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Ayurveda has a long-standing tradition of healthcare in Southeast Asia. Swarnaprash, a classical Ayurveda preparation, is commonly given as the pre-lacteal feed to neonates to prevent labor-related complications and infections. It comprises incinerated gold particles (InAuP/Swarna Bhasma), honey (Madhu), and clarified butter oil (CBO/Cow Ghrita). This in vitro study aimed to evaluate the therapeutic potential of the individual ingredients and combinations of Swarnaprash against selected neonatal gut pathobionts and symbionts. The study employed sophisticated instruments, including SEM with EDAX and X-ray diffraction analysis, to investigate the shape and structural disparities in the ingredients of Swarnaprash. The reported size of gold particles in Swarnaprash ranges from 0.6 to 9.5 µm. These particles are relatively smaller than those in Swarna Bhasma but larger than synthetic gold particles. Swarnaprash demonstrated both bactericidal and bacteriostatic activity against selected neonatal gut pathobionts, with the largest inhibition zones observed for P. aeruginosa and S. Typhi. It surpassed the individual efficacy of its components-Prash, InAuPs, honey, or CBO alone. Notably, Swarnaprash did not affect the selected beneficial gut bacteria. The results warrant further in vivo and clinical studies to explore the effects of Swarnaprash on neonatal gut flora, which would provide vital information for research in neonatal healthcare., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Automatic text summarization is a cornerstone of natural language processing, yet existing methods often struggle to maintain contextual integrity and capture nuanced sentence relationships. Introducing the Optimized Auto Encoded Long Short-Term Memory Network (OAELSTM), enhanced by the Whale Optimization Algorithm (WOA), offers a novel approach to this challenge. Existing summarization models frequently produce summaries that are either too generic or disjointed, failing to preserve the essential content. The OAELSTM model, integrating deep LSTM layers and autoencoder mechanisms, focuses on extracting key phrases and concepts, ensuring that summaries are both informative and coherent. WOA fine-tunes the model's parameters, enhancing its precision and efficiency. Evaluation on datasets like CNN/Daily Mail and Gigaword demonstrates the model's superiority over existing approaches. It achieves a ROUGE Score of 0.456, an accuracy rate of 84.47%, and a specificity score of 0.3244, all within an efficient processing time of 4,341.95 s., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Gurusamy, Rangarajan and Altalbe.)

Background and Aims: We provide an overview and data visualization trends of orthopaedic research published by the Journal of Orthopedics (JOO) from 2013 to 2024., Methods: We used Scopus database to retrieve all articles published by the JOO from 2013 to 2024, as of 15.7.2024. Bibliometric analysis and visualization of the global orthopaedic literature were performed using Microsoft Excel and VOSviewer software to explore the research hotspots in this field in the past 12 years., Results: The 2074 publications covered in the JOO published between 2013 and 2024 were identified. The annual average and six-year cumulative publications depicted growth rates of 36.23 % and 147.99 %, respectively. Of the 80 global publications, the main participating countries were from Europe (n = 26), and Asia (n = 13). North America (37.37 %), Europe (34.89 %) and Asia (30.42 %) contributed a significant share of journal output. The most contributing countries were the USA, followed by the U.K., India, and Japan. The visualization and analysis of topical research trends reveal that the JOO covers almost the entire spectrum of orthopaedic research, with the most focus on the Knee (26.38 %), Hip (21.53 %), Shoulder (8.79 %) and Spine (7.09 %) and its subfields, such as arthroplasty (882 papers), surgery (192 papers), radiography (177 papers), osteoarthritis (166), pain (135 papers), fractures (133) and arthroscopy (70). The 68 (3.32 %) of the 2047 publications received 30 and above citations and together received 3466 citations, constituting 51.73 % share of total citations. The Hospital for Special Surgery (USA), and Singapore General Hospital were the most productive organizations, while the most impactful organizations were the University of Toledo Medical Center (USA), and Università degli Studi di Messina (Italy). The most productive authors were R. Vaishya (India), and J.A. Dubin (USA), whereas V. Filardi (Italy) and J.M. Newman (USA) were the most impactful authors of the JOO., Conclusion: The JOO is a destination for global orthopaedic research. It has progressively received an increasing number of manuscripts and depicted high annual average publication growth rates, besides witnessing an increase in the significant number of citations received. It has helped to improve the journal's ranking, impact and reputation., Competing Interests: We wish to confirm that none of the authors have any competing interest related to this manuscript. However, the Authors #1,2,3 are on the editorial board of the Journal of Orthopaedics, but will not have any role in the editorial review and decision making on this article., (© 2024 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Introduction: Evidence on the prevalence of foot problems among people with diabetes in India at a national level is lacking. Hence, this study was aimed to assess the burden of high-risk (HR) feet in people with diabetes across India., Research Design and Methods: A cross-sectional national-level project 'Save the Feet and Keep Walking' campaign was conducted by the Research Society for the Study of Diabetes in India (RSSDI) from July 10, 2022 to August 10, 2022. A modified version of 3 min foot examination was used to assess the foot problems. Around 10 000 doctors with RSSDI membership were trained online to conduct foot screening and provided a standardised monofilament for detection of loss of protective sensation. People with diabetes aged >18 years who visited the clinics during the study period were examined for foot problems. Data were collected online using the semi-structured questionnaire. A total of 33 259 participants with complete information were included for the final analysis. The foot at risk was categorised based on International Working Group on the Diabetic Foot guidelines 2023., Results: Nearly 75% of the participants were aged above 45 years. Around 49% had diabetes duration >5 years and uncontrolled diabetes (hemoglobin A1c >8%). Presence of history of foot ulcer (20%), lower limb amputation (15.3%), foot deformities (24.5%) and absence of diminished dorsal pedis and posterior tibial pulses (26.4%) was noted in the study participants. Around 25.2% of them had HR feet and highly prevalent among males. Diabetic kidney and retinal complications were present in 70% and 75.5% of people with HR feet. Presence of heel fissures (OR (95% CI) 4.6 (4.2 to 5.1)) and callus or corns (OR (95% CI) 3.6 (3.3 to 4.0)) were significantly associated with HR feet., Conclusions: One-fourth of people with diabetes were found to have HR feet in India. The findings are suggestive of regular screening of people with diabetes for foot problems and strengthening of primary healthcare., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Aims: Nonunion of fractures continue to be the most challenging complication. The increased interest in this area has been anecdotally recognized through published research. The study aimed to conduct a comprehensive bibliometric analysis of global research on nonunion and delayed union of fractures to identify key trends, hotspots, and potential areas for future research development., Methods: Using a pre-defined search strategy, articles related to "Nonunion and Delayed Union of Fractures" that were published from January 1st, 2004 to December 31st, 2023, were retrieved from the Web of Science Core Collection for scientometric analysis. The bibliometrics method was used to analyze the publication dates, countries, institutions, journals, authors, highly cited literature and research hotspots., Results: A total of 1997 publications were identified, which registered an average of 21.42 citations per paper (CPP). The 30.39 % and 3.55 % of the 1997 global publications have received external funding support and were highly-cited papers, respectively. The USA, China and UK, were the most productive countries, while Canada, Scotland, and Belgium registered the highest citation impact. University Leeds, Shanghai Jiao Tong University and Kobe University were the most productive organizations, while Vanderbilt University, University of Edinburgh and University Leeds registered the highest citation impact. Giannoudis PV, Egol KA, and Konda SR were the most productive authors, while Bhandari M, Mehta S, and Schemitsch EH registered the highest citation impact. Injury, Journal of Orthopaedic Trauma and Archives of Orthopaedic and Trauma Surgery contributed the most papers, while Journal of Bone and Joint Surgery-American, Injury and Clinical Orthopaedics and Related Research registered the highest citation impact per paper., Conclusion: The present bibliometric analysis shows the characteristics and trends of non-union fracture research and illuminates the current research situation and developmental trends., Competing Interests: Declaration of competing interest All the authors of “Scientometric Analysis of Global Research on Delayed and Nonunion of Fractures (2004–2023): Insights from the Web of Science Core Collections” declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background and Aims: Prediabetes and osteoporosis are two commonly prevalent diseases that can have interconnected implications for overall well-being. There is a paucity of literature on "prediabetes and osteoporosis". We aimed to assess the current state of cross-sectional studies involving osteoporosis and prediabetes as well as their bibliometric features., Methods: Publications about prediabetes and osteoporosis between January 1994 and November 2023 were taken from the Scopus database, and VOSviewer and Microsoft Office Excel were used for bibliometric analysis and visualization., Results: We identified 272 documents that were written by 531 authors from 48 countries including 252 organizations. The USA was the leading country with the highest publications (n = 84) and Canada had the largest citation impact per paper (109.0). University of California, San Francisco contributed the most publications (n = 6), while Universita degli Studi di Torino, Italy (275.0 and 5.25), had the highest citation impact. Frontiers in Endocrinology (n = 7), was the most productive journal, while Annals of Internal Medicine (322.0) was the most influential in terms of citation impact per paper. The funded research was 30.5 %, while 17.6 % of research were involved in international collaboration., Conclusion: The number of publications on this topic has increased over three decades. The highest citations per paper were received by the publications which had external funding, followed by those which had international collaboration. All the highly cited papers were published from high-income countries., (© 2024 Delhi Orthopedic Association. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Globally, diabetes mellitus (DM) is a substantial contributor to morbidity and mortality. Comorbidities and intercurrent illnesses in people with diabetes may necessitate the use of steroids. Acute as well as chronic use of steroids contributes substantially to the development of various complications. Despite this, there are no standard guidelines or consensus to provide a unified approach for the rational use of steroids in people with diabetes. Also, there is scant harmonization among clinicians with the use of different steroids in routine practice. To address the inconsistencies in this clinical arena, the consensus working group (CWG) formulated a unified consensus for steroid use in people with diabetes. In people with diabetes, the use of steroids causes hyperglycemia and may precipitate diabetic ketoacidosis (DKA). An increase in weight is directly related to the dose and duration of the steroid therapy. Steroid-related alterations in hyperglycemia, dyslipidemia, and hypertension (HTN) add to the increased risk of cardiovascular (CV) disease. The risk of complications such as infections, osteoporosis, myopathy, acne, cataracts, and glaucoma may increase with the use of steroids. Appropriate and timely monitoring of these complications is necessary for early detection and treatment of such complications. Given the systemic effects of various antihyperglycemic drugs, there is a possibility of aggravating or diminishing the specific complications. Preference to a safer steroid is required matching the steroid dose equivalence and individualizing patient management. In conclusion, short-, intermediate-, or long-term use of steroids in people with diabetes demands their rational use and holistic approach to identify, monitor, and treat the complications induced or aggravated by the steroids., (© Journal of the Association of Physicians of India 2024.)

