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Abstract In recent decades, microalgae have been getting attention as one sustainable and promising feedstock for biofuel production. Algal biomass can be a viable and long-term alternative for biofuel generation and has the capability to replace petroleum or diesel. According to technological economic models, algal biomass can become economically comparable to petroleum due to lowering carbon energy indices. This review entails the process, mechanism, comparative studies, challenges, and various reports involved in algal-based biofuel production. It also discusses the revolutionizing potential or option of algal biofuel, particularly in the transportation sector. Several advantages of algal biofuel over fossil fuels have been discussed, such as renewable, clean, low-cost, and commercial viability. Biofuels can be used as the primary fuel in motors or as a supplement. Sustainable issues regarding renewable biofuel have been addressed, which reduces greenhouse gas emissions. The preparation of biofuel from three basic components, which are lipids, carbohydrates, and proteins, is also discussed. Algae biomass can be used as an energy source for vehicular engines or as an additive to traditional fuels, such as by blending ethanol from sugar biomass with gasoline, offering a sustainable solution for both green product manufacturing and renewable energy requirements. In the aspect of carbon neutrality, algal biomass can be converted intobiofuels, including biomethane, bioethanol, and biohydrogen. The variety of available research and updated mechanisms represent a clear-cut idea for the suitability of industrial-scale biofuel production using selected algal strains. Finally, this review will be helpful to researchers who are working to improve production efficiency, reduce production costs, and realize industrial-scale production.

Pure and Fe-doped TiO2 nanoparticles were synthesized through green synthesis route for wastewater remediation application. Pure and Fe-doped TiO2 nanoparticles were further characterised through various techniques like XRD, SEM, and EDS. The XRD patterns indicate pure anatase phase with space group I 41/a m d through the Rietveld refinement. The average crystalline size of Fe-doped TiO2 nanoparticles decreases with the increment in the concentration of doping. The high agglomeration of pure and Fe-doped TiO2 nanoparticles is observed through SEM. EDS analysis conforms the presence of Fe, Ti, and O elements in the nanoparticles. The photo catalytic activities of pure and Fe-doped TiO2 under ultraviolet (UV) light with different concentration were investigated. The dissolved oxygen in the water increases with the increment of Fe doping and time of exposer of UV light.

Longitudinal stent deformation (LSD) is an infrequent complication of percutaneous coronary intervention. While the occurrence of gross LSD is a rare phenomenon, minor changes in length are common and have been recognized as accepted behavior of stents during implantation. Due to the proximity of the guide catheter, ostial or ostio-proximal lesions are prone to stent deformation either by the guide or other devices during navigation. Moreover, to satisfy the fractal geometry of coronary bifurcation, the proximal optimization technique is commonly performed during different bifurcation procedures, which can subject the stent to extreme overexpansion resulting in structural deformation. We describe two cases of longitudinal stent elongation during ostial deployment and try to analyze the factors behind this rare, yet complicated behavior of the latest-generation drug-eluting stent.

Salmonella enterica is a foodborne pathogen associated with both typhoid and non-typhoid illness in humans and animals. This problem is further exacerbated by the emergence of antibiotic-resistant strains of Salmonella enterica. Therefore, to meet public health and safety, there is a need for an alternative strategy to tackle antibiotic-resistant bacteria. Bacteriophages or (bacterial viruses), due to their specificity, self-dosing, and antibiofilm activity, serve as a better approach to fighting against drug-resistant bacteria. In the current study, a broad-host range lytic phage phiSalP219 was isolated against multidrug-resistant Salmonella enterica serotypes Paratyphi from a pond water sample. Salmonella phage phiSalP219 was able to lyse 28/30 tested strains of Salmonella enterica. Salmonella phage phiSalP219 exhibits activity in acidic environments (pH3) and high temperatures (70°C). Electron microscopy and genome analysis revealed that phage phiSalP219 is a member of class Caudoviricetes. The genome of Salmonella phage phiSalP219 is 146Kb in size with 44.5% GC content. A total of 250 Coding Sequence (CDS) and 25 tRNAs were predicted in its genome. Predicted open reading frames (ORFs) were divided into five groups based on their annotation results: (1) nucleotide metabolism, (2) DNA replication and transcription, (3) structural proteins, (4) lysis protein, and (5) other proteins. The absence of lysogeny-related genes in their genome indicates that Salmonella phage phiSalP219 is lytic in nature. Phage phiSalP219 was also found to be microbiologically safe (due to the absence of toxin or virulence-related genes) in the control of Salmonella enterica serovar Typhimurium infections in the ready-to-eat meat and also able to eradicate biofilm formed by the same bacterium on the borosilicate glass surface.

Measurement of gas concentrations is crucial for the calculation of emissions from livestock buildings. The study aimed to examine how the concentrations of greenhouse gases (CO2, CH4) and ammonia (NH3) vary seasonally and influenced by climatic conditions in loose housing cattle sheds in India. Two dairy cow sheds with different layouts, floor types, and cleaning practices were selected for measurements during the summer, rainy, and winter seasons. The concentrations of CO2, CH4, and NH3 exhibited significant variations, ranging from 405 to 717 ppm for CO2, 0.01 to 16.12 ppm for CH4, and 0.00 to 1.90 ppm for NH3. The winter season showed higher levels of CO2 and CH4, while NH3 concentrations were higher during the summer season. Notable differences were observed in CO2 and CH4 levels between sheds during feeding, as well as in CO2 levels during cleaning activities. The study revealed a weak correlation between greenhouse gases, ammonia, and climatic conditions in the cattle sheds, except for a moderate positive correlation between CO2 and relative humidity during winter which means other factors such as housing design, facilities and practices play a significant role.

Introduction: Various therapeutic procedures, such as cleft palate surgery, uvulopalatopharyngoplasty, nasopharyngoscopy, and nasogastric intubation, rely on the morphometric measurements of the hard palate. Additionally, it plays a crucial role in passive speech articulation. Therefore, understanding the morphological and osteological diversity of the hard palate holds clinical significance. Aim: To assess the normal and aberrant morphology and morphometry of the hard palate. Materials and Methods: The present cross-sectional study was initiated in December 2017 and completed in December 2021. It was conducted on 100 dry adult human skulls collected from the Department of Anatomy, Government Medical College, Amritsar, Punjab, India. The palate was analysed to determine the mean palatal length, breadth, and height. Additionally, the palatal index and palatal height index were calculated. Different osteological parameters of the lesser palatine foramen, including its number, distance from the greater palatine foramen, palatomaxillary suture, and interpalatine suture, were measured. Mean, standard deviation, range, and p-value were calculated for the metric parameters. Results: The mean palatal length, breadth, and height were 46.16±4.18 mm, 33.01±2.67 mm, and 11.06±1.88 mm, respectively. In the present study, 83% of skulls belonged to the leptostaphyline type, 10% to the mesostaphyline type, and 7% to the brachystaphyline type. The number of lesser palatine foramen varied from 0-2 on both sides, with predominance of a single foramen on both sides. The distances of the lesser palatine foramen from the greater palatine foramen, palatomaxillary suture, and intermaxillary suture were found to be 3.55±1.56 mm, 11.45±2.42 mm, and 17.57±3.06 mm on the right side, and 3.38±1.57 mm, 10.90±2.39 mm, and 17.47±2.99 mm on the left side, respectively. Conclusion: The data provided by this study will be helpful in various disciplines of medical, dental, and anthropometrical sciences.

