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Abstract Background The biofloc system (BFS) provides a sustainable aquaculture system through its efficient in situ water quality maintenance by the microbial biomass, besides continuous availability of these protein-rich microbes as feed to enhance growth and immunity of the reared organism. This study explores the gill architecture, growth performance, digestive enzyme activity, intestinal microbial composition, and histology of three freshwater fish species, Puntius gonionotus, Pangasianodon hypophthalmus, and Heteropneustus fossilis reared in biofloc based polyculture system. Results The three species in T2 showed significantly higher WG and SGR, followed by T1 and T3. The wet mount of gill architecture showed smaller inter-filament gaps in gill arches of silver barb followed by stinging catfish and stripped catfish, but showed no correlation with the weight gain. However, silver barb being an omnivore and filter-feeder, accumulated a more diverse microbial community, both in T1 and BFS (T2 and T3), while the bottom feeder H. fossilis exhibited unique gut bacterial adaptability. The presence of floc in T2 and T3 enhanced bacterial abundance in water and fish gut, but their microbial diversities significantly reduced compared to T1 receiving only feed. Next-generation sequencing revealed that the Pseudomonas dominated in gut of P. gonionotus and P. hypophthalmus in T1, Enterobacterales and Fusobacterium prevailed in those of T2 and T3, respectively. In contrast, gut of H. fossilis had the highest proportion of Clostridium in T1, while Rhizobiaceae dominated in T3. Similarly in floc samples, Enterococcus dominated in T1 while Micrococcales and Rhizobiaceae dominated in T2 and T3, respectively. A positive correlation of enterobacteria, with the digestive enzyme activities and growth patterns was observed in all treatments. Conclusion The present study revealed feeding behaviour to play crucial role in distinguishing the gut microbial composition patterns in fishes reared in Biofloc System. Further it revealed the requirement of supplementary feed along with floc in these three species for higher growth in the biofloc system.

Abstract Background Effective endodontic treatment requires the use of a root canal sealer with optimal properties to ensure a hermetic seal, prevent reinfection, and promote healing. Despite the availability of various sealers, a standardized evaluation system still needs to be improved. Objectives To develop a Clinical Utility Index (CUI) that systematically evaluates and ranks root canal sealers based on their sealing ability, antimicrobial efficacy, flow rate, and solubility. Methods The CUI was developed through a structured process involving expert identification, panel discussions, and the establishment of scoring criteria. Five sealers were evaluated (Sealers A, B, C, D, and E). Mean values for the core properties were calculated, and sealers were ranked accordingly. The total CUI for each sealer was computed based on the assigned scores for each property. Results Sealer B achieved the highest CUI at 95%, demonstrating superior performance across all core properties. Sealer C followed with a CUI of 80%, while Sealer A ranked third with 60%. Sealers D and E showed the lowest performance, with CUIs of 30% and 35%, respectively, highlighting deficiencies in multiple properties. Discussion The CUI provides a comprehensive evaluation framework for root canal sealers, facilitating informed decision-making by practitioners. Sealer B's high CUI underscores the importance of balancing sealing ability, antimicrobial effect, flow rate, and solubility. The results align with existing literature emphasizing the critical role of these properties in endodontic success. Conclusion The CUI offers a robust and balanced method for evaluating root canal sealers, aiding in selecting the most suitable sealer based on empirical data. Future research should refine the index and validate its applicability in diverse clinical scenarios to enhance endodontic treatment outcomes.

Background: Clinical teaching and educational activities are of the utmost importance in nursing education for overcoming the theory–practice gap. There is a significant paucity of knowledge on nursing students’ experiences in the clinical learning setting and how supervision is carried out. AIM: The intent of this research is to determine the perception of undergraduate nursing student towards clinical learning environment and supervision. Methods: An institution-based, cross-sectional, descriptive-exploratory study comprising 476 nursing students selected through stratified sampling, conducted in the selected Institutes of National Importance (INI) using Google Form. The study instrument used includes self-structured demographic section and rating scale to assess the students’ perception towards the clinical learning environment and supervision. Descriptive and inferential statistics were used for data analysis using IBM SPSS (version 23). Results: A study of 476 nursing students from across INI, majority were aged 21–24 years (74.8%), found significant differences in their perceptions of the clinical learning environment and supervision. In terms of the clinical learning environment, almost all of first-year students (94.1%) considered nursing officers in the unit were learning sources, and 92.4% said that they learned something new every day in clinical settings. The majority of third-year students (89.1%) stated that increasing exposure to patients was the primary source of their clinical learning. First-year students had positive perceptions of supervision, although their expectations differed from those of higher-year students. Conclusion: According to the study, the majority of students feel that effective clinical learning environment necessitates excellent communication skills, a positive attitude, motivation and effective problem-solving strategies. Regarding supervision, students respect good communication skills, confidence in the supervisory relationship, constructive criticism and trust.

Abstract Introduction In remote communities, maternal and child health is often compromised due to limited access to healthcare. Simultaneously, these communities historically rely greatly on traditional birth attendants (TBAs). However, optimal integration of these traditional methods with modern healthcare practices remains a topic of debate. We assessed the effect of maternal and child health training of traditional birth attendants on adverse pregnancy outcomes. Methods We conducted a systematic review and meta-analysis to answer the above research question. We independently screened studies using databases like PubMed, Scopus, and CENTRAL, extracted data, and assessed the study quality. Due to fewer original studies in this field, we considered both pre-post and between-group differences to assess the effect of differences. These were synthesised separately, assessed against a p-value function, and subjected to sensitivity analyses. Results We included six interventional studies. Training TBAs reduced the risk of perinatal mortality [0.69, 0.61–0.78] and 7-day neonatal mortality [0.65, 0.53–0.80] but not stillbirth [0.70, 0.39–1.26]. In randomized controlled trials, there is a lower risk of perinatal mortality [0.73, 0.67–0.79] and neonatal mortality [0.70, 0.62–0.80] but not stillbirth [0.81, 0.56–1.18] with trained traditional birth attendants. There are methodological concerns with most existing studies, including domains like allocation concealment. Discussion There is some evidence of the benefit of training TBAs, though of a low to very low certainty. Due to fewer studies, inconsistent estimates for different critical outcomes, and concerns with the existing studies, further well-designed studies can give more insights. They can also help optimize the contents of TBA training interventions. Protocol CRD42023412935 (PROSPERO).

A total of 200 day-old COBB-500 chicks were randomly allocated into four dietary treatments with five replications and ten birds per replicate for 28 days to select the most effective forms of plantain herb for broiler performance and meat quality. The control diet (CL-D) and different forms of plantain diets were based on corn-soybean meal that was iso-caloric and iso-nitrogenous. The different forms of plantain diets were fresh plantain-diet (FP-D): CL-D + fresh-plantain, shade-dried plantain-diet (SP-D): CL-D + shade-dried plantain powder, and blanched-dried plantain-diet (BP-D): CL-D + blanched-dried plantain powder. Plantain herb was given at a 1.0% dry matter basis. Daily feed consumption and weekly body weight were noted, whereas blood samples were taken and a meat panel test was confirmed by specialists in meat on day 28. Birds given the different forms of plantain diets revealed a 6-10% greater body weight gain compared to the CL-D (P < 0.05). Plantain diets in different forms showed a 3–6% better feed, crude protein, and metabolizable energy conversion ratio compared to the CL-D (P < 0.05), but no difference was observed between BP-D and SP-D (P > 0.05). Compared to the CL-D, birds fed the different forms of plantain diets reduced serum triglyceride and total cholesterol by 4–11% and 6–9%, respectively (P

Introduction: Newborn care practices and beliefs vary word-wide, country to country and region to region. These care practices play a vital role in morbidity and mortality of newborn. A descriptive cross-sectional study was conducted to assess the newborn care practices and beliefs of newborn care. Methods: Data was collected from 429 post-natal mothers, who delivered in selected government hospitals of Santhal parganas, Deoghar, Jharkhand. Convenience sampling technique was used to collect the data from February 2023 to April 2023. Results: Findings of the study are, 86.9% mothers accepted that they massage the baby with oil before bath, 89.3% participants have given breastfeeding within one hour of delivery, 93.7% have given prelacteal feeds to the newborn. Applying Heeng (Asafoetida) over the umbilicus was found a common practice to cure the abdominal pain, 70.8% accepted that they apply ashes or powder or cow dung on the umbilical cord, and 88.3% rub the dough on baby’s skin to remove excess hairs, 99.3% mothers had firm belief that hot and cold foods in their diet could harm the baby. In continuation 98.8% believed that tooth eruption is associated with diarrhoea, 95.6% are applying kajal in the eyes of new born. Majority 98.8% believed that baby’s skin should be exposed to sunlight in case of jaundice and 94% avoid dressing of new born with yellow clothes. Conclusion: Continuous Health Education programs must be organized in Community to Educate the people about beneficial and harmful newborn care practices, which will help to reduce morbidity and mortality in newborn.

