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The increased seismic activity observed in the Himalayas, coupled with the expanding urbanization of the surrounding areas in northern India, poses significant risks to both human lives and property. Developing an earthquake early warning system in the region could help in alleviating these risks, especially benefiting cities and towns in mountainous and foothill regions close to potential earthquake epicenters. To address this concern, the government and the science and engineering community collaborated to establish the Uttarakhand State Earthquake Early Warning System (UEEWS). The government of Uttarakhand successfully launched this full-fledged operational system to the public on 4 August 2021. The UEEWS includes an array of 170 accelerometers installed in the seismogenic areas of the Uttarakhand. Ground motion data from these sensors are transmitted to the central server through the dedicated private telecommunication network 24 hours a day, seven days a week. This system is designed to issue warnings for moderate to high-magnitude earthquakes via a mobile app freely available for smartphone users and by blowing sirens units installed in the buildings earmarked by the government. The UEEWS has successfully issued alerts for light earthquakes that have occurred in the instrumented region and warnings for moderate earthquakes that have triggered in the vicinity of the instrumented area. This paper provides an overview of the design of the UEEWS, details of instrumentation, adaptation of attributes and their relation to earthquake parameters, operational flow of the system, and information about dissemination of warnings to the public.

Background: Intense marketing of fast-food items impacts the eating habits among children and adolescents. Various studies suggest that increased screen time leads to increased fast-food consumption and decreased sleep duration, both of which are linked to obesity in growing age., Objectives: To assess screen time and dietary habits among the study group and to estimate their effect on sleep deprivation and obesity., Methods: This cross-sectional study was conducted from January 2019 to December 2019 in three schools in Amritsar selected by lottery method of simple random sampling. Out of 4,226 students, 355 overweight and obese students were interviewed regarding their dietary habits. An informed written assent was taken from the mothers. The information was collected on a semi-structured, pre-designed questionnaire by interviewing the mothers of students between 6 and 11 years of age and the students of 12-16 years., Results: 94.4% of students preferred fast foods to regular meals and 58.3% were in the habit of skipping breakfast. 59.4% had a history of daily intake of fast foods while 76.1% had a habit of consuming fast foods while watching television. Only 31.7% had an adequate sleeping pattern of 9-11 hours and 79.7% of the students had a screen time of over 3 hours., Conclusions: More the screen time, the more the chances of missing meals. Being awake for a long odd time leads to increased consumption of foods/snacks furthermore. Regarding the harmful effects of fast foods, the source of information was from schools, but only 41.4% were aware about these effects., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

The primary form of treatment for salivary gland cancer is surgical resection. Radiation therapy is used as adjuvant therapy in cases of aggressive tumours, currently patients with recurrent or metastatic cancer who are not suitable for surgery or radiation are most often treated with chemotherapy. PRISMA guidelines for systematic reviews were followed to evaluate salivary gland malignancies involving cytotoxic chemotherapy and biologic agents. An electronic literature search of Medline, PubMed, Scopus, etc. was performed and relevant articles were selected based on the inclusion criteria. Cytotoxic chemotherapies and biologic drugs such as anti HER - 2, anti-EGFR and anti-C-Kit are used to treat salivary gland cancer. Although most trials have respond poorly to standard chemotherapy with short durability and significant toxicity. Most of the research has focused on ACC and the use of combination therapy with cisplastin in conjunction with other treatments has been found to improve overall survival rate. Due to the limited patient population it was difficult to assess the efficacy of chemotherapy, which achieved very modest results. There are potential molecular targets such as HER2,NTRK and targeted treatments are becoming more popular. However to further explore potential treatment alternatives SGC patients should be enrolled in clinical trials., Competing Interests: Conflict of interestThere are no conflicts of interest., (© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