Background: Over the years, several studies have been conducted by utilizing bibliometric techniques to reveal research trends in various sub-fields of medical sciences, including arthritis research. Although no bibliometric study has been conducted Methods:In this study, we examined the publications of Indian scholars on Rheumatoid Arthritis (RA) in the last three decades, using various quantitative and qualitative bibliometric indicators. The publications on RA (from 1994-2023) in the Scopus database were identified, analysed and evaluated using a pre-defined search strategy, and specialised software., Results: 1603 papers were published on RA research that was cited 36814 times (averaging 11.48 citations per paper or CPP). The 18.65% and 16.71% of India's total publications indicated received external funding. The most productive Indian organizations were AIIMS (New Delhi), SGPGIMS (Lucknow) and PGIMER (Chandigarh). The most impactful organizations were AMU (Aligarh), Fortis Healthcare Ltd. (Gurgaon), and Punjab University (Chandigarh). The most productive authors were A. Aggarwal, R. Misra, A. Chopra, and U. Kumar. The most impactful authors were A. Aggarwal, A. Ghosh, S. Shankar, and R. Misra. Medicine (64.2% share), Pharmacology, Toxicology and Pharmaceutics (22.0% share), Biochemistry, Genetics and Molecular Biology (19.8% share) and Immunology and Microbiology (12.8% share) contributed the most publications in this area. Clinical studies (40.9% share), pathophysiology (13.2% share) and the treatment outcome (9.0% share) accounted maximally. The most significant keywords appearing in the area were: "Rheumatoid Arthritis", "Methotrexate", and "Rheumatoid Factor"., Conclusions: This study provides insight into past, present, and future areas of India on research in RA and will help scholars identify the areas of collaboration.

In recent years, medical technological innovators have focused on diverse clinical therapies to find innovative ways to overcome clinical challenges. But still, there emerge certain drawbacks like high computational cost, increased error, less training ability, the requirement of high storage space and degraded accuracy. To conquer these drawbacks, the proposed research article presents an innovative cascaded extreme learning machine for effective heart disease (HD) prediction. Missing data filtering and normalization methods are carried out for data pre-processing. From the pre-processed data, the features are extracted using the Framingham risk factor extraction module, whereas the extracted features are fused to generate a feature vector. The most significant features are selected using Rhino Satin Herd optimization algorithm. Using a linear weight assignment approach, the feature weighting process is undertaken by allocating higher weights to significant features and less weight to unwanted features. Finally, classification is performed through the Cascaded kernel soft plus extreme learning machine with a stacked autoencoder model. The performance is analyzed using PYTHON to evaluate the superiority of the proposed model. The proposed model obtained an overall accuracy of 90%, precision of 94%, recall of 91.3% and F1 measure of 92.6% in the Cleveland-Hungarian dataset, which is comparatively superior to the existing methods. An accuracy of 92.6% is attained for predicting HD in terms of the heart patient dataset. The proposed model attains better performance because of effective accuracy outcome, reduced overfitting issues, fewer error rates, better convergence and training ability.

Background: The research field of stem cell-based therapies in orthopaedics has witnessed significant growth in the recent past. We aimed to identify and analyze the bibliometric characteristics of the global highly cited papers (HCPs) in stem cell research in orthopaedics., Methods: This study relied on secondary data extracted from Scopus, Elsevier's abstract and citation database. An advanced search string was employed, for the period from 1995 to 2020. For each paper, the extracted information included the number of citations, title, authors (name, number, authorship position, and country), year of publication, title of the journals, study design, and thematic field. The VOSviewer (1.6.20) was used to uncover relationships between authors, institutions, keywords, and publications., Results: There were a total of 1427 publications and out of these 186 papers had 100 or more citations (range 100-2644) and were considered as HCPs. The average citation per paper (CPP) was 265.8. Only 4% of the top HCPs contributed 20% of the total citations of all HCPs. All the HCPs were published from high-income countries, and the USA was the leading country in all aspects of publication on stem cell research. Méndez-Ferrer S registered the highest citation ( n  = 2644), Prockop DJ was the most prolific author ( n  = 8 papers), and Harvard Medical School, USA emerged as the most prolific organization with 12 HCPs., Conclusion: Global research in stem cell therapies for orthopaedic problems is making strides, and is an emerging field of research. Stem cell research offers the potential for improved treatment outcomes for various musculoskeletal conditions., Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-024-01160-0., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest., (© Indian Orthopaedics Association 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

A barrier to meeting the goal of universal health coverage in India is the inequality in utilisation of health services between indigenous and non-indigenous people. This study aimed to explore the determinants of utilisation, or non-utilisation, of public healthcare services among the Santals, an indigenous community living in West Bengal, India. The study holistically explored the utilisation of public healthcare facilities using a framework that conceptualised service coverage to be dependent on a set of determinants - viz. the nature and severity of the ailment, availability, accessibility (geographical and financial), and acceptability of the healthcare options and decision-making around these further depends on background characteristics of the individual or their family/household. This cross-sectional study adopts ethnographic approach for detailed insight into the issue and interviewed 422 adult members of Santals living in both rural (Bankura) and urban (Howrah) areas of West Bengal for demographic, socio-economic characteristics and healthcare utilisation behaviour using pre-tested data collection schedule. The findings revealed that utilisation of the public healthcare facilities was low, especially in urban areas. Residence in urban areas, being female, having higher education, engaging in salaried occupation and having availability of private allopathic and homoeopathic doctors in the locality had higher odds of not utilising public healthcare services. Issues like misbehaviour from the health personnel, unavailability of medicine, poor quality of care, and high patient load were reported as the major reasons for non-utilisation of public health services. The finding highlights the importance of improving the availability and quality of care of healthcare services for marginalised populations because these communities live in geographically isolated places and have low affordability of private healthcare. The health programme needs to address these issues to improve the utilisation and reduce the inequality in healthcare utilisation, which would be beneficial for all segments of Indian population.

