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Abstract Background The pivotal intent of this study was to investigate the medicinal potential of synthesized nanotransferosomes utilizing Clerodendrum serratum L. hydroalcoholic extract (CS-NTs). Three batches, CS-NTs 25, CS-NTs 50, and CS-NTs 100, were formulated using the thin-film hydration approach with varying concentrations of phospholipids (soya phosphatidylcholine) at 25, 50, and 100 mg, respectively, to evaluate their efficacy against skin cancer cell lines. Several analytical approaches, such as UV/Vis spectroscopy, XRD spectra, FTIR, TEM, SEM, particle size distribution, and zeta potential analysis, were employed to assess the synthesized CS-NTs. Results Experimental results revealed that CS-NTs exhibited a circular shape, with average vesicle sizes approximately measured at 463.6 ± 100.5 nm, 265.5 ± 61.6 nm, and 409.6 ± 106.2 nm for CS-NTs 25, CS-NTs 50, and CS-NTs 100, respectively. Notably, biologically synthesized CS-NTs 25 offer potential anticancer benefits against B10F16 (skin cancer cell line) cells, exhibiting no signs of adverse effects. The heightened biological potential of CS-NTs can be ascribed to their unique characteristics at the nanoscale, characterized by an average vesicle size and lower polydispersity value, which facilitate augmented responsiveness and interactions with biological systems. Conclusion CS-NTs 25 formulated through the biogenic process using C. serratum hydroalcoholic plant root extract hold significant potential for anticancer activity. Graphical abstract

Current endeavors are being made to develop substitute asphalt binders using different biomass sources for upcoming flexible pavement construction, propelled by sustainability and the escalating expenses of traditional petroleum-centered asphalt. The primary objective of this research is to explore the feasibility of employing activated carbon (ATC) produced from biowaste, specifically walnut shells and sawdust, as a modification for petroleum-based virgin asphalt binders through chemical, physical, and rheological assessments. A comprehensive array of evaluations was carried out, encompassing examinations of homogeneity, physical characteristics, Carbon, Hydrogen, Nitrogen, Sulphur, and Oxygen (CHNSO) analysis, proximate analysis, infrared spectroscopy, multiple stress creep and recovery (MSCR), rheological attributes, and temperature sweep. The CHNSO analysis provided the elemental composition and helped develop molecular formulas for ATC. The results show that binders modified with ATC exhibited a heightening carbon content proportionate to the AC ratio, analyzed at 5%, 10%, and 15%. Temperature sweep tests revealed that adding AC significantly increased binder stiffness in accordance with the complex modulus (G*) and phase angle (δ). This increased rigidity from the ATC modification declines the temperature susceptibility of the modified binders.

Transportation demands in developing countries necessitate the use of underground infrastructure, notably tunnels, which also serve as storage spaces for vehicles and military equipment, expanding their utility. Mega Tunnels, defined as those with a diameter exceeding 10m, offer diverse functionalities, including facilitating the storage and movement of large equipment and establishing comprehensive operational systems for urban areas. However, ensuring the stability of these tunnels’ faces poses a significant challenge due to their larger diameter, making it a crucial research focus. This study investigates the impact of various geological strength variables, such as Young’s modulus and coefficient of lateral earth pressure, on Mega Tunnel face stability. Employing the numerical analysis-based computational tool Midas Gts Nx, three-dimensional modelling was conducted to analyze Mega Tunnels. A parametric study involving approximately 40 models was undertaken, focusing on key locations including the crown, invert, and vertical sidewalls. Variable parameters such as critical cover-to-diameter ratio (C/D), Young’s modulus, and coefficient of lateral earth pressure were examined. The findings highlight the significant influence of geological strength characteristics on tunnel face stability prediction. This research offers valuable insights for the planning and design of Mega Tunnels in urban areas during the preplanning phase, enhancing their efficiency and effectiveness.

Background: Carbonic anhydrase II (CA II) deficiency is a rare autosomal recessive genetic disorder presenting with the characteristic triad of osteopetrosis, renal tubular acidosis (RTA), and intracerebral calcifications. However, the spectrum of mutations and clinical features varies. Objectives: A systematic review of case reports was done to describe the clinical spectrum and genetic mutations of children reported with carbonic anhydrase deficiency. Methods: A comprehensive search was done in major databases, using defined search terms. The identified reports underwent screening by different authors as per inclusion and exclusion criteria. Results: Twenty-two children (median age: 5 years) with genetically proven CA II deficiency were included, mostly males, all having RTA, classic triad being present in 64%. Over half of them had global developmental delay and one-third had vision and hearing defect, each. The most common mutation was c. 232 + 1 G >T, followed by del 12/ins4 at codon 211, seen in 9 (41%) and 4 (18%) children, respectively. Conclusion: Not all children with CA II deficiency present with triad, though RTA is present universally, c. 232 + 1 G >T being the most common variant in CA2 gene.

