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Pneumonia stands as a serious global health hazard that kills millions of lives annually, especially among susceptible populations such as the elderly and young children. Timely and accurate detection is paramount for initiating prompt intervention and improving patient prognoses. This article explores the transformative impact of deep learning on pneumonia diagnosis, emphasizing their pivotal role in revolutionizing the field. It specifically focuses on how these technologies are changing pneumonia diagnosis through intricate and advanced image analysis techniques. Using transfer learning with pre-trained models like ResNet50, MobileNetV2, AlexNet, EfficientNetB0, and Xception, the study focuses on automated pneumonia detection from X-ray images. It studies the efficacy of Contrast Limited Adaptive Histogram Equalization (CLAHE) and cross-validation techniques to enhance model performance. Results highlight the profound impact of deep learning models, with EfficientNetB0 consistently outperforming others, attaining test accuracy of 99.78% and perfect scores (100%) in precision, recall, F1-score, and 99.54% specificity. The study also highlights the importance of data preprocessing and rigorous evaluation methodologies in achieving remarkable accuracy in pneumonia detection. The study also highlights the importance of data preprocessing and rigorous evaluation methodologies in achieving remarkable accuracy in pneumonia detection. Our work shows superior performance in chest X-ray classification with other state-of-the-art models. Real-time analysis can be made possible by implementing these models in web-based or mobile apps, particularly in situations when resources are scarce or remote.

Microbial desalination cell (MDC) can treat wastewater and saline water simultaneously and generate power. The aim of the present research work was to identify the critical factors influencing COD reduction and power generation from the MDC reactor and to optimize the control parameters. The experimental study was conducted by using medium to high-strength wastewater from distillery and brewery industry in batch-wise operation. The maximum voltage of 702 mV and current of 2.16 mA were observed for the carbon brush electrode. The mediated aeration process with the presence of potassium ferricyanide was reported in 87% COD reduction and 992 mV voltage generation. The presence of the microbial culture provided 82% COD reduction and 51% TDS reduction. The maximum current density (CD) of 0.04 mA/cm2 was observed for carbon brush, and a maximum power density (PD) of 15.56 mW/cm2 was found with aeration and potassium ferricyanide mediator. This study provided insight towards the impact of the electrode materials and the effects of mediator, aeration, and microbial culture on MDC performance. HIGHLIGHTS Effect of different mediators and microbial culture on the desalination efficiencies.; Effect of different electrode materials on power generation.; Variation profile of pH in anode, desalination chamber, and cathode chamber.; Morphological study on the microbial growth on electrodes, AEM, and CEM.;

Abstract Background Sunlight contains ultraviolet B (UVB) radiation that triggers the production of vitamin D by skin. Vitamin D has widespread effects on brain function in both developing and adult brains. However, many people live at latitudes (about > 40 N or S) that do not receive enough UVB in winter to produce vitamin D. This exploratory study investigated the association between the age of onset of bipolar I disorder and the threshold for UVB sufficient for vitamin D production in a large global sample. Methods Data for 6972 patients with bipolar I disorder were obtained at 75 collection sites in 41 countries in both hemispheres. The best model to assess the relation between the threshold for UVB sufficient for vitamin D production and age of onset included 1 or more months below the threshold, family history of mood disorders, and birth cohort. All coefficients estimated at P ≤ 0.001. Results The 6972 patients had an onset in 582 locations in 70 countries, with a mean age of onset of 25.6 years. Of the onset locations, 34.0% had at least 1 month below the threshold for UVB sufficient for vitamin D production. The age of onset at locations with 1 or more months of less than or equal to the threshold for UVB was 1.66 years younger. Conclusion UVB and vitamin D may have an important influence on the development of bipolar disorder. Study limitations included a lack of data on patient vitamin D levels, lifestyles, or supplement use. More study of the impacts of UVB and vitamin D in bipolar disorder is needed to evaluate this supposition.

