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Background In India, the absence of formal training in geriatric dentistry and the lack of recognition of it as a speciality contributes to the deterioration of oral health in the older adults. India lacks specific oral healthcare policies for older adults. Additionally, caregivers’ perspective in old age homes regarding oral healthcare services remains underexplored, necessitating further studies in this context. Methods A mixed method study was conducted, and the quantitative component focused on assessing the oral health status of institutionalized older adults and caregivers’ perceptions using a questionnaire. The qualitative part evaluates caregivers’ perceptions of providing oral healthcare services for older adults through in-depth interviews. Results Mean DMFT among institutionalized older adults was 15.52±8.23. More than 50% of caregivers perceived that the oral health status of institutionalized older adults was fair. Barriers to oral health services include autonomy, difficulty in traveling, lack of financial support, lack of knowledge and time. Approaches to enhancing oral health services for institutionalized older adults include oral health education for older adults and their caregivers, monthly dental visits to the institution, utilization of portable dental chair services, collaboration with dental colleges/dental clinics, distribution of oral health education materials, and provision of oral hygiene aids. Conclusion Findings from our study indicate the need to collaborate with dental institutions to provide oral health services in old age homes, to improve the oral health status of older adults and caregivers' knowledge.

AIM: The aim of this study was to compare the efficacy of sub-Tenon and peribulbar anesthesia in vitreoretinal surgeries. Methods: This was a retrospective study where patients who received peribulbar or sub-Tenon anesthesia during vitreoretinal surgeries between July 2023 and September 2023 were included. Lid movements, subconjunctival hemorrhage, chemosis, and akinesia were evaluated after anesthesia was injected in the two groups. Pain score was evaluated at the time of anesthesia, intraoperatively, and postoperatively after 1 h. Results: We included 108 patients, of which 58 were given peribulbar and 50 had sub-Tenon anesthesia and had mean ± standard deviation age of 56.8 ± 12.6 years and 57.90 ± 13.0 years, respectively (P = 0.67). Baseline, intraoperative, and postoperative (at 1 h after surgery) systolic blood pressure (BP), diastolic BP, and pulse rate were similar in both groups. None of the patients had any systemic complications in both the peribulbar and sub-Tenon groups. The mean pain score at postoperative 1 h was similar in both groups (P = 0.58). At postoperative 1 day, two patients had ecchymosis in the peribulbar group. Eighteen cases had lid edema in the peribulbar group compared to no lid edema in the sub-Tenon group (P < 0.001). Conclusion: Sub-Tenon anesthesia is a simple, safe, and less traumatic technique that is as good as peribulbar in terms of providing analgesia. Although sub-Tenon could not produce total akinesia in most of the cases, the surgeon was able to operate comfortably with negligible chance of anesthesia-related complications. However, the anesthetist also plays an important role in a multidisciplinary approach in the management of vitreoretinal surgeries.

Prediction plays a ubiquitous role in cancer care. At every stage of the illness, the patient, the physician, and the family must make numerous decisions. Utilizing epidemiological, clinical, biological, lifestyle, and genetic factors, a cancer-specific risk assessment model calculates the likelihood of developing cancer. In India, oral cancer ranks as the fourth most common cancer, affecting nearly 3,000,00 individuals annually. Because it is in the premalignant stage, oral cancer is easily detectable in the oral cavity. Prompt identification of this lesion can result in better outcomes and a higher standard of living. Advanced statistical techniques have been used to develop prediction algorithms or risk scores that identify individuals with a high risk of developing oral cancer. With the aid of these risk assessment models, specific individuals can be screened to aid in the early detection of the disease, which may result in better outcomes and lifestyle modifications. Finding the best model among the current risk models for oral cancer may be aided by a thorough examination of all these models. Finding and assessing the risk model that primary care physicians can use and easily apply in clinical practice will be made easier with a succinct and straightforward comparison of the models. This review compares the current models to determine which has the best performance metrics, which could lead to a better understanding of the advantages and disadvantages of various risk prediction models of oral cancer.

Background: Periodontitis is a chronic inflammatory disease affecting the oral cavity’s supportive structures, including gums and surrounding bone. Herbal mouthwashes have phytopharmacological agents such as Moringa oleifera (MO), and the use of herbal mouthwash has increased. Moringa mouthwash has potential for oral health due to its biocompatibility and anti-inflammatory effect. This study compares the effect of chlorhexidine gluconate (CHX) and moringa mouthwash on plaque and its reduction. Methodology: The in vitro tests included the determination of minimum inhibitory concentration using broth dilution and agar diffusion. This interventional study included 25 individuals with more than 1 plaque score. The study was conducted for 2 months with a washout period of 2 weeks between the use of both mouthwashes. The Quigley–Hein Plaque Index of the study subjects was recorded at the designated baseline and after 28 days of use throughout the study period. The statistical test used was the Wilcoxon signed-rank test, and the level of significance was considered to be

One of the best ways to remove organic dyes based contaminant from water resources and industrial waste water is the sunlight driven photo-catalytic degradation method. The theme of the present investigation is the photocatalytic degradation of methylene blue (MB) dye using economically produced Cu2-XSe nanoparticles (NPs) catalyst under solar radiations. The Cu2-XSe NPs crystallized in the cubic structural phase with an average crystallite size around 19 nm. The direct band gap was found to be 2.1 eV. The PL spectra and corresponding CIE diagram show the Cu2-xSe NPs emitted yellow color. The SEM micrographs show that the small grains staked over others to form large grains or patches. The FTIR and EDX spectra confirmed the formation of Cu2-XSe NPs. The obtained optimum photocatalytic degradation efficiency for Cu2-XSe NPs is 90.3 %. For first cycle analysis. The pseudo-first order and second order models were used to analyze the kinetic data of Cu2-XSe NPs for varying concentrations. The multiple-cycle degradation analysis by catalyst of MB dye in one day spam for continuous four cycles were also analysed and discussed. The sun light driven multi-cycle catalytic degradation confirms the re-usability of Cu2-xSe NPs for the treatment of industrial waste water and other contaminated water bodies for the survival of aquatic life and for saving environment.