As the cases of COVID-19 have declined, the number of patients who have recovered from the dreaded disease is reporting for elective or emergency surgeries. Surgical planning in patients who have recovered from COVD-19 requires special considerations because of the morbidity and mortality associated with the infection and its devastating after-effects. There is a distinct paucity of literature on guidelines and protocols to follow in the perioperative management of these patients. With the help of experience gained over the past 2 years of the 'COVID-19 era', we have been able to establish important recommendations, guidelines and useful protocols during perioperative management of COVID-recovered patients. These protocols include important anesthetic and surgical considerations, which are both practical as well as implementable and are also in cognizance with government-laid down advisories. Although SARS-CoV-2 infection primarily affects the pulmonary and cardiac systems, it has the potential for serious and severely affect multiple organs and various other body systems in erratic and unpredictable manner. All of these factors can have significant implications that make the perioperative management of post-COVID-19 patients, difficult and challenging. Considering the far-reaching and long-lasting effects of this infection on the human body, the protocols and recommendations presented in this article can serve as a valuable guide for clinicians to effectively manage the surgical patient and help reduce perioperative complications attributable to COVID-19 infection., Competing Interests: Conflict of interestThere are no conflicts of interest., (© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Objectives: Tonic spinal cord stimulation (SCS) is accompanied by paresthesia in affected body regions. Comparatively, the absence of paresthesia with burst SCS suggests different involvement of the dorsal column system conveying afferent impulses from low-threshold mechanoreceptors. This study evaluated cortical activation changes during gentle brushing of a pain-free leg during four SCS pulse intensities to assess the effect of intensity on recruitment of dorsal column system fibers during burst and tonic SCS., Materials and Methods: Twenty patients using SCS (11 burst, nine tonic) for neuropathic leg pain participated. Brushing was administered to a pain-free area of the leg during four SCS intensities: therapeutic (100%), medium (66%), low (33%), and no stimulation. Whole-brain electroencephalography was continuously recorded. Changes in spectral power during brushing were evaluated using the event-related desynchronization (ERD) method in theta (4-7 Hz), alpha (8-13 Hz), and beta (16-24 Hz) frequency bands., Results: Brushing was accompanied by a suppression of cortical oscillations in the range 4-24 Hz. Stronger intensities of burst and tonic SCS led to less suppression of 4-7 Hz and 8-13 Hz bands in parietal electrodes, and in central electrodes in the 16-24 Hz band, with the strongest, statistically significant suppression at medium intensity. Tonic SCS showed a stronger reduction in 4-7 Hz oscillations over right sensorimotor electrodes, and over right frontal and left sensorimotor electrodes in the 8-13 Hz band, compared to burst SCS., Conclusions: Results suggest that burst and tonic SCS are mediated by both different and shared mechanisms. Attenuated brushing-related ERD with tonic SCS suggests a gating of cortical activation by afferent impulses in the dorsal column, whereas burst may engage different pathways. Diminished brushing-related ERD at medium and therapeutic intensities of burst and tonic SCS points towards a nonlinear effect of SCS on somatosensory processing., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Moebius Syndrome is a rare congenital neurological condition characterized by paralysis of several cranial nerves, commonly the VI(Abducens) and VII(Facial) cranial nerves which causes lateral gaze strabismus and internal strabismus & classical mask like appearance respectively. Other cranial nerves such as V, VII, IX, X, XI, XII are rarely affected. Von Graefe and German neurologist Moebius (1888), after whom the syndrome was eventually named, provided the earliest descriptions of it. Although the etiopathogenesis is unknown, it appears to occur sporadically in the majority of cases, and some documented cases show hereditary predisposition. This paper presents a rare instance of trigeminal neuralgia associated with Moebius syndrome. According to the author's research, this is the first case of Poland Moebius syndrome with trigeminal neuralgia documented from India., Competing Interests: Conflict of InterestThere are no conflicts of interest., (© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

