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Background: Spinal anesthesia often causes more post-operative nausea and vomiting (PONV). Cesarean-section patients have a significantly more PONV rate. Therefore, evidence-based knowledge about PONV prevention and care for high-risk individuals is urgently needed to reduce the consequences. Aims and Objectives: The aim of the study was to compare the efficacy and safety of granisetron with that of ondansetron in the prevention of PONV in patients undergoing cesarean section under spinal anesthesia. Materials and Methods: A total of 86 pregnant women with American Society of Anesthesiologists grade I–II scheduled for cesarean delivery under spinal anesthesia were enrolled. Patients were divided into two equal groups (n=43): Ten minutes before spinal anesthesia, patients in group B (granisetron) received 2 mg granisetron intravenously diluted to 10 mL with normal saline, whereas patients in group A (ondansetron) received 4 mg ondansetron. Results: There was no significant difference between Groups A and B in terms of the number of vomiting episodes between 0 and 6 h. Group A had significantly more episodes of nausea after 2 h than Group B after 0–2 h. After 2–6 h, however, the nausea was similar in all groups. Of the patients in Group A, 4 (9.3%) required antiemetic medication, in Group B, it was 2 (4.7%). In Group A, 8 patients (18.6%) and 6 patients (14%) complained of headache and dizziness, respectively; in Group B, 3 patients (7.0%) and (0%), respectively. Dizziness was significantly more pronounced in Group A than in Group B. Conclusion: The results of the study show that granisetron (2 mg) was more effective than ondansetron (4 mg) in minimizing PONV episodes in women undergoing spinal anesthesia for cesarean section. There were no significant side effects and both drugs were comparatively safe.

Chickpea is considered a rich source of nutrients, especially protein and dietary fibre. Besides, chickpea has potential benefits for the maintenance of gut health by improving intestinal integrity and serving as a source of energy for the gut microbiota. Moreover, chickpea consumption has been found to possess anti-cancer, anti-inflammatory, and antioxidant activity. On undergoing certain treatments like soaking, dehulling, roasting, and germination, the anti-nutritional profile of chickpeas can be reduced. Observing these benefits, this review explores the impact of chickpea and its components on maintaining gut health, emphasizing various benefits. Besides, the paper comprehensively covers the nutritional composition of chickpeas and factors influencing the bioavailability of its components concerning gut health. Additionally, it outlines the mechanisms through which chickpeas influence gastrointestinal health, providing valuable insights into complex processes and potential therapeutic applications. Furthermore, the review identifies contributions that can guide future research, encouraging further exploration of chickpeas' role in gut health and the development of interventions. As a result of the presented review, chickpeas can be used as an affordable source of food, which is nutritionally stable and prevents gastrointestinal diseases.

Abstract The economic repercussions of waiting for lumbar disc surgery have not been well studied. The primary goal of this study was to perform a cost-consequence analysis of patients receiving early vs late surgery for symptomatic disc herniation from a societal perspective. Secondarily, we compared patient factors and patient-reported outcomes. This is a retrospective analysis of prospectively collected data from the CSORN registry. A cost-consequence analysis was performed where direct and indirect costs were compared, and different outcomes were listed separately. Comparisons were made on an observational cohort of patients receiving surgery less than 60 days after consent (short wait) or 60 days or more after consent (long wait). This study included 493 patients with surgery between January 2015 and October 2021 with 272 patients (55.2%) in the short wait group and 221 patients (44.8%) classified as long wait. There was no difference in proportions of patients who returned to work at 3 and 12-months. Time from surgery to return to work was similar between both groups (34.0 vs 34.9 days, p = 0.804). Time from consent to return to work was longer in the longer wait group corresponding to an additional $11,753.10 mean indirect cost per patient. The short wait group showed increased healthcare usage at 3 months with more emergency department visits (52.6% vs 25.0%, p