Enolase, a ubiquitous enzyme, catalyzes the reversible conversion of 2-phosphoglycerate (2PG) to phosphoenolpyruvate (PEP) in the glycolytic pathway of organisms of all three domains of life. The underlying mechanism of the 2PG to PEP conversion has been studied in great detail in previous work, however that of the reverse reaction remains to be explored. Here we present structural snapshots of Mycobacterium tuberculosis (Mtb) enolase in apo, PEP-bound and two 2PG-bound forms as it catalyzes the conversion of PEP to 2PG. The two 2PG-bound complex structures differed in the conformation of the bound product (2PG) viz the widely reported canonical conformation and a novel binding pose, which we refer to here as the alternate conformation. Notably, we observed two major differences compared with the forward reaction: the presence of MgB is non-obligatory for the reaction and 2PG assumes an alternate conformation that is likely to facilitate its dissociation from the active site. Molecular dynamics studies and binding free energy calculations further substantiate that the alternate conformation of 2PG causes distortions in both metal ion coordination and hydrogen-bonding interactions, resulting in an increased flexibility of the active-site loops and aiding product release. Taken together, this study presents a probable mechanism involved in PEP to 2PG catalysis that is likely to be mediated by the conformational change of 2PG at the active site.

Detecting and identifying hydrogen gas leakage before a potential disaster is a critical safety concern. To address this issue, a low-cost and simple-design sensor is required with high response and fast sensing time, capable of detecting hydrogen gas even at low concentrations of 5–500 ppm. This study investigates the use of magnetron-sputtered SnO2 thin films with palladium as a catalytic layer to achieve better sensing output. The developed Pd-caped SnO2 thin film sensors showed increased sensitivity with increasing thickness, up to 246.1 nm at an operating temperature of 250 °C. The sensor with a thickness of 246.1 nm exhibited excellent selectivity for H2 gas, even in humid conditions, and was able to distinguish it from other gases such as CO, NH3, and NO2. The sensor demonstrated high response (99%) with a response/recovery time of 58 s/35 s for (5–500 ppm) hydrogen gas. The sensor showed linear response to H2 gas concentration variation (5–500 ppm) at 250 °C. The sensor was found to be mechanically stable even after 60 days in a high-humidity environment. The LOD of sensor was 151.6 ppb, making it a suitable candidate for applied sensing applications. The Pd-caped SnO2 thin film sensor with thickness of ~245 nm could potentially improve the safety of hydrogen gas handling.

Sabin Kumar Ranabhat,1 Nishan Raj Rijal,2 Muskan Dubey,3 Arun Kumar Dubey,4 Neelam Dwivedi,5 Arun Kumar Mohan,6 Ravikant Ravikant,7 Ramesh Lolla4 1Department of Pathology, Xavier University School of Medicine, Oranjestad, Aruba; 2Department of Pathology, Chitwan Medical College Teaching Hospital, Bharatpur, Nepal; 3Xavier University School of Medicine, Oranjestad, Aruba; 4Department of Pharmacology, Xavier University School of Medicine, Oranjestad, Aruba; 5Department of Medicine, OSCE and SP Program, Xavier University School of Medicine, Oranjestad, Aruba; 6Department of Physiology, Xavier University School of Medicine, Oranjestad, Aruba; 7Department of Microbiology, Xavier University School of Medicine, Oranjestad, ArubaCorrespondence: Sabin Kumar Ranabhat, Email sabinmd@xusom.comBackground: Hashimoto thyroiditis is an autoimmune disease which is diagnosed based on well-defined clinical and cytological criteria.Purpose: The objective of this research is to study cytomorphological features in patients of Hashimoto thyroiditis and compare the findings with other studies. Literature on morphology of multinucleated giant cells was found to be lacking, and this study has focused on the number and morphology of these cells in this study.Material and Methods: FNAC was done in patients who met the clinical diagnostic criteria of Hashimoto thyroiditis formulated by “Japan Thyroid Association” and smears were analyzed by light microscopy. Data analysis was done by XLSTAT in Microsoft Excel 2010. The Wilcoxon Signed Rank Test was done to analyze the data on multinucleated giant cells. The null hypothesis was that the median of the population of differences between the paired data of small and large giant cells is zero.Results: A total of 26 patients were included in a period of one year. Contrary to observations in other studies, multinucleated giant cells were found in most participants. The Wilcoxon Signed Rank Test proved that small multinucleated giant cells were significantly more common than large multinucleated giant cells in Hashimoto thyroiditis; P value (two-tailed) being < 0.0001 at significance alpha of 0.05. This study has also revealed that a few patients with Hashimoto thyroiditis can have large and very large multinucleated giant cells in a small number. Data on other cytomorphological features were no different than in other studies.Conclusion: The presence of multinucleated giant cells in 92.3% of patients in this study is far higher than in other studies which can have important diagnostic implications. Few large multinucleated giant cells can be present in a small number in a few patients as in Hashimoto thyroiditis.Keywords: Hashimoto thyroiditis, cytomorphology, giant cells

Background: Among the Indian adolescents, the prevalence of psychiatric morbidity and alcohol use disorders (AUD) are 7.3% and 1.3%. However, no separate data are available for indigenous tribal populations. This study estimated the prevalence of psychiatric morbidity and AUD and associated socio-demographic factors among adolescents in the tribal communities in three widely varying states in India. Methods: Using validated Indian versions of the MINI 6.0, MINI Kid 6.0, and ICD-10 criteria, we conducted a cross-sectional survey from January to May 2019 in three Indian sites: Valsad, Gujarat (western India); Nilgiris, Tamil Nadu (south India); and East Khasi Hills district of Meghalaya (north-east India) on 623 indigenous tribal adolescents. Results: Aggregate prevalence of any psychiatric morbidity was 15.9% (95% CI: 13.1–19.0) (males: 13.6%, 95% CI: 10.0–18.1; females: 17.9%, 95% CI: 13.9–22.6), with site-wise statistically significant differences: Gujarat: 23.8% (95% CI: 18.1–30.2), Meghalaya: 17.1% (95% CI: 12.4–22.7), Tamil Nadu: 6.2% (95% CI: 3.2–10.5). The prevalence of diagnostic groups was mood disorders 6.4% ( n = 40), neurotic- and stress-related disorders 9.1% ( n = 57), phobic anxiety disorder 6.3% ( n = 39), AUD 2.7% ( n = 17), behavioral and emotional disorders 2.7% ( n = 17), and obsessive-compulsive disorder 2.2% ( n = 14). These differed across the sites. Conclusion: The prevalence of psychiatric morbidity in adolescent tribals is approximately twice the national average. The most common psychiatric morbidities reported are mood (affective) disorders, neurotic- and stress-related disorders, phobic anxiety disorder, AUD, behavioral and emotional disorders, andobsessive-compulsive disorder.

The main objective of the current study is to determine the engine performance, combustion, and emission analysis of compression ignition engines fuelled with Chlorella Protothecoides microalgal biodiesel (CPMB). The biodiesel was derived from Chlorella Protothecoides microalgal oil (CPMO) through transesterification. Under the specified conditions, which included a methanol-to-oil molar ratio of 7.41 (vol/vol), a reaction time of 105.6 min, a reaction temperature of 65 °C, and a catalyst concentration of 1.024 (% wt/vol) and achieved a biodiesel yield of 98.1%. The fuel properties were determined using standard methods, revealing that the density and kinematic viscosity of CPMB were significantly higher than those of diesel. However, CPMB still exhibits satisfactory fuel properties that meet most biodiesel specifications. CPMB boasts a low cloud point (CP) and pour point (PP) of 0 and -3 °C, respectively, indicating its effective usability in cold climates. The oxidation stability of CPMB, determined by the modified Rancimat method, was found to be 4.6 h, satisfying ASTM specifications. The fuel tested in this study was 20% biodiesel with diesel, 100% biodiesel, and neat diesel. These fuels had been tested on a CI engine in which the engine speed and compression ratio were fixed at 1500 rpm and 18:1, respectively. Based on the results, it is found that the indicated thermal efficiency decreases up to 3.68% and 8.22% with B20 and B100 as compared to diesel. However, mechanical efficiency, volumetric efficiency, and indicated power were estimated to be higher at peak engine load conditions when correlated with neat diesel. Furthermore, the mean effective pressure for B20 and B100 was estimated to be decreasing while the mass fraction of fuel burnt and the rate of pressure rise increased compared to diesel at peak load conditions. For exhaust emission analysis, a significant reduction was recorded in CO and UHC emissions, while NOX emission increases at peak engine loads. From the above results, it is accomplished that the performance of B20 blends is nearly identical to diesel, and it can be recommended to be used in engines without any modification.

