance use disorder, and eating disorders. Aim: The aim of the study was to find the association between body image and self-esteem, anxiety, and depression in undergraduate female medical students. Materials and Methods: This cross-sectional, observational study was conducted on female undergraduate (MBBS) students after permission from the institute ethics committee. Informed written consent was taken from all participants. A total of 184 students participated in the study, but only 164 were included, as 20 students had incomplete forms. Body image was assessed using a Body Image Questionnaire (BIQ), self-esteem was assessed using a Rosenberg’s self-esteem questionnaire, whereas anxiety and depression were assessed by a clinician using Hamilton’s Anxiety Rating Scale and Hamilton’s Depression Rating Scale. Results: We found that 35% of female students had low self-esteem. 27.4% of them had anxiety and 19.5% suffered from depression. The majority of 4th-year students had a low body image, followed by 1st-year students. Students with low self-esteem had a poorer body image, as suggested by a higher BIQ score (61.34 ± 4.22). Similarly, students with severe anxiety and severe depression had a higher BIQ score and a poorer body image compared to those with moderate and mild anxiety and depression. All these findings were statistically significant (P < 0.05). On applying multiple regression analysis, body image was found to be significantly associated (P < 0.05) with self-esteem and depression. Conclusion: Students with poor body image had lower self-esteem and a significant level of anxiety and depression.

Background: Postpartum depression (PPD) is a significant public health concern with detrimental effects on maternal and child well-being. Social support, breastfeeding attitudes, and self-efficacy have been identified as potential protective or risk factors for PPD. This study aimed to investigate the associations between PPD, social support, breastfeeding attitudes, and self-efficacy among postpartum women in Gujarat, India. Methods: A cross-sectional study was conducted among 403 postpartum women in Gujarat, India. Data on sociodemographic characteristics, obstetric factors, PPD (assessed using the Edinburgh Postnatal Depression Scale), social support, breastfeeding attitudes, and self-efficacy were collected through structured interviews. Bivariate and multivariate logistic regression analyses were performed to examine the associations between PPD and the independent variables. Results: The prevalence of PPD in the study population was 50.1% (n = 202), with 28.8% (n = 116) experiencing mild depression, 16.6% (n = 67) moderate depression, and 4.7% (n = 19) severe depression. Lower educational level (n = 120, 29.8%; AOR: 1.72, 95% CI: 1.04–2.85), lower socioeconomic status (n = 242, 60%; AOR: 1.84, 95% CI: 1.12–3.02), non-exclusive breastfeeding (n = 167, 41.4%; AOR: 1.68, 95% CI: 1.11–2.54), low social support (n = 101, 25.1%; AOR: 2.51, 95% CI: 1.57–4.02), and a history of depression (n = 93, 23.1%; AOR: 2.94, 95% CI: 1.82–4.75) were significantly associated with higher odds of PPD in the multivariate analysis. In addition, negative breastfeeding attitudes and low self-efficacy levels were associated with increased odds of PPD. Conclusions: The findings highlight the significant associations between PPD and various sociodemographic, obstetric, and psychosocial factors among postpartum women in Gujarat, India. Interventions targeting social support, breastfeeding attitudes, and self-efficacy, as well as targeted support for women with identified risk factors, may help mitigate the burden of PPD and promote maternal well-being.

Purpose – In developing nations, the utility and intention to use algorithmic trading (AT) platforms and financial services are predominantly reliant on investors’ technological knowledge. This study aims to investigate the effect of investor awareness of AT (AAT), trust in AT (TAT), and acceptance of innovativeness (AOI) on intention to use the AT (IUAT) platforms among Indian investors. Design/methodology/approach – The authors used a structured questionnaire with a five-point Likert scale to collect the data from 392 Indian retail investors through a purposeful sampling approach. And, the authors carried out structural equation modeling to analyze the serial mediation among the latent (independent) and observed (dependent) variables. Findings – The findings suggest that investor awareness exerts a statistically significant and positive effect on the IUAT platforms. Additionally, TAT platforms and innovation acceptance, independently as well as mediator, significantly influences the usage decision of AT platforms among Indian investors. Research limitations/implications – The findings on determinants of AT platform usage can guide investment regulators to promote technological awareness, build trust, and provide a safe algorithmic trading environment for retail investors in India. The suggestions may take the edge off a few behavioural impediments among the investors w.r.t. AT platform usage. Originality/value – Off the back of extensive literary exploration our field research is among the first that probes an intellectual discourse and documents the empirical evidence on linkages between investor AAT, TAT, AOI and the IUAT platforms in the Indian stock market.

Introduction: For a dentist, it is a matter of concern to restore the original luster or glaze on a Monolithic Zirconia (MZ) restoration after clinical adjustments. For a long time, the gold standard for surface restoration was reglazing; however, with advancements in technology, new polishing kits optimised for zirconia have become available for chairside polishing. Aim: To examine the effects of grinding, reglazing, and polishing techniques on the surface roughness and flexural strength of MZ specimens. Materials and Methods: This in-vitro study was conducted in the Department of Prosthodontics at MM College of Dental Sceiences and Research in Mullana, Haryana, India from April to December 2019 and 32 specimens of MZ, each measuring 20 mm × 5 mm × 3 mm, were fabricated and divided into four groups, with each group consisting of eight specimens. Group C was considered the Control group. Specimens in Group G were only Ground, specimens in Group GR were Ground and Reglazed, and specimens in Group GP were Ground and Polished using a zirconia polishing kit. All specimens were then analysed for surface roughness and flexural strength using a profilometer and a Universal Testing Machine (UTM), respectively. Statistical analysis was performed using Analysis of Variance (ANOVA), Honest Significant Test (HSD) post-hoc test, Pearson’s correlation, and other methods using International Business Machine (IBM) Statistics version 25.0 (Armonk, USA). Results: The surface roughness (Ra) of the control group (C) was 0.4403 μm, followed by the Polished Group (GP) at 0.656 μm and the Reglazed Group (GR) at 0.809 μm. The difference between the polished (GP) and reglazed (GR) groups, was statistically insignificant (p=0.53). There was a statistically significant increase in flexural strength in the reglazed samples (GR) when compared to the polished samples (GP). No significant correlation (p=0.58 and r=-0.1) was found between surface roughness and flexural strength. Conclusion: Chairside polishing can be an effective alternative to reglazing for restoring the surface finish of MZ. Additionally, polishing increases the strength of zirconia after adjustments.