BACKGROUND: Due to the physical demands of work, blue-collar workers (BCW) frequently experience fatigue, musculoskeletal pain, and burnout. The purpose of this study was to determine the feasibility and utility of introducing yoga-based loosening exercises (YLE) at the workplace for improving fatigue, musculoskeletal pain, and burnout among BCW. MATERIALS AND METHODS: One hundred and twenty-eight BCW were randomized into a yoga group that received 40 minutes of supervised YLE daily, 5 days a week, for 1 month, followed by 1 month of unsupervised practice at home or a waitlisted control group. The Chalder Fatigue Scale (CFS), Visual Analog Scale for pain, Oldenburg Burnout Inventory (OLBI), sit-and-reach test (SRT), handgrip strength dynamometer, and the Short Form-8 (SF-8) questionnaire were measured at baseline, at the end of the first month, and at follow-up after the first month. RESULTS: All the participants adhered well to the YLE (≈86% at the workplace, ≈70% at home). Compared to the controls, the yoga group reported significant reductions in fatigue, pain, and burnout and significant improvements in flexibility, strength, and quality of life (P < 0.001) at all the time points. CONCLUSION: Our findings demonstrate that workplace yoga programs for BCW are feasible and can considerably reduce fatigue, pain, and burnout and improve their quality of life.

MYB98 is master regulator of the molecular network involved in pollen tube attraction. Until recently, it was unclear how this gene exhibits exclusively synergid cell-specific expression in ovule. Our recent study has established that a 16-bp-long SaeM element is crucial for its synergid cell-specific expression in ovule, and an 84-bp-long fragment harboring SaeM is sufficient to drive the process. In this study, we have developed a workflow to predict functional roles of potential transcription factors (TFs) putatively binding to the promoter region, taking MYB98 promoter as a test subject. After sequential assessment of co-expression pattern, network analysis, and potential master regulator identification, we have proposed a multi-TF model for MYB98 regulation. Our study suggests that ANL2, GT-1, and their respective homologs could be direct regulators of MYB98 and indicates that TCP15, TCP16, FRS9, and HB34 are likely master regulators of the majority of the TFs involved in its regulation. Comprehensive studies in the future are expected to offer more insights into such propositions. Developed workflow can be used while designing similar regulome-related studies for any other species and genes.

Background: Suicide is a serious mental health problem in India, and suicide rates in India have risen over the past decades. Reporting of suicide by the media is a common cause for spurts of suicides that may occur. Methodology: Suspected suicide by the renowned actor Sushant Singh Rajput was selected as the reference case. The top two Indian daily newspapers published in English having the highest circulation as per data provided by the Registrar of Newspapers, Government of India, were selected to be part of the study. The authors screened all news stories in the two newspapers within a 6-month period (3 months prior and 3 months post the date of the reference suicide case), and these news reports were evaluated as per the suicide reporting guidelines for media laid down by the Indian Psychiatric Society. The data were analyzed using Chi-square test and descriptive statistics where appropriate. Results: Our search yielded 158 articles from a period of 6 months, with 50 articles published before the suspected celebrity suicide and 108 published after. 29.7% had the word suicide in headline, 14.6% of them had news printed on the first page, 17.7% had a suicide note mentioned, whereas 1.9% mentioned prior attempts by victim. Conclusions: There is no change in media trend toward reporting suicide as noted following postcelebrity suicide, and so it is essential that media follow guidelines stringently when reporting a serious problem like suicide.

Abstract Background Adolescents with depression need access to culturally relevant psychological treatment. In many low- and middle-income countries treatments are only accessible to a minority. We adapted group interpersonal therapy (IPT) for adolescents to be delivered through schools in Nepal. Here we report IPT's feasibility, acceptability, and cost. Methods We recruited 32 boys and 30 girls (aged 13–19) who screened positive for depression. IPT comprised of two individual and 12 group sessions facilitated by nurses or lay workers. Using a pre-post design we assessed adolescents at baseline, post-treatment (0–2 weeks after IPT), and follow-up (8–10 weeks after IPT). We measured depressive symptoms with the Depression Self-Rating Scale (DSRS), and functional impairment with a local tool. To assess intervention fidelity supervisors rated facilitators' IPT skills across 27/90 sessions using a standardised checklist. We conducted qualitative interviews with 16 adolescents and six facilitators post-intervention, and an activity-based cost analysis from the provider perspective. Results Adolescents attended 82.3% (standard deviation 18.9) of group sessions. All were followed up. Depression and functional impairment improved between baseline and follow-up: DSRS score decreased by 81% (95% confidence interval 70–95); functional impairment decreased by 288% (249–351). In total, 95.3% of facilitator IPT skills were rated superior/satisfactory. Adolescents found the intervention useful and acceptable, although some had concerns about privacy in schools. The estimate of intervention unit cost was US $96.9 with facilitators operating at capacity. Conclusions School-based group IPT is feasible and acceptable in Nepal. Findings support progression to a randomised controlled trial to assess effectiveness and cost-effectiveness.