Fungal endogenous endophthalmitis (FEE) is an intraocular infection secondary to the fungemia, spreading through the hematogenous route. We here report a case of a 60-year-old female diagnosed with FEE and culture-proven Aspergillus fumigatus in a chronic kidney disease (CKD) patient, which is a rare and challenging condition to manage. Early diagnosis and prompt treatment are the only keys to achieve suitable outcomes. It can be achieved by a multidisciplinary approach involving nephrologists and ophthalmologists. Routine ophthalmology review in CKD patients under hemodialysis may prove to be effective in early diagnosis of the fungal endophthalmitis or even help in ruling out systemic infections.

Title: “Intraepithelial inclusions on urinalysis screening among COVID-19 cases: Are they Covicytes?—A hospital-based cohort study with narrative review.” Context: Coronavirus disease 2019 (COVID-19)-associated delayed acute kidney injury (AKI) is often reported in subsequent waves of the pandemic. Early intervention and regular follow-up influence the outcome and inhibit progression into chronic kidney disease (CKD). This is the first study to identify urinary cytomorphological abnormalities (Covicytes) and predict COVID-19-associated delayed AKI with a narrative review of the possible etiologies for intraepithelial inclusions. Settings and Design: A hospital-based cohort study with a narrative review. Material and Methods: Screening urinalysis to assess the cytomorphology of epithelial cells (ECs) and inclusions in Leishman and periodic acid–Schiff (PAS)-stained smears by two independent pathologists was performed in reverse transcriptase polymerase chain reaction (RT-PCR)-confirmed COVID-19 cases at a tertiary care center. Statistical Analysis: Basic statistical tools were used for descriptive statistical analysis, and data were expressed in mean, proportion, and frequency. Results: Cytomorphological abnormalities (48/188) were predominant among adult males. Leukocyturia (39/48) with positive nitrite test (28/39), high ECs (27/48) and squamous cell-to-tubular EC (SC:TEC) ratio, intraepithelial intracytoplasmic inclusions predominantly in TECs (Covicytes), and multiple well-visualized, perinuclear PAS-negative neutrophilic vacuoles (17/39) were found. The association with preexisting diabetes (31/48), hypertension (10/48), and disease severity was noted. Conclusions: This study reported COVID-19-associated urinary cytomorphological abnormalities and interesting unique inclusions (Covicytes) that may be a result of underlying inflammatory changes, reactive hyperplasia, degenerative changes, or defective endocytosed vacuoles. The possible etiologies for renal inclusions were reviewed. We recommend compulsory baseline and follow-up urinary cytology screening for all COVID-19-suspected patients to detect and predict delayed AKI before clinical and biochemical manifestation during disease endemicity.

A 17-year-old female, a known case of Marfan syndrome, presented with complaints of diminution of vision in both the eyes for 10 years. Clinical examination revealed that the presence of lens coloboma with advanced retinitis pigmentosa (RP) in the right eye and left eye showed cataractous changes along with persistent hyperplastic primary vitreous (PHPV) on ultrasonography B scan. This report describes the rare association of RP, lens coloboma, and PHPV in Marfan syndrome.

IntroductionThe utilization of plant material for synthesizing nanoparticles effectively triggers physiological and biochemical responses in plants to combat abiotic stresses. Salt stress, particularly caused by NaCl, significantly affects plant morphology and physiology, leading to reduced crop yields. Understanding the mechanisms of salt tolerance is crucial for maintaining crop productivity.MethodsIn this study, we examined the effects of 150 μM spinach-assisted gold nanoparticles (S-AuNPs) on various parameters related to seed germination, growth attributes, photosynthetic pigments, stomatal traits, ion concentrations, stress markers, antioxidants, metabolites, and nutritional contents of spinach plants irrigated with 50 mM NaCl.ResultsResults showed that S-AuNPs enhanced chlorophyll levels, leading to improved light absorption, increased photosynthates production, higher sugar content, and stimulated plant growth under NaCl stress. Stomatal traits were improved, and partially closed stomata were reopened with S-AuNPs treatment, possibly due to K+/Na+ modulation, resulting in enhanced relative water content and stomatal conductance. ABA content decreased under S-AuNPs application, possibly due to K+ ion accumulation. S-AuNPs supplementation increased proline and flavonoid contents while reducing ROS accumulation and lipid peroxidation via activation of both non-enzymatic and enzymatic antioxidants. S-AuNPs also regulated the ionic ratio of K+/Na+, leading to decreased Na+ accumulation and increased levels of essential ions in spinach plants under NaCl irrigation.DiscussionOverall, these findings suggest that S-AuNPs significantly contribute to salt stress endurance in spinach plants by modulating various physiological attributes.

The variability in climate affects the agricultural production especially in drylands. It is necessary to understand and quantify the impacts of resilient technologies as well as effects of extreme events. Keeping these in view, the primary data on household characteristics and the farm income was collected from a sample of 60 farmers each from National Innovations in Climate Resilient Agriculture (NICRA) program adopted village and a comparable control village in the district. The sample was also post classified into small, medium and large farmer to bring out the economic impact across land classes. The impact was estimated following the difference-in-differences (DiD) model as the data allows us to use effectively the data across time and regions. The results show us that the average income of a farm household in the NICRA village is more than 40 percent than non-adopted village and during a drought situation the farmers under NICRA intervention where better off by 19.5 percent. The income from crops and livestock production in adopted village was significantly higher than the control village. The DiD model output showed the farm income of adopted village was 40 percent higher showing that better climate smart interventions improved the farm incomes. The estimate showed that the treated farm household had higher income of Rs. 54,717 than the control during a drought year. Better knowledge and quantification of impact of technology adoption on farm income specially during drought will help to effectively design technological and policy interventions for better drought management in drylands.