Introduction: Anaemia and cancer are two non communicable diseases with high global prevalence. The presence of anaemia in cancer patients is common, and its aetiology is multifactorial. Aim: To analyse the clinical profile, type and severity of anaemia in non haematological malignancies and to determine how the presence of metastasis affects it. Materials and Methods: A cross-sectional study was conducted in the Department of General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India, between January 2022 and December 2023. Out of 1,294 patients diagnosed with malignancy, 190 subjects were analysed. The study included patients over 18 years of age diagnosed with non haematological malignancies who had anaemia according to the World Health Organisation (WHO) definition {females with Haemoglobin (Hb)

Biofilm is an assemblage of microorganisms embedded within the extracellular matrix that provides mechanical stability, nutrient absorption, antimicrobial resistance, cell-cell interactions, and defence against host immune system. Various biomolecules such as lipids, carbohydrates, protein polymers (amyloid), and eDNA are present in the matrix playing significant role in determining the distinctive properties of biofilm. The formation of biofilms contributes to resistance against antimicrobial therapy in most of the human infections and exacerbates existing diseases. Therefore, this field requires several state-of-the-art techniques to fully understand the 3-D organization of biofilms, their cell behaviour and responses to pharmaceutical treatments. Here, we explore the assembly and regulation of biofilm biogenesis in the context of matrix components and highlight the significance of high-resolution imaging and analysing techniques for monitoring complex biofilm architecture. Our review also emphasizes the novelty and advancements in techniques to visualise biofilm structure and composition, providing valuable insights to understand biofilm-related infections.

Introduction: The major leading cause of disease-related mortality in children is childhood cancer. It can be difficult to make an accurate diagnosis using only histopathology due to overlapping features and similar histomorphological appearances in various cancers. Immunohistochemistry (IHC) markers can help distinguish tumors that show similar histomorphological features. Aims & Objectives: This study was undertaken to evaluate the histopathological spectrum of pediatric solid malignant neoplasms with IHC and to assess the role of IHC in pediatric solid malignant tumors. Study Design: An observational study of resected malignant solid tumors in the pediatric population including Gross and Histopathological examination was conducted. Materials and methods: 55 samples were collected for five years. All samples were processed for routine histopathology and IHC was done on the majority of these samples. Results: The top five categories of tumors were retinoblastomas, lymphomas, neuroblastomas, bone and soft tissue tumors, and renal and reproductive system tumors. The mean age is 6.6 years and most commonly presented in 0-5 years of age constituting 30 cases. 35 cases seen were in male patients, and 20 in female patients. IHC was performed on 44 cases for confirmation of diagnosis. For the rest of the 11 cases, the histopathological study is the gold standard for diagnosis. Conclusion: An integrated approach including Histomorphological features is required for provisional diagnosis and IHC is necessary for final diagnosis and further characterization.

Background and Objective: Often, the treatment goals for chronic periodontitis in smokers are not achieved only by scaling and root planing (SRP) as non-surgical periodontal therapy. Adjunctive therapy such as local drug delivery (LDD) can be carried out in an attempt to reduce the need for periodontal surgery. The study was carried out to determine the efficacy of subgingivally delivered ketoprofen (K) + doxycycline (D) gel and compare it with that of subgingivally delivered ketoprofen (K) gel alone as an adjunct to SRP in smokers and non-smoker patients having chronic periodontitis. Materials and Methods: Twelve patients in the non-smoker group and nine patients in the smoker group having chronic periodontitis with ≥4-mm pocket depth in at least three adjacent teeth in each quadrant were recruited for the study. The quadrants were randomized into K alone and K + D subgroups. 2.5% ketoprofen gel and 2.5% ketoprofen + 3% doxycycline gel were delivered into designated sites after SRP, and the sites were secured using periodontal dressing. Plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), and relative attachment level (RAL) were recorded at baseline and 3 months. Results: At 3 months follow-up, both the groups showed significant improvement in PI, BOP, PPD, and RAL (P < 0.05). K + D showed a significantly greater reduction of PI, BOP, PPD, and RAL in both smokers and non-smokers than K alone (P < 0.05). Non-smokers responded significantly better than smokers for PI, BOP, PPD, and RAL with both treatment modalities (P < 0.05). Conclusion: The results indicate that smokers and non-smokers demonstrate better clinical outcomes by using K + D LDD as an adjunct to SRP. Moreover, non-smokers responded better to both modalities than smokers.

Nosocomial infections linked to medical implants, wound infections, and cystic fibrosis infections are mostly caused by biofilms linked to Pseudomonas aeruginosa. The development of biofilms on medical equipment continues to a growing health and financial burden with increased the risk of infections and patient morbidity associated with indwelling medical devices. Pseudomonas aeruginosa exhibited high antibiotic resistance, posing challenges for effective treatment of infections associated with medical implants. Therefore, our objective was to adopt a combinatorial approach for formulating antibiotic complexes for maximum eradication of biofilms associated with medical implants.In this study, we optimized the ratio of Tobramycin (TOB) complexes with complexing agents such as sodium bicarbonate (BC), β-cyclodextrin (β-CD), and ethylenediaminetetraacetic acid (EDTA). Further stability and flexibility of the complexes were examined through molecular docking and dynamics. Subculturing and gram staining were performed for the isolation and identification of Pseudomonas aeruginosa. The antibacterial activity was tested using the broth dilution method and well diffusion method to calculate the MIC (minimum inhibitory concentration) against Pseudomonas aeruginosa planktonic cells and biofilms, respectively. The MIC tests indicated that optimized complexes required a concentration of 8 μg/ml to eradicate both planktonic cells as well as biofilms. However, the TOB-BC-(β-CD)-EDTA complex showed lower optical density (OD) compared to other complexes exhibiting better biofilm inhibition. Subsequently a gel formulation using this optimized (TOB-BC-(β-CD)-EDTA) complex that could be applied to medical equipment or potentially converted into a film using different polymer concentrations was developed. The TOB-BC-(β-CD)-EDTA gel formulation was characterized for pH, viscosity, spreadability, % yield, moisture content, drug content, in-vitro drug diffusion, and antibacterial efficacy assay. Among all batches, F2 demonstrated the highest % drug diffusion after 24 h and fit well to the Korsmeyer-Peppas kinetic model. The viscosity of the F2 batch remained within acceptable limits and was stable at 40 ± 0.5 °C and 75.0 ± 5 % RH. The gel efficiently delivered antimicrobial drugs to bacteria within biofilms. In conclusion, tobramycin complex gel showed promising potential for addressing infections related to biofilms on medical implants.

Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with loss of lung function, poor quality of life, loss of exercise capacity, risk of serious cardiovascular events, hospitalization, and death. However, patients underreport exacerbations, and evidence suggests that unreported exacerbations have similar negative health implications for patients as those that are reported. Whilst there is guidance for physicians to identify patients who are at risk of exacerbations, they do not help patients recognise and report them. Newly developed tools, such as the COPD Exacerbation Recognition Tool (CERT) have been designed to achieve this objective. This review focuses on the underreporting of COPD exacerbations by patients, the factors associated with this, the consequences of underreporting, and potential solutions.

