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Purpose: This study evaluates the recent trends in ocular morbidities and vision-related practices in “out-of-school” children in urban slums of Gurugram in North India. Methods: In this observational study, a validated questionnaire was administered to 161 students from two nonformal slum schools. Sociocultural, demographic data, vision-related practices, and visual acuity with subjective refraction of the children were recorded. Results: A total of 80 boys and 81 girls (9.17 ± 2.58 years) participated in this study. About 40% of the children were from lower socioeconomic status. The visual acuity recorded for all the children, except three children, was 6/6 in both eyes. One child had a pre-phthisical eye with no light perception, following a childhood trauma, with the other eye having 6/6 vision. Two children had refractive errors (myopia and compound myopic astigmatism), with a best corrected visual acuity (BCVA) of 6/6. Thirteen children (8%) had Bitot’s spots and 67 (35.4%) had allergic conjunctivitis. Eight (5%) children complained of dry eye–related symptoms like redness and watering of eyes, while 19 (11.8%) had diffuse headache. Average number of years spent in school for these children was less than 1.7 years (range: 1 month–6 years). Only 10.5% of the children gave the history of watching television more than 30 h/week. Significant association was found between the income of father and use of digital devices in children below 10 years (P = 0.003) and children playing outdoors (P = 0.001). There was a significant association noted for age and use of digital devices (P = 0.037). Conclusion: The prevalence of refractive errors in “out-of-school” children of urban slum was much less than the national average. Almost one in three children suffered from eye allergies, while 8% children had Bitot’s spots. The data about the prevalence of ocular comorbidities in underserved areas like urban slums can be used to update and strategize eye health-care delivery models for out-of-school children.

Refractive errors, particularly myopia, are among the most prevalent visual impairments globally, with rising incidence in children and adolescents. This review explores the epidemiology and risk factors associated with the development of refractive errors, focusing on the environmental and lifestyle factors contributing to the current surge in myopia. We provide an overview of key genetic factors and molecular pathways driving the pathogenesis of myopia and other refractive errors, emphasizing the complex interplay between genetic predisposition and environmental triggers. Understanding the underlying mechanisms is crucial for identifying new strategies for intervention. We discuss current approaches to slow myopia progression in pediatric populations, including pharmacological treatment regimens (low-dose atropine), optical interventions, and lifestyle modifications. In addition to established therapies, we highlight emerging innovations, including new pharmacological agents and advanced optical devices, and insights into potential future treatments. Cutting-edge research into gene therapy, molecular inhibitors, and neuroprotective strategies may yield novel therapeutic targets that address the root causes of refractive errors. This comprehensive review underscores the importance of early intervention and highlights promising avenues for future research, aiming to provide pediatricians with guidance to ultimately improve clinical outcomes in managing and preventing myopia progression in children and young adults.

