Search

Background: Laparoscopic cholecystectomy is a minimally invasive surgery which most often is associated with post-operative pain. Pre-emptive administration of ketamine and diclofenac in combination reduces post-operative pain. Aims and Objectives: In patients undergoing laparoscopic cholecystectomy, the aim of this study was to evaluate the efficacy of preemptively administered ketamine and diclofenac and their combination on post-operative pain. Materials and Methods: A total of 90 patients, with American Society of Anesthesiologists physical grading I and II, were recruited for the study. Patients were allocated randomly into the following groups: Group I was administered 100 mL isotonic saline intravenous (IV) 20 min before the induction of anesthesia and 0.15 mg/kg ketamine IV diluted in 5-mL isotonic saline before skin incision; Group II received diclofenac in the dose of 1 mg/kg diluted in 100-mL isotonic saline IV 20 min before the induction of anesthesia and 5-mL isotonic saline IV before skin incision; Group III was administered a combination of diclofenac 1 mg/kg diluted in 100-mL isotonic saline IV 20 min before the induction of anesthesia and 0.15 mg/kg ketamine diluted in 5-mL isotonic saline IV before skin incision. Time for rescue analgesia, post-operative Visual Analog Scale score, hemodynamic changes, and adverse effects were evaluated. Results: Post-operative analgesia was longer in Group III as compared to Group II and Group I at 2, 4, and 6 h (P

Introduction: Anti-thyroid antibodies not only cause thyroid dysfunction but have independent adverse outcomes in the fetus and mother during pregnancy and after birth. Chronic lymphocytic thyroiditis as a presentation of immune system deregulation may be associated with a generalized activation of the immune system at the fetus–maternal unit, the placenta. This interference could be associated with pregnancy morbidities in m o t h e r a n d fetus. This study was done to find out the frequency of autoimmune thyroid disease and its effect on maternal and fetal outcomes in a tertiary care facility in Jharkhand. Method: This is an Observational Prospective Study done during an 18-month period on 254 pregnant women in their second trimester who came to the antenatal clinic (ANC) clinic with singleton pregnancy at RIMS Ranchi. Result: 222 (87.4%) out of the 254 pregnant women had anti- TPO antibodies less than 35 IU/ml. Anti-thyroid peroxidase (anti-TPO) antibody positivity with values greater than 35 IU/ml was found in 32 patients (12.6%). Anti-TPO antibody mean value was 22.54 ± 19.67 IU/ml. Among the 222 individuals who tested negative for the anti-TPO antibody, 7 (3.3%) had miscarriages, 182 (88.3%) gave birth vaginally, and 33 (14.9%) underwent a cesarean section. Of the 32 individuals who tested positive for the anti-TPO antibody, 2 (6.3%) had miscarriages, 24 (75.0%) had vaginal deliveries, and 6 (18.8%) had cesarean sections. Using the Chi-square test, a P value of 0.549 was calculated, indicating statistical insignificance (Pearson Chi-square test value = 0.200a). Conclusion: Anti-TPO antibody positivity was significantly related to miscarriage and anemia. Other complications like preterm delivery, pre-eclampsia, and low birth weight were higher in anti-TPO antibody-positive patients as compared to anti-TPO antibody-negative patients. However, these findings were not statistically significant.

Background: Cervical cancer is a leading cause of cancer mortality among women in India. Screening can help in early detection and improve outcomes. However, uptake remains low, especially in rural areas. Understanding multidimensional factors influencing screening in local contexts is essential to promote equitable access. This study examined knowledge, attitudes, practices, and sociocultural factors associated with cervical cancer screening and vaccination in rural India. Methods: A mixed methods study was conducted among 400 women aged 18–60 years in rural Maharashtra. Quantitative data were collected on knowledge, attitudes, and screening practices by using a structured questionnaire. Qualitative data were gathered through in-depth interviews with 30 participants on perspectives influencing screening. Quantitative data were analyzed using descriptive statistics and logistic regression. Thematic analysis was done for qualitative data. The integration provided complementary insights. Results: Quantitative results showed poor knowledge (17% had good knowledge) and positive attitudes (64%) but low screening uptake (9%). Qualitative findings revealed limited awareness, stigma around gynecological exams, gender inequities, fear, fatalism, and low prioritization of self-care as screening barriers. Conclusion: Multifaceted strategies addressing knowledge gaps, gender roles, stigma, and access are required to improve cervical cancer screening in marginalized rural communities. Mixed methods provide comprehensive evidence for designing context-specific interventions.

