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Purpose: The main objective of this study is to explore the efficacy of olopatadine 0.1% treatment in the resolution of symptoms of vernal keratoconjunctivitis (VKC) among the Indian population. Methods: This single-center, prospective cohort study involved 234 patients with VKC. Patients were treated with olopatadine 0.1%, twice daily for a period of 12 weeks and then followed up in 1st week, 4th week, 3rd month, and 6th month. The extent of relief in the symptoms of VKC was measured using total ocular symptom score (TOSS) and ocular surface disease index (OSDI). Results: In the present study, the dropout rate was 5.6%. Total of 136 males and 85 females with a mean age of 37.68 ± 11.35 years completed the study. TOSS score reduced from 58.85 to 5.06 and the OSDI score reduced from 75.41 to 11.2 with statistical significance (P < 0.01) from 1st week to 6th week after olopatadine 0.1% treatment. The data showed relief in subjective symptoms of itching, tearing, and redness, and relief in discomfort in functions related to ocular grittiness, visuals like reading, and environmental like tolerability in dry conditions. Further, olopatadine 0.1% was effective in both males and females, and patients across ages 18–70 years. Conclusion: Based on TOSS and OSDI scores, the findings of this study validate safety and tolerability as revealed by low adverse effects and moderate efficacy of olopatadine 0.1% in reducing VKC symptoms in a broader age group (18–70 years) of both genders.

Crack development is common occurrence in concrete structural element. By the cracks, which permits the H2O and varies form of chemicals inside the concrete elements and lessen their durability characteristics, properties of strength and which make the rust on rebar when its contact with H2O, Carbon-di-oxide(CO2) including other chemicals. In the concrete structures to repair it needs usual maintenance and particular unique method of treatment but it will not be cost effective. To rectify the issue the mechanism of self-healing is induced in concrete element which assists by generating crystallization of CaCO3 to repair the cracks which helps to clog the micro nano-cracks and endopores. The literatures studies were carried and the bacteria were selected based on the condition of survive in the pH greater than 10. The mix design of M30 concrete grade was designed for the work. The Culturing or Diluting of Calcite Depositing Bacillus Subtilis Bacteria was carried. The casted specimens are to determine the mechanical characteristics of concrete without and with bacteria for different cell concentrations for the comparison. After the curing period, the concrete with bacteria improves the structural properties which were found by the strength characteristics experiments on different cell concentration specimens in comparison with normal concrete. The crack closure and micro structural analysis were carried out by using Ultrasonic pulse velocity test and SEM analysis.

A Union territory in India, Pondicherry was a major trading port with the Chinese during the Chola era, having been active since 100 B.C. About 150 km south of Chennai, it was an open roadstead anchorage port. Until the late 1980s, the old port operated as a lighter-age port during French rule, beginning in the 17th century. From 1986 until 1989, the New Port was developed. An offshore (south) breakwater connected to a north breakwater by a bridge makes up the New Port. The channel, which is 2000 meters long and 40 meters broad, was built between 1986 and 1989. It also has a 150-meter container berth. An undersea tunnel has been built between the north and south breakwaters to facilitate maintenance dredging and allow cargo and fishing vessels to pass through without interruption. The port was in use until 2004, when it was shut down for a lack of maintenance dredging. Since 2004, there has been no freight business; only small fishing boats are currently in use. The viability of enhancing Pondicherry Port's current infrastructure to accommodate feeder-class vessels is investigated in this paper.

Ophthalmia nodosa is an ocular inflammatory reaction due to the lodging of foreign bodies such as caterpillar spines and tarantula hair. Initial manifestations include edematous eyelids, conjunctival injection associated with multiple corneal abrasions. Subsequent migration of insect hair anteriorly to posteriorly may result in nodular conjunctivitis, iridocyclitis, vitritis, and even panophthalmitis. We report a case of ophthalmia nodosa in a military recruit who presented to us 1 week after the injury. By the time, he presented the setae were deep-seated leading to significant ocular manifestations and was initially managed conservatively before actively intervening to remove the setae.