Background: Research and clinical studies on multiligamentous knee injuries (MLKI) have recently gained interest with several clinical studies reported recently. This study aims to identify, visualize, and characterize the MLKI research, to analyze the knowledge structure of MLKI during 2008-2023 and to identify the emerging research trends from a bibliometric perspective., Methods: All articles reporting MLKI from 2008 to 2023 were curated from the Scopus database, on 1st January 2024. VOS viewer and Microsoft Excel were used to analyze the publications including the participating countries, authors, organizations, journals and research focus. These data were used to generate visual knowledge maps of the outputs., Results: 406 papers on MLKI were published in 115 journals by 483 authors. There has been a slow publication growth in the past 16 years. The United States had more than 50% share in global publications. Knee Surgery Sports Traumatology Arthroscopy, Orthopaedic Journal of Sports Medicine and American Journal of Sports Medicine published the most papers. The three USA institutions, namely Mayo Clinic, Hospital for Special Surgery-New York and Twin Cities Orthopedics contributed the largest number of publications. B.A. Levy (Mayo Clinic, USA) (n = 66) and M.J. Stuart (Mayo Clinic, USA) (n = 63) have registered the highest collaborative links with other authors., Conclusions: This study is the first comprehensive bibliometric study to analyze MLKI. The findings shed light on the growth trajectory of publications, the extent of international collaborations, the influence of highly cited articles, and the key countries, institutions, journals, and authors contributing to the field., Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-024-01149-9., Competing Interests: Conflict of interestNone of the authors have any competing interests to disclose., (© Indian Orthopaedics Association 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Heavy metals (HMs) enter waterbodies through various means, which, when exceeding a threshold limit, cause toxic effects both on the environment and in humans upon entering their systems. Recent times have seen an increase in such HM influx incident rates. This requires an instant response in this regard to review the challenges in the available classical methods for HM detection and removal. As well as provide an opportunity to explore the applications of artificial intelligence (AI) and machine learning (ML) for the identification and further redemption of water and wastewater from the HMs. This review of research focuses on such applications in conjunction with the available in-silico models producing worldwide data for HM levels. Furthermore, the effect of HMs on various disease progressions has been provided, along with a brief account of prediction models analysing the health impact of HM intoxication. Also discussing the ethical and other challenges associated with the use of AI and ML in this field is the futuristic approach intended to follow, opening a wide scope of possibilities for improvement in wastewater treatment methodologies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Objective: To evaluate the efficacy and adverse events of fezolinetant for treating vasomotor symptoms (VMS) of menopause., Data Sources: PubMed/MEDLINE, ClinicalTrials.gov , EMBASE, Cochrane Database, Scopus, and WHO International Clinical Trials Registry Platform were searched through June 2023 for publications and randomized controlled trials on fezolinetant compared with placebo in menopausal women who experienced moderate-to-severe VMS., Methods of Study Selection: Our literature search identified 330 articles, of which five studies with six reports were included in our meta-analysis per our eligibility criteria., Tabulation, Integration, and Results: The risk of bias was evaluated using Cochrane's RoB 2 (Risk of Bias version 2) tool, quality of evidence was graded using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach, and outcome measures data for effect size were pooled in random-effects model and rated. A total of 2,168 participants from five randomized clinical trials (six reports) were included. Fezolinetant significantly lowered VMS frequency, with pooled mean difference of 2.62 (95% CI, 1.84-3.41). The pooled mean difference for fezolinetant compared with placebo for the MENQOL (Menopause-Specific Quality of Life) measure was -0.60 (95% CI, -0.92 to -0.28), and the mean percentage improvement in VMS frequency was 22.51% (95% CI, 15.35-29.67). Fezolinetant was associated with improvement in sleep quality when compared with placebo., Conclusion: Fezolinetant is effective in lowering moderate-to-severe VMS frequency and sleep disturbances in postmenopausal women., Systematic Review Registration: PROSPERO, CRD42023427616., Competing Interests: Financial Disclosure The authors did not report any potential conflicts of interest., (Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: This study presents a global research scenario in the broad domain of osteoarthritis (OA) research, using quantitative and qualitative publication and citation indicators., Methods: The study is based on 45,368 global publications, sourced from the Scopus bibliographical database, covering three decades (1994-2023). We studied the performance of the top 12 developed and top 12 developing countries. The key countries, organizations and authors at national and international levels were identified. The broad subject areas and key journals contributing to global OA research were delineated, besides identifying the broad characteristics of highly cited papers in the field., Results: The United States and China were the most productive countries, while the Netherlands and Canada made the largest citation impact. Harvard Medical School and the University of Sydney made the most contribution, while Boston University and Pfizer Inc., USA registered the highest citation impact. Hunter DJ and Guermazi A were the most productive authors, while Lohmander LS, and Hochberg MC registered the highest citation impact. Osteoarthritis and Cartilage ( n  = 4879) and Annals of the Rheumatic Diseases ( n  = 786) published the maximum papers, while Arthritis and Rheumatism and Nature Reviews Rheumatology registered the largest citation impact. The highly cited papers with 100 or more citations constituted 6.25% of the total publications., Conclusions: There has been a systematic growth of publications on OA. The research on OA was mainly done in developed countries, with the maximum publications coming from the United States of America, China and Canada. The most impactful publications on OA were from the Netherlands, Canada and the United States of America., Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-024-01111-9., Competing Interests: Conflict of interestNone., (© Indian Orthopaedics Association 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Backgroundand Aims: Prosthetic Joint Infection (PJI) is a serious clinical problem after Arthroplasty. The research field on PJI is emerging, but there is a paucity of information on the most impactful publications on it. This prompted us to conduct a bibliometric analysis of the global research output, from 2003 to 2022, to identify the growth of publications, the key players in this research field and to evaluate the characteristics of highly-cited publications (HCPs) on the PJI., Methods: Publications related to PJI research were identified globally from the Scopus database, using specific keywords, covering the literature from 2003 to 2022. The HCPs were considered those with 100 or more citations. Information on publication year, citation count, funding sources, title, author, journal, country, institution, research area, and strategic keywords were collected from these HCPs. Publication data was imported into Microsoft Excel and analyzed further using VOSviewer and R software., Results: There were 182 HCPs (3.12%), which received a total citation of 124701 (average CPP of 21.41), with the citation range from 100 to 1921. Research articles were the most predominant publications (69.2%), but their average citations per paper (CPP) of 189.78 was lower than that of Review articles (average CPP: 253.17). The USA has been the leading country in terms of total publications (31.58%), and HCPs (36.99%), followed by Switzerland, Spain, UK and China. There were no HCPs from developing countries. J. Parvizi of Thomas Jefferson University, USA (with a total publications of 31 and an average CPP of 315.7), and W. Zimmerli of Basel University, Switzerland (with a TP of 11 and an average CPP of 341.9), were the most productive and impactful authors in PJI global research output., Conclusion: This bibliometric analysis identified the most productive and impactful authors, organizations, countries, and journals in the research of PJI, of the last two decades., Competing Interests: None of the authors of the present study have declared any competing interests., (© 2024 Delhi Orthopedic Association. All rights reserved.)

