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Abstract Background Exercise in healthy individuals is associated with a hypercoagulable phase, leading to a temporary increase in clot mass and strength, which are controlled by an effective fibrinolytic system. Conversely, people with cardiovascular diseases often have a reduced fibrinolytic pathway, increased clot mass and abnormal clot contraction, resulting in poorer outcomes. We assessed clot microstructure, particularly the contractile forces of clot formation, in response to two exercise intensities in middle-aged/older runners. Methods Twenty-eight habitual male and female runners aged over 40 years completed a 10 km moderate-intensity run; 14 of them performed a 3 km high-intensity run. Blood samples were collected at baseline, immediately postexercise and after 1 h of rest. Clot structural biomarkers d f, gel time, and measurements of mature clot mechanical properties (gel time, G’ Max and CF max ) were analysed alongside conventional plasma markers. Results Both exercise intensities altered markers of coagulant activity (PT, APTT and FVIII) and fibrinolysis (D-dimer), indicating hypercoagulability. Compared with longer-duration lower-intensity exercise, d f was greater after short-duration intensified exercise bouts. Following an hour of rest, d f dropped to baseline levels. Additionally, CF max decreased across timepoints at both exercise intensities. This effect was noted after one hour of rest compared with baseline, suggesting continuous fibrinolytic activity postexercise. Conclusion Exercise transiently induces an intensity-dependent hypercoagulable state, resulting in denser clot formation and a reduced clot contractile force due to fibrinolysis. These findings can help guide the safe commencement of rehabilitation exercise programs for cerebrovascular patients.

Context: Diabetic retinopathy (DR) is a major cause of vision impairment among diabetics, with significant regional variations in its prevalence and associated risk factors across India. Aims: This study aims to assess the variation in risk factors for DR, including demographic and behavioral characteristics, and to identify regional differences in the severity of DR across four geographic zones in India. Settings and Design: Data were sourced from the INDO EYE registry, encompassing six tertiary eye care hospitals across India. The study was designed to analyze and compare DR-related variables among different geographic zones: south, central, west, and east. Subjects and Methods: The study analyzed data from 7112 eyes of 3699 patients diagnosed with DR. Demographic, clinical, and behavioral data were collected, including age, gender, substance abuse history, comorbidities, and DR severity . Statistical Analysis Used: Descriptive statistics summarized demographic and clinical characteristics. Chi-square tests assessed associations between categorical variables, and one-way ANOVA evaluated continuous variables across zones. Statistical significance was set at P < 0.05, with analysis performed using the IBM SPSS Statistics 28. Results: The study revealed significant regional differences in DR severity and risk factors. The central zone had the highest proportion of proliferative DR and diabetic macular edema, while the south and west zones showed better visual outcomes and higher proportions of certain comorbidities. The east zone exhibited higher substance abuse rates and a broader range of visual acuity outcomes. Conclusions: Regional disparities in DR prevalence and severity highlight the need for targeted public health strategies to address local risk factors and improve diabetes management across India. Enhanced healthcare access and tailored interventions are crucial for reducing DR-related vision loss.

Although fatigue is a common non-motor symptom of Parkinson’s disease (PD), it is often overlooked during routine assessments of individuals with PD. This can be attributed partly to the lack of recognition of this symptom and the coexistence of other confounding symptoms, such as apathy, somnolence, and depression. However, considering the effects of fatigue on the quality of life (QoL) of individuals with PD, it is crucial to review its causes and management strategies. According to the diagnostic criteria for PD-related fatigue, patients must report significantly reduced energy levels or an increased perception of effort disproportionate to their attempted activities. PD-related fatigue can be divided into central and peripheral types. Peripheral fatigue involves muscle weakness and impaired voluntary movements, influenced by tremors and bradykinesia. Central fatigue, which can be divided into mental and physical subtypes, manifests as persistent exhaustion without peripheral motor deficits. The pathophysiology of central fatigue in PD is complex. It involves dysfunction in the striato–limbic–serotonergic system, imbalance of neurotransmitters (dopamine and serotonin), as well as hypoconnectivity in the supplementary motor area and hyperconnectivity in the default mode network. Emerging evidence suggests that neuroinflammation and autonomic dysfunction may contribute to fatigue. Fatigue in PD is treated using pharmacological therapies (such as dopaminergic agents, antidepressants, methylphenidate, and modafinil) and non-pharmacological interventions (such as exercise). There is a gap in the current understanding, measurement, and treatment of fatigue in PD. A deeper understanding of the patho-mechanisms of fatigue in PD is needed to establish evidence-based treatment guidelines. The QoL of individuals with PD can be improved by focusing on person-centered interventions targeting fatigue.