This investigation delves into the inhibitory impact of Caesalpinia crista (Kanchaki) seed extract (CCE) on the corrosion of aluminium alloy (AA6061) at temperatures varying between 303 and 333K, employing Potentiodynamic Polarisation (PDP), Electrochemical Impedance Spectroscopy (EIS), and weight loss methodologies. Findings demonstrate that CCE extract effectively safeguards Al against corrosion, with efficacy increasing at higher concentrations. The observed inhibitory action exhibits a cathodic-type behavior across all concentrations and temperatures, aligning well with Langmuir isotherm. Notably, the highest level of inhibitory efficiency, reaching 96.87 ​%, is attained at a concentration of 2.0 ​g/L and a temperature of 303 ​K for 3 hours. Consistency is observed between the results obtained through EIS and PDP. A plausible mechanism for preventing corrosion in Al alloy is proposed. Surface analysis techniques, such as Atomic Force Microscopy (AFM) and Scanning Electron Microscopy/Energy Dispersive X-ray analysis (SEM/EDX), validate the adsorption of the inhibitor onto Al alloy surfaces. Morphological examinations corroborate electrochemical findings, confirming protection against uniform corrosion in HCl solutions. Additional analyses involve the computation of activation energy and thermodynamic parameters, with a thorough discussion of the results.

The increasing global demand for clean drinking water calls for innovative approaches to optimize desalination processes, making them more sustainable and efficient. The integration of nanotechnology with artificial intelligence (AI)—particularly through machine learning and neural networks—is driving the development of advanced nanomembranes with enhanced performance and reliability. AI algorithms embedded in these nanomembrane systems enable real-time monitoring, adaptive responses to changing conditions, and proactive maintenance strategies. For instance, AI can optimize energy consumption, mitigate membrane fouling, and extend membrane lifespan. As these AI-enhanced systems operate, they continuously learn and improve their efficiency under diverse conditions. This technology also supports decentralized water solutions by enabling remote management, reducing the need for on-site personnel, and expanding access to clean water in remote areas. AI-driven systems can analyze real-time data and make informed decisions, ensuring consistent and sustainable operation. However, challenges remain, such as the development of desalination-specific AI algorithms, ensuring scalability and compatibility, and addressing data privacy and security concerns. While the convergence of AI and nanomembrane technology holds immense potential for revolutionizing water desalination, ongoing research and design efforts are essential to fully realize its capabilities in the coming years.

Background Orthodontic appliances hinder proper oral hygiene, leading to plaque retention and biofilm formation which can cause dental diseases. This study investigates the initial impact of orthodontic treatment with fixed appliances versus clear aligners on microbial profiles and gingival/plaque indices.Methods Nine patients were included in this small-scale prospective longitudinal pilot study – five in treatment with fixed appliances and four with clear aligners. Plaque biofilm samples were collected subgingivally, supragingivally and from clear aligner trays, and gingival and plaque indices were recorded at six timepoints over 3 months. DNA was extracted and next-generation 16S rRNA sequencing of the V4 region was performed.Results Fixed appliance patients showed higher plaque and gingival index scores early on (p ≤ 0.05) and higher levels of oral pathogens (p ≤ 0.05). Microbiological analysis revealed distinct microbial communities on clear aligner trays, with health- and disease-associated microbes present at significantly different levels (p ≤ 0.05) compared to intraoral plaque samples.Conclusions Patients undergoing orthodontic therapy with fixed appliances had higher levels of plaque retention and oral pathogens. Clear aligner patients’ had microbial profiles with more oral health-associated species and lower gingival/plaque indices. However, the biofilm on clear aligner trays requires further study, and the small sample size limits the conclusiveness of all findings.Implications Dentists may consider clear aligners as an alternative to fixed appliances, with potential benefits in plaque accumulation and oral microbial composition. All patients undergoing orthodontic therapy should practice good oral hygiene to prevent plaque retention and reduce oral pathogen colonization.Continuing Education Credit Available: A CDA Continuing Education quiz is online for this article: https://www.cdapresents360.com/learn/catalog/view/20The practice worksheet is available online: https://doi.org/10.1080/19424396.2024.2423594

Background: Due to the heterogeneity of existing studies and wide range of human papilloma virus (HPV) prevalence in India, further research into the incidence of HR-HPV and its spectrum of genotypes is essential to develop screening policies. This study aimed to determine the incidence and demographic distribution of HR-HPV among cisgender female patients attending a tertiary care facility in North India. Materials and Methods: This study was conducted in the Department of Obstetrics and Gynaecology, SGRR Institute of Medical and Health Sciences, Dehradun, India. HPV-DNA test results of 653 female patients were assessed for HR-HPV positivity, genotyping, and age-based differences via Chi-square analysis. Results: Overall prevalence of HR-HPV was 4.90%, HPV-16 was 1.37%, HPV-18 was 0.76%, and HPV non-16,18 was 2.7%. In patients ≤ 50 years, prevalence of HPV-16 was 0.97%, HPV-18 was 0.38%, and HR-HPV non-16,18 was 2.71%. In patients > 50 years, prevalence of HPV-16 was 2.89%, HPV-18 was 2.17%, and HR-HPV non-16,18 was 2.89%. The difference in the prevalence of HPV-16,18 between patients ≤ and > 50 years was found to be highly statistically significant (P = 0.007485). The difference in the prevalence of total HR-HPV between patients ≤ and > 50 years was not found to be statistically significant (P = 0.059905). Conclusion: Our study’s finding of higher HR-HPV positivity rates in patients > 50 years emphasizes the need for continued HR-HPV-DNA-based screening of this cohort. With widespread use in post-menopausal patients, HPV screening can serve as an important armamentarium in the fight against cervical cancer.

Aim: The study aimed to know the changes in spirometry parameters in chronic smokers and evaluate how the presence of type 2 diabetes mellitus (T2DM) affects their lung function. Materials and Methods: A prospective, cross-sectional, observational study was done for 12 months at a tertiary care hospital in the western region of Maharashtra State in India. Two groups of patients and one group of healthy volunteers aged 18 years or more were studied (with 50 in each group, n = 150). Group A consisted of smokers with T2DM, Group B- smokers without T2DM and Group 3- healthy controls who were non-smokers and non-diabetic. Spirometry was done for the following parameters: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio, and peak expiratory flow (PEF) and results compared between the three groups. Results: The mean age of the participants was 51.13 ± 10.74 years. There were 137 (91.3%) males and 13 (8.6%) females. Among the enrolled subjects, 66% had smoked for more than ten years. All spirometry parameters were significantly different across all three groups. When the spirometry parameters were compared between smokers with and without T2DM, all the parameters were significantly decreased (P < 0.05). FEV1 and FEV1/FVC were significantly decreased in T2DM patients with HbA1c >7%. Conclusion: The presence of T2DM in smokers significantly affects their pulmonary function tests. Uncontrolled T2DM (HbA1c >7%) can result in increased abnormality in the spirometry parameters studied. Thus, adequate glycemic control and cessation of smoking can be beneficial for the improvement of lung functions in smokers.