The present study deals with stakeholder-driven implementation of pen culture for raising of fish seed for Culture-based fisheries (CBF) in Chamta, a floodplain wetland, in Gangetic plains through polyculture of Indian Major Carps (IMCs) Labeo catla, Labeo rohita and Cirrhinus mrigala with Small Indigenous Fishes (SIFs) Labeo bata, Systomus sarana and grass carp, Ctenopharyngodon idella in co-management mode. In the first polyculture trial IMCs and minor carps were cultured in 4 High Density Poly Ethylene (HDPE) pens (0.1 ha each) at a stocking density of 25 Nos. m−3 in equal numbers for 90 days. In the second polyculture trial IMCs were cultured with grass carp at a density of 25 Nos. m−3 in 4 HDPE pens in the ratio of 1:1:1:2 for 90 days. The same set of pens was utilized for both trials during different times of the year. Net yield of 682.3 ± 20.6 kg and 413.9 ± 21.7 kg per pen was achieved through polyculture of IMCs and SIFs and polyculture and for IMCs and grass carp, respectively. The survival percentage varied with species and culture period with overall survival of 77 (IMCs + minor carps) to 85% (IMCs + grass carp). Polyculture was economically feasible with a BC ratio of 2.01 for IMC and SIFs and 1.88 for IMC and grass carp. All the seeds produced in the pens were released to the wetland as input for CBF. The study indicated the potential of grass carp fishery in macrophyte-infested wetland. The species could attain 1.5–2 kg in 6 months and up to 3–3.5 kg weight within 1 year, utilizing macrophyte resources of the wetland. SIFs S. sarana and L. bata were observed to attain maturity in pens. The study indicated pen as an economically feasible technology to boost CBF in the wetland. The cultivation of SIFs through pen culture and CBF can enhance their production while alleviating pressure on their natural populations. Integrating pen culture using diversified species will promote sustainable fisheries management in these floodplain wetlands.

Municipal sewage sludge, a by-product of wastewater treatment plants, presents environmental challenges due to its complex composition. Particular concern is the lipophilic and aliphatic compounds that pose risks to the environment and human health. This study focuses on the efficient removal of those compounds from sewage sludge using several organic solvents (hexane, toluene, chloroform, dichloromethane, acetone, hexane-methanol mixture, ethanol, and methanol) and ionic liquids (ILs) like tetrakis(hydroxymethyl)phosphonium chloride and 1-ethyl-3-methylimidazolium acetate by solvent extraction techniques. To determine optimal conditions, various factors such as solvent types, contact time, and temperature were examined. The results reveal that solvent polarity significantly impacts extract composition, with non-polar solvents like hexane and toluene yielding profiles characteristic of lipid-type compounds. An in-depth analysis of contaminants present in the sewage sludge was studied by Fourier-transform infrared spectroscopy (FTIR). Additionally, nuclear magnetic resonance (NMR) was used to identify the extracted compounds, including triglycerides, aliphatic esters, aliphatic alcohols, and free carboxylic acids. NMR provides data on the composition of the sewage sludge and indicates that among all the solvents used, tetrakis(hydroxymethyl) phosphonium chloride was the most suitable solvent for removing lipophilic and aliphatic compounds. Regeneration potential and reusability of the IL were conducted and verified by NMR. The results showed that tetrakis(hydroxymethyl) phosphonium chloride ionic liquid could be used for several extraction cycles. Identifying these compounds in the extracted mixture demonstrates that it adds value and potential for various applications. Towards environmental sustainability and circular economy, this effort develops strategies for the safe management, disposal, and recyclability of sewage sludge and, the reduction in environmental and health hazards associated with organic compounds.

