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Abstract Background Cysticercosis, a parasitic infection caused by the larval stages of the pork tapeworm, Taenia solium, predominantly affects cerebral and ocular tissues. The subcutaneous manifestation of this disease is a relatively uncommon clinical occurrence. Previously very few or no cases of cysticercosis presenting as subcutaneous solitary painful swelling have been reported in the literature. In previous reports, the swelling was described as painless and not solitary. Case presentation We present a rare case of subcutaneous cysticercosis in an Indian female in her forties, localized over the left scapular region, exhibiting gradual enlargement over 4 weeks. The patient experienced pain and intense itching without neurological or ocular involvement. Physical examination revealed a well-defined nodular swelling measuring approximately 3.5 cm × 3 cm, painful, nonfluctuating, nonreducible, soft to firm consistency, with no attachment to the underlying muscle, observed at the inferior angle of the left scapula. The overlying skin was tense, glossy, erythematous, and indurated, with mild superficial scaling at a few places and excoriation marks around the swelling. No similar swelling was found elsewhere on the body. The rest of the systemic and physical examination was unremarkable. The clinical diagnosis included an abscess, infected sebaceous cyst, lipoma with inflamed overlying skin, and a remote possibility of subcutaneous cysticercosis. Stool examination for ova, cysts, and parasites was unremarkable. Cysticercus IgG antibody by enzyme-linked immunosorbent assay was negative. A chest X-ray and radiograph of the left scapular region were normal. Fine needle aspiration biopsy of the lesion was planned but could not be completed as the patient did not consent. Local part ultrasonography revealed a well-defined cystic area of 1.9 × 1.1 × 1.6 cm3 (anteroposterior × transverse × craniocaudal) with peripheral calcified streaks (scolex) and surrounding edema suggestive of subcutaneous cysticercosis. The diagnosis was established by the ultrasonography of the lesion suggesting features consistent with cysticercus, and later established by complete resolution after a course of albendazole. Management involved a 3-week course of albendazole and 5 days of paracetamol for pain, leading to the full resolution of swelling and symptoms. On follow-up at 1 month, the swelling had disappeared with no new swelling or symptoms. Conclusion Subcutaneous cysticercosis is an unusual presentation of Taenia solium infestation that requires a high index of suspicion for accurate diagnosis. This case report emphasizes the importance of considering parasitic infections in the differential diagnosis of subcutaneous nodules. Early diagnosis and appropriate management are crucial for preventing complications and improving patient outcomes.

Foot-and-mouth disease Virus (FMDV) serotype Asia1 is prevalent in the Indian subcontinent, with only G-III and G-VIII reported in India until 2020. However, in 2019, a novel genetic group within serotype Asia1, designated as G-IX, emerged in Bangladesh, followed by its detection in India in 2020. This report presents analyses of the complete coding region sequences of the G-IX lineage isolates. The length of the open reading frame (ORF) of the two G-IX isolates was 6990 nucleotides without any deletion or insertion. The G-IX isolates showed the highest sequence similarity with an isolate of G-III at the ORF, L, P2, and P3 regions, and with an isolate of G-VIII at the P1 region. Phylogenetic analysis based on the capsid region (P1) supports the hypothesis that G-VIII and G-IX originated from a common ancestor, as speculated earlier. Further, VP1 region-based phylogenetic analyses revealed the re-emergence of G-VIII after a gap of 3 years. One isolate of G-VIII collected during 2023 revealed a codon insertion in the G-H loop of VP1. The vaccine matching studies support the suitability of the currently used Indian vaccine strain IND63/1972 to contain outbreaks due to viruses belonging to G-IX.

Context: Although neuroleptics are available for treating schizophrenia, patient compliance with treatment remains a major hurdle. Such patients turn into treatment-resistant schizophrenia (TRS) where clozapine can be prescribed, but it causes severe side effects. Many markers can predict favorable responses to clozapine therapy. Aims: To assess sociodemographic, clinical, electrophysiological, and biochemical parameters among TRS patients and to evaluate the difference between TRS patients with and without response to clozapine. Settings and Design: A prospective observational study was carried out for a period of 2 years from October 31, 2020, to November 1, 2022, in the Psychiatry Department of a Tertiary Care Hospital in Eastern Odisha. Materials and Methods: All patients visiting the Psychiatry Department of a tertiary care hospital, diagnosed with International Classification of Diseases schizophrenia were screened for TRS as per modified Kane’s criteria. The assessed parameters were compared using the Brief Psychiatry Rating Scale, the Positive and Negative Syndrome Scale of Schizophrenia, and Clinical Global Impressions scale. Statistical Analysis Used: Data were compiled and analyzed using IBM corporation’s Statistical Package for the Social Sciences (SPSS) software version 27. Results: Thirty-one eligible patients consented to the study, with 21 (67.7%) females and 10 (32.3%) males. Maximum, 17 (54.8%), belonged to 18–35 years of age. The biochemical parameters, fasting blood sugar (FBS), and triglycerides (TGs) had mean values of 94.56 (±6.6) mg/dL and 157 (±9.8) mg/dL, respectively. Gross electroencephalogram abnormalities were seen in 3 (10%) cases. Conclusions: The female gender, higher education, and a shorter duration of untreated psychosis predicted a better outcome. The patients showing good responses had higher trends in FBS and TGs at follow-up. Clozapine was associated with increased electrophysiological intra- and interhemispheric asymmetry.

Abstract Construction industry plays a significant role in the economic development of the nation. Due to site and other constraints, concreting is preferred by ready mix concrete (RMC) plants. It is very well-known fact that the construction industry immensely contributed for CO2 emission mainly from cement-based materials. One of the way to achieve smart city objective to effectively manage ready mix concrete plants. While opting for RMC over site mixing offers various advantages. In this study, key factors governing the sustainability and energy consumption of RMC plants are identified. This study investigates the efficiency and sustainability of RMC production in Maharashtra, suggesting that its efficiency hinges on various factors. Through a constructivist perspective, the research examines twelve RMC plants in Pune mainly and other parts of Maharashtra, finding that power supply, plant output, and capacity require sustainability. While raw material supply is deemed sustainable, management methods and product control were found lacking. The study identifies challenges affecting demand, such as regulatory issues, management issues and technological limitations. The conclusion emphasizes the need for alternative and sustainable power sources, skilled labor, and improved business processes to enhance RMC production efficiency in Maharashtra, recommending measures like waste reuse and innovative advancements. This study will help the stakeholders in prioritizing the resources and process towards more sustainable way.