Traditional medicine practitioners (TMPs) are a critical part of healthcare systems in many sub-Saharan African countries and play vital roles in caring for patients with cancer. Despite some progress in describing TMPs' caring experiences in abstract terms, literature about practice models in Africa remains limited. This study aimed to develop a substantive theory to clarify the care provided by TMPs to patients with cancer in Uganda. This study adhered to the principal features of the modified Straussian grounded theory design. Participants were 18 TMPs caring for patients with cancer from 10 districts in Uganda, selected by purposive and theoretical sampling methods. Researcher-administered in-depth interviews were conducted, along with three focus group discussions. Data were analyzed using constant comparative analysis. The core category that represented TMPs' meaning of caring for patients with cancer was "Restoring patients' hope in life through individualizing care." TMPs restored patients' hope through five main processes: 1) ensuring continuity in the predecessors' role; 2) having full knowledge of a patient's cancer disease; 3) restoring hope in life; 4) customizing or individualizing care, and 5) improving the patient's condition/health. Despite practice challenges, the substantive theory suggests that TMPs restore hope for patients with cancer in a culturally sensitive manner, which may partly explain why patients with cancer continue to seek their services. The findings of this study may guide research, education, and public health policy to advance traditional medicine in sub-Saharan Africa.

Abstract Background Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun’s electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p

India consists of 16% of the world's population, but sustains only 2.4% of land resources. The agriculture sector is the only livelihood to two-third of its population, which gives employment to 57% of the workforce and is a raw material source to a large number of industries. Farmer suicides account for approximately 10% of all suicides in India. The national suicide rate is 10.6/lac, whereas in Maharashtra it is 14.2/lac, in Andhra Pradesh 12.1/lac, in Telangana 27.7/lac, and in Chhattisgarh 27.7/lac. The National Crime Records Bureau data from 1995 to 2006 show that 200,000 farmers had committed suicide, with an average rate of 16,000/year. Every 7th suicide in the country is a farmers' suicide. The first state where suicides were reported was Maharashtra with particularly in the Vidarbha region. In Maharashtra, farmers' suicide rate is 60% higher than the general suicide rate. Every 5th farmers' suicide committed in the country had occurred in Maharashtra, Vidarbha being a particularly sensitive region but also in Punjab, Uttar Pradesh, Kerala, and Karnataka. In a country of 70 million farmers, 10 in every 100,000 farmers commit suicide. Many inquiry commissions were formed and recommendations were implemented, especially in Punjab. The problem of suicide is not only reported in India but also reported in different parts of the world like England and Wales. We adopted the psychological autopsy approach to offer some insight into the reason why these individuals resorted to such a drastic step.

Introduction: As the global climate is undergoing significant changes, the incidence of natural disasters of various characters and intensity is on the rise. Many direct and indirect mental health impacts have been observed as an aftermath of these disasters. The study attempts to assess the psychiatric symptoms prevalent among disaster-affected individuals, 4–6 months after the impact. Methods: A community based cross-sectional survey was conducted 4–6 months after a flood in Kodagu (Coorg) district of Karnataka state. 171 randomly selected samples were assessed. Demographic details and disaster experiences were collected and symptoms psychiatric disorders were evaluated. The data were entered into Microsoft Excel and analyzed using SPSS version 23 software. The descriptive data were presented in percentages and bar charts appropriately. Categorical data were presented in tables tests for significance were done appropriately. Results: The prevalence of psychiatric symptoms among residents of flood-affected areas was 66.7%. The major symptoms detected were that of Depression, Anxiety, Somatic disorders, Sleep problems and Substance abuse. Leaving the house during the disaster and damage to the house were found as the most important factors influencing the development of these symptoms. Conclusion: The Prevalence of psychiatric symptoms in the district, was high and hence more community-based activities should be designed by the health department to address this problem. The symptoms were significantly higher among people who stayed in flood relief camps and faced partial or complete damage to their house. These people should be identified to prevent further development of illness.