Sexually transmitted diseases/infections (STDs/STIs) are one of major public health concern, and syphilis in today’s era is not an uncommon diagnosis. The rising trend of syphilis cases can be attributed to changes in sexual practices such as individuals being engaged in oro-genital or anogenital sex, having multiple sexual partners, increase in men having sex with men, HIV co-infection, and drug abuse. Syphilis mimics many other diseases, and diagnosis can be delayed if the clinician is not aware of varied presentations. Often, unusual mucocutaneous manifestations have fascinated dermatologists, leading to diagnostic difficulties. In today’s era, cases of secondary and latent syphilis are being more commonly encountered than those of primary syphilis. Herein, we emphasize on varied mucocutaneous manifestations of secondary syphilis among young individuals. We would like to highlight the need for the implementation of sex education among adolescents/young adults to prevent STDs/STIs.

Abstract Background This update outlines amendments to the CHAMPION2/STRIPES2 cluster randomised trial protocol primarily made due to the COVID-19 pandemic and nationwide lockdown in India in 2020. These amendments were in line with national guidelines for health research during the COVID-19 pandemic. Methods We did not change the original trial design, eligibility, and outcomes. Amendments were introduced to minimise the risk of COVID-19 transmission and ensure safety and wellbeing of trial staff, participants, and other villagers. CHAMPION2 intervention: participatory learning and action (PLA) and fixed day service (FDS) meeting were revised to incorporate social distancing and hygiene precautions. During the COVID-19 pandemic, PLA participation was limited to pregnant women and birthing partners. STRIPES2 intervention: before/after-school classes were halted for a period and then modified temporarily (reducing class sizes, and/or changing meeting places) with hygiene and safe distancing practices introduced. Data collection: The research team gathered as much information as possible from participants by telephone. If the participant had no telephone or could not be contacted by telephone, data were collected in person. COVID-19 precautions: trial teams were trained on COVID-19 precautions and used personal protective equipment whilst in the villages for trial-related activities. After restarting the trial between June and September 2020 in a phased manner, some trial activities were suspended again in all the trial villages from April to June 2021 due to the second wave of COVID-19 cases and lockdown imposed in Satna, Madhya Pradesh. Trial timelines were also revised, with outcomes measured later than originally planned. Trial registration Clinical Trial Registry of India CTRI/2019/05/019296. Registered 23 May 2019. https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MzExOTg=&Enc=&userName=champion2 .

One of the most common diseases causing the destruction of enamel and remaining tooth structure is dental caries which further leads to pulpal and periapical inflammation if not treated. As tools for revealing important factors in identifying targets disease and pathophysiology for the evolution of prevention and treatment strategies, molecular and cellular biology plays a pivotal role. Finding an accurate diagnosis that will serve as the foundation for effective treatment continues to be one of the key issues in endodontics. Inflammatory biomarkers play a diverse and broad role in endodontics, with the potential to become a key factor in determining treatment plans by assisting in diagnosis and prognosis. Inflammatory biomarkers have the potential to become a key factor in determining treatment plans by assisting in diagnosis and prognosis. Endodontists are still divided on issues such as vital pulp therapy versus traditional root canal therapy and retreatment versus periapical surgery. Furthermore, clinical challenges such as determining the appropriate tissue fluid to analyse, establishing a precise inflammatory threshold, and delivering results at the chairside must be overcome. Endodontists may soon be able to use chairside genetic tests to make more informed treatment decisions for their patients.

There are well-established rules and methods about sample size estimation in quantitative research approaches. However, qualitative research approaches justify very little about sample size estimation principles and largely depend on subjective judgements and arbitrariness. Contrarily, an adequate sample size is essential for a study to address the core elements of validity and credibility in qualitative research too such as rigor, trustworthiness, conformability and acceptance. Therefore, this review was carried out to explain the available methods to estimate sample size for qualitative studies. After conducting a thorough literature review, we discovered related articles that explore the estimation of sample size for qualitative studies. By examining these findings and integrating the information with our personal experience for estimation of sample size in the field of qualitative studies, we have produced an all-encompassing narrative review. After an in-depth literature search, four different approaches were described in this paper to answer the question of how to estimate sample size in qualitative studies. The four approaches described in this paper are (a) rules of thumb, (b) conceptual models, (c) concept of saturation and (d) statistics-based methods for sample size estimation in qualitative research. The paper presents four methods for estimating sample size in qualitative studies and simplifies the statistical approach for saturation calculation in qualitative studies. Yet, it is vital to responsibly integrate these methods, acknowledging their limitations and maintaining the importance of sample size estimation in qualitative studies.

The study explores the intricate interplay between land use land cover (LULC), normalized difference vegetation index (NDVI), and land surface temperature (LST) within the Lower Son River Basin in India from 1991 to 2020. The region’s ecological balance has been increasingly strained due to rapid urbanization and changing land use patterns. Through a combination of Landsat TM & OLI/TIRS satellite imageries and geospatial analysis techniques, this study unveils the intricate connection between land use and land cover changes, vegetation, and land surface temperature variations. The study area is classified into three altitudinal zones (Zone I: 39–300 m, Zone II: 301–600 m and Zone III: 601–1,247 m) to examine the changes in depth. The area has seen significant changes in LULC, vegetation and LST in all the three altitudinal zones. The findings hold significant implications for sustainable land management and environmental conservation strategies in the Lower Son River Basin. As per the result, 103,438 ha of vegetation was converted into agriculture land and 82,572 ha of agricultural land was transformed into settlements from 1991 to 2020. This trend shows human pressure on the land resource in the study area. Minor increase in water body is seen which is attributed to commissioning of Bansagar dam. Zone I has seen highest settlement growth while Zone III experienced severe deforestation of around 15%. Zone II and III needs attention for holistic sustenance. Analysis of LST shows that it has increased by 0.82 °C from 1991 to 2020 which is a red flag. The study underscores the critical importance of balanced land use practices to preserve ecological integrity and mitigate the adverse effects of urbanization and climate change.

Abstract Advanced diagnostic methods are necessary for the prompt and reliable identification of tuberculosis (TB), which continues to be a worldwide health problem. Globally, there were projected to be 10 million new cases of tuberculosis in 2021, of which 9.8 million affected adults and 0.2 million children. About 15% of fatalities worldwide are attributable to tuberculosis (1.5 million deaths for every 10 million infections). To create a reliable model for tuberculosis (TB) identification using chest X‐ray pictures, we use deep learning approaches in this work, namely Convolutional Neural Networks (CNNs) and a combination of transfer learning and hyperparameter tuning. The dataset provides a varied selection of 3500 normal and 700 TB‐infected patients. It consists of 4200 photos that were obtained from the “Tuberculosis (TB) Chest X‐ray Database” on Kaggle. By utilizing the benefits of a trained model, the suggested methodological approach incorporates transfer learning. To maximize the performance of the suggested model, hyperparameter adjustment is also used. Using the VGG19 pre‐trained neural network, the model design is based on the concepts of transfer learning. The architecture makes use of task‐specific layers, regularization methods, and deliberate layer freezing to enable sophisticated categorization. Training and assessment stages demonstrate encouraging outcomes, with an accuracy of almost 98% attained on a different test dataset. A more thorough examination highlights the need for caution when interpreting high accuracy, nevertheless, by highlighting possible difficulties.