Background: Medical management of adenomyosis is an emerging perspective in modern gynecology. Though levonorgestrel intrauterine system (LNG-IUS) and dienogest (DNG) effectively relieve symptoms in adenomyosis, neither has been approved for the same indication. Our study aims to compare the efficacy and safety of these progestins in treating adenomyosis., Objective: To study the efficacy and safety of LNG-IUS versus DNG in patients with symptomatic adenomyosis., Design: Open-labeled, parallel, single-centered, randomized clinical trial., Methods: Patients with adenomyosis-associated pain with or without abnormal uterine bleeding were randomly allocated to either LNG-IUS group or DNG group. The primary outcome was a reduction in painful symptoms after 12 weeks of treatment measured by visual analog scale (VAS) score. Changes in menstrual blood loss (MBL), improvement in quality of life (QoL), and adverse drug reactions were also analyzed., Results: The VAS score significantly decreased from baseline in both groups. The baseline and post-treatment VAS scores in the LNG-IUS group were 6.41 ± 1.07 and 3.41 ± 1.04 ( p  = <0.001) and in the DNG group, were 6.41 ± 0.95 and 3.12 ± 1.40 ( p  = <0.001), respectively. A significantly greater proportion of patients in the LNG-IUS group experienced lighter MBL as compared to the DNG group [27/30 (90%) in the LNG-IUS group versus 17/22 (77.2%) in the DNG group ( p  = 0.006)]. Both the groups had improvement in QOL scores calculated by the World Heath Organisation QOL scale (WHOQOL BREF) questionnaire; however, it was more pronounced in the DNG group [(28.76 ± 30.47 in the LNG-IUS group versus 48.26 ± 44.91 in the DNG group ( p  = 0.04)]. Both the agents were safe as there were no reported major adverse drug reactions., Conclusion: DNG can be an effective and safe alternative to LNG-IUS for the medical management of adenomyosis., Trial Registration: The trial was prospectively registered at the clinical trial registry - India (CTRI) vide CTRI number CTRI/2020/05/025186., Competing Interests: The authors declare that there is no conflict of interest., (© The Author(s), 2024.)

In recent years, herbal nanomedicines have gained tremendous popularity for novel drug discovery. Nanotechnology has provided several advances in the healthcare sector, emerging several novel nanocarriers that potentiate the bioavailability and therapeutic efficacy of the herbal drug. The recent advances in nanotechnology with accelerated strategies of ophthalmic nanosystems have paved a new path for overcoming the limitations associated with ocular drug delivery systems, such as low bioavailability, poor absorption, stability, and precorneal drug loss. Ophthalmic drug delivery is challenging due to anatomical and physiological barriers. Due to the presence of these barriers, the herbal drug entry into the eyes can be affected when administered by following multiple routes, i.e., topical, injectables, or systemic. However, the advancement of nanotechnology with intelligent systems enables the herbal active constituent to successfully entrap within the system, which is usually difficult to reach employing conventional herbal formulations. Herbal-loaded nanocarrier drug delivery systems demonstrated enhanced herbal drug permeation and prolonged herbal drug delivery. In this current manuscript, an extensive search is conducted for original research papers using databases Viz. , PubMed, Google Scholar, Science Direct, Web of Science, etc. Further painstaking efforts are made to compile and update the novel herbal nanocarriers such as liposomes, polymeric nanoparticles, solid lipid nanoparticles, nanostructure lipid carriers, micelles, niosomes, nanoemulsions, dendrimers, etc., which are mostly used for ophthalmic drug delivery system. This article presents a comprehensive survey of diverse applications used for the preventative measures and treatment therapy of varied eye disorders. Further, this article highlights the recent findings that the innovators are exclusively working on ophthalmic nanosystems for herbal drug delivery systems. The nanocarriers are promising drug delivery systems that enable an effective and supreme therapeutic potential circumventing the limitations associated with conventional ocular drug delivery systems. The nanotechnology-based approach is useful to encapsulate the herbal bioactive and prevent them from degradation and therefore providing them for controlled and sustained release with enhanced herbal drug permeation. Extensive research is still being carried out in the field of herbal nanotechnology to design an ophthalmic nanosystem with improved biopharmaceutical properties., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

COVID-19 is an RNA virus that attacks the targeting organs, which express angiotensin- converting enzyme-2 (ACE-2), such as the lungs, heart, renal system, and gastrointestinal tract. The virus that enters the cell by endocytosis triggers ROS production within the confines of endosomes via a NOX-2 containing NADPH-oxidase. Various isoforms of NADPH oxidase are expressed in airways and alveolar epithelial cells, endothelial and vascular smooth muscle cells, and inflammatory cells, such as alveolar macrophages, monocytes, neutrophils, and Tlymphocytes. The key NOX isoform expressed in macrophages and neutrophils is the NOX-2 oxidase, whereas, in airways and alveolar epithelial cells, it appears to be NOX-1 and NOX-2. The respiratory RNA viruses induce NOX-2-mediated ROS production in the endosomes of alveolar macrophages. The mitochondrial and NADPH oxidase (NOX) generated ROS can enhance TGF-β signaling to promote fibrosis of the lungs. The endothelium-derived ROS and platelet-derived ROS, due to activation of the NADPH-oxidase enzyme, play a crucial role in platelet activation. It has been observed that NOX-2 is generally activated in COVID-19 patients. The post-COVID complications like pulmonary fibrosis and platelet aggregation may be due to the activation of NOX-2. NOX-2 inhibitors may be a useful drug candidate to prevent COVID-19 complications like pulmonary fibrosis and platelet aggregation., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Osteoarthritis (OA) is a chronic degenerative joint disorder primarily affecting the elderly, characterized by a prominent inflammatory component. The long-term side effects associated with current therapeutic approaches necessitate the development of safer and more efficacious alternatives. Nutraceuticals, such as Vitamin D and curcumin, present promising therapeutic potentials due to their safety, efficacy, and cost-effectiveness. In this study, we utilized a proinflammatory human chondrocyte model of OA to assess the anti-inflammatory properties of Vitamin D and curcumin, with a particular focus on the Protease-Activated Receptor-2 (PAR-2) mediated inflammatory pathway. Employing a robust siRNA approach, we effectively modulated the expression of PAR-2 to understand its role in the inflammatory process. Our results reveal that both Vitamin D and curcumin attenuate the expression of PAR-2, leading to a reduction in the downstream proinflammatory cytokines, such as Tumor Necrosis Factor-alpha (TNF-α), Interleukin 6 (IL-6), and Interleukin 8 (IL-8), implicated in the OA pathogenesis. Concurrently, these compounds suppressed the expression of Receptor Activator of Nuclear Factor kappa-Β Ligand (RANKL) and its receptor RANK, which are associated with PAR-2 mediated TNF-α stimulation. Additionally, Vitamin D and curcumin downregulated the expression of Interferon gamma (IFN-γ), known to elevate RANKL levels, underscoring their potential therapeutic implications in OA. This study, for the first time, provides evidence of the mitigating effect of Vitamin D and curcumin on PAR-2 mediated inflammation, employing an siRNA approach in OA. Thus, our findings pave the way for future research and the development of novel, safer, and more effective therapeutic strategies for managing OA., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Patnaik et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In outer space, we find many types of radiations that are due to solar flares, radiation belt, cosmic rays, etc. We are fortunate enough to be protected from these radiations on the surface of the Earth, whereas in other celestial objects such as planets and satellites, without a protecting atmosphere, penetration of radiation that may be ionising or non-ionising is inevitable. Hence, studying radiation environment and its effect on such celestial objects is very important for establishing facilities such as satellites, payloads, vehicles and human exploration. For such cases, manufacturing the products with lightweight, thermally stable, flexible, mechanically durable materials is essential and needs to be studied for the radiation effect. Hence, in the present work, we have made an attempt to calculate the rate of absorbed dose in case of polymers such as Polyvinyl Chloride (PVC), polytetrafluoroethylene, Mylar, polystyrene and Zylon for the lunar radiation environment. From the literature, it is found that ions up to iron has a lion share in the ionic radiation in space. The simulations were carried out for ions from hydrogen to iron using the SRIM software with various energies. It is observed that the absorbed dose rate in the polymers increases with the increase in ion mass. Further, the study can be extended to get the information of various flexible materials for these ions from which a suitable material can be chosen for the different space applications., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been used for almost a decade and have proven to be effective not only in managing Type 2 diabetes (T2D), but their cardio and renal protective features make them very useful in managing patients with risk of multiple comorbidities. This systematic review was undertaken by the authors because there is no evidence currently available in India that has studied the suitability of SGLT2i as a first-line agent in patients newly diagnosed with T2D in India., Materials and Methods: First, literature was searched to identify features that are considered important when deciding on a first-line agent for managing T2D. A total of 5 broad topics were identified-glycemic control, extra glycemic effects, antihyperglycemic combination therapy, safety, and cost-effectiveness. These domains had further subheadings, and a total of 16 domains were identified. Metformin is the drug of choice as a first-line agent in such situations and has been considered the gold standard for evaluating the effects of SGLT2i across these domains. A systematic literature review on each domain was conducted to compare SGLT2i with the gold standard in Indian patients newly diagnosed with T2D. Evidence was graded (levels of evidence (LoE)-A, B, and C), and recommendations (class of recommendation (CoR)-I, II, and III) were classified by the expert group as defined in the methodology., Results: According to the systematic reviews conducted, 11 domains had Level A evidence, 2 domains (impact on lipids and gut microbiome) had Level B, and 3 domains had Level C (β-cell function, renal protection, and glycemic variability) evidence. Based on evidence and expert opinion, the authors recommend SGLT2i as a first-line agent for managing newly diagnosed patients with T2D with a Class I recommendation for 13 domains and Class II for the remaining 3 (impact on lipids, gut microbiome, and β-cell function). Although a poorer level of evidence (Level C) was available for the glycemic variability domain, the authors still reported this as Class I recommendations according to their expert opinion and consensus., Conclusion: This article advocates adopting SGLT2 inhibitors as the primary treatment choice for treating patients with newly diagnosed T2D in India., (© Journal of the Association of Physicians of India 2023.)