Agriculture is significantly impacted by the variability in weather patterns, imposing substantial constraints on farmers’ ability to make informed tactical and strategic decisions regarding their crops. Seasonal climate projections have shown potential for informing agricultural decisions, but the actual adoption of climate information by farmers has been relatively slow and limited. The present study was conducted with the objective of investigating the characteristics of adopters, the communication network, and the level of farmer’s satisfaction concerning the adoption and continued use of Agromet Advisories Services (AAS). Two semi-arid districts, namely Kurnool and Anantapur in Andhra Pradesh, were purposively selected, wherein 280 farmers constituted the sampling frame. In this study, social network analysis (SNA) was conducted to examine the peer-to-peer communication patterns, while importance-performance analysis (IPA) was employed to evaluate farmer’s satisfaction, contributing to the continued adoption of AAS. The findings revealed that with regard to personality and communication characteristics, farmers were in the low category for their ability to cope with uncertainties and risk and even for their information-seeking behavior. Furthermore, the results showed farmers to be highly satisfied with the overall adoption of AAS. However, the IPA matrix revealed that among the nine attributes, the credibility of the forecasts needed refinement to promote sustained adoption. Excessive emphasis was placed on attributes such as the frequency of forecasts, which could be channeled into other initiatives. Peer-to-peer communication emerged as a crucial strategy in the adoption of AAS. Governments, non-governmental organizations, and extension functionaries should make a concerted effort to enhance the continued adoption of AAS by involving local stakeholders in sharing and participating in climate information production, forming farmer’s groups, and focusing on farmers’ literacy toward AAS.

Ozurdex is an approved drug for managing vitritis. Raised intraocular pressure and cataract formation are known complications of Ozurdex implant; however, a fractured Ozurdex implant after injection is a rare entity. Here, we report a case of a 19-year-old male patient who received an intravitreal Ozurdex implant for vitritis, which was found to be broken into three pieces at a 1-week follow-up. Usually, the breakage of Ozurdex in the vitreous cavity does not alter its efficacy or result in any complications and, thus, does not require any intervention. However, frequent and careful monitoring is required to rule out any unexpected complications.

This review aims to explore the various antinutritional factors found in grains and oilseeds, their sources, and the different methods employed to mitigate their effects. Both traditional and innovative processing techniques have been utilized to reduce antinutrients. Traditional methods such as dehulling, soaking, boiling, pressure cooking, sprouting, and fermentation have proven effective in reducing specific antinutrients like α-galactosides, phytic acid, enzyme inhibitors, lathyrogens, lectins, saponins, and tannins. However, optimization of these techniques is necessary to maximize their effectiveness and minimize antinutrient content. The review also provides an overview of various analytical methods used to quantify antinutritional factors in grains and oilseeds. These methods encompass classical gravimetric and titrimetric analysis, potentiometric titrations, chromatographic and electrophoretic separation techniques, as well as spectroscopic methods, fluorescence, and biosensors. A systematic and chronological review of these analytical approaches and detection systems is presented. Furthermore, the review identifies research gaps and highlights potential areas for future exploration in the field of antinutrients in grains and oilseeds. By addressing these gaps, we can further enhance our understanding and develop more effective strategies to mitigate antinutrients, thus promoting the utilization of grains and oilseeds for their optimal health benefits.

Introduction: Sepsis is a life-threatening condition with a very narrow golden period in which confirmatory diagnosis may change the outcome dramatically. No confirmatory biomarker is available till date for early diagnosis of sepsis. This study aimed to evaluate the combined and independent role of quick sequential organ failure assessment (qSOFA) score, lactate, and neutrophil–lymphocyte ratio (NLR) in diagnosis and mortality prediction in early sepsis. Methods: This was a hospital-based, single-center, prospective cohort study conducted in a tertiary care institute, Karnataka, India. Three hundred adult sepsis patients were recruited during 10-month period, and demographic data, qSOFA score, lactate, NLR, and culture samples were collected in ED within 1 h of admission. Outcome groups (survivor and nonsurvivor) were statistically analyzed with relative frequencies (%), median, mean ± standard deviation with 95% confidence interval (CI), univariate, bivariate, and multivariate logistic regression analysis, and Receiver -operating characteristic curve (ROC) curve to test the predictive ability of initial levels of three biomarkers. Results: Sepsis was more prevalent among middle-aged male patients. Male gender (odds ratio [OR], 6.9; 95% CI: 1.61–30.1), qSOFA (OR, 154; 95% CI: 15–1565), and lactate (OR, 1.36; 95% CI: 22–833) show 97% (area under the curve) predictive accuracy of the model for sepsis on bivariate and multivariate logistic regression analysis. A significant rise in NLR was a poor outcome indicator on univariate analysis (P = 0.773). Conclusion: All three biomarkers are good outcome predictors whereas qSOFA and lactate have diagnostic significance in early sepsis. These markers can be used for patient triaging, minimizing culture report dependence for treatment and ultimately the outcome.