Data transfer between components, continuous device monitoring, and other features are possible with an IoT-based energy management system. Due to its lightweight, compact, and expandable characteristics, the Message Queuing Telemetry Transport protocol (MQTT) has recently played an important role in IoT. Since the MQTT protocol cannot provide security between the publishing house and the subscription service, cryptographic techniques can be enforced. This work implements a public-key encryption system-based Elliptic Curve Cryptography (ECC) technique to secure data from Publisher's end to the Subscriber's end. The data from the Raspberry plane is sent to the MQTT publisher with elliptical curve encryption built-in feature. The message/text is converted into cipher text and conveyed through the topic within the MQTT protocol to the subscribed Broker. The subscriber decrypts the cipher text using the elliptical curve cryptography technique with the secret key. This protects data, personal privacy, and safety in a more efficient and convenient way. ECC and MQTT protocols implemented in this work proved to be worthy for both burst mode and continuous data transmissions when compared to the conventional cryptographic techniques.

Aim: Cyanoacrylate synthetic glue is an instant acting adhesive material often used for household, biomedical and industrial requirements. Accidental instillation of glue into eyes seems to be the commonest mode of chemical eye injuries especially in the paediatric and geriatric population. Methods: A series of five cases of synthetic glue eye injuries following accidental instillation into eyes that presented to our hospital were reported. Results: All the cases were managed conservatively as per the current guidelines with good visual outcome. Conclusion: These case series highlight how even daily activities utilizing the superglue may result in unexpected serious eye injuries. Creating awareness and provision of immediate medical aid can prevent ocular morbidity in such eye injuries.

Introduction: Birth asphyxia is leading cause of perinatal and neonatal mortality and morbidity especially in developing countries. Around 20% of neonatal deaths in India are due to birth asphyxia. There are around one million cases of birth asphyxia per year worldwide. Majority of deaths and disabilities can be prevented by timely identification of pathologies and early initiation of rehabilitation. Magnetic Resonance Imaging (MRI) and Magnetic Resonance Spectroscopy (MRS) plays a vital role by helping in identification of such pathologies. Aim: To assess the severity of injury to brain in hypoxic ischaemic encephalopathy infants using MRI and MRS which helps in prognosticating the disease outcome. Materials and Methods: A cross-sectional study was conducted on 30 term infants with low Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score in the Department of Radiodiagnosis, from all the Hospitals attached to Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India from November 2018 to May 2020. Patients were subjected to brain MRI and basal ganglia MRS. All MR imaging examinations were performed on a SIEMENS magneto Avanto 1.5 Tesla system. Conventional MR imaging findings were documented and MR spectroscopy values of Basal Ganglia (BG) N-Acetyl Aspartate (NAA), Creatinine (Cr), Choline (Cho) and lactate were obtained. Metabolite levels were correlated with APGAR scores by performing Pearson correlation. Chi-square test was applied with Fisher’s-exact correction to see the association between lactate peak and diffusion changes in brain. Results: A total of 30 term neonates with low APGAR score at birth were selected, of which 12 were females and 18 were males. Babies with APGAR score of 2 at one minute showed only subcortical and parasagittal areas of diffusion restriction. Basal ganglia diffusion restriction is noted only in babies with very low APGAR score of 1 at one minute. Positive correlation was noted between APGAR score and BG-NAA and BG-Cr. Negative correlation was noted between BG-Cho and APGAR score. Hence, BG-NAA:Cr, NAA:Cho and Cho:Cr can be used to assess severity of hypoxic ischaemic encephalopathy (p-value

Purpose: Ipomoea aquatica belongs to convulvulaceae family and finds use in various ailments including anticancer activity. A secondary metabolite merromoside (a resin glycoside) isolated from this plant is evaluated for anti-breast cancer activity through in vivo studies. Methods: The Extract of the whole plant has been prepared by maceration method using 50%v/v ethanol in distilled water to get a hydroalcoholic extract. The phytochemical evaluation reveals that the active secondary metabolite was isolated by using column chromatographic technique. The isolated compound was evaluated for its anticancer properties through invivo method using 7,12-Dimethylbenz[a]anthracene induced mice models. Results: The isolated compound (W04) from the plant extract was found to have a significant enzymatic antioxidant effects and percentage reduction of tumour cells of DMBA induced breast tissue of Sprague dawley rats. Conclusion: The isolated compound merromoside from hydroalcoholic extract of Ipomoea aquatica has been evaluated for anti-breast cancer properties. The down regulation of inflammatory cytokines, P-gp efflux & ROS species will prevent reverse signalling and angiogenesis. This indicates that merromoside isolated from Ipomoea aquatica will overcome MDR (multi-drug resistance) in breast cancer especially DOX-resistant (Doxorubicin) and also it will be further used to develop drug formulations in order to overcome world challenges in cancer treatment