A series of methoxy substituted pyrazole based pyrazoline derivatives (4a-j) were synthesized in good to excellent yield from corresponding pyrazole-chalcones (3a-j). All synthesized derivatives were characterized and screened for their in vitro anti-inflammatory, antioxidant, antidiabetic, and antibacterial activities. Among the series, compounds 4f, 4j, 4a, and 4i showed better anti-inflammatory activity as compared to diclofenac sodium. In DPPH free radical scavenging assay, all the compounds were shown excellent activity and moderate to good activity in SO and NO free radical scavenging assay as compared to standard ascorbic acid. Antibacterial screening of synthesized pyrazolines showed that compounds 4f and 4j have significant antibacterial activity. The compounds 4j, 4f, 4h, 4a, and 4c have shown comparable inhibition of alpha-amylase enzyme leading to good antidiabetic activity as compared to standard acarbose. Molecular docking studies suggest that these compounds have strong binding with COX-2 and alpha-amylase enzyme due to significant capability of aromatic and hydrophobic interaction. The outstanding results of reported compounds in all biological screening will pave the way for the design of new drug candidate bearing pyrazole moiety.

Repositioning of FDA approved/clinical phase drugs has recently opened a new opportunity for rapid approval of drugs, as it shortens the overall process of drug discovery and development. In previous studies, we predicted the possibility of better activity profiles of flavopiridol, the FDA approved orphan drug with better fit value 2.79 using a common feature pharmacophore model for anti-adipogenic compounds (CFMPA). The present study aimed to investigate the effect of flavopiridol on adipocyte differentiation and to determine the underlying mechanism. Flavopiridol inhibited adipocyte differentiation in different cell models like 3T3-L1, C3H10T1/2, and hMSCs at 150 nM. Flavopiridol was around 135 times more potent than its parent molecule rohitukine. The effect was mediated through down-regulation of key transcription factors of adipogenesis i.e. Peroxisome proliferator-activated receptor gamma (PPARγ), CCAAT/enhancer-binding protein alpha (C/EBPα), and their downstream targets, including adipocyte protein −2 (aP2) and fatty acid synthase (FAS). Further, results revealed that flavopiridol arrested the cell cycle in G1/S phase during mitotic clonal expansion by suppressing cell cycle regulatory proteins i.e. Cyclins and CDKs. Flavopiridol inhibited insulin-stimulated signalling in the early phase of adipocyte differentiation by downregulation of AKT/mTOR pathway. In addition, flavopiridol improved mitochondrial function in terms of increased oxygen consumption rate (OCR) in mature adipocytes. In the mouse model of diet-induced obesity, flavopiridol attenuated obesity-associated adipose tissue inflammation and improved serum lipid profile, glucose tolerance as well as insulin sensitivity. In conclusion, the FDA approved drug flavopiridol could be placed as a potential drug candidate for the treatment of cancer and obesity comorbid patients.

Tuberculosis (TB) is a major worldwide health problem, particularly in India, where it accounts for a quarter of infections. Adherence to the directly observed treatment, short-course (DOTS), which is necessary for TB treatment, is difficult in resource-limited circumstances. This study addressed the knowledge, attitude, and perceived barriers related to TB and DOTS adherence among patients and caregivers. A cross-sectional survey was undertaken at the selected TB clinics between November 2023 and March 2024. Purposive sample yielded 180 patients and 217 caregivers. Data were obtained using validated, self-structured questionnaires that assessed knowledge, attitude, and perceived barriers to TB and DOTS adherence. Statistical analysis was carried out with IBM SPSS version 23.0. The study found that caregivers had considerably greater TB knowledge than patients (p

In recent times, outlier detection has played a crucial role in computer networks, fraud detection, and many such applications. Despite adequate research initiatives addressing the topic of finding outliers in datasets, still faces numerous obstacles in establishing an appropriate approach for addressing specific applications of interest. The paper introduces an unsupervised outlier detection method, achieving robust local density estimation through the customization of a nonparametric kernel density evaluation. The identification of outliers involves comparing the local density of each data point with that of its neighbors. Additionally, the proposed method addresses the challenge of manually selecting the parameter for the size of the nearest neighborhood by assigning a predefined value to this parameter. With this predefined value of the parameter, the proposed method demonstrates efficient results, unlike other existing methods that require different values of this parameter for different datasets. To demonstrate the impact of this parameter and evaluate the performance of the proposed method, several assessments were done. The findings prove that the suggested method effectively detects local outliers.

Introduction Practice variation in newborn toxicology testing during the birth hospitalization exists across institutions and legal jurisdictions. While testing can provide benefits, indiscriminate testing has been shown to perpetuate health care inequities. In the backdrop of an opioid epidemic and a charged medicolegal landscape, this workshop guides participants to reexamine newborn toxicology testing through a shared ethical lens. Methods We conducted a live, 90-minute workshop in English at an international pediatric conference. Physicians, residents, and fellows participated in large- and small-group breakout sessions to learn relevant clinical and bioethical frameworks, share their own local context and expertise, and explore ethical applications through case-based discussions. We administered two anonymous online follow-up surveys to assess self-perceived impact on participant knowledge, behavior, and clinical practice. Results Seven facilitators and 45 individuals participated in the workshop. Eighteen participants completed survey 1 immediately following workshop conclusion, and six participants completed survey 2 after 3 months had elapsed. Immediately following the workshop, 94% of respondents reported that they had been introduced to a new idea, and 82% were considering practice change. A low response rate to survey 2 limited interpretation, but some respondents reported self-perceived change following workshop attendance. Discussion This workshop facilitated conversation between physician participants on a complex pediatric health care inequity issue using an ethical framework.

Background: Curry leaf (Murraya koenigii) is a frequently used medicinal plant. The M. koenigii plant is a type of spice in the Rutaceae family. Curry leaf ethanol extract contains flavonoid compounds. Quercetin is a flavonol compound, a flavonoid derivative that has a 3-hydroxyflavone skeleton. There is a need to analyze the quercetin level in curry leaves utilizing high-performance liquid chromatography (HPLC). Methods: This research was conducted from August to October 2023. A total of 500 g of powdered curry leaves were placed in a maceration vessel. The liquid ethanol extract was mixed with the first re-maceration filtration product. Qualitative analysis was performed by comparing the retention time of the sample solution chromatogram with the reference standard solution of quercetin under identical HPLC conditions. Results: The quantity of curry leave ethanol extract was 52.613 g. Analysis of the curry leaf extract samples revealed that sample 1 had a quercetin level of 0.080 mg/g, while sample 2 had a quercetin level of 0.079 mg/g. The final analysis of the curry leaf ethanol extract samples showed an average quercetin level of 0.03%. Conclusion: These results indicate that the curry leave ethanol extract contains flavonoid compounds, especially quercetin.

Cytomegalovirus (CMV) infection in early infancy arises more commonly as congenital infection or less commonly is acquired postnatally, although exact differentiation between both categories could be difficult. We hereby describe the case of severe CMV infection in a 2-month-old infant who was born prematurely of a twin pregnancy at 29.4 weeks. The baby presented with an array of skin manifestations comprising target lesions, papulovesicles, ulcers, and crusting along with systemic involvement (bronchopneumonia). We report this case to highlight the various unusual cutaneous manifestations of CMV infection in infancy and to raise the awareness among clinicians for the early diagnosis and prompt treatment.