Introduction: Unprovoked seizures are common events in children, occurring as single episodes or recurring, as seen in epilepsy. The First Unprovoked Seizure (FUS) poses diagnostic challenges and raises concerns about aetiology, the initiation of anti-seizure medication and prognosis. The roles of Electroencephalogram (EEG) and neuroimaging in the diagnosis and management of FUS are debated. While EEGs play a crucial role in identifying seizure onset and epilepsy syndromes, neuroimaging aids in diagnosing underlying pathologies. Despite recommendations for routine EEGs in evaluating FUS, the role of neuroimaging remains less defined. Aim: To characterise the clinical profile of children presenting with FUS and investigate the relationship between clinical features, EEG findings and neuroimaging findings. Additionally, it explores the aetiology of FUS based on patterns of neuroradiological abnormalities and EEG changes. Materials and Methods: A cross-sectional study was conducted from April 2021 to July 2022 in the Paediatric Intensive Care Unit (PICU) and Paediatric Ward at Government TD Medical College, Alappuzha, Kerala, India. A total of 72 children aged beyond the neonatal period up to 12 years who were admitted with FUS at a tertiary care centre over an 18-month period were included in the study. Clinical data were recorded and standard techniques were used to perform EEGs and Magnetic Resonance Imaging (MRI) on all subjects. Results: The minimum age of participants in the study was two months, with a median age of 3.9 years. Among the 72 participants, most were in the infantile age group, with 23 (31.94%) falling into this category. The most frequently observed seizure type was generalised onset, with 47 (65.28%) cases. EEG irregularities were noted in 25 (34.72%) subjects, while 21 (29.16%) showed MRI abnormalities. Most frequent EEG abnormalities included generalised spike-and-wave discharges in 7 (28%) cases and modified hypsarrhythmia in 6 (24%) cases. The MRI scans revealed ischaemic changes and cerebral dysgenesis, each occurring in 7 out of 21 cases. A considerable proportion of children with abnormal EEGs had abnormal neuroimaging findings. Conclusion: The study recommends that both EEG and MRI should be included as part of the routine evaluation for children presenting with FUS. In cases with abnormalities in EEG, the detection rate of abnormalities through MRI was statistically significant. Additionally, MRI should be performed even when the EEG results are normal.

The rise of electric vehicles (EVs) in the transportation sector aids in curbing global greenhouse gas emissions yet efficiently integrating them into the existing infrastructure presents challenges in guaranteeing the real-time availability of charging points and the dynamic nature of electric mobility. This paper presents a novel dynamic demand scheduling framework that utilizes predictive analytics to address the issue of emergency charging requests; situations where an EV urgently require to reach a charging point due to critically low battery levels. The framework is integrated with advanced dynamic demand scheduling algorithm (ADDSA), which utilizes real-time charging data collected from Trivandrum, Kerala state, India. Using the comprehensive dataset, the framework identifies delayed EVs and considers the charging point status (active, idle or faulty) and charging point pricing to optimize the charging station allocation. By employing the K-Means clustering algorithm, the ADDSA categorizes charging points based on their performance and availability. To evaluate the effectiveness of these clusters, we utilize internal metrics such as the Silhouette score, Calinski-Harabasz (CH) index, and Davies-Bouldin (DB) index. Our findings demonstrate that K-Means outperforms other clustering algorithms, including DBSCAN, K-Medoids, Agglomerative clustering, and Gaussian mixture models (GMM), with a CH score of 1200, a Silhouette score of 0.45, and a DB score of 0.74. In the final stage of ADDSA, groups of available charging points along with their pricing information is generated, facilitating informed decision-making for EV users. With the rapid growth of the EV population, our unique dynamic demand scheduling framework, featuring real-time constraints, offers a promising solution for efficiently addressing the emergency charging needs of EVs.

Abstract The unique characteristics of Indian trans-identity are shaped by cultural intricacies, setting it apart from its Western counterparts. Despite facing marginalisation in mainstream Indian society, the intricacies of their constructed trans-culture further complicate their experiences. According to the interactionist perspective of gender identity within sociological theory, an individual’s interactions with peers, family, and society influence the development of their gender identity. Examining this concept within the diverse Indian context reveals the significant nuances of Indian trans-identity. Two Bengali-Indian films, Kaushik Ganguly’s Nagarkirtan (2019) and Rituparno Ghosh’s Chitrangada: The Crowning Wish (2012), depict the intense and challenging journeys of individuals embracing their trans identities. This research aims to analyse the films from an interactionist perspective, exploring how the Indian cultural discourses portrayed in the films influence the formation of trans identities. The findings suggest that the development of trans identity involves complex processes influenced by social interactions, where conflicts between one’s generalised self and instinctual self arise due to sexual digression. Additionally, this study indicates that the sexual scripting of trans individuals is influenced by various factors, including class, culture, financial status, and social position, making it challenging to conform to the binary gender script of a normalised society. This qualitative research utilises the Interactionist theory of gender identity to analyse the two Bengali-Indian films.

Background: Oral ulcers are frequent ulcerative conditions in the oral cavity that cause pain, recur often, and negatively impact quality of life. Aim and Objective: This study aims to assess the effectiveness of herbal extracts containing saffron, Withania somnifera, dry ginger, and tulsi as anti-inflammatory and cytotoxic agents for treating oral ulcers. Materials and Methods: A blend of 1 g each of tulsi, Withania somnifera, and dry ginger powders was mixed with 100 ml of distilled water and heated at 50 to 60 degrees Celsius for 15 minutes. The anti-inflammatory and cytotoxic activities were tested by adding 5 ml of the extract to a gel composed of 5 g of carboxylate methyl cellulose and carbopol. The anti-inflammatory properties of the herbs were assessed using the Membrane Stabilization Assay, BSA Assay, and EA Assay, while the cytotoxic effect was evaluated using the Brine Shrimp Lethality Assay. Results: The Membrane Stabilization Assay at concentrations of 10, 20, 30, 40, and 50 micrograms/ml showed values of 53, 64, 77, 79, and 85, respectively. The BSA Assay results were 42, 56, 67, 75, and 77, and the EA Assay results were 54, 61, 65, 69, and 78. The P values were 0.658 for the Membrane Stabilization Assay, 0.281 for the BSA Assay, and 0.647 for the EA Assay. These values indicate that the herbal ingredients’ cytotoxic activity is comparable to the standard. Conclusion: This study demonstrates that the natural components of medicinal herbs can effectively treat oral ulcers, improving patients’ quality of life. Thus, herbal medicines can be used alongside commercially available allopathic drugs.