AIM: The aim of this study was to study the safety profile of a rituximab (RTX) biosimilar Reditux® in patients of rheumatological disorders at a tertiary care hospital in North India. Methodology: An observational study was carried out to ascertain the safety of RTX in rheumatology patients. A total of 60 patients initiated on RTX were followed up for a mean duration of 14 months for adverse events. Results: A total of seven mild infusion reactions were recorded during the first infusion of RTX. Eighteen infective events were recorded including a case of extrapulmonary tuberculosis (TB), three cases of hepatitis B virus (HBV) reactivation, four cases of herpes zoster, and a fatal case of disseminated varicella infection. There were no cases of JC virus infection or malignancies in our study. Conclusion: This study highlights a much higher incidence of infections following the use of RTX in India as compared to international studies published so far. We also observed a higher rate of reactivation of HBV, varicella zoster virus, and TB in our cohort. This emphasizes the need for revising protocols for screening, vaccination, and chemoprophylaxis for chronic infections in countries with high burden of infections.

PURPOSEThe spectrum of EGFR is inadequately researched in patients with early-stage non–small cell lung cancer (NSCLC) in India. EARLY-epidermal growth factor receptor (EGFR) India (ClinicalTrials.gov identifier: NCT04742192), as part of a noninterventional, real-world global study, evaluated the prevalence of EGFR mutations in early-stage NSCLC in India.METHODSProspective data from adult patients with surgically resected stage IA to IIIB (American Joint Committee on Cancer eighth edition) NSCLC between March 2021 and October 2022 were analyzed. In addition to descriptive statistics, Fisher's exact test with Monte Carlo was used to determine the association between EGFR mutations and clinicodemographic parameters.RESULTSOf 74 patients (median age, 57.0 [range, 33.0-77.0] years) enrolled from eight centers in India, 73.0% (54 of 74) were males, 56.1% (37 of 66) were nonsmokers, and 95.9% (71 of 74) had adenocarcinoma. The EGFR mutation prevalence was 26.0% (19 of 73), of which Exon-19 deletions were the predominant subtype (13, 68.4%) followed by Exon 21-L858R (4, 21.1%), Exon 20-T790M (1, 5.3%), and compound (1, 5.3%) mutations. Nearly half (48.6%, 36 of 74) of the patients underwent only surgical resection. The remaining 51.4% (38 of 74) of the patients were prescribed neoadjuvant (n = 12; 16.2%) and adjuvant (n = 31; 41.9%) systemic therapies, and one patient (1.4%) received radiotherapy along with systemic therapy. In 60 patients with stage IB to IIIB NSCLC, systemic therapies, mainly platinum-based chemotherapy, were prescribed in 36 (60.0%). Only 8.1% (6 of 74) of the patients were prescribed EGFR-tyrosine kinase inhibitor (TKI), of which two received neoadjuvant and four were planned for adjuvant EGFR-TKI. Two (2.7%) patients were prescribed adjuvant immunotherapy. The univariate analysis showed higher odds of EGFR mutation for females (odds ratio, 3.96; P = .017).CONCLUSIONEARLY-EGFR India results showed the prevalence of EGFR mutation to be 26%. The study emphasized the pressing need for up-front biomarker testing at diagnosis to ensure optimal and timely personalized treatment.

Escalating air pollution in urban areas is a matter of concern, and deteriorating air quality is having numerous impacts on human health and the environment. Kolkata is one of the most densely populated and highly polluted cities in India. The aim of this work is to predict the concentration of ambient PM2.5 using different air pollutants and meteorological parameters as predictor variables by using statistical and different Machine Learning techniques as well as to understand the influence of other air pollutants and meteorological factors in ambient PM2.5 prediction. Different advanced machine learning algorithms like Random Forest Regression, decision trees, k-nearest Neighbour, Support Vector Regression, Ridge Regression, Lasso Regression, and XGBoost have been used, and the results show that the XGBoost model exhibits higher linearity between predictions and observations, among other models. Moreover seasonal variation of the most influential factor for prediction of PM2.5 is also noticed during the analysis. This work adds to the broader comprehension of the convergence of environmental science, public health, and machine learning and it offers significant perspectives for sustainable urban planning and pollution control tactics in rapidly expanding metropolitan areas such as Kolkata.

In this study, we developed and analyzed a compartmental epidemic model and a system model that incorporate vaccination, elimination, and quarantine techniques, with a saturated incidence rate, by theoretical and numerical means. The model is described by a system of four nonlinear differential equations. Our analysis included determining the reproduction number Rq and examining equilibrium solutions. The outcomes of the disease are identified through the threshold Rq. When Rq1, the unique endemic equilibrium is asymptotically stable locally. The stability of the endemic and disease-free equilibria globally has been examined using the Routh–Hurwitz and Dulac criteria. Subsequently, numerical simulations were utilized to illustrate the theoretical findings effectively.

A smart grid (SG), also referred to as an electric grid, represents an exceptionally reliable, efficient, and secure system for transmitting both electricity and data. Researchers and the power industry are becoming increasingly interested in SG because of its varied responsibilities. To achieve secure communication in SG environment, there is a need to establish a key exchange between participants. In an SG environment, a number of key exchange techniques have been developed for secure communication. Nevertheless, the most of them do not offer anonymity and function inadequately for SG communication. In this paper, we propose a robus key exchanged and authentication protocol for SG environment using elliptic curve cryptography. The proposed protocol provides anonymity and mutual authentication between participants in SG environment. In addition to an informal security analysis, we offer a formal security analysis of the proposed protocol based on the random oracle model. Further, we provide comparison of the security and functionality features of the proposed protocol with existing ECC-based protocols. A performance analysis in terms of computational and communication costs is carried out in comparison with existing dozen advanced authentication and key exchanged protocols, showing the superiority of the proposed protocol. Our protocol achieves high security with minimum computational and communication costs. The proposed protocol reduced computational cost $\approx 79.64\%$ , cost of communication is reduced $\approx 71.54 \%$ , while energy consumption reduced to $\approx 79.65 \%$ respectively of the mean value of all alternatives, thus proving the robustness of the presented protocol for securing SG communications.