Background: There are significant barriers to healthcare access in tribal areas, even though for every 834 people, there is one public physician (registered allopathic and AYUSH doctors). More than 86% of hospital visits occur in rural areas. Furthermore, the bulk of them travel long distances to reach hospitals. A telemedicine center was established in the aspirational tribal district of Sirohi, Rajasthan, to provide accessible quality health care. Objective: To understand providers’ attitudes and satisfaction with telemedicine services for tribal populations. Materials and Methods: This cross-sectional, mixed-method study enrolled consultants from various clinical departments of AIIMS Jodhpur (n = 23) who provide teleconsultations to the tribal population. Result: The mean score of the satisfactory index was 54.7 ± 22.04. The higher score is 87.4 regarding the ability to use the technology platform during teleconsultation. The lower score was 34.7 for video quality during teleconsultation at STHR. 91.3% found this a beneficial model for the tribal population. Consultants providing teleconsultations expressed that this model is a boon for tribal patients as a screening tool and will save time and money for improved accessibility. Conclusion: Positive indications of teleconsultation with a provider’s utility, acceptability, and satisfaction. Most marginalized people can efficiently access all levels of (primary, secondary, or tertiary) health care from experts through telemedicine, which will broaden outreach in hard-to-reach or inaccessible tribal or rural areas.

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

Background: Acute kidney injury (AKI) is a common comorbidity in critically ill children and is associated with an increased risk of morbidity and mortality in children with nephrotic syndrome. The etiology of AKI in nephrotic syndrome is complex and multifactorial. Aims and Objectives: To determine the proportion, risk factors, and outcomes of patients with AKI in children hospitalized with nephrotic syndrome. Materials and Methods: This cross-sectional study was done on children between 1 month and 14 years of age attending the pediatric department for 1 year from October 2020 to June 15, 2022. Detailed history, physical examination, and investigations were done in children with nephrotic syndrome as per pro forma. Information was collected on demographic variables, vital signs, anthropometry, diagnosis, comorbidities, therapies, presence of hypovolemia, sepsis or shock, use of diuretics or nephrotoxic medications, need for oxygen, mechanical ventilation, vasopressors or renal replacement therapy, length of hospital stay, and outcome at discharge. For those children having AKI, clinical outcomes were measured in terms of duration of hospital stay, recovery of S.creatinine, and urine output. Results: A total of 64 patients with nephrotic syndrome were enrolled in this study. Fifteen patients had AKI (23.4%) among children with nephrotic syndrome. The most common etiology being sepsis accounting for 4 out of 15 (26.7%) of total cases followed by acute respiratory distress syndrome (13.3%), nephrotoxic medications (13.3%), renal parenchymal disease (13.3%), Post-streptococcal glomerulonephritis (13.3% each) and Sickle cell disease with nephritis and acute fulminant hepatitis (6.7%). There was significantly more mortality among subjects with stage 2 (14.3%) and 3 (14.3%) kidney disease. Conclusion: AKI is common in our children with nephrotic syndrome and the main risk factors of AKI include sepsis, gross hematuria, urinary tract infections, peritonitis, and exposure to potentially nephrotoxic medications. There is a need to identify the patients with nephrotic syndrome at risk of AKI and apply strategies to prevent AKI in focused at-risk groups.

Objectives: Current research aimed to compare the effects of fungal and bacterial phytase with or without citric acid (CA) on growth performance, serum mineral profile, bone quality, and nutrient retention in birds given non-phytate phosphorus (nPP)-deficient diets. Materials and Methods: A total of 216 Indian River broiler chicks were disturbed into six groups, namely, i) positive control (PC), ii) negative control (NC) contained 0.2% lower nPP than that in the PC diet, iii) NC + fungal phytase (Aspergillus niger), iv) NC + fungal phytase with 2% CA, v) NC + bacterial phytase (Escherichia coli), and vi) NC + bacterial phytase with 2% CA. Results: Compared to the PC group, the NC group showed poor performance, serum phospho¬rus (P) content, P retention, and bone quality. However, with the inclusion of phytase, all these phenomena were improved. The addition of bacterial phytase showed better values compared with fungal phytase. The main effects of phytase were significant for the feed conversion ratio (FCR), metabolizable energy conversion ratio (MECR), and P retention. The addition of CA, either with fungal or bacterial phytases, did not show considerable beneficial effects on overall performance. However, the main effects of CA were significant on the FCR, MECR, and crude protein conversion ratio. Conclusion: Incorporating bacterial and fungal phytase into low-nPP diets enhanced the broiler's performance. The effects of bacterial phytase were more apparent than those of fungal phytase. However, the efficacy of phytase based on the source might relate to dose, and other factors need further investigation. [J Adv Vet Anim Res 2024; 11(2.000): 376-383]

Aim: To analyze the potential predisposing factors and clinical presentation of mucormycosis in patients with COVID-19. Material and Methods: Medical records of 141 patients with COVID-19-associated mucormycosis (CAM) treated at a tertiary care center in Bihar were reviewed. The predisposing factors, clinical features, and imaging findings of mucormycosis were analyzed. Results: The median age was 48 years (IQR, 43-60). A total of 58 patients developed concurrent CAM and 83 post-CAM. The median interval between COVID-19 and onset of CAM symptoms was 15 days (IQR, 9–16). A total of 80 patients received at-home treatment for COVID-19, and 73 had mild-to-moderate disease. While 61 patients received in-hospital treatment, 57 had severe disease. At presentation, 131 patients had hyperglycemia: 64 type 2 diabetes mellitus (DM) and 67 new-onset DM. The history of glucocorticoid use for COVID-19 was present in 125 patients; 47% were administered at home without monitoring plasma glucose. The common presenting features were toothache, periocular or facial pain, and edema. Rhino-orbital mucormycosis was the most common. Imaging revealed rhinosinusitis in all patients, including pansinusitis (68%), pterygopalatine fossa involvement (21%), cavernous sinus thrombosis (38%), brain abscess (8%), and infarct (4%). All patients received intravenous liposomal amphotericin B, and surgical debridement was performed in 113. Conclusion: COVID-19 patients with hyperglycemia are at risk of developing CAM, irrespective of the severity. Timely recognition of symptoms and prompt initiation of therapy by primary healthcare physicians are imperative for enhancing outcomes. Additionally, glucocorticoid overuse should be avoided, and close monitoring for hyperglycemia development is warranted.

Background and Aims: Sleep disruption and reduced quality of life are common long coronavirus disease (COVID) manifestations, affecting survivors irrespective of initial COVID-19 severity. Limited research investigates symptoms beyond 24 months post-infection. We aimed to address this gap by longitudinally studying sleep patterns and overall quality of life in non-hospitalized adults, 24 months after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Methods: This prospective observational study involved the enrolment of 337 adult non-hospitalized patients in a consecutive fashion. Individuals with past COVID-19 (from 15 April 2020 to 30 June 2021) were examined at two Government hospitals and completed a telephone interview between 1 May 2023 and 30 June 2023, located in Jharkhand, India. Participants were queried about their sleep patterns and quality of life, utilizing the DSM5 LEVEL 2 and EQ-ED-5L tool, respectively. Results: Among 337 non-hospitalized participants, 212 completed the survey. Within this group (59.4% men, mean age 38), 36 (17.0%) experienced sleep impairment. All five dimensions of quality of life (QoL) were adversely affected in long COVID patients. Advanced age, high income, residing in rural or semi-urban areas, and having comorbidities were associated with a higher likelihood of decreased quality of life across various domains. Conversely, participants who were married, employed in healthcare or government positions, and vaccinated exhibited a reduced likelihood of experiencing lower quality of life. Conclusion: Long COVID-19 affects sleep and quality of life, with various demographic and clinical factors influencing outcomes. This study provides insights into the extended consequences of long COVID-19 and aids healthcare systems in addressing the challenges posed by this condition.

