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Abstract Background Inhaled medications have been the cornerstone of treatment for the exacerbations as well as stable chronic obstructive pulmonary disease (COPD) which is one of the leading cause of deaths in the recent times. Inadequate knowledge on handling of inhalers leads to noncompliance which in turn results in increased hospital visits limelighting the negative impact on the morbidity status. The aim of our study was to assess the compliance of inhalers and to correlate the level of compliance to the morbidity of COPD as assessed by number of hospital visits. Methods In our cross-sectional observational study conducted in the rural medical college hospital in Dakshina Kannada of Karnataka, 69 subjects with COPD were evaluated for the compliance of inhaler usage, and the morbidity related to the disease was assessed with number of hospital visits in the past 6 months. Appropriate statistical analysis was used in evaluation. Results Out of 69 patients, 24 patients visited the health care facility at least 3 times or more. Of these 24 patients, 20 (83.33%) of them were not compliant with inhalers. Among the 45 patients who visited the health care facility less than 2 times, 28 (62.22%) patients were compliant with inhalers. This relationship was found to be statistically significant proving that the higher the number of visits, the lesser the compliance and vice versa. Conclusions Our study highlights the importance of patient education about compliance to inhalers which is an economical and effective modality which has significant impact on reduction of exacerbations and morbidity.

This study investigates the integration of spaceborne Global Ecosystem Dynamics Investigation (GEDI) LiDAR data with optical imagery from Linear Imaging Self Scanning Sensor (LISS IV), Sentinel-1 Synthetic Aperture Radar (SAR) and PALSAR data for continuous forest canopy height mapping in Kaziranga National Park (KNP), Assam for the years 2018 and 2022. Four machine learning models were trained and evaluated to assess the predictive ability of LISS IV data in conjunction with SAR variables. The mean canopy height was measured at approximately 8.58 m in 2018, which increased to about 9.07m in 2022. Results reveal Extreme Gradient Boosting (XGB) as the top-performing model, achieving an RMSE of 5.47m and an R2 of 0.55. In comparison, Random Forest (RF), Support Vector Machine (SVM), and k-Nearest Neighbors (kNN) achieved RMSE values of 5.49, 5.51, and 5.73, respectively. Analysis shows a prevalent occurrence of canopy heights below 5 meters in KNP (more than 35% of the area), while taller canopies beyond 20m can be found in less than 5% of the area. This finding underscores the importance of integrating satellite data and machine learning and highlights the novel application of LISS IV data in enhancing canopy height mapping. Furthermore, it represents the first comprehensive attempt to map canopy height in KNP, laying the groundwork for further research on biomass assessment and carbon sequestration in this vital biodiversity hotspot. Overall, the study highlights the potential of leveraging advanced remote sensing technologies and machine learning approaches for improved understanding and management of forest ecosystems.

Abstract Systematic under-representation of pregnant women and gender diverse pregnant people in clinical research has prevented them from benefitting fairly from biomedical advances. The resulting lack of pharmacological safety and efficacy data leads to medicine discontinuation, sub-optimal dosing, and reliance on repurposed therapies. We identify four roadblocks to fair inclusion. First, investment and research are inhibited by protectionist attitudes among research gatekeepers who view pregnancy as a vulnerable state. Second, exclusion ignores human-specific biological variations affecting medication absorption and impacts on the pregnant body. Third, pregnant populations in low-and middle-income countries face a double disadvantage due to gender and location, despite bearing a disproportionate maternal mortality burden. Fourth, perspectives and experiences of pregnant populations are undervalued in clinical intervention design. We propose five actions to optimize fair inclusion: fostering reciprocal partnerships, prioritizing multi-disciplinary research, awareness-raising of the need for pharmaceutical innovation, conducting regulatory analyses, and promoting responsible inclusion over presumptive exclusion.