Introduction: Helicobacter pylori (H. pylori), despite its high prevalence in the Indian population, has been subjected to limited studies concerning its potential role as a risk factor for Metabolic Syndrome (MetS) and Insulin Resistance (IR). Proposed mechanisms include inflammatory mediators, atherogenic lipid profiles, and vasoconstriction. Aim: To determine the association between H. pylori infection and MetS components, focusing on Highly sensitive C-Reactive Protein (hs-CRP) levels, to enhance understanding and management of these conditions. Materials and Methods: This cross-sectional study was conducted at the Department of Medicine, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India spanning from September 2017 to August 2019. This study involved 100 dyspeptic patients aged 18 years or older undergoing upper Gastrointestinal (GI) endoscopy. Data collection included fasting/postprandial blood parameters, serum lipids, hs-CRP, and H. pylori detection via both rapid urease test and Histopathological Examination (HPE). Physical assessments covered height, weight, Waist Circumference (WC), and blood pressure. MetS was evaluated using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Statistical analysis employed unpaired t-tests, Chi-square tests, and Fisher-Exact tests using IBM Statistical Package for Social Sciences (SPSS) version 21.0. Results: The study of 100 dyspeptic patients, predominantly females, revealed a significant association between H. pylori infection and MetS (p-value

Abstract Introduction Clinical remission is a relatively new concept in asthma but recent research initiatives suggest it could be an ambitious and achievable therapeutic target for patients with asthma. Methods In this modified Delphi study (comprising two online surveys, completed either side of a virtual scientific workshop), the opinions of a panel of respiratory physicians were evaluated to summarize perspective statements on key therapeutic outcomes and criteria for on-treatment clinical remission in patients with moderate asthma. An agreement threshold was pre-defined as agreement by ≥ 75% of participants. Results Surveys 1 and 2 were completed by 20 and 18 participants, respectively. Most participants (95%) agreed with the concept of clinical remission in moderate asthma and that this should be a desirable treatment goal (90%). Based on a composite measure of 4–6 desirable therapeutic outcomes, current understanding of clinical remission was considered as 12 months with no exacerbations, no oral corticosteroids, no daytime or night-time asthma symptoms (Asthma Control Test score ≥ 20 or Asthma Control Questionnaire score ≤ 0.75), stable lung function, and no treatment-related adverse events. No agreement was reached on the role of relievers in defining therapeutic outcomes or on the wider use of biomarkers and airway hyperresponsiveness for defining asthma remission in clinical practice. Conclusions In line with recent consensus statements from the United States and Europe, there was a high level of agreement on the elements of clinical remission among a panel of respiratory physicians from Asia, the Middle East, and South America. Extension of the concept of clinical remission to patients with moderate asthma was considered aligned with the potential of clinical remission as a goal of therapy.

Abstract Background and Aims Healthcare students are expected to lead healthy lives yet they may engage in health risk behaviors (HRBs) like physical inactivity, poor diet, and substance use. These behaviors can have negative consequences for both the individual's health and well‐being, as well as their ability to perform their future roles as healthcare providers. This study aimed to assess the prevalence of HRBs and associated factors among medical and nursing students at Lumbini Medical College, Nepal. Methods A cross‐sectional study was conducted among 412 undergraduate healthcare students using a self‐administered questionnaire. HRBs across various domains were assessed. Validated scales screened for anxiety and depression. Regression analyses determined associations between mental health and HRBs. Results Low physical activity was prevalent, with only 10.7% exercising ≥5 times/week. Inadequate fruit/vegetable intake (1–2 servings/day) was reported by 79.9% students. Short sleep duration (5–6 h) on weeknights (51.2%) was common. More than three quarter (76.5%) of students met the screening cutoff score for HRBs. The study highlighted that students with addiction, depression and anxiety are more likely to exhibit HRBs (p

The inhibitory effects of the novel molecule N1, N1'-(ethane-1,2-diyl)di(ethane-1,2-diamine) (TETA) on aluminum (Al) corrosion were investigated in 0.2, 0.3, and 0.4 M HCl solutions. Electrochemical impedance spectroscopy (EIS), potentiodynamic polarization (PDP), quantitative techniques, and surface morphology characterisation were utilised. Surface morphology characterisation via atomic force microscopy (AFM) and scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM/EDS) confirmed the efficacy of the inhibitor in preventing corrosion. Weight loss research revealed that the protective efficacy of TETA grows with increasing concentration but shrinks with increasing temperature of the acidic solution. The findings indicate a marked increase in inhibition efficiency as TETA content rises, reaching 99.0 % when measured by the weight loss method, 98.34% through EIS, and 94.13% via electrochemical polarization. Polarization curves show that TETA stops hydrochloric acid from acting on the anodic type. Both the charge-transfer resistance and the double-layer capacitance decrease with increasing inhibitor concentration, as shown by the adsorption mechanism and supported by the EIS results. ''The Langmuir isotherm and negative Gibb's free energy values demonstrate that the inhibitor molecules cling to the metal and that they adsorb to the aluminium spontaneously. In addition to analysing TETA via density functional theory (DFT), the adsorption of TETA on the surface of aluminium (Al) was examined via molecular dynamics (MD) simulations. The results show that the TETA molecule successfully blocks the corrosion process.

Idiopathic macular hole (IMH) is a condition that arises from a combination of interactions among several forces on the fovea, remarkably from vitreous traction in the anteroposterior and tangential directions. Recent studies have highlighted the significance of microincision vitrectomy surgery, and IMH surgery was performed with minimal invasiveness, and visual improvement was an expected outcome. This study aimed to observe the pre-operative optical coherence tomography (OCT) indices correlated with visual acuity in the closure of IMH after surgery. Primarily, the findings were associated with clinical characteristics, including OCT indices, change in best corrected visual acuity (BCVA), clinical factors associated with IMH closure, and prognostic factors for the visual outcomes. This retrospective study included pre- and post-operative BCVA and OCT indices of 110 eyes with IMH. Each OCT variable was subjected to stepwise regression analysis regarding therapeutic factors that predict the need for IMH closure. Our results revealed that the hole form factor (HFF, r = 0.196), macular hole index (MHI, r = 0.669), and tractional hole index (THI, r = 0.085) had a positive correlation with visual acuity. However, basal hole diameter (BHD, r = −0.696) and minimum hole diameter (MHD, r = −0.407) showed a negative correlation. Out of them, HFF, MHI, BHD, and MHD were observed to be statistically significant (p