Abstract Background Neonatal mortality in India has fallen steadily and was estimated to be 24 per 1000 live births in the year 2017. However, neonatal mortality remains high in rural parts of the country. The Community Health Promotion and Medical Provision and Impact On Neonates (CHAMPION2) trial investigates the effect of a complex health intervention on neonatal mortality in the Satna District of Madhya Pradesh. Methods/design The CHAMPION2 trial forms one part of a cluster-randomised controlled trial with villages (clusters) randomised to receive either a health (CHAMPION2) or education (STRIPES2) intervention. Villages receiving the health intervention are controls for the education intervention and vice versa. The primary outcome is neonatal mortality. The effect of the active intervention on the primary outcome (compared to usual care) will be expressed as a risk ratio, estimated using a generalised estimating equation approach with robust standard errors that take account of clustering at village level. Secondary outcomes include maternal mortality, stillbirths, perinatal deaths, causes of death, health care and knowledge, hospital admissions of enrolled women during pregnancy or in the immediate post-natal care period or of their babies (during the neonatal period), maternal blood transfusions, and the cost effectiveness of the intervention. A total of 196 villages have been randomised and over 34,000 women have been recruited in CHAMPION2. Discussion This update to the published trial protocol gives a detailed plan for the statistical analysis of the CHAMPION2 trial. Trial registration Registry of India: CTRI/2019/05/019296. Registered on 23 May 2019. https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MzExOTg=&Enc=&userName=champion2

Abstract Background Intimate partner violence (IPV) against women has harmful effects on their psychological and physical health. However, help-seeking for IPV is significantly low among women in the Indian context. This study examines the different factors that influence help-seeking behaviour among women in India. It also studies associations of the type of IPV with the source of help. Methods The study analyses data from the fifth round of the National Family Health Survey that was conducted in India (2019–2021). Independent variables were categorized at individual, relationship-household and community levels. The Stata 14.2 software was used to calculate the prevalence ratios and their corresponding 95% confidence intervals. Variables with p-values less than 0.05 were considered statistically significant. Poisson regression helped identify factors associated with help-seeking. Results Results indicate that among 72,320 women aged 18–49 years, 17,765 women ever-faced IPV. Of them, 14.2% of women who faced either physical and/or sexual IPV sought any help. Husband’s consumption of alcohol almost doubled the likelihood of help-seeking among women (19.91%), compared to women whose husbands did not drink alcohol (10.19%). Witnessing parental IPV also increased the odds (17.26%) of help-seeking. Women who were not empowered were more likely to seek help (14.11%) compared to women who were empowered (12.56%). The police were the predominant source where women went for formal help (6.94 to 8.43%), followed by doctors (1.84 to 2.71%). Close to 1 in 4 women (22.5%) sought help for sexual IPV, while 14.4% of women sought help for physical IPV. Around 95% of all women who faced IPV sought informal help, with 3 in 5 of them approaching their own families, and 3 in 10 approaching their in-laws or marital families. Conclusions Two significant factors that associate positively with help-seeking by women facing IPV are husbands’ alcohol consumption and witnessing parental IPV. Most women preferred informal help from the natal family, while among formal providers, the police were the foremost choice. Programmes and initiatives to build capacities of communities, and of police to respond to women seeking help for IPV, would enable more women to reach out for help.

Objective: This research aimed to assess the effects of dried plantain herb, lemongrass, and their combination on milk yield, immunological, liver enzymatic, serum, and milk mineral status in dairy cows. Materials and Methods: Twenty cows were arbitrarily assigned to 4 diets. Cows were given a basal ration considered as control diet (CL-D) having 14.93% crude protein (CP)and 10.96 MJ ME per kg dry matter (DM). Each cow was given 100 gm plantain, 100 gm lemongrass, and 50 gm plantain + 50 gm lemongrass with CL-D and taken as plantain diet (PT-D), lemongrass diet (LG-D), and plantain-lemongrass diet (PL-D), daily for 63 days, respectively. Blood and milk samples were taken four times at an interval of 14 days. Data were analyzed using a two-way repeated measures analysis of covariance. Results: Better DM consumption and milk yield were observed in the PT-D and LG-D compared to the CL-D (p ≤ 0.05). LG-D improved the milk's total solids, protein, and fat compared to CL-D (p < 0.05). Substantially, herbal groups improved serum albumin and reduced globulin concentrations compared to CL-D. LG-D had the highest serum immunoglobulin G, while herbal groups effectively reduced the liver enzymes compared to CL-D. Herbal groups did not affect serum and milk's calcium and phosphorus concentrations, while LG-D and PL-D substantially improved serum and milk zinc concentrations. Conclusions: Both plantain and lemongrass improved dairy cows' DM consumption and milk yield. Plantain and/or lemongrass enhanced the immune system and liver health, but not serum and milk calcium and phosphorus level. Lemongrass and a combination of plantain and lemongrass increased the serum and milk zinc concentrations. [J Adv Vet Anim Res 2024; 11(1.000): 185-193]

Objective: The effect of feeding yeast-fermented feed in various forms on broiler growth performance and bone mineralization was studied. Materials and Methods: Initially, a corn-soy-based diet was formulated and fermented in anaerobic conditions at 28°C in laboratory space for 48 h with yeast (2.0%) and moisture (50%). Afterward, the 150 newly hatched Arbeor Acres commercial broiler chicks were divided into 5 dietary groups (30 chicks, 6 cages, and 5 birds per cage). Each group received one of the following formulated and fermented diets: dry feed (DF), moist feed (MF), yeast-added dry feed (Y-DF), yeast-added moist feed (Y-MF), or yeast-fermented moist feed (YF-MF). Water and feed were supplied ad libitum. Six birds per group were slaughtered at age 37 for the determination of carcass traits and tibia ash. Results: Fermentation improved crude protein from 20.7% to 22.8% but declined crude fiber from 7.9% to 6.3% in the YF-MF group compared to the DF group. High body weight gain was recorded in 771, 830, and 992 gm in the MF, Y-MF, and YF-MF groups, respectively, compared to the DF (762 gm) group (p < 0.01). The feed conversion ratio was better in the Y-MF (1.57) and YF-MF (1.57) groups than in the DF (1.75) group. Feeding a fermented, moist diet resulted in improved carcass yield (69%) in the YF-MF group. Bone mineralization expressed a better tibia ash percentage (35% from 30%) in the YF-MF group compared to the DF group. Conclusion: Therefore, YF-MF enhanced the quality of feed and improved growth, carcass weight, and bone mineralization in broiler. [J Adv Vet Anim Res 2024; 11(1.000): 78-84]

Macrophages are integral part of the body's defense against pathogens and serve as vital regulators of inflammation. Adaptor molecules, featuring diverse domains, intricately orchestrate the recruitment and transmission of inflammatory responses through signaling cascades. Key domains involved in macrophage polarization include Toll-like receptors (TLRs), Src Homology2 (SH2) and other small domains, alongside receptor tyrosine kinases, crucial for pathway activation. This review aims to elucidate the enigmatic role of macrophage adaptor molecules in modulating macrophage activation, emphasizing their diverse roles and potential therapeutic and investigative avenues for further exploration.

A smart grid is a power network from generation to consumers and provides beneficial, steady, and safe electricity. It utilizes smart meters for billing, phasor measurement units to check the system's health., etc. As a result, it contains enormous volumes of real-time data that may be shared and stored by users, control centers, and services in a smart grid. It weakens the smart grid's communication networks. The size of the data in a smart grid will grow extremely in the future. As a result, it must reduce distortion in data compression and denoise while minimizing the demand on storage and communication networks. The goal of data compression and denoising should be to maximally conserve the useful data while accurately reflecting the state of the system and providing sufficient data regeneration at the receiving end. This paper has used lower-order different wavelets to represent a design to compress and reconstruct data at level three using wavelet Packet Transform. It works on the phasor measurement unit's current magnitude and voltage sag signals. • The proposed design has a better compression ratio. • Low reconstruction error. • This design is easy to access, systematic, profitable, and not time-consuming.

