Search

Background: One of the drugs that is most frequently used in dentistry is local anesthetics. They are decisive while performing any dental procedure. The average length of a dental procedure is 47 min, but the local anesthetics used in standard dental procedures last between 1 and 3 h, with the most common inadequacy being the persistence of soft-tissue anesthesia (the numbness of the lips, cheeks, and tongue), which can persist for at least 3–5 h. This extended soft-tissue anesthetic in children can result in self-inflicted wounds like biting of the lips, tongue, or cheek. Aim: The study’s aim was to evaluate dental practitioners’ knowledge, awareness, and usage of phentolamine mesylate, a soft-tissue local anesthetic reversal agent. Materials and Methods: Two hundred and two dentists and graduate students participated in the study by filling out a validated questionnaire. The data obtained were entered into an Excel sheet and statistically analyzed using SPSS software version 22.0. It was observed that 66.50% of the participants had knowledge scores that were lower than the mean, 81.07% had awareness scores that were lower than the mean, and 91.26% had practice scores that were lower than the mean. With a very statistically significant P = 0.0001 (P = 0.05), Karl Pearson’s correlation coefficient revealed a positive correlation between knowledge, awareness, and practice. Conclusion: There was a general lack of knowledge about the drug phentolamine mesylate leading to lesser attitude, thereby leading to lesser use of the drug.

Abstract Introduction Primary health care has regained its importance in global policy making. In 2018, the Government of India initiated the Ayushman Bharat - Comprehensive Primary Health Care (AB-CPHC) programme. It was based on upgrading the existing primary health facilities into Health and Wellness Centers (HWCs). The current study aimed to assess the readiness and performance of HWCs in providing comprehensive primary health care services in India’s Chhattisgarh state. Methods We conducted a cross-sectional health facility assessment with a state-representative sample of 404 HWCs. A standardized health facility survey tool was used to collect information on essential inputs and service outputs of HWCs. The expected population healthcare needs were estimated using secondary sources. The performance of HWCs was assessed by comparing the volume of services provided against the expected population need for outpatient care. Results On an average, 358 outpatients including 128 non-communicable disease (NCD) patients were treated monthly at an HWC. HWCs were able to cover 31% of the total population’s health need for outpatient care, 26% for hypertension, and 21% for diabetes care. In addition to services for reproductive and child health, HWCs provided services for common acute ailments (cold, cough, fever, aches and pains); infections of skin, eye, ear, and reproductive tract, and minor injuries. HWCs were also contributing significantly to national disease control programmes. Acute ailments followed by NCDs and communicable diseases had the largest share among services provided. The key gaps were in coverage of mental illnesses and chronic respiratory diseases. Most of the HWCs showed adequate readiness for the availability of required human resources, supplies, and infrastructure. Conclusion HWCs were able to provide a comprehensive range of primary care services and able to cater to a sizable portion of the rural population’s acute and chronic health care needs. The performance was made possible by the adequate availability of medicines, staff, training programmes and tele-consultation linkages. If HWCs in other states are able to reach a similar level of performance, the initiative will prove to be a game changer for equitable primary care in India.

Background: Tuberculous meningitis (TBM) is a challenging condition to diagnose, and current laboratory methods have limitations, especially in developing countries. This study evaluated the diagnostic utility of the Lancet consensus scoring (LCS) system in suspected TBM cases at a tertiary care center in India. Methods: The clinical manifestations of 75 patients with suspected TBM were prospectively evaluated using the LCS system, which categorizes cases as “definite” (laboratory confirmed), “probable” (>10 points without imaging or > 12 points with imaging), and “possible” (6–9 points without imaging or 6–11 points with imaging). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the LCS system were compared to GeneXpert and mycobacterial growth indicator tube (MGIT) liquid culture, which are considered the gold standard tests. Results: Out of 75 recruited cases, 11 were confirmed as definite TBM cases. The LCS system correctly identified 8 of these as “probable” and 3 as “possible” cases. Compared to GeneXpert, the LCS system had a specificity of 100%, sensitivity of 54.55%, NPV of 92.7%, and PPV of 100%. Compared to MGIT liquid culture, the LCS system had a specificity of 100%, sensitivity of 81.82%, NPV of 96.97%, and PPV of 100%. The diagnostic accuracy was higher for MGIT liquid culture (97.33%) than GeneXpert (93.33%). Conclusion: The LCS system is a practical and easily applicable tool that can aid the diagnosis of suspected TBM cases, particularly in resource-limited settings. Despite some limitations, the LCS system demonstrated good diagnostic performance, suggesting its potential utility in improving TBM diagnosis and management.

Background: Transferosomes provide delivery of the drug into systemic circulation via the skin as a topical delivery system. So, this study started with the objective of formulating Etodolac transfersomal gel to enhance its skin permeation. Methodology: A total of nine transferosomes (ET-1 to ET-9) containing lecithin, different grades of span and tween, were successfully prepared using a rotary film evaporator. Results and Discussion: After primary evaluation, results were as particle sizes ranged from 222 to 421 nm, zeta potential shows results from –18.50 to –62.53 mV with PDI values 0.254 to 0.303, and the entrapment efficiency (EE%) of Etodolac in the transferosomes ranged from 54.15% to 80.25%. Additionally, the transfersomes formulations were included in carbopol 940 gels (ETC-1 to ETC-9 and EC-0 without transferosomes) and assessed for various characteristics like color, pH, homogeneity, spreadability, viscosity, and in vitro drug release study. Optimized formulation (ET4 and ETC4) underwent further analysis using SEM, TEM, DSC, FTIR, XRD, ex vivo skin permeation, skin irritation and in vivo studies. The in vivo results were compared. % edema inhibition maximum was observed with optimized transfersomal gel formulation (ETC4) as compared to the marketed formulation and plain Carbopol gel when the study was completed after 8 hrs. Conclusion: After this research, it is suggested that Etodolac Transfersomal gel (ETC4) can be considered as an alternate drug carriers system for topical delivery and it could be used to treat Rheumatoid Arthritis

Background: Papaya seeds are a rich source of proteins, fat, fibers, vitamins, minerals, monounsaturated fatty acids, polyphenols, and powerful antioxidants like flavonoids. Low solubility limits the absorption and bioavailability of herbal constituents. Hence, phytosomes of Papaya seed extract were formulated to enhance its solubility and bioavailability. Methodology: Papaya seeds were extracted using ethanol as solvent, and all the phytoconstituents present in the extract were assessed during the phytochemical screening and LC-MS analysis. In-vitro antidiabetic activity pure extract was determined by alpha-amylase and alpha-glucosidase enzyme inhibitory assay. The phytosomes of extract were formulated using the lipid thin film formation method and Soya lecithin and Cholesterol as lipids. The formulated phytosomes were analyzed for parameters such as particle size, zeta potential, encapsulation efficiency, percent drug content, and In-vitro dissolution study. The chemical nature of the formulation was studied using FTIR analysis and powder X-ray diffractometry. Thermal stability of phytosomes analyzed with the help of Differential Scanning calorimetry. Results: LC-MS identified 16 phytoconstituents. In-vitro antidiabetic activity showed 59.97% and 51.17% inhibition of enzymes alpha-amylase and alpha-glucosidase, respectively. The encapsulation efficiency of the optimized formulation was 88.41±0.91% with a particle size of 188.0±53.7nm. TEM images of formulation confirm the formation of phytosomes. FTIR, DSC, and Powder X-ray diffractometry showed no unwanted peaks. The in vitro dissolution study showed 89.26±1.05% CDR of phytosome, while the extract showed 47.78±0.59% CDR. Conclusion: Evaluation results of phytosomes suggest that this formulation can be used as an effective herbal antidiabetic formulation