Doubled haploid technology, which enables the generation of homozygous lines in a single step, is one of the modern tools being employed for accelerating breeding processes in different crops. In rice, a globally important staple food crop, doubled haploid production through androgenesis is increasingly being employed in breeding programs. Amongst the androgenic rice lines, doubled haploids are formed spontaneously at about 50-60%, while the remaining 40-50% of plants remain as haploids. As haploids cannot be easily identified, it is routine to grow all the rice androgenic lines till maturity and harvest the seeds from the fertile doubled haploids. Therefore, the methods that facilitate easy identification of haploids at an early developmental stage in rice would enable treatment of such haploid lines with colchicine, to increase the efficiency of doubled haploid production. Further, it would also help in eliminating the operational cost involved in maintaining them till maturity. In the above context, a systematic study to identify easily observable physiological and morphological differences between haploid and doubled haploid rice lines was undertaken. Rice haploids were found to be noticeably different from doubled haploids in photosynthetic rate, transpiration rate, stomatal conductance, and morphology of lodicules, stigma and style, features which have not been reported before. Most importantly, rice haploids invariably have acute leaf apex which is easily distinguishable from the doubled haploids that have attenuated leaf apex shape. Very high per cent accuracy in the prediction of ploidy level was observed when haploids were identified at an early developmental stage based on leaf apex shape, and the results verified with flow cytometry perfectly matches with leaf apex shape. The study establishes 'acute leaf apex' shape as an accurate visual marker to rapidly identify haploid rice lines at an early developmental stage in a cost-effective manner., (© 2023. The Author(s).)

A man in his early 80s presented with acute onset aphasia and right-sided weakness with an NIH Stroke Scale (NIHSS) of 17. He was last seen normal 9 hours before the presentation. MRI of the brain showed acute infarcts in the left caudate, lentiform nucleus and corona radiata. MRI angiogram (MRA) revealed an occluded left main middle cerebral artery (MCA) and an associated ipsilateral patent duplicated middle cerebral artery (DMCA). Mechanical thrombectomy (MT) was performed, and he was discharged with an NIHSS of 8. In this report, we review and discuss the challenges during the intervention of MCA occlusion in the presence of duplicated MCA, a rare anomaly., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Aims: This study aimed to assess the current status of India's COVID-19 research from the top 100 most cited papers, using bibliometrics methods and indicators and suggest strengths and weaknesses., Methodology: Publications on COVID-19 research from India between December 2019 and 22 August 2023 were retrieved from the Scopus database. From 37101 studies retrieved, the first top 100 Highly Cited Papers (HCPs) having received 270 to 2931 citations, were identified., Results: The top 100 most cited Indian papers were published from 2020 to 2023, with the majority (75) in the year 2021, followed by 24 in 2022. They were cited a total of 56661 times (average - 566.61 times). The 242 authors of these HCPs were from 159 Indian organizations, and the articles were published in 60 journals. 29 % and 59 % of these HCPs received external funding support and were involved in international collaborations, respectively. There was poor collaboration among Indian research institutions and a dearth of funding from India. None of the Indian HCPs figured in the global 100 HCPs., Conclusions: Although citations of research papers published from India increased during COVID-19, limited collaboration, inadequate funding, and subpar publications hindered Indian scientists. To enhance India's research landscape, we propose dismantling barriers, nurturing collaboration, and encouraging knowledge exchange among domestic institutions., Competing Interests: Declaration of competing interest All the authors hereby declare that there is conflict of interest regarding this manuscript & no funding was received from any source. We declare that this manuscript has been solely submitted to this journal and is not under consideration by any other journal. All the research presented in this paper is original., (Copyright © 2023 Research Trust of DiabetesIndia (DiabetesIndia) and National Diabetes Obesity and Cholesterol Foundation (N-DOC). Published by Elsevier Ltd. All rights reserved.)

In this study, representative urban and peri-urban Indian food baskets have been studied for the presence of toxic and essential elements. The concentration of target toxic and essential elements was used to estimate dietary intakes (EDIs) and health risks. Across all food matrices, toxic elements like Cd and Pb were dominant. The highest concentrations of the target elements were found in vegetables, with Cd, Pb, and Ni being beyond permissible limits of the Food and Agriculture Organization of the United Nations and the World Health organization (0.05 mg/kg, 0.1 mg/kg, and 1.5 mg/kg, respectively) in okra, spinach, and cauliflower. The sum of concentrations of the toxic elements (As, Ni, Hg, Cr, Cd, Pb) in vegetables had a range of 0.54-12.08 mg/kg, the highest sum was found in spinach (median 12.08 mg/kg), followed by okra (median 1.68 mg/kg). The EDI was observed for vegetables with a contribution as high as 92% for Cd. Dairy products were found with the highest loading for Ni with a dietary intake of 3.1 mg/kg/day for adults and twice as much for children. Carcinogenic risk for Ni was the highest and found above the threshold for all food categories, as was the case with As. Cumulative carcinogenic and non-carcinogenic risks were mostly contributed by milk and vegetables, in particular, spinach., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives : The objective of this consensus article was to form a list of expert recommendations and an easily adaptable algorithm for obesity management in India by primary care physicians (PCPs). Methods : A Delphi-based model was followed to form a list of the consensus recommendations. Consensus statements were created from the results of a literature review that were graded as per the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria. After being evaluated by an expert panel comprising diabetologists, endocrinologists, cardiologists, bariatric surgeons, and gynecologists, the statements were revised and reevaluated by a larger group of practitioners, including PCPs and diabetologists, to arrive at a consensus. Results : The panel opined that obesity is increasing in prevalence in India and is projected to rise in the coming years. Body mass index and waist circumference were both recommended for better identification of people at risk of obesity-related comorbidities than either of them alone. The Edmonton Obesity Staging System (EOSS) was suggested as being most suitable for the assessment (staging) of obesity. A multidisciplinary team was considered invaluable for assessing and managing patients with obesity. The use of once-a-week semaglutide (2.4 mg) via the subcutaneous route was suggested as the first-choice anti-obesity treatment when pharmacotherapy is deemed necessary. An algorithm considering all these aspects was proposed. Conclusion : Obesity needs to be recognized as a significant contributor to other comorbidities. The diagnosis and management of obesity should be comprehensive and consider patient psychology, the presence or absence of comorbidities, available pharmacologic agents, and long-term outcomes. The proposed algorithm could help clinicians in this aspect and improve the overall outcomes. How to cite this article : Deshpande NR, Kapoor N, Dalal JJ, et al. Consensus on Current Landscape and Treatment Trends of Obesity in India for Primary Care Physicians. J Assoc Physicians India 2023;71(10):69-77., (© Journal of the Association of Physicians of India 2023.)