Background: Dental implant surfaces play a crucial role in determining the success of osseointegration and long-term stability. Understanding the cellular response to various implant surfaces is essential for optimizing implant design and clinical outcomes. Materials and Methods: In this in vitro study, we investigated the cellular response to different dental implant surfaces. Titanium implants with three distinct surface treatments (polished, acid-etched, and sandblasted) were prepared. Human osteoblast-like cells were cultured on these surfaces, and cellular behaviors including adhesion, proliferation, and morphology were evaluated using standard assays and imaging techniques. Results: Our results revealed significant differences in cellular responses among the different implant surfaces. Cells exhibited higher adhesion and proliferation rates on the acid-etched and sandblasted surfaces compared to the polished surface. Furthermore, cells displayed a more spread-out morphology with well-defined filopodia and lamellipodia on the acid-etched and sandblasted surfaces, indicating enhanced cellular interaction and spreading. Conclusion: The cellular response to dental implant surfaces varies depending on surface characteristics. Acid-etched and sandblasted surfaces promote better cellular adhesion, proliferation, and spreading compared to polished surfaces. These findings underscore the importance of surface modifications in enhancing osseointegration and ultimately improving the success rates of dental implant procedures.

Abstract Background and Aims Given the significance of addressing neonatal mortality in pursuing the 2030 Sustainable Development Goal on child health, research focus on this area is crucial. Despite the persistent high rates of neonatal mortality rate (NMR) in Bangladesh, there remains a notable lack of robust evidence addressing inequalities in NMR in the country. Therefore, this study aims to fill the knowledge gap by comprehensively investigating inequalities in NMR in Bangladesh. Methods The Bangladesh Demographic and Health Survey (BDHS) data from 2000 to 2017 were analyzed. The equity stratifiers used to measure the inequalities were wealth status, mother's education, place of residence, and subnational region. Difference (D) and population attributable fraction (PAF) were absolute measures, whereas population attributable risk (PAR) and ratio (R) were relative measures of inequality. Statistical significance was considered by estimating 95% confidence intervals (CIs) for each estimate. Results A declining trend in NMR was found in Bangladesh, from 50.2 in 2000 to 31.9 deaths per 1000 live births in 2017. This study detected significant wealth‐driven (PAF: −20.6, 95% CI: −24.9, −16.3; PAR: −6.6, 95% CI: −7.9, −5.2), education‐related (PAF: −11.6, 95% CI: −13.4, −9.7; PAR: −3.7, 95% CI: −4.3, −3.1), and regional (PAF: −20.6, 95% CI: −27.0, −14.3; PAR: −6.6, 95% CI: −8.6, −4.6) disparities in NMR in all survey points. We also found a significant urban–rural inequality from 2000 to 2014, except in 2017. Both absolute and relative inequalities in NMR were observed; however, these inequalities decreased over time. Conclusion Significant variations in NMR across subgroups in Bangladesh highlight the need for comprehensive, and targeted interventions. Empowering women through improved access to economic resources and education may help address disparities in NMR in Bangladesh. Future research and policies should focus on developing strategies to address these disparities and promote equitable health outcomes for all newborns.

Alpha and beta cobalt hydroxide nanostructures were synthesized by hydrothermal method and characterized using X-ray diffraction and electron microscopy. The turbostatic alpha-Co(OH)2 has large interlayer spacing compared to the beta-Co(OH)2 and is less explored in the literature. Both nanostructures were efficient in degrading methylene blue dye in the presence of visible light. Under identical conditions, the rate constant of photocatalytic dye degradation in the presence of alpha and beta cobalt hydroxide was calculated as 60.22 × 10−3 min−1 and 19.05 × 10−3 min−1, respectively, which is highest when compared to the previous reports. The superior activity of alpha-Co(OH)2 when compared to beta-Co(OH)2 is also demonstrated in this work. Additionally, a Csp value of 137 F/g and 2.4 F/g, respectively, at a current density of 1 A/g, was obtained from the GCD analysis of devices made using alpha-Co(OH)2 and beta-Co(OH)2. A higher cyclic stability and power density were observed for alpha-Co(OH)2 when compared to beta-Co(OH)2. The findings suggest that alpha and beta cobalt hydroxide nanostructures hold promise as effective catalysts for dye degradation and potential materials for high-performance supercapacitors. Further investigations into the unique properties of the relatively superior alpha-Co(OH)2 could lead to advancements in environmental remediation and energy storage technologies.

Key Clinical Message Sarcoidosis‐induced LETM represents a rare but life‐threatening neurological manifestation of sarcoidosis, characterized by spinal cord inflammation, and associated neurological deficits. Sarcoidosis should be included in the differential diagnosis of LETM, particularly in patients with no lung involvement. Prompt recognition and management are obligatory to optimize outcomes and prevent long‐term disability. Abstract Sarcoidosis is a multisystem inflammatory granulomatous disorder characterized by the formation of noncaseating granulomas. Although sarcoidosis commonly affects the skin, lymph nodes, and lungs, neurological involvement of sarcoidosis has also been reported. Longitudinally extensive transverse myelitis (LETM) is a rare but well‐documented serious manifestation of neuroscoidosis. We report a case of LETM caused by sarcoidosis in a 53‐year‐old male who presented with progressive bilateral lower extremity weakness, urinary retention, and paresthesia. Laboratory evaluations revealed elevated inflammatory markers. Magnetic resonance imaging of the spine showed hyperintense signals consistent with transverse myelitis. Cerebrospinal fluid analysis revealed lymphocytic pleocytosis and elevated protein levels. Chest computed tomography showed hilar lymphadenopathy. A biopsy of the intrathoracic lymph node showed noncaseating granulomas consistent with sarcoidosis. A diagnosis of sarcoidosis‐induced LETM was made after ruling out all other possible etiologies. His condition improved gradually after starting high‐dose prednisone, mycophenolate, and rehabilitation strategies. Our case underscores the importance of prompt diagnosis and management of sarcoidosis‐induced LETM and highlights that sarcoidosis must be included among differential diagnoses of LETM, especially in cases with no lung involvement.

Aims: Compare the efficacy of 2% lidocaine with adrenaline (1:200,000) and 4% articaine with adrenaline (1:100,000) in inferior alveolar nerve block prior to extraction of bilateral teeth posterior to canine in interval of one week. Methods and Material: Thirty-five patients were selected for the study. Patients were divided into two different groups: Group 1 – (2% lignocaine with adrenaline (1:200,000)) and Group 2 – (4% articaine with adrenaline (1:100,000)) solution. The study variables for each anaesthetic agent were: onset of action and depth of anaesthesia. A pulp tester was used to demonstrate quantitative values and a visual analogue scale (VAS) was used for qualitative evaluation of the two anaesthetic drugs in 2 min cycle for 10 min with respect to test canine. Anaesthesia was considered successful when pulp tester value 64 was achieved in 10 min for both the anaesthetic agent. Statistical Analysis Used: The difference in the efficacy of lignocaine and articaine was analysed using Student’s t test. Within group comparison of the response to the pulp vitality test and VAS over various time periods was analysed using repeated measures Analysis of Variance (ANOVA) with post-hoc Bonferroni test. Results: Data analysis showed statistical differences in onset and depth of anaesthesia between the two groups (P < 0.05). Conclusions: 4% Articaine with adrenaline (1:100,000) onset of action is faster and depth of anaesthesia is better compared to 2% lignocaine with adrenaline (1:200,000). Many previous studies reported onset of anaesthesia, but this study evaluates onset and depth of both the anaesthetic agent quantitatively and qualitatively.