Purpose: To evaluate the cases of retinal artery occlusion (RAO) and retinal vein occlusion (RVO) after severe acute respiratory syndrome coronavirus (SARS-CoV-2) disease 2019 vaccination. Design: Retrospective study of the cases reported to the Centers for Disease Control and Prevention Vaccine Adverse Events Reporting System between December 11, 2020 and July 1, 2022. Participants: Patients diagnosed with RVO after vaccination with BNT162b2, mRNA-1273, and Ad26.COV2.S, globally. Methods: We performed a descriptive analysis of the demographics and presentation in patients with RVO. The correlations between the vaccines and continuous and categorical variables were assessed. We performed the post hoc analysis to evaluate the association between RAO, RVO onset postvaccination, and vaccine and dosage. A 30-day reverse Kaplan-Meier analysis was conducted for RAO and RVO onset after vaccination. Main Outcome Measures: The crude reporting rate of RVO after SARS-CoV-2 vaccine. The ocular and systemic presentations, onset duration, and short-term risk of RAO and RVO after vaccination. Results: One thousand three hundred and fifty-one RVO cases were reported globally. The crude reporting rates for BNT162b2, mRNA-1273, and Ad26.COV2.S were 0.36, 0.41, and 0.69, respectively. The majority of the cases were reported after BNT162b2 (n = 606, 74.17%). The mean age of patients with RVO and RAO was 58.54 ± 16.06 years and 64.63 ± 16.16 years, respectively. Most cases of RVO (41.12%) and RAO (48.27%) were reported within the first week. The mean onset interval for RVO was significantly longer in patients who received Ad26.Cov2.S (54.07 ± 88.98 days) compared with BNT162b2 (18.07 ± 28.66 days) and mRNA-1273 (22.85 ± 38.13 days) vaccines (P < 0.0001). This was confirmed by post hoc analysis (P < 0.0001). The reverse Kaplan-Meier 30-day risk analysis showed a significant a higher risk of RVO onset after BNT162b2 compared with other vaccines (P < 0.0001). Conclusions: The low crude reporting rate highlights a low safety concern for RVO after SARS-CoV-2 vaccination. This study provides insights into possible temporal association between reported RVO events with SARS-CoV-2 vaccines; however, further insights are needed to understand the underlying immunopathologic mechanisms that promote thrombosis of retinal vasculature on vaccine administration. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Background: Manifestation of epithelial-to-mesenchymal transition (EMT) program in tumor cells is associated with the occurrence of multiple intermediate phenotypic states namely epithelial (E), mesenchymal (M) and hybrid E/M across the epithelial-mesenchymal spectrum and these states exhibit different invasive properties. Understanding the cellular and molecular mechanisms defining the E/M hybrid state of the cells during bladder tumor development may significantly aid in the identification of novel diagnostic and prognostic markers. Materials and methods: The present study is taken up to identify hybrid E/M score based on the immunohistochemical localization and surface expressions of epithelial proteins [E-cadherin and Beta-catenin] and mesenchymal marker proteins [N-cadherin and Vimentin] on formalin fixed paraffin embedded tumor sections of the prospective series of 99 non-muscle invasive bladder cancer (NMIBC) and 87 muscle invasive bladder cancer (MIBC) patients. E/M score was then statistically examined with patients’ demographics to assess its potential in the diagnosis and prognosis of UCB patients. Results: Among the E (E-cadherinhigh, β-cateninhigh), hybrid E/M (E-cadherinlow, β-cateninlow, N- cadherinhigh and Vimentinhigh) and M (N-cadherinhigh and Vimentinhigh) phenotypes, E/M phenotype was observed to be more prevalent in MIBC compared to E phenotype in NMIBC subtype. The current study reports the statistical association of tumor stage and tumor grade with the hybrid E/M state of urothelial tumor cells across both the subtypes. Hybrid E/M phenotype in MIBC patients was significantly shown to lower the overall survival time period compared to NMIBC patients. This supports the contribution of hybrid E/M state of tumor cells to the.aggressiveness of the disease. Conclusions: Characterizing the hybrid E/M state instead of all or none phenotype becomes an imperative to understand the dynamics of EMT and MET in the tumor pathophysiology of NMIBC and MIBC subtypes, and could contribute to better patient stratification and therapeutic strategies.

Introduction: Penile cancer is a rare malignancy of the genitourinary tract. We aimed to validate the recent changes in the T2 and T3 stages of penile cancer in the American Joint Committee on Cancer (AJCC) 8th edition and to compare its predictive ability with two other modified staging systems for survival outcomes. Methods: This is a retrospective study of patients diagnosed with penile cancer from June 2015 to March 2020. The AJCC 8th edition and two other newly proposed systems by Li et al. and Sali et al. were used for staging the tumor. All variables were categorized and correlated with lymph node (LN) metastases and overall survival (OS). Results: Fifty-four patients were eligible for this study. The mean age was 58 years (range 46–72 years). The tumor stage (P = 0.016), clinical LN stage (P = 0.001), the involvement of the spongiosa (P = 0.015) and the cavernosa (P = 0.002), lymphovascular invasion (LVI) (P = 0.000), and PNI (P = 0.021) were found to be the significant predictors of LN metastases. When the 5 year OS was compared between the T2 and T3 stages of the AJCC 8th edition, Li staging and the Sali staging systems, it was 91% and 50.1% (P = 0.001), 97.5% and 10.3% (P = 0.000), 94.4% and 14.7% (P = 0.000), respectively. The presence of LVI (P = 0.001) was the most significant independent predictor of OS. Conclusions: The recent changes in the AJCC 8th edition pertaining to the T2-T3 stage are relevant, although the other two newly proposed staging systems were more precise in predicting the survival outcomes.