Context: Concerns about brolucizumab’s (Pagenax®) association with intraocular inflammation (IOI) limit its use despite its cost-effectiveness and efficacy. This multicentric study analyzes IOI incidence across 21 tertiary eyecare centers in India since its introduction in October 2020. Purpose: To determine the real-world incidence rate of IOI in Indian patients secondary to intravitreal brolucizumab across 21 tertiary eye care centers in India. Settings and Design: Retrospective multicentric, survey-based study. Methods: Data including number of patients treated, clinical indications, side effects encountered, and IOI case details was collected via Google Forms in 21 Indian tertiary eye care centers since October 2020. Mean, median, frequency, and standard deviation were calculated for statistical analysis. Results: All centers used pro re nata protocol for brolucizumab injections with a minimum injection interval of 8 weeks. The incidence of IOI was 0.79% (21 events out of 2655 eyes). Treatment indications included idiopathic polypoidal choroidal vasculopathy, neovascular age-related macular degeneration, diabetic macular edema, and off-label uses. IOI was experienced after the first injection (57%) in majority of cases with a median onset of 14 days (range: 1–65 days). IOI was mild in 28.5%, moderate in 33%, and severe in 38% of cases. Eighteen out of 21 IOI eyes recovered preinjection best corrected visual acuity or better. Conclusions: Our study found a lower IOI incidence (0.79%) with brolucizumab (Pagenax) in Indian patients compared to previously reported literature. IOI events were mostly mild to moderate, and post-treatment, most patients improved or maintained BCVA. Larger prospective multicentric studies with PRN dosing protocol are needed to confirm these findings.

Abstract Organic electrode materials (OEMs) possess low discharge potentials and charge‒discharge rates, making them suitable for use as affordable and eco-friendly rechargeable energy storage systems without needing metals such as lithium or sodium. OEMs can provide a sustainable energy economy by their development into stable and efficient next-generation high-power batteries. Despite the presence of several classes of OEMs, such as conducting polymers, 2D and 3D metal-organic frameworks, organolithium derivatives, 2D covalent organic frameworks, aromatic heterocyclic imides, and viologen derivatives, since their introduction in the 1960s, carbonyl-based molecules have maintained low discharge potentials and stable charging/discharging properties. Nevertheless, several redox-active organic molecules, including carbonyl derivatives, show poor electrochemical stability and ionic mobility in standard battery electrolytes, hampering their commercial use. Therefore, with the increased demand for renewable energy, the synthesis and testing of carbonyl-based OEMs continue to be performed in energy research. This review summarizes recent advances in developing carbonyl-based OEMs and their performance in rechargeable batteries.

As a tropical fruit, the banana is one of the favorite fruits, and the banana herb only bears fruit once in its lifespan; it is chopped off after harvesting, and only 40% of it is adequately utilized, leaving the remaining 60% as trash rich in cellulose, hemicellulose, and natural fibers. The pseudostem accounts for 75% of the waste, with the rest accounting for 25%. The purpose of this paper is to raise important awareness about the bioactive chemicals found in banana pseudostems hence they can be considered as sustainable foods and their applications as culinary raw materials and in other sectors. Even though bulk waste is biodegradable, it causes many problems in our environment, so sustainable waste usage with proper management and utilization of the residues can not only help in the utilization of the bioactive and nutrient compounds present but also increase the economic and environmental issues associated with the problem. The banana pseudostem is used in various businesses as culinary ingredients, fibers, and hazardous removers. Even when used for heavy metal treatment in wastewater, the fiber in it is strong enough to manufacture cardboard and food packaging materials. Some pseudostem types can even be extracted for pectin and used as food additives. The powdered pseudostem is used to boost the nutritional content of numerous recipes. In summary, the banana pseudostem can be divided into two first the central core part that can be used as food raw material and other outer sheaths in various different industries.

Transition metal oxides like ZnO nanostructures are pivotal in various scientific and technological fields due to their chemical stability, high electrochemical coupling efficiency, and broad radiation absorption spectrum. This study offers an in-depth examination of ZnO nanostructures synthesized via the green route using Piper Longum L, emphasizing their photocatalytic efficacy in degrading organic pollutants such as Sulphanilamide and Chromium. The ZnO nanostructures with a rod-like morphology exhibited an average crystallite size of 26 nm and an optical bandgap of 2.8 eV. Solid state structure of ZnO was investigated by Fourier Transform Infrared spectroscopy (FTIR) and X-Ray Diffraction (XRD). Zinc in the synthesized organo zinc complex and zinc oxide was estimated to 324.325 and 133.02 ppm, respectively. The saturation magnetization obtained from Superconducting Quantum Interference Device-Vibrating Sample Magnetometer (SQUID-VSM) for organo zinc complex and ZnO is 2.1 × 10−3 and 1.7 × 10−3 emu/g, respectively. These nanostructures achieved 99 and 93 % degradation of chromium (VI) ions present in solutions of two different concentrations in about 30 and 80 min, respectively, under UV and visible radiation, a remarkable achievement. Almost the same efficiency was maintained during three consecutive runs and then deactivation of the catalyst was observed. Additionally, a rapid 84 % degradation of Sulphanilamide was observed in 42 min, underscoring the potential of ZnO nanostructures as efficient photocatalysts for environmental remediation.