Digital twins (DT) are digital copies of tangible assets and operations utilised in some industries to improve efficiency and foster creativity, accuracy, and decision making. Although beneficial, they have brought up some of the most critical security issues due to the complexity of their implementation and how they are incorporated into strategic systems. In this study, the security aspects of DTs that deal with challenges relating to data integrity, privacy, and secrecy are covered: potential vulnerabilities. For example, data used for malicious reasons, gaining unauthorised access, and interference with authorised network activities are considered in the planned attempt. In this study, the authors provide a secure and efficient protocol based on elliptic curve cryptography (ECC) to address security, privacy, and associated concerns in vehicular digital twins (VDT) networks. In addition, the paper discusses formal and informal security analysis based on the random oracle model, Burrows-Abadi Needham (BAN) logic, and Scyther verification tool. The proposed protocol ensures security, privacy, and other related security attacks and attributes in VDT networks. Furthermore, in the performance analysis section, we compare the communication and computation costs of the proposed protocol and related protocols. The proposed framework is secure and efficient in VDT network systems. Our analysis shows that the proposed protocol may apply to future VDT networks.

Cloud vehicular networking is a relatively new inter-vehicle communication paradigm. The ability of cloud vehicular networking to address critical safety issues in road traffic is highly rated by operators. This study examines cloud vehicular networking technology, its advantages, problems, and possible remedies. It focuses on overcoming control system issues while placing a stronger emphasis on security. Integrating vehicles into the cloud ecosystem presents numerous security and efficiency challenges. This study thoroughly examines the current protocols and suggests a brand-new, Secure, and Efficient Protocol for Cloud Vehicular Networking (SEPCVN). The proposed protocol aims to improve data transmission efficiency and address security flaws in cloud-connected vehicle networks. We discuss a specialized authentication method for secure vehicle-to-vehicle communication to tackle many challenges. According to the security study, formally and informally, our suggested protocol satisfies the necessary security requirements. Using the Automated Validation of Internet Security Protocols and Applications (AVISPA) tool, a simulation analysis was carried out on the proposed protocol, which is safe from man-in-the-middle and reply attacks. Compared to similar protocols, the proposed framework is computationally and communicably effective. The results indicate that the suggested plan for cloud vehicular networking is both effective and safe.

In this study, we utilize density functional theory (DFT) calculations to investigate the structural and electronic properties of YAg-B2(CsCl) and YCu-B2(CsCl) intermetallic compounds (IMCs). Our enthalpy calculations confirm that these compounds crystallize in a CsCl-type structure, highlighting their stability in this phase. The lattice constants provide insights into the atomic arrangement and bonding strength within the crystal, influencing the material’s density and overall structural integrity. The bulk modulus reflects the material’s resistance to uniform compression, indicative of its incompressibility, and rigidity, which are essential for applications requiring high strength and durability. By analyzing the density of states (DOSs) and electronic band structure (BS), we further discuss the electronic stability and metallic nature of these materials. Additionally, the electronic properties derived from the DOS and BS analysis suggest good electrical conductivity, making these materials suitable for use in electronic and optoelectronic devices. The calculated equilibrium structural parameters, including bulk modulus, lattice constants, and their derivatives, are found to be in good agreement with available experimental and theoretical data. Understanding these properties is crucial for optimizing the performance of YAg and YCu intermetallics in practical applications, from structural components to advanced electronic systems.

IntroductionSingle-cell multi-omics studies, such as multidimensional transcriptomics (whole transcriptomic analysis, WTA), and surface marker analysis (antibody sequencing, AbSeq), have turned out to be valuable techniques that offer inaccessible possibilities for single-cell profiling of mRNA, lncRNA, and proteins.MethodsWe used this technique to understand the dynamics of mRNA and protein-level differences in healthy, COVID-19-infected and recovered individuals using peripheral blood mononuclear cells (PBMCs). Our results demonstrate that compared to mRNA expression, protein abundance is a better indicator of the disease state.ResultsWe demonstrate that compared to mRNA expression, protein abundance is a better indicator of the disease state. We observed high levels of cell identity and regulatory markers, CD3E, CD4, CD8A, CD5, CD7, GITR, and KLRB1 in healthy individuals, whereas markers related to cell activation, CD38, CD28, CD69, CD62L, CD14, and CD16 elevated in the SARS-CoV-2 infected patients at both WTA and AbSeq levels. Curiously, in recovered individuals, there was a high expression of cytokine and chemokine receptors (CCR5, CCR7, CCR4, CXCR3, and PTGRD2). We also observed variations in the expression of markers within cell populations under different states.DiscussionFurthermore, our study emphasizes the significance of employing an oligo-based method (AbSeq) that can help in diagnosis, prognosis, and protection from disease/s by identifying cell surface markers that are unique to different cell types or states. It also allows simultaneous study of a vast array of markers, surpassing the constraints of techniques like FACS to query the vast repertoire of proteins.

Intelligent Transportation System (ITS) heavily relies on the unique mobile ad-hoc network (MANET) known as the vehicular ad-hoc network (VANET). The convenience that the Location Based Service (LBS), security issues arising from VANETs' great portability. Among the most widely used privacy-preserving techniques, distributed k-anonymity does not consider users' reliability, which results in hostile vehicle tracking. Therefore, Blockchain-enabled, Trust and Location dependent-Privacy Preserving (BTLB-PP) authentication system in VANET to overcome issues. Trust Management (TM) based on Dirichlet distribution, client and member will only collaborate with vehicles they confide by explicitly examining various prerequisites of claimed vehicle and collaborative vehicle during construction of unidentified obfuscation region and integrating attributes of these two functions. Using blockchain, a data structure has been proposed to promptly register trust of vehicles on publicly available blocks, allowing any vehicle to retrieve. In the trials, tests on various datasets have been run. Suggested system is resistant to multiple trust model threats, improving the security of vehicles' confidentiality and privacy. The performance evaluation metrics are precision, recall, f-measure and false positive rate (FPR) are used to evaluate the proposed system. Results from the simulation show that the proposed method is efficient and practical in reality. The suggested method was tested in a simulated traffic situation to verify its effectiveness.