Acute promyelocytic leukemia (APML) is a rare subtype of acute myeloid leukemia characterized by the predominance of atypical promyelocytes. Acute perforating appendicitis with atypical promyelocytic infiltration of the appendix is exceptionally rare. The presence of a dual emergency complicates diagnosis, management, and survival. A 31-year-old female presented to the emergency department with a 2-week history of fever with chills, diffuse abdominal pain, and vomiting, followed by swelling and pain in the left lower limb, loose stools, and generalized weakness. Hematological findings and abdominal imaging showed APML and acute perforative appendicitis, respectively. She had an emergency laparoscopic appendectomy, which revealed atypical promyelocytic infiltration with perforative appendicitis on histological examination. Despite aggressive treatment, she died as a result of APML-related complications such as disseminated intravascular coagulation, hemorrhages, and shock. This case highlighted the importance of using an early multidisciplinary approach to diagnose and treat these fatal emergencies as promptly as possible.

Objective: To determine whether a single dose of gonadotropin-releasing hormone (GnRH) agonist administered subcutaneously in addition to the regular progesterone supplementation could provide a better luteal support in antagonist protocol fresh embryo transfer cycles. Methods: This prospective, multicentric, cohort study included total 140 women, 70 in each group. Controlled ovarian stimulation was carried out as per fixed GnRH antagonist protocol. The trigger was given with hCG. In vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) was performed and day-3 embryos were transferred. Patients were divided into groups 1 and 2 based on computer generated randomization sheet. Six days following oocyte retrieval, group 1 received 0.2 mg decapeptyl subcutaneously in addition to regular progesterone support while group 2 received progesterone only. Luteal support was given for 14 days to both groups; if pregnancy was confirmed luteal support was continued till 12 weeks of gestation. The clinical pregnancy rate was the primary outcome. The implantation rate, miscarriage rate, live birth delivery rate, and multiple pregnancy rates were the secondary outcomes. Results: A total of 140 patients were analysed, 70 in each group. Clinical pregnancy rates (47.1% vs. 35.7%; P=0.17), implantation rates (23.4% vs. 18.1%, P=0.24), live birth delivery rates (41.4% vs. 27.1%, P=0.08), and multiple pregnancy rates (21.2% vs. 16.0%, P=0.74) were higher in group 1 than in group 2. Group 1 had a lower miscarriage rate than group 2 (5.7% vs. 8.6%; P=0.75). However, these differences were not statistically significant between the two groups. Conclusions: Administration of a single dose of GnRH agonist in addition to regular natural micronized vaginal progesterone as luteal support in GnRH antagonist protocol cycles marginally improves implantation rates, clinical pregnancy rates, and live birth delivery rates. However, more studies with higher sample sizes are needed before any conclusive statements about GnRH agonist as luteal phase support can be made.

Objectives: The present study was performed to provide a normal reference range for humerus diaphysis length at the second trimester of pregnancy in an Indian population. Materials and Methods: This cross-sectional study was performed on 25 radiographs of aborted normal human fetuses of gestational age (GA) between 13th and 28th weeks. The radiographs were used to measure the maximum length of the humerus using a vernier calliper. Data were collected, tabulated, and statistically analyzed. Results: The mean diaphyseal length of humerus at the fourth lunar month was 22.18 ± 6.59 mm, and at the seventh lunar month, it was 41.39 ± 10.08 mm. Simple linear regression analysis shows a strongly significant linear relationship of humerus length with GA, biparietal diameter, head circumference, and abdomen circumference. Conclusion: We have provided a normal reference range for humerus diaphysis length at the second trimester of pregnancy in an Indian population.

Invasive mold infections (IMIs) are a major cause of morbidity and mortality in hospitalized and immunocompromised patients. Over the last decade, the incidence of IMIs has increased at an alarming rate in India. Radiology, histopathology, and validated biomarkers play an important role in the diagnosis of IMIs, including aspergillosis and mucormycosis. Despite major advances in the field of diagnostics, newer diagnostic aids are not available in India. Further, the cost is a major consideration in the Indian context. While antifungal therapies are the mainstay of treatment for aspergillosis, surgery along with antifungal therapy is the mainstay treatment for patients with mucormycosis. Furthermore, there is a paucity of data regarding the diagnosis and management of IMIs, especially in India. This study presents an expert opinion on the diagnosis and management of IMIs in Indian settings. The key opinions proposed by the subject expert group are summarized in this paper.

Background: The objective of this study was to estimate serum vitamin B12 levels and its correlation with severity of clinical presentation in patients with trigeminal neuralgia (TN). Methods: A total of 80 participants were included and rendered into study group: 40 TN patients and control group: 40 healthy individuals. The serum vitamin B12 estimation of each participant was carried out by using serum vitamin B12 ELISA kit and pain characteristics of TN patients were recorded in details. Results: The mean serum vitamin B12 level was noticed to be significantly lower (p = 0.042) in study group (296.87 ± 248.75 pg/mol) as compared to control group (423.5 ± 296.41 pg/mol). There was a statistically significant difference in serum vitamin B12 level between vegetarian TN patients and those who were on mixed diet (p = 0.001). The pain associated with TN predominantly reported unilaterally involving the right side (55%), female gender (55%) and mandibular division (50%). Although pain intensity showed no significant relation (p = 0.024), duration of pain reported a strong negative association with mean serum vitamin B12 levels in TN patients (p = 0.001). Conclusions: Vitamin B12 supplements can be added to the established treatment protocol for the holistic management of TN patients particularly those who are on vegetarian diet.

The present work evaluates the impact of the cubical titanium nitride (c-TiN) coating on the corrosion characteristics of the 304 L stainless steel SS(304 L). A thick and crystalline c-TiN layer with a hierarchical nano-pyramid-like structure was prepared by a single-step sputtered method at RT on a mechanically polished SS(304 L) substrate. Most of the basic characterization techniques were employed to understand the growth mechanism of c-TiN coating. The corrosion characteristics of the prepared coating were executed in two distinct ways, Tafel and EIS plots, in terms of polarization resistance (Rp) under saline water ambient [3.5 % NaCl]. The obtained results reveal the superior corrosion resistance of coated substrate compared to the bare substrate after a long immersion (∼6 h) of the sample in saline water. The c-TiN coated sample offers low corrosion current density (Icorr) (19.8 µA/cm2) compared to the bare substrate (213 µA/cm2). Similarly, EIS and equivalent circuit results also indicate superior corrosion resistance of c-TiN-coated SS-304 L, resulting in a significantly low corrosion rate (CR) of ∼ 0.0213 µmpy. The formation of corrosion products was discussed by using surface morphology analysis, while the electrochemical ion kinetic study was also presented to understand the anti-corrosion mechanism of c-TiN coating.