Objective Determine the pharmacokinetics (PK) and exposure–response of hydroxychloroquine (HCQ) and desethylhydroxychloroquine (DHCQ) in paediatric SLE (pSLE).Methods We conducted an exploratory phase 2, direct-to-family trial. Children enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry with a diagnosis of pSLE were eligible if they were receiving HCQ as standard of care for ≥3 months. Biological samples were collected at up to four visits over a 6-month period. At each visit, plasma was obtained to measure the concentrations of HCQ and DHCQ, as well as cytokines. HCQ and DHCQ plasma PK data were analysed using a population PK modelling approach.Results Twenty-five subjects provided a total of 88 plasma concentrations for PK analysis. There was a poor linear fit between HCQ concentrations and total body weight (R2=0.03). There was a decline in both interferon (IFN)-alpha and IFN-gamma with higher concentrations of HCQ and DHCQ. Volume of distribution for HCQ in plasma was higher in children compared with published values in adults (73 000 L vs 44 000 L), but clearance values in children were similar to adults.Conclusions We report the first population PK model for HCQ and DHCQ in children using data from a novel direct-to-family clinical trial. We observed high interindividual variability in HCQ PK and found that weight-based dosing for HCQ is poorly correlated with drug concentrations, suggesting the need to use therapeutic drug monitoring to individualise dosing. Furthermore, our results suggest that the current weight-based dosing paradigm for HCQ may result in suboptimal drug exposures, particularly for children with obesity. Accordingly, additional studies of HCQ are needed in pSLE to determine the optimal drug concentration and dosing to reduce disease activity and improve outcomes.Trial registration number NCT04358302.

Introduction Direct-to-family clinical trials efficiently provide data while reducing the participation burden for children and their families. Although these trials can offer significant advantages over traditional clinical trials, the process of designing and implementing direct-to-family studies is poorly defined, especially in children with rheumatic disease. This paper provides lessons learnt from the design and implementation of a self-controlled, direct-to-family pilot trial aimed to evaluate the effects of a medication management device on adherence to hydroxychloroquine in paediatric SLE.Methods Several design features accommodate a direct-to-family approach. Participants meeting eligibility criteria from across the USA were identified a priori through a disease registry, and all outcome data are collected remotely. The primary outcome (medication adherence) is evaluated using electronic medication event-monitoring, plasma drug levels, patient questionnaires and pill counts. Secondary and exploratory endpoints include (1) lupus disease activity measured by a remote SLE Disease Activity Index examination and the Systemic Lupus Activity Questionnaire; and (2) hydroxychloroquine pharmacokinetics and pharmacodynamics. Recruitment of the initial target of 20 participants was achieved within 10 days. Due to initial recruitment success, enrolment was increased to 26 participants. Additional participants who were interested were placed on a waiting list in case of dropouts during the study.Discussion and dissemination Direct-to-family trials offer several advantages but present unique challenges. Lessons learnt from the protocol development, design, and implementation of this trial will inform future direct-to-family trials for children and adults with rheumatic diseases. Additionally, the data collected remotely in this trial will provide critical information regarding the accuracy of teleresearch in lupus, the impact of adherence to hydroxychloroquine on disease activity and a pharmacokinetic analysis to inform paediatric-specific dosing of hydroxychloroquine.Trial registration number ClinicalTrials.gov Registry (NCT04358302).

Aim: We aimed to describe the pattern and clinical presentation of panfacial fractures and to analyze if the panfacial fractures differ from other maxillofacial injuries concerning the time of intervention and duration of hospital stay, thereby evaluating if panfacial fractures place a burden on our hospital which is a tertiary reference center in South India. Materials and methods: This was a prospective study conducted for a duration of two years from January 2018 to January 2020 among 28 patients who reported with panfacial fractures. Descriptive data were entered and chi-square test was done to find out the association between categorical variables. Results: Patients who reported with panfacial fractures were young adults (n = 17, 60.7%), males (92.8%) predominantly. Among those with a history of Road Traffic Accidents (n = 23, 82%), 91% (n = 21) did not use any protective devices. Conclusions: Males, young adults, use of two-wheelers, consumption of alcohol before driving, and avoidance of protective devices were most commonly associated with panfacial fractures (p < 0.05). Based on the study, panfacial fractures place a burden on the hospital in terms of the need for special care and prolonged stay period and operating time compared to other maxillofacial injuries (p < 0.05).