Abstract Background Studies on several preclinical models of type 2 diabetes mellitus have been conducted to establish the hypoglycemic activity of Momordica charantia L. Concerned with appropriateness of these models, we designed a systematic review to establish the efficacy and safety of M. charantia L. in preclinical models of type 2 diabetes mellitus. Methods Review authors will search without language restriction in MEDLINE/PubMed, Web of Science, Embase, Scopus, and CINAHL databases through April 2019. Search filters will be applied to enhance search efficiency. The authors will search for gray literature in Google and Google Scholar, OpenGrey, and ProQuest Dissertations & Theses. Two authors will evaluate full texts, extract data, and asses risk of bias independently. The review will include randomized or non-randomized studies that assessed the efficacy or safety of M. charantia L. with vehicle control group. The primary endpoint will be fasting blood glucose level. We will use Egger’s test to assess publication biases. Chi-square test and I 2 will be used to assess heterogeneity in effect size of the primary outcome. Using RevMan software version 5.3, the authors will perform a meta-analysis of quantitative data. Discussion The strength of evidence will be rated as high, moderate, low, or very low using GRADE framework for animal studies. This systematic review will potentially improve research practice by identifying risks of bias and design features that compromise translatability and contribute to evidence-based clinical trial design. Systematic review registration PROSPERO CRD42019119181

The gel electrolyte significantly influences gel valve-regulated lead acid battery performance. To address this, the paper describes the preparation of novel polymer gel electrolytes using poly (vinyl alcohol) (PVA) and tetraethylorthosilicate (TEOS) for valve-regulated lead–acid batteries. FTIR technique is used to confirm the chemical reaction between PVA and TEOS. Electrochemical analyses such as cyclic voltammetry and electrochemical impedance spectroscopy were applied to optimize the concentration of PVA-TEOS polymer gel electrolyte. The optimum concentration of polymer gel electrolyte was determined as 20 wt% of TEOS in PVA (PE-1) with higher anodic peak and lower Rs and Rct values. The Galvanostatic charge–discharge tests were performed on the optimized gel system prototype battery. The highest capacity of 6.86 × 10−5 Ah at a current density of 0.2 mA cm−2 was achieved with an excellent capacity retention ratio of 85.7% over 500 cycles. The exceptional cycle performance and high capacity make PVA-TEOS gel electrolyte a promising candidate for practical battery application.

: BACKGROUND: Sleep-disordered breathing (SDB) is characterized by upper airway dysfunction and is linked to severe health issues. Individuals with SDB have distinct craniofacial morphology for which orthodontists are most suitable for the management due to their dental expertise. AIM: This study aims to discern key differences in dental parameters between individuals with and without SDB. METHODS: The present study is a cross-sectional observational study conducted for 12 months. Out of 70 participants, 35 were placed in the SDB group as per the Berlin questionnaire (BQ) and 35 in the control aged 18-22 years. Criteria excluded individuals with preexisting illnesses, missing teeth, tonsillectomy, orthodontic or jaw surgeries, cleft lip/palate, or craniofacial anomalies. Dental assessments included interdental width, palatal vault depth and shape, molar relation, overjet, and overbite. In addition, self-perceived orthodontic treatment needs were evaluated as a secondary measure. RESULTS: In the SDB group, interdental distances were significantly reduced in the canine, first premolars, second premolars, and molar regions by 2, 3, 4, and 1.8 mm, respectively. A noticeable V-shaped arch was observed. Overjet and overbite increased by 42.85 and 31.42, respectively, with Class 1 malocclusion more prevalent than Class 2. The Berlin questionnaire identified 54.3 as high-risk SDB. The Index of Orthodontic Treatment Need-Esthetic Component (IOTN-AC) revealed that 68.6 of snoring participants required orthodontic treatment. CONCLUSION: Individuals with SDB exhibit a constricted maxilla and reduced interdental measurements, indicating a moderate risk. The Berlin questionnaire proves valuable in assessing SDB severity. Moreover, individuals displaying signs of SDB often present a high prevalence of orthodontic treatment needs, as indicated by the IOTN-AC. Keywords: Index of Orthodontic Treatment Need, mouth breathing, questionnaire, sleep, sleep apnea syndromes, sleep disorder, Author(s): Dipasha K. Rao [1]; Bhagyalakshmi Avinash [1]; T. M. Amulya [2]; B. S. Prakash [2]; N. Raghunath [1]; Vidya G. Doddawad (corresponding author) [3] Sleep-disordered breathing (SDB), characterized by [...]