Background: The causal association between IgA nephropathy (IgAN) and celiac disease (CeD) is based on their clinical coexistence. In this prospective study, we screened patients with IgAN for CeD and explored the utility of analysis of IgA anti-TG2 antibody deposits, for establishing a causal association. Methods: Biopsy-proven patients of IgAN were screened for serum IgA anti-tissue transglutaminase antibody (IgA anti-tTG Ab) titer and thereafter were invited to undergo endoscopic duodenal biopsy. Corresponding duodenal and kidney biopsies were subjected to IgA anti-TG2 antibody colocalization study using dual-color immunohistochemistry and immunofluorescence techniques. Additionally, kidney biopsies from 105 patients with IgAN who did not give consent for serology analysis, 30 non-IgA nephropathies, and 10 normal controls were also included. Dual-color-stained slides were interpreted based on stain distribution and intensity scores, and Pearson's index >0.3–1 on confocal imaging was considered significant. Results: Of a cohort of 151 patients with IgAN, 32 consented to undergo sero-screening and 5 of them had high serum anti-tTG Ab titer. Two out of the latter consented to endoscopic duodenal biopsies, in whom modified Marsh grade 3b changes were identified. Strong IgA anti-TG2 antibody deposits were noted in the kidney and duodenal biopsies of these patients. One patient out of non-consenting 105 patients with IgAN and 3 out of 30 patients with other non-IgA nephropathies also showed IgA anti-TG2 deposits. None of the healthy kidney tissues showed IgA anti-TG2 Ab deposits. Conclusions: Co-localized IgA anti-TG2 deposits in the kidney biopsies in patients with IgAN help to establish a pathogenic link with CeD. A small proportion of patients with IgAN have associated CeD.

Background and Objectives: Silicosis continues to pose an important health hazard among workers having occupational exposure to stone dust. Several studies have addressed clinical presentation, radiographic and pulmonary function abnormalities in workers with silicosis. This study was planned to analyze sociodemographic profile and awareness about several aspects of silicosis among the stone mine workers visiting our centre. Methods: A questionnaire was administered in a convenient sample of eligible subjects over six years period. The questionnaire was aimed to collect sociodemographic variables, like age, gender, educational status, residential background, smoking status etc., apart from information on work-related profile including protective measures taken. Also knowledge and attitude regarding silicosis was assessed. Silicosis awareness index was also calculated as per the response received. Results: Majority of the study subjects were male (96.6%) with rural background (98.5%). 54.1% subjects were in the age group of 30 to 50 years. 81.9% mine workers were illiterate. The common addictions observed among them included smoking (60%), tobacco chewing (34%), alcohol (20%) etc., Varying duration of work exposure was observed with more than 10 years in 63.4% and more than 20 years in 32.2% workers. The commonest work exposing them to stone dust was breaking stones by chisel and hammer (51%) followed by separation of stone slab (20%) and stone drilling (15%). 80.9% subjects were not aware of the term silicosis, more than 80% were not aware of the symptoms and causes of silicosis. Only one fifth subjects were having awareness of using protection against the disease. Overall awareness about silicosis was better among literate and youngers participants. Conclusions: Stone mining industry reflects male dominance, poor literacy, long working hours for many years, financial compulsion to start and continue the job and very poor awareness regarding the disease silicosis and importance of personal protection at workplace.

Long-Range networks are increasingly used in smart spaces due to their ability to provide longer communication range while consuming low energy. To facilitate communication among different Long-Range nodes, a gateway is used. For instance, in smart buildings such as airports, railway stations, indoor stadiums, and auditoriums, sensory data from multiple sites are transferred to a base station through a Long-Range gateway. However, when multiple nodes transmit data simultaneously to the gateway, it generates network interference, especially in high-ceiling smart buildings where Long-Range nodes with sensors are attached to monitor the building’s health. In this paper, we present a new method for identifying interfering Long-Range Nodes (LNs) in high-ceiling smart buildings using a classification model. Our approach involves gathering and analyzing network parameters, such as signal-to-noise ratio and received signal strength indicator, from the signals to extract features that the classifier uses for interference classification. The approach categorizes interference based on the number of interfering LNs, with each class representing a distinct number of interfering LNs. We also introduce a push-based mechanism to detect and adjust the power levels of faulty LNs, reducing interference. Our method is cost-effective as it is hardware-independent, making it feasible to implement on the LG platform. Finally, we present a dataset of network interference generated by varying the number of nodes, obstacles, and other parameters. We train the model on the generated dataset and evaluate its effectiveness using a test bed. The experimental results demonstrate that the approach can successfully identify interference nodes in a complex network.

Background: Fluoroquinolone (FQ) antibiotics are among the most potent second-line antitubercular drugs these days. The aim of the study was to analyze the frequency and pattern of genetic mutation in preextensive (pre-XDR) and extensively drug-resistant Mycobacterium tuberculosis using second-line line probe assay (LPA) and to compare drug-resistant mutations with different treatment outcomes. Methods: Sputum, lymph node aspirate, and cold accesses from patients with rifampicin-resistant Tuberculosis (TB) were subjected to first-line and second-line LPA (Genotype MTBDRsl by Hain Life Science, Germany) to assess additional drug resistance to fluoroquinolones (levofloxacin and moxifloxacin). Final treatment outcomes as per the National TB Elimination Program were assessed and compared with the mutation profile. Results: One hundred and fifty subjects were observed to have mutations associated with resistance to FQs and constituted the final study population. The most frequent mutation observed among GyrA drug resistance mutation was D94G (Gyr A MUT3C, 44/150, 66%) corresponding to high-level resistance to levofloxacin and moxifloxacin. The same mutation was associated with poor treatment outcome as died or treatment failure (odds ratio 2.50, relative risk 1.67, P = 0.043). The most common hetero-resistance mutation pattern observed in GyrA gene was wild type plus Asp94Gly mutation in 24.6% of isolates. Conclusions: GyrA MUT3C hybridization corresponding to single-point mutation of aspartic acid to glycine at codon 94 constitutes the most common mutation in GyrA gene locus in M. tuberculosis with significant association with treatment outcome as died compared to those with treatment outcome as cured.

