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Introduction: The diaphragm is one of the most significant skeletal muscles in the human body, performing vital respiratory functions. It is not only the primary inspiratory muscle but is also involved in non respiratory activities and plays a dynamic role in Postural stabilisation. Low Back Pain (LBP) is the leading cause of disability worldwide, presenting a significant health issue that imposes substantial social and economic costs on both the community and healthcare systems. Although the precise cause of non specific LBP is still unknown, its progression has been greatly affected by mechanical factors that are generally agreed upon. Aim: To determine the effect of diaphragmatic breathing exercises on hamstring length and functional disability in subjects with chronic LBP. Materials and Methods: A single-group pre- to post-test quasi-experimental study was conducted with 66 subjects at the Padmashree Rehabilitation Centre, Bengaluru, Karnataka, India from June 2023 to August 2023. Ethical clearance was obtained from the Padmashree Institutional Ethical Committee, and the subjects were recruited based on specific selection criteria. Baseline variables, including age, gender, and Body Mass Index (BMI), were recorded. The main outcomes measured were the Active Knee Extension (AKE) test and the Oswestry Disability Index (ODI) Questionnaire. Values before and after the intervention were recorded and a paired sample t-test was used to compare the scores before and after the intervention. Results: The pretest mean score was 27.85±2.40, while the post-test mean score was 24.77±2.26 (AKE RT). The paired t-test indicated a significant improvement in AKE postintervention for both the right and left lower limb (p-value

Summary: Background: Globally, most of the randomised trials with hypofractionation in patients with breast cancer have used 3-dimensional conformal radiotherapy technique (3D-CRT). As facilities for 3D-CRT technique may not be available in low-resource settings, there is a need to see if hypofractionation is feasible and safe with 2-dimensional (2-D) technique. In this study, we compared a 3-week radiation schedule with a 2-week schedule of hypofractionated radiotherapy in patients with breast cancer with 2-D technique. Methods: The current study was an open-label, randomised, phase 3 trial. Patients with breast cancer, stage I-III, post mastectomy or after breast conservative surgery who needed adjuvant locoregional radiotherapy were randomised in the Department of Radiotherapy & Oncology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India; to 34Gy in 10 fractions over 2 weeks (2-week arm) or 35Gy in 15 fractions over 3 weeks to the chest wall and 40Gy/15#/3wks to breast and supraclavicular fossa (3-week arm). Boost dose when indicated was 8–10Gy/2–4#/2–4 days in both the arms. Patients were planned on a 2-dimensional (2D) simulator with 2 tangential fields to breast/chest wall and incident supraclavicular fossa field. Acute toxicity was assessed using the Radiation Therapy Oncology Group (RTOG) grading scale. Assessments were carried out weekly during radiotherapy and at 4 weeks after treatment by the physician. Cosmetic outcome was assessed using the Harvard/National Surgical Adjuvant Breast and Bowel Project (NSABP)/RTOG scale. The toxicity rates between the two arms were compared using Fisher's exact tests. The trial was approved by institutional ethics committee and registered with ClinicalTrials.gov, number NCT04075058. Findings: This study included 1121 eligible patients from June 2015 to December 2020. Median follow-up was 35 months (6–84 months). Mean age was 48 years (24–75 years). The patient characteristics were comparable between the two arms except for more mastectomies in the 3-week arm and more node-positive patients in the 2-week arm. There were more oestrogen receptor-positive tumors in the 3-week arm. Acute skin toxicities were comparable between the two arms. Grade 2 and 3 skin toxicity was 100 (18%) and 82 (15%); and 16 (3%) and 12 (2%) in the 3-week and 2-week arm (p = 0.21), respectively. Cosmetic outcome was assessed as Excellent or Good for 89% of patients in the 3-week arm as compared to 94% in the 2-week arm (p = 0.004). Interpretation: The two radiation schedules were comparable in terms of acute skin toxicity. The cosmetic outcome was better with the 2-week schedule. The preliminary findings indicate 2-week radiotherapy schedule with 2-D technique was better than the 3-week schedule in patients with breast cancer. However, disease outcomes and late-term toxicities need to be further checked. Funding: This study was funded by Science and Engineering Research Board (SERB), India.