Abstract Anthrophony is an important determinant of habitat quality in the Anthropocene. Acoustic adaptation of birds at lower levels of anthrophony is known. However, threshold anthrophony, beyond which biophony starts decreasing, is less explored. Here, we present empirical results of the relationship between anthrophony and biophony in four terrestrial soundscapes. The constancy of the predicted threshold vector normalised anthropogenic power spectral density (~ 0.40 Watts/Hz) at all the study sites is intriguing. We propose the threshold value of anthropogenic power spectral density as an indicator of the avian acoustic tolerance level in the study sites. The findings pave the way to determine permissible sound levels within protected landscapes and directly contribute to conservation planning.

Metformin hydrochloride, an antidiabetic agent, is useful in reducing the blood glucose concentration in Type II diabetes. It is also finding its use as a repurposed drug. The formulations consisted of micro drug delivery systems prepared by emulsification method and were evaluated in-vitro and in-vivo. Process variables like amount of polymer, speed of agitation and stirring, presence or absence of surfactant and cross linker offered a versatile approach towards obtaining the formulation though affected physicochemical properties of formulations. Discrete, spherical, and free-flowing microspheres, in the size range and granularity of 250 to 700µ were used to control the drug release rate. Drug release was diffusion controlled as evident from the Higuchi kinetics. The physical characteristics of the formulations were reproducible. Healthy and alloxan induced hyperglycaemic male albino mice were used for in-vivo experimentation by evaluating plasma glucose level reduction and % reduction in the blood glucose level after administration of pure drug and formulations. The results indicate significant sustained fall in the blood glucose level for about 10 hrs following formulation administration as compared to the pure drug.

Purpose: The knowledge and attitude of participants toward clinical trials (CTs) are a key determinant in successful recruitment and retention. This study aimed to evaluate knowledge and awareness-attitude among the recruited CT participants about CTs. Methods: This was a cross-sectional face-to-face survey comprising CT participants involved in the past or currently a part of a CT during this study within the Indian Ophthalmology Clinical Trial Network (IOCTN). A previously validated questionnaire was used, and data regarding demographics, knowledge, and awareness-attitude about CTs were collected. The total awareness-attitude score was used to determine the knowledge and awareness of the participants. Results: A total of 121 subjects had participated in the study who were part of ongoing trials, of which only five participants had prior experience of CTs. The majority (90%) had knowledge about CTs, whereas only 7% had confirmed signing consent forms. The total awareness-attitude score significantly varied across locations (27% for the southern zone, 53% for the central zone, and 52% for the western zone), and this was negatively associated with education. The most negative attitude (38.6%) was observed regarding adequate information sharing among participants, whereas non-disruption of their routine family life (60.7%) and financial stability (67.6%) were the top most positive attitudes revealed during their participation. The participants' pre- and post-participation attitude toward CTs revealed a positive attitude. Conclusion: The factors influencing a participant's knowledge and attitudes toward CTs were revealed in the study. Furthermore, the need for awareness regarding benefits of CTs to the public, participant's rights, and their voluntary power were the major highlights.

A male in his 40's with no known comorbidities developed severe COVID-19 pneumonia and received a four-week course of methylprednisolone. The patient subsequently developed disseminated Aspergillus endocarditis, manifesting as multiple organ involvement including the heart, eyes, and brain. Despite the poor prognosis generally associated with fungal endocarditis, the patient survived following aggressive medical management with a combination of liposomal amphotericin b and voriconazole therapy and is now doing well for over two years and is off antifungal therapy for a year.

Purpose: Dry eye syndrome (DES) is a familiar sequelae of radiation therapy (RT) for head and neck cancers (HNC). Ocular surface changes such as DES occur due to injury to the conjunctival epithelium, goblet cells, corneal surface, lacrimal glands, and meibomian glands. This study aimed at the evaluation and early detection of changes in ocular surface parameters in patients receiving RT for extraocular HNC. Methods: Forty-two eyes of 21 patients undergoing HNC RT were evaluated. Radiation technique and dose of radiation to the lens and eye were recorded. Subjects were evaluated for meibomian gland changes by meiboscore grading, ocular surface disease index (OSDI) questionnaire, Schirmer’s test, tear film break-up time (TBUT), and slit-lamp examination before RT, immediately post RT, and 6 weeks post RT. A comparison of the ipsilateral eye on the irradiated side to the contralateral eye was done. Results: A significant reduction in TBUT was seen immediately post RT and 6 weeks post RT (P < 0.001 and 0.008, respectively), with an increase in meiboscore at both visits (P < 0.001). An OSDI score of >13 was seen in 23.80% of patients post RT, with a significant difference from baseline (P < 0.001). On comparing ipsilateral and contralateral eye groups, a significant difference from baseline was seen in TBUT (P < 0.001 and 0.033, respectively) and meiboscore (P < 0.001 for both eyes). A significant change of >1 second in TBUT and >1.7 in meiboscore was seen with a mean dose of around 8 Gy to the lens. Conclusion: All patients undergoing HNC RT should be followed up for ocular surface and meibomian gland changes. The contralateral eye should also be evaluated. Patients receiving lower doses to the ocular structures should also be kept under follow-up.