A tumor is carried on by rapid and uncontrolled cell growth in the brain. If it is not treated in the initial phases, it could prove fatal. Despite numerous significant efforts and encouraging outcomes, accurate segmentation and classification continue to be a challenge. Detection of brain tumors is significantly complicated by the distinctions in tumor position, structure, and proportions. The main disinterest of this study stays to offer investigators, comprehensive literature on Magnetic Resonance (MR) imaging’s ability to identify brain tumors. Using computational intelligence and statistical image processing techniques, this research paper proposed several ways to detect brain cancer and tumors. This study also shows an assessment matrix for a specific system using particular systems and dataset types. This paper also explains the morphology of brain tumors, accessible data sets, augmentation methods, component extraction, and categorization among Deep Learning (DL), Transfer Learning (TL), and Machine Learning (ML) models. Finally, our study compiles all relevant material for the identification of understanding tumors, including their benefits, drawbacks, advancements, and upcoming trends.

Background: YouTube is a popular social media platform accessed by people to obtain relevant health and disease-related information. The purpose of this study was to evaluate YouTube videos as a source of information on amblyopia. Material and Methods: In this prospective, cross-sectional study a YouTube search was conducted using three keywords, 'Lazy eye', 'amblyopia' and 'Lazy eye treatment' on 26th January, 2022. Video quality assessment was done using Modified DISCERN (mDISCERN), Global Quality Score and the Health on the Net Foundation Code of Conduct (HONcode) scale. Video content was analysed as a health professional and non-health professional, video length, release date, daily view count and Video Power Index. The relationship between the groups and video quality was evaluated. Results: Of the 300 initial videos investigated for the study, 219 videos met the inclusion criteria and were subjected to statistical analysis. Nearly 50% of videos contained content related to medical education. More than half of the videos analysed (130; 59.36%) were uploaded by healthcare professionals (HCPs). The mDISCERN mean ± SD score for the videos was 2.65 ± 1.24, for the Journal of the American Medical Association (JAMA) scoring was 2.37 ± 1.02 and for the HONcode was 3.72 ± 1.75. All scoring systems were better for HCPs as compared with non-healthcare professionals (NHCPs). Conclusion: A wide variety of information about amblyopia is available on YouTube™. Videos uploaded by NHCP had suboptimal flow as well as information of limited use to patients.

The morphological plasticity of plant roots is a key factor in their ability to tolerate a wide range of edaphic stresses. There are many unanswered questions relating to nanotechnology and its potential uses for sustainable agriculture. The main purpose of this study was to examine the effects of salinity-induced morphogenic responses and zinc oxide nanoparticles (ZnO-NPs) on root characteristics, growth, MDA content, antioxidant enzymatic activity, and root ion accumulation in rice (Oryza sativa L.). The experiment was conducted in a hydroponic culture containing 50 mg/L of ZnO-NPs and different concentrations (60, 80, and 100 mM) of NaCl for 14 days. The results indicated a decrease in rice root growth due to exposure to salinity (length, fresh, and root dry weight). The results showed that salinity caused a reduction in rice root growth (length, fresh, and root dry weight). Higher root sodium (Na+) accumulation, MDA content, and potassium level decreased with increasing salinity. Root length, root fresh weight, root dry weight, root K+ content, and root antioxidant enzymatic activity were all enhanced by applying 50 mg/L ZnO-NPs often in salinity. SEM analysis revealed that ZnO-NPs treatments significantly improved root morphology. There was a notable decrease in root Na+ content as a result, which improved the K+/Na+ ratio in the rice’s root system. These findings suggest that O. sativa, when treated with ZnO-NPs, can thrive under salt-stress conditions, opening up the possibility of cultivating the plant in extreme climates.