Abstract Introduction Monitoring changes in cessation behaviors and cessation assistance is critical for policymaking. Methods We analyzed two rounds (2009–2014 and 2015–2021) of Global Adult Tobacco Surveys in 13 countries. We estimated the quit ratio, quit attempt, and utilization of cessation assistance. The availability of cessation services was obtained from World Health Organization reports. We calculated absolute and relative changes in quit ratio, quit attempt, and cessation assistance. We assessed socio-economic determinants of cessation behaviors by binary logistic regression analyses on pooled data. Results In all countries during both rounds smoking prevalence was 7.6–33.8%, the quit ratio was 0.15–0.54%, and the quit attempt was 17.7–52.8%. Quit ratio improved in Indonesia by 100% but declined in Turkey by 56%. Quit attempts increased in Indonesia (31.9%), Mexico (16.9%) and China (15.9%) but decreased in Turkey (140.4%), Vietnam (43.1%), and Romania (62.4%). In both rounds, using at least one method was 12.5–99.8% while the WHO-recommended method was 4.1–88.4%. In both rounds “try to quit without any assistance” and “other methods” were the most frequently reported cessation assistance. Nicotine replacement therapy (0.2–25.3%) was frequently used as recommended cessation assistance. Nicotine replacement therapy was available in most countries but not quitline and support services. Conclusion Limited progress was made in smoking cessation behaviors and cessation assistance in most countries. Health education to improve demand for smoking cessation and availability of evidence-based, low-cost smoking cessation assistance including quit-smoking may improve quit ratios in the population.

Abstract Radiopharmaceutical therapy using $$\upalpha$$ α -emitting $$^{225}$$ 225 Ac is an emerging treatment for patients with advanced metastatic cancers. Measurement of the spatial dose distribution in organs and tumors is needed to inform treatment dose prescription and reduce off-target toxicity, at not only organ but also sub-organ scales. Digital autoradiography with $$\upalpha$$ α -sensitive detection devices can measure radioactivity distributions at 20–40 $$\upmu {\hbox {m}}$$ μ m resolution, but anatomical characterization is typically limited to 2D. We collected digital autoradiographs across whole tissues to generate 3D dose volumes and used them to evaluate the simultaneous tumor control and regional kidney dosimetry of a novel therapeutic radiopharmaceutical for prostate cancer, [225Ac]Ac-Macropa-PEG4-YS5, in mice. 22Rv1 xenograft-bearing mice treated with 18.5 kBq of [225Ac]Ac-Macropa-PEG4-YS5 were sacrificed at 24 h and 168 h post-injection for quantitative $$\upalpha$$ α -particle digital autoradiography and hematoxylin and eosin staining. Gamma-ray spectroscopy of biodistribution data was used to determine temporal dynamics and $$^{213}$$ 213 Bi redistribution. Tumor control probability and sub-kidney dosimetry were assessed. Heterogeneous $$^{225}$$ 225 Ac spatial distribution was observed in both tumors and kidneys. Tumor control was maintained despite heterogeneity if cold spots coincided with necrotic regions. $$^{225}$$ 225 Ac dose-rate was highest in the cortex and renal vasculature. Extrapolation of tumor control suggested that kidney absorbed dose could be reduced by 41% while maintaining 90% TCP. The 3D dosimetry methods described allow for whole tumor and organ dose measurements following $$^{225}$$ 225 Ac radiopharmaceutical therapy, which correlate to tumor control and toxicity outcomes.

Background: Early breastfeeding support helps in achieving exclusive breastfeeding by reducing the incidence of painful breast problems. A comparison of the impact of lactation counselling by lactation consultants and nursing staff would help to optimise care. Methods: In this prospective study conducted in the maternity ward of a private sector tertiary care hospital in an urban area, breastfeeding outcomes such as achievement of exclusive breastfeeding and incidence of painful breast problems such as sore nipples and breast engorgement as well as breastfeeding technique were compared between two groups of mother–newborn dyads receiving support from lactation consultants (study group) and maternity ward nursing staff (control group), respectively. Results: A total of 477 mother–newborn pairs were enrolled. Sixty-three out of 225 mothers (28%) in the study group complained of sore nipples as against 122 out of 252 mothers (48.4%) in the control group (odd ratio [OR] 0.414, 95% confidence intervals [CI] 0.282–0.607, P < 0.001). Breast engorgement was reported in 45 mothers (20%) in the study group and 117 mothers (46.4%) in the control group (OR 0.288, 95% CI 0.191–0.434, P < 0.001). Two hundred and three newborns (90.2%) from the study group were discharged on exclusive breastfeeding as compared to 149 newborns (59.1%) in the control group (OR 0.156, 95% CI 0.094–0.260, P < 0.001). Conclusions: Lactation consultants are significantly better than nursing staff at improving breastfeeding outcomes by providing trained support to optimise breastfeeding position and attachment, thereby preventing painful breast problems.

Background: Posaconazole, currently available as a solid oral dosage form, possesses erratic pharmacokinetics that complicate dosing regimens and increase the risk of adverse effects and drug interactions. Hence, innovative strategies, especially topical ones, are necessary to enhance the therapeutic profile and improve patient outcomes. Methodology: The regular 23 factorial design and the concentrations of Oleic acid: Span 80 (2:1) ratio, Cholesterol, and Tween 80 as independent variables were used for the formulation development. The preliminary effect was determined by dependent variables like vesicle size and entrapment efficiency; then the final optimized batch was loaded in 3 % w/w Carbopol gel. Result and Discussion: The optimized batch's vesicle size and entrapment efficiency were 193.34+14.84 nm and 90.03+0.11 %, respectively. These results were found statistically significant (ANOVA) in the trial version of Stat-Ease 360®. Other evaluation parameters like zeta potential and pH of all the formulations were also significant (p

Peripheral nerve sheath tumors known as neurofibromas are benign and can be a part of syndromes like neurofibromatosis Type-1 (NF1) or type-2. NF1 is linked to plexiform neurofibroma. They are primarily made up of fibroblasts and Schwann cells. It can involve any nerve. In our case, a branch of the superficial peroneal nerve gave rise to neurofibroma, which extrinsically compressed the deep peroneal nerve. The patient’s symptoms resembled those of anterior tarsal tunnel syndrome.

AlScN is a new wide bandgap, high-k, ferroelectric material for radio frequency (RF), memory, and power applications. Successful integration of high-quality AlScN with GaN in epitaxial layer stacks depends strongly on the ability to control lattice parameters and surface or interface through growth. This study investigates the molecular beam epitaxy growth and transport properties of AlScN/GaN multilayer heterostructures. Single-layer Al1−xScxN/GaN heterostructures exhibited lattice-matched composition within x = 0.09–0.11 using substrate (thermocouple) growth temperatures between 330 and 630 °C. By targeting the lattice-matched Sc composition, pseudomorphic AlScN/GaN multilayer structures with ten and twenty periods were achieved, exhibiting excellent structural and interface properties as confirmed by x-ray diffraction (XRD) and scanning transmission electron microscopy (STEM). These multilayer heterostructures exhibited substantial polarization-induced net mobile charge densities of up to 8.24 × 1014/cm2 for twenty channels. The sheet density scales with the number of AlScN/GaN periods. By identifying lattice-matched growth condition and using it to generate multiple conductive channels, this work enhances our understanding of the AlScN/GaN material platform.