Background: Positive patient care attitudes for mental illness cases must be developed in the early stages of medical education since those affected by mental illness or having some mental disorder suffer negative attitudes from other people in the community. Earlier studies identified several factors that affect medical students' attitudes toward patients with mental illnesses. Purpose: The purpose of the study was to determine the attitude of medical students toward patients of mental illness. Methods: In this cross-sectional study using convenience sampling, 3rd and 4th year medical students (220) were assessed for attitudes toward mental illness using a pretested and pre-designed questionnaire which included details of socio-demographic variables such as age, gender, year of study, personal experience with mental illness, family history of mental illness or having direct contact with mental illness cases and knowledge about mental illness. Percentage and proportion were calculated, and the chi square test was applied to assess significance of the results. Results: The factors significantly associated with medical students’ attitudes toward mental illness were age, year of study, and knowing or having direct contact with mental illness patients. Those knowing mental illness cases in their family or friends had good attitude toward such patients. Conclusion: Education and direct contact with cases of mental illness serve as intervention strategies to reduce negative attitudes associated with mental illness among medical students.

Objective: To provide comprehensive information about barriers to using dental services in India. Material and Methods: Original research articles published on factors and(or) barriers to dental and oral health care services utilization were extracted from four electronic databases such as Scopus, PubMed, Web of Science, and EMBASE. The selection process involved looking for English-language articles published between 2005 and 2023 that addressed one or more areas of dental and oral health care barriers in India. Selected articles were analysed using thematic analysis. Results: 188 original studies were retrieved from the four databases, and 23 were extracted. The barriers to dental and oral health care service utilization were classified into three major themes: sociodemographic factors, dental care access, and individual factors. The findings of the selected articles showed that the high cost of dental care, educational level, fear of dental treatment, poor perception about teeth, and(or) lack of felt need and lack of time were the most frequently reported barriers. Conclusion: Appropriate utilization of dental and oral health care services was one of the key principles in achieving "Health for All."Dental care delivery systems should address the barriers to its utilization by incorporating policies to overcome the utilization barriers and community-based oral health awareness programs.

Introduction Shisha tobacco use is gaining popularity around the world, especially among young people and college students. Shisha users are exposed to many of the same harmful substances as cigarette smokers but at much higher levels, which could have more serious adverse health impacts. The aims of this study were to: 1) determine the patterns of shisha smoking among university students in the Northern Province of Saudi Arabia; 2) identify the reasons for using shisha tobacco; and 3) ascertain whether usage of shisha smoking differs by their sociodemographic characteristics. Methods A cross-sectional survey was conducted among students of seven different colleges at a public university between October and December 2022. A modified version of the Global Youth Tobacco Survey questionnaire was used to collect information specifically on shisha smoking. After adjusting for confounding variables, a logistic regression analysis was used to determine the related factors. Results A total of 418 participants were included in the study. Of the studied population, shisha smoking was seen in 73.7% (n=308). Out of 308 shisha smokers, 208 (67.5%) had their first session of shisha smoking within the past two years; 34.4% of participants had used it in the past 30 days (current users), of which 27.4% had smoked shisha from 1 to 7 days during the past 30 days. The majority of respondents (63.6%) reported having friends that smoke. The most popular flavor among respondents (24.6%) was apple. For quitting attempts, 46.4% reported a 24-hour quit attempt in the previous year. Stress (23.0%) was reported as the main reason for beginning shisha use. Shisha smoking was significantly associated with age (Ref. 18–20 years; 24–26 years, AOR=0.08; 95% CI: 0.02–0.33, p