Abstract Background The morbidity associated with advanced stage melanoma is an important consideration in the dialog surrounding early detection and overdiagnosis. Few studies have stratified melanoma patient quality of life (QoL) by stage at diagnosis. Objective We sought to investigate if melanoma stage is independently associated with changes in QoL within a large, community‐based melanoma registry. Secondarily, we investigated whether demographic factors such as age, geographic location or level of education are associated with changes in QoL in the same population. Methods 1108 melanoma patients were surveyed over a three‐month period using the QoL in Adult Cancer Survivors Survey, consisting of 47 items on a 7‐point frequency scale. Data were analysed using both descriptive statistical models and adjusted multivariate logistic regression. Results There were 677 respondents generating a 61% response rate. Overall, higher stage at diagnosis correlated with the largest decreases in QoL as it pertained to both general (p = 0.001) and Cancer‐Specific stressors (p

Rapidlyincreasing population, the demand for food has increased substantially. To overcome food deficits, an increase in agricultural production is needed, and for sustainability, the qualities of crops as well as maintaining the fertility of the soil are challenging situations. Soil contains limited amount of macro, micronutrients and innumerable amounts of soil microflora, which helps in crop production. Since the mid-19th century, a plethora of chemical fertilizers have been extensively used to improve crop production, but over time, they have shown disastrous effects on the soil compositionand profile. In the current alarming scenario, a new technology arearising, namely nanotechnology, in the field of agriculture. Nano-chemicals can play a paramount role in sustainable agriculture. This reviewsummarizes a variety of nanomaterials as pesticide, fertilizers and control of attack of fungus and bacterial diseases. Here discussed a range of nanomaterials including Ag, Fe, Cu, Si, Se, Al, Zn, ZnO, TiO _2 and carbon nanotubes non-propitious effectsof biomagnification. This review alsodiscussesthe several mechanisms which show how nanomaterials does work as nanofertilizer, nano pesticides, and control bacterial and fungal diseases along with the advantages and disadvantages in the sustainable approach of agriculture. Furthermore, it discusses the synergistic effect of nanomaterials and conventional approach involved in agriculture practices. Nano-fertilizers and nano-biofertilizers are new tools that have evolved for the sustainableagricultural and food security.

Objective The purpose of this study was to find out the incidence of typical and atypical radiological imaging findings of hepatocellular carcinoma (HCC) on multiphase multidetector computed tomography (MDCT) scans in histologically proven cases. Materials and Methods A multiphase computed tomography study of 73 patients with histologically proven HCC was evaluated by a radiologist. Our multiphasic protocol was composed of precontrast, arterial, portal, and delayed venous phases. The reviewers analyzed the CT images for tumor size, enhancement patterns of HCC in different phases, relative timing of washout, internal cystic changes, and presence of dysmorphic intratumoral vessel aneurysms or arteriovenous shunt. Results Most of the cases (95.9%) showed typical enhancement patterns in MDCT, i.e., enhancements in the arterial phase with the portal or delayed venous phase contrast washout. Three cases (4.9%) out of 73 HCC showed enhancements in the portal phase and washout in the delayed venous phase. Seven cases out of total 73 HCC (9.5%) patients showed heterogeneous enhancements in both arterial and portal phases and contrast washout in the delayed venous phase. Venous thrombosis was noted in about 44 cases (60%) out of total 73 patients, in which portal vein thrombosis was more common than hepatic veins/inferior vena cava. Conclusion Most of the HCC show typical enhancement patterns, i.e., heterogeneous enhancements in the arterial phase and washout in the portal venous phase when we use MDCT. These findings are higher than those described previously. However, in our study, the main difference with MDCT was lower frequency of intratumoral pseudoaneurysm and bile duct invasion, and intratumoral fat and calcification (atypical character of HCC) were not found which were rare findings in previous study.

French bean (Phaseolus vulgaris L.) cultivation faces multipronged challenges of low farm productivity, poor economic returns, and soil health deterioration in the hilly ecosystem of India. Hence, the development of a cost-effective and soil-supportive French bean cultivation technology is highly warranted. Thus, a field experiment was conducted for two consecutive seasons in the Sikkim region of the Indian Himalayas to assess the impact of different organic nutrient sources on the production potential, profitability, and soil health of French bean. Eight organic nutrient management practices, viz., farmers' practice, 100% recommended dose of nitrogen (RDN) through FYM, 100% RDN through mixed compost (MC), 100% RDN through vermicompost (VC), 50% RDN through FYM + 50% RDN through MC, 50% RDN through FYM + 50% RDN through VC, 50% RDN through MC + 50% RDN through VC, and 33% RDN through FYM + 33% RDN through MC + 33% RDN through VC, were assigned in a three times replicated randomized complete block design. The results revealed that the supply of 33% RDN through FYM + 33% RDN through MC + 33% RDN through VC 33% recorded the highest pod yield (8.30 and 8.00 Mg ha−1) and net returns (1,831 and 1,718 US$ ha−1). Furthermore, the supply of 33% RDN through FYM + 33% RDN through MC + 33% RDN through VC 33% also had a positive impact on soil health. It was shown that an equal supply of RDN through FYM + MC + VC increases soil pH by 8.35%, SOC by 5.45%, available N by 6.32%, available P by 16%, available K by 9.92%, and micronutrients by 5–7% over farmers' practice. Thus, the supply of RDN through the integration of FYM + MC + VC in equal proportion is an economically robust and soil-supportive nutrients management practice for organic French bean production in the hilly ecosystem of North East India.

Opportunistic behavior of commensal bacteria during severe infection, especially of the intestine is always considered as a predisposing threat for the severely ill patient admitted to hospitals. A descriptive-analytical case-control study was carried out to detect the prevalence and risk factor analysis of fecal carriage of Carbapenem-resistant Enterobacteriaceae. Patients having fecal carriage of Carbapenem-resistant Enterobacteriaceae were considered as cases and patients who were without Carbapenem-resistant Enterobacteriaceae were taken as the control in a proportion of 1:4. Carbapenem-resistant Enterobacteriaceae (CRE) was confirmed by both conventional as well as molecular methods. Methods such as Combined Disk Test, mCIMtest, and RAPIDEC CarbaNP Test were used for phenotypic identification of CRE, Whereas Real-Time (RT)-PCR was used for the detection of bla-gene encoded for CRE (blaNDM1, blaVIM, blaKPC, blaIMP, and blaOXA48). All patients belonging to medicine wards were included in the study. we screened 436 patients during the study and found 160 patients suitable for our study, out of which 32 (20%) were cases and 128 (80%) were controls. We found a total number of 25 genes out of 16 isolates, where NDM 1 was identified in maximum numbers followed by KPC &VIM. Standard statistical analyses such as chi-squire and odd ratios were conducted to determine the risk factor of different variables. Stepwise multiple logistic regressions were carried out, where we found, that transfer from other wards to medicine ward, use of nebulizer and intravenous catheter, and use of multiple antibiotics were still statistically significant. Implementation of Multi-modal colonization prevention and control is the need for the present situation throughout the world.