Abstract Metal–organic frameworks (MOFs) have emerged as promising materials for triboelectric nanogenerators (TENGs), but the effects of ligand choice on triboelectric charge remain underexplored. Hence, this paper demonstrates the effect of single, binary, and ternary ligands on TENG performance of cobalt/cerium‐based (Co─Ce) bimetallic MOFs utilizing 2‐methylimidazole (2Melm), terephthalic acid (BDC), and benzene tricarboxylic acid (BTC) as ligands. The detailed structural characterization revealed that varying ligand chemistries led to distinct MOF features affecting TENG performance. Single ligand bimetallic MOFs (designated as CoCe‐2MeIm, CoCe‐BDC, CoCe‐BTC) has lower performance than binary ligand (designated as CoCe‐2MeIm‐BDC, CoCe‐2MeIm‐BTC, CoCe‐BDC‐BTC) and ternary ligand MOFs (designated as CoCe‐2MeIm‐BDC‐BTC). Among all, the binary ligand MOF, CoCe‐2MeIm‐BTC, shows the best results (598 V, 26.7 µA) due to the combined effect of imidazole ring and (─COO─) groups. This is attributed to lone pairs on nitrogen atoms and a delocalized π‐electron system in imidazole system in this material. CoCe‐BTC has the lowest results (31 V, 3.2 µA) due to the bulkier nature of the electron‐withdrawing (─COO─) groups and their impact on the π‐electron system of the benzene ring. This study showcases the potential of ligand chemistry manipulation to control triboelectric charge and thereby enhance MOF‐based TENG performance.

Abdominal cocoon syndrome is a rare clinical presentation that has been associated with abdominal tuberculosis in rural India. It is also known as sclerosing encapsulating peritonitis, where the small bowel becomes encapsulated by a fibrous membrane due to unclear causes, leading to obstipation. Common symptoms include vomiting, nausea, and constipation. Due to these general clinical symptoms, it can be mistaken for other gastrointestinal disorders, resulting in delayed diagnosis, which may lead to adverse outcomes or even mortality. Surgery is often used to free the entrapped bowel and remove the fibrous tissue, while supportive care and problem management are crucial. The present case involves a 55-year-old male who presented with a distended abdomen and obstipation, leading to intestinal perforation and sclerosing encapsulating peritonitis, which was managed through resection and anastomosis of the small intestine. The patient was followed-up after three months with no new complaints. The present case helps in understanding the sequelae of acute intestinal perforation that can result in abdominal cocoon syndrome.

Vascularized Composite Tissue Allotransplantation (VCA) allows replacement of lost body parts from brain-dead donors. These surgeries are laborious, time-intensive, and require vast planning. With the advent of better immunosuppressants, VCA will increasingly play an important role in the reconstructive field. In this paper, the authors share their standard operating protocol created after much deliberation.

Abstract Background Inquiring conservative Asian women about their menopausal symptoms is often challenging in crowded primary healthcare clinics. Furthermore, the subject matter is culturally sensitive to most Malaysian women. Hence, the translation of the MQ6 into Malay is crucial to enable self-administration, eliminating the necessity for interviewers and mitigating potential respondent shyness. Methods The Menopause Quick 6 (MQ6) questionnaire was translated into the Malay language with an addition of an item, henceforth termed MQ6 (M). Forward and backward translation was performed. Face and content validity were conducted. MQ6 (M) was self-administered to 400 women aged between 40 and 60 attending six primary healthcare clinics in Malaysia. To ascertain the reliability for MQ6 (M), corrected Item-Total Correlation, Squared Multiple Correlation, Cronbach’s Alpha if the Item is Deleted, and Kuder-Richardson Reliability Coefficients (KR20). Exploratory factor analysis was done to determine its’ construct validity. Results The outcome of the validation was satisfactory. By the Lawshe method, the content validity ratios ranged from 0.6 to 1.0 and the content validity index was 0.914. The Internal consistency for the MQ6(M) Cronbach’s alpha was 0.711 while Kuder-Richardson Reliability Coefficients KR20 was 0.676. Factor loading of all four items is above 0.70, indicating a well-defined structure. Whereas factor loading for three items fell within the range of 0.50–0.69 indicating a practically significant threshold for a new questionnaire. Conclusion The MQ6 (M) has acceptable reliability and construct validity to be considered as a self-administered screening tool in primary care clinics in Malaysia.

Primary tuberculous osteomyelitis involving the mandible represents less than 2% of skeletal locations. In this paper, we report a case of mandibular tuberculosis (TB) detected after histopathological analysis of the surgically resected specimen during surgical management of a suspected case of ameloblastoma. A 14-year-old male patient presented to us with history of right-sided chin swelling. The clinical examination revealed a swelling, involving right body and parasymphysis of mandible, measuring approximately 6 cm in length and 2 cm in width, extending from right lateral incisor till the first molar. Radiological scans revealed a large multiloculated osteolytic expansive lesion measuring 52 × 20 × 18 mm. Excision of the lesion was performed and reconstruction was done with iliac bone grafting. The histopathological findings revealed a granulomatous lesion, suggestive of tuberculous osteomyelitis. The patient was successfully treated with standard multidrug therapy. One year after completion of therapy, there were no signs of recurrence. Primary mandibular TB is an extremely rare entity. Its clinical presentation is not specific. Radiologically, TB has no characteristic appearance. The positive diagnosis is based on histology. Primary mandibular TB is rare and should be kept among differential diagnoses in susceptible population and in endemic areas.

ABSTRACTThis study investigates the influence of material thickness on the mechanical properties, specifically flexural and tensile properties, of scapula bone specimens from Deccani breed sheep in India. A three-point bending test and a tensile test were conducted on samples with varying thicknesses (1, 2 and 5 mm), and the flexural strength, flexural modulus, ultimate load, tensile deformation and von Mises stress were measured. Thicker specimens exhibited higher flexural properties than thinner counterparts. Statistical analysis using one-way ANOVA confirmed that material thickness significantly impacted the flexural and tensile properties of the samples. Additionally, a simulation analysis was performed using ANSYS Workbench to validate the experimental results and provide insights into the tensile and flexural behaviour of the specimens. The findings suggest that thicker samples are better equipped to handle bending stresses and tensile loads and are more suitable for applications requiring resistance to bending loads, stiffness, load-bearing capacity and tensile strength.