Abstract Water pollution from synthetic dyes and oil spills has a significant impact on the environment and living species. Here, we developed a low-cost, environmentally friendly and easily biodegradable magnetic hybrid bio-sponge nanocomposite from renewable resources such as collagen and cellulose (Kenaf fibre cellulose–collagen, KFCC). We loaded it with magnetic bimetallic Fe3O4@TiO2 (BFT) NPs to produce a photocatalyst material (KFCC-BFT) for the treatment of colored wastewater as well as a sorbent for oil–water separation. The characterization of the bimetallic BFT NPs by XRD, HRTEM and VSM showed the deposition of TiO2 particles onto the surface of Fe3O4 with lattice interlayers spacing of 0.24 and 0.33 nm for Fe3O4 and TiO2, respectively with ferromagnetic property. The UV–vis diffuse reflectance spectra result indicated that the band gap energy of bio-sponges decreases with the increase of the bimetallic moiety. The photocatalytic efficiency of the as-prepared magnetic hybrid bio-sponge in the degradation of crystal violet dye was up to 91.2% under visible light conditions and 86.6% under direct sunlight exposure. Furthermore, the magnetic hybrid bio-sponge was used to separate motor oil from water (> 99%) and had a high oil sorption capacity of 46.1 g/g. Investigation of the recyclability and reusability performance for 9 cycles revealed that the bio-sponge had a high sorption capacity for up to 5 cycles. Our results suggest that the bio-polymer-supported BFT hybrid nanocomposite is a cost-effective and easily biodegradable photocatalyst and has great potential for real-field environmental remediation applications.

Abstract Over 380 host plant species have been known to develop leaf spots as a result of the fungus Alternaria alternata. It is an aspiring pathogen that affects a variety of hosts and causes rots, blights, and leaf spots on different plant sections. In this investigation, the lipopeptides from the B. subtilis strains T3, T4, T5, and T6 were evaluated for their antifungal activities. In the genomic DNA, iturin, surfactin, and fengycin genes were found recovered from B. subtilis bacterium by PCR amplification. From different B. subtilis strains, antifungal Lipopeptides were extracted, identified by HPLC, and quantified with values for T3 (24 g/ml), T4 (32 g/ml), T5 (28 g/ml), and T6 (18 g/ml). To test the antifungal activity, the isolated lipopeptides from the B. subtilis T3, T4, T5, and T6 strains were applied to Alternaria alternata at a concentration of 10 g/ml. Lipopeptides were found to suppress Alternaria alternata at rates of T3 (75.14%), T4 (75.93%), T5 (80.40%), and T6 (85.88%). The T6 strain outperformed the other three by having the highest antifungal activity against Alternaria alternata (85.88%).

Alzheimer's disease (AD) is a neurological disorder characterized by cognitive decline and memory loss. An early and precise diagnosis of Alzheimer's disease is critical for effective therapy and management. The electroencephalogram (EEG) has shown promise as a non-invasive and cost-effective tool for Alzheimer's disease (AD) categorization. The capacity to diagnose Alzheimer's disease at an early stage is one of the benefits of EEG (electroencephalogram) over other methodologies in Alzheimer's disease research. Traditional EEG analysis approaches, such as estimating coherence between various pairs of electrodes, necessitate a significant amount of human labor. We introduce a novel strategy for AD classification based on EEG by combining deep generative adversarial networks (GANs) and the Marine Predators Algorithm (MPA). GANs are powerful deep-learning models that can be trained to generate realistic samples via negative generator and discriminator training. MPA is a nature-inspired optimization method well-known for its ability to solve complicated optimization problems. The proposed system generates synthetic EEG samples using GANs' ability to learn meaningful representations from raw EEG data. The MPA is then employed to enhance classification performance by optimizing the discriminative features extracted by GANs. The MPA simulates the hunting behavior of marine predators, facilitating the exploration of the feature space and identifying significant characteristics for AD categorization. We evaluated the efficacy of the proposed strategy using a publicly accessible EEG database of AD patients and healthy controls. The results of classification precision, sensitivity, and specificity demonstrate that deep GANs with MPA are superior to state-of-the-art techniques.