A compact source, G0.02467–0.0727, was detected in Atacama Large Millimeter/submillimeter Array 3 mm observations in continuum and very broad line emission. The continuum emission has a spectral index α ≈ 3.3, suggesting that the emission is from dust. The line emission is detected in several transitions of CS, SO, and SO _2 and exhibits a line width FWHM ≈ 160 km s ^−1 . The line profile appears Gaussian. The emission is weakly spatially resolved, coming from an area on the sky ≲1″ in diameter (≲10 ^4 au at the distance of the Galactic center, GC). The centroid velocity is v _LSR ≈ 40–50 km s ^−1 , which is consistent with a location in the GC. With multiple SO lines detected, and assuming local thermodynamic equilibrium (LTE) conditions, the gas temperature is T _LTE = 13 K, which is colder than seen in typical GC clouds, though we cannot rule out low-density, subthermally excited, warmer gas. Despite the high velocity dispersion, no emission is observed from SiO, suggesting that there are no strong (≳10 km s ^−1 ) shocks in the molecular gas. There are no detections at other wavelengths, including X-ray, infrared, and radio. We consider several explanations for the millimeter ultra-broad-line object (MUBLO), including protostellar outflow, explosive outflow, a collapsing cloud, an evolved star, a stellar merger, a high-velocity compact cloud, an intermediate-mass black hole, and a background galaxy. Most of these conceptual models are either inconsistent with the data or do not fully explain them. The MUBLO is, at present, an observationally unique object.

Centella asiatica is a medicinal herb, well known for its phytochemical activities because of the presence of terpenoids and polyphenols, which contribute to the bioactivity of herb extract that can be effectively utilized in the packaging industry. Biopolymers infused with C. asiatica extract could be a promising solution in the food sector. The antibacterial and antioxidant qualities of C. asiatica can help preserve the quality and lengthen the freshness of food products, thereby preventing food loss. Selection of a suitable extraction method is essential to retain the yield and properties of the bioactive compounds of C. asiatica extract. Many research has been conducted on the separation of C. asiatica by using conventional and novel extraction techniques and its execution in packaging as a functional component. This review provides an overview of the extraction of phytochemicals from C. asiatica and its utilization in biopolymer film as an active component to modify the packaging film characteristics.

Background: Nutrition especially micro-mineral nutrients plays a major role in the etiology of chronic periodontitis. Serum levels of micro-mineral nutrients can be used as markers for the incidence of periodontitis and may also be used as indicators for dietary supplementation. Aims and Objectives: The aim of the study was to estimate the serum levels of Zn, Cu, Fe, and Mg of chronic periodontitis patients and normal healthy controls., to measure the clinical parameters (gingival index, probing pocket depth [PPD], and clinical attachment loss) in chronic periodontitis patients and normal healthy controls., to compare the levels of serum Zn, Cu, Fe, and Mg levels of chronic periodontitis patients and healthy controls and to correlate the levels of serum micronutrients with clinical parameters (gingival index, PPD, and clinical attachment loss) in chronic periodontitis patients and healthy controls. Materials and Methods: A total of 110 subjects, 55 subjects with chronic periodontitis and 55 healthy control subjects in the age group 35–65 years were selected for the study. Serum micronutrient levels of Cu, Fe, Zn, Mg, and the clinical parameters were measured. Results: Serum concentrations of Cu and Fe showed statistically significant increase and serum Zn and Mg showed a significant decrease in peridontitis patients as compared to normal healthy controls. Copper and Fe showed a significant positive correlation and Zn and Mg showed a significant negative correlation with clinical parameters (gingival index, PPD, and clinical attachment loss). Conclusion: The present study supports and extends the view that the assessment of serum mineral micronutrient can serve as possible biomarkers or indicators for an inflammatory condition like chronic periodontitis.

Digital image compression is the technique in digital image processing where special attention is provided in decreasing the number of bits required to represent a digital image. A wide range of techniques have been developed over the years, and novel approaches continue to emerge. This paper proposes a new technique for optimizing image compression using Fast Fourier Transform (FFT) and Intelligent Water Drop (IWD) algorithm. IWD-based FFT Compression is a emerging ethodology, and we expect compression findings to be much better than the methods currently being applied in the domain. This work aims to enhance the degree of compression of the image while maintaining the features that contribute most. It optimizes the FFT threshold values using swarm-based optimization technique (IWD) and compares the results in terms of Structural Similarity Index Measure (SSIM). The criterion of structural similarity of image quality is based on the premise that the human visual system is highly adapted to obtain structural information from the scene, so a measure of structural similarity provides a reasonable estimate of the perceived image quality.

Background: A person is said to have a functional limitation when he/she does not have the physical or cognitive ability to independently perform the routine activities of daily living. If recognized at an early stage, these can often be improved greatly, helping them regain their functional abilities and independence. Objective: The objective of the study was to determine the prevalence of functional limitations among older adults in a rural area in south Kerala. Materials and Methods: The cross-sectional study was conducted among older adults residing in the field practice area of a rural health training center of a medical college in south Kerala for 3 months from October 2019 to December 2019. Data were collected by interview of the participants by the investigator. The modified Barthel Index for activities of daily living was used to determine the prevalence of functional limitations. Results: The overall prevalence of functional limitations among older adults in a rural area in south Kerala was 35.9%. The most common functional limitation experienced by the participants was difficulty in climbing stairs. Functional limitation was found to be significantly associated with the age, socioeconomic status, and type of family of the participants. Conclusion: There is an urgent need to focus on the functional limitation among older adults, especially among the oldest old and those in lower socioeconomic status with emphasis on the need to strengthen the health-care facilities for them, with respect to early identification and management of their functional limitations.