Abstract Groundwater is an important source for drinking water supply in hard rock terrain of Bundelkhand massif particularly in District Mahoba, Uttar Pradesh, India. An attempt has been made in this work to understand the suitability of groundwater for human consumption. The parameters like pH, electrical conductivity, total dissolved solids, alkalinity, total hardness, calcium, magnesium, sodium, potassium, bicarbonate, sulfate, chloride, fluoride, nitrate, copper, manganese, silver, zinc, iron and nickel were analysed to estimate the groundwater quality. The water quality index (WQI) has been applied to categorize the water quality viz: excellent, good, poor, etc. which is quite useful to infer the quality of water to the people and policy makers in the concerned area. The WQI in the study area ranges from 4.75 to 115.93. The overall WQI in the study area indicates that the groundwater is safe and potable except few localized pockets in Charkhari and Jaitpur Blocks. The Hill-Piper Trilinear diagram reveals that the groundwater of the study area falls under Na+-Cl−, mixed Ca2+-Mg2+-Cl− and Ca2+- $${\text{HCO}}_{3}^{ - }$$ HCO 3 - types. The granite-gneiss contains orthoclase feldspar and biotite minerals which after weathering yields bicarbonate and chloride rich groundwater. The correlation matrix has been created and analysed to observe their significant impetus on the assessment of groundwater quality. The current study suggests that the groundwater of the area under deteriorated water quality needs treatment before consumption and also to be protected from the perils of geogenic/anthropogenic contamination.

Background: Ever since the World Health Organization (WHO) announced the SARS-CoV-2 or nCOVID-19 infection (a pandemic), continuous spread of the virus has been observed which has continuously seen to affect and kill multitudes of individuals all over the world. An understanding of the pathophysiology of this disease is necessary for an effective treatment. Laboratory investigations play an important role in the diagnosis as well as treatment of this infectious disease. Hematological parameters demonstrate alterations during the progression of nCOVID-19 infection. Of these, many are indicative of extremely poor clinical outcome. Hematological findings like leukopenia, lymphopenia, thrombocytopenia and coagulation-related abnormalities are the most common manifestations. The aim of this study was to assess the dynamic profile and clinical implications of hematological and immunological parameters among nCOVID-19 infections. Materials and Methods: This retrospective study was designed after categorizing patients suffering from COVID-19 into three groups: (a) Group I; (b) Group II and (c) Group III or severe critical patients. Hematological and immunological parameters of neutrophilic and white blood cell counts, d-dimer levels, hemoglobin levels, immunoglobulin G (IgG) and M (IgM) levels and interleukin-6 (IL-6) levels were assessed. Statistical analysis using Kruskal–Wallis test was used. Results: Normal white blood cell and neutrophil count among COVID-19 patients was seen. However, median values in Group II (P < 0.01) and Group III (P < 0.0001) were found to show significantly higher values when compared to Group I. A significant (P < 0.01) decrease in lymphocytic counts was found among severe and critical patients. Hemoglobin level was found to demonstrate higher decrease (P < 0.01) among severe and critical patients. Platelet count was found in normal range in all COVID-19 patients. Routine coagulation tests revealed increased fibrinogen (P < 0.01) and d-dimer levels (P < 0.0001) in severe and critical patients. Normal proportions of total CD3+ and CD4 + T lymphocytes were observed in COVID-19. However, CD8 + T lymphocytes proportion was found to be decreased (P-value < 0.05). Immunoglobulin G levels among Groups II and III patients were found to be lower when compared with Group I (P < 0.001). No statistical significance was observed between the groups in IgM levels. Plasma IL-6 levels were found to show progressive rise among Groups II and III patients (P < 0.05). Conclusion: Analysis of hematological and immunological parameters profiles in COVID-19 patients may help in deciphering the clinical progression of patients suffering from COVID-19 disease. Thus, regular monitoring of the hospitalized patients may help in planning the management of these cases.

Migration of people from one geographical location to another, within or outside a country, has a major role to play in the socio-economic development across the globe. "Migrants" and "immigrants" that showcase entrepreneurial traits and are valued in both home and host countries. Transnational entrepreneurs are often studied in various cross-national entrepreneurial research streams, like international entrepreneurship, immigrant entrepreneurship, thus causing ambiguity in the existing definitions. This paper contributes a specific definition of "transnational entrepreneurship", based on secondary research, which takes into account different mobility types. It emphasizes the importance of this construct for developing transnational entrepreneurial typologies. The authors propose a "framework of transnational entrepreneurship" in the paper.