Abstract Introduction Despite the proven benefits of inhaled corticosteroid (ICS)-containing triple therapy for chronic obstructive pulmonary disease (COPD), clinicians limit patient exposure to ICS due to the risk of pneumonia. However, there are multiple factors associated with the risk of pneumonia in patients with COPD. This post hoc analysis of IMPACT trial data aims to set the risks associated with ICS into a context of specific patient-related factors that contribute to the risk of pneumonia. Methods The 52-week, double-blind IMPACT trial randomized patients with symptomatic COPD and ≥1 exacerbation in the prior year 2:2:1 to once-daily fluticasone furoate (FF)/umeclidinium (UMEC)/vilanterol (VI), FF/VI or UMEC/VI. Annual rate of on-treatment pneumonias in the intent-to-treat population associated with age, body mass index (BMI), percent predicted forced expiratory volume in 1 s (FEV1) and blood eosinophil count (BEC) was evaluated. Results This analysis revealed that the annual rate of pneumonia showed the lowest risk at the age of 50 years. The 95% confidence intervals (CI) between ICS-containing and non-ICS containing treatments diverged in ages > 63 years, suggesting a significantly increased ICS-related risk in older patients. In contrast, the annual rate of pneumonia rose in both groups below BMI of 22.5 kg/m2, but above that, there was no relationship to pneumonia rate and no differential effect between the two groups. The relationship between BEC and pneumonia was flat up to > 300/µL cells with ICS-containing treatment and then rose. In contrast, the rate of pneumonia with non-ICS containing treatment appeared to increase at a lower level of BEC (~ 200/µL). Conclusions There was little evidence of a differential effect of older age, lower BMI, lower FEV1 and BEC on the pneumonia rate between ICS-containing and non-ICS containing treatments. This analysis points to the need for a balanced approach to risk versus benefit in the use of ICS-containing treatments in COPD. Clinical trial registration IMPACT ClinicalTrials.gov number, NCT02164513.

This paper tackles the complex interplay between Human Immunodeficiency virus (HIV-1) and Mycobacterium tuberculosis (M. tuberculosis) infections, particularly their contribution to immunosenescence, the age-related decline in immune function. Using the current literature, we discuss the immunological mechanisms behind TB and HIV-induced immunosenescence and critically evaluate the BCG (Bacillus Calmette-Guérin) vaccine’s role. Both HIV-1 and M. tuberculosis demonstrably accelerate immunosenescence: M. tuberculosis through DNA modification and heightened inflammation, and HIV-1 through chronic immune activation and T cell production compromise. HIV-1 and M. tuberculosis co-infection further hastens immunosenescence by affecting T cell differentiation, underscoring the need for prevention and treatment. Furthermore, the use of the BCG tuberculosis vaccine is contraindicated in patients who are HIV positive and there is a lack of investigation regarding the use of this vaccine in patients who develop HIV co-infection with possible immunosenescence. As HIV does not currently have a vaccine, we focus our review more so on the BCG vaccine response as a result of immunosenescence. We found that there are overall limitations with the BCG vaccine, one of which is that it cannot necessarily prevent re-occurrence of infection due to effects of immunosenescence or protect the elderly due to this reason. Overall, there is conflicting evidence to show the vaccine’s usage due to factors involving its production and administration. Further research into developing a vaccine for HIV and improving the BCG vaccine is warranted to expand scientific understanding for public health and beyond.

Key Clinical Message In babies presenting with an omphalocele, other components of the prune belly syndrome should be scrutinized for early diagnosis and timely intervention. Abstract A male baby on his 13th day of life presented with an omphalocele. On evaluation, he had congenital absence of left kidney and bilateral cryptorchidism. Therefore, he was diagnosed with prune belly syndrome. He responded well to abdminoplasty, and wait and watch policy was applied for his cryptorchidism.

Abstract Respiratory syncytial virus (RSV) is a significant global health concern and major cause of hospitalization, particularly among infants and older adults. The clinical impact of RSV is well characterized in infants; however, in many countries, the burden and risk of RSV in older populations are overlooked. In Latin America, there are limited data on RSV epidemiology and disease management in older adults. Therefore, the impact of RSV in this region needs to be addressed. Here, current insights on RSV infections in older populations in Latin America, including those with underlying health conditions, are discussed. We also outline the key challenges limiting our understanding of the burden of RSV in Latin America in a worldwide context and propose an expert consensus to improve our understanding of the burden of RSV in the region. By so doing, we aim to ultimately improve disease management and outcomes of those at risk and to alleviate the impact on healthcare systems. A graphical plain language summary is available with this article. Graphical Plain Language Summary

ABSTRACT: Objectives: Artemisinin (ART) resistance in Plasmodium is threatening the artemisinin combination therapies—the first line of defence against malaria. ART resistance has been established to be mediated by the Plasmodium Kelch13 (PfK13) protein. For the crucial role of PfK13 in multiple pathways of the Plasmodium life cycle and ART resistance, it is imperative that we investigate its interacting partners. Methods: We recombinantly expressed PfK13-p (Bric a brac/Poxvirus and zinc finger and propeller domains), generating anti-PfK13-p antibodies to perform co-immunoprecipitation assays and probed PfK13 interacting partners. Surface plasmon resonance and pull-down assays were performed to establish physical interactions of representative proteins with PfK13-p. Results: The co-immunoprecipitation assays identified 17 proteins with distinct functions in the parasite life cycle– protein folding, cellular metabolism, and protein binding and invasion. In addition to the overlap with previously identified proteins, our study identified 10 unique proteins. Fructose-biphosphate aldolase and heat shock protein 70 demonstrated strong biophysical interaction with PfK13-p, with KD values of 6.6 µM and 7.6 µM, respectively. Additionally, Plasmodium merozoite surface protein 1 formed a complex with PfK13-p, which is evident from the pull-down assay. Conclusion: This study adds to our knowledge of the PfK13 protein in mediating ART resistance by identifying new PfK13 interacting partners. Three representative proteins—fructose-biphosphate aldolase, heat shock protein 70, and merozoite surface protein 1—demonstrated clear evidence of biophysical interactions with PfK13-p. However, elucidation of the functional relevance of these physical interactions are crucial in context of PfK13 role in ART resistance.

Abstract Introduction The objective of this Delphi study was to understand and assess the level of consensus among respiratory experts on the clinical application of GOLD 2023 recommendations in management of patients with chronic obstructive pulmonary disease (COPD). Methods The study comprised two online surveys and a participant meeting with 34 respiratory experts from 16 countries. Responses of 73 questions were recorded using a Likert scale ranging from 0 (disagreement) to 9 (agreement). The consensus threshold was 75%. Results Survey 1 and survey 2 had 34 and 32 participants, respectively; and 25 attended the participant meeting. Consensus was reached on survey 1: 28/42; survey 2: 18/30 close-ended questions. A consensus was reached on the clinical relevance of most updates in definitions and diagnosis of COPD. Mixed results for the treatment recommendations by GOLD were noted: 74% agreed with the recommendation to initiate treatment with dual bronchodilators for group E patients; 63% agreed for including inhaled corticosteroids (ICS)/long-acting β2 agonist(LABA)/ Long-acting muscarinic receptor antagonists (LAMA) as a treatment option for GOLD B patients. Also, consensus lacked on removing ICS + LABA as an initial therapeutic option, in countries with challenges in access to other treatment option;. 88% agreed that they use GOLD recommendations in their daily clinical practice. Conclusions This Delphi study demonstrated a high level of consensus regarding key concepts of GOLD 2023 report, with most participants favoring recent updates in definitions, diagnosis, management, and prevention of COPD. More evidence on the etiotype based management and treatment options for group B and E are required which could further strengthen clinical application of the GOLD report.