ABSTRACTAZD1222 (ChAdOx1 nCoV-19) is a replication-deficient adenoviral vectored coronavirus disease-19 (COVID-19) vaccine that is manufactured as SII-ChAdOx1 nCoV-19 by the Serum Institute of India Pvt Ltd following technology transfer from Oxford University/AstraZeneca. The non-inferiority of SII-ChAdOx1 nCoV-19 with AZD1222 was previously demonstrated in an observer-blind, phase 2/3 immuno-bridging study (trial registration: CTRI/2020/08/027170). In this analysis of immunogenicity and safety data 6 months post first vaccination (Day 180), 1,601 participants were randomized 3:1 to SII-ChAdOx1 nCoV-19 or AZD1222 (immunogenicity/reactogenicity cohort n = 401) and 3:1 to SII-ChAdOx1 nCoV-19 or placebo (safety cohort n = 1,200). Immunogenicity was measured by anti-severe acute respiratory syndrome coronavirus 2 spike (anti-S) binding immunoglobulin G and neutralizing antibody (nAb) titers. A decline in anti-S titers was observed in both vaccine groups, albeit with a greater decline in SII-ChAdOx1 nCoV-19 vaccinees (geometric mean titer [GMT] ratio [95% confidence interval (CI) of SII-ChAdOx1 nCoV-19 to AZD1222]: 0.60 [0.41–0.87]). Consistent similar decreases in nAb titers were observed between vaccine groups (GMT ratio [95% CI]: 0.88 [0.44–1.73]). No cases of severe COVID-19 were reported following vaccination, while one case was observed in the placebo group. No causally related serious adverse events were reported through 180 days. No thromboembolic or autoimmune adverse events of special interest were reported. Collectively, these data illustrate that SII-ChAdOx1 nCoV-19 maintained a high level of immunogenicity 6 months post-vaccination. SII-ChAdOx1 nCoV-19 was safe and well tolerated.

BackgroundDuring adolescence, a critical phase in human life, the groundwork for a healthful future is established. Physical inactivity poses a significant risk factor for non-communicable diseases (NCDs) and related mortality worldwide. To assess adolescents’ behavioral intentions regarding regular physical activity, the Theory of Planned Behavior (TPB) examines ‘Attitude,’ ‘Subjective norm,’ and ‘Perceived behavioral control.’ Utilizing TPB, this study focuses on evaluating the impact of a school-based health promotion intervention on behavioral intentions toward physical activity among urban adolescents in West Bengal, India.MethodsA school-based nonrandomized controlled interventional study with parallel group design was conducted among adolescents aged between 12 and 16 years. Behavioral intention towards performing regular physical activity was determined with the measurements of the constructs from the TPB. Cluster analysis was conducted using measurements from both the intervention and control groups. Participants with higher mean scores in the constructs were classified as intenders, while the rest were considered non-intenders. The intervention’s impact was evaluated by calculating the Relative Risk (RR) through a generalized linear model with robust standard error estimates, to ascertain the probability of belonging to the higher intention cluster.ResultFollowing the intervention, construct-wise scores improved significantly, particularly the perceived behavioral control mean score in the intervention group. The Relative Risk (RR) of becoming an intender for regular physical activity in the intervention group was 1.24 (95% CI: 1.04–1.48) when compared to the control group.ConclusionHealth Promoting Schools has been recognized as a strategic and cost-effective vehicle to promote positive development and healthful living, and the current evidence suggests they can effectively reduce the emergence of significant NCD risk factor like physical inactivity. Schools must establish strong partnerships with diverse stakeholders to address barriers beyond the school environment and enhance their control over critical issues.

Introduction The rise of antimicrobial resistance represents a critical threat to global health, exacerbated by the excessive and inappropriate dispensing and use of antimicrobial drugs, notably antibiotics, which specifically target bacterial infections. The surge in antibiotic consumption globally is particularly concerning in low-income and middle-income countries (LMICs), where informal healthcare providers (IPs) play a vital role in the healthcare landscape. Often the initial point of contact for healthcare-seeking individuals, IPs play a crucial role in delivering primary care services in these regions. Despite the prevalent dispensing of antibiotics by IPs in many LMICs, as highlighted by existing research, there remains a gap in the comprehensive synthesis of antibiotic dispensing practices and the influencing factors among IPs. Hence, this scoping review seeks to map and consolidate the literature regarding antibiotic dispensing and its drivers among IPs in LMICs.Methods and analysis This review will follow the Joanna Briggs Institute guideline for scoping review. A comprehensive search across nine electronic databases (MEDLINE, EMBASE, SCOPUS, Global Health, CINAHL, Web of Science, LILACS, AJOL and IMSEAR) will be performed, supplemented by manual searches of reference lists of eligible publications. The search strategy will impose no constraints on study design, methodology, publication date or language. The study selection process will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The findings on antibiotic dispensing and its patterns will be synthesised and reported descriptively using tables, visuals and a narrative summary. Additionally, factors influencing antibiotic dispensing will be elucidated through both inductive and deductive content analysis methods.Ethics and dissemination Ethical approval is not required for scoping reviews. The findings will be disseminated through peer-reviewed publications and presentations at relevant conferences.

Introduction: Citrus sinensis (L.) Osbeck, a member of the Rutaceae family, is medicinal plant high in polyphenols and well-documented in traditional Chinese system of medicine for various significant pharmacological activities. The present study evaluates the antioxidant and antidiabetic potential of leftover hydrodistilled peels of C. sinensis. Method: Crude extract and fractions of Leftover hydrodistilled peels were studied for polyphenolic content. Biological evaluation of crude water extract and fractions at different concentrations was done for in vitro antioxidant DPPH and ABTS assay and antidiabetic α amylase and α-glucosidase inhibition. Result: The estimated phenolic content in crude water extract and chloroform, ethyl acetate, n-butanol and residual fractions were found in a range of 9.26±1.02 - 403±1.3 mg/g equivalent to gallic acid. The flavonoid content was estimated as 3.61±1.34 - 51.4±0.38 mg/g equivalent to quercetin with predominance in ethyl acetate fraction. Antioxidant potential using DPPH and ABTS revealed concentration-dependent activity in ethyl acetate fraction followed by chloroform, crude water extract, residual fraction and n-butanol fraction. Further inhibition of α-glucosidase, and α-amylase indicated the use of hydrodistilled leftover peels as an additional source of antidiabetic compound. Conclusion: The findings of this study indicate that a notable percentage of this waste provided evidence for its utilization scope in the medicinal and nutraceutical sectors and must be recycled to obtain value-added products that can be used to meet population demand.

An excellent technique for reconstructing the perineum following extensive perineal resection for restoration of a traumatised anal sphincter is the Gracilis myocutaneous flap. Direct anal trauma or pelvic injuries can separate the anal sphincters. An overlapping sphincteroplasty has a fair possibility of regaining acceptable fecal continence if roughly half of the sphincter ring is still functional. A case of a 22-year-old male who underwent Gracilis myocutaneous flap reconstruction after being diagnosed with a non functioning anal sphincter is reported. A free muscle transplant was done to repair the sphincter, utilising denervated muscle with an intact blood supply. New muscle was attached to those sphincter muscles which were still functional. The transplanted muscle receives new muscular fibers, enabling the repaired sphincter to contract voluntarily in addition to reflexively. The surgical approach is determined based on the presented sphincter defect. Free muscle transplantation can be preferred in cases where the external sphincter has some degree of functionality.