Aqueous fruits extract of Abelmoschus esculentus (L.) Moench (Malvaceae) has been used traditionally in several communities to alleviate elevated blood glucose levels. However, optimized extraction conditions have not been reported. Thus, this study determined the optimal extraction conditions for extracting polyphenols from A. esculentus fruits and evaluated antihyperglycemic activity in vivo. Extraction time, temperature, and solid-to-solvent ratio were optimized using Response Surface Methodology (RSM). Total polyphenols and flavonoids were quantified using the Folin-Ciocalteu and aluminium chloride colorimetric methods, respectively. The fingerprint and quantification of quercetin-a major flavonoid with an antihyperglycemic effect was done using the chromatographic method. The antihyperglycemic activity was determined in a high-fat diet-Streptozotocin rat model. The rats were assigned to five groups (n = 6): Group 1 and 2 were normal and diabetic control received distilled water 1 mL/100g; Treatment group 3 and 4 received standardized A. esculentus fruit extract (AEFE) at a dose of 100 and 200 mg/kg, respectively; Group 5 received 5 mg/kg glibenclamide. All treatments were given orally for 14 days. Measurements of fasting plasma glucose (FPG) and body weight were done weekly. The RSM quadratic model predicted total polyphenols of 22.16 mg GAE/g DW. At optimal conditions of a solid-to-solvent ratio of 5%, extraction time 1 h, and extraction temperature of 70°C, confirmation experiments yield 20.2 [95% CI; 16.7 to 27.6] mg GAE/g DW, implying the model successfully predicted total polyphenols. The extract HPLC fingerprint showed 13 characteristic peaks with 0.45 ± 0.02 μg/g DW of quercetin. Compared with diabetic control, the standardized AEFE reduced FPG level dose-dependently (P < 0.001) with an EC50 of 141.4 mg/kg. Together, at optimal extraction conditions, extract with a high content of total polyphenols and good antihyperglycemic activity can be obtained. Studies are needed to identify additional polyphenolic compounds and determine their antidiabetic effects.

The study was undertaken to estimate the genetic parameters, direct and correlated responses for the test day and lactation milk yield in Frieswal cattle. Data on 9,955 daily milk yield records of 973 Frieswal cows calved during 2005 to 2014 at Ambala and Meerut dairy farms were utilized. The variance components, heritability estimates, genetic and phenotypic correlations for all the 11 traits were estimated simultaneously by fitting multi-trait animal model using the Wombat program of Meyer (2006) with contemporary groups as fixed effect, the additive genetic random effects, linear and quadratic regressions of covariate age at first calving and linear regression of covariate first lactation length. The expected genetic gain (DG), correlated response (CR) in cumulative 305-day yield and vice versa and the relative efficiency (RE %) of selection based on different test day yields were estimated. The results revealed lower additive genetic variance and heritability estimates for different test days and cumulative 305-day yield. The genetic correlations between the test days up to 225 and cumulative 305-days were higher which indicated the positive relationship between these traits. The higher correlated responses in cumulative 305- day yield estimated through the selection for TD135, TD165 and TD45, in that order indicated that early selection of sires using test day records would be efficient in genetic improvement for lactational milk yield in Frieswal breed of cattle.

Introduction Patient rights are “those rights that are attributed to a person seeking healthcare”. Patient rights have implications for quality of healthcare and acts as a key accountability tool. It can galvanise structural improvements in the health system and reinforces ethical healthcare. States are duty bound to respect, protect and promote patient rights. The rhetoric on patient rights is burgeoning across the globe. With changing modes of governance arrangements, a number of state and non-state actors and institutions at various levels play a role in the design and implementation of (patient rights) policies. However, there is limited understanding on the multilevel institutional mechanisms for patient rights implementation in health facilities. We attempt to fill this gap by analysing the available scholarship on patient rights through a critical interpretive synthesis approach in a systematic scoping review.Methods The review question is ‘how do the multilevel actors, institutional structures, processes interact and influence the patient rights implementation in healthcare facilities? How do they work at what level and in which contexts?” Three databases PubMed, LexisNexis and Web of Science will be systematically searched until 30th April 2020, for empirical and non-empirical literature in English from both lower middle-income countries and high-income countries. Targeted search will be performed in grey literature and through citation and reference tracking of key records. Using the critical interpretive synthesis approach, a multilevel governance framework on the implementation of patient rights in health facilities which is grounded in the data will be developed.Ethics and dissemination The review uses published literature hence ethics approval is not required. The findings of the review will be published in a peer-reviewed journal.Registration number PROSPERO 2020 CRD42020176939