Background: Assessment drives learning is a well-known adage. If the assessment is subjective, it can under/overestimate the student's performance and thus impair the learning process. Rubrics help standardize the assessment by giving guidelines to both the assessor and the student and minimize subjectivity. Methodology: A mixed method design was employed to identify the inter- and intra-rater reliability of assessing narrative reports and explore the faculty perceptions on using rubrics for the assessment of narrative reports. Results: The inter-rater reliability scores were 0.08 without the use of rubrics and 0.93 with the use of rubrics demonstrating a statistically significant-excellent reliability when rubrics were used. The intra- and inter-examiner mean total assessment scores showed a statistically significant variation when rubrics were not used while the variation was reduced with the use of rubric. The two examiners who were part of the study welcomed the use of rubrics for assessment. They concurred that rubrics gave the assessor the schema and minimized the subjectivity of the assessment. Although the time taken for assessment was initially longer with a rubric scale, subsequently, the time taken was reduced. The assessors felt that they were now in a position to give richer constructive feedback to students. They felt that the students should also know the rubric scale beforehand so that it sets the expectations and helps the student to set self-determined learning goals. Conclusion: The use of rubrics improves inter- and intra-rater reliability of assessment scores. It gives a direction to the examiners and helps categorizing the student performance with minimal subjectivity.

Introduction: Creating oral cancer awareness among adolescents will bring change by modifying the risk factors responsible for oral cancer. Social cognitive theory (SCT) is one promising theory for developing oral cancer awareness programmes among school adolescents. However, data are limited on SCT-based intervention assessment in creating oral cancer awareness among rural community. To develop and validate a SCT-based Oral Cancer Awareness (SCT-OCA) assessment/survey tool for evaluation of intervention implementation. Material and Methods: A mixed method design encompassing both qualitative and quantitative was accomplished to develop and validate the assessment tool for rural setting. Methods and Material: Domains and items for SCT-OCA assessment tool for adolescents were selected using subject matter expert. A 21-item assessment tool was developed using three rounds of Delphi technique and validated using Lawshe method. The knowledge on oral cancer and its risk factors and key constructs of social-cognitive theory was selected as items of the tool. The final assessment tool was translated to regional language, which was used for evaluation of intervention implementation. Statistical analysis was conducted using SPSS, version 16. Descriptive statistics includes means, standard deviations and frequency. Validation using Lawshe, component factor analysis and Cronbach alpha coefficients were calculated. Results: The overall content validity ratio was agreeable, and 21 items were finally selected in assessment tool. The overall Cronbach's alphas of 0.718 for survey was acceptable. The agreement was good for the domains of tool. Conclusions: This study developed the SCT-OCA assessment tool for intervention specifically designed for adolescents to measure oral cancer awareness.

Abstract Background Kinesin-3 family motors drive diverse cellular processes and have significant clinical importance. The ATPase cycle is integral to the processive motility of kinesin motors to drive long-distance intracellular transport. Our previous work has demonstrated that kinesin-3 motors are fast and superprocessive with high microtubule affinity. However, chemomechanics of these motors remain poorly understood. Results We purified kinesin-3 motors using the Sf9-baculovirus expression system and demonstrated that their motility properties are on par with the motors expressed in mammalian cells. Using biochemical analysis, we show for the first time that kinesin-3 motors exhibited high ATP turnover rates, which is 1.3- to threefold higher compared to the well-studied kinesin-1 motor. Remarkably, these ATPase rates correlate to their stepping rate, suggesting a tight coupling between chemical and mechanical cycles. Intriguingly, kinesin-3 velocities (KIF1A > KIF13A > KIF13B > KIF16B) show an inverse correlation with their microtubule-binding affinities (KIF1A

Soil erosion and its future projection play an important role in the changing climatic scenario. An attempt has been made to establish a relationship between NDVI and cover-management factor (C-factor) which varies with area and crop. IRS LISS III data with 23.5 m resolution is used to derive precisely NDVI and correlated with C-factor, the derived regression equation shows a good relationship between NDVI and C-factor value. An approach was made to use this area specific equation for getting C- factor for the whole Mahabubnagar district, Telangana from 2013 imagery data and the study was conducted in 2017. For future scenarios study, a relationship between rainfall, temperature, and NDVI of the whole district was derived. The NDVI value of the study area varies between 0.63 and 0.046. Based on the regression model C-factor for the future scenarios using available CMIP5 (Coupled Model Intercomparison Project-5) has been mapped for the whole district. Using the NDVI map, the C-factor map of the area was prepared in ArcGIS 10.0 software. The spatial distribution shows that the C-factor values varied between 0.52-0.86. On an average C- factor for 2020s, 2050s and in 2080s were 0.53, 0.76, and 0.77 respectively. The predicted C- factor values were then brought under the GIS environment and C- factor prediction maps were generated.

Introduction: Assessment of age in adults is a difficult task in forensic medicine. In craniofacial structures, the mental, mandibular foramina and teeth are useful in age estimation. Because the pulp-to-tooth area ratio (PTR) based on secondary dentin deposition and the distance between the inferior border of the mental foramen and lower border of the mandible stays largely consistent over the course of a person's life, PTR and position of mental foramen are sensitive age markers. Aim: This study aims to assess an accurate method for age estimation, by comparing the results of the two different age estimation techniques such as mandibular canine's PTR and vertical position of the mental foramen using cone beam computed tomographic (CBCT) images. Materials and Methods: In 80 mandibular CBCT images, the pulp area and tooth area of the canine were measured from the axial section and a ratio was obtained. The same process was used for the sagittal sectional image. Another method involved measuring the mental foramen's four variables (X1, X2, X3, and X4) using a panoramic sectional image. The procured data were subjected to statistical analysis. Results: A negative linear relationship was acquired among the pulp cavity width, the height of the mandible (X1), and the age. Cubic regression analysis was performed, and the regression formulae were acquired. A mean difference of 2.11 years in axial section, 3.93 years in sagittal section, and 11.23 years in the mental foramen vertical position was acquired among the age estimated and chronological age. Conclusion: The sagittal sectional image of the mandibular canine's PTR is more accurate for determining age when compared with the vertical position of the mental foramen.