Objective: Hesperetin is a natural flavonoid with antioxidant potential and can be used to treat disorders of the brain. Therefore, present study is designed to investigate effect of hesperetin on dimethylsulphoxide induced cognitive dysfunction mediated through oxidative stress marker and neuroinflammation in hippocampus Methodology: The experiment was conducted using five treatment groups, each group consisting six rats. Group 1 (control) received 1 ml/kg normal saline interperitoneally for 14 days. Group 2 received 1 ml/kg DMSO per oral for14 days. Group 3 received donepezil 3 mg/kg per day for 14 days and DMSO (1 ml/kg p.o.) for 14th day. Group 4 and 5 received a dose of 25 mg /kg of hesperetin (H1) and 50 mg/kg hesperetin (H2) per oral, per day for 14 days, respectively. Hesperetin was dissolved in DMSO to get 25 mg/ml solution. On 14th day, the memory of rats was assessed by Cook's pole climbing apparatus and Morris water maze test. On 15th day, six rats of each group were sacrificed and the isolated brain tissues were subjected for the estimation of biochemical parameters, beta actin blot analysis and histopathological examination. Results: The DMSO treated rats showed significantly enhanced escape latency time (P

Obstructive sleep apnea syndrome (OSAS) is a highly prevalent yet under recognized sleep disorder, characterized by repeated disruptions of breathing during sleep. Not just merely a local phenomenon of upper respiratory tract obstruction, this has many consequences that includes intermittent hypoxia, intermittent hypercapnia, reoxygenation, intra thoracic pressure changes, sympathetic activation, micro-awakenings and sleep fragmentation leading to metabolic dysregulation, endothelial dysfunction, systemic inflammation, oxidative stress, hypercoagulation, and neurohumoral changes that causes excessive daytime sleepiness, neurocognitive deterioration, endocrine, metabolic and other systemic effects including poor quality of life. There are increasing evidences to suggest that OSAS is a systemic inflammatory disease. Epidemiological studies have identified OSAS as an independent risk factor in cardiovascular diseases, metabolic syndrome and bronchial asthma. Patho-physiological changes in OSAS are causally linked to the hypertension with increase risk for heart failure, stroke and cardiovascular mortality. In addition, OSAS is associated with several other disorders and comorbidities that may affect almost every organ systems of our body. Despite having many complex systemic consequences, OSAS and its secondary effects are mostly controllable by continuous positive air pressure (CPAP). This disorder largely remains an underestimated clinical entity due to unawareness by both the patient and physician alike. There is need for awareness regarding this entity among all specialties of medicine and surgery as the so called undetected/occult disease if remain untreated may lead to significant systemic morbidities and at times mortality.

Subcutaneous emphysema is defined as an escape of air in subcutaneous tissue. It is one of the most common complications after inter-costal chest tube drainage. Subcutaneous emphysema is usually benign requiring no specific treatment, but extensive subcutaneous emphysema can be uncomfortable and alarming for the patient. It can rarely lead to airway compromise, respiratory failure and death. Factors leading to its development, following chest tube insertion and methods of management, have not been extensively studied and published. This was an analytical study done over a period of two years, on indoor patients who developed subcutaneous emphysema. These cases were managed using four different modalities and were analyzed for various factors contributing to the development, severity, and resolution of subcutaneous emphysema. Results of this study highlight that the cases of hydropneumothorax and secondary pneumothorax were significantly more predisposed to the development of severe subcutaneous emphysema (following intercostal chest tube insertion) and large air leak as compared to others. Larger air leak develops higher grades of subcutaneous emphysema. The average time for resolution of subcutaneous emphysema was similar among the different modalities of management compared in the study.

A sleep disorder is characterised by alteration in normal pattern of sleep enough to interfere with the normal functioning of an individual. Sleep disorders are broadly classified as primary sleep disorders such as dyssomnias, hypersomnia and parasomnias and secondary due to medical and mental disorders such as anxiety or substance abuse. We report the case of a 12-year-old boy who presented to us with episodic hypersomnolence, hyperphagia and behavioural abnormalities and was initially managed as epilepsy at another hospital. He was subsequently diagnosed as primary sleep disorder, Kleine–Levin syndrome. We also describe the diagnostic approach to such a case and the crucial role of functional brain imaging in it.

Abstract Background Viral diseases are highly widespread infections caused by viruses. These viruses are passing from one human to other humans through a certain medium. The medium might be mosquito, animal, reservoir and food, etc. Here, the population of both human and mosquito vectors are important. Main body of the abstract The main objectives are here to introduce the historical perspective of mathematical modeling, enable the mathematical modeler to understand the basic mathematical theory behind this and present a systematic review on mathematical modeling for four vector-borne viral diseases using the deterministic approach. Furthermore, we also introduced other mathematical techniques to deal with vector-borne diseases. Mathematical models could help forecast the infectious population of humans and vectors during the outbreak. Short conclusion This study will be helpful for mathematical modelers in vector-borne diseases and ready-made material in the review for future advancement in the subject. This study will not only benefit vector-borne conditions but will enable ideas for other illnesses.

As of August 16, 2021, there have been 207,173,086 confirmed cases and 4,361,996 deaths due to the coronavirus disease (COVID-19), and the pandemic remains a global challenge. To date, no effective and approved drugs are available for the treatment of COVID-19. Angiotensin-converting enzyme 2 (ACE2) plays a crucial role in the invasion into host cells by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of COVID-19. Notably, ACE2 density is influenced by medical conditions, such as hypertension, or by drugs, including angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), which can change the fate of SARS-CoV-2 infectivity. ACE2 is a target for these drugs and can be manipulated to limit the viral entry and replication within the cells. Different strategies aimed at blocking ACE2 with small molecules, peptides, and antibodies, or by neutralizing the virus through its competitive binding with human recombinant soluble ACE2 (hrsACE2) are currently under investigation. In this article, we review the current state of knowledge that emphasizes the need to find effective therapeutic agents against COVID-19 by exploiting ACE2 as a potential target. The increased soluble ACE2 levels and the application of hrsACE2 in patients with COVID-19 can be implemented to control the disease. It has not yet been established whether hypertension and other comorbidities, independent of age, have a direct role in COVID-19. Therefore, the use of renin-angiotensin system inhibitors, ACEIs and ARBs, should not be discontinued during COVID-19 treatment.