The construction of dams threatens the health of watershed ecosystems. The purpose of this study is to show how multiple dams in a basin can impact hydrological flow regimes and subsequently aquatic ecosystems that depend on river flows. The approach assesses the ecosystem services (ESs), including the tradeoffs between economic and ecological services due to altered flow regimes. It uses a previously developed model that integrates a landscape-based hydrological model with a reservoir operations model on a basin scale. The approach is novel because not only does it offer the analysis of alterations in ecosystem services on a daily scale when pre-dam data are unavailable but also allows for dams to be synthetically placed anywhere in the river network and the corresponding alterations in flow regimes to be simulated in a flexible manner. As a proof of concept, we analyse the economic and ecological performances of different spatial configuration of existing reservoirs instead of synthetically placed reservoirs in the upper Cauvery River basin in India. Such a study is timely and conducted for the first time, especially in light of calls to assess the cascade of reservoirs in India and regions elsewhere where pre-dam data are unavailable. The hydrological impact of different configurations of reservoirs is quantified using indicators of hydrologic alteration (IHAs). Additionally, the production of two major ecosystem services that depend on the flow regime of the river, as indicated by irrigated agricultural production and the normalized fish diversity index (NFDI), is estimated, and a tradeoff curve, i.e. a production possibility frontier, for the two services is established. Through the lens of the indices chosen for the ecosystem services, the results show that smaller reservoirs on lower-order streams are better for the basin economy and the environment than larger reservoirs. Cultivating irrigated crops of higher value can maximize the value of stored water and, with lower storage, generate a better economic value than cultivating lower-value crops while reducing hydrological alterations. The proposed approach, especially when simulating synthetic spatial configurations of reservoirs, can help water and river basin managers to understand the provision of ecosystem services in hydrologically altered basins, optimize dam operations, or even prioritize dam removals with a goal of achieving a balanced provision of ecosystem services.

Introduction: Full outline of unresponsiveness (FOUR) score has advantages over Glasgow Coma Scale (GCS); as it can be used in intubated patients and provides greater neurological details. It has been studied mainly in the trauma and neuroscience setting. Our primary objective was to compare the FOUR versus GCS score as predictors of mortality at 30 days and poor functional outcome at 3 months among nontrauma patients in the emergency department (ED). Methods: This prospective observational study was conducted on adult patients presenting with altered mental status (duration

Background: Social work education has undergone significant transformations in recent years, with educators embracing innovative teaching methods to enhance student learning and better prepare future practitioners for the complex challenges of the profession. This thematic research review aims to critically analyse and synthesise the recent innovations in teaching social work, exploring their theoretical underpinnings, pedagogical approaches, and potential implications for social work education. Method: A comprehensive literature search was conducted across multiple databases, including ERIC, PsycINFO, and SocINDEX, to identify relevant peer-reviewed articles published in the last two decades. The selected studies were analysed using a thematic synthesis approach, allowing for the identification and interpretation of key themes and patterns. Result: The review identified four major themes: (1) the integration of technology and digital tools in the classroom; (2) the adoption of experiential and immersive learning strategies; (3) the emphasis on culturally responsive and anti-oppressive pedagogies; and (4) the incorporation of interdisciplinary and community-based learning experiences. The findings highlight the diverse range of innovations being implemented in social work education, reflecting a shift towards more student-centred, interactive, and collaborative learning environments. These innovations aim to cultivate critical thinking, cultural competence, and practical skills among social work students, better preparing them for the complexities of real-world practice. Conclusion: Moving beyond traditional textbook learning offers exciting opportunities to prepare future social workers for the complexities of the field. By critically analysing innovative teaching practices and addressing potential challenges, social work educators can equip students with the knowledge, skills, and critical thinking necessary to become effective changemakers.