In the present study, we define hybrid enriched contractions of the Hardy–Rogers type and of the Ćirić–Reich–Rus type in the framework of convex metric space. We demonstrate the presence and the approximation of fixed points for contraction mappings by using Krasnoselskij iteration. The main conclusions of this study are shown to be corollaries or implications of multiple important fixed point theory findings. Some examples have also been provided to show the validity of our results. Towards the end of this paper, we study the solution of the nonlinear equations as an application of our main results.

Crop nitrogen (N) and phosphorus (P) use efficiencies (NUE/PUE) are important to minimize wastage and nutrient pollution, but no improved crop for both is currently available. We addressed them together in rice, in the view of its high consumption of NPK fertilizers. We analyzed 46 morphophysiological parameters for the N/P response in three popular indica genotypes, namely, BPT 5204, Panvel 1, and CR Dhan 301 at low, medium, and normal N/P doses. They include 18 vegetative, 15 physiological, and 13 reproductive parameters. The segregation of significantly N/P-responsive parameters correlating with NUE/PUE revealed 21 NUE, 22 PUE, and 12 common parameters. Feature selection analyses revealed the common high-ranking parameters including the photosynthetic rate at the reproductive stage, tiller number, root–shoot ratio, culm thickness, and flag leaf width. The venn selection using the reported NUE/PUE-related candidate genes in rice revealed five genes in common for both, namely OsIAA3, OsEXPA10, OsCYP75B4, OsSultr3;4, and OsFER2, which were associated with three of the common traits for NUE/PUE. Their expression studies using qRT-PCR revealed the opposite regulation in contrasting genotypes for OsSultr3;4 and OsEXPA10 in N-response and for OsFER2 in P-response, indicating their role in contrasting N/P use efficiencies. Overall, CR Dhan 301 has the highest NUE and PUE followed by Panvel 1 and BPT5204 among the studied genotypes.

Head and Neck Lymphedema (HNL) is one of the complications of Head and Neck Carcinoma (HNC). It can be a consequence of the disease progression or can occur as a complication of HNC management. HNL patients not only have facial disfigurement but also have psychological effects and poor quality of life. Severe lymph edema can cause impairment in speaking, chewing, and hearing. The gold standard treatment for HNL is Complete Decongestive Therapy (CDT). We present a case of a 59-year-old male with metastatic squamous cell carcinoma of the tongue who came with complaints of painless and gradual swelling of the face, lips, eyelids, and neck leading to doubling of the head size. He had severe lymphedema of the head and neck which was refractory to treatment.

In this article, a coastal region of India having high water demand for irrigation supply was studied for its groundwater quality in temporal and spatial domains. The statistical tests (Shapiro–Wilk W and Anderson–Darling A) of the chemical data of over 100 groundwater samples of the study area indicate the non-parametric nature of the distribution. High concentrations of F− and NO3− ions above drinking water permissible limits were present in 12% and 28% of samples, respectively. Similarly, Cl– ion, and total hardness were higher while Ca2+, Mg2+, and Na+ ions were marginally higher compared to drinking water limits. Kruskal–Wallis (ANOVA) test results indicate that seasonal variations are not very significant among chemical species. Based on irrigation water quality indicators, groundwater samples fall under the excellent to doubtful category during premonsoon and permissible to unsuitable category during postmonsoon season. These inferences were verified by using the Entropy Water Quality Index (EWQI). The spatial contours of the EWQI values clearly suggest that the impact of anthropogenic activities on groundwater is greater in the northern parts of the study area. Optimizing fertilizer application and effluent treatment can improve the groundwater quality thereby achieving sustainable groundwater management in this region. HIGHLIGHTS Hydrochemistry of the groundwater suggests a high vulnerability to nitrate contamination in the northern parts.; Seasonal variations in water quality data infer that the premonsoon season is better than postmonsoon season.; Indicators representing the water quality for irrigation show that groundwater is in the excellent to doubtful category excepting magnesium hazard and Kelley's ratio.;

Background: Periodontal health is a critical aspect of overall oral health, yet public awareness and education on this topic remain limited. With the increasing prevalence of online health education platforms, it is essential to evaluate the effectiveness of online periodontal health workshops compared with traditional in-person workshops on improving public awareness. Materials and Methods: Study Design: This randomized controlled trial (RCT) aimed to assess the impact of online and in-person periodontal health workshops on public awareness. Participants (N = 500) were randomly assigned to one of two groups: the online workshop group or the in-person workshop group. Online Workshop: Participants in this group accessed an interactive online periodontal health workshop, consisting of video presentations, animations, and quizzes. The workshop covered topics, such as gum disease prevention, oral hygiene, and the importance of regular dental checkups. In-Person Workshop: Participants in this group attended a traditional in-person periodontal health workshop conducted by dental professionals. The content and duration of this workshop mirrored the online version. Pre- and Postworkshop Assessments: Both groups completed pre-workshop and postworkshop assessments, including a knowledge questionnaire and a self-assessment of oral health habits. Arbitrary scores were assigned to quantify knowledge gain (0–100%). Results: Participants in the online workshop group showed a mean knowledge gain of 30% (standard deviation (SD) = 5.2), while those in the in-person workshop group exhibited a mean knowledge gain of 35% (SD = 4.7). The self-assessment of oral health habits indicated an improvement in both groups, with 60% of participants reporting better oral hygiene practices. Conclusion: Both online and in-person periodontal health workshops demonstrated effectiveness in improving public awareness and promoting better oral health habits. Combining both modalities could be an effective strategy for comprehensive public education on periodontal health.

Background: Community water fluoridation is a well-recognized public health initiative known for its efficacy in preventing dental cavities. The positive effects of fluoride on tooth enamel have led to widespread implementation of water fluoridation programs. Materials and Methods: This cross-sectional study involved 1,000 participants from diverse age groups, spanning children, adolescents, adults, and older adults, residing in both fluoridated and non-fluoridated communities. Comprehensive periodontal assessments included measurements of probing depth (PD), clinical attachment level (CAL), and the presence of gingival inflammation. Participants were categorized into “fluoridated” or “non-fluoridated” groups based on their residential history. Results: Fluoridated communities consistently displayed lower mean PDs, CALs, and rates of gingival inflammation across all age groups. Notably, the reduction in PD and CAL reached approximately 0.5 millimeters and 0.3 millimeters, respectively, while the decrease in gingival inflammation ranged from 3% to 5%. Conclusion: This study suggests a potential link between community water fluoridation and enhanced periodontal health, as evidenced by improved PDs, CALs, and reduced gingival inflammation.