Background: Abdominal tuberculosis presenting as acute surgical emergency continues to be a major issue in developing countries including India. Being an indolent disease with varied presentation, there is a need to describe the epidemiology, clinicopathological nature of the disease. Hence, this series was conducted with the aim of describing our institutional experience in the management of abdominal tuberculosis presenting as acute surgical emergency, outlining the epidemiology, management aspects and the analysis of risk factors for poor outcome in our population., Methods: This was a descriptive series of patients operated for abdominal tuberculosis presenting as acute surgical emergency at a tertiary care hospital in Eastern India from January 2021 to January 2022. All consecutive patients presenting with intestinal obstruction or peritonitis who underwent laparotomy with intra operative and histopathological finding suggestive of tuberculosis were taken for the study., Results: A total of 30 patients with acute abdominal tuberculosis were included in the study. 56.7% of patients were males; the mean age of presentation was 43 years with majority of patients in the younger to middle age groups. Most (80%) patients were from rural areas with limited access to healthcare. One patient had co-infection with HIV. Five patients had diabetes and six patients had hypertension as co-morbidities. 73.3% of patients had primary intestinal tuberculosis. Majority (76.7%) presented with acute intestinal obstruction. All patients had colicky abdominal pain as a consistent feature. 40% of patients were anaemic and 70% had low serum albumin levels. The most common site of affection was Ileo-cecal region (73.3%) with stricture as the pathology. Segmental resection with end to end anastomosis was the most common procedure performed (46.7%). 26.7% of patients had an adverse post operative complication, and 23.3% had surgical site infection (SSI). The mortality rate in our series was 6.7%. Although coexisting SSI, co-morbidities were associated with increased mortality, it was not found to be statistically significant (p = 0.08). 16 patients were lost to follow up., Conclusion: Abdominal tuberculosis presenting as acute abdomen continues to challenge surgeons even in the 21st century. Majority in the developing countries present late with varied complications. A high index of clinical suspicion is required for timely diagnosis to reduce the mortality and morbidity of the disease., Competing Interests: Conflicts of interest The authors have none to declare., (Copyright © 2023 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)

Aim: In modern obstetrics, need of labor induction is increasing along with increased caesarean deliveries. Major contributions for these operative deliveries are due to induction failure. This demands a potent labor-inducing agent. Dinoprostone gel is an established method but having some drawbacks. Misoprostol could be an effective alternative to Dinoprostone, but its fetal safety is not yet well established. This study aimed to evaluate the fetal safety of vaginal Misoprostol tablet by measuring fetal heart rate changes during induction of labor., Methods: This was a single-center randomized controlled trial incorporating 140 term women, equally randomized to get either tablet Misoprostol or Dinoprostone gel. Fetal heart rate patterns were compared in both the groups by continuous cardiotocographic tracing. All the data were analyzed on an intention-to-treat basis., Results: There were no statistically significant changes in fetal heart rate pattern in both Misoprostol and Dinoprostone groups. Vaginal deliveries were statistically higher in Misoprostol group. Neonatal parameters like 1 min Appearance, Pulse, Grimace, Activity, and Respiration score and neonatal intensive care unit admission were comparable, and there was no significant difference in terms of major adverse events and side effects., Conclusions: Misoprostol is a safe alternative to Dinoprostone gel for induction of labor and found to be more effective labor-inducing agent. In the background of higher caesarean rate, vaginal Misoprostol can be a potential labor-inducing agent especially in a resource poor setting., (© 2023 Japan Society of Obstetrics and Gynecology.)

Host-guest complexation-based suprasomes successfully deliver benzimidazolium amphiphiles. β-CD and Zn 2+ or an acidic environment act as the stimuli for the assembly and disassembly of suprasomes. The supramolecular nanomedicine developed by encapsulating tetracycline showed strong and tunable antibacterial activity and holds potential for the next-generation vesicle-based drug delivery system.

The increasing resistance of bacteria to commercially available antibiotics threatens patient safety in healthcare settings. Perturbation of ion homeostasis has emerged as a potential therapeutic strategy to fight against antibacterial resistance and other channelopathies. This study reports the development of 8-aminoquinoline (QN) derivatives and their transmembrane Zn 2+ transport activities. Our findings showed that a potent QN-based Zn 2+ transporter exhibits promising antibacterial properties against Gram-positive bacteria with reduced hemolytic activity and cytotoxicity to mammalian cells. Furthermore, this combination showed excellent in vivo efficacy against Staphylococcus aureus . Interestingly, this combination prevented bacterial resistance and restored susceptibility of gentamicin and methicillin-resistant S. aureus to commercially available β-lactam and other antibiotics that had lost their activity against the drug-resistant bacterial strain. Our findings suggest that the transmembrane transport of Zn 2+ by QN derivatives could be a promising strategy to combat bacterial infections and restore the activity of other antibiotics.

Background and Aim: There is regional variation in the eradication rates of Helicobacter pylori (H. pylori) regimens depending on the local antibiotic resistance patterns. The aim of this study was to compare the efficacies of triple, quadruple and sequential antibiotic therapy in eradicating H. pylori infection., Methods: A total of 296 H. pylori-positive patients were randomized to receive one of the three regimens (triple, quadruple or sequential antibiotic therapy) and eradication rate was assessed by H. pylori stool antigen test., Results: The eradication rates of standard triple therapy, sequential therapy and quadruple therapy were 93%, 92.9% and 96.4%, respectively (p = 0.57)., Conclusion: Fourteen days of standard triple therapy, 14 days of bismuth-based quadruple therapy and 10 days of sequential therapy are equally efficacious in eradicating H. pylori and all regimens have optimum H. pylori eradication rates., Trial Registration: ClinicalTrials.gov Identifier: CTRI/2020/04/024929., (© 2023. Indian Society of Gastroenterology.)

Background: Chondrocytes are the primary cells responsible for maintaining cartilage integrity and function. Their role in cartilage homeostasis and response to inflammation is crucial for understanding the progression and potential therapeutic interventions for various cartilage-related disorders. Developing an accessible and cost-effective model to generate viable chondrocytes and to assess their response to different bioactive compounds can significantly advance our knowledge of cartilage biology and contribute to the discovery of novel therapeutic approaches., Objective: We developed a novel, streamlined protocol for generating chondrocytes from bone marrow-derived mesenchymal stem cells (BMSCs) in a 3D culture system that offers significant implications for the study of cartilage biology and the discovery of potential therapeutic interventions for cartilage-related and associated disorders., Methods: We developed a streamlined protocol for generating chondrocytes from BMSCs in a 3D culture system using an "in-tube" culture approach. This simple pellet-based 3D culture system allows for cell aggregation and spheroid formation, facilitating cell-cell and cell-extracellular matrix interactions that better mimic the in vivo cellular environment compared with 2D monolayer cultures. A proinflammatory chondrocyte model was created by treating the chondrocytes with lipopolysaccharide and was subsequently used to evaluate the anti-inflammatory effects of vitamin D, curcumin, and resveratrol., Results: The established protocol successfully generated a large quantity of viable chondrocytes, characterized by alcian blue and toluidine blue staining, and demonstrated versatility in assessing the anti-inflammatory effects of various bioactive compounds. The chondrocytes exhibited reduced inflammation, as evidenced by the decreased tumor necrosis factor-α levels, in response to vitamin D, curcumin, and resveratrol treatment., Conclusions: Our novel protocol offers an accessible and cost-effective approach for generating chondrocytes from BMSCs and for evaluating potential therapeutic leads in the context of inflammatory chondrocyte-related diseases. Although our approach has several advantages, further investigation is required to address its limitations, such as the potential differences between chondrocytes generated using our protocol and those derived from other established methods, and to refine the model for broader applicability and clinical translation., (©Rajashree Patnaik, Shirin Jannati, Bala Mohan Sivani, Manfredi Rizzo, Nerissa Naidoo, Yajnavalka Banerjee. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 28.07.2023.)

Thallium(i) and lead(ii) ions are heavy metals and extremely toxic. These metals are environmental pollutants, posing a severe risk to the environment and human health. In this study, two approaches were examined using aptamer and nanomaterial-based conjugates for thallium and lead detection. The first approach utilized an in-solution adsorption-desorption approach to develop colorimetric aptasensors for the detection of thallium(i) and lead(ii) using gold or silver nanoparticles. The second approach was the development of lateral flow assays, and their performance was tested with thallium (limit of detection is 7.4 μM) and lead ion (limit of detection is 6.6 nM) spiked into real samples. The approaches assessed are rapid, inexpensive, and time efficient with the potential to become the basis for future biosensor devices., Competing Interests: The authors declare no conflict of interest., (This journal is © The Royal Society of Chemistry.)