Marriage can be defined as the state of being united as spouses in a consensual and contractual relationship recognized by law. The general population generally believes marriage to be a solution to mental illnesses. It can be agreed that mental disorders and marital issues have some relation. Parents of patients with psychoses expect that marriage is the solution to the illness and often approach doctors and seek validation about the success of the marriage of their mentally ill child, which is a guarantee no doctor can give in even normal circumstances. Evidence on sexual functioning in patients of psychosis is limited and needs further understanding. Studies show about 60%–70% women of the schizophrenia spectrum and illness to experience sexual difficulties. Based on available information, sexual dysfunction in population with psychosis can be attributed to a variety of psychosocial factors, ranging from the psychotic symptoms in itself to social stigma and institutionalization and also due to the antipsychotic treatment. Despite the decline in sexual activity and quality of life in general, it is very rarely addressed by both the treating doctor and by the patient themselves hence creating a lacuna in the patient’s care and availability of information regarding the illness’ pathophysiology. Patients become noncompliant with medications due to this undesirable effect and hence it requires to be given more attention during treatment. It was also found that paranoid type of schizophrenia patient had lower chances of separation than patients with other types of schizophrenia. The risk of relapse in cases with later age of onset of the disease, lower education, a positive family history of psychosis or a lower income increased more than other populations.

Abstract Background Momordica charantia Linnaeus (Cucurbitaceae) has been used traditionally as a nutritious food and as a herbal medicine for type 2 diabetes mellitus. However, human studies that investigated its glycemic control have generated inconsistent findings. Therefore, this systematic review and meta-analysis is aimed at evaluating the safety and efficacy of M. charantia L. preparations in human studies that have investigated its role in glycemic control. Methods This protocol has been prepared according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The review will include randomized clinical trials and non-randomized clinical trials. The included studies will have assessed glycemic control of M. charantia preparations with placebo or standard oral anti-hyperglycemic agents in adult pre-diabetes and/or type 2 diabetes mellitus patients and have at least 4 weeks of follow-up. The primary outcomes of review are fasting blood glucose levels, glycosylated hemoglobin A1c, and post-prandial blood glucose level. Electronic database search for published literatures will be conducted without language restriction in EMBASE, MEDLINE/PubMed, the Cochrane Library, SCOPUS, Web of Sciences, and CINAHL databases. Search for gray literatures and references of the retrieved full-text articles will be conducted in Google, Google Scholar, OpenGrey, ProQuest dissertations & Theses, British Library EThos, and university digital library systems. Two independent reviewers will later evaluate full texts, extract data, and assess risk of bias of eligible articles. Publication biases will be assessed by testing asymmetry of funnel plot using Egger’s or Begg’s tests while heterogeneity will be assessed using Cochran Q test, P value, and I 2. Revman software version 5.3 will be used for meta-analysis including subgroup and sensitivity analysis. Discussion This systematic review and meta-analysis will investigate both safety and efficacy of M. charantia preparations in type 2 diabetes mellitus. The review results will be published in a peer-reviewed journal. The results will bring better understanding of clinical outcomes in treatment of type 2 diabetes mellitus patients and highlight gaps for future research. Systematic review registration PROSPERO CRD42018083653.

Background: Substance abuse is one of the most significant global public health issues among youths. Electronic media has become a part of day-to-day life for all. This systematic review is undertaken to comprehensively explore the effect of electronic media on substance abuse among children and adolescents. Methodology: Two review authors independently searched various electronic databases and other sources. Selection Criteria: Randomized control trials that assessed the effect of exposure of electronic media (defined as television, internet, gaming, mobile phones/phones, and radio) among participants in the age range of 5–19 years on substance abuse were included in the review. Data Collection and Analysis: Two reviewers independently extracted data. We used an approach proposed by the Cochrane Collaboration. We used GRADE profiler to assess the overall quality of the evidence. Main Results: We retrieved 6003 studies and found 15 studies that fulfilled our inclusion criteria. Since included studies differed in the type of intervention and reporting of outcomes, we did not undertake meta-analysis and choose to describe studies narratively. Quality of evidence was rated as “very low” due to too little information or too few data to be able to reach any conclusions. Authors' Conclusions: Clinicians, policymakers, and educators to partner with caregivers and youth to support electronic media use that promotes positive outcome in these areas. Registration of Systematic Review: This systematic review has been registered at PROSPERO International prospective register of systematic reviews (Registration number: PROSPERO 2018 CRD42018086935) available at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID = 86935.