Background: Motorized two-wheelers, pedestrians, and cyclists are termed vulnerable road users (VRUs).Globally up to 50% of road deaths involve VRU and up to 80% in developing and rapidly motorizing economies. Objective: The objective of this study is to study the prehospital and clinical profile of fatally injured VRU. This would help in informed decision-making regarding prevention and trauma care infrastructure. Materials and Methods: A hospital-based study was performed at a Trauma Centre in Puducherry from January 2013 to June 2014 (18 months). Puducherry is a union territory of India in the state of Tamil Nadu. A total of 193 deaths due to Road traffic accident were included in this study. The demographics, prehospital findings, and the clinical progress of fatally injured VRU are described. Results: More than 80% of road traffic collision/crash deaths involved VRU of which the elderly comprised a significant proportion. Alcohol was a serious issue even in the elderly pedestrian. This study revealed specific injury patterns and severity. Head injury was the most common cause of death. Early deaths, that is within 24 h of injury was common at 50%. Conclusion: The majority of deaths were in the early phase of trauma hence mandating a strong call for prevention, along with strengthening of trauma care.

Abstract 2D transition metal oxides have created revolution in the field of supercapacitors due to their fabulous electrochemical performance and stability. Molybdenum trioxides (MoO3) are one of the most prominent solid-state materials employed in energy storage applications. In this present work, we report a non-laborious physical vapor deposition (PVD) and ultrasonic extraction (USE) followed by vacuum assisted solvothermal treatment (VST) route (DEST), to produce 2D MoO3 nanosheets, without any complex equipment requirements. Phase transition in MoO3 is often achieved at very high temperatures by other reported works. But our well-thought-out, robust approach led to a phase transition from one phase to another phase, for e.g., hexagonal (h-MoO3) to orthorhombic (α-MoO3) structure at very low temperature (90 °C), using a green solvent (H2O) and renewable energy. This was achieved by implementing the concept of oxygen vacancy defects and solvolysis. The synthesized 2D nanomaterials were investigated for electrochemical performance as supercapacitor electrode materials. The α-MoO3 electrode material has shown supreme capacitance (256 Fg−1) than its counterpart h-MoO3 and mixed phases (h and α) of MoO3 (

Anaesthesia is one of the few sub-specialties of medicine, which has quickly adapted technology to improve patient safety. This application of technology can be seen in patient monitoring, advances in anaesthesia machines, intubating devices, ultrasound for visualisation of nerves and vessels, etc., Anaesthesia machines have come a long way in the last 100 years, the improvements being driven both by patient safety as well as functionality and economy of use. Incorporation of safety features in anaesthesia machines and ensuring that a proper check of the machine is done before use on a patient ensures patient safety. This review will trace all the present safety features in the machine and their evolution.

Fungal endophytes were isolated from the leaves of spurred mangrove, Ceriops tagal and the isolation frequency was found to be 11.66 %. The endophytes were identified by both morphological and molecular methods. A total of 106 endophytic fungi were isolated with the majority (96 %) belonging to the Ascomycota and Basidiomycota constituted only 4 % of the total isolates. Within Ascomycota, three classes (Sordariomycetes, Eurotiomycetes, and Saccharomycetes) and 4 orders were observed. In Basidiomycota only agaricomycetes was obtained. Aspergillus (58 %) was the dominant genus, followed by Penicillium (20 %), Colletotrichum (9 %), and Schizophyllum (6 %). Notably, Aspergillus sydowii (35 %) was the predominant endophytic fungus in C. tagal. The colonization frequency was highest for Aspergillus sydowii (4.1 %) followed by Penicillium citrinum (3 %) and Aspergillus flavus (2.3 %). In total, 11 endophytic fungal species were identified from C. tagal. The isolates exhibited noteworthy hydrolytic enzyme production and antimicrobial properties, suggesting their suitability for potential applications as bioremediators and antimicrobials in aquaculture and medicine.