Background: Health-care workers form the strong linkage between the health-care system and the community they belong. The glaring maldistribution of dental workforce in rural areas with higher prevalence of oral cancer warrants the need for involving health-care workers for playing an active role in the prevention of oral cancer. Aim: The aim of this study is to study the perceptions and attitude of the health-care workers in creating the awareness on oral cancer and its associated risk factors to the community they serve. Settings and Design: Chikkaballapur District and Qualitative research. Subjects and Methods: Since the aim was to assess the perceptions and attitude, qualitative research method adopting ethnography strategy was conducted. The data were collected through focus group discussions (FGDs). The FGDs were carried out on the informed schedules with health workers to know their perceptions and attitude. The tools used were semistructured interview/discussion guides. Statistical Analysis Used: The codes were extracted by the deductive approach, and data analysis was done using the Spradley's method (1979) for Ethnography. This includes domain analysis, componential analysis, and identifying themes. Results: A total of 44 key informants and health workers were involved and more than 250 codes emerged after inductive coding. Eleven domains and three themes were identified reflecting the participants' compassion to serve people. Three themes emerged from the FGDs are: (i) Perception that oral cancer can be prevented, (ii) Recognition of the myths and practices associated with the disease and its treatment, and (iii) Motivation to educate people in their villages. Conclusions: Health workers perceived oral cancer was preventable and showed positive attitude to help their rural community by educating about OC and its risk factors.

Introduction: The device VELscope (Visually enhanced lesion scope) is intended as an aid to the clinician to complement a conventional white light exam (whether it be a general oral cavity examination or examination of a particular lesion) to detect abnormal tissue that might have otherwise been overlooked. In this study, it was used concomitantly with ploidy status to evaluate the malignancy potential of Oral Potentially Malignant Disorders (OPMD). Aim: To evaluate potential of Deoxyribonucleic Acid (DNA) ploidy as a preliminary adjunct to oral biopsy to identify patients with aneuploidy for the necessity of biopsy, and to assess the sensitivity of VELscope in the determination of accurate clinical parameters of the lesions in the oral mucosa. Materials and Methods: This in-vivo cross-sectional study was carried out in Department of Oral and Maxillofacial Pathology and Oral Microbiology, Bharati Vidyapeeth Deemed to be University, Pune from February 2020 to February 2021. Clinically diagnosed OPMD were included in the study, after verification of clinical extension boundaries by VELscope. DNA ploidy status was evaluated with DNA image cytometry and exclusive individuals with aneuploidy were biopsied followed by histopathological evaluation and surgical removal of the lesion. One way Analysis of Variance (ANOVA) test was used to compare the mean in 4 study groups [Oral leukoplakia, Oral submucous fibrosis, Oral lichen planus and Tobacco pouch keratosis] vs control. Sensitivity, specificity, positive predictive value and negative positive value was calculated by using the ROC (Receiver Operating Characteristic Curve) analysis. A p-value

Objectives To estimate the prevalence of prediabetes and to assess the association of prediabetic stages with sociodemographic, lifestyle and clinical factorsDesign Cross-sectional study at the screening and inclusion stage of a Diabetes Prevention Education Program (DiPEP) trialSetting The study was conducted in two urban communities in Nepal (October 2019–March 2020).Participants A total of 6222 residents of two study sites, aged 18–64 years and without a history of diabetes, were eligible for prediabetes screening. Exclusion criteria were pregnancy, history of diabetes and critical illness. A total of 291 participants with prediabetes were included in this study.Primary and secondary outcome measures Prevalence of prediabetes based on glycated haemoglobin (HbA1c) criteria (5.7%–6.4%) was the primary outcome of the study. Odds Ratio and 95% CI were estimated to assess the associations between the outcome prediabetic stages (5.7%–5.9% vs 6.0%–6.4%) and sociodemographic, lifestyle and clinical factors in both unadjusted and adjusted models.Results Out of 6222 screened participants, 308 (5%, 95% CI: 4.4% to 5.5%) individuals were detected with prediabetes based on HbA1c. The mean age of 291 responded participants was 50.3±7.6 years and 67% were females. Among them, 78% aged 45–64 years, 97% had central obesity, 90% had high waist–hip ratio, 63% were hypertensive and 66% had no family history of diabetes. Approximately, 54% and 46% of individuals with prediabetes had HbA1c of 5.7%–5.9% and 6.0%–6.4%, respectively. Female gender was associated with prediabetes with HbA1c 6.0%–6.4% (OR, 1.98, 95% CI: 1.07 to 3.67) in the adjusted model.Conclusion The estimated prevalence of prediabetes was 5% among screened participants, and female gender was associated with the prediabetic stage. As a large proportion of the population with prediabetes were not aware of their status, this study demonstrates a need for regular community screening programmes to detect individuals with prediabetes and provide them a comprehensive lifestyle intervention for diabetes prevention.Trial registration number NCT04074148, 2019/783.

Abdominal computed tomography (CT) is a frequently used imaging modality for evaluating gastrointestinal diseases. The detection of colorectal cancer is often realized using CT before a more invasive colonoscopy. When a CT exam is performed for indications other than colorectal evaluation, the tortuous structure of the long, tubular colon makes it difficult to analyze the colon carefully and thoroughly. In addition, the sensitivity of CT in detecting colorectal cancer is greatly dependent on the size of the tumor. Missed incidental colon cancers using CT are an emerging problem for clinicians and radiologists; consequently, the automatic localization of lesions in the CT images of unprepared bowels is needed. Therefore, this study used artificial intelligence (AI) to localize colorectal cancer in CT images. We enrolled 190 colorectal cancer patients to obtain 1558 tumor slices annotated by radiologists and colorectal surgeons. The tumor sites were double-confirmed via colonoscopy or other related examinations, including physical examination or image study, and the final tumor sites were obtained from the operation records if available. The localization and training models used were RetinaNet, YOLOv3, and YOLOv8. We achieved an F1 score of 0.97 (±0.002), a mAP of 0.984 when performing slice-wise testing, 0.83 (±0.29) sensitivity, 0.97 (±0.01) specificity, and 0.96 (±0.01) accuracy when performing patient-wise testing using our derived model YOLOv8 with hyperparameter tuning.