Introduction: Diabetes adversely affects sexual health with its negative consequences on well-being in both males and females. Literature is scanty regarding female sexual dysfunction (FSD) in diabetic women, furthermore reported literature is lacking regarding the differential impact on different domains of sexual health, especially in Indian females. In the present analysis, we aim to study the prevalence of sexual dysfunctions in diabetic women as well as different domains affected by diabetes. Materials and Methods: This cross-sectional study was carried out at a tertiary care teaching centre in North India over a duration of 6 months (January 2021 to June 2021). A total of 100 married females were enrolled including 50 diabetics and 50 healthy non-diabetic females. All the participants were subjected to a validated female sexual function index (FSFI) questionnaire for sexual function assessment. Results: FSD was seen in 35 diabetic females (70%) with desire being the most affected domain (92%) in comparison to 15 healthy subjects (30%) with an overall mean FSFI of 23.5 in diabetics and 29.2 in the control group. Mean FSFI in diabetic females with sexual dysfunction was 21.04 ± 9. All domains of FSFI were affected significantly (P value < 0.05) in the diabetic group in comparison to the control group except for the satisfaction domain. There was no significant association of different domains of FSFI seen with the duration of diabetes and other comorbidities. A significant association of arousal and pain domain was seen with the glycaemic (HbA1C) index (P value-0.006 and 0.031, respectively). Conclusion: Females with diabetes mellitus (DM) have a higher prevalence of sexual dysfunction affecting all domains. Glycosylated haemoglobin is associated independently with arousal and pain domains of FSFI as well as desire being the most affected domain, although further randomized studies with larger sample sizes are needed to authenticate our findings. To improve the quality of life of diabetic females, clinicians should focus on this aspect also while treating diabetes.

Environmental pollution, resource dwindling, and soil degradation questioned the sustainability of contemporary agricultural production systems. Organic farming is advocated as a sustainable solution for ensuring food security without compromising environmental sustainability. However, poor farm productivity quizzed the sustainability of organic production systems. Hence, a field study was carried out in the Sikkim region of the Indian Himalayas to assess the efficacy of conservation-effective tilling and diversified cropping on system productivity, profitability, environmental quality, and soil nutrient balance in organic farming. Three tillage systems, namely, (i) conventional tillage (CT), (ii) reduced tillage (RT), and (iii) zero tillage (ZT), and four maize based diversified cropping systems (maize–black gram–toria, maize–black gram–buckwheat, maize–rajmash–toria, and maize–rajmash–buckwheat) were tested using a three times replicated split-plot design. The ZT system recorded 13.5 and 3.5% higher system productivity over CT and RT, respectively. Of the four diversified cropping systems, the maize–rajmash–buckwheat system recorded the maximum system productivity (13.99 Mg ha−1) and net returns (3,141 US$ ha−1) followed by the maize–black gram–buckwheat system. Among the tillage practices, ZT recorded the significantly high eco-efficiency index (EEI; 1.55 US$ per kg CO2-eq emission) and the lowest greenhouse gas intensity (GHGI; 0.15 kg CO2-eq per kg production). Of the diversified cropping systems, the maize-rajmash-buckwheat registered the lowest GHGI (0.14 CO2-eq per kg production) and the highest EEI (1.47 US$ per kg CO2-eq emission). Concerning soil nutrient balance, after three cropping cycles, the soil under ZT recorded significantly higher available N (340.0 kg ha−1), P (16.6 kg ha−1), and K (337.3 kg ha−1) over the CT system at 0–10 cm soil depth. Similarly, the soil under the maize–black gram–buckwheat system had the maximum bio-available NPK. Thus, the study suggests that the cultivation of the maize–black gram/rajmash–buckwheat systems under ZT and/or RT would increase farm productivity, profitability, and soil fertility with minimum GHGI in organic farming under the Eastern Himalayan region of India.

Ecological indicators are herculean contrivance for assessing management practices' impacts on environmental changes. Soil organic carbon (SOC) potentially regulates the agricultural sustainability. Unfortunately, the SOC has been widely degraded through unsustainable land uses and agricultural practices. Hence, the efficacy of conservation tilling and diversified cropping were assessed in terms of restoration of SOC and associated soil properties in fixed plots, which are related with farm productivity and other ecosystem services under organic production systems of the Indian Himalayas. Three tillage management were selected as treatments of the study: i) conventional tilling (CT), ii) reduced tilling (RT), and iii) Zero tilling (ZT) applied to four diversified cropping systems [CS1- maize–black gram–toria, CS2 maize–black gram–buckwheat, CS3- maize–rajmash–toria and CS4 maize–rajmash–buckwheat]. The ZT had the highest SOC content (19.58 g kg−1) as well as the C pool (25.24 Mg ha−1) at a soil depth of 0–10 cm. On the contrary, ZT had the lowest ρb (1.29 Mg m3) and soil penetration resistance (1.32 MPa) at 0–5 cm and 5–10 cm soil depth. Concerning SOC partitioning, regardless of soil depth, it had been evident that more SOC were allocated in the active pool over the passive pool. Out of the diversified cropping systems, the CS2 produced a considerably higher total carbon pool of 24.98, and 23.0 Mg ha−1 at 0–10 cm, and 10–20 cm soil depths, respectively, and active and passive C pools. Hence, abolition of tillage and cultivation of legume embedding cropping systems resulted as a sustainable management system under organic farming for SOC restoration and soil quality improvement in the Himalayan ecosystem. Thus, the study suggested that the cultivation of CS2 under ZT may be promoted for efficient land resource management planning in the study region of the Indian Himalayas.

Kleine-Levin syndrome (KLS) is a rare illness of recurrent episodes of hypersomnia associated with hyperphagia, cognitive dysfunctions and behavioural abnormalities. KLS, a disorder often reported in young males has been described in fewer females. It is rare in patients with age beyond second decade. We report a case of a female in early thirties who presented with recurrent episodes of excessive sleepiness and hyperphagia with cognitive dysfunctions. Her eating and subsequent weight gain was so prominent that she was referred to addiction treatment centre. She was managed with Lithium and Modafinil.

Introduction: Enterically transmitted Hepatitis A Virus (HAV) and Hepatitis E Virus (HEV) are the most common cause of Acute Viral Hepatitis (AVH) and a major health concern in developing nations like India. Both viruses cause AVH and are spread predominantly through the faecal-oral pathway, most commonly through contaminated water. Aim: To estimate the prevalence of HAV and HEV infection in patients presenting with AVH. Materials and Methods: An analytical cross-sectional study was undertaken in Indira Gandhi Institute of Medical Sciences, Bihar. The study was conducted over a period of 24 months from November 2019 to October 2021. All patients presenting with AVH were included as study participants. The blood samples were subjected to test anti-HAV and anti-HEV positivity. Prevalence of HAV and HEV was calculated taking total cases of AVH as denominator. Patients with confirmed infection with HCV, HBV and any other cause of hepatitis were excluded from the study. Templates were generated in an Microsoft Excel spreadsheet and analysis of data was done using Statistical Package of the Social Sciences software (SPSS) version 20.0. Quantitative data were presented as frequency and percentages. Results: A total of 682 patients presented with acute hepatitis. The AVH patients comprised 467 males (68.5%) and 215 (31.5%) females with the mean age 39.6±18.87 years. The current study reports the seroprevalence of 9.18% HAV and 8.35% of HEV. A total of 4 patients tested positive for coinfection with HAV and HEV. Most of the HAV patients belonged to an age group less than or equal to 12 years (25,58.1%) and none were more than 60 years. However, none of the HEV patients were children and most of them were aged between 13 to 60 years (46,92%). A male preponderance among HAV (28,65.1%), and HEV (38,76%) was noted. Conclusion: Low seroprevalence was noted, with infection more common in younger age group and male patients. Further studies and vaccination along with surveillance system strengthening are warranted.