Abstract Background Marketing and sales of e-cigarettes are unregulated in Malaysia. We analyzed content displayed on e-cigarette retailer websites to identify marketing claims, promotional strategies, and product details in the year 2022. Methods We analyzed 30 Malaysia-based retailer websites using a mixed methods approach. Data were extracted as the frequency of occurrences of marketing claims, presence of regulatory information, product types, and flavors of e-juice as per a predefined codebook based on published literature. We also extracted textual details published on the websites about marketing claims, and slogans. Results Most retailer websites provided contact information and physical store addresses (83%) but only half had ‘click through’ age verification (57%) that seldom needed any identification proof for age (3%). Marketing claims were related to health (47%), smoking cessation (37%), and modernity/trend (37%) and none had health warnings. Promotional strategies were discounts (80%). starter kits (57%) and email subscriptions (53%). Product types displayed were rechargeable (97%) and disposable (87%) devices and e-liquids (90%) of an array of flavors (> 100). Nicotine presence, its concentration, and “nicotine is an addictive chemical” were displayed in 93%, 53%, and 23% of websites respectively. Conclusion Surveillance of content displayed online on e-cigarette retailer websites and regulation of online marketing and sales should be implemented by the Ministry of Health, Malaysia. Such measures are needed to prevent access to, and initiation of e-cigarette use among the youth and adults who do not smoke.

Abstract Background Secondary cell wall holds considerable potential as it has gained immense momentum to replace the lignocellulosic feedstock into fuels. Lignin one of the components of secondary cell wall tightly holds the polysaccharides thereby enhancing the recalcitrance and complexity in the biomass. Laccases (LAC) and peroxidases (PRX) are the major phenyl-oxidases playing key functions during the polymerization of monolignols into lignin. Yet, the functions of laccase and peroxidases gene families remained largely unknown. Hence, the objective of this conducted study is to understand the role of specific LAC and PRX in Populus wood formation and to further investigate how the altered Lac and Prx expression affects biomass recalcitrance and plant growth. This study of heterologous expression of Arabidopsis Lac and Prx genes was conducted in poplar to avoid any otherwise occurring co-suppression mechanism during the homologous overexpression of highly expressed native genes. In the pursuit of optimizing lignocellulosic biomass for biofuel production, the present study focuses on harnessing the enzymatic potential of Arabidopsis thaliana Laccase2, Laccase4, and Peroxidase52 through heterologous expression. Results We overexpressed selected Arabidopsis laccase2 (AtLac2), laccase4 (AtLac4), and peroxidase52 (AtPrx52) genes, based on their high transcript expression respective to the differentiating xylem tissues in the stem, in hybrid poplar (cv. 717) expressed under the developing xylem tissue-specific promoter, DX15 characterized the transgenic populus for the investigation of growth phenotypes and recalcitrance efficiency. Bioinformatics analyses conducted on AtLac2 and AtLac4 and AtPrx52, revealed the evolutionary relationship between the laccase gene and peroxidase gene homologs, respectively. Transgenic poplar plant lines overexpressing the AtLac2 gene (AtLac2-OE) showed an increase in plant height without a change in biomass yield as compared to the controls; whereas, AtLac4-OE and AtPrx52-OE transgenic lines did not show any such observable growth phenotypes compared to their respective controls. The changes in the levels of lignin content and S/G ratios in the transgenic poplar resulted in a significant increase in the saccharification efficiency as compared to the control plants. Conclusions Overall, saccharification efficiency was increased by 35–50%, 21–42%, and 8–39% in AtLac2-OE, AtLac4-OE, and AtPrx52-OE transgenic poplar lines, respectively, as compared to their controls. Moreover, the bioengineered plants maintained normal growth and development, underscoring the feasibility of this approach for biomass improvement without compromising overall plant fitness. This study also sheds light on the potential of exploiting regulatory elements of DX15 to drive targeted expression of lignin-modifying enzymes, thereby providing a promising avenue for tailoring biomass for improved biofuel production. These findings contribute to the growing body of knowledge in synthetic biology and plant biotechnology, offering a sustainable solution to address the challenges associated with lignocellulosic biomass recalcitrance.

Mucocele of the appendix is a rare condition caused by mucus accumulation due to a blocked appendix resulting from inflammation, infection, or faecal matter blockage. It presents as lower abdominal pain, vomiting, nausea, abdominal mass, and distension. It is more common in individuals over 50 years old and is more prevalent in the elderly. Mucocele can be differentiated into mucinous cystadenocarcinoma, mucosal hyperplasia, and mucinous cystadenoma. It is often diagnosed incidentally during radiological, laparoscopic, or surgical interventions. Ultrasound and computed tomography imaging techniques are useful in screening and diagnosing appendiceal mucocele, as they can detect a cystic mass or soft tissue mass and differentiate between a mucocele and other neoplasms. Most cases are reported in older individuals, with few in young adults. In the present case report, the authors present a case of a 34-year-old female with a history of occasional abdominal pain. On investigation, it was found to be an inflamed appendix with a mass in the right iliac fossa for which the patient underwent appendectomy. Due to the involvement of the right adnexa with tubo-ovarian complex and omentum, the present case presents a unique manifestation of an appendix mucocele.

Background: Herbo-mineral-metallic formulations are an inseparable part of the Ayurveda system of traditional medicine. Hridayarnava Rasa (HR) is a preparation containing metals like copper, sulphur, and mercury in processed forms and other herbs that do not produce toxic effects and adverse drug reactions when taken in appropriate dosage. Ayurveda practitioners use it in treating cardiac diseases like hypertension, cardiotoxicity and many more. The rasa-aushadhis possess characteristics such as rapid efficacy, little dosage required, and extensive therapeutic applicability. Hridayarnava Rasa [AFI Part-1, 20:55] has been employed for the treatment of various diseases from ancient times. A systematic study of these formulations manufacturing is required to maintain their quality, safety, and efficacy is a need of time to protect the immense faith of patients in Ayurveda. Objectives: The present study aimed to prepare HR as per standard operating procedures mentioned in the classical text and to characterize it physio-chemically using advanced analytical techniques. Materials and Methods: HR was prepared and physicochemical analyses and assay of elements by ICP-AES were carried out as per Ayurvedic Pharmacopoeia of India (API). Powder X-ray diffraction (XRD), Field emission gun scanning electron microscopy with energy dispersive spectroscopy (FEG SEM, EDAX), CHNS-O analysis, Fourier Transform Infrared Spectroscopy (FTIR), Thermo-gravimetric analysis (TGA), Particle size distribution analysis (PSD) was carried out. Results: The XRD analysis of HR showed the presence of unreacted sulphur and sulfides of copper and mercury. FEG SEM revealed the particles in the form of aggregates as nanocrystallites in the range of 100–1000 nm. Elemental analysis showed the presence of copper, sulphur, and mercury in major, along with traces of iron, calcium, sodium, potassium, and magnesium. In FTIR analysis, 18 peaks were observed, which strongly suggests the presence of various organic groups. In the TGA, four peaks were seen, which can be attributed to sulphur volatilization and oxidative changes in mercury. In PSD analysis, 50% of the material was found below 16.40 μm. Conclusion: To establish a piece of fundamental knowledge and ensure uniformity of these rasa-aushadhis, it is imperative to conduct an analysis of their characteristics as per classical texts and modern analytical techniques. Additionally, it is crucial to investigate the significance of each procedural step included in the preparation process. The inferences drawn are helpful as an essential aid for quality assurance and standardization of this herbo-mineral-metallic formulation.