Background and Objective: The povidone-iodine (PvP-I) nasal antiseptic has been shown to completely inactivate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro at variable concentrations. This study was performed to investigate the effect of 0.5% PvP-I nasal drops and oral gargles on the nasopharyngeal and oropharyngeal viral loads in SARS-CoV-2-positive patients. Methods: This was a double-blind, placebo-controlled, randomized clinical trial among patients aged ≥18 years with reverse-transcriptase polymerase chain reaction confirmed in the mild to moderate category of SARS-CoV-2 infection. A total of 32 patients were randomly assigned to receive either freshly prepared 0.5% PvP-I solution or distilled water in the form of supervised self-administered 4–5 nasal drops, followed by 20 ml for gargling for at least 30 seconds. The main outcome measure was the mean change in viral titer and Ct values in the nasopharyngeal and oropharyngeal samples at baseline, 5 minutes, and 3 hours post intervention. Results: The mean change in viral titers across the time duration for the test group when compared with the control group was not statistically significant (P = 0.109). However, the mean change in Ct value was found to be borderline statistically significant (P = 0.042). Noticeable differences were noted among the mean viral titers and Ct values in the intervention group when plotted against the time of testing as compared to the control group. PvP-I solution at 0.5% dilution was well tolerated, and no evident side effects were reported. Conclusions: This study shows that 0.5% PvP-I has an effect on reducing nasopharyngeal and oropharyngeal viral loads in COVID-19 patients. This can be of substantial aid for the primary care physicians, especially for the practitioners in remote and resource poor areas.

Objective: This study was conducted to evaluate diffusion capacity of lung for carbon monoxide (DLCO) in patients with simple and complicated silicosis and to correlate abnormal findings detected, if any, with the computed tomography abnormalities in these patients. Methods: This study included 56 patients with simple and complicated silicosis and without tuberculosis, in whom we performed DLCO as per standard technique. Various computed tomography findings, that is, presence, size and distribution of nodules associated with relative parenchymal and vascular markings, were recorded in the study subjects and classified into standard grading to be finally compared with DLCO. Visual grading score system was used to describe the extent of emphysematous changes based on the area of abnormally low attenuation, vascular disruption, bullae and so on and data were recorded. Results: Results showed that 85.7% patients had small opacities of varying grades and 28.5% showed large opacities, with 16% of them having type 'C' large opacities. The mean DLCO (% predicted) of patients with category '0' high-resolution computed tomography (HRCT) abnormality was 92.3 ± 6.8 (within normal limits), and this gradually decreased with increasing HRCT category to 44.2 ± 11.2 in grade '4' of progressive massive fibrosis (PMF) patients in this study (P < 0.01). This reflects a significant inverse correlation between visual HRCT category and the DLCO % predicted (r > −0.89, P < 0.001). The mean DLCO (% predicted) was 51 ± 12.6 in patients with grade '1' emphysema in HRCT, 53 ± 13.5 in grade '2', 43 ± 6.4 in grade '3' and 37.7 ± 6.3 in grade '4'; however, there was no correlation between emphysema grading and pulmonary functional index (r = −0.33, P = 0.15). Conclusion: This study observed significant abnormality in DLCO among silicosis patients and its strong correlation with the extent of radiological abnormality. HRCT finding of large opacities could be an important indicator of the severity of silicosis, as reflected by significantly reduced DLCO in such patients.

Breast cancer is a public health challenge globally as well as in India. Improving outcome and cure requires appropriate biomarker testing to assign risk and plan treatment. Because it is documented that significant ethnic and geographical variations in biological and genetic features exist worldwide, such biomarkers need to be validated and approved by authorities in the region where these are intended to be used. The use of western guidelines, appropriate for the Caucasian population, can lead to inappropriate overtreatment or undertreatment in Asia and India. A virtual meeting of domain experts discussed the published literature, real-world practical experience, and results of opinion poll involving 185 oncologists treating breast cancer across 58 cities of India. They arrived at a practical consensus recommendation statement to guide community oncologists in the management of hormone positive (HR-positive) Her2-negative early breast cancer (EBC). India has a majority (about 50%) of breast cancer patients who are diagnosed in the premenopausal stage (less than 50 years of age). The only currently available predictive test for HR-positive Her2-negative EBC that has been validated in Indian patients is CanAssist Breast. If this test gives a score indicative of low risk (< 15.5), adjuvant chemotherapy will not increase the chance of metastasis-free survival and should not be given. This is applicable even during the ongoing COVID-19 pandemic.

Chondrosarcoma are malignant tumours in which neoplastic cells produce cartilage. The most commonly affected sites are pelvis, femur, humerus and ribs. Scapula involvement is relatively rare. Surgery remains the primary modality of treatment for chondrosarcoma. Radiotherapy is used as an adjuvant therapy in high grade tumours and in cases of residual disease. Present study reports a rare case of scapular chondrosarcoma in a 37 year old male, managed with multimodality treatment and discusses briefly the prognostic parameters and treatment modalities. Only few studies have discussed about scapular chondrosarcoma and more studies with larger number of patients are needed to develop an evidence-based treatment and follow-up protocol for these patients.

Objective: Volumetric modulated arc therapy (VMAT) is a useful treatment technique that can reduce treatment time while producing improved dose distribution to target structures. The main aim of the study is to evaluate the outcome of oropharyngeal cancer patients treated with VMAT, sequential (SEQ) versus simultaneous integrated boost (SIB) technique in terms of survival and failures and to assess late radiation toxicities with their dosimetric parameters. Material and Methods: Total 54 patients of histologically proved oropharyngeal cancer patients treated by definitive radiotherapy using VMAT technique in January 2019 to December 2020 were followed up and evaluated in terms of survival, patterns of failure and late radiation toxicities by RTOG toxicity criteria. Results: After a median follow up of 12 months, overall survival (OS) and disease free survival (DFS) were 64.8% and 48.1% respectively. In terms of patterns of failure, 44.4% showed local recurrence, 7.4% as regional relapse and 3.7% showed distant metastasis. While comparing sequential versus SIB, no significant difference was found in OS (64.9% vs. 59.8%, p = 0.689), DFS (52.8% vs. 35.3%, p = 0.266), local control (LC) (58.3% vs. 47.1%, p = 0.437) and regional control (RC) (94.3% vs. 88.2%, p = 0.151) respectively. Among late radiation toxicities, the most common were xerostomia (42.2% for SEQ and 24.2% for SIB group), dysphagia (33.3% for SEQ and 15.1% for SIB group) and hoarseness of voice (15.1% for SEQ and 12.1% for SIB group). Conclusion: SIB technique proved better than SEQ technique in terms of pattern of failure or late toxicity, but no significant difference can be reported.