Aim: The present study aimed at analysing the probable effects of full mouth oral rehabilitation on bite forces at their maximum extent in young paediatric patients with primary as well as mixed dentitions. Methodology: The present study is one of a kind and explores the maximum bite forces in young children. A statistically significant number of children (n = 30) with a mean age of 6.54 years. About 44.75% were boys and 55.25% were girls. The maximum voluntary bite force was assessed for each participant immediately before treatment and 1 month (3–5 weeks) following completion of the needful dental treatment. The difference in bite force magnitude before and after dental treatment was analysed statistically. In addition, the correlations of key variables including, age, height, weight, BMI, gender and caries severity or dental status with maximum bite force were statistically analysed. Results: The mean maximum bite force for the total sample (n = 30) prior to treatment was found to be 167.83 N (SD = 65.20). The mean bite force in the male subgroup was 175.39 N (SD = 64.69) while for the females the mean bite force was equal to 166.29 N (SD = 68.93). Following comprehensive dental treatment, the recorded mean maximum bite force for the children (n = 30) who attended the post-treatment review appointment was 182.60 N (SD = 68.58). Conclusion: The essential factors such as the extent of dental caries, their severity, presence of clinical signs and symptoms has a negative impact on maximum bite force.

Background and Aims: Host immune response is altered by a series of physiologic and pathologic factors like age, gender, inflammation, surgery, medication etc., The present study was conducted to evaluate differences in salivary IgA (S-IgA) levels among pedodontic subjects undergoing active orthodontic treatment with fixed and removable appliance. The levels of S- IgA were determined before 3 months and 6 months post active orthodontic treatment. Methods: A total of 40 healthy pedodontic subjects (aged 8-15 years) were recruited in the present study. They were equally divided into Group A (fixed orthodontic group) and Group B (removable orthodontic group) with 20 subjects each. 1.5 mL of saliva per subject was obtained before 3 and 6 months after treatment. Enzyme Linked Immunosorbent Assay (ELISA) technique was used for measurement of Salivary IgA levels. Results: Group A and B both showed significant rise in S-IgA levels 3 months and 6 months post active orthodontic treatment. Mean value of S-IgA 3 months post treatment in the saliva of children in group B and group A were (144.27 ± 5.32) and (164.0 ± 3.23) μg/ml respectively. While mean value of S-IgA after 6 months of treatment in group B and group A were (149.8 ± 6.02) and (166.4 ± 3.65) μg/ml respectively. Conclusion: Salivary Immunoglobulin A level values were significantly higher statistically in both group A and group B post active orthodontic treatment than before. The results however, showed that Group A (fixed orthodontic group) showed statistically significant higher levels of S-IgA than Group B (removable orthodontic group). Active orthodontic treatment triggered a stronger stimulus for oral secretory immunity, hence the increase in levels were detected. There is a significant positive correlation between S-IgA and active fixed as well as removable orthodontic treatment. Orthodontic treatment is hence a local immunogenic factor.

Introduction: Mandibular angle fracture is common in road traffic accidents. This study was conducted to compare 3D miniplate system with 2D plates for treatment of mandibular angle fractures. Materials and Methods: The study was conducted on 120 patients with mandibular angle fracture of both genders. After selecting patients, patients were divided into 2 groups of 60 each. In group I, patients were treated with 3D, 2.0-mm titanium plates, and in group II, patients were treated with 2D, 2.0-mm titanium miniplate in mandibular angle fracture. Patients were evaluated regularly after 1, 3, and 6 months for outcome of treatment. Results: In group I, males were 22 and females were 38. In group II, males were 40 and females were 20. Right angle fracture was seen in 32 patients in group I and 26 in group II. Left angle fracture was seen in 24 in group I and 28 in group II. Right angle and left parasymphysis fracture was seen in 3 in group I and 4 in group II. Left angle and right parasymphysis fracture was seen in 1 in group I and 2 in group II. [Table 3], [Graph 1] shows that in group I, after 1 month sensory deficit was present in 5 patients and in group II in 12 patients. After 3 months, there were no patients with sensory deficit in group I and 2 in group II. Preoperatively in group I, mouth opening was 24 mm and in group II patients was 25.80 mm, which increased to 31.20 mm in group I and 28.20 mm in group II at 1 month, 32 mm in group I and 30 mm in group II at 3 months, and 37.20 and 32.12 mm in groups I and II, respectively, at 6 months. The difference was significant (P < 0.05). Conclusion: 3D miniplate system is reliable and effective treatment modality for mandibular angle fractures as compared with traditional 2D miniplates.[INLINE:1]