The synthesis and characterization of two new Schiff base ligands containing 1,2,4-triazole moieties and their oxovanadium(IV) complexes have been reported. The ligands and their complexes were studied by ultraviolet-visible (UV-Vis), Fourier transform infrared (FTIR), proton nuclear magnetic resonance ( 1 H NMR), electron paramagnetic resonance (EPR), X-ray diffraction (XRD), conductivity measurement, cyclic voltammetry (CV), and elemental analyses. The molar conductance of oxovanadium(IV) complexes were found to be relatively low, depicting their non-electrolytic nature. The XRD patterns reveal the size of particles to be 47.53 nm and 26.28 nm for the two complexes in the monoclinic crystal system. The molecular structures, geometrical parameters, chemical reactivity, stability, and frontier molecular orbital pictures were determined by density functional theory (DFT) calculations. The theoretical vibrational frequencies and EPR g -factors (1.98) were found to correlate well with the experimental values. A distorted square pyramidal geometry with C 2 symmetry of the complexes has been proposed from experimental and theoretical results in a synergistic manner. The antimicrobial sensitivity of the ligands and their metal complexes assayed in vitro against four bacterial pathogens viz. Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Salmonella Typhi s howed that the oxovanadium(IV) complexes are slightly stronger antibacterial agents than their corresponding Schiff base precursors. The binding affinities obtained from the molecular docking calculations with the receptor proteins of bacterial strains (2EUG, 3UWZ, 4GVF, and 4JVD) showed that the Schiff bases and their oxovanadium(IV) complexes have considerable capacity inferring activeness for effective inhibition. The molecular dynamics simulation of a protein-ligand (4JVD-HL 2 ) complex with the best binding affinity of -12.8 kcal/mol for 100 ns showed acceptable stability of the docked pose and binding free energy of -15.17 ± 2.29 kcal/mol from molecular mechanics-generalized Born surface area (MM-GBSA) calculations indicated spontaneity of the reaction. The outcome of the research shows the complementary role of computational methods in material characterization and provides an interesting avenue to pursue for exploring new triazole based Schiff's bases and its vanadium compounds for better properties., Competing Interests: The authors declare no conflict of interest., (©2023PublishedbyElsevierLtd.)

There has been always a need of new methods to control post operative complications in OMFS. A randomized prospective study was done to assess the effect of K tape on postoperative swelling, pain, trismus in Zygomatico-maxillary Complex (ZMC) fracture after open reduction with internal fixation using two point fixation. 30 patients of either gender undergoing ORIF for ZMC fracture using two point fixation of age group between 18 and 50 years were included in the study. Patients were divided into treatment either with or without Kinesiologic tape. Tape was applied directly after surgery and maintained for at least 5 days postoperatively. Facial swelling was quantified using a five-line measurement at six specific points of time. Pain and degree of mouth opening was measured. Patient's subjective feeling was asked. The values were subjected to Fischer's exact test, Independent sample test, Mann whitney U test, Wilocoxon sign rank test. The results of this study show that application of Kinesiologic tape after zygomatico maxillary complex fracture surgery significantly reduced the incidence of swelling with an earlier resolution of swelling, and decreased the maximum turgidity for more than 60% during the first 2 days after surgery. Although, Kinesiologic tape has no significant influence on pain control but reduction in trismus in the Kinesiologic tape group compared to the non-Kinesiologic tape group. Furthermore, patients with Kinesiologic tape felt significantly lower morbidity than those without Kinesiologic tape. This study suggests that Kinesiologic tape is a promising, simple, less traumatic, economical approach, which is free from adverse reaction and improves patients quality of life., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Association of Otolaryngologists of India 2022.)