Background: Several sporadic cases and outbreaks of Zika virus disease have been reported from different states of India. Objectives: This paper explored the possibility of any ongoing transmission of Zika virus (ZIKV) in the Bhopal region of Central India, where the last outbreak of this disease was reported in 2018. Materials and Methods: We screened a group of 75 febrile patients who had already tested negative for the locally endemic causes of fever like dengue, chikungunya, enteric fever, malaria, and scrub typhus and two groups of asymptomatic healthy individuals represented by blood donors (n = 75) and antenatal mothers (n = 75). We tested blood samples of febrile patients for ZIKV RNA using real-time polymerase chain reaction (PCR), and for the healthy individuals, we determined anti-zika immunoglobulin G (IgG) antibodies using enzyme-linked immunosorbent assay. Results: ZIKV RNA was not detected in any of the 75 samples tested by real-time PCR assay. Among the voluntary blood donors and antenatal mothers, a total of 10 (15.38%) and 5 (6.66%) individuals were found to be seropositive for anti-ZIKV IgG antibodies, respectively. The seropositive group was found to have higher age 33.06 (±10.83) years as compared to seronegative individuals 26.60 (±5.12) years (P = 0.037). Conclusion: This study, which is the first survey of seroprevalence of anti-Zika antibodies from India, reports an overall seropositivity rate of 10% for anti-Zika antibodies among the healthy population, suggesting an ongoing, low level, silent transmission of ZIKV in the local community.

Introduction: Rabies is a zoonotic disease that can be fatal and continues to impose a significant financial burden on developing countries. Recently, there have been advancements in the introduction of cell culture vaccines and immunoglobulin, as well as the approval of Intradermal (ID) schedules for vaccine administration. Aim: To assess the knowledge of doctors in Rewa District regarding the National Guidelines for Rabies Prophylaxis in 2019. Materials and Methods: A cross-sectional study was conducted, involving doctors from tertiary healthcare centres, district hospitals, and private practices. Data were collected over a period of one month from 206 doctors using a Google form, which included information about their field of practice and their knowledge of recent guidelines on Rabies prophylaxis. Data analysis was performed using the Chi-square test. Results: Out of the 206 doctors surveyed, 92 (44.7%) were male. A 56.7% of the doctors were aware of the regimen and dosage for ID administration of the Anti Rabies Vaccine, (ARV) and 44.6% were knowledgeable about the modification of Post-Exposure Prophylaxis (PEP) to Pre-Exposure Prophylaxis (PrEP) in the Essen regimen. Furthermore, 70.9% of the doctors were familiar with the dosage of Human Rabies Immunoglobulin (HRIG), while 42.7% knew how to manage animal bites in immunocompromised patients. Conclusion: The study revealed a lack of sufficient knowledge on various aspects of rabies management among the doctors surveyed. This underscores the need for reorientation programs and Continuing Medical Education (CMEs) training to be provided to doctors to enhance their knowledge of rabies and improve the effective management of animal bites.

Introduction: Subarachnoid Block (SAB) with Hyperbaric Bupivacaine (HB) is the most common anaesthetic technique for Lower Segment Caesarean Section (LSCS). Levo-bupivacaine, an enantiomer of racemic bupivacaine, has been developed to provide anaesthesia with the same effectiveness but with better haemodynamic stability. Aim: To compare the effectiveness of hyperbaric levo-bupivacaine to HB in achieving sensory and motor blocks in Caesarean Section(CS) using equivalent doses. Materials and Methods: Eighty parturients aged 18-38 years with no co-morbidities were randomly divided into two groups receiving equivalent doses of HB and hyperbaric levo-bupivacaine for SAB. The effectiveness of the two drugs was compared in terms of the time taken to achieve sensory and motor blocks, as well as the time for block regression for two segments for sensory block and the return of motor block assessed by the ability to flex the ankle joint. Adverse events such as a fall in Systolic Blood Pressure (SBP) and the dose of vasopressor were noted for the two groups. Results: The time taken to attain a T6 dermatomal block level was 2.43±1.00 and 2.80±1.51 (p-value 0.08) for the bupivacaine and levo-bupivacaine groups, respectively. Complete motor block of the lower limb was achieved in 4.85±1.67 and 5.15±1.82 (p-value 0.53). However, the time to 2-segment regression for sensory block was significantly faster in the levo-bupivacaine group than in the bupivacaine group (125.9±28.56 minutes and 109.13±28.84 minutes, respectively, p-value 0.009). Regression from motor block was also found to be highly statistically significant (158.38±34.92 minutes for bupivacaine and 138.75±25.71 minutes for the levo-bupivacaine group, p-value 0.006). Spinal-induced hypotension was comparable in both groups, but the bupivacaine group needed a much higher repetition of dose of vasopressor than the levo-bupivacaine group. Conclusion: Levo-bupivacaine is comparable to its racemic isomer bupivacaine in achieving anaesthesia when administered Intrathecally (IT) for CS. However, with equivalent doses, the duration of action is significantly shorter with hyperbaric levo-bupivacaine. Dose adjustment might be required with hyperbaric levo-bupivacaine based on the duration of the surgery. Haemodynamic stability is also similar with both drugs.