Objective: To compare the accuracy of working length determination between cone beam computed tomography (CBCT) and electronic apex locator by measuring the actual working length of teeth. Material and Methods: A total of 150 single-rooted tooth assessed by radiograph undergoing root canal therapy were selected. The process was repeated to obtain a buccolingual and mesiodistal section of all teeth. The measurement line was considered from the reference occlusal plane following the center of the canal to the terminus. All information regarding the accuracy of cone-beam computed tomography and apex locator was noted in a pre-designed proforma. Results: CBCT consistently demonstrated high accuracy across all tooth types in both jaws. The electronic apex locator exhibited varying precision, with greater accuracy observed in the mandible. Statistical analyses revealed significant differences in electronic apex locator accuracy among tooth types in the maxilla (p=0.042), emphasizing the importance of specific clinical considerations. Conclusion: Cone beam computed tomography emerges as a reliable diagnostic tool for accurate working length determination, especially in complex cases, while the electronic apex locator remains valuable with careful consideration of potential variations in accuracy. An individualized approach, considering tooth type, jaw location, and clinical context, is crucial for precise working length determination in endodontic practice.

Market instability, increased competition, escalating price and reduced availability of conventional ingredients warrants the researchers to rely on alternative feed ingredients. This approach may help in producing aqua feeds in a sustainable and cost-effective way to accomplish the global food and nutritional securities. Mahua oil cake (Bassia latifolia) is an underutilized non-conventional ingredient that holds promise for incorporation into aqua feed following nutrient enhancement by solid-state fermentation. A five-month pond feeding trial was carried out to investigate the effects of Sachharomyces cerevisiae and Bacillus subtilis fermented mahua oil cake (MOC) on the production performance, nutrient utilization, digestive capacity, and innate immunological responses of Labeo rohita fingerlings. For this, two iso-nitrogenous feed were formulated and prepared incorporating fermented MOC at different levels i.e. 0 and 40 percentage replacing soybean meal and other feed ingredients and fed to rohu fingerlings of two treatment groups in pond culture for 5 months duration. Improved growth performance, feed conversion ratio, feed intake, protein efficiency ratio and digestive capacity were observed in fish fed diets with 40 percent of fermented MOC compared to control. Innate immune responses parameters (respiratory burst activity, myeloperoxidase, lysozyme and hemaglutination activities) were significantly higher (P < 0.05) in fishes fed with fermented MOC. Therefore, we conclude incorporation of solid state fermented mahua oil cake up to 40% level in diet of L. rohita fingerlings in pond culture without any adverse effects on growth, nutrient utilization and innate immune response.

Abstract Background There is a dearth of evidence on the trends and inequalities in utilizing cesarean section (CS) among women in Bangladesh. Hence, this study aimed to estimate the socioeconomic and geographical inequalities in delivery by CS among Bangladeshi women from 2004 to 2017. Methods Data from Bangladesh Demographic and Health Survey 2004, 2007, 2011, 2014, and 2017 were analyzed using the WHO’s Health Equity Assessment Toolkit (HEAT) software. Inequalities were measured using four summary measures: Difference (D), Population Attributable Risk (PAR), Population Attributable Fraction (PAF), and Ratio (R). Socioeconomic inequalities were assessed using two equity dimensions: household wealth status, and level of education, while geographical disparities were measured using two equity dimensions: place of residence, and sub-national regions. For each measure, point estimates and their 95% confidence intervals were reported. Results An increasing trend in the prevalence (weighted) of CS in Bangladesh use was found from 4.50% in 2004 to 32.73% in 2017 We found significant socioeconomic inequalities in CS in every survey point, with a higher concentration of CS among the rich (in 2017, PAR = 28.57; 95% CI: 26.69–30.46) indicating a pro-rich inequality, and higher educated (in 2017, PAF = 23.97; 95% CI: 12.26–35.68) sub-groups. We also identified significant geographical disparities in CS with a higher concentration of CS among people from urban areas (in 2017, PAR = 10.99; 95% CI: 10.19–11.79), and a coastal region (Khulna division) (in 2017, PAF: 30.48 (95% CI: 18.66–42.30). Conclusion We observed both socioeconomic and geographical inequalities in CS exist in Bangladesh, though the trends of these inequalities were curved over time. Thus, it is important to comprehend these pro-rich and geographical inequalities better and implement appropriate interventions and policies to alleviate them.

Abstract The extension of classical fuzzy sets are hesitant fuzzy sets (HFSs), in which each element has a possible value from [0,1]. Similarity and distance measures are useful implements for solving medical, clustering and pattern-recognition problems. Most of the researchers have suggested their ideas for HFSs using distance measures and extract the similarity measure from distance measure but most of them are getting inadequate results. Therefore, we proposed a new similarity measure to resolve these problems and also satisfied the properties of proposed measure for HFSs. Additionally, numerous examples are taken in consideration using HFS and compared the performance of existing measures with proposed measure for different cases. Furthermore, we have applied proposed measure for pattern recognition problems using three different examples and also calculate performance index (i.e., Degree of Confidence) to explore the behavior of different measures. Finally, we suggested MST based clustering algorithm using HF-environment and contrast the performance of proposed measure with existing ones. All these comparison illustrate that proposed measure is getting efficient and reasonable results and it also verified that proposed measure is not restricted to particular domain, it can be effectively applied for diverse field of application.

Background: Mobile health applications are an established tool for healthcare management, patient education, and even capacity building for healthcare providers. However, its use among traditional birth attendants (TBAs) is limited. The aim of this study is to explore the needs and bottlenecks of developing an interactive mobile application for maternal and infant care (MAI) of TBAs. Materials and Methods: It is a qualitative study having in-depth interviews (face-to-face approach) conducted among the seekers of MAI services. Setting: This study is conducted in tribal and rural locations in the district Sirohi, Rajasthan. Participants: TBAs and tribal females of reproductive age in tribal-dominated areas have participated. The development of an interactive mobile application MAI has three phases: (1) a need-based approach to identify the needs on the ground; (2) identifying intervention bottlenecks and possible solutions; (3) design and development of the mobile application. Results: Ninety-six tribal females of reproductive age participated in the needs assessment. Eighty percent of them were ≤ 30 years of age and 40% of them were uneducated. Most participants informed that lack of information (culturally/locally appropriate content), peer advocacy, affordability, lack of transportation, and the influence of TBAs are the significant factors for less uptake of maternity and child health services in the tribal and rural areas. Conclusion: The MAI app has culturally/locally appropriate content and is prepared by the local TBAs and Accredited Social Health Activists, with full local character and clothing. MAI app has videos and audio in the local language (Marwari) with pictorial quizzes. Using the MAI app, TBAs may self-educate and guide tribal pregnant women about maternal hygiene and infant healthcare as needed at various stages of pregnancy and childbirth.

Xp11 translocation renal cell carcinoma (XPTRCC) is a very rare kidney neoplasm, which has been predominantly reported in young patients. Sarcomatoid transformation in renal cell carcinomas is known. However, its occurrence in XPTRCC is unreported so far in the literature. We report a unique case of sarcomatoid transformation in a XPTRCC in a 23-year-old female, who presented with a huge right-sided renal mass and had metastatic deposits in lungs. Morphologically, clear cell morphology with papillary architecture along with foci of sarcomatoid transformation and rhabdoid differentiation were noted. Immunohistochemistry showed Pax-8 and TFE-3 expression in all components including the sarcomatous areas, whereas CK and EMA were expressed in conventional clear cell component. We present an extremely rare case of sarcomatous transformation in XPTRCC and discuss the case as determined by histopathology and immunocytochemistry. To our knowledge, this is the first case of sarcomatoid transformation XPTRCC being reported in the world literature.