Decaprenylphosphoryl-β-D-ribose-oxidase (DprE1), a subunit of the essential decaprenylphosphoribose-2′-epimerase, plays a crucial role in the synthesis of cell wall arabinan components in mycobacteria, including the pathogen responsible for tuberculosis, Mycobacterium tuberculosis. In this study, we designed, synthesised, and evaluated 15 (BOK-1–BOK-10 and BOP-1–BOP-5) potential inhibitors of DprE1 from a series of 1,2,3-triazole ligands using a validated DprE1 inhibition assay. Two compounds, BOK-2 and BOK-3, demonstrated significant inhibition with IC50 values of 2.2 ± 0.1 and 3.0 ± 0.6 μM, respectively, whereas the standard drug (TCA-1) showed inhibition at 3.0 ± 0.2 μM. Through molecular modelling and dynamic simulations, we explored the structural relationships between selected 1,2,3-triazole compounds and DprE1, revealing key features for effective drug–target interactions. This study introduces a novel approach for designing ligands against DprE1, offering a potential therapeutic strategy for tuberculosis treatment.

Introduction: The technique for harvesting Split-thickness Skin Grafts (STSG) varies among surgeons. To control bleeding from split-thickness skin graft donor sites, the use of several haemostatic agents has been reported. The tumescent technique involves injecting tumescent fluid into the subcutaneous fat, obtaining swelling and firmness (tumescence) of the surgical area. This creates regional anaesthesia of the skin and subcutaneous tissue, allowing painless cutaneous surgery, with adrenaline acts as a haemostatic agent. Aim: To compare the surgical outcomes in terms of blood loss during the harvesting of STSG, postoperative pain experienced by the patient, healing of the donor site, and graft take rate with tumescent versus non tumescent techniques of STSG. Materials and Methods: The present prospective cohort study was conducted in the Department of General Surgery, M S Ramaiah Medical College, Bengaluru, Karnataka, India, from November 2017 to March 2019. A total of 56 patients were enrolled after applying inclusion and exclusion criteria. Patients were alternately assigned into the groups of tumescent or non tumescent technique groups. Intraoperative bleeding was assessed, postoperative pain was assessed using the Visual Analogue Score (VAS), and healing of the donor and recipient sites were assessed. Student’s t-test (two-tailed, independent) was used to find the significance of study parameters on a continuous scale between the two groups. The Chi-square/Fisher’s-exact test was used to assess the significance of study parameters on a categorical scale between two or more groups. Results: The mean±Standard Deviation (SD) age of patients in the tumescent group was 48.25±12.79 years and in the non tumescent group was 52.79±12.91 years. Intraoperative bleeding ranged from 0-25% in all 28 patients in the tumescent group, while it ranged from 76-100% in all 28 patients in the control group (p-value

Melatonin and magnesium nanoparticles exhibit diverse pharmacological properties. Trimethyltin and trimethyltin derived compounds both are toxic to neurons. The proposed research work is focus on synthesis on novel magnesium oxide nanoparticles conjugated with melatonin and evaluate its neuroprotective efficacy against trimethyltin induced neurotoxicity. Sol-gel method was used to fabricate Melatonin-MgO nanoparticles. Synthesized Melatonin-MgO particle were spectrally characterized. UV spectral analysis showed lambda max of Melatonin-MgO at 342 nm. Particle size analysis indicated that M − MgO nanoparticles have Z-average of 160.6 nm. Zeta potential estimation revealed that M − MgO exhibited Zeta potential of −0.1 mV. XRD analysis of M − MgO nanoparticles indicated that it has amorphous nature. SEM images revealed the agglomerated state of the particles. The cytotoxicity studies revealed that the IC50 value of M − MgO against L929 mouse fibroblast cell line for 24 h treatment was found to be 77.02 μg/ml. The results of this investigation indicate that the Neuroprotective studies revealed that melatonin conjugated magnesium oxide was exhibited maximum neuroprotection rendering cell viability of 88.59 % at 30 μg/ml against trimethyltin induced neurointoxication in SK-N-SH cells. By utilizing the distinct neuroprotective properties of both substances, melatonin-functionalized magnesium oxide nanoparticles may provide a more efficient and focused method of treating oxidative stress and neuronal dysfunction in a range of neurological conditions.