Apolipoproteins and Scavenger Receptor Class B1 (SCARB1) proteins are involved in the etiology of HIV-associated lipodystrophy (HIVLD). APOC3 3238C/G, APOB 12669G/A and SCARB1 1050C/T polymorphisms were linked with increased level of APOB, TG, HDL-C and risk of cardiovascular diseases (CVDs). Hence, we evaluated the genetic variations of APOC3 3238C/G, APOB 12669G/A and SCARB1 1050C/T in 187 patients of HIV (64 with HIVLD, 123 without HIVLD) and 139 healthy controls using PCR-RFLP and expression by qPCR. The genotypes of SCARB1 1050 TT and APOB 12669AA showed a risk to severe HIVLD (P = 0.23, OR = 4.95; P = 0.16, OR = 2.02). The APOC3 3238 GG genotype was associated with a lesser risk of severe HIVLD (P = 0.07, OR = 0.22). The APOB 12669 GA genotype was associated with a greater risk of HIVLD severity in patients with impaired LDL, triglyceride (TG), and cholesterol levels (P = 0.34, OR = 4.13; P = 0.25, OR = 3.64; P = 0.26, OR = 5.47). Similarly, APOB 12669AA genotypes in the presence of impaired triglyceride levels displayed the susceptibility to severity of HIVLD (P = 0.77, OR = 2.91). APOB 12669 GA genotype along with impaired HDL and cholesterol levels indicated an increased risk for HIVLD acquisition among patients without HIVLD (P = 0.42, OR = 2.42; P = 0.26, OR = 2.27). In patients with and without HIVLD, APOC3 3238CG genotypes having impaired cholesterol and glucose levels had higher risk for severity and development of HIVLD (P = 0.13, OR = 2.84, P = 0.34, OR = 1.58; P = 0.71, OR = 1.86; P = 0.14, OR = 2.30). An increased expression of APOB and SCARB1 genes were observed in patients with HIVLD (+0.51 vs. −0.93; +4.78 vs. +3.29), and decreased expression of APOC3 gene was observed in patients with HIVLD (−0.35 vs. −1.65). In conclusion, the polymorphisms mentioned above were not associated with the modulation of HIVLD. However, in the presence of impaired triglyceride, HDL, cholesterol and glucose levels, APOB 12669AA and 12669 GA, APOC3 3238CG genotypes indicated a risk for the development and severity of HIVLD.

Subansiri is the largest tributary of the Brahmaputra River basin originated in the Tibet Autonomous Region of China. After flowing about 160 km as Chayul Chu in Tibet, it runs as Subansiri in Arunachal Pradesh state of India for about 360 km before merging into the Brahmaputra River in Assam (India). This study was carried out to understand the hydro-morphometry of the entire Subansiri Basin comprising of three sub-basins: Chayul Chu, Upper Subansiri and Lower Subansiri. Geomorphometric parameters were extracted from Shuttle Radar Topographic Mission (SRTM) Digital Elevation Model of 30 m spatial resolution using Google Earth Engine and GIS software. On comparison, significant difference and spatial variation have been noticed in various morphometric parameters of the sub-basins. Notable differences are observed in some key morphometric parameters such as drainage density, stream frequency, constant of channel maintenance, infiltration number, drainage ratio, drainage texture, dissection index, ruggedness number, form factor ratio, elongation ratio etc. Hypsometric analysis has highlighted further the difference in geomorphic fabric, terrain maturity and hydrologic characteristics of these different sub-basins. Hydro-morphometric parameters have direct bearing on the hydrology. Thus, outcome of this study will be useful in water resources management and in finding engineering solutions to hydro-hazards for this basin and other basins worldwide.

Fluorescent organic dyes are extensively used in the design and discovery of new materials, photovoltaic cells, light sensors, imaging applications, medicinal chemistry, drug design, energy harvesting technologies, dye and pigment industries, and pharmaceutical industries, among other things. However, designing and synthesizing new fluorescent organic dyes with desirable properties for specific applications requires knowledge of the chemical and physical properties of previously studied molecules. It is a difficult task for experimentalists to identify the photophysical properties of the required chemical molecule at negligible time and financial cost. For this purpose, machine learning-based models are a highly demanding technique for estimating photophysical properties and may be an alternative approach to density functional theory. In this study, we used 15 single models and proposed three different hybrid models to assess a dataset of 3066 organic materials for predicting photophysical properties. The performance of these models was evaluated using three evaluation parameters: mean absolute error, root mean squared error, and the coefficient of determination (R2) on the test-size data. All the proposed hybrid models achieved the highest accuracy (R2) of 97.28%, 95.19%, and 74.01% for predicting the absorption wavelengths, emission wavelengths, and quantum yields, respectively. These resultant outcomes of the proposed hybrid models are ∼1.9%, ∼2.7%, and ∼2.4% higher than the recently reported best models’ values in the same dataset for absorption wavelengths, emission wavelengths, and quantum yields, respectively. This research promotes the quick and accurate production of new fluorescent organic dyes with desirable photophysical properties for specific applications.

In the past, the occurrence of macro alga Ulva lactuca on the coastal areas of Jeju Island, Korea, has resulted in the expansion of devastating green tides, thus affecting coastal sustainability, aesthetic appearances, and tourism activities. Taking consideration of the above scenario, substantial economic costs are required for the environmental protection of the island, and it is highly recommended to employ Ulva lactuca in an alternative useful way. Hence, this paper proposes a new strategy to utilize Ulva lactuca as a tribopositive layer in a triboelectric nanogenerator (TENG). Based on the coastal bio-waste Ulva lactuca, the fabricated TENG device generates a maximum output voltage of 875 V, output current of 52 μA, and power density of 272.72 μW/cm2. Furthermore, the device presents excellent cyclic stability with no degradation in the output voltage even after 10000 consecutive cycles at a frequency of 2 Hz. The proposed TENG is further employed to charge the various commercially available capacitors, lightning LEDs, power stopwatches, and scavenge energy from body motions. It is anticipated that the proposed TENG device will pave a new way towards Ulva lactuca management for sustainable energy harvesting and clean coastlines.

Abstract Background Low birthweight (LBW) infants are at increased risk of morbidity and mortality. Exclusive breastfeeding up to six months is recommended to help them thrive through infection prevention, growth improvements, and enhancements in neurodevelopment. However, limited data exist on the feeding experiences of LBW infants, their caregivers and key community influencers. The qualitative component of the Low Birthweight Infant Feeding Exploration (LIFE) study aimed to understand practices, facilitators, and barriers to optimal feeding options in the first six months for LBW infants in low-resource settings. Methods This study was conducted in four sites in India, Malawi, and Tanzania from July 2019 to August 2020. We conducted 37 focus group discussions with mothers and family members of LBW infants and community leaders and 142 in-depth interviews with healthcare providers, government officials, and supply chain and donor human milk (DHM) experts. Data were analyzed using a framework approach. Results All participants believed that mother’s own milk was best for LBW infants. Direct breastfeeding was predominant and feeding expressed breast milk and infant formula were rare. DHM was a new concept for most. Adequate maternal nutrition, lactation support, and privacy in the facility aided breastfeeding and expression, but perceived insufficient milk, limited feeding counseling, and infant immaturity were common barriers. Most believed that DHM uptake could be enabled through community awareness by overcoming misconceptions, safety concerns, and perceived family resistance. Conclusion This study fills an evidence gap in LBW infant feeding practices and their facilitators and barriers in resource-limited settings. LBW infants face unique feeding challenges such as poor latching and tiring at the breast. Similarly, their mothers are faced with numerous difficulties, including attainment of adequate milk supply, breast pain and emotional stress. Lactation support and feeding counseling could address obstacles faced by mothers and infants by providing psychosocial, verbal and physical support to empower mothers with skills, knowledge and confidence and facilitate earlier, more and better breast milk feeding. Findings on DHM are critical to the future development of human milk banks and highlight the need to solicit partnership from stakeholders in the community and health system.