This research paper introduces a comprehensive study on fixed points in orthogonal fuzzy metric spaces. The primary objective is to establish the existence and uniqueness of fixed points for self-mappings satisfying implicit relation criteria in complete orthogonal fuzzy metric spaces. By doing so, our proven results extend and generalise well-known findings in the field of fixed-point theory. To demonstrate the significance of the established results, several related examples are provided, serving to support and validate the theoretical findings in orthogonal fuzzy metric spaces. The implications of these results are discussed, shedding light on their potential applications in various practical scenarios. In addition to theoretical advancements, the paper also demonstrates a practical application of our established results in solving integral equations. This application exemplifies the effectiveness and versatility of the proposed approach in real-world problem-solving scenarios.

To prevent substantial economic losses brought on by problems in rolling element bearings, Industrial revolution 4.0 detection methods have been revitalized by Artificial Intelligence (AI) and anIndustrialized Internet of Things (IIoT). Strategies in final devices have been challenged because diagnostic systems receive a range of inputs that provide variances in the input space. Normally, a two-way cross-domain training strategy was used to solve this problem. For the final devices, the researchers provide a soft real-time defect diagnosis technology that utilizes a training strategy to adapt the domain. Deep Learning (DL) patterns develop concepts independently of the input dimension used in the survey. A comparative study was done on a dataset accessible to determine the effectiveness of the proposed methodology with an average accuracy of 88.08%.Experimental results showed in an IIoT ecosystem and our proposed system using a short-term memory system provides the most accurate bearing detecting results.

Lemon (Citrus limon) Rutaceae) is one of the most popular world fruit crops, contains active phytochemicals that are polyphenolic compounds, flavonoids, vitamin C, folic acid, potassium, pectin etc. The bioactives compound of lemon are preventing radical-mediated diseases like cancer, diabetes, neurodegenerative disorders but no one reported that effect of Citrus limon juice on scopolamine induced amnesia model in animal. Rats were divided into five groups. Group 1 rats (normal control) received 1 ml/kg normal saline for 14 days intraperitoneally (i.p.). Group 2 rats received scopolamine (3 mg/kg, i.p.) 30 min prior to the trial on the 14th day. Group 3 rats received 3 mg/kg/day of donepezil as pre-treatment for 14 days and scopolamine (3 mg/kg, i.p.) 30 min prior to the trial on the 14th day. Group 4 and 5 rats received Citrus limon juice (0.6, 1.2 ml/kg/day) for 14 days and scopolamine (3 mg/kg, i.p) 30 min prior to the trial on 14th day respectively. On the day 14, working memory and long-term memory in rats were tested by experimental paradigms and Morris Water Maze (MWM) task. On day 15, 6 rats of each group were sacrificed and brain tissue of these rats was isolated for the estimation of biochemical parameters, histopathological examination and western blot analysis. Scopolamine treated rats showed significantly increased escape latency (p

The biggest public health catastrophe of this century-the SARS coronavirus-2, 2019 (COVID-19) pandemic has affected nearly all countries. Countries after countries were gripped by the intermittent waves of the infection. One of the most affected countries was India, wherein the second wave of the pandemic afflicted the vast swathe of the nation. The medical community was overwhelmed and stressed with the inordinate number of patients. Doctors were inundated with the task of managing all kinds of COVID-19 patients ranging from mildly symptomatic to critically ill, in addition to the non-COVID-19 patients. The life of most of the population was significantly disrupted due to the fear of infection and lockdowns in various places. Due to multiple reasons, physician access was limited for mild to moderately sick patients. During this time, online consultations were at their peak and many groups came forward to help Indian patients. These groups were supported largely by Indian doctors based overseas.

Coronavirus is known to cause various systemic infections both in human and animal which are mostly mild in nature. However, recent years have seen major pandemics caused by coronavirus which are very invasive and virulent in nature. The recent SARS-CoV2 is a new addition to this list of coronavirus pandemics. So the present study was done to systematically review the CNS involvement and its manifestations in SARS-CoV2 positive patients. Systemic review of article published between 1st Dec 2019 to 31st July 2020 searched through web-based database of MEDLINE (Pubmed) and Google scholar using following keywords “COVID -19” OR “CORONAVIRUS” OR “SARS-CoV2” AND “NEUROLOGICAL” OR “CNS” OR “BRAIN”. Using the steps of systemic review eight article were selected for qualitative analysis. Majority of these article were reporting neurological symptoms among patients admitted in different wards along with others general symptoms. None of the study was specifically devoted to study the neurological manifestations and complications in SARS-CoV2 positive patients. The present study concludes that there is a scarcity of good quality research which attempts to establish the role of SARS-CoV2 infection in CNS and its manifestations. However, there are evidences that CNS involvement is present in majority of the patients. Proper documentation of theses involvement and indentification of these into mild, moderate and severe infection will help in early identification and treatment of these patients.

The primary objective of the paper is to present the Banach contraction theorem in soft fuzzy metric spaces while taking into consideration a restriction on the soft fuzzy metric between the soft points of the absolute soft set. A new altering distance function, namely the Ψ-contraction function, is introduced on soft fuzzy metric spaces, and some fixed point results are proven by considering soft mappings that comprise Ψ-contraction with the continuity of soft t-norm. In addition to that, some illustrations are supplied for the support of the established soft fuzzy Banach contraction theorem and fixed point results over Ψ-contraction mappings. The obtained results generalize and extend some well-known results present in the literature on fixed point theory.

Spontaneous pneumothorax is a very uncommon occurrence in patients having coronavirus disease 2019 (COVID-19) pneumonia. It is mostly seen due to barotrauma in patients receiving mechanical ventilation. Although it may occur at different courses of COVID pneumonia and in patients with no underlying lung disease, it has been seen in patients having underlying asthma, chronic obstructive pulmonary disease, and bronchiectasis. This report describes spontaneous pneumothorax in a silicosis patient during the course of COVID-19 pneumonia with successful outcomes. Possible mechanism of pneumothorax in COVID-19 pneumonia and contributing the role of silicosis is also mentioned with the importance of detecting such complications in time to reduce mortality in such patients.