Mandible fractures are regularly encountered by maxillofacial surgeons and various treatment protocols are available for the management of these fractures. The aim of study compares the efficacy of open reduction and internal fixation of mandibular fractures with and without use of intra-operative inter-maxillary fixation. Twenty patients between age group ranging l8-65 years who reported with single mandibular fracture in Dental college in India, during Oct 2012-March 2015 were the study subjects. These patients were divided into two groups. In one group fracture reduction was done by using inter-maxillary fixation and miniplate fixation was done. In other group fracture reduction was done manually and then fractured fragments were held in position by the assistant and miniplate fixation was done. Post-operatively patients were evaluated for occlusion, bone alignment and soft tissue/hard tissue infection at 1st, 4th, 8th, 12th weeks in both the groups. Statistics done by using Spearman's Rank correlation coefficient and Mann-Whitney U test. It was observed thatthere was no statistically significant difference seen in both the groups in terms of post-operative occlusion, radiological alignment and soft/hard tissue infection. Statistically significant difference was seen when the mean operating time was compared. The Group A showed mean difference of 35.50 min more time than Group B. The results of our study suggested that, use of intra-operative IMF does not show any advantages in terms of post-operative occlusion, bone alignment and soft/hard tissue infection. We have concluded from the study that the increased intra-operative time for the placement of IMF increases the cost of the surgery in regard to equipment and theatre time. There is no benefit in terms of radiographic and clinical outcome. Hence use of intra-operative IMF can be avoided for ORIF of single mandibular fracture., Competing Interests: Conflict of interestThere are no conflicts of interest., (© Association of Otolaryngologists of India 2021.)

Background: Wireless percutaneous nerve stimulation (PNS) for chronic pain is rapidly evolving in the ever expanding neuromodulation paradigm. Safety and lower risks with a potential of long-term analgesia cannot be over emphasised especially with the ongoing opioid pandemic. PNS with an implanted pulse generator (IPG) has also been shown to provide good benefit, without often unpleasant widespread paraesthesia from conventional spinal cord stimulators., Aim and Methods: We retrospectively extracted data on all wireless PNS implants in our highly specialised pain neuromodulation centre since initiation of wireless PNS service in August 2019. Patient demographics, pain history, analgesic intake and details on implant follow-up data within 1 year post-implant including pain relief, EuroQol-5 Dimension (EQ-5D) and Patients' Global Impression of Change (PGIC) scores were extracted. The cases are presented in a narrative format., Result: A total of five patients were implanted with wireless (Stimwave ® ) PNS from August 2019 to February 2020. Neuropathic pain was the most common presenting diagnosis. All patients showed >50% pain relief at 3 months. EQ-5D and PGIC did not show any improvement in the subjects. Two of the patients managed to decrease their analgesics after implantation. Similar sustained benefits could not be demonstrated after 1 year., Discussion: PNS can provide analgesia in appropriately selected cases. Naivety of the technique and procedure might cause some degree of uncertainty. External pulse generator with wireless transmission avoids IPG and tunnelling related side effects, but requires individualised special wearable technology to power the lead. Minimally invasive nature of the technique might be attractive and preferable for patients with complex medical issues, nickel allergy and poor general health who may otherwise be unsuitable for Spinal Cord Stimulation (SCS) with conventional hardware. Robust prospective controlled studies and RCTs in future might provide further insights on utility in other neuropathic pain diagnosis, long-term outcomes and acceptability compared to conventional SCS., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

Background: Percutaneous cervical cordotomy (PCC) offers pain relief to patients with unilateral treatment-refractory cancer-related pain. There is insufficient evidence about any effects of this intervention on patients' quality of life., Method: Comprehensive multimodal assessment to determine how PCC affects pain, analgesic intake and quality of life of patients with medically refractory, unilateral cancer-related pain.This study was set in a multidisciplinary, tertiary cancer pain service. Patient outcomes immediately following PCC were prospectively recorded. Patients were also followed up at 4 weeks., Results: Outcome variables collected included: background and breakthrough pain numerical rating scores before PCC, at discharge and 4 weeks postprocedure; oral morphine equivalent opioid dose changes, Patient's Global Impression of Change, Eastern Cooperative oncology group performance status and health related quality of life score, that is, EuroQol-5 dimension-5 level (EQ-5D)., Conclusions: Despite significant improvement in pain and other standard outcomes sustained at 4 weeks, there was little evidence of improvement in EQ-5D scores. In patients with terminal cancer, improved pain levels following cordotomy for cancer-related pain does not appear to translate into improvements in overall quality of life as assessed with the generic EQ-5D measure., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)