Abstract Surface ozone (O3) data at Pune (1998–2014) and Delhi (1998–2013) are studied to examine their temporal characteristics. Study also examines role of meteorology and atmospheric boundary layer height (ABLH) in modulating surface O3 at these sites. Using diurnal variability of surface O3, rate of change of surface O3, [d(O3)/dt] is estimated to infer the nature of surface O3 formation/destruction mechanisms. Analysis of data reveals that at both locations, surface O3 concentrations during daytime are significantly high as compared to those during nighttime. Seasonally, at Pune averaged daytime surface O3 concentrations are high during pre-monsoon and low in monsoon while those during winter and post-monsoon are found to be significantly higher than those in monsoon but half as compared to those in pre-monsoon. At Delhi, averaged daytime surface O3 concentration is minimum in winter and maximum in pre-monsoon with monsoon and post-monsoon values being about 0.79–0.82 times with respect to pre-monsoon O3 concentrations. High natural/anthropogenic pollutant concentration, abundance of ozone precursor gases, high temperature and high rate of photo-oxidation of precursor gases due to solar flux are the causal factors for increased surface O3 concentrations in pre-monsoon season. Reduced solar flux decreases photo-dissociation of ozone precursor gases resulting in low O3 concentration during winter season. Occurrence of low surface O3 during early morning hours in monsoon, post-monsoon and winter seasons is because of low ABLH and low stratosphere-troposphere exchange (STE). [d(O3)/dt] values during morning/evening at Pune and Delhi are indicative of asymmetric and symmetric nature of ozone formation/destruction mechanisms.

Nephropathy is considered as one of the major secondary complications in diabetic patients. The goal of the current study was to perform preclinical screening of virgin coconut oil (VCO) solubilised curcumin in diabetes-induced nephropathy. Male albino rats of the Wistar strain were injected with a single dose of streptozotocin (STZ) (60 mg/kg/i.p). Diabetic nephropathy (DN) was developed after 4 weeks of STZ injection and the treatment was continued for further 4 weeks (i.e 8 weeks). DN rats were treated with VCO (8ml), VCO solubilised curcumin at a low dose (0.66mg/4ml/kg) and high dose (1.32mh/8ml/kg). DN was assessed by evaluating biochemical parameters such as blood glucose, total protein, albumin, urea, creatinine, and total bilirubin from serum and urine sample, whereas the activity of endogenous antioxidant and membrane- bound phosphatases were studied from kidney homogenate. VCO-solubilised curcumin significantly reduced blood and urine glucose level, increased body weight and reduced kidney weight and kidney hypertrophy. It also normalized urine volume, albumin, creatinine, total protein, total bilirubin and urea levels. Treatment also significantly improved antioxidants and membrane-bound phosphatase activities. In conclusion, compared to the individual treatment group, VCO solubilized curcumin significantly modifies the altered parameters toward normal. The potent antioxidant activity of these substances may be to blame for this defense. Keywords: Virgin coconut oil, curcumin, diabetes, nephropathy, antioxidants

Immunology and microbiology research has witnessed remarkable growth and innovation globally, playing a pivotal role in advancing our understanding of immune mechanisms, disease pathogenesis, and therapeutic interventions. This manuscript presents a comprehensive exploration of the key areas in immunology research, spanning from the utilisation of bacterial proteins as antibody reagents to the intricate realms of clinical immunology and disease management. The utilisation of bacterial immunoglobulin-binding proteins (IBPs), including protein A (SpA), protein G (SpG), and protein L (SpL), has revolutionised serological diagnostics, showing promise in early disease detection and precision medicine. Microbiological studies have shed light on antimicrobial resistance patterns, particularly the emergence of extended-spectrum beta-lactamases (ESBLs), guiding antimicrobial stewardship programmes and informing therapeutic strategies. Clinical immunology research has elucidated the molecular pathways underlying immune-mediated disorders, resulting in tailored management strategies for conditions such as severe combined immunodeficiency (SCID), neuropsychiatric systemic lupus erythematosus (NPSLE), etc. Additionally, significant efforts in vaccine development against tuberculosis and HIV are highlighted, underscoring the ongoing global pursuit of effective preventive measures against these infectious diseases. In summary, immunology and microbiology research have provided significant contributions to global healthcare, fostering collaboration, innovation, and improved patient outcomes.

This paper presents a new framework using MEMS flow sensors on turbine blades (SOTB) to investigate unsteady flow features of a rotating wind turbine. Self-heating flow sensors were implemented by the U18 complementary metal-oxide semiconductor (CMOS) MEMS foundry provided by Taiwan Semiconductor Research Institute (TSRI). Flow sensor chips with a size of 1.5 mm × 1.5 mm were parylene-coated, output via a wireless data acquisition system (WDAQ), and mounted at the root, middle and tip of a 1.2 m diameter semi-rigid turbine blade of a 400 W horizontal axis wind turbine (HAWT). The instantaneous angles of attack (AOAs) of the SOTB were found to be 46~62°, much higher than the general stall AOA of 15°, but were accurate considering the normal detection of the flow sensors. The computational fluid dynamics (CFD) simulation of the HAWT was also compared with the SOTB output. The onsite measurement herein revealed that the 3D secondary flow increment, mostly obvious near the middle part of the turbine blades, degraded both the sensor and the turbine performance and initially justified the onsite measurement application.

Abstract Recently a function was constructed that satisfies all known properties of a tree-level scattering of four massless scalars via the exchange of an infinite tower of particles with masses given by the non-trivial zeroes of the Riemann zeta function. A key ingredient in the construction is an even entire function whose only zeroes coincide with the non-trivial zeroes of the Riemann zeta function. In this paper we show that exactly the same conclusions can be drawn for an infinite class of even entire functions with only zeroes on the real line. This shows that the previous result does not seem to be connected to specific properties of the Riemann zeta function, but it applies more generally. As an application, we show that exactly the same conclusions can be drawn for L-functions other than the Riemann zeta function.

Abstract Background Nicotine dependence, factors associated with dependence, and self-reported side effects among people who use e-cigarettes are scarce in developing countries. Methods A sample of 302 persons who currently use e-cigarettes was recruited from discussion forums on Reddit, Facebook, and the forum ‘lowyat’. The online Google form survey collected data on demographics, e-cigarette use, and the reasons, for cigarette smoking, Fagerstorm Test for Nicotine Dependence adapted for e-cigarettes (eFTND), and side effects experienced. Results The mean age was 25.5 years (6.5), 60.6% were males and 86% had higher education. About 47% were using e-cigarettes only, 27.8% were currently using dual products (both electronic and conventional cigarettes), and 25.2% had also smoked cigarettes in the past. ‘Less harmful than cigarettes’ (56.3%), ‘because I enjoy it’ (46.7%), and ‘it has a variety of flavors (40.4%) were the common reasons for e-cigarette use. The mean eFTND score was 3.9 (SD = 2.2), with a median of four side effects (IQR 3–6), sore or dry mouth/throat (41.4%), cough 33.4%, headache (20.5%), dizziness (16.2%) were commonly reported side effects. eFTND score and side effects were higher among persons using dual products. By multiple linear regression analysis, males (β = 0.56 95% CI 0.45, 1.05, p = 0.033), dual-use (β = 0.95 95% CI 0.34, 1.56, p

Background Local wound care in perianal burn wounds is difficult owing to the risk of contamination from fecal soiling. The problem is aggravated in small children and bedridden critical patients who are unable to convey passage of stools. We used diaper-based wound care to reduce contamination.