Purpose: Our primary aim was to evaluate intraocular cytokines (IC) before and after dexamethasone in diabetic macular edema (DME). Our secondary aim was to study the early and late effects of single dexamethasone implant in DME. Methods: This before and after comparative study was conducted at the Department of Ophthalmology and Centre for Nanosciences at a quaternary referral center in Kerala, India, from September 2016 to September 2018. Patients underwent complete ophthalmological examination and cytokine analysis before and after dexamethasone implant. Levels of cytokines at baseline and repeat sample were studied. Results: Twenty-seven eyes (21 patients) were divided into two groups depending on time from baseline to second injection. Group 1 included patients with 3 months between the two samples –15 (55.6%). Best corrected visual acuity (BCVA) and central macular thickness (CMT) improved significantly post-dexamethasone in group 1, but not in group 2. Interleukin (IL)-4, IL-6, IL-10, vascular endothelial growth factor (VEGF), IL-1β, interferon-gamma inducible protein-10 (IP-10), monocyte chemoattractant protein-1 (MCP-1), and IL-2 decreased post-injection in group 1. But cytokines increased post-dexamethasone in group 2, except IL-10. When compared to baseline, IL-6 reduced to half in group 1 (P-value 0.814) and it tripled in group 2 ( P-value 0.009). The level of VEGF in the first and second samples was not different in either group. Conclusion: Our study suggests that dexamethasone acts more on IC than VEGF in DME. This is significant in the first 3 months with a rebound effect on IL-6 after 3 months. Our study also suggests that repeat injection of DEX in DME should be done at 3 months to prevent deterioration of visual acuity (VA) and worsening of CMT.

Purpose: Our aim was to determine the various risk factors for secondary ocular hypertension (OHT) following pars plana vitrectomy (PPV) with silicone oil (SO) injection. Methods: A prospective cohort study was performed on 46 eyes of 42 patients who underwent PPV with SO injection under a single surgeon between January 2020 and July 2021. Complete ophthalmological examination including gonioscopy and Goldmann applanation tonometry was performed preoperatively and on three postoperative visits, that is, day 7, day 30, and day 90. Axial length and lens thickness were measured at baseline using immersion A-scan. Anterior segment optical coherence tomography (OCT) was used for measuring anterior chamber depth (ACD) at baseline and at 3 months. Results: There was a statistically significant increase in intraocular pressure (IOP) (>21 mmHg) on day 7 (4.70 ± 7.754 mmHg), day 30 (5.24 ± 7.481 mmHg), and day 90 (2.39 ± 5.659 mmHg) (P

Purpose: The purpose of the study was to evaluate the knowledge and perception of health-care professionals (HCPs), such as doctors/surgeons, pharmacists, nurses, optometrists, and lab technicians, on clinical trials (CTs) in India. Methods: The study was a pan-Indian cross-sectional survey initiated by the Indian Ophthalmology Clinical Trial Network (IOCTN) by using a previously validated questionnaire for three months of data collection. An online survey was used to record information regarding demographics, CT knowledge, and CT perception among HCPs. Results: A total of 630 responses were recorded from HCPs: 207 doctors and surgeons, 159 pharmacists, and 264 laboratory technicians, nurses, and optometrists across India. Over 90% of HCPs had a clear knowledge on the purpose of CTs, the informed consent (IC) process, ethical approval by the Drugs Controller General of India (DCGI). About 80% and 90% were aware of confidentiality of patients, voluntariness of participation, and good clinical practice. Surprisingly, less than 50% had lesser knowledge regarding monetary incentives of CT participants (CTPs). A slightly positive perception was observed regarding the potential benefits of CTPs, compensation related to injury, and importance of obtaining IC. Less than 50% had a negative perception that monetary compensation to CTPs led to bias and deprivation of standard treatments. However, no significant difference was observed between other aspects of demographics and perception regarding CTs. Conclusion: We observed doctors and surgeons to be having the highest regarding CTs, followed by pharmacists. The survey highlighted the necessity of scheduling awareness programs among the HCPs, which would improve their misconceptions and perception of CTs while interacting with patients for CT enrollment.

Purpose: Advances in patient treatment depend heavily on clinical trials (CTs). Patient volunteers for CT are tougher to recruit and retain. In order to administer CTs effectively, it is necessary to comprehend how the public views and perceives participating in them. The study assessed the perception and attitudes of patients and bystanders toward CTs in India. Methods: This was a multi-centric, cross-sectional study among patients and bystanders using a questionnaire that consisted of socio-demographic characteristics and questions on knowledge and attitude toward participation in CTs. The minimum sample size estimated for the survey was 750. Results: A total of 1260 respondents (patients and bystanders) had participated in the survey. 42% of total respondents were aware about CTs. Unawareness regarding (i) voluntary power of an individual to participate in a CT (only 47%), (ii) entitled benefits of free treatment and medical insurance during enrolment in a CT (only 47%), and (iii) only 16% of the respondents knew involvement of human subjects in CT were the major highlights among those who had prior knowledge about CTs. Education was the most pervasive factor in shaping positive perception among the respondents. Occupation was another ubiquitous factor in shaping their perception regarding CTs. Conclusion: The majority of respondents were not aware of CTs. The major concerns observed were time consumption and harmful nature of CTs that influenced their unwillingness to participate in CTs. Initiatives such as awareness campaigns and survey assessments that would result in scientifically effective health service policies would be strategic methods to enhance CT participation.