Artificial intelligence (AI) has emerged as a transformative tool in the field of ophthalmology, revolutionizing disease diagnosis and management. This paper provides a comprehensive overview of AI applications in various retinal diseases, highlighting its potential to enhance screening efficiency, facilitate early diagnosis, and improve patient outcomes. Herein, we elucidate the fundamental concepts of AI, including machine learning (ML) and deep learning (DL), and their application in ophthalmology, underscoring the significance of AI-driven solutions in addressing the complexity and variability of retinal diseases. Furthermore, we delve into the specific applications of AI in retinal diseases such as diabetic retinopathy (DR), age-related macular degeneration (AMD), Macular Neovascularization, retinopathy of prematurity (ROP), retinal vein occlusion (RVO), hypertensive retinopathy (HR), Retinitis Pigmentosa, Stargardt disease, best vitelliform macular dystrophy, and sickle cell retinopathy. We focus on the current landscape of AI technologies, including various AI models, their performance metrics, and clinical implications. Furthermore, we aim to address challenges and pitfalls associated with the integration of AI in clinical practice, including the “black box phenomenon”, biases in data representation, and limitations in comprehensive patient assessment. In conclusion, this review emphasizes the collaborative role of AI alongside healthcare professionals, advocating for a synergistic approach to healthcare delivery. It highlights the importance of leveraging AI to augment, rather than replace, human expertise, thereby maximizing its potential to revolutionize healthcare delivery, mitigate healthcare disparities, and improve patient outcomes in the evolving landscape of medicine.

Percutaneous drains are commonly used to drain collections in surgical patients. The choice of drain can determine the potential complications. Herein, the authors presented a case of a 32- year-old female with a drain complication and its management in a posttransplant patient. The patient developed a post-transplant perigraft lymphocele and underwent drainage using Malecot’s catheter. However, during the removal of drain, the Malecot catheter accidentally broke, leaving the tip inside the perigraft region. To locate the tip, a non-contrast Computed Tomography (CT) scan was performed. Subsequently, the patient underwent a transperitoneal reexploration, successfully removing the tip. It was discovered that the catheter tip had ingrown tissue between the prongs, impeding its removal. It is crucial to exercise caution in such situations as Malecot catheters may sometimes have ingrown tissue between the prongs, hindering their removal.

The reliability of using abrupt changes in the spatial Hurst exponent for identifying temporal points of abrupt change in climate dynamics is explored. If a spatio-temporal dynamical system undergoes an abrupt change at a particular time, the time series of spatial Hurst exponent obtained from the data of any variable of the system should also show an abrupt change at that time. As expected, spatial Hurst exponents for each of the two variables of a model spatio-temporal system – a globally coupled map lattice based on the Burgers' chaotic map – showed abrupt change at the same time that a parameter of the system was changed. This method was applied for the identification of change points in climate dynamics using the NCEP/NCAR data on air temperature, pressure and relative humidity variables. Different abrupt change points in spatial Hurst exponents were detected for the data of these different variables. That suggests, for a dynamical system, change point detected using the two-dimensional detrended fluctuation analysis method on a single variable alone is insufficient to comment about the abrupt change in the system dynamics and should be based on multiple variables of the dynamical system. HIGHLIGHTS In a non-linear dynamical system, the spatio-temporal images of one variable also contain information about the interaction of this variable with other coupled variables of the system.; When a parameter of the dynamical system changes abruptly, the spatial distribution of all the coupled variables should show an abrupt change simultaneously.; It is found that the 2D-DFA method successfully detected abrupt change points in each variable of GCML based on Burgers' chaotic map at the same time as a system parameter was changed.; The 2D-DFA method detected different abrupt change points in the time series of the spatial Hurst for the NCEP/NCAR data of three different variables.; This study suggests, for a dynamical system, change point detected using 2D-DFA method on a single variable alone is insufficient to comment about the abrupt change in the system dynamics and should be based on multiple variables of the dynamical system.;