Aims: Autoimmune liver diseases (AILD) represent a spectrum of related yet distinct immune-mediated disorders. The literature on the prevalence of these AILDs in Indian population is scarce. This study aims to assess the prevalence and clinicopathological spectrum of various AILDs especially the overlap syndrome. Materials and Methods: A 10-year (2011–2020) cross-sectional, retrospective observational study of histological proven cases of AILD was conducted. Clinical, demographic, and laboratory parameters were retrieved. Two pathologists independently reviewed the liver biopsies and reassessed 18 histopathological parameters. Results: During the study period, 17664 liver biopsies were received, out of which 1060 (6%) biopsies of AILD were identified. After exclusion, we had 721 cases which revealed a distribution of autoimmune hepatitis (AIH)-64.7%, primary biliary cholangitis (PBC)-14.8%, primary sclerosing cholangitis (PSC)-7.6%, overlap AIH-PBC 11%, and overlap AIH-PSC 1.7%. AIH patients had significantly higher prevalence for severe lobular inflammation (27%, P ≤ 0.001), several lobular plasma cells (37%, P ≤ 0.001), central perivenulitis (30%, P ≤ 0.001), hepatic rosettes (51%, P ≤ 0.001), and necrosis (35.5%, P ≤ 0.001), while PBC patients had significantly higher frequency of florid duct lesions (11.2%, P ≤ 0.001), duct loss (83.17%, P ≤ 0.001), bile duct damage (76.6%, P ≤ 0.001), and periportal copper deposits (19.6%, P ≤ 0.001). Overlap AIH-PBC group had the highest proportion of severe portal inflammation (27.5%, P ≤ 0.001), prominent portal plasma cells (75%, P ≤ 0.001), moderate interface activity (53.7%, P ≤ 0.001), Mallory-Denk bodies (27.5%, P ≤ 0.001), and periportal cholate stasis (25%, P ≤ 0.001). Conclusion: Prevalence of biopsy-proven AILDs in our study cohort is 6%. AIH (64.7%) is the most common AILD followed by PBC (14.8%). Overlap syndrome (AIH-PBC) showed prevalence of 11%.

The novel coronavirus (COVID-19) has inundated the whole world by causing severe acute respiratory syndrome in humans, thus posing serious public health concerns. The oral and olfactory systems are significantly impacted by the COVID-19 condition, in addition to the respiratory and digestive systems. Oral symptoms of COVID-19 can be caused by a loss in oral hygiene, immune system suppression, a decline in general health, and candidiasis due to prolonged antibiotic use. Because many aerosols and droplets are produced during various dental operations, dental professionals and dentists are at a significant risk of contracting the COVID-19 infection. Few precautionary measures include performing a pre-appointment health screening for all patients, performing aerosol-producing procedures in a designated space or operatory, using proper personal protective equipment and disinfecting the operatory between patients, and limiting the number of dental procedures at one time. Against this background, the purposes of this article are to explore the oral presentations of COVID-19 infection and to emphasize the hazards to dental professionals during COVID-19 pandemic. Additionally, few preventive measures are also highlighted.

Objectives Direct intrahepatic portosystemic shunt (DIPS) stent placement is an effective treatment for patients with Budd-Chiari syndrome (BCS); however, thrombotic occlusion of DIPS stent remains a cause of concern. The purpose of this study is to describe a novel technique of balloon-occluded-thrombolysis (BOT) for occluded DIPS stent, and compare it with the conventional catheter-directed-thrombolysis (CDT).

Background: The probability of survival for childhood cancer in several low- and middle-income countries (LMIC) is less than 30%. Myths and misconceptions among the general public concerning childhood cancers have detrimental effects on early detection and treatment. Materials and methods: This study aimed to assess public perceptions of childhood cancer among the public. We conducted a cross-sectional survey with 310 respondents by using an interview schedule. Results: Most (n = 244, 79.7%) participants were aware of the occurrence of childhood cancer in the community and the curability of cancer in children. The respondents’ knowledge was mainly derived from online media (television, cinema, or social media). Most (n = 189, 61.8%) respondents knew that blood cancer was the most common malignancy among children. Among the causative factors, the infectious nature, environmental factors, and curse of god were perceived as reasons by 19.6%, 29%, and 33% of the subjects, respectively. Half of the cohort felt that the child would never return to normal life after treatment completion. The reasons for hesitancy to treat even after knowing the curability of the disease were fear of treatment expenses, wrong beliefs, wrong/lack of information, fear of adverse effects, and lack of family support. Conclusion: Despite the advances in the diagnosis and treatment of childhood cancers, cancer remains a stigma in our community, interfering with the reintegration process of children into society, which is a significant barrier to improving survival.

Introduction The development of a yeast-expressed recombinant protein-based vaccine technology co-developed with LMIC vaccine producers and suitable as a COVID-19 vaccine for global access is described. The proof-of-concept for developing a SARS-CoV-2 spike protein receptor-binding domain (RBD) antigen as a yeast-derived recombinant protein vaccine technology is described. Areas Covered Genetic Engineering: The strategy is presented for the design and genetic modification used during cloning and expression in the yeast system. Process and Assay Development: A summary is presented of how a scalable, reproducible, and robust production process for the recombinant protein COVID-19 vaccine antigen was developed. Formulation and Pre-clinical Strategy: We report on the pre-clinical and formulation strategy used for the proof-of-concept evaluation of the SARS-CoV-2 RBD vaccine antigen. Technology Transfer and Partnerships: The process used for the technology transfer and co-development with LMIC vaccine producers is described. Clinical Development and Delivery: The approach used by LMIC developers to establish the industrial process, clinical development, and deployment is described. Expert Opinion Highlighted is an alternative model for developing new vaccines for emerging infectious diseases of pandemic importance starting with an academic institution directly transferring their technology to LMIC vaccine producers without the involvement of multinational pharma companies.

An adaptive control approach for a three-phase grid-interfaced solar photovoltaic system based on the new Neuro-Fuzzy Inference System with Rain Optimization Algorithm (ANROA) methodology is proposed and discussed in this manuscript. This method incorporates an Adaptive Neuro-fuzzy Inference System (ANFIS) with a Rain Optimization Algorithm (ROA). The ANFIS controller has excellent maximum tracking capability because it includes features of both neural and fuzzy techniques. The ROA technique is in charge of controlling the voltage source converter switching. Avoiding power quality problems including voltage fluctuations, harmonics, and flickers as well as unbalanced loads and reactive power usage is the major goal. Besides, the proposed method performs at zero voltage regulation and unity power factor modes. The suggested control approach has been modeled and simulated, and its performance has been assessed using existing alternative methods. A statistical analysis of proposed and existing techniques has been also presented and discussed. The results of the simulations demonstrate that, when compared to alternative approaches, the suggested strategy may properly and effectively identify the best global solutions. Furthermore, the system’s robustness has been studied by using MATLAB/SIMULINK environment and experimentally by Field Programmable Gate Arrays Controller (FPGA)-based Hardware-in-Loop (HLL).

Background: Although the conventional replacement for lost teeth has been partial or full dentures, the need for a fixed, esthetic, and functional restoration makes dental implants a reliable alternative. Aim: To evaluate the initial and final stability of platelet rich fibrin coated implants using resonance frequency analyzer. Method: ology: Thirteen patients with two or more missing teeth were informed about the procedure, and a consent form was obtained after cone beam computer tomography evaluation. Blood was drawn from the anticubital area of the patient, which was centrifuged to obtain platelet-rich fibrin. In all, 26 implants were placed, among which 13 were platelet-rich fibrin-coated (test group) and 13 were without platelet-rich fibrin (control group), and implant stability quotient values were recorded. Results: The mean age of the patients was 34.4 (SD = 4.28). Majority of the patients were males (9; 69.2%) whereas there were only four (30.8%) female patients. When comparison between overall primary implant stability with and without PRF was done, the mean difference was 5.12 and this difference was not statistically significant (p = 0.221) whereas a statistically significant difference (p = 0.019) was found when comparison between overall secondary implant stability was done with and without PRF. The primary and secondary stability values for the control group were 69.18 ± 7.45 and 73.84 ± 8.21 respectively, and the primary and secondary stability values for the test group were 64.06 ± 12.66 and 81.49 ± 7.61 respectively, which showed statistically significant differences among the groups. The difference in these values signify that primary stability is more in control group whereas secondary stability is more in case group. This signifies that PRF enhances the stability of implant. Conclusion: Implants coated with platelet-rich fibrin exhibited better osseointegration than implants without platelet-rich fibrin.