Purpose: Diabetic retinopathy (DR) is a leading cause of ocular morbidity. Its progression depends mainly on retinal vasculature and ocular blood flow. Color Doppler imaging (CDI) is a noninvasive imaging technique that measures blood flow velocity. The resistivity index (RI), calculated by the CDI, reflects the vascular resistance distal to the measuring location. RI is independent of the doppler angle and position of the patient, making it a reliable and reproducible parameter. To the best of our knowledge, there is only one study in literature studying the association between resistivity index (RI) of the central retinal artery (CRA) and severity of DR. Aim: To determine the association between RI of CRA and severity of DR. To determine the association between RI of CRA and spectral-domain optical coherence tomography (SD-OCT) biomarkers for DR. Methods: Type II diabetics visiting our OPD underwent DR screening and were graded into three categories according to ETDRS classification which include Group A—No diabetic retinopathy (No DR), Group B—Nonproliferative diabetic retinopathy (Moderate–Severe–Very Severe NPDR), and Group C—Proliferative diabetic retinopathy (PDR). SD-OCT was performed. Ultrasonic color doppler imaging was done. RI of the CRA was noted. It was compared between the three groups and its association with severity of DR and OCT biomarkers (central subfield thickness, cube average thickness and ellipsoid zone disruption) was studied. Results: 56 eyes of 28 patients were included in our study with 20 in Group A,14 in Group B, and 22 in Group C. RI of CRA compared within groups showed statistically significant association with severity of DR (P < 0.001). The presenting BCVA (LogMar) showed positive correlation with RI in all groups. OCT biomarker central subfield thickness showed a positive correlation with RI in Groups A (P < 0.001) and B. Ellipsoid zone (EZ) disruption showed a statistically significant association with RI in Group C (P < 0.001). Conclusion: The RI of CRA is a reliable biomarker for the assessment of the severity of DR. Patients with high RI of CRA had higher chances of EZ disruption and presented with poor visual acuity.

Background: COVID-19 infection is associated with neurological manifestations, including various types of movement disorders (MD). A thorough review of individual patients with COVID-19-induced MD would help in better understanding the clinical profile and outcome of these patients and in prognostication. Objective: We conducted an individual patient-systematic review to study the clinical and imaging profile and outcomes of patients with COVID-19-associated MD. Methods: A systematic literature search of PubMed, EMBASE, and Cochrane databases was conducted by two independent reviewers. Individual patient data COVID from case reports and case series on COVID-19-associated MD, published between December 2019 and December 2022, were extracted and analyzed. Results: Data of 133 patients with COVID-19-associated MD from 82 studies were analyzed. Mean age was 55 ± 18 years and 77% were males. A mixed movement disorder was most commonly seen (41%); myoclonus-ataxia was the most frequent (44.4%). Myoclonus significantly correlated with age (odds ratio (OR) 1.02 P = 0.03, CI 1-1.04). Tremor had the longest latency to develop after SARS-CoV-2 infection [median (IQR) 21 (10-40) days, P = 0.009, CI 1.01-1.05]. At short-term follow-up, myoclonus improved (OR 14.35, P value = 0.01, CI 1.71-120.65), whereas parkinsonism (OR 0.09, P value = 0.002, CI 0.19-0.41) and tremor (OR 0.16, P value = 0.016, CI 0.04-0.71) persisted. Conclusion: Myoclonus-ataxia was the most common movement disorder after COVID-19 infection. Myoclonus was seen in older individuals and usually improved. Tremor and parkinsonism developed after a long latency and did not improve in the short-term.

Diffuse dermal angiomatosis (DDA) is a rare, benign disease that can serve as the precursor to critical limb ischemia. Pruritic, erythematous plaques form from a proliferation of endothelial cells in response to dermal hypoxia. We present the case of a 63-year-old female patient with DDA of the left medial thigh, followed by ischemia of her distal extremities. Revascularization of her left leg resulted in resolution of the DDA and healing of her ulcers. DDA can be an important clue to identify significant peripheral vascular disease.

Summary: Membraneless organelles, or biomolecular condensates, enable cells to compartmentalize material and processes into unique biochemical environments. While specific, attractive molecular interactions are known to stabilize biomolecular condensates, repulsive interactions, and the balance between these opposing forces, are largely unexplored. Here, we demonstrate that repulsive and attractive electrostatic interactions regulate condensate stability, internal mobility, interfaces, and selective partitioning of molecules both in vitro and in cells. We find that signaling ions, such as calcium, alter repulsions between model Ddx3 and Ddx4 condensate proteins by directly binding to negatively charged amino acid sidechains and effectively inverting their charge, in a manner fundamentally dissimilar to electrostatic screening. Using a polymerization model combined with generalized stickers and spacers, we accurately quantify and predict condensate stability over a wide range of pH, salt concentrations, and amino acid sequences. Our model provides a general quantitative treatment for understanding how charge and ions reversibly control condensate stability.