Knowledge of the position of lung fissures is necessary for the appreciation of lobar anatomy and thus locating the bronchopulmonary segments. The study aimed to investigate the patterns of fissures and lobes of the lungs and their variations in Andhra Pradesh, India and to find their clinical implications and compare them with the previous studies. Methods: The patterns of lobes, fissures, and hilar anatomy of lungs and its variations of 47 lungs by dissection method of embalmed cadavers was performed in the Department of Anatomy, Narayana Medical College (Nellore, India). The specimens were macroscopically observed for gross morphology of fissures and lobes. Results. The study showed oblique fissure in 33 % (grade 1), 26 % (grade 2), 24 % (grade 3) and 14 % (grade 4) of right lungs and 27 % (grade 1), 31 % (grade 2), 12 % (grade 3) and 12 % (grade 4) of left lungs. The incomplete horizontal fissure was seen in 38 % of right-sided lungs (grade 1). 19 % of right lungs and 10 % of left lungs had accessory lung fissures. Conclusions. Awareness of the variations in the lobes and fissures of the lungs is important for radiologists while interpreting magnetic resonance imaging and computed tomography scans. Also, we believe that the data from the present study certainly adds an important reference in the medical literature to thoracic surgeons in performing pneumonectomy and segmental resection.

Abstract Background We conducted this study to identify the influence of prolonged use of hydroxychloroquine (HCQ), glucocorticoids and other immunosuppressants (IS) on occurrence and outcome of COVID-19 in patients with autoimmune rheumatic diseases (AIRDs). Methods This was a prospective, multicenter, non-interventional longitudinal study across 15 specialist rheumatology centers. Consecutive AIRD patients on treatment with immunosuppressants were recruited and followed up longitudinally to assess parameters contributing to development of COVID-19 and its outcome. Results COVID-19 occurred in 314 (3.45%) of 9212 AIRD patients during a median follow up of 177 (IQR 129, 219) days. Long term HCQ use had no major impact on the occurrence or the outcome of COVID-19. Glucocorticoids in moderate dose (7.5–20 mg/day) conferred higher risk (RR = 1.72) of infection. Among the IS, Mycophenolate mofetil (MMF), Cyclophosphamide (CYC) and Rituximab (RTX) use was higher in patients with COVID 19. However, the conventional risk factors such as male sex (RR = 1.51), coexistent diabetes mellitus (RR = 1.64), pre-existing lung disease (RR = 2.01) and smoking (RR = 3.32) were the major contributing risk factors for COVID-19. Thirteen patients (4.14%) died, the strongest risk factor being pre-existing lung disease (RR = 6.36, p = 0.01). Incidence (17.5 vs 5.3 per 1 lakh (Karnataka) and 25.3 vs 7.9 per 1 lakh (Kerala)) and case fatality (4.1% vs 1.3% (Karnataka) and 4.3% vs 0.4% (Kerala)) rate of COVID-19 was significantly higher (p

Loss of appetite (LOA) may have a negative impact on a patient’s well-being owing to loss of nutrition and associated conditions. The current study assessed the effects of an appetite-stimulating medication containing multivitamins, lysine, and zinc in Indian patients with a history of LOA. Using an investigator-initiated, single-center, open-label, single-arm design, we evaluated the effectiveness and safety of the appetite-stimulating medication (15 mL) in 50 male or female patients (18–55 years old) attending the outpatient department, with a confirmed diagnosis of LOA after two weeks of therapy and assessed the change in Council on Nutrition Appetite Questionnaire (CNAQ) score and safety of the medication after two weeks of treatment. CNAQ scores were presented as mean (standard deviation (SD)). The mean age of patients was 42.1 years, with the majority (66%) being males. At weeks 1 and 2, a statistically significant improvement was observed in the mean CNAQ scores of 25.48 (5.10) and 25.48 (4.29), respectively, vs. baseline (22.08 (2.76); P ≤ 0.0001 both). Majority of the patients had CNAQ appetite scores of 17–28 at baseline (94%), week 1 (66%), and week 2 (78%) of treatment. For patients with acute and chronic illness, a statistically significant improvement was observed in the mean CNAQ score at week 1 (26.75 (3.69), P = 0.0256; 25.24 (5.33), P = 0.0004) and at week 2 (26.63 (3.46), P = 0.0027; 25.26 (4.43), P ≤ 0.0001) from baseline (21.88 (3.31) and 22.12 (2.69), respectively). No serious adverse events were reported during the study. The study findings suggest that appetite-stimulating medication containing multivitamins, lysine, and zinc could be a suitable treatment option for the management of LOA with no significant safety concerns.