Over the past ten years, microfluidic paper-based analytical devices (micro-PADs) have attracted a lot of attention as a viable analytical platform. It is expanding as a result of advances in manufacturing processes and device integration. Conventional microfluidics approaches have some drawbacks, including high costs, lengthy evaluation times, complicated fabrication, and the necessity of experienced employees. Hence, it is extremely important to construct a detection system that is quick, affordable, portable, and efficient. Nowadays, micro-PADs are frequently employed, particularly in electrochemical analyses, to replicate the classic standard laboratory experiments on a miniature paper chip. It has benefits like rapid assessment, small sample consumption, quick reaction, accuracy, and multiplex function. The goal of this review is to examine modern paper microfluidics-based electrochemical sensing devices for the detection of macromolecules, small molecules, and cells in a variety of real samples. The design and fabrication of micro-PADs using conventional and the latest techniques have also been discussed in detail. Lastly, the limitations and potential of these analytical platforms are examined in order to shed light on future research.

Laser Additive Manufacturing (LAM) is a promising technology for manufacturing gas turbine components with enhanced design capability and a significant reduction in part weight. Additive manufacturing of alloy 718 using Laser Powder Bed fusion (L-PBF) process poses certain challenges pertaining to complex residual stress, micro-segregation of Nb, and undesired Laves phase formation in the as-printed state. The built-up residual stress and undesired brittle phase may lead to cracks and build failures. This article studied residual stress evolution during L-PBF of alloy 718 using Finite Element (FE) thermo-mechanical simulation implemented in Simufact Additive® software. The model adopted the bundling of physical powder in voxel mesh to minimize the computational time and mimic the actual process scenario during part-scale simulation. Experimental flow curves generated from Gleeble 3800® tests at elevated temperatures were utilized to calibrate material property for better accuracy in the FE simulation. The calibrated model was used to study the residual stress evolution during support structure removal. Verification and validation of simulated results were performed using X-ray diffraction (XRD) measurements. The simulated value agrees well with the experimental value with a maximum deviation of 7%. Finally, the experimentally validated model was used to correlate the effect of layer thickness variation on residual stress evolution.

Objective: Despite conflicting evidence, it is common practice to use continuous antibiotic prophylaxis (CAP) in patients with indwelling double-J (DJ) stents. Cranberry extracts and d-mannose have been shown to prevent colonization of the urinary tract. We evaluated their role in this setting. Methods: We conducted a prospective randomized study to evaluate patients with indwelling DJ stents following urological procedures. They were randomized into three groups. Group A (n=46) received CAP (nitrofurantoin 100 mg once daily [OD]). Group B (n=48) received cranberry extract 300 mg and d-mannose 600 mg twice daily (BD). Group C (n=40) received no prophylaxis. The stents were removed between 15 days and 45 days after surgery. Three groups were compared in terms of colonization of stent and urine, stent related symptoms and febrile urinary tract infections (UTIs) during the period of indwelling stent and until 1 week after removal. Results: In Group A, 9 (19.5%) patients had significant bacterial growth on the stents. This was 8 (16.7%) in the Group B and 5 (12.5%) in Group C (p-value: 0.743). However, the culture positivity rate of urine specimens showed a significant difference (p-value: 0.023) with Group B showing least colonization of urine compared to groups A and C. There was no statistically significant difference in the frequency of stent related symptoms (p-value: 0.242) or febrile UTIs (p-value: 0.399) among the groups. Conclusion: Prophylactic agents have no role in altering bacterial growth on temporary indwelling DJ stent, stent related symptoms or febrile UTIs. Cranberry extract may reduce the colonization of urinary tract, but its clinical significance needs further evaluation.