Context: Electronic media has become a part of day-to-day life for all, and particularly more so for children and adolescents. Exposure to electronic media may be beneficial as well as harmful. Aim: The aim of the study is to systematically synthesize existing published and non-published empirical evidence on the effect of exposure to electronic media on diet, exercise, and sexual activity. Methodology: Two reviewers independently searched online databases such as MEDLINE, CENTRAL, and EMBASE. We applied no language, date, or publication restrictions. Selection Criteria: We included randomized control trials that assessed the effect of exposure of electronic media on diet, exercise, and sexual activity in participants between 5 and 19 years. Study Selection, Data Extraction: Two reviewers independently screened studies identified in electronic search and independently extracted data and assessed the risk of bias of included studies. Data Analysis: We had planned to use the risk ratio or odds ratio for dichotomous data, and mean difference (MD) or standardized MD for continuous data. However, as included studied differed in types of intervention and reporting of outcomes, we did not undertake meta-analysis. Main Results: All included trials were parallel randomized controlled trials except for one that was a crossover trial. Eight studies reported the effect of electronic media on diet and exercise, two on diet, two on exercise, and one on sexual activity. Quality of evidence was rated as “very low” for all outcomes due to too little information or too few data to be able to reach to any conclusions. Conclusions: There is a little body of evidence that limits conclusions. We need to comprehend as to how to swap undesirable effects of electronic media and make it more desirable. Registration of Systematic Review: This systematic review has been registered at PROSPERO International prospective register of systematic reviews (Registration number: PROSPERO 2018 CRD42018086935) available at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=86935.

The relationship between marriage and mental illness is very complicated, and this issue commonly arises in psychotic illnesses. Psychosis is usually diagnosed at late adolescent and early adulthood. Being a disease of the age at which decision of marriage is taken, the question of whether to marry or not and whether marriage will lead to improvement or deterioration in psychoses is equally faced by patients, their family members, and treating psychiatrists. Mental disorders and problems in marriage are closely linked although there is a controversy about the sequence. In India, marriages are usually arranged by parents and are influenced by a number of factors such as astrological compatibility, caste regulation, geographic proximity, and expectations of dowry. We have worked for two decades in this area. The work summarizes as “Effect of marriage on clinical outcome of persons with bipolar affective disorder: A case–control study.” Married persons had experienced more episodes of illness and for longer duration. Males are more prone for illness than females in both groups (married and never married). Marriage did not influence the severity of illness in persons with bipolar affective disorder. The effects of marriage on women with schizophrenia are as follows: This study concluded that most of the patients and relatives were of the opinion that marriage can cure mental illness. Child birth was found to be a protective factor for decreasing separation in cases. Severity of mental illness was slightly higher in cases than comparison group. It was observed that with increasing severity of illness marital adjustment deteriorates with antagonistic interaction among members.

Knowledge on the cellular immune responses to infection with Mycobacterium tuberculosis has improved drastically in recent years. Though eosinophils and hypereosinophilia are linked with the disease process of tuberculosis, there is paucity of information to prove the actual role played by these polymorphonuclear leukocytes. The aim of this review is to provide an overview of the existing literature on what is known so far about eosinophils and tuberculosis.

Tetraethylorthosilicate (TEOS)-crosslinked poly(vinyl alcohol) (PVA) solution was prepared and treated with benzaldehyde 2 sulphonic sodium salt acid (B2SA) for sulfonation. Different contents of graphene were incorporated into B2SA-grafted PVA–TEOS hybrid membrane to improve the membrane stability, mechanical strength, and overall pervaporation performance of the membranes. Membranes were fabricated using the casting technique. Developed membranes were then analyzed for their physicochemical changes by means of Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), scanning electron microscope (SEM), wide-angle X-ray diffraction (WAXD), thermogravimetric analysis (TGA), contact angle analysis (CA), and mechanical strength. The lower d-spacing value observed in WAXD was evidence for the decreased inter-chain distance between the polymer chains. DSC exhibited the enhanced thermal stability of the developed membranes compared to the plane PVA membrane with enhancement in Tg value (106 °C), which was well above the pervaporation experimental temperature. Incorporation of graphene induced higher mechanical strength to the fabricated membranes. Further, the membranes were tested for the pervaporation separation of bioethanol. All the membranes were stable throughout the pervaporation studies, with M-2 G showing the total permeation flux of 11.66 × 10−2 kg/(m2 h) at 30 °C.