Pollution owing to the dye house wastewater and negligent disposal of proteinaceous wastes are major threats to the environment. The conventional water treatment and solid waste management techniques are neither efficient nor cost effective. Here, we developed a collagen-TiO2 nanoparticles based photocatalytic nanobio-sponge from bio-waste for the remediation of organic dyes from wastewater. TiO2 nanoparticles were functionalized (TIF) with 3-aminopropyltriethoxysilane for stabilizing type-I collagen fibers extracted from cowhide wastes. 13C-nuclear magnetic resonance (13C NMR) and Fourier-transform infrared (FT-IR) spectroscopic analyses confirm the amine functionalization on the surface of TiO2 nanoparticles. Thermal stability of collagen fibers is increased to 84 °C after treatment with TIF, which is 20 °C higher than that of pristine collagen fibers. Further, we converted them into a bio-sponge for photocatalytic degradation of Rhodamine-B (RhB). We demonstrate that the collagen nanobio-sponge loaded with 10% (w/w) TIF nanoparticles can degrade RhB up to 95% under visible light irradiation as well as direct sunlight with a reduction in chemical oxygen demand up to 94%. Photo degradation of RhB was not manifested when the reaction was carried out in dark conditions. The results of this study pave way for the cost-effective and sustainable development of engineered biomass based sponges for real-life environmental remediation applications.

The use of wireless and Internet of Things (IoT) devices is growing rapidly. Because of this expansion, nowadays, mobile apps are integrated into low-cost, low-power platforms. Low-power, inexpensive sensor nodes are used to facilitate this integration. Given that they self-organize, these systems qualify as IoT-based wireless sensor networks. WSNs have gained tremendous popularity in recent years, but they are also subject to security breaches from multiple entities. WSNs pose various challenges, such as the possibility of numerous attacks, their innate power, and their unfeasibility for use in standard security solutions. In this paper, to overcome these issues, we propose the secure encryption random permutation pseudo algorithm (SERPPA) for achieving network security and energy consumption. SERPPA contains a major entity known as a cluster head responsible for backing up and monitoring the activities of the nodes in the network. The proposed work performance is compared with other work based on secure IoT devices. The calculation metrics taken for consideration are energy, overheads, computation cost, and time consumption. The obtained results show that the proposed SERPPA is very significant in comparison to the existing works, such as GKA (Group Key Agreement) and MPKE (Multipath Key Establishment), in terms of data transfer rate, energy consumption and throughput.