Malaria is a global infectious disease that remains a leading cause of morbidity and mortality in the developing world. Multiple environmental and host and parasite factors govern the clinical outcomes of malaria. The host immune response against the Plasmodium parasite is heterogenous and stage-specific both in the human host and mosquito vector. The Plasmodium parasite virulence is predominantly associated with its ability to evade the host’s immune response. Despite the availability of drug-based therapies, Plasmodium parasites can acquire drug resistance due to high antigenic variations and allelic polymorphisms. The lack of licensed vaccines against Plasmodium infection necessitates the development of effective, safe and successful therapeutics. To design an effective vaccine, it is important to study the immune evasion strategies and stage-specific Plasmodium proteins, which are targets of the host immune response. This review provides an overview of the host immune defense mechanisms and parasite immune evasion strategies during Plasmodium infection. Furthermore, we also summarize and discuss the current progress in various anti-malarial vaccine approaches, along with antibody-based therapy involving monoclonal antibodies, and research advancements in host-directed therapy, which can together open new avenues for developing novel immunotherapies against malaria infection and transmission.

Introduction: Staging of liver fibrosis is essential for making therapeutic decisions in patients with Chronic Hepatitis B (CHB) having raised Hepatitis B Virus Deoxyribonucleic Acid (HBV DNA) levels (>2000 IU/ml) and normal or mildly elevated Alanine Transaminase (ALT). Though the gold standard for assessment of liver fibrosis has been liver biopsy, many non invasive models have been developed to mitigate the risks associated with liver biopsy and overcome its limitations. Aim: To evaluate the non invasive models predictive of significant fibrosis in this selected subgroup of Chronic Hepatitis B patients. Materials and Methods: Fifty-six CHB patients were evaluated. This longitudinal observational study was conducted at Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University from February 2017 to July 2018 on 56 patients. Liver Stiffness Measurement (LSM), Aspartate Aminotransferase (AST) to Platelet Ratio Index (APRI), FIBROSIS-4 (FIB-4) and Gamma-Glutamyl Transpeptidase (GGT) to platelet ratio (GPR) were estimated. Liver fibrosis staging was done using Metavir score. Significant fibrosis corresponds to Metavir score F2-F4 and advanced fibrosis as more than F3.The performance of non invasive methods was assessed using Receiver Operating Characteristic (ROC) curves. Z -test was used to compare Area Under ROC Curves (AUROCs). Results: Twenty-one patients (37.5%) had significant fibrosis, out of which seven had F3-F4 fibrosis. Patients with F2-F4 fibrosis had higher age, Hepatitis B e antigen (HBeAg) positivity, HBV DNA, ALT, AST, GGT, LSM, APRI, FIB-4 and GPR values than patients with F0-F1 fibrosis. Metavir fibrosis stages positively correlated with LSM values (r=0.831, p

In the present scenario, the challenge of emerging antimicrobial resistance is affecting human health globally. The increasing incidences of multidrug-resistant infections have become harder to treat, causing high morbidity, and mortality, and are posing extensive financial loss. Limited discovery of new antibiotic molecules has further complicated the situation and has forced researchers to think and explore alternatives to antibiotics. This has led to the resurgence of the bacteriophages as an effective alternative as they have a proven history in the Eastern world where lytic bacteriophages have been used since their first implementation over a century ago. To help researchers and clinicians towards strengthening bacteriophages as a more effective, safe, and economical therapeutic alternative, the present review provides an elaborate narrative about the important aspects of bacteriophages. It abridges the prerequisite essential requirements of phage therapy, the role of phage biobank, and the details of immune responses reported while using bacteriophages in the clinical trials/compassionate grounds by examining the up-to-date case reports and their effects on the human gut microbiome. This review also discusses the potential of bacteriophages as a biocontrol agent against food-borne diseases in the food industry and aquaculture, in addition to clinical therapy. It finishes with a discussion of the major challenges, as well as phage therapy and phage-mediated biocontrols future prospects.

The north Indian states of Haryana and Punjab are believed to be the key sources of air pollution in the National Capital Region due to massive agricultural waste burning in crop harvesting seasons. However, with the pandemic COVID-19 hitting the country, the usual practices were disrupted. COVID-19 preventive lockdown led to restricted vehicular and industrial emissions and caused the labours to leave the agricultural business in Haryana and Punjab. With the changed scenario of 2020, the present study investigates the variations in air quality over the Haryana and Punjab, and their relative impact on the air quality of Delhi. The work attempts to understand the change in agricultural waste burning during 2020 and its implication on the local air quality over both the states and the transported pollution on the national capital Delhi. The study utilises in-situ data for the year 2019–2020 with satellite observations of MODIS aqua/terra for fire counts, aerosol optical depth (AOD) and back-trajectories run by the hybrid single-particle Lagrangian integrated trajectory model (HYSPLIT).

Clean, renewable, and sustainable energy is required daily to improve social, economic, and environmental health, leading to economic development and productivity. The aim of the work has deliberated on the reoccurrence of renewable energies to assist in the mitigation of climate change and environmental health excellently. This work aims to determine whether renewable energy sources are viable and study how a shift from fossil fuel-based energy sources to renewable energy sources would assist in reducing climate change and its impact. State of the art in biofuels and energy generation from lignocellulosic biomasses has shown that applying advanced technologies such as biorefinery and bioreactors to the chemical transformation process is a sustained strategy. To optimally exploit biorefineries' potential, government policies must favour technological innovations in universities and in an industry that can help produce high-value fuels and products from various biomasses. This work deliberated to light the prospects allied with renewable energy sources; energy security, access to energy, social and economic progress, and climate change mitigation to reduce ecological and health impacts.

ABSTRACT: Background: This study produced these Folate-Chitosan (FA-CS) conjugates by coupling a reaction with FA with CS, which resulted in better performance than previously attained due to the preservation of CS's basic chemical properties as well as the integration of the folate targeting receptor. Methods: The FA-CS conjugates were synthesised using tripolyphosphate (TPP), which is based on the chemical conjugation of the amino group of CS with the carboxylic group of FA and was validated using FTIR and 1H NMR spectroscopy, respectively. Results: The FA-CS-NPs were shown to exhibit a unique core-shell structure under transmission electron microscopy; the encapsulation efficiency EE (percentage) and loading efficiency LE (percentage) of Dasatinib in FA-CS-DS-NPs were 50.7 ± 0.27% and 12.8 ± 0.21%, respectively. The FA-CS-DS-NPs exhibited a homogenous particle distribution of 103.17 ± 5.20 nm (PDI 0.081, zeta potential 20.2 ± 5.9 mV). As the pH of the dissolving solution lowers, the rate of DS release from the NPs increases, indicating that DS release from FA-CS-DS-NPs may be higher in a low pH environment than in a high pH environment. The MTT assay was used to examine the cell viability profile, which indicated that FA-CS-NPs did not induce significant cytotoxicity. In the cellular uptake study, for example, the intracellular concentration of DS in MCF-7 cells after exposure to FA-CS-DS-NPs was considerably higher than the concentration of DS in cells exposed to DS alone. Conclusion: As a result, FA-CS-DS-NPs show promise as a cancer therapeutic drug delivery mechanism.

Abstract Multiferroic composites are promising candidates for magnetic field sensors, next-generation low power memory and spintronic devices, as they exhibit much higher magnetoelectric (ME) coupling and coupled ordering parameters compared to the single-phase multiferroics. Hence, the 3-0 type particulate multiferroic composites having general formula (1 − Φ)[PbFe0.5Nb0.5O3]-Φ[Co0.6Zn0.4Fe1.7Mn0.3O4] (Φ = 0.0, 0.05, 0.1, 0.2, 0.3, 0.4, 0.5, 1.0, (1 − Φ) PFN-ΦCZFMO) were prepared using a hybrid synthesis technique. Preliminary structural and microstructural analysis were carried out using XRD and FESEM techniques, which suggest the formation of 3-0 type particulate composite without the presence of any impurity phases. The multiferroic behaviour of the composites is studied with polarization versus electric field (P-E) and magnetization versus magnetic field (M-H) characteristics at room temperature. The nature of ME coupling was investigated elaborately by employing the Landau free energy equation along with the magneto-capacitance measurement. This investigation suggests the existence of biquadratic nature of ME coupling (P2M2). The magneto-electric coupling measurement also suggests that strain mediated domain coupling between the ferroelectric and magnetic ordering is responsible for the magneto-electric behaviour. The obtained value of direct ME coefficient 26.78 mV/cm-Oe for Φ = 0.3, found to be higher than the well-known single-phase materials and polycrystalline composites.