Background: Ulcerative colitis (UC), a chronic inflammatory disease of gastrointestinal tract, can have initial presentation which is clinically difficult to differentiate from functional bowel disorders [irritable bowel syndrome (IBS) and irritable bowel disease (IBD)]. Conventional laboratory tests, such as erythrocyte sedimentation rate (ESR), C-reactive protein, and albumin express systemic patient responses instead of intestinal inflammation. In the last decade, fecal calprotectin, a calcium-binding protein, has been suggested as a sensitive marker of intestinal inflammation. However, only few studies have investigated its role in relation with the extent of the disease., Aim: To evaluate the usefulness of fecal calprotectin as a biomarker for disease activity in UC, its correlation with disease extent and its utility in differentiating IBS from IBD., Methods: A total of 75 patients (50 cases with colonoscopic evidence of inflammation and 25 cases with normal colonoscopic examination) were included in the study. Fecal calprotectin test was done on the day of colonoscopy. Severity of the disease was assessed by modified Mayo's endoscopy score (MMES)., Results: Age and baseline parameters were comparable in both the groups (UC and IBS). Patients in the ulcerative group had tachycardia (95 vs 74), high ESR (26 vs 20), high leukocytes count (9198 vs 8852), high fecal calprotectin (594 vs 29), low albumin (3.00 vs 3.80) and low hemoglobin (11 vs 13.40). Minimum and maximum MMES were 2 and 13.2. A significant correlation was observed between fecal calprotectin and MMES ( p -value < 0.001)., Conclusion: Fecal calprotectin is a simple, noninvasive, cost-effective marker that is strongly associated with colorectal inflammation; moreover, it has better role in the differentiation of IBD (UC) from IBS., How to Cite This Article: Acharya K, Bhardwaj V, Chuahan I, et al . Comparison of Fecal Calprotectin with Different Endoscopic Scores in the Assessment of Ulcerative Colitis (UC) Activity and Its Utility in Differentiating IBS from IBD. Euroasian J Hepato-Gastroenterol 2023;13(2):120-123., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2023; The Author(s).)

Introduction: A highly cited paper (HCP) is considered a landmark that can influence both research and clinical practice. The characteristics of HCPs in avascular necrosis of the femoral head (AVNFH) were identified and the research status was explored in a scientometric analysis., Methods: The present bibliometric analysis were based on the Scopus database from 1991 to 2021. Microsoft Excel and VOSviewer were used for co-authorship, co-citation, and co-occurrence analysis. From 8496 papers, only 2.9% (244) were HCPs, with 200.8 citations registered per article., Results: Of the HCPs, 11.9% and 12.3% were externally funded and had international collaboration, respectively. These were published in 84 journals by 1625 authors from 425 organizations of 33 countries. The USA, Japan, Switzerland, and Israel were the leading countries.The lead research organizations were Sinai Hospital and John Hopkins University (USA). The most impactful organizations were University of Arkansas for Medical Science, and Good Samaritan Hospital (USA). R.A. Mont (USA) and K.H. Koo (South Korea) were the most prolific contributing authors, while R. Ganz (Switzerland) and R.S. Weinstein (USA) registered the most impactful contributions. The most prolific publishing journal was the Journal of Bone and Joint Surgery., Conclusion: The HCPs contributed to the knowledge of AVNFH by examining research perspectives and identifying important subareas through keyword analysis., Level of Evidence: Not applicable., Trial Registration: Not applicable., (© 2023. The Author(s).)

Clinical empathy is one of the most essential tools of medical practice, and it is an act of correctly acknowledging the emotional state of another without experiencing that state oneself. Empathy comprises four components. Mounting evidence exists to support the use of clinical empathy as a tactic for effective health care. Resolving the multi-fold barriers of clinical empathy is important. Clinical empathy is very important in the current era, and a trust-based relationship in patient care is a way to optimal clinical outcomes that can be achieved through better communication and treatment-compliance plans between health care professionals and patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, B et al.)

Background: A novel, simple, efficient, rapid, and precise reverse-phase high-performance liquid chromatography (RP-HPLC) method was developed for the estimation of Tenofovir and Emtricitabine in the bulk and pharmaceutical dosage form. The currently developed method was subsequently validated according to ICH guidelines in terms of linearity, accuracy, precision, the limit of detection, the limit of quantification, robustness, etc. Methods: The separation of the selected drugs was optimized after several trials including change of mobile phase and its composition, stationary phase, flow rate, column temperature, etc. The separation was performed by using an Inertsil ODS C18 column (250 mm x 4.6 mm, 5μ) and UV absorption was measured at 231 nm. Methanol: Acetonitrile: Water was selected as the mobile phase in the ratio of 50:20:30 (V/V/V) at a flow rate of 1 mL/min. As per International Conference on Harmonization (ICH) Q2 R1 guidelines, several validation parameters were evaluated which include specificity, linearity, precision, accuracy, the limit of detection (LOD), and the limit of quantitation (LOQ)., Results: The acceptable degree of linearity range was found to be 40-100 µg/mL. The standard solution exhibited retention times of 3.06 minutes and 5.07 minutes for Tenofovir and Emtricitabine respectively. The LOD and LOQ obtained were 0.05µg/ml and 0.02µg/mL, 15µg/mL, and 0.08µg/mL for Tenofovir and Emtricitabine respectively. The percent recovery was found to be 98 to 102%., Conclusion: Hence, the proposed method is simple, selective, and specifically meets the requirements of ICH guidelines for the validation of the analytical method., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Increasing evidence supports vanillin and its analogs as potent toll-like receptor signaling inhibitors that strongly attenuate inflammation, though, the underlying molecular mechanism remains elusive. Here, we report that vanillin inhibits lipopolysaccharide (LPS)-induced toll-like receptor 4 activation in macrophages by targeting the myeloid differentiation primary-response gene 88 (MyD88)-dependent pathway through direct interaction and suppression of interleukin-1 receptor-associated kinase 4 (IRAK4) activity. Moreover, incubation of vanillin in cells expressing constitutively active forms of different toll-like receptor 4 signaling molecules revealed that vanillin could only able to block the ligand-independent constitutively activated IRAK4/1 or its upstream molecules-associated NF-κB activation and NF-κB transactivation along with the expression of various proinflammatory cytokines. A significant inhibition of LPS-induced IRAK4/MyD88, IRAK4/IRAK1, and IRAK1/TRAF6 association was evinced in response to vanillin treatment. Furthermore, mutations at Tyr262 and Asp329 residues in IRAK4 or modifications of 3-OMe and 4-OH side groups in vanillin, significantly reduced IRAK4 activity and vanillin function, respectively. Mice pretreated with vanillin followed by LPS challenge markedly impaired LPS-induced IRAK4 activation and inflammation in peritoneal macrophages. Thus, the present study posits vanillin as a novel and potent IRAK4 inhibitor and thus providing an opportunity for its therapeutic application in managing various inflammatory diseases., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest with the contents of this article., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Severe cases of COVID-19 are characterized by hyperinflammation induced by cytokine storm, ARDS leading to multiorgan failure and death. JAK-STAT signaling has been implicated in immunopathogenesis of COVID-19 infection under different stages such as viral entry, escaping innate immunity, replication, and subsequent inflammatory processes. Prompted by this fact and prior utilization as an immunomodulatory agent for several autoimmune, allergic, and inflammatory conditions, Jakinibs have been recognized as validated small molecules targeting the rapid release of proinflammatory cytokines, primarily IL-6, and GM-CSF. Various clinical trials are under investigation to evaluate Jakinibs as potential candidates for treating COVID-19. Till date, there is only one small molecule Jakinib known as baricitinib has received FDA-approval as a standalone immunomodulatory agent in treating critical COVID-19 patients. Though various meta-analyses have confirmed and validated the safety and efficacy of Jakinibs, further studies are required to understand the elaborated pathogenesis of COVID-19, duration of Jakinib treatment, and assess the combination therapeutic strategies. In this review, we highlighted JAK-STAT signalling in the pathogenesis of COVID-19 and clinically approved Jakinibs. Moreover, this review described substantially the promising use of Jakinibs and discussed their limitations in the context of COVID-19 therapy. Hence, this review article provides a concise, yet significant insight into the therapeutic implications of Jakinibs as potential anti-COVID agents which opens up a new horizon in the treatment of COVID-19, effectively., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Jain, Tailang, Jain, Chandrasekaran, Sahoo, Subramanian, Thangavel, Aldahish, Chidambaram, Alagusundaram, Kumar and Selvam.)