Background and Objectives: Diabetes Mellitus (DM) is a significant health concern in India, characterized as a modern-day epidemic, with the potential to affect multiple organs and lead to various complications. Cardiac autonomic neuropathy (CAN) represents one of the serious yet often overlooked complications of diabetes. This study aims to ascertain the prevalence of CAN in diabetic patients and investigate its correlation with the duration of DM and glycemic control. Materials and Methods: 134 diabetic patients were included based on predetermined criteria. Demographic information, medical history, and clinical examinations were recorded. CAN assessment involved three tests for parasympathetic and two tests for sympathetic function, with patients categorized as normal, early CAN, definite CAN, or severe CAN according to Ewing's criteria. Results: The prevalence of CAN among the study population was 60%. Individuals with CAN exhibited significantly longer durations of diabetes and higher HbA1c levels compared to those with normal cardiac autonomic function. CAN showed a significant association with DM duration and glycemic control, but not with age. CAN patients presented with background retinopathy, various retinopathies, maculopathy and clinical symptoms such as diabetic foot, cataracts, muscle wasting, and tingling. Conclusion: CAN emerges as a prevalent and often asymptomatic consequence of diabetes. Hence, routine screening for CAN is recommended for all diabetic patients to facilitate early detection and intervention. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a major public health problem among non communicable diseases in India. It is an important area of research due to its high prevalence and being major risk factor for cardiovascular diseases and other complications. Objectives: Aim of this study to determine the prevalence of hypertension and its associated risk factors among adult population living in study area. Material & Methods: This was a cross sectional observational study conducted in department of medicine, in a tertiary care hospital, India. Participants > 18 years of age with both sexes were enrolled in the study. A socio-demographics data was collected; family history of hypertension, clinical examination, blood pressure measurement and all relevant investigation was done. Results The prevalence of hypertension among study participants was 24.35%. Prevalence of hypertension was found more in male subjects as compared to females' subjects. The risk factors found to be significantly associated with HTN in this study were increasing age, male gender, family history of hypertension, obesity (high\BMI), diabetes, smoking, alcohol, sedentary lifestyle and hyperlipidemia Conclusion: There is significant association of hypertension was found in obesity, smoking, alcohol consumption, physical inactivity, stress and diabetes mellitus. Strong public health measures need to be seriously implemented to combat hypertension and its consequences. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) is a rapidly rising chronic illness in developing countries. Glycosylated hemoglobin (HbA1c) is a widely used tool for diagnosing, screening, and managing patients with diabetes, hence proper interpretation of the HbA1c is crucial. Objectives: To investigate the risk factors affecting type 2 diabetes mellitus HbA1c and their correlation with glycosylated hemoglobin (HbA1c). Material & Methods: Diagnosed patients with type 2 diabetes mellitus during study period were enrolled in this study. Criteria for diagnosis were: HbA1c = 6.5% (48 mmol/mol), Fasting plasma glucose = 126 mg/dL (7.0mmol/L) 2-Hour postprandial plasma = 200 mg/dL (11.1 mmol/L). Demographic data and risk factors associated with diabetes were analysed. Results: Majority of the patients (37%) were 51-70 years age group, predominantly male (63%). Among risk factors assessment, 66.5% were overweight or obese, 53.3% had positive family history of DM, 55.3% were hypertensives, 43.5% had dyslipidemia, 32.7% had a family history of CAD, 39.3% were smokers and 32% were physically inactive. HbA1c were significantly associated with the all these risk factors. Conclusion: Age, higher BMI, family history of DM, smoking, physical inactivity, hypertension, dyslipidemia and history of CVD are positively correlated with the HbA1c level. [ABSTRACT FROM AUTHOR]

Biofuel production by a sustainable method using microalgae is entirely dependent on biomass production. However, commercialization at large scale using microalgae is a major obstacle using analytical grade growth nutrients, due to their cost effectiveness. Hence, development of a cost effective method is essential to reduce the production cost. Therefore, the present study envisaged the effect of low-cost commercial fertilizers such as urea, sodium bicarbonate, magnesium sulfate, potash and di-ammonium phosphate as growth nutrients for the production of biomass and total lipid of Botryococcus braunii were made. The biomass and total lipid production were optimized using Response Surface Methodology by 25 Central Composite Design. The result showed 225 mg L-1 of urea, 650 mg L-1 of sodium bicarbonate, 225 mg L-1 of magnesium sulfate, 150 mg L-1 of potash and 15 mg L-1 of di-ammonium phosphate supported the algal growth with a maximum biomass and total lipid of 0.792 gL-1 dry wt.. and 260 mg L-1 dry wt.., respectively. The biomass productivity of alga B. brauniiat the above condition recorded as 0.04 gL-1 day-1 with a generation time of 1.90 days.