Background and Aims: Fine Needle aspiration cytology has emerged as an essential pre-biopsy investigation to rule out or confirm malignancy in superficial as well as deep seated lesions. Radiological assistance has proved to be a blessing for obtaining adequate samples. With unwavering leading position of lung cancer in terms of incidence and mortality, it has become necessary to study the trends of our population and assess the usefulness of techniques aiding in early diagnosis. The objective is to obtain prevalence of lung cancer and utility of various methods in obtaining cytological material for assessment in intrathoracic lesions. Material and Methods: We conducted an observational analytic study at a tertiary care teaching hospital over a period of 3.5 years including a total of 307 patients with suspected lung malignancy. Samples were collected using image guided techniques including Fibre-optic bronchoscopy (FOB), Ultra-sonography (USG) and Computed tomography (CT). The smears were processed as per standard institutional protocol and were evaluated by a senior pathologist. Results: Squamous cell carcinoma was the most frequent type of Primary lung malignancy, followed by adenocarcinoma. The malignancies were more common in males and in age group of 61 to 70 years. Conclusion: Respiratory cytology remains the initial mode of investigation in intra-thoracic malignancies. The high sensitivity, low-cost and rapidity of the results works its advantages for both the patient and the clinician. High cellular yield obtained with the use of trans-bronchial needle aspiration and bronchial brushing rationalizes their use as a screening test to establish both malignant as well as non-malignant diagnoses. Further improvement in utilization of the available modalities and addition of ancillary testing can reduce the need of invasive procedures.

Aim: Single- and multiple-visit root canal treatment has been the subject of long-standing debate in the endodontic community, so the purpose of this study was to determine the incidence of postoperative flare-up after single- and multiple-visit endodontic therapy in permanent teeth. Materials and Methods: A total of 65 children aged >10 years who underwent root canal treatment were randomly categorized equally into two treatment groups: the first group underwent single-visit treatment, and the other group underwent multiple-visit therapy. The visual analog scale was employed to evaluate pain preoperatively and postoperatively after obturation. Recall visits were carried out after 1 week, 1 and 3, 6 and 9 months. The Statistical Package for the Social Sciences version 15.0 was employed for statistical analysis. Results: Except at the baseline, at all the other time intervals, the mean pain score in the multiple-visit group was higher as compared to that of the single-visit group; statistically no significant difference was found. Conclusion: The mean pain score in the single-visit group was lower as compared to that of the multiple-visit group; however, the difference between the two groups was statistically significant (P > 0.05).

Background: Patient's satisfaction is of utmost importance to the dental professionals among all those who have undergone prosthodontic rehabilitation.The success of every dental prosthesis lies in the patient wearing those removable prostheses thereby restoring masticatory function and Phonatics, hence the aim of the present study is to determine various factors affecting the patient satisfaction among patients undergone removable Prosthodontic rehabilitation. Materials and Methods: The present study is a cross-sectional questionnaire descriptive study. The study is conducted among 183 patients undergone removable Prosthodontic rehabilitation and visiting private dental clinics for follow-up. The study was conducted in October to December 2019. The study was conducted among patients age between 21 and 60 years of age wearing removable prosthesis. Results: Among all study participants, majority of study participants were moderately satisfied with the Retention {79 (43.16%)}, Esthetics {87 (47.54%)}, Mastication {68 (37.15%)}, Finish of the denture {89 (48.63%)}, and Overall satisfaction for maxillary and mandibular dentures {93 (50.81%)}. Patient's behavior was significantly associated with overall patient satisfaction (P = 0.00*). Conclusion: Factors affecting any parameter of patient satisfaction was age, Gender, Smoking habits, duration of wearing prosthesis, no. of removal prosthesis used, number of times denture was repaired, patient behavior was significantly associated with overall patient satisfaction.

Aim: The aim of this study was to evaluate effectiveness of bethanechol and pilocarpine among xerostomic denture wearers. Materials and Methods: This in vitro study was conducted in 60 complete denture wearers of both genders. For assessment of salivary flow, resting saliva and stimulated saliva were collected. Patients were split into two groups consisting of 30 patients each. Pilocarpine was given to patients in group I and patients in group II received bethanechol. Salivary flow was measured at baseline, after 2 weeks, and after 4 weeks. Results: The mean whole resting saliva in patients of group I was 0.61 mg/mL and in that of group II was 0.65 mg/mL. The mean whole stimulated saliva in patients of group I was 1.35 mg/mL and in group II it was 1.51 mg/mL. The mean whole resting saliva after 2 weeks in patients of group I was 0.83 mg/mL and in group II was 0.92 mg/mL. Whole stimulated saliva in patients of group I was 1.67 mg/mL, and in patients of group II it was 1.86 mg/mL. The difference noted was significant (P < 0.05). The mean whole resting saliva after 4 weeks in patients of group I was 1.23 mg/mL and in that of group II was 1.43 mg/mL. Whole stimulated saliva in patients of group I was 1.98 mg/mL and in patients of group II it was 2.04 mg/mL. Conclusion: Authors found that both agents were effective in increasing salivary secretions. However, pilocarpine is a more effective sialagogue as compared to bethanechol in completely edentulous patients with xerostomia.