Background As per the vaccine management policy of the Government of India all vaccine vials opened for an immunization session were discarded at the end of that session, irrespective of the type of vaccine or the number of doses remaining in the vial prior to 2013. Subsequently, open vial policy (OVP) was introduced in 2013 and should reduce both vaccine wastage as well as governmental healthcare costs for immunization. This study evaluates the vaccine wastage after introduction of the OVP and its comparison with the previous study of vaccine wastage in Surat city before implementation of OVP. It needs to mention that the vaccine policy for this period under comparison was uniform except for the OVP. Methods Information regarding vaccine doses consumed and children vaccinated during immunization sessions of 24 urban health centers (UHCs) of Surat city were retrieved for the period of January 1st, 2014 to March 31st, 2014. The data were analyzed to estimate vaccine wastage rate (WR) and vaccine wastage factor (WF). In order to assess the impact of OVP, vaccine WR of this study was compared with that of previous study conducted in Surat city during January 1st, 2012 to March 31st, 2012. Results The vaccine WR for oral polio vaccine (OPV) has decreased from 25% to 13.62%, while the WRs for DPT, hepatitis B virus (HBV) and the pentavalent vaccine combinedly have decreased from 17.94% to 8.05%. Thus, by implementation of OVP, an estimated 747 727 doses of OPV and 343 725 doses of diphtheria, pertussis and tetanus toxoid vaccine (DPT), HBV and the pentavalent vaccines combinedly have been saved in Surat city of India in a year. Conclusion The implementation of the OVP in Surat city has led to a significant lowering in the vaccine wastage, leading to savings due to lower vaccine requirements.

In this paper, we introduce the concept ss-sequentially quotient mapping. Using this concept, we characterize s-Fréchet-Urysohn spaces and s-sequential spaces. Finally, we develop the properties of I-Fréchet-Urysohn spaces which is the generalized form of s-Fréchet-Urysohn spaces. Also, we give an example that product of two I-Fréchet-Urysohn spaces need not be an I-Fréchet-Urysohn space for any I.

Background: Adolescent girls are particularly vulnerable to anemia compared.KAP assessment is suitable to evaluate the effectiveness of intervention programs. This study was carried out to assess the knowledge, attitude and practice regarding anemia and improvement in same after health education among high school girls in rural Bangalore. Materials and Methods: It’s a cross sectional interventional study. All girls were included age group 14 to 16 years and those who did not consent were excluded from the study which was carried out in Govt High School in Hoskote, Rural Bangalore for a period of three months. All the data were entered in Microsoft excel and analyzed using SPSS v 22. Results: Among 100 study participants, 78 % belonged to age group of 13-14 years, 85% belonged to nuclear family. Initial assessment showed Knowledge being poor, Attitude being negative and practice being unsatisfactory and health education were given through various forms. Conclusion: The overall findings of the study showed the knowledge, attitude and practices of female adolescents are moving in a desirable direction post health education. Comprehensive nutritional education regarding anemia and consequences among adolescents can yield a great dividend in future life of women.

Introduction: After starting free Anti Retroviral Therapy (ART) in India, challenge has changed from gaining access to taking the treatment correctly and consistently in order to realize the rewards of improved health status, and reduced morbidity and mortality from HIV. This study was aimed to identify of socio-demographic risk factors responsible for non-adherence to ART. Methodology: This Case Control Study was conducted at ART centre where all patients with poor adherence percentage i.e. ≤ 95% of Treatment Adherence were denoted as ‘Case’ and good adherence percentage i.e. > 95% of Treatment Adherence were denoted as ‘Control’. The ‘Pill Count method’ was used to measure the adherence level. Results: Mean age of 104 cases and 208 unmatched controls was 36.29 years and 39.21 years respectively (p