Background: The objective was to compare ultrasonographic findings with clinical and radiographic findings in osteoarthritis (OA)-affected knee joints. Methods: This prospective study was conducted in Subharti Medical College, Meerut, after getting clearance from the ethical committee. Eighty-five symptomatic knees fulfilling American College of Rheumatology criteria for OA were included in the study. Patients with trauma, inflammatory, and infective conditions of the knee and with a history of intra-articular interventions and surgery were excluded. Demographic data, body mass index (BMI), visual analog scale (VAS), and Western Ontario and McMaster Universities Arthritis (WOMAC) questionnaire score were obtained. Kellgren–Lawrence (K-L) score was obtained on radiography. Ultrasonographic findings which were recorded include effusion, meniscal extrusion, femorotrochlear cartilage grading, maximum length of osteophytes at medial and lateral compartments, and presence or absence of Baker cyst. Results: A total of 85 consecutive symptomatic knees were examined. The male: female ratio was 22:63, with a mean age of 54.52 ± 9.44 years, mean duration of disease of 24.24 ± 19.14 months, mean BMI of 28.91 ± 3.69 kg/m2, and mean score of VAS and WOMAC pain scale of 6.27 ± 1.45 and 62.45 ± 10.96, respectively. K-L grading of 1, 2, 3, and 4 was reported in 12.9%, 21.2%, 25.9%, and 40% of the knees, respectively. The mean VAS score and WOMAC score showed statistically significant correlation with KL grading (P < 0.05). Knees with the presence of osteophytes, medial meniscal extrusion, effusion, and medial femoral trochlear cartilage grading showed statistically significant correlation with VAS and WOMAC scores (P < 0.05). However, the correlation was not significant for lateral meniscus extrusion and lateral femoral trochlear cartilage grading. Conclusion: Our study found that K-L grading and few ultrasonographic criteria showed a significant positive correlation with pain scores, while few other ultrasonographic criteria did not. Both imaging modalities are complementary to each other, rather than one being superior to the other.

Background: In India, the coronavirus disease-2019 (COVID-19) outbreak led to an extensive lockdown, leaving the other time-sensitive medical conditions, such as cancer unaddressed. Patients with cancer are extremely vulnerable to infections owing to their already immunocompromised status and the need for prolonged treatment. Objectives: We aimed to study the impact of the COVID-19 lockdown on the utilization of health-care services by patients with cancer in the Muzaffarpur district of North Bihar, India. Materials and Methods: This descriptive, cross-sectional study was conducted at a preventive oncology clinic in the Muzaffarpur district of North Bihar in India. All consecutive patients registered in the population-based cancer registry of Muzaffarpur were telephonically contacted between April 15, 2020, and May 7, 2020, during the first phase of the nationwide lockdown. The patients were asked questions related to their disease, treatment status, and impact of the lockdown on their treatment. Detailed responses were recorded and analyzed. Results: The study comprised 210 patients of which majority were women (62.9%) and aged more than 40 years (77.1%). A total of 162 (77%) patients were found to be affected by the lockdown, of which 137 (65.4%) missed their scheduled visits, 1 (0.5%) missed surgery, 1 (0.5%) missed chemotherapy, and 24 (11.4%) could not get the prescribed drugs. Most patients who missed their scheduled appointments were aged more than 60 years, women, inhabitants of rural areas, with multiple comorbidities, or belonged to the lower middle-income economic strata. About 70% of the patients faced transportation issues, and 55% experienced financial problems during the lockdown. Conclusion: The lockdown led to difficulties in accessing cancer care in almost 80% of the patients with cancer. This suggests the need for strategic planning of health-care services for patients with cancer during the current pandemic, by means of telemedicine consultation, home-based palliative care services, and ensuring the availibility of essential cancer drugs.

Introduction: Surgery may be complex in some bone and soft tissue tumors. Preoperative intra-arterial embolization is a developing method for benign and malignant tumors. The present study was done to assess the outcome on the size of tumor and blood loss by preoperative tumor embolization and pain relief in patients with inoperable tumors. Materials and Methods: Twenty-five patients with biopsy-proven bony tumors of extremities were subjected to embolization. In 12 cases, embolization was done preoperatively to decrease the blood loss. In 13 patients, it was done as a palliative treatment to reduce pain, as patients were inoperable. The embolization was done with the right Judkins catheter. Some cases were done with a microcatheter. The material used for embolization was either polyvinyl alcohol (PVA) particles, microcoils, or gel foam used in various combinations, selectively into the feeding vessel. Results: Mean age of the patients was 44.5 years. Fifteen were male and 10 were female. A total of 60 vessels were embolized, 25 with gel foam, 24 with PVA particles, and 11 with microcoils. In 90% of operated patients, gel foam was used, whereas, in almost 100% of nonoperated patients, PVA particles were used. There was a significant decrease in blood loss in patients with preoperative embolization (865 ± 420 vs. 1633 ± 660 ml). In patients with palliative embolization, the mean pain score before embolization was 6.32–2.58, which was decreased to 3. 2–1.53. Conclusion: Preoperative and palliative transarterial embolization of soft tissue and bony tumors is a safe, effective, and minimally invasive modality for pain relief and de-vascularization of large bony tumors in anatomically difficult locations.

The Indian agriculture in the region of semi-arid tropics (SAT), characterized by small holders, small water harvesting and recycling system assumes a significant potential to sustain agricultural productivity by providing supplemental as well aslifesaving irrigation and mitigating mid-season drought. In Indian Agriculture, major energy consuming activities include on-farm water management. Efficient and cost-effective irrigation system matching the small-scale water harvesting and storage, are anot available in this region. In view of this, a carry-and-irrigate type micro-sprinkler irrigation system was designed and developedin order to achieve the holistic utilization of water resources and niche-potential of solar energy and gravity. The performance was measured on various parameters of application rate, Christiansen uniformity coefficient and pattern efficiency and were quantified as 14.2 mm/h, 91.3% and 89.01% respectively. The develop irrigation system qualified the performance criteria as standardized by ASAE, 1996. Given the characteristics of low cost and portability, it can considerably substantiate the vegetable production at household scale. Though, this system is developed exclusively for the location representing typical dryland agriculture of India, it can be easily and effectively replicated in other part of the world having similar agro-ecosystem. This simple water management technique utilizing the niche potential of gravity and solar energy can significantly contribute to the various objectives of sustainable development goal.

Patients with novel coronavirus disease 2019 (COVID-19) are at significantly increased risk for mortality and morbidity. Current management remains supportive care, ranging from symptomatic outpatient management to full–intensive care support, including intravenous fluids, invasive, and non-invasive oxygen supplementation. In patients with septic shock, treatment with antibiotics and vasopressors are recommended to keep mean arterial pressure (MAP) ≥ 65 mm Hg and lactate < 2 mmol/L. Because of the lack of effectiveness and possible adverse effects, routine corticosteroids should be avoided unless they are indicated for another reason (exacerbation of asthma or chronic obstructive pulmonary disease [COPD], and septic shock in whom fluids and vasopressors do not restore hemodynamic stability). There is currently no sufficient evidence of efficacy of hydroxychloroquine/chloroquine, remdesivir, and other antivirals in the treatment or prevention of COVID-19. Limited evidence shows that COVID-19 convalescent plasma can be used as a treatment of COVID-19 without the occurrence of severe adverse events. Drug regulatory agencies granted an emergency-use authorization of chloroquine/hydroxychloroquine and remdesivir to treat patients when a clinical trial is not available or participation is not feasible. Chloroquine and hydroxychloroquine are associated with QT interval prolongation and life-threatening cardiac arrhythmia in patients with pre-existing cardiovascular disease. Guidelines are issued for use of convalescent plasma in patients with serious or immediately life-threatening COVID-19. Data from several ongoing randomized controlled trials will provide further evidence regarding the safety and efficacy of these drugs for the treatment of COVID-19.