Background: Hand, Foot and Mouth Disease (HFMD) has been widely spread in Asia and resulted in a high disease burden among children in many countries. It remains a common problem in India, yet its etiology is largely unknown as diagnosis is based on clinical characteristics. Aim and Objectives: To investigate the circulation of strains, clinical, molecular and virological aspects of the disease. Material and Methods: Vesicular lesion and throat swab specimens were referred from eight children for laboratory diagnosis of HFMD. The detection of enteroviruses was performed by nested PCR, virus isolation using HeLa cell line and sequencing of 5′UTR. Results: Coxsackieviruses A6, A10 and B4 were identified by nested PCR, isolated in HeLa cell line and reconfirmed. The phylogenetic analysis of Coxsackieviruses A6, A10 and B4 showed similarity with Beijing-China, Pune-India, and France respectively. Conclusion: The findings of this study indicate the co-circulation of Coxsackieviruses A6, A10 and B4. Coxsackievirus B4 was isolated and detected for the first time from Pune, India. Additionally, results emphasize the importance of virus isolation using cell lines for laboratory diagnosis. Point-of-Care testing and vaccine development would be beneficial towards control and prevention of HFMD.

Diabetic nephropathy (DN) has become an utmost reason for long-standing renal dysfunction and end-stage renal disease globally. Oxidative stress induced by persistent hyperglycemia is considered a fundamental element in the evolution of DN. The goal of this research was to discover the outcome of appendages of natural antioxidants such as lycopene and co-enzyme Q10 (CoQ10) in DN rats and to observe the preventive effects in DN. A diabetes model was developed in a Wistar strain of male rats (200–250 g) by subcutaneous injection of streptozotocin (55 mg/kg). Development of nephropathy was assessed by renal function tests including blood glucose, creatinine, albumin, total protein, total bilirubin, uric acid, total cholesterol, triglycerides, and CRP level. Oxidative stress markers such as LPO and GSH content and activity of membrane-bound Na+/K+ ATPases were measured in kidney homogenate. Renal damage was assessed by performing a histopathological analysis. DN rats showed a significant elevation in creatinine, albumin, total protein, total bilirubin, uric acid, total cholesterol, triglycerides, CRP, and LPO levels whereas a significant reduction in creatinine clearance and GSH level. Treatment with antioxidants such as lycopene (5 mg/kg/p.o.) and CoQ10 (10 mg/kg/p.o.) along with their combination for 4 weeks notably altered the level of renal function biomarkers and oxidative stress markers. These antioxidants and their combination also protected the kidney from abnormal morphological changes. The present findings suggest that the combined administration of lycopene and CoQ10, which are antioxidants, exhibits synergistic effects in mitigating renal injury by reducing hyperglycemia, oxidative stress markers, and histopathological alterations.

The variation in bird variety over geography and time is a common indicator for assessing environmental changes. Traditionally, such data was gathered by experienced observers, but passively collect acoustic data is quickly developing as a viable alternative survey technique. Now-a-days, avifaunal diversity has been decline due to the demolition of natural habitation. The aim of the study to identify avifaunal diversity of Rawanwadi reservoir, Rawamwadi District Bhandara, investigation period was from month of November 2020 to October 2022, in and around of Rawanwadi Reservoir. In the present investigation, a total of 39 species of birds were spotted during the current inquiry near the Rawanwadi reservoir. Based on their habitat, such as Residential Common, Winter Visitor, and Uncommon, the birds were divided into different groups. The Avifaunal diversity have been categories in diverse group’s position on their regular migratory habitat residential are as migratory winter traveler, internal migratory visitor, external migratory visitors and external emigratory visitors.

Indigenous people often have poor health due to a lack of access to health care. We studied healthcare-seeking behaviors and associated factors of Orang Asli populations living in remote hilly areas of Peninsular Malaysia. A house-to-house survey was done in 11 of 28 randomly selected villages. A sample of 225 Adults aged 18 years and above were interviewed about healthcare-seeking behavior for an episode of illness 30 days before the survey date. Factors associated with appropriate healthcare-seeking behavior as determined by binary logistic regression analyses. More than a third of the Orang Asli adults (88/225) did not consult any healthcare provider (39%) for which ‘illness does not need treatment’ or ‘not sick enough’ (22%) and no transportation (12%) were the main reasons. Being of older age (aOR 0.95, 95%CI 0.9, 0.98), income higher than 500 Malaysian Ringgits per month (aOR 2.35, 95%CI 1.04, 5.39), perception of illness as ‘severe’(aOR 54.79 95% CI 12.61, 239.9), and closer distance of health facility (aOR 0.86 95% CI 0.81, 0.93) were associated with appropriate healthcare-seeking behavior. Health promotion campaigns are needed to improve awareness about common illnesses and improve care-seeking behavior.

Background: Nigeria has the highest maternal mortality rate among sub-Saharan African countries. Recently, universal health insurance coverage has been embraced as a means to enhance population health in low- and middle-income countries. Hitherto, the effect of health insurance coverage on the utilisation of facility-level delivery is largely unknown in the face of the earnest need to lower maternal mortality rates in developing countries. Aim: To empirically investigate the association of health insurance coverage on health services utilisation of facility-level delivery and the extent to which public- and private-sector facility delivery in Nigeria had a disproportionate associational effect with health insurance coverage, in the universal health coverage era. Setting: A cross-sectional study conducted for Nigeria. Methods: This study employed a quasi-experimental method using propensity scores along with different matching methods that were applied to the most recent wave of Nigeria’s Demographic and Health Survey (2020) data. Results: Evidence suggests that childbearing mothers from insured households had an average of 25% probability of utilising facility-level delivery relative to mothers from uninsured households in the year that preceded the survey. Moreover, private-sector facility delivery had a 31% higher associational effect with health insurance coverage than public-sector facility delivery, which had an estimated probability of 21%. Conclusion: Expansion of health insurance coverage in Nigeria will be a desirable way to stimulate the utilisation of facility-level delivery by women of childbearing age. Consequently, coverage expansion has the potential to save many maternal and newborn lives in Nigeria. Contribution: This study has contributed to the urgent attention of the federal government of Nigeria to monitor and revamp the health insurance coverage policies of the country for better facilitation of health services to the Nigerian population.

Stingless bee honey, also known as pot honey, is a unique product that differs from other honey (Apis) in terms of flavor, chemical composition, biological characteristics, and sourness. Raw and by-products made from this honey have substantial use for its diverse health benefits and human dietary requirements. The physiochemical properties of honey from stingless bee mainly rely on nectar sources, geographic locations, climate, bee species, and handling and storage conditions. The honey contains reducing sugars, water, minerals, and ash content, and its characteristic features include color, acidity, pH, electrical conductivity, and viscosity. Further, it contains several biological and therapeutic constituents such as flavonoids, antioxidants, antibacterial, wound-healing, antidiabetic, and anticancer properties, and the Maillard reaction product hydroxymethylfurfural. This review summarizes the literature on the physical and biological properties and therapeutic constituents' use of stingless bee honey. It also highlights the quality standards available worldwide and required modifications in establishing universal standards for promoting this honey.