A monolayer of boron known as borophene has emerged as a novel and fascinating two-dimensional (2D) material with exceptional features, such as anisotropic metallic behavior and supple mechanical and optical capabilities. The engineering of smart functionalized opto-electric 2D materials is essential to obtain biosensors or biodevices of desired performance. Borophene is one of the most emerging 2D materials, and owing to its excellent electroactive surface area, high electron transport, anisotropic behavior, controllable optical and electrochemical properties, ability to be deposited on thin films, and potential to create surface functionalities, it has recently become one of the sophisticated platforms. Despite the difficulty of production, borophene may be immobilized utilizing chemistries, be functionalized on a flexible substrate, and be controlled over electro-optical properties to create a highly sensitive biosensor system that could be used for point-of-care diagnostics. Its electrochemical properties can be tailored by using appropriate nanomaterials, redox mediators, conducting polymers, etc., which will be quite useful for the detection of biomolecules at even trace levels with a high sensitivity and less detection time. This will be quite helpful in developing biosensing devices with a very high sensitivity and with less response time. So, this review will be a crucial foundation as we have discussed the basic properties, synthesis, and potential applications of borophene in nanobiosensing, as well as therapeutic applications.

The aim of the study is to provide an objective preoperative assessment protocol by computerized tomography angiography by measuring the vein volume (πr2h) instead of the vein diameter for accurate size and blood flow assessment in case of multiple renal veins during donor nephrectomy. To reduce rewarm ischemia time, smaller renal veins were safely ligated without compromising drainage due to their robust intrarenal anastomotic communications. The selection of vein for safe ligation is crucial to avoid congestion and high intrarenal pressures in the allograft venous system and was made by calculating the vein volume. Application of this formula in 343 donors with multiple veins (2003–2021) has led to uneventful intra- and postoperative course. This method prevails over the existing subjective assessment techniques, thereby ensuring the best possible perfusion and drainage of the allograft.

Broiler diets frequently include fats and oils to improve energy density, feed palatability, and functionality associated with Ω-3 PUFA. The purpose of this research was to examine how dietary supplementation of linseed affects growth performance and lipid profile of broiler chickens. The study was carried out at the poultry farm of the Banaras Hindu University, Varanasi. The experiment is approved by the Central Animal Ethics Committee of the University (IAEC/3036). Total 200 male Cobb-400, 7-day-old broiler chicks were randomly distributed into 5 treatment groups and fed with different levels of LS (0, 2.5, 5, 7.5, and 10%), respectively. The chickens fed rations supplemented with different levels of LS resulted in significantly decreased body weight and significantly increased feed conversion ratio. In blood lipid profile, CHO, TRI, LDL-C, and VLD-C concentrate levels decreased when fed with different level of LS, while HDL-C increased significantly.

Introduction: Positron emission tomography (PET) is not a standard recommendation in most of the major guidelines for the evaluation of renal cell carcinoma (RCC). Earlier studies evaluating PET scan in patients with RCC have provided discordant results. However, with the advent of newer hybrid PET/computed tomography (CT) scanning systems, this modality has shown increased efficacy in the evaluation of primary renal masses along with the detection of extrarenal metastases, restaging recurrent RCC, and also in monitoring response to targeted therapy. We performed a systematic review of the existing literature on the role of PET scan in the evaluation of RCC. Methodology: We systematically searched the databases of PubMed/Medline, Embase, and Google Scholar to identify studies on the use of PET scan in RCC. Using Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, 94 full-text articles were selected, of which 54 relevant articles were then reviewed, after a consensus by the authors. Results: Several studies have shown similar sensitivity and specificity of fluoro-2-deoxy-2-d-glucose-PET (FDG-PET) scan as compared to conventional CT scan for the initial diagnosis of RCC, and an improved sensitivity and specificity for the detection of metastases and recurrences following curative therapy. The PET scan may also play a role in predicting the initial tumor biology and pathology and predicting the prognosis as well as the response to therapy. Conclusion: The current guidelines do not recommend PET scan in the staging armamentarium of RCCs. However, FDG-PET scan is as efficacious, if not better than conventional imaging alone, in the evaluation of the primary and metastatic RCC, as well as in evaluating the response to therapy, due to its ability to pick up areas of increased metabolic activity early on. Newer tracers such as Ga68 prostate specific membrane antigen-labeled ligands may help in opening up newer avenues of theragnostics.