Background and objective: Nutrition in pregnancy plays an important role for wellbeing of mother and fetus, later it further influences the development of child. Iron is one among the most important micronutrients required in pregnancy. There is no validated Food frequency questionnaire (FFQ) to assess iron intake in pregnant women. This initiated the process to develop and validate a FFQ to assess dietary intake of Iron in Pregnant women. Methodology: Based on the food habits in study region and foods rich in iron, in reference to the standard literature, the FFQ was prepared. FFQ was designed in the following categories-cereal grains and products, pulses & legumes, green leafy vegetables, roots-tuber & other vegetables, nuts & seeds, Fruits, non-veg foods and milk & milk products. Content validity carried out by subject experts. To perform construct validity, 25 Primary health centre and 25 Tertiary care hospital pregnant women were interviewed using this FFQ and 24 h diet recall method. The results of both records were analyzed using Wilcoxon signed rank test. Internal reliability (Cronbach's alpha) and construct validity (Pearson correlation) of the questionnaire were determined. Results: Overall internal reliability of questionnaire is 0.804, indicating good reliability and showing satisfactory construct validity. Median dietary iron intake from FFQ method was 7.67 mg/day and 24 h dietary recall method was 15.70 mg/day. There was a significant difference between both method in assessing dietary iron intake. Conclusion: The FFQ designed in this study is reliable and valid tool to assess dietary iron intake among pregnant women.

Introduction: Chest tube insertion is a common procedure designed to alleviate the accumulation of air, fluid, pus, or blood in the pleural cavity. Despite being a bedside procedure often performed by emergency residents, Intercostal Drain (ICD) tube insertion carries associated risks, if not executed with care. Complications such as misplacement, organ injury, bleeding and pain are noteworthy concerns. Aim: To assess surgical outcome of Trocar versus Blunt dissection technique for ICD insertion. Materials and Methods: The present prospective interventional study was conducted in the Department of General Surgery, M S Ramaiah Hospitals, Bengaluru, India, from September 2018 and August 2020, with a sample size of 64 after obtaining Institutional Ethical Committee approval. Patients requiring ICD insertion were divided into two groups: Blunt (group A) and Trocar (group B) dissection, with 32 participants in each group. Demographic, clinical and diagnostic data were meticulously documented. Statistical analyses, including descriptive statistics, t-tests and Chi-square test, were employed to compare variables such as insertion time, complications and pain scores. Both groups were assessed for the time required for insertion and complications with each method during and after the procedure. Results: The mean age among subjects with the Blunt dissection method and Trocar method was 45.53±14.85 years and 45.06±10.46 years, respectively. In the Blunt dissection technique, 6 (18.8%) were females and 26 (81.3%) were males, while of those who underwent the Trocar method of insertion, 7 (21.9%) were females and 25 (78.1%) were males. The present study findings revealed that the Trocar method demonstrates comparable surgical outcomes to the Blunt dissection method. Trocar insertion proves notably quicker, especially in obese patients. The time taken for insertion was significantly longer (p-value

Background: Congenital myasthenic syndrome is a rare inherited neuromuscular disorder resulting in abnormal weakness and fatigue on exertion with onset at or shortly after birth or in early childhood. Clinical Description: A 2-year-old boy presented to us with respiratory failure, having a history of recurrent respiratory tract infections and underlying isolated motor delay. His 7-year-old elder sister had undiagnosed generalized weakness. Management and Outcome: While the index case was being stabilized with mechanical ventilation, his elder sibling was evaluated. Ptosis was noted in her, which improved with neostigmine. Examination and laboratory investigations ruled out other differentials. Clinical exome sequencing was sent which showed homozygous CHRNE ENST00000649488.2.c.1367_1369del. (p.Asn456del) resulting in acetylcholine receptor deficiency. Both siblings were started on oral pyridostigmine and salbutamol, resulting in improvement in muscle weakness over 3 months and 4 months in younger and older sibling, respectively. Conclusion: Recurrent respiratory insufficiency when associated with motor delay may be suggestive of a neuromuscular disorder. Even siblings with the same mutation may have different levels of severity of clinical manifestation.