Metal Organic Frameworks (MOFs) are extensively used for a wide range of applications due to their exceptionally high surface area. MOF particles are conventionally in micron size, but the nanosized MOFs show good transportation/mobility due to their small size, and when combined with the high surface area of MOFs, it makes MOF nanoparticles an ideal candidate to study for environmental remediation. Therefore, it is important to study the ecotoxicological impact of these MOFs. In this study, we developed rhodamine labelled nanoparticles of zinc imidazolate metal organic framework (ZIF-8 MOFs) as a means of in vivo tracing the MOF translocation in C. elegans. Rhodamine B isothiocyanate functionalized ZIF-8 MOFs nanoparticles (RBITC@ZIF-8 MOF nanoparticles; size 44 ± 7 nm) were fed to the worms naturally within a concentration range of 0.16–16.4 μg mg−1. Fluorescence was detected in the pharyngeal and gut lumen regions of the worms after 4 h of treatment, for exposure concentrations >0.163 μg mg−1. A higher intensity of fluorescence was observed at the end of 24 h for all exposure concentrations. Worms treated with RBITC@ZIF-8 MOF concentrations of ≥1.63 μg mg−1 for 24 h showed a bright stable fluorescence signal at the tail region. The uptake of RBITC@ZIF-8 MOF for an exposure concentration of 0.163, 1.63, and 8.2 μg mg−1 was found to be 52.1, 11.4 and 28.6%, respectively. Through this study, we showed that RBITC@ZIF-8 MOFs can be exposed to C. elegans and imaged at low concentrations of ∼0.16 μg mg−1.

The selection of better polarisation and incidence angle for soil moisture retrieval using RISAT-1 microwave data was experimented at Hayathnagar research farm of ICAR-CRIDA, Hyderabad. Fine Resolution Sensor (FRS-1) data (spatial resolution of 3 m) and Medium Resolution ScanSAR (MRS) data (spatial resolution of 25 m) acquired from circular and dual polarised microwave data were used for the retrieval of soil moisture and to identify the best polarisation suitable for the study area. The evaluation was carried out during 2016-17. FRS-1 data was more accurate than MRS data for the extraction of soil moisture in the study area. Circular and dual-Polarisation retrieved soil moisture values were compared with volumetric soil moisture values for assessing the better polarisation. Dual polarisation and the incident angle between 15-20 degrees with R2=0.952 performed better as compared to circular polarisation with more or less than 20 degrees' incident angle. A correction factor of -0.723 was derived and applied to FRS-1 data with less than a 20-degree incident angle for getting real soil moisture values on the spatio-temporal basis to optimize the management of natural ecosystems under climate change threat.

Abstract Background The purpose of this study will be to improve diabetes prevention, access to care and advocacy through a novel cost-effective nurse-led continuum of care approach that incorporates diabetes prevention, awareness, screening and management for low-income settings, and furthermore utilizes the endeavor to advocate for establishing a standard diabetes program in Nepal. Methods We will conduct a two-arm, parallel group, stratified cluster randomized controlled trial of the NUrse-led COntinuum of care for people with Diabetes (N 1 = 200) and prediabetes (N 2 = 1036) (NUCOD) program, with primary care centers (9 outreach centers and 17 government health posts) as a unit of randomization. The NUCOD program will be delivered through the trained diabetes nurses in the community to the intervention group and the outcomes will be compared with the usual treatment group at 6 and 12 months of the intervention. The primary outcome will be the change in glycated hemoglobin (HbA1c) level among diabetes individuals and progression to type 2 diabetes among prediabetes individuals, and implementation outcomes measured using the RE-AIM (reach, effectiveness, adoption, implementation and maintenance) framework. Outcomes will be analyzed on an intention-to-treat basis. Discussion The results of this trial will provide information about the effectiveness of the NUCOD program in improving clinical outcomes for diabetes and prediabetes individuals, and implementation outcomes for the organization. The continuum of care model can be used for the prevention and management of diabetes and other noncommunicable diseases within and beyond Nepal with similar context. Trial registration ClinicalTrials.gov, NCT04131257 . Registered on 18 October 2019.

Background: Currently, vitrectomy is considered as the first line of treatment in the management of macular holes. Various surgical modalities have been described to obtain anatomical closure. However, there are still challenges when the hole is large and chronic (>400 microns) in nature. Here we describe a modified technique of internal limiting membrane (ILM) peeling which results in the successful closure of such macular holes. Purpose: To demonstrate modified ILM flap techniques in management of chronic macular holes. Synopsis: Here we have described the role of modified ILM peeling techniques in three different cases such as chronic traumatic macular hole >400 microns, chronic idiopathic macular hole >400 microns and

Rainfed agriculture, though resource-poor, contributes to around 40 percent of total food production in India. Fodder grass-strip-based systems improve soil’s physical and biological properties, control soil erosion, and help in slope stabilization without compromising productivity. Permanent fodder grass strips can effectively check the depletion of soil nutrients and can also act as sediment traps vis-à-vis meeting the green fodder requirement for small ruminants. This study was carried out with the major objective to quantify the impact of grass-strip-based cropping systems on soil quality. Further fodder quality assessment was carried out using the grass quality index for small ruminant feed and the profitability of different treatments was analyzed. Random block design (RBD) with three treatments which included two types of fodder grass (Brachiaria ruziziensis and Stylosanthes hamata) on both sides of the cropped field was used for the study. The results showed that the soil quality increased from 0.39 to 0.52 and the runoff reduced significantly with soil loss reduction by 65-70 percent. The fodder quality assessment showed that the palatability of Stylosanthes hamata and Brachiaria ruziziensis was about 65 percent and 40 percent, respectively. The fodder grass strip increased the net returns by 30 percent. This easily adaptable natural resource management technology reduces soil nutrient loss and will help resource-poor rainfed farmers to maintain soil health and productivity under variable rainfall conditions with fair support to small ruminants.