The world, as we are experiencing it, is in transition because of the COVID-19 pandemic. The crisis has engulfed every aspect of life forcing a re-evaluation of policies, priorities and practices. This viewpoint proposes that community embedded values inherent in some Education for Sustainable Development (ESD) practices could be used in the rebuilding of a post-COVID world. It contends that mere digitalisation of content will not suffice. We need to adopt an approach that considers situated and intergenerational thought and practice. We need to create a world that draws on indigenous knowledge practices and fuses these with the wonders of modern technology and multi-stakeholder interactions. Examples of community projects in Africa and India are used to point to how ESD practitioners could innovate and radically reorient learning environments.

Trampolines are widely used by children, but trampoline injuries can be severe and may require hospital care or even surgery. This pilot study examined the effectiveness of an educational intervention on caregivers' perceptions of trampoline use and safety for their children.Primary caregivers were recruited from the orthopedic clinic at the Children's Hospital at our institution in 2015. Caregivers were asked to complete a survey at two time points, initially in clinic and one week post educational intervention. The educational intervention was a pamphlet outlining trampoline safety data. Data analysis occurred in 2016.From the 100 primary caregivers recruited, 39 caregivers owned a trampoline, and 10 had presented to the emergency department with their child for an injury related to trampoline use. After educational intervention, caregivers had higher rating of perceived danger associated with trampolines (6/10 vs. 8/10, p

Teratogens are compounds that can induce birth defects upon exposure of the developing fetus. To date, most teratogen studies utilize pregnant rodents to determine compound teratogenicity in vivo. However, this is a low throughput approach that cannot easily meet the need for comprehensive high-volume teratogen assessment, a goal of the US Environmental Protection Agency. In addition, rodent and human development differ substantially, and therefore the use of assays using relevant human cells has utility. For these reasons, interest has recently focused on the use of human embryonic stem cells for teratogen assessment. Here we present a highly standardized and quantitative system for the detection and analysis of teratogens that utilizes well-characterized and purified highly pluripotent stem cells. We have devised strategies to mass-produce thousands of uniformly sized spheroids of human ESCs (hESCs) that can be caused to undergo synchronous differentiation to yield embryoid bodies (EBs) in the presence and absence of suspected teratogens. The system uses all human cells and rigorously controlled and standardized EB culture conditions. Furthermore, the approach has been made quantitative by using high-content imaging approaches. Our system offers distinct advantages over earlier EB systems that rely heavily on the use on mouse ESCs and EB aggregates of stochastic sizes. Together, our results show that thousands of suspected teratogens could be assessed using human EB-based approaches.

In the present study, full length sequencing of NS gene was done in 91 samples which were obtained from patients over the time period of five years from 2009 to 2013. The sequencing of NS gene was undertaken in order to determine the changes/mutations taking place in the NS gene of A H1N1 pdm (09) since its emergence in 2009. Analysis has shown that the majority of samples belong to New York (G1 type) strain with valine at position 123. Effector domain of NS1 protein displays the appearance of three mutations L90I, I123V, and N205S in almost all the samples from 2010 onwards. Phylogenetic analysis of available NS1 sequences from India has grouped all the sequences into four clusters with mean genetic distance ranging from 12% to 24% between the clusters. Variability in length of NS1 protein was seen in sequences from these clusters, 230-amino-acid-residue NS1 for all strains from year 2007 to 2008 and for 21 strains from year 2009 and 219-residue products for 37 strains from year 2009 and all strains from year 2010 to 2013. Mutations like K62R, K131Q, L147R, and A202P were observed for the first time in NS1 protein and their function remains to be determined.

Topoisomerase I (TOP I) is a valuable molecular target for the development of clinically used anticancer agents. Indenoisoquinolines have emerged as potent topoisomerase I inhibitors. So, with an aim to elucidate the important features responsible for their activity, QSAR studies on breast cancer cell line using stepwise multiple linear regressions, partial least square, and neural network were performed. The MLR and PLS models showed good correlation values of , and , respectively. The model revealed the importance of steric arrangement of functional groups and number of H bond acceptors. In addition to MLR and PLS, neural network architecture was also constructed using selected descriptors and the inhibitory activities in order to evaluate the mode of dependencies of biological activity on obtained descriptors.