Introduction: We aimed to present our experience in managing renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombus. Methods: Records of all patients aged 18 years and older, with a diagnosis of primary renal masses with IVC thrombus, presenting to our institute from January 2012 to August 2020 were retrospectively reviewed. Patients with tumor thrombus limited only to renal vein were excluded from the analysis. Their hospital course and outcomes were recorded and evaluated for predictors of survival. Results: During the study period, we treated 61 patients with a renal mass and concurrent IVC thrombus and 56 of these underwent surgery. 7 of them had level III and 6 had level IV thrombus. A total of six patients received neoadjuvant tyrosine kinase inhibitor (TKI) therapy and all of them showed a decrease in size and level of tumor thrombus and cardiopulmonary bypass was safely avoided. Fourteen patients had distant metastasis and underwent cytoreductive surgery and of these 12 patients received TKI therapy after surgery with a mean survival of 26.8 months. The overall survival at 2 and 5 years of nonmetastatic group was 81.1% and 47.5% respectively and in metastatic group was 35.1% and 0%, respectively. Poor performance status, distant metastasis, higher T stage, higher thrombus levels, and positive surgical margins were all predictors of decreased survival. Conclusions: Complete surgical resection in both nonmetastatic and metastatic RCC with IVC thrombus has long-term survival benefits. Neoadjuvant TKI therapy, with adequate preoperative planning, helps in decreasing the size of the thrombus and in safely avoiding bypass in level III and IV IVC thrombi.

Upper tract urothelial carcinoma (UTUC) of the renal pelvis and the ureter is incidentally detected in a small proportion of cases. However, the majority of UTUC cases present with hematuria, flank pain, and clot colic. Typical imaging features include hydronephrosis of the kidney (s) due to obstruction by the mass with a soft-tissue lesion that typically shows low-grade enhancement with or without a filling defect. Rarely, such a tumor may present with signs and symptoms mimicking an inflammatory or infective pathology of the kidney and is diagnosed only on biopsy or on nephrectomy. We present three such patients and cite another similar case we have published earlier. All three of these patients presented with signs and symptoms of an obstructed infected kidney with long-standing renal calculi and a forgotten DJ stent in one instance. Nephrectomy for the presumed infected kidney in all three cases revealed high-grade UTUC. In patients presenting with equivocal findings on cross-sectional imaging with a history of renal calculi or foreign bodies, we should have a high index of suspicion for malignancy.

Nanobiosensors are devices that utilize a very small probe and any form of electrical, optical, or magnetic technology to detect and analyze a biochemical or biological process. With an increasing population today, nanobiosensors have become the broadly used electroanalytical tools for the timely detection of many infectious (dengue, hepatitis, tuberculosis, leukemia, etc.) and other fatal diseases, such as prostate cancer, breast cancer, etc., at their early stage. Compared to classical or traditional analytical methods, nanobiosensors have significant benefits, including low detection limit, high selectivity and sensitivity, shorter analysis duration, easier portability, biocompatibility, and ease of miniaturization for on-site monitoring. Very similar to biosensors, nanobiosensors can also be classified in numerous ways, either depending on biological molecules, such as enzymes, antibodies, and aptamer, or by working principles, such as optical and electrochemical. Various nanobiosensors, such as cyclic voltametric, amperometric, impedimetric, etc., have been discussed for the timely monitoring of the infectious and fatal diseases at their early stage. Nanobiosensors performance and efficiency can be enhanced by using a variety of engineered nanostructures, which include nanotubes, nanoparticles, nanopores, self-adhesive monolayers, nanowires, and nanocomposites. Here, this mini review recaps the application of two-dimensional (2D) materials, especially graphitic carbon nitride (g-C3N4), graphene oxide, black phosphorous, and MXenes, for the construction of the nanobiosensors and their application for the diagnosis of various infectious diseases at very early stage.

Background and Aims: Radiological evaluation of renal cell carcinoma (RCC) is used for non-invasive staging for better surgical planning. However, the correlation of radiological staging using magnetic resonance imaging (MRI) with histopathological findings has not been done so far. The aim of this study is to assess the role of MRI in pre-operative staging of RCC in patients undergoing radical nephrectomy and nephron sparing surgery (NSS) and correlate it with histopathological findings. Settings and Design: This prospective observational study was conducted from February 2015 to October 2016 at a tertiary care hospital in northern India. Methods: MR imaging was done on 3 Tesla MR scanner (Signa Hdxt General Electrics, Milwaukee, USA). Preoperative staging was based on 2010 TNM staging system. The preoperative parameters in MRI were tumor size, detection/breach of pseudocapsule, tumor extension into perirenal fat and detection of tumor venous thrombus. The staging on MRI was compared with surgical and pathological staging. Statistical Analysis Used: The agreement between these three staging methods was determined using the kappa statistics (0.0-0.2, poor; 0.2-0.4, fair; 0.4-0.6, moderate; 0.6-0.8, good; 0.8-1.0, excellent). Results: 30 patients with suspected RCC underwent NSS (n - 10) and radical nephrectomy (n - 20). Mean tumor size was 9.66 ± 2.99 cm in the radical nephrectomy group and 4.06 ± 1.16 cm in the NSS group. There was perfect agreement between MRI, surgical and pathological staging for breach of pseudocapsule (κ -1.0, Percentage of Agreement - 100%,P < 0.05). In none of the patients, MRI missed extension beyond the Gerota’s fascia or presence of venous thrombus. Conclusion: MRI staging of RCC is an accurate predictor of the surgical and pathological stage and has the potential to become a useful tool for preoperative identification of patients with RCC who can undergo NSS.

Background: To address the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), vaccination efforts were initiated across the globe in December 2020 and are continuing. We report the onset interval and clinical presentations of ocular adverse effects following SARS-CoV-2 vaccination. Methods: For this narrative review, articles in the English language, published between 1 January 2020 to 1 September 2022, were included to formulate a list of the reported ocular adverse effects of different COVID-19 vaccines. Results: During this period, ocular adverse effects have been reported with BNT162b2 (Pfizer), mRNA-1273 (Moderna), AZD-1222 (AstraZeneca), and Ad26.COV2.S (Johnson & Johnson) vaccines. Endothelial graft rejection, herpes simplex virus keratitis, herpes zoster ophthalmicus, anterior uveitis, eyelid edema, purpuric rashes, ischemic optic neuropathy, and cranial nerve palsies were the most reported with BNT163b2. Retinal hemorrhages, vascular occlusions, and angle closure glaucoma were the most reported with AZD-1222. Most of the ocular adverse effects reported in the literature had a good to fair prognosis with appropriate management. Conclusions: Evidence regarding the ocular adverse effects does not outweigh the benefits of SARS-CoV-2 vaccination in patients with pre-existing systemic or ophthalmic diseases. This review provides insights into the possible temporal association between reported ocular adverse events and SARS-CoV-2 vaccines; however, further investigations are required to identify the link between potential causality and pathological mechanisms.

Background: To counter the rapidly spreading severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), global vaccination efforts were initiated in December 2020. We assess the risk of glaucoma following SARS-CoV-2 vaccination and evaluate its onset interval and clinical presentations in patients. Methods: We performed a retrospective analysis of the glaucoma cases reported to the Vaccine Adverse Event Reporting System (VAERS) database between 16 December 2020, and 30 April 2022. We assessed the crude reporting rate of glaucoma, clinical presentations, onset duration, and associated risk factors. Results: During this period, 161 glaucoma cases were reported, with crude reporting rates (per million doses) of 0.09, 0.06, and 0.07 for BNT162b2, mRNA-1273, and Ad26.COV2.S, respectively. The mean age of the patients was 60.41 ± 17.56 years, and 67.7% were women. More than half (56.6%) of the cases were reported within the first week of vaccination. The cumulative-incidence analysis showed a higher risk of glaucoma in patients who received the BNT162b2 vaccines compared with mRNA-1273 (p = 0.05). Conclusions: The incidence of glaucoma following vaccination with BNT162b2, mRNA-1273, or Ad26.COV2.S is extremely rare. Amongst the patients diagnosed