Abstract Background Present investigation for research was to develop matrix-type transdermal drug delivery system of flurbiprofen (FBP) with the various ratio of matrix polymers (hydrophilic and hydrophobic), the concentration of plasticizer and natural penetration enhancer by Box–Behnken statistical design to investigate the combined outcome of selected independent variables for effective management of rheumatoid arthritis. The influence of a binary mixture of polymers, plasticizer and penetration enhancer on physicochemical considerations including thickness, tensile strength, percent elongation, weight variation, percent moisture content, percent moisture uptake, water vapour transmission rate, folding endurance, drug content, in vitro drug dissolution study and then ex vivo drug permeation study was evaluated. Results The study demonstrated that the tensile strength of films improved by matrix polymer ratio and to a slighter gradation in the rise of plasticizer and natural penetration enhancer. Ex vivo drug permeation study was accompanied via excised porcine skin as a permeation barrier in Franz diffusion cell. Ex vivo drug permeation study indicated that matrix polymer ratio (HPMC K15M:ERL100) at 3:1 and natural penetration enhancer (d-limonene) at highest concentration 7.5% w/w containing formulation FBPT7 delivered maximum flux and supplementary improved the permeation of drug. The result of the skin irritation test revealed that the developed formulation is free from any type of skin irritation effects like erythema and oedema. Conclusion Based on the findings of this research, it can be established that a well-controlled release and very effective skin penetration of the drug was accomplished by the film FBPT7 in the existence of permeation enhancers for prolonged periods.

We investigate the neon isotopic composition and elemental abundance in eucrites and diogenites and compare them with the inventories from interiors of the terrestrial planets. The framework of this study is the utilization of isotopic data of eucrites and diogenites in order to constrain the trapped components in Vesta. The isotopic ratios 20Ne/22Ne and 21Ne/22Ne in eucrites and diogenites are dominated by the cosmogenic component. We estimate the average abundances of 20Ne trapped in diogenites as, 1.02 × 10-8 cm3STP/g and in eucrites as, 8.02 × 10-9 cm3STP/g, respectively. The concentrations of trapped 20Ne in diogenites and eucrites are lower by an order compared to the chondrites, but similar to the interiors of the planets Earth and Mars. Preferential degassing of neon during accretionary and post-accretionary processes in Vesta and its subsequent loss to space is considered as a viable mechanism for the observed depletion in the eucrites and diogenites.

Introduction: The silent killer, hypertension (HTN), is a significant risk factor for cardiovascular disease. In India, HTN has a major public health effect on cardiovascular health and health-care systems. Aim: The present study was aimed to evaluate the awareness of general practitioners (GPs) toward HTN management and also their approach toward management. Materials and Methods: The present study was a questionnaire-based assessment study. A total of 100 GPs were included in the study as our study sample. All the participants were well informed about the study and after that those who were willing to participate were enrolled after obtaining a written informed consent. Results: The common presenting symptoms of hypertensive patients were predominantly morning headache (71%), dizziness (41%), palpitation (39%), and fatigability (29%). Majority (84%) practiced cuff placement method covering about 2/3rd of the arm at heart level. The preferred position while blood pressure (BP) examination of patient by majority of practitioners was while sitting (53%). The number of readings usually taken for measuring BP for each patient was as follows: one (3%), two (42%), and three (55)%. Conclusion: Although GPs in our study are well informed and up to date on certain aspects of HTN diagnosis and treatment, they may still lack an appropriate approach to HTN history taking, diagnosis, and treatment.

Background: The COVID-19 pandemic is still spreading throughout the world along with its strange and frightening mutations, and the World Health Organization (WHO) has declared it as a global pandemic. Objective: The present investigation aims to evaluate the effect of SARS-CoV-2 infection on mother and newborn outcomes and the vertical transmission potential of this virus. Study Design: This was a cross-sectional study conducted at a tertiary care dedicated COVID-19 hospital. A total of 40 pregnant females (RT-PCR positive for SARS-CoV-2) and their 41 neonates (including stillbirths and a twin delivery) were included in the present study. Results: All the mothers in the study were SARS-CoV-2 positive on the RT-PCR test, but none had any COVID-19 symptoms (pneumonia-like fever, cough, fatigue, sore throat, shortness of breath, and diarrhea). Out of 41 newborns, 38 (92.7%) were healthy, one (2.4%) was a stillbirth, and two newborns (4.9%) could not be revived. All the 41 (100.0%) neonates, including stillborn and preterm were negative for the SARS-CoV-2 RT-PCR test. Twenty-Six neonates (63.4%) were delivered by caesarean section, whereas 15 cases (36.6%) had a normal vaginal delivery. Conclusion: The present study showed no suggestion of vertical transmission of SARS-CoV-2 in pregnant females. Therefore, the placenta might function as a barrier to the SARS-CoV-2 virus. Also, there were no complications come upon during the delivery of any neonate in the present study.

Background: A foodborne disease outbreak among wedding attendees from Makunsar village, Palghar district, Maharashtra state, India, was reported on February 18, 2018. Objectives: The outbreak investigation was conducted to find out the epidemiology of the outbreak and to identify the etiologic agent and risk factors. Methods: A case–control study was carried out, where cases (patients), controls, and food handlers were interviewed and leftover foods were collected for culture. A case was defined as a person having vomiting or diarrhea (i.e., ≥3 loose stools within 24 h) who attended the wedding ceremony at Makunsar village, Palghar district, Maharashtra, on February 18, 2018. Attack rate and odds ratio (OR) were calculated with 95% confidence intervals (CIs). Results: Out of 75 cases, 63% were female. Altogether, forty-two (56%) cases were hospitalized, and later on, all of them were discharged from hospital without any mortality. About 93%, 68%, 43%, and 41% of the cases reported with vomiting, nausea, abdominal pain, and diarrhea, respectively. The median incubation period was found to be 4 h (range: 2–8 h). Eating gaajar halwa (carrot pudding) was significantly associated with illness (OR: 12.8; 95% CI: 3.5–46). Gaajar halwa is prepared with khoa, a perishable milk product. The gaajar halwa culture yielded no growth. Conclusion: The case-patients' clinical presentation and incubation period were consistent with enterotoxin-producing Staphylococcus aureus as the probable etiologic agent. The epidemiologic investigation identified the probable etiologic agent and food source in a low-resource community setting. Community food handlers were educated on food preparation hygiene and safe storage measures to prevent future outbreaks.