Background: Oral cancer is a significant global health issue, with prevention and early detection being pivotal for improved outcomes. This study investigates the impact of cultural and socioeconomic factors on oral cancer prevention behaviors, screening participation, and treatment outcomes. Materials and Methods: A cross-sectional study design was employed, involving a sample size of 1,000 participants. Participants were recruited through stratified sampling to ensure cultural and socioeconomic diversity. Statistical analyses, including logistic regression, were used to explore associations between factors and outcomes. Results: The study revealed multifaceted influences of cultural and socioeconomic factors on oral cancer-related aspects. Cultural factors significantly influenced prevention behaviors, with participants from certain cultural backgrounds exhibiting higher rates of tobacco use and lower rates of dietary adherence). Socioeconomic status played a role in screening uptake, with individuals from lower income brackets less likely to undergo regular screenings. Conclusion: Cultural and socioeconomic factors have a substantial influence on oral cancer prevention behaviors, screening participation, and treatment outcomes.

Background: Oral cancer is a significant global health concern with substantial morbidity and mortality rates. Early detection during routine dental check-ups is crucial for improved patient outcomes. Dental professionals play a pivotal role in conducting oral cancer screenings, but the frequency and methods they employ remain understudied. Aim: This cross-sectional study aimed to investigate the frequency of oral cancer screenings during routine dental check-ups conducted by dental professionals and the methods they commonly use. Materials and Methods: A survey was administered to 500 dental professionals, including dentists and dental hygienists, representing diverse demographics and practice settings. The survey collected data on the frequency of oral cancer screenings and the primary methods employed. Descriptive statistics and Chi-square tests were used for data analysis. Results: The study found that 85% of dental professionals conduct oral cancer screenings during routine dental check-ups, with 48% performing them annually and 33% at every visit. Visual inspection (97%) and palpation (83%) were the most commonly used methods, while adjunctive screening tools (45%) were less frequently incorporated. Conclusion: Dental professionals are actively engaged in oral cancer screenings during routine dental check-ups, demonstrating a commitment to early detection. Visual inspection and palpation are commonly employed methods, but there is room for improvement in the adoption of adjunctive screening tools.

The utility of X-ray crystal structures determined under ambient-temperature conditions is becoming increasingly recognized. Such experiments can allow protein dynamics to be characterized and are particularly well suited to challenging protein targets that may form fragile crystals that are difficult to cryo-cool. Room-temperature data collection also enables time-resolved experiments. In contrast to the high-throughput highly automated pipelines for determination of structures at cryogenic temperatures widely available at synchrotron beamlines, room-temperature methodology is less mature. Here, the current status of the fully automated ambient-temperature beamline VMXi at Diamond Light Source is described, and a highly efficient pipeline from protein sample to final multi-crystal data analysis and structure determination is shown. The capability of the pipeline is illustrated using a range of user case studies representing different challenges, and from high and lower symmetry space groups and varied crystal sizes. It is also demonstrated that very rapid structure determination from crystals in situ within crystallization plates is now routine with minimal user intervention.

Hepatitis B is the most prevalent infection and a global concern that affects a large population. Healthcare workers (HCWs) are at higher risk of developing the disease, because of their regular contact with blood and body fluids. Objective of the study was to analyze all HCWs Knowledge, Attitude, and Practice (KAP) concerning hepatitis B infection and its vaccination, as well as the impact of educational training among them. A cross-sectional KAP study was done at a tertiary care hospital using a self structured questionnaire survey regarding hepatitis B infection and its vaccination among 156 HCWs. A short educational PowerPoint presentation (PPT) was given to them, followed by the same questionnaire survey. Pre and post-intervention data were collected to evaluate the effects of training on all HCWs. A Pre-assessment revealed that HCWs had inadequate KAP regarding Hepatitis B infection and vaccination. Ward attendants demonstrated the lowest grades in knowledge and practice and were identified as being at the highest risk. The instructional PPT intervention implemented in the study was proven to be highly effective. The results indicated a significant increase in knowledge and a favorable shift in the attitude towards hepatitis B infection and its vaccination among HCWs. Improvement in knowledge and attitude among all three types of HCW were extremely statistically significant after educational PPT presentation. Hence, this study recommends that increasing awareness of HBV infection and prevention through orientation and educational training, as well as routine tests and immunizations, will be beneficial.

One of the major causes of vision impairment among elderly people in developed nations is age-related macular degeneration (AMD). The distinctive features of AMD are the accumulation of extracellular deposits called drusen and the gradual deterioration of photoreceptors and nearby tissues in the macula. AMD is a complex and multifaceted disease influenced by several factors such as aging, environmental risk factors, and a person’s genetic susceptibility to the condition. The interaction among these factors leads to the initiation and advancement of AMD, where genetic predisposition plays a crucial role. With the advent of high-throughput genotyping technologies, many novel genetic loci associated with AMD have been identified, enhancing our knowledge of its genetic architecture. The common genetic variants linked to AMD are found on chromosome 1q32 (in the complement factor H gene) and 10q26 (age-related maculopathy susceptibility 2 and high-temperature requirement A serine peptidase 1 genes) loci, along with several other risk variants. This review summarizes the common genetic variants of complement pathways, lipid metabolism, and extracellular matrix proteins associated with AMD risk, highlighting the intricate pathways contributing to AMD pathogenesis. Knowledge of the genetic underpinnings of AMD will allow for the future development of personalized diagnostics and targeted therapeutic interventions, paving the way for more effective management of AMD and improved outcomes for affected individuals.

A rare association exists between systemic lupus erythematosus (SLE) and multiple myeloma (MM). SLE is associated with a variety of symptoms. A combination of MM and SLE is uncommon in the young population. An unusual case of SLE associated with MM is described here. We present the case of a 39-year-old woman who was a known case of SLE and presented with severe chest and abdominal pain. We summarize the clinical characteristics of MM in SLE. The possible mechanisms that could be at the root of this association are also discussed.