Abstract Background In tropical dry forests, variation in understory light availability due to season and canopy tree density could be a governing factor in establishment and growth of tree seedlings. Species with varying life history traits are expected to respond differentially to such heterogeneity. We investigated the response of seedlings of four tree species in a tropical day forest in relation to spatiotemporal variability of light. We attempt to explore the role of leaf attributes in explaining intra- and inter-specific variations in relative growth rate. Four study sites, each with three contrasting canopy conditions, were selected along a soil moisture gradient. Seedlings of four tree species (viz., Acacia catechu, Bridelia retusa, Lagerstroemia parviflora, and Shorea robusta), varying in life history traits, were monitored for seasonal variations in growth traits across canopy condition and sites for 2 years. Results We observed a larger variation in leaf attributes for pioneer species. A. catechu showed highest mean values for leaf dry matter content, leaf nitrogen concentration, leaf phosphorus concentration, net stomatal conductance, net photosynthetic rate, and relative growth rate in high light conditions. S. robusta and B. retusa demonstrated highest mean values for all the leaf attributes (except leaf dry matter content) in low light conditions. However, intermediate values for leaf attributes were observed in L. parviflora which preferred moderate light conditions. Conclusions Seasonal variations in light availability at the forest floor appear to play an important role in the establishment and growth of tree seedlings in seasonal dry forests. Leaf attributes can be used to explain intra- and inter-specific variation in response to light availability. Leaf attributes in combinations can be used to predict relative growth rate of tree species in tropical dry environment, which apart from soil moisture is also determined by light availability due to seasonal changes and canopy tree density.

Scrub typhus is a zoonotic infection which is endemic to the tropical regions of South-East Asia including the sub-Himalayan belt of North India. Clinical manifestations of scrub typhus range from self-limiting acute febrile illness to sometimes fatal multiorgan involvement. However, it does not usually involve the central nervous system, if affected meningoencephalitis is the most common presentation. Hereby the authors report a 60-year-old patient of scrub encephalitis who developed acute onset ascending, symmetric flaccid quadriparesis with sensory involvement. Electrophysiological studies and demonstration of antiganglioside antibodies confirmed the diagnosis of AMSAN variant of Guillain-Barré syndrome. The patient was treated successfully with five days of intravenous immunoglobulins. She became ambulatory with complete recovery four weeks after discharge. Guillain-Barré syndrome is a treatable entity and should be evaluated in all cases of scrub typhus having a similar presentation. It can lead to a diagnostic challenge that can often be missed as it is a rare presentation of scrub infection. Therefore, prompt diagnosis and treatment is necessary for better outcomes.

Abstract Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder that affects joints of hands and feet and introduces injury in secondary organs such as cardiac tissue. In the present study, we induced RA in male Balb/c mice (CAIA) using collagen-antibody cocktail (C-Ab) and lipopolysaccharide intraperitoneal injections. Induction of RA in the animals was detected through the loss of body weight, food, and water consumption, pedal edema, increased arthritis score of the paw and ankle, increase in radiological and histological lesion score of ankle and knee joints and enhanced pain perception in the C-Ab induced RA animals. Ashwashila is a herbo-mineral medicine from Indian Ayurvedic system. Human equivalent doses of Ashwashila (ASHW) and standard of care, Methotrexate were given to the CAIA animals for two weeks. ASHW treatment significantly reversed the effect of C-Ab with reduced pedal edema, arthritis score, radiological and histological lesion scores in ankle-joint, knee-joint and articular cartilage, reduced pain perception. These effects were comparable with the Methotrexate treatment. In human monocytic (THP-1) cells, ASHW was found to be biocompatible at in-vitro test doses. The anti-arthritis mechanism of action for ASHW was established through the suppression of pro-inflammatory cytokines such as IL-1β, IL-6, TNF-α; and upstream regulator, NF-κB. Taken together, we show the pre-clinical efficacy of ASHW in reducing RA associated symptoms by controlling inflammation and suggest it as a potential therapeutic candidate for rheumatoid arthritis.

Background: Currently, in developing countries like India, there is a paradigm shift in the mortality patterns of elderly from communicable to noncommunicable diseases. Objective: This study is aimed at providing an insight on mortality patterns of elderly patients within a 2-year period in a tertiary hospital, All India Institute of Medical Sciences (AIIMS), Rishikesh, India. Materials and Methods: This study is a retrospective review of mortality patterns of elderly patients from March 2016 to March 2018 occurring in the Department of General Medicine, in AIIMS, Rishikesh, India. Information derived from the Medical Records Department of AIIMS Rishikesh include age, sex, clinical history, diagnosis, duration, and cause of death. Results: During this period, a total of 1101 elderly (≥60 years) admissions were done in the Department of General Medicine, AIIMS Rishikesh. A total of 66 patients had expired during their hospital stay. Among this, 35 and 31 cases were elderly male and female patients, respectively, and therefore the ratio of male to female was 1.1:1.0. The peak age group was 60–64 years accounting for 23 patients (34.8%). The age range of patients was 60–94 years, while the modal and mean ages were 65 and 69 years, respectively, with 8.1 standard deviation. The most commonly encountered cause of mortality was cerebrovascular accident constituting 19 (28.8%) cases. The second majority of mortality cases were hypertensive disorders constituting 13 (19.7%) cases, and the third majority were septicemia and pneumonia accounting for 12 (18.2%) and 12 (18.2%) cases, respectively. Others include diabetes mellitus [metabolic disorder; 10 (15.2%) cases], acute renal failure [10 (15.2%) cases], ischemic heart disease or coronary artery disease [6 (9.1%) cases], while malignancies, tuberculosis, hepatitis, chronic liver disease, and chronic obstructive pulmonary disease consisted of five cases (7.6%) each. Conclusion: Noncommunicable diseases particularly cerebrovascular diseases and hypertensive disorders were the most commonly encountered cause of elderly mortality in this region of North India, that is, the state of Uttarakhand. Notwithstanding a large percentage of mortality patterns also results from communicable diseases with septicemia and pneumonia as the third leading cause of mortality.

Coronavirus Disease 2019 (COVID-19) pandemic has stirred up chaos in the whole world. After prolonged lockdowns, finally, society is opening again for business and day-to-day life. Mass gatherings are undoubtedly again expected to start, but carry additional risks for transmission of the virus. We designed a concept model that was validated in about 1000 people gathering in a convocation ceremony at the beginning of the COVID-19 outbreak. A protocol was made, a risk assessment was done, and attendees followed-up. The emphasis on thermal screening, hand hygiene, physical distancing, open-air ventilation, refusing attendees having Influenza-Like Illnesses (ILI), and other preventive measures were the means to contain the potential transmission in an organised mass gathering of this magnitude. The dictum “prevention is better than cure” held amidst this outbreak. As a result of this well-structured mass gathering, the event was quite successfully conducted. Further event planning in the COVID-19 scenario or other outbreaks of similar infections must be managed in this way for the prevention of spread.