The urgency of the problem addressed in this research lies in the fact that many students still lack independent attitude skills. This issue became evident during the implementation of the Pancasila student profile strengthening project at SDN Cikerut. According to pre-research interviews, SDN Cikerut carried out three themes for the Pancasila student profile strengthening project, each of which targeted the independence dimension as one of the key areas of focus. Independence is one of the most important characteristics an individual can possess. The development of an independent attitude is directly linked to the formation of self-identity. This attitude fosters self-reliance, confidence, and self-control over one's thoughts, emotions, and actions. For students, independence plays a critical role in their academic journey, as those who learn independently are able to achieve their educational goals without relying on assistance from peers. Consequently, these learners become responsible not only for their learning process but also for the outcomes of their studies. To cultivate this independent attitude, schools must provide various forms of support. One key support involves educators facilitating activities that encourage students to develop their independence. At SDN Cikerut, one of the primary efforts to foster independent character is through the implementation of a Pancasila student profile strengthening project. This study was conducted to support the project's goal of enhancing students' independent attitudes. The research utilized a descriptive method through a qualitative approach, conducted at SDN Cikerut in Cilegon City. The study subjects included the Principal, Grade V teacher, and Grade V students. Data was collected through observation, interviews, and documentation. The analysis involved data reduction, presentation, and conclusion drawing. The findings showed that the project successfully improved the independent attitude of Grade V students. Challenges that arose during implementation were effectively addressed by the teachers.

A 42-year-old male patient presented with complaints of vertigo, neck pain, swallowing difficulties, and difficulty in maintaining an upright posture. The patient took allopathic consultation for the complaints and was advised to undergo MDCT scan of brain, hematological and audiological evaluations. No abnormalities were detected in the investigations and he was given some medications for symptomatic management. As no relief was noted, the patient took an Ayurveda consultation. After clinical evaluation, the patient was advised to perform an X-ray of the cervical spine and was diagnosed with congenital block vertebrae at C3 – C4 vertebral bodies and posterior appendages with hypoplastic intervening disc space. He was advised to take Ekangveerarasa 250 mg BD before food with honey, Trayodashang guggulu 1 gm BD after food, Vishatinduka vati 250 mg BD after food, Aswagandha churna 3 gm BD after food with milk.The patient was also advised to do light massage and mild hot fomentation in the neck region twice a day with Mahavishagarbha oil. Remarkable relief was observed with all signs and symptoms including a reduction of score in the Neck Disability Index (NDI) within a very short duration of treatment. Considerable improvements were noted in the quality of life of the patient as confirmed by the WHO QOL BREF score. This case report shows that Ayurveda can offer safer and more effective symptomatic treatment for conditions like congenitally fused vertebrae.

The Adivasi people, termed Scheduled Tribes in India, have a lifeworld entwined with nature, land, and resources. Their relationship with the land produces a particular form of lived experience. This interface between land and culture that shapes the body of knowledge is not written or recorded like other practices and traditions. Adivasi/Tribal women play an important role in articulating this knowledge and contributing to its formation. However, this particular lived experience, especially concerning women, has not received the recognition it deserves within the context of mainstream feminism, which has not paid attention to Adivasi/Tribal women as victims of colonial and imperialist oppression. However, the Adivasi/Tribal struggle over land rights in India is also a feminist struggle. Adivasi/Tribal feminism fails to be encapsulated by the colonial lens of the body/earth dichotomy. This paper critically analyzes narratives from the Chotanagpur (Central Plateau of India) and the Northeast region of India, capturing the Adivasi/Tribal women's worldview and their struggles to save their territory. By exploring the oral history of women-led struggles and movements, this paper argues that the theoretical framework of Adivasi/Tribal feminism emerges organically from Adivasi/Tribal perspectives about land, paving the way for a more comprehensive understanding of their struggles and aspirations. Keywords: Adivasi, Indigeneity, Adivasi/Tribal feminism, Land, Oral history, Adivasi/Tribal knowledge, India., Introduction Most of the Adivasi (3) tribal communities in India share a symbiotic relationship with land and natural resources; their lifeworld involves a close interface with land, which is reflected [...]

