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To reduce TB deaths, Tamil Nadu, a southern Indian state, implemented the first state-wide differentiated TB care strategy starting April 2022. Triage-positive severely ill patients are prioritised for comprehensive assessment and inpatient care. Routine program data during October–December 2022 revealed that documentation of total score after comprehensive assessment was available in only 39%, possibly indicating poor quality of comprehensive assessment. We confirmed this using operational research. The case record form to record comprehensive assessment was used only in 26% and among these, the completeness and correctness in filling out the form were sub-optimal. There is a clear need to enhance the quality of comprehensive assessments.

Abstract Background To report the role of Polymerase Chain Reaction in confirming the diagnosis of presumed Mycobacterium Tuberculosis (MTB) Intermediate Uveitis. Method Retrospective analysis of 22 eyes of 14 cases of presumed tubercular intermediate uveitis wherein intraocular fluid was tested for MTB DNA by Nested & Real-time PCR, based on clinical suspicion of tubercular aetiology. QuantiFERON TB gold test and High-Resolution CT Chest were done. Patients were treated with anti-tubercular therapy with oral steroids & immunomodulators. In the study, eleven were male (79%) and three female (21%). The median age was 34 years. Nested PCR for both IS 6110 & MPB 64 was positive in 64% of the cases, IS 6110 positive in 23% and MPB 64 positive in 15%. Real-time PCR was positive in 48% of the cases. Vision improved in 33% of cases, maintained in 57%, and worsened in 10% of cases. Conclusion Presumed Tubercular intermediate uveitis can be confirmed by PCR of intraocular fluids. Anti-tubercular therapy with immunosuppression can improve vision and prevent recurrences in such cases.

This paper addresses the problem of multi-stability analysis for fractional-order quaternion-valued neural networks (QVNNs) with time delay. Based on the geometrical properties of activation functions and intermediate value theorem, some conditions are derived for the existence of at least $ (2\mathcal{K}_p^R+1)^n, (2\mathcal{K}_p^I+1)^n, (2\mathcal{K}_p^J+1)^n, (2\mathcal{K}_p^K+1)^n $ equilibrium points, in which $ [(\mathcal{K}_p^R+1)]^n, [(\mathcal{K}_p^I+1)]^n, [(\mathcal{K}_p^J+1)]^n, [(\mathcal{K}_p^K+1)]^n $ of them are uniformly stable while the other equilibrium points become unstable. Thus the developed results show that the QVNNs can have more generalized properties than the real-valued neural networks (RVNNs) or complex-valued neural networks (CVNNs). Finally, two simulation results are given to illustrate the effectiveness and validity of our obtained theoretical results.

Purpose: To evaluate the correlation of quantitative real-time polymerase chain reaction (qRT-PCR) to the clinical characteristics of patients with viral retinitis.Methods: Retrospective case series. Results: Aqueous or vitreous samples of 20 out of 35 eyes showed qRT-PCR positivity for virus etiology (57.14%). Cytomegalovirus (CMV) was most commonly identified in nine eyes (45%). The mean DNA copy number was 2,68,339.65 copies/mL (range: 90–3205397). DNA copy number significantly correlated with the extent of clinical involvement (P = 0.013); however, there was no correlation between DNA copy number and presenting visual acuity (P = 0.31), macular involvement (P = 0.675), optic nerve involvement (P = 0.14), and development of retinal detachment (P = 0.73). There was a significant correlation between the number of DNA copies and the timing of sampling (P = 0.0005). Samples taken earlier in the course of the disease had higher viral copies than later ones. Conclusion: qRT-PCR is useful in confirming a viral etiology in over 50% of cases of suspected viral retinitis. It correlates well with the extent of clinical involvement and timing of sampling.

Biomedical waste (BMW) is any sort of litter generated in the course of human or animal research operations, such as diagnosis, treatment, or immunization, or during the development or trial of pharmaceutical products or in health camps. In dental sectors, BMW, if not adequately handled, can provide a number of health risks to dental practitioners, patients, and other dental healthcare service providers who operate in dental offices. The aim of the study is to examine the knowledge, awareness, and practice of BMW segregation among dental offices. A well-framed questionnaire containing 10 self-structured questions was formed and distributed among 100 students of dentistry through an online Google Forms link. The results were collected, tabulated, and statistically analyzed using the Software SPSS. Chi-square test was performed to assess the P value. Biological waste segregation was known to 98% of the participants, in which most of them had more than 10 years of expertise in dentistry. It is evident that dentists with a lot of experience over the years in the field of dentistry possess considerably increased awareness regarding the segregation of BMWs in their dental offices. Chi-square test done between the years of experience in dentistry and the knowledge on BMW segregation reveals that 0.031 < 0.05 is the P value, which is statistically significant. Most dentists having experience of above 10 years in the field of dentistry have excellent knowledge and practice of segregating BMWs in their dental offices.