The purpose of this study was to compare the efficacy of oral triclofos (TRI), intranasal midazolam (INM), and intranasal dexmedetomidine (IND) in achieving successful sedation in children undergoing MRI. This open-label, three-arm, randomized trial was conducted in a tertiary care teaching hospital over 18-month period. Children scheduled for MRI were enrolled. Rate of successful/adequate sedation was assessed using the Paediatric Sedation State Scale (PSSS). The primary outcome was the efficacy (successful sedation or sedation rate) of the three drugs. One-hundred and ninety-five children were included for the MRI procedure. IND was found to be superior in terms of achieving successful sedation. INM had a shorter onset and duration of sedation compared to IND and TRI, but with an increased failure rate (88.3%). Keeping INM as the reference group, it was found that the odds of sedation increased 4.1 times on changing from INM to IND (p < 0.01), and 2.26 times on changing from INM to TRI (p < 0.01). Adverse events included nasal discomfort (18.3%) in INM group; and self-limited tachycardia (4.6%) and hypotension (10.8%) in the IND group., Conclusion: IND was more efficacious than INM or TRI for procedural sedation in children undergoing MRI without any significant adverse events., Clinical Trial Registration: CTRI/2019/01/017257; date registered: 25/01/2019., What Is Known: • Oral triclofos (TRI) and intranasal midazolam (INM) have been used for procedural sedation in children undergoing MRI with variable success; but the experience with intranasal dexmedetomidine (IND) is limited., What Is New: • IND provides more effective sedation compared to INM or TRI for procedural sedation in children undergoing MRI, without any significant adverse events., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Visceral leishmaniasis (VL) is a severe form of leishmaniasis, primarily affecting the poor in developing countries. Although several studies have highlighted the importance of toll-like receptors (TLRs) in the pathophysiology of leishmaniasis, the role of specific TLRs and their binding partners involved in Leishmania donovani uptake are still elusive. To investigate the mechanism of L. donovani entry inside the macrophages, we found that the parasite lipophosphoglycan (LPG) interacted with the macrophage TLR4, leading to parasite uptake without any significant alteration of macrophage cell viability. Increased parasite numbers within macrophages markedly inhibited lipopolysachharide-induced pro-inflammatory cytokines gene expression. Silencing of macrophage-TLR4, or inhibition of parasite-LPG, significantly stemmed parasite infection in macrophages. Interestingly, we observed a significant enhancement of macrophage migration, and generation of reactive oxygen species (ROS) in the parasite-infected TLR4-silenced macrophages, whereas parasite infection in TLR4-overexpressed macrophages exhibited a notable reduction of macrophage migration and ROS generation. Moreover, mutations in the leucine-rich repeats (LRRs), particularly LRR5 and LRR6, significantly prevented TLR4 interaction with LPG, thus inhibiting cellular parasite entry. All these results suggest that parasite LPG recognition by the LRR5 and LRR6 of macrophage-TLR4 facilitated parasite entry, and impaired macrophage functions. Therefore, targeting LRR5/LRR6 interactions with LPG could provide a novel option to prevent VL., (© The Author(s) 2023. Published by Oxford University Press on behalf of FEMS.)

More than two hundred years ago, taurine was first isolated from materials derived from animals. It is abundantly found in a wide range of mammalian and non-mammalian tissues and diverse environments. Taurine was discovered to be a by-product of the metabolism of sulfur only a little over a century and a half ago. Recently, there has been a renewed academic interest in researching and exploring various uses of the amino acid taurine, and recent research has indicated that it may be useful in the treatment of a variety of disorders, including seizures, high blood pressure, cardiac infarction, neurodegeneration, and diabetes. Taurine is currently authorised for the therapy of congestive heart failure in Japan, and it has shown promising results in the management of several other illnesses as well. Moreover, it was found to be effective in some clinical trials, and hence it was patented for the same. This review compiles the research data that supports the prospective usage of taurine as an antibacterial, antioxidant, anti-inflammatory, diabetic, retinal protective, and membrane stabilizing agent, amongst other applications., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Tempol (TP) was introduced in 1960 by Lebedev and Kazarnovskii and is an excellent catalyst extensively used in the synthesis and oxidation of various reagents. 4-Hydroxy-2,2,6,6- tetramethylpiperidin-1-oxyl (TP) has also been explored against various disorders like inflammation, superoxide anion-influenced molecular linked behavioural modifications, radical capturing, cardioprotective, protective ocular damage, against skin burns, fibrocystic diseases, breast cancer prevention, respiratory infections, alopecia, and cerebral malaria, etc. This review article comprises five major aspects of TP namely (a) Approx. 25 different Synthesis schemes of TP (b) major reactions catalysed by TP (c) Therapeutic potential of TP. It also provides scientific information that supports the use of TP which may be proven as a "MIRACLE" drug for the treatment of numerous disorders namely in reducing the reactive oxygen species, superoxide mutases, vision disorders, cancer as well as in covid. It also possesses a significant role in minimising side effects in combination therapy. This review will be beneficial to researchers, healthcare, and academic professionals for further research., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Right from the breakthrough of carbapenems since 1976, many schemes on synthesis, structure-activity relationship (SAR), and biological activities have been carried out, and several carbapenems have been developed, including parentally active carbapenems like imipenem, doripenem, biapenem, meropenem, ertapenem, panipenem, razupenem, tomopenem, and cilastatin, whereas orally active carbapenems like GV-118819, GV-104326, CS-834, L-084, DZ-2640, CL 191, 121, L-646, 591, S-4661, ER-35768, MK-826. Prodrugs of carbapenem with increased bioavailability include temopenem, tebipenem, sanfetrinem, LK-157, and CP 5484. Merck, Glaxo Welcome Research Group, Johnson & Johnson, Sankyo Group and Dai-ichi Group, and Wyeth-Ayerst Group were among the businesses that produced carbapenems. In this review Witting reaction, Mitsunobu reaction, Dieckmann reaction, palladium-catalyzed hydrogenolysis, E. coli-based cloned synthesis, as well as biosynthetic enzymes such as carbapenem synthetase (carA), carboxymethylproline synthase (carB), carbapenem synthase (carC) are included. Carbapenems are biologically mainly active in the infections like urinary tract infections, bloodstream infections, tuberculosis, intra-abdominal infections, and pathogens like anaerobes, gram-positive and gram-negative bacteria., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Homegarden (HG) agroforestry combines biological carbon (C) sequestration with biodiversity conservation outcomes. Although C stocks and species richness of HGs vary along elevational gradients and as a function of holding sizes, there is no consensus on the nature and magnitude of such variations. Field studies were conducted in the Western Ghats region of central Kerala, India (180 homesteads in 20 selected panchayats), to evaluate the effects of elevation (near sea level to 1938 m) and garden size (162-10,117 m 2 ) on aboveground C stocks and floristic diversity. The C stocks (per unit area) of HGs (arborescent species) were highly variable (0.63-93.65 Mg ha -1 ), as garden management was highly individualistic and it exhibited a weak negative relationship with elevation. Likewise, there was a weak negative relationship between C stocks and garden size. Tree stocking levels (stems/garden) and species richness (species/garden) positively impacted total C stocks per garden. Floristic diversity was high in the study area (753 species) and included many rare and endangered species (43 IUCN Red-Listed species) making homegardens circa situm reservoirs of biodiversity. Elevation and holding size exerted a weak negative linear relationship on Simpson's floristic diversity index, which ranged from 0.26 to 0.93 for the arboreal species. Homegardens, regardless of elevation or size, contribute to C sequestration and agrobiodiversity conservation and help achieve the UN Sustainable Development Goals (SDGs), particularly Climate Action (SDG-13) and conserving agrobiodiversity (SDG-15, Life on Land)., Competing Interests: Conflict of interestThe author declares that he has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The author further declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© The Author(s), under exclusive licence to Springer Nature B.V. 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)