Introduction Evidence suggests that diabetes burden can be reduced by implementing early lifestyle intervention programmes in population with pre-diabetes in high-income countries. However, little is known in developing nations like Nepal. This study aims to assess effectiveness of community-based Diabetes Prevention Education Program (DiPEP) on haemoglobin A1c (HbA1c) level, proportion of pre-diabetes reverting to normoglycaemia, diet, physical activity, weight reduction, diabetes knowledge and health literacy after 6 months of follow-up. Furthermore, we will also conduct qualitative studies to explore experiences of participants of intervention sessions and perception of healthcare workers/volunteers about DiPEP.Methods and analyses This is a community-based two-arm, open-label, cluster randomised controlled trial. We will randomise 14 clusters into intervention arm and control arm. Estimated total sample size is 448. We will screen individuals without diabetes, aged 18–64 years, and permanent residents of study sites. HbA1c test will be only performed if both Indian Diabetes Risk Score and random blood sugar value are ≥60 and 140–250 mg/dL, respectively. At baseline, participants in intervention arm will receive DiPEP package (including intensive intervention classes, diabetes prevention brochure, exercise calendar and food record booklet), and participants in control arm will be provided only with diabetes prevention brochure. The change in outcome measures will be compared between intervention to control arm after 6 months of follow-up by linear mixed models. Also, we will conduct individual interviews among participants and healthcare workers as part of a qualitative study. We will use thematic analysis to analyse qualitative data.Ethics and dissemination Regional Committee for Medical and Health Research Ethics, Norway; Nepal Health Research Council, Nepal and Institutional Review Committee, Kathmandu University School of Medical Sciences have approved the study. The DiPEP package can be implemented in other communities of Nepal if it is effective in preventing diabetes.Trial registration number NCT04074148, 2019/783.

Retinal folds are rare complications of rhegmatogenous retinal detachment surgery. They may be located in periphery or involve macula, with the latter ones being associated with severe visual loss. Due to the paucity of scientific reports, its management remains debatable. Most authors advocate an early surgical intervention for symptomatic macular folds (MF). We present 2 cases of symptomatic dry macular fold which were managed successfully after different time intervals. As evidence gets collected that late intervention also leads to good visual outcome, long standing MF should not be considered an absolute contraindication for surgical intervention.

Background: Lower respiratory tract infections are one of the most common infections among the patients in Intensive Care Units (ICUs). Admission in ICUs and use of life supporting devices increase the risk of infection with multidrug resistant pathogens. Aims and Objectives: This study was aimed to determine the prevalence and antibiograms ofthe bacterial pathogens causing lower respiratory tract infectionsamong patients of ICUs. Materials and Methods: A total of 184 specimens from patients admitted in ICUswith lower respiratory tract infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Carbapenamase detection was performed by modified Hodge test method.Detection of metallo beta lactamase (MBL) was tested by imipenem and imipenem/EDTA disc. Detection of Klebsiellapneumoniaecarbapenamase (KPC) was performed by imipenem and imipenem/phenyl boronic acid. Results: Out of 184 samples, 131 showed significant growth of bacterial pathogens. Acinetobacter species (42.6%), Staphylococcus aureus (16.9%) and Pseudomonasaeruginosa(13.9%)were the three most common isolates. Out of 22 imipenem resistant isolates of Acientobacter species, 9 were KPC producer, 4 were MBL producers and 3 isolates were positive for MBL and KPC both. Among the Acinetobacter species, 5.1% isolates were resistant to tigecycline and colistin. One isolate of Pseudomonas aeruginosa was positive for MBL. Conclusions:High prevalence of multidrug resistant bacteria in ICUs was recorded. Gram negative bacilli were predominantly associated with LRTI among ICU patients;Acinetobacterspecies being most common isolate. Detection of carbapenamase among the Acinetobacterand emergence of tigecycline resistancelimits the therapeutic options.Regular monitoring of such resistant isolates would be important for managing infection control in critical units.

Background: Pulmonary pathologies constitute a major ailment in terms of morbidity and mortality. Recent technological advancements provide cytological analysis that accentuates accurate diagnosis, early intervention, management, and ease of clinical follow-up with improved outcomes. This study aimed to correlate the sensitivity and describe advantages and disadvantages of the various cytological means of the diagnosis of lung pathologies along with the sequential approach. Materials and Methods: This was a prospective study performed during the period of January 2013 to January 2015. Samples of sputum and bronchoscopy-mediated bronchoalveolar lavage (BAL) fluid, air-dried and alcohol-fixed smears of bronchial brushing (BB), transbronchial needle aspiration (TBNA), and formalin-fixed bronchial biopsy tissues were received, processed, and analyzed from all clinically and radiologically suspected cases of pulmonary pathologies. Results: Two hundred cases of lung lesions were included with all the four cytological sampling interventions and tissue biopsy in the present study with an age range of 21–90 years and male:female ratio of 2.45:1. There were 111 neoplastic and 89 nonneoplastic cases. The diagnostic sensitivity was maximum with BB cytology for nonneoplastic as well as neoplastic lesions. The overall diagnostic utility observed in 200 cases reveals sputum cytology as least sensitive and BB cytology as most sensitive investigation. Conclusion: Sputum cytology is used in patients who are unfit for bronchoscopy and inpatients for their routine evaluation of underlying infection. BAL enhances yield from intraluminal lesions, and TBNA enhances yield in submucosal and mediastinal lesions. The proposed protocol for cytomorphological diagnosis should be as sputum > BAL > TBNA > BB in order of ease.