sRNAs are noncoding transcripts that play critical roles in posttranscriptional regulation in prokaryotes. In the intracellular bacterium Chlamydia, sRNAs have been identified, but functional studies have been limited to an E. coli heterologous system. We have developed an inducible sRNA overexpression system in Chlamydia trachomatis and used it to screen putative sRNAs for effects on the Chlamydia developmental cycle, which involves conversion between replicating (RB) and infectious (EB) chlamydial forms. Overexpression of 4 of 13 C. trachomatis sRNAs decreased production of infectious EBs. We performed detailed characterization of CtrR3 and CtrR7, the two sRNAs that caused the largest progeny defects in our screen. By quantifying chlamydial number and infectious progeny, and by visualizing chlamydial forms using electron microscopy, we showed that overexpression of CtrR3 prevented RB-to-EB conversion, whereas CtrR7 overexpression blocked bacterial replication. We also describe a workflow that allowed us to identify the mRNA targets of CtrR3 in Chlamydia. We first used MS2 aptamer affinity purification coupled with RNA sequencing as an unbiased approach to isolate interacting mRNAs. We then prioritized candidates based on sequence complementarity to the CtrR3 target recognition sequence, which we had identified with bioinformatic and mutational analyses. Finally, we tested putative targets with translational fusion assays in E. coli and C. trachomatis. Using this integrated approach, we provide experimental evidence that YtgB and CTL0389 are mRNA targets of CtrR3 in Chlamydia. These findings demonstrate how our C. trachomatis sRNA overexpression system can be used to investigate the functions and mRNA targets of chlamydial sRNAs. IMPORTANCE Small RNAs (sRNAs) are a class of regulatory RNAs that play important roles in bacterial physiology and pathogenesis. In the intracellular bacterium Chlamydia, however, sRNAs are poorly understood, and functional studies have been limited to a heterologous system. In this study, we developed a genetic system for studying sRNAs in Chlamydia trachomatis and used it to identify four chlamydial sRNAs whose overexpression decreased the production of infectious bacteria. We also successfully utilized this genetic system to determine the target recognition sequence and mRNA targets of an uncharacterized, chlamydial sRNA named CtrR3. Overall, this work offers a generalizable approach for investigating the role of chlamydial sRNAs in their native organism.

Background: The search for the ideal sedative during regional anesthesia continues. Propofol is widely as a sedative intraoperatively. It may cause troublesome hemodynamic changes. Dexmedetomidine is an α2 agonist with sedative, anxiolytic, and analgesic properties. In this study, we compared dexmedetomidine with propofol as sedatives during surgeries under brachial plexus block. Materials and Methods: In our study, 70 American Society of Anesthesiologists I Class and II patients about to undergo upper limb surgeries under brachial plexus block were blinded and randomly allocated to receive either propofol (Group P) or dexmedetomidine (Group D) infusion. Brachial plexus block was performed, and after confirmation of adequate sensory and motor block, an initial loading dose of the drug was administered over 10 min, followed by a maintenance dose till the end of the surgery. Titration of the rate of infusion was done so as to maintain Ramsay Sedation Score (RSS) of 3–4 and Bispectral Index (BIS) of 60–80. Hemodynamic and respiratory parameters were monitored intraoperatively. Adverse effects such as hypotension, bradycardia, respiratory depression, and incidence of oversedation and undersedation were also noted. The collected data were evaluated using appropriate statistical tests in SPSS version 22®. P

BACKGROUND: The transition from medical student to intern represents a challenging period of professional and personal development. This study aimed to explore junior doctors’ experiences navigating this critical passage. MATERIALS AND METHODS: An exploratory qualitative study was conducted on a junior intern doctor working in a tertiary care hospital, in Gujarat. About 40 junior doctors participated in semi-structured interviews reflecting on their internship transition. Data were analyzed using thematic analysis. RESULTS: Perceived deficits in preparedness for clinical work and emotional readiness were a major theme. Interns felt underprepared in skills like clinical reasoning and procedures. The abrupt onset of patient care responsibility provoked anxiety and eroded confidence. Difficulty adapting to workplace culture and hierarchies was another challenge. Long work hours, unfamiliar team dynamics, and new professional relationships were demanding. The intensity of workload and patient care duties provoked overwhelming stress, fatigue, and burnout risk during the junior doctor transition. Peer support and mentoring facilitated adaptation. Enhanced undergraduate training in practical skills and professional competencies was advised to improve preparedness. CONCLUSION: Junior doctors face major challenges to their well-being, confidence, and competence as they transition into clinical practice. Support structures to ease this demanding passage of professional development are needed. Medical schools must strengthen curricula to address preparedness gaps. Improved onboarding and supervised orientation may also benefit new interns. Facilitating an optimal student-to-doctor transition has important implications for physician training, satisfaction, and retention.