Lung cancers exhibit pronounced functional heterogeneity, confounding precision medicine. We studied how the cell of origin contributes to phenotypic heterogeneity following conditional expression of KrasG12D and loss of Lkb1 (Kras;Lkb1). Using progenitor cell-type-restricted adenoviral Cre to target cells expressing surfactant protein C (SPC) or club cell antigen 10 (CC10), we show that Ad5-CC10-Cre-infected mice exhibit a shorter latency compared with Ad5-SPC-Cre cohorts. We further demonstrate that CC10+ cells are the predominant progenitors of adenosquamous carcinoma (ASC) tumors and give rise to a wider spectrum of histotypes that includes mucinous and acinar adenocarcinomas. Transcriptome analysis shows ASC histotype-specific upregulation of pro-inflammatory and immunomodulatory genes. This is accompanied by an ASC-specific immunosuppressive environment, consisting of downregulated MHC genes, recruitment of CD11b+ Gr-1+ tumor-associated neutrophils (TANs), and decreased T cell numbers. We conclude that progenitor cell-specific etiology influences the Kras;Lkb1-driven tumor histopathology spectrum and histotype-specific immune microenvironment.

Vascular anatomy of the genitourinary system is essential to understand the complications related to surgeries, as it may influence the blood flow to the kidney and to the gonads. In the present case report, arterial and venous variations were presented in the kidney. The inferior polar artery to the kidney was seen to arise from the aorta on the left side and the left testicular artery was one of the branches from the inferior polar artery. On the right side, duplication of renal veins was present and right gonadal vein was draining into the accessory renal vein, instead of inferior vena cava. Knowledge regarding such variations is of much use for the vascular surgeries in the retroperitoneal region and during the transplantation surgeries. Sometimes, these accessory arteries may compress renal pelvis, causing hydronephrosis.

This study aimed to determine the antibiotic susceptibility pattern of Staphylococcus aureus (SA) and the circulating clones in Bangalore, India. Susceptibility testing was performed for all cases of SA infections in a tertiary-care hospital. Panton-Valentine leucocidin (PVL) encoding genes were detected, and sequence type and spa type were determined. Out of the 92 collected strains, 52.2% were methicillin-resistant SA (MRSA), isolated from community-acquired (CA) infections in 60.4% and hospital-acquired (HA) infections in 39.6%. S. aureus isolates were also highly resistant to erythromycin (54.3%) and ciprofloxacin (70.6%) in methicillin-susceptible SA (MSSA) and MRSA, as well as in CA and HA infections. MRSA were found to be significantly more resistant to gentamicin (p

Aim: The current study was the first of its kind taken upon indigenous ecotypes of the Karnataka in order to unravel the diversity details at 20 chicken microsatellite regions. Materials and Methods: 210 indigenous chicken belonging to six districts of Bangalore and Mysore division formed the target sample for the present study. The genomic deoxyribonucleic acid was isolated by phenol chloroform isoamyl alcohol method. A panel of 20 microsatellite regions, including 14 recommended by FAO and six identified from published scientific literature became the targeted chicken genomic region. 27-33 samples were successfully genotyped in each of the six ecotypes through simplex or multiplex polymerase chain reactions, polyacrylamide gel electrophoresis and silver staining for the selected microsatellite panel. Results: The chickens of Ramanagara and Chamrajnagara were most distant with a Nei’s genetic distance value of 0.22. The chickens of Bangalore rural and Mysore were least distant with a value of 0.056. The Ramanagara and Chamrajnagara pair had Nei’s genetic identity value of 0.802, which is least among all pairs of ecotypes. There were five main nodes from which the six ecotypes evolved on the basis 20 microsatellite markers used in this study. This study indicates that the four ecotypes Ramnagara, Bangalore Rural, Chickaballapura and Mysore are genetically identical due to their common ancestral evolution while, Mandya and Chamrajnagara ecotypes formed a relatively different cluster due to a separate common ancestral chicken population and less number of generations since drifting from bifurcation node. Conclusion: Twenty microsatellite markers based genetic diversity study on six indigenous ecotypes indicated lower genetic distances as well as lower FST values compared to the distinguished breeds reported. There were two main clusters, which differentiated into six ecotypes. They may differentiate into more distinct varieties if bred in isolation for a longer number of generations.