Background: Direct laryngoscopy necessitates the alignment of the oropharyngeal-laryngeal axis whereas video laryngoscope is an optical vision which doesn’t require alignment. This study aimed to compare direct laryngoscopy with a Macintosh blade to King-Vision Video laryngoscope for endotracheal intubation in patients who were scheduled for elective laproscopic surgeries under general anaesthesia. Methods: In this prospective randomised clinical study,118 adults with ASA I and II requiring endotracheal intubation for laproscopic surgeries under general anaesthesia were enrolled and randomised into either of the two groups by envelope method, Group DL-direct laryngoscope and Group VL-video laryngoscope where they were intubated using direct laryngoscope with Macintosh blade or King Vision videolaryngoscope. The Primary objective was to compare Time to intubate(TTI), Visualization of the laryngeal view by Cormack-Lehane grade and Successful first attempt. Secondary objective was to record the Number of intubation failure, Number of attempts, Change of anaesthesiologist and use of adjunct equipment and the complications such as oropharyngeal trauma, neck pain, dysphagia and hoarseness. Results: In comparison to group DL (21.67±4.318s), group VL took longer time to intubate (26.21± 4.150s) but had superior glottic vision than DL group(p=0.0177). Compared to DL group (72.4%), the VL (84.5%) patients had their first successful attempt, inspite of 2 failures. Complications such as pharyngeal pain (8.6%vs29.3%), hoarseness (5.2%vs29.3%), Use of adjunct equipment like bougie (19%vs 3.4%) were significantly higher in DL compared to VL group, while oropharyngeal injury, dysphagia, number of attempts and change of anaesthetists were similar in both groups. Conclusion: In comparison to the Macintosh laryngoscope, the King-vision VideoLaryngoscope took longer to intubate but had clearer glottis visualisation and a higher first-time success rate and can be used as a good teaching tool. In King-vision video laryngoscope, there was less use of auxiliary equipment and fewer complications.

Over the last decades, a significant rise in fruit consumption has been noticed as they contain numerous nutritional components, which has led to the rise in fruit production globally. However, fruits are highly liable to spoilage in nature and remain vulnerable to losses during the storage and preservation stages. Therefore, it is crucial to enhance the storage life and safeness of fruits for the consumers. To keep up the grade and prolong storage duration, various techniques are employed in the food sector. Among these, biopolymer coatings have gained widespread acceptance due to their improved characteristics and ideal substitution for synthetic polymer coatings. As there is concern regarding the safety of the consumers and sustainability, edible coatings have become a selective substitution for nurturing fruit quality and preventing decay. The application of polysaccharide-based edible coatings offers a versatile solution to prevent the passage of moisture, gases, and pathogens, which are considered major threats to fruit deterioration. Different polysaccharide substances such as chitin, pectin, carrageenan, cellulose, starch, etc., are extensively used for preparing edible coatings for a wide array of fruits. The implementation of coatings provides better preservation of the fruits such as mango, strawberry, pineapple, apple, etc. Furthermore, the inclusion of functional ingredients, including polyphenols, natural antioxidants, antimicrobials, and bio-nanomaterials, into the edible coating solution matrix adds to the nutritional, functional, and sensory attributes of the fruits. The blending of essential oil and active agents in polysaccharide-based coatings prevents the growth of food-borne pathogens and enhances the storage life of the pineapple, also improving the preservation of strawberries and mangoes. This paper aims to provide collective data regarding the utilization of polysaccharide-based edible coatings concerning their characteristics and advancements for fruit preservation.

Dry eye can initially cause mild symptoms of irritation and may rapidly progress to corneal scarring and blindness. Tear substitutes can only help for mild cases. With the advancement in microsurgical techniques, an option of transferring vascularized salivary glands has shown positive results. We present a case of a 5-year-old boy with congenital alacrimia with ocular surface damage. Vascularized autologous submandibular gland transfer was considered as a viable option for this patient. We performed the gland transfer in two separate stages for the two eyes (1 year 5 months apart). The patient was evaluated for up to 2 years for the right eye and for 7 months for the left eye. Dry eye workup showed drastic improvement (right > left). Biochemical analysis showed gradual transition to resemble that of natural tears. This procedure can result in significant symptomatic improvement and can be a promising treatment option for cases of severe dry eye.

We present the case of an 87-year-old man with a ruptured right internal iliac artery aneurysm with hemoperitoneum. The right internal iliac artery aneurysm appeared to fill from the retrograde profunda femoris artery in the setting of a previously repaired abdominal aortic aneurysm with aorta-bi-iliac bypass with ligation of the bilateral internal iliac arteries. Abdominal computed tomography revealed an aneurysm of the right internal iliac artery measuring 8.9 cm, with filling through the collateral vessels. Open repair was performed, leading to complete exclusion of the aneurysm with no perioperative complications.

Introduction: Healthcare workers were the frontline defence against the COVID-19 pandemic, especially the junior resident doctors, and were among those at the highest risk of acquiring the disease. Disease transmission among them was worsened by overcrowding, lower work force, lack of isolation facilities, lack of standard quality personal protection equipment, contaminated environment and inadequate knowledge and practice of infection control practices. Objectives: To assess the knowledge, attitude and anxiety among junior resident doctors in India with respect to COVID-19 Methods: A cross-sectional study was conducted during August-October 2020 among 451 junior resident doctors in India. A validated 35-item questionnaire was distributed to the participants using social media platforms. The snowball sampling technique was used. Results: A total of 451 junior resident doctors were included as study participants, of whom 52.3% were women. More than 90% of them had a good level of knowledge regarding COVID-19.Almost allof the participants believed that wearing masks (98%) and keeping social distance (100%) would reduce the risk of COVID-19 transmission, but that government regulations were insufficient to combat the disease (63%). The level of anxiety among study participants was on the higher side. Conclusions & Recommendations: The level of anxiety among the junior resident doctors was relatively high. Therefore, mental and psychological support is crucial for them, and in turn, essential for effective management of the health crisis.