Background: Hemoglobin (Hb) variants arise due to point mutations in globin chains and their pathological treatments rely heavily on the identification of the nature and location of the mutation in the globin chains. Traditional methods for diagnosis such as HPLC and electrophoresis have their own limitations. Therefore, the present study aims to develop and optimize a specific method of sample processing that could lead to improved sequence coverage and analysis of Hb variants by nano LC−MALDI MS/MS. Methods: In our study, we primarily standardized various sample processing methods such as conventional digestion with trypsin followed by 10% acetonitrile treatment, digestion with multiple proteases like trypsin, Glu−C, Lys−C, and trypsin digestion subsequent to 2,2,2 trifluoroethanol (TFE) treatment. Finally, the peptides were identified by LC−MALDI MS/MS. All of these sample processing steps were primarily tested with recombinant Hb samples. After initial optimization, we found that the TFE method was the most suitable one and the efficiency of this method was applied in Hb variant identification based on high sequence coverage. Results: We developed and optimized a method using an organic solvent TFE and heat denaturation prior to digestion, resulting in 100% sequence coverage in the β−chains and 95% sequence coverage in the α−chains, which further helped in the identification of Hb mutations. A Hb variant protein sequence database was created to specify the search and reduce the search time. Conclusion: All of the mutations were identified using a bottom−up non−target approach. Therefore, a sensitive, robust and reproducible method was developed to identify single substitution mutations in the Hb variants from the sequence of the entire globin chains. Biological Significance: Over 330,000 infants are born annually with hemoglobinopathies and it is the major cause of morbidity and mortality in early childhood. Hb variants generally arise due to point mutation in the globin chains. There is high sequence homology between normal Hb and Hb variant chains. Due to this high homology between the two forms, identification of variants by mass spectrometry is very difficult and requires the full sequence coverage of α− and β−chains. As such, there is a need for a suitable method that provides 100% sequence coverage of globin chains for variant analysis by mass spectrometry. Our study provides a simple, robust, and reproducible method that is suitable for LC−MALDI and provides nearly complete sequence coverage in the globin chains. This method may be used in the near future in routine diagnosis for Hb variant analysis.

Objective: Endometrial cancer (EC) is the most commonly diagnosed malignancy and has the second-highest mortality rate among gynecological cancers. Adenomyosis is well-known for abnormal uterine bleeding and is a widely reported entity; however, an EC arising from the adenomyosis is a rare event; even rarer is the occurrence of serous endometrial carcinoma. Case report: A 60-year post-menopausal female presented with post-menopausal bleeding. Subsequently, she underwent a hysterectomy, which showed atrophic and cystic endometrium with extensive adenomyosis and atypical endometrial glands, which are diffusely P53 positive with intervening negative benign and focally positive dysplastic endometrial glands. A final diagnosis of serous endometrial carcinoma arising from adenomyosis was rendered. In a table format, previously reported serous endometrial carcinoma Arising cases from adenomyosis using PubMed search had been described. Conclusion: Serous endometrial carcinoma arising from adenomyosis (

Introduction: The increase in prevalence of oral premalignant lesions and oral cancer in India is due to cultural, ethnic, geographic factors and varying lifestyle factors like consumption of tobacco, alcohol and standard of living. Some of the risk factors are modifiable and emphasises the need for detailed assessment of these modifiable risk factors and increasing awareness among general public and policy makers. Aim: The present study was conducted to assess the association between lifestyle factors and Oral Potentially Malignant Disorders (OPMDs). Materials and Methods: A case-control study was conducted where 154 cases and controls were selected from MS Ramaiah Dental College and Hospital, Bangalore and peripheral outreach centers of MS Ramaiah Dental College and Hospital, Bangalore. Cases diagnosed as oral leukoplakia, erythroplakia and Oral Submucous Fibrosis (OSMF) based on the World Health Organisation (WHO) criteria (1980) were included in the study group. Age and sex (1:1) matched controls without OPMDs were included in control group. The data was collected regarding socio-demographic factors, blood group and lifestyle factors using specially designed proforma. Chisquare test and odds ratio were utilised to association and strength of association between various lifestyle factors and development of OPMDs. Univariate logistic regression test was done followed by multiple logistic regression for identifying the risk factors. The p-value

Visceral leishmaniasis (VL)-related mortality and morbidity imposes a great deal of health concern across the globe. The existing anti-leishmanial drug regimen generally fails to eliminate newly emerging resistant isolates of this dreadful parasite. In such circumstances, the development of a prophylactic strategy to impart protection against the disease is likely to take center stage. In order to develop a promising prophylactic vaccine, it is desirable to identify an adequately potential vaccine candidate. In silico analysis of Leishmania tubulin folding cofactor D protein predicted its potential to activate both B- and T-cell repertoires. Furthermore, the ELISA employing anti-peptide27 (a segment of tubulin folding cofactor D) antibody revealed its proficiency in VL diagnosis and treatment monitoring. The peptide27 and its cocktail with another Leishmania peptide (peptide23) prompted the up-regulation of pro-inflammatory cytokines, such as IFN-γ, TNF-α, IL-2, IL-17, etc., and the down-regulation of immune-regulatory cytokines, such as IL-10, in the immunized BALB/c mice. Coherent to the consequence of peptide-specific humoral immune response, peptide cocktail-based immunization ensued in the predominant amplification of pathogen-specific IgG2a over the IgG1 isotype, up-regulated proliferation of T lymphocytes, and enhanced production of nitric oxide, reactive oxygen species, etc. We also established that the peptide cocktail modulated host MAPK signaling to favor the amplification of Th1-dominated immune response in the host. The peptide cocktail mediated the activation of the host immune armory, which was eventually translated into a significant decline in parasitic load in the visceral organs of experimental animals challenged with Leishmania donovani.