ABSTRACTPhosphorus, a vital macronutrient, often limits primary productivity in marine environments. Marine Synechococcus strains, including WH8102, rely on high-affinity phosphate-binding proteins (PstS) to scavenge inorganic phosphate in oligotrophic oceans. However, WH8102 possesses three distinct PstS homologs whose substrate specificity and ecological roles are unclear. The three PstS homologs were heterologously expressed and purified to investigate their substrate specificity and binding kinetics. Our study revealed that all three PstS homologs exhibited a high degree of specificity for phosphate but differed in phosphate binding affinities. Notably, PstS1b displayed nearly 10-fold higher binding affinity (KD = 0.44 µM) compared to PstS1a (KD = 3.3 μM) and PstS2 (KD = 4.3 μM). Structural modeling suggested a single amino acid variation in the binding pocket of PstS1b (threonine instead of serine in PstS1a and PstS2) likely contributed to its higher Pi affinity. Genome context data, together with the protein biophysical data, suggest distinct ecological roles for the three PstS homologs. We propose that PstS1b may be involved in scavenging inorganic phosphorus in oligotrophic conditions and that PstS1a may be involved in transporting recycled phosphate derived from organic phosphate cleavage. The role of PstS2 is less clear, but it may be involved in phosphate uptake when environmental phosphate concentrations are transiently higher. The conservation of three distinct PstS homologs in Synechococcus clade III strains likely reflects distinct adaptations for P acquisition under varying oligotrophic conditions.IMPORTANCEPhosphorus is an essential macronutrient that plays a key role in marine primary productivity and biogeochemistry. However, intense competition for bioavailable phosphorus in the marine environment limits growth and productivity of ecologically important cyanobacteria. In oligotrophic oceans, marine Synechococcus strains, like WH8102, utilize high-affinity phosphate-binding proteins (PstS) to scavenge inorganic phosphate. However, WH8102 possesses three distinct PstS homologs, with unclear substrate specificity and ecological roles, creating a knowledge gap in understanding phosphorus acquisition mechanisms in picocyanobacteria. Through genomic, functional, biophysical, and structural analysis, our study unravels the ecological functions of these homologs. Our findings enhance our understanding of cyanobacterial nutritional uptake strategies and shed light on the crucial role of these conserved nutrient uptake systems in adaptation to specific niches, which ultimately underpins the success of marine Synechococcus across a diverse array of marine ecosystems.

The inhibition effectiveness of diverse concentrations of Datura Fruit Extract (DFE) on the corrosion of zinc in 0.05–0.1 M HCl solutions was examined by weight loss (WL), Electrochemical Impedance Spectroscopy (EIS), potentiodynamic polarization (PDP), and surface analysis techniques. The mass loss method's results demonstrated that raising the DFE concentration improved the efficiency of the inhibition. The maximum inhibition efficiency was 99.40% at 2.0 g/L of DFE. In the temperature ranging from 303 to 333 K, the effect of temperature on the corrosion behavior while adding DFE was also investigated. A DFE extract had been adsorbed on the surface of the metal by Langmuir adsorption isotherm models. It was established that the DFE's activation parameters and negative Gibb's free energy show that rates of adsorption have been spontaneous. According to polarization analysis, DFE regulates both the cathodic and the anodic response. Images obtained using a SEM (Scanning Electron Microscope) reveal that the DFE reduces surface damage. The adsorption inhibition mechanism is supported by the AFM analysis findings. FT-IR (Fourier transform infrared) spectroscopy has been utilized to ascertain the functional group of the DFE. All of the applicable approaches' experimental findings are in good agreement.

Wnt signaling is a critical pathway involved in cell proliferation, differentiation and cellular homeostasis. To address treatment need of diseases associated with the dysregulated Wnt signaling like cancer, Alzheimer’s disease, Osteoporosis, Myocardial infarction etc.; small molecules that target the very first and unique component of the Wnt pathway, Porcupine enzyme, have been proven to be effective. Till date, none of the Porcupine inhibitor has reached to market. To design the novel Porcupine inhibitors, there was a need of crystal structure of Porcupine but in 2019, it was not resolved and deposited in the protein data bank. So, with an aim to predict its 3D structure, homology modeling study was performed using two distinct platforms; I-TASSER and Molsoft ICMPro so that we could use the best validated model for the designing of NCEs. Both the generated homology models were compared through Ramachandran plot, Protein health tool of Molsoft ICM and other tools available on metaserver, SAVES v6.0. Molsoft model was found better with 84.6 % residues in most favored region and only 0.3 % residues in disallowed region in Ramachandran plot in comparison to 75.9 % and 1.7 % residues respectively in I-TASSER model. The ICM model was further refined for 50 ns under MD simulation where it got stabilized after 36 ns. Quantification of protein was done by Radius of Gyration (ROG) where model showed larger ROG value of 23.25°A which indicated closely packed structure. Binding site in the predicted structure of Porcupine was identified using ICM binding pocket identifier and used for molecular docking of known Porcupine inhibitors like IWP-2, IWP-3, IWP-L6, and LKG974. Key binding site residues; Arg124, Phe257, Leu261, Val302, Trp305, Asn306, Ser310, Leu313, His341, Phen345, Ala349, Val350 etc. involved in the interaction were identified after MD simulation which can be useful in designing of novel porcupine inhibitors in future.

Citrus fruits belong to the Rutaceae family, which comprises sweet oranges, sour and bitter oranges, mandarins, lemons, limes, grapefruit, pomelo, citrons, etc, and a wide range of hybrids and cybrids. The presence of vitamin and flavonoid enhance the nutritional and medicinal properties. Hesperidin, found in citrus fruits is one of the major flavonoids which binds with the active protein site of the severe acute respiratory syndrome, SARS-CoV-2 (Corona Virus-2). Citrus also helps to boost immunity. Fruits cannot be kept for a longer period under normal conditions due to postharvest decay which causes heavy economic losses of up to 30% of the total production and can go up to 50% in underdeveloped countries. This post-harvest loss causes non-utilization and wastage of citrus and the world need nutritional security to prevent the pandemic and hidden hunger. So, it is required to process the fruit in the form of canned products, squash, juice, juice concentrate, puree, essential oil, pickle, vinegar, etc and enriched & fortified products such as fortified vermicelli or cookies with orange peel powder can help to enhance immunity and prevent respiratory issues for utilization of citrus. The by-product obtained after processing can be used to extract the essential oil and pectin from the waste. This value addition, enrichment, and fortification help the citrus to reach the people for consumption and develop immunity. Hence, it could help to reduce the activity against the COVID virus; and help to resolve the issue of hidden hunger.

In the present research, a few well-known artificial intelligence tools were explored for efficient hit selection which could be further utilized for the discovery of CaMK-II inhibitors for the Treatment of arrhythmia. To achieve the desired goals pharmacophore modelling, database retrieval, molecular docking studies, and toxicity prediction were performed. Pharmacophore modelling was performed with the Pharmit open-source database which gave the features viz. Hydrogen Bond Donor, Hydrogen Bond Acceptor, and Hydrophobic. This pharmacophore is generated with the aid of the protein of CaMK-II (PDB ID: 2WEL) and co-crystallized ligand K88. Further, this generated pharmacophore was screened through the various Pharmit databases which include CHEMBL30, ChemDiv, ChemSpace, MCULE, MolPort, NCI Open Chemical Repository, Lab Network, and ZINC. Further, the top two hits from each database that has maximum similarity with the pharmacophore have been selected for the molecular docking and ADMET studies. Among, all the hits CHEMBL 1952032 showed good binding interactions with CaMK-II. Also, it was found to be non-toxic upon evaluation through the OSIRIS property explorer. In the future, it can be explored against the CaMK-II for the development of novel CaMK-II inhibitors which can be used for the mitigation of arrhythmia.