Background and Aims: The insertion of central venous catheters (CVCs) is an integral part of the management of critically ill patients. We aimed to study the impact of ultrasonography (USG) on CVC insertion in intensive care. Setting and Design: A prospective study of 450 patients requiring CVC in the intensive care unit (ICU) of a tertiary care hospital. Methods and Materials: The patients were randomized into two groups: to have CVC insertion with USG-guidance or with the anatomic landmark technique (ALT). Data were collected on patient demographics; operator experience; and method, site and side of insertion. Outcome measures included successful insertion of CVC, number of attempts needed and complications. Results: Internal jugular vein (IJV) cannulation was successful in 177/194 patients (91.2%) using ALT and in 200/205 patients (97.6%) using USG guidance, a significant difference of 6.4% (P = 0.006). Using ALT, 72.7% of cannulations could be accomplished in the first attempt as compared with 84.4% with USG guidance (P = 0.004). The overall complication rate was 28/399 (7%), with 19 (9.8%) complications in the ALT group and 9 (4.4%) in the USG group (age-, sex-, and operator-adjusted OR = 0.35, 95% CI: 0.13-0.96; P = 0.03). For subclavian vein catheterization, the success rate was 26/28 (92.9%) in the ALT group and 17/17 (100%) in the USG group (P = 0.52). Using ALT, 71.4% cannulation could be accomplished in the first attempt as compared with 82.4% under USG guidance (P = 0.49). The overall complication rate was 6/45 (13.3%), with 4 (14.3%) complications in the ALT group and 2 (11.8%) in the USG group (P > 0.99). Conclusions: Real-time USG guidance improves success rates, reduces the number of attempts and decreases the complications associated with CVC insertion, especially for the IJV, and should become the standard of care in intensive care.

Long-term efficacy of the protein-enriched flour of pea (Pisum sativum L. var. Bonneville) in its toxicity, progeny reduction and organoleptic properties was evaluated by combining it with wheat flour and testing the admixture against the red flour beetle, Tribolium castaneum (Herbst). The toxicity and progeny-reducing effects of the wheat flour treated with protein-enriched pea flour were stable for a period of 5 months when stored at 28°C with 75% r.h. Heat treatment destroyed the biological activity of the protein-enriched pea flour containing the active ingredient due to the denaturation of proteins. The organoleptic properties of stored wheat flour were not affected by the treatment with protein-enriched pea flour.

BackgroundMigration from rural areas of India contributes to urbanisation and may increase the risk of obesity and diabetes. We tested the hypotheses that rural-to-urban migrants have a higher prevalence of obesity and diabetes than rural nonmigrants, that migrants would have an intermediate prevalence of obesity and diabetes compared with life-long urban and rural dwellers, and that longer time since migration would be associated with a higher prevalence of obesity and of diabetes.Methods and findingsThe place of origin of people working in factories in north, central, and south India was identified. Migrants of rural origin, their rural dwelling sibs, and those of urban origin together with their urban dwelling sibs were assessed by interview, examination, and fasting blood samples. Obesity, diabetes, and other cardiovascular risk factors were compared. A total of 6,510 participants (42% women) were recruited. Among urban, migrant, and rural men the age- and factory-adjusted percentages classified as obese (body mass index [BMI] >25 kg/m(2)) were 41.9% (95% confidence interval [CI] 39.1-44.7), 37.8% (95% CI 35.0-40.6), and 19.0% (95% CI 17.0-21.0), respectively, and as diabetic were 13.5% (95% CI 11.6-15.4), 14.3% (95% CI 12.2-16.4), and 6.2% (95% CI 5.0-7.4), respectively. Findings for women showed similar patterns. Rural men had lower blood pressure, lipids, and fasting blood glucose than urban and migrant men, whereas no differences were seen in women. Among migrant men, but not women, there was weak evidence for a lower prevalence of both diabetes and obesity among more recent (ConclusionsMigration into urban areas is associated with increases in obesity, which drive other risk factor changes. Migrants have adopted modes of life that put them at similar risk to the urban population. Gender differences in some risk factors by place of origin are unexpected and require further exploration. Please see later in the article for the Editors' Summary.