Resin-based composites are increasingly employed in dental restorations due to their esthetics. Flexural strength is the characteristic feature of a substance, and it can be described as the stress present in the material just before it renders in a flexure test. The purpose of this study was to determine the flexural strength of a bulk-fill composite following immersion in fruit juices. Ten samples of bulk-fill type composite filling material were created, with four samples from Restofill (Group 1) and four samples from Ivoclar Vivadent (Group 2). Out of which, four specimens of each brand were included for immersion in fruit juices; two specimens were kept as control. The eight samples were put through a flexural strength test, with four remaining as controls, before being measured for maximum force and displacement on the Instron E3000 universal testing equipment. SPSS version 23 (IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp.) was used to examine the calculated flexural strength. The composite Ivoclar has a mean flexural strength of 20.52, whereas the composite Restofill has a mean flexural strength of 20.55. The P value for the independent sample t-test between the two groups, Ivoclar and Restofill, was 0.089 (>0.05), which is statistically insignificant. It is clear from this research that the bulk-fill composite resin Ivoclar has a low flexural strength when compared to the sample Restofill after immersion in fruit juices.

This article studies the finite-time (FNT) and fixed-time (FXT) stability theorems of general fractional-order impulsive discontinuous systems (FOIDSs) through an indefinite Lyapunov functional (LF) approach. Using differential inclusion theory and set-valued map concept, the general FOIDSs can be transformed into fractional-order impulsive differential inclusions (FOIDIs). Two new stability theorems on finite and FXT stability of FOIDSs with finite impulsive instants are derived using an indefinite LF and fractional derivatives of the LF on some impulsive instants, respectively. The settling time is explicitly calculated. The obtained theoretical findings are applied to fractional-order discontinuous multi-agent systems. Discrete control schemes and indefinite Lyapunov-Krasovskii functions (LKFs) are also developed for ensuring FXT synchronization in fractional-order discontinuous multiagent systems. To demonstrate the efficiency and feasibility of the proposed method, some numerical simulations are conducted.

Abstract Eales’ disease is a retinal vasculitis characterized by retinal inflammation, ischemia, and neovascularization. Exact pathogenesis of this disease is yet to be found out. We present a 29-year-old male, diagnosed with Eales’ disease in both eyes with persistent intraocular inflammation. Enucleation of the pthisical right eye was subjected for histopathological examination immunohistochemistry and molecular biologic study for mycobacterial tuberculosis DNA. Our study showed that Eales disease is probably a T cell mediated disease which is triggered by mycobacterial TB DNA. Further studies are needed to confirm our findings.

This abstract describes an IoT-based system for fault detection and diagnosis in solar PV panels. The proposed Fuzzy logic-based fault detection algorithms aims to improve the performance and reliability of solar PV panels, which can be affected by various faults such as shading, soiling, degradation, and electrical faults. The system includes wireless sensor nodes that are deployed on the panels to collect data on their electrical parameters and environmental conditions, such as temperature, irradiance, and humidity. The collected data is then transmitted to a central server for processing and analysis using machine learning algorithms. The system can detect and diagnose faults in real-time, and provide alerts and recommendations to maintenance personnel to take appropriate actions to prevent further damage or downtime. The system has several advantages over traditional manual inspection and maintenance methods, including reduced downtime, lower maintenance costs, and improved energy efficiency. The proposed system has been validated through experimental tests, and the results show that it can accurately detect and diagnose faults in solar PV panels with high reliability and efficiency.

Water footprint (WF) is a comprehensive summation of the volume of freshwater consumed directly and indirectly in all the steps of the production chain of a product. The water footprint concept has been widely used in agricultural water resources management. Water for irrigation is supplied in Sri Lanka to farmers at no cost, and thus the question is arising, whether the current management strategies the authorities and the farmers follow are appropriate to achieve productive water utilization. Therefore, this study aims at evaluating the water footprint of rice production in an irrigation scheme in the dry zone of Sri Lanka, the Walawe irrigation scheme. Due to the unreliability of the rainfall in the study area paddy cultivation depends entirely on irrigation, thus, the WFblue, in other terms the volume of water evaporated from the irrigation water supply is considered as the total WF (WFtot) in this study. Actual crop evapotranspiration (equivalent to ETblue) was estimated based on the Penman-Monteith (P-M) model integrating effective rainfall, and crop coefficient published in Sri Lankan Irrigation Design Guidelines. The study spanned for three irrigation years from 2018–2021. Actual irrigation water issued to the field was estimated based on the data recorded by the government body responsible for irrigation water management of the area—Mahaweli Authority of Sri Lanka. The total volume of percolated water was computed employing the water balance method while assuming runoff is negligible. Results show that the average annual WFblue found to be 2.27 m3/kg, which is higher than global and national WFtot. As the crop yield in the study area (6.5 ton/ha) is also higher than the global (4.49 ton/ha) and national (3.5 ton/ha) yields, a conclusion was drawn that the irrigation water usage (CWUTblue) in the area may be significantly higher. It was then noted the higher CWUTblue was due to relatively higher evapotranspiration in the area. Thus, it is vital to reduce excess water usage by shifting irrigation practices from flooded irrigation to the System of Rice Intensification (SRI).

A 31-year-old male patient presented with sudden onset loss of vision in the left eye. Ocular examination revealed significant vitritis with chorioretinitis lesion in the posterior pole. Subsequent investigations revealed positive human immunodeficiency virus (HIV) and syphilis serology; chest imaging revealed active pulmonary tuberculosis. Polymerase chain reaction from aqueous aspirate was positive for Mycobacterium tuberculosis. There was complete resolution of the lesions following antisyphilitic medications, antitubercular therapy along with highly active antiretroviral therapy. Syphilis and tuberculosis coinfection in a previously unknown HIV patient is rare but can occur. It is worthwhile to look for multiple coinfections in HIV patients.

This case report represents an unusual presentation of Mycobacterium tuberculosis-associated corneal ulcer with hypopyon. A 64-year-old man presented with a hypopyon corneal ulcer in the right eye. His corneal scrapings were negative, and the ulcer was not responding to empirical antimicrobial therapy. A real-time polymerase chain reaction from an aqueous aspirate of the right eye detected 422 copies of M. tuberculosis. Subsequent investigations revealed positive Mantoux and interferon-gamma release assay, supportive radiology. The patient was successfully treated with a course of antitubercular therapy and topical steroids. Hypopyon corneal ulcer, though a rare manifestation of ocular tuberculosis, should be considered in cases not responding to standard antimicrobial therapy.

Mass lesions arising from the anterior segment in children involving the iris and ciliary body can be of myogenic, neurogenic, or hematogenic/vascular origin. These include nevi, melanomas, adenoma, adenocarcinoma, cysts, metastatic tumours among others. Multiple iris mass lesions due to tuberculosis in children are rare. We present an uncommon atypical presentation of multiple anterior segment mass lesions referred to us as neoplasia. Although excision biopsy can be diagnostic, it was deferred and anterior chamber tap was done. Aqueous cytology was suspicious of juvenile xanthogranuloma (JXG) but polymerase chain reaction (PCR) confirmed tuberculous etiology. Treatment with antituberculous therapy (ATT) and steroids lead to complete resolution of the lesions.

Composite is usually a mixture of two phases. The composites used in dentistry have high durability. The individual properties of each phase are important to increase the mechanical property of the composite. This study aimed to determine the surface roughness changes of two composite resin restorative materials after thermocycling. Two of the commercially available composites were chosen (Nanocomposite 3M Z350 and Nanohybrid composite 3M Z250). The composite disks of dimension 10mm diameter and 3mm height were prepared using silicone molds, and every increment was light cured for 30s. A stylus profilometer was used to assess the surface roughness pre thermocycling, and then, the disks were subjected to an integrated thermocycler (T.S-4.4) for 1000 cycles. The post surface roughness was obtained after the thermocycling process using the same stylus profilometer. The surface parameter values before and after thermocycling of the 3M Z350 sample is less than that of 3M Z250. There was a significant difference between the Rz and Rq values of the two different commercially available composite materials. Thus, the present study concludes that thermocycling influenced the surface roughness of composite resin and increased the surface roughness of both the 3M Z250 & Z350 composites. [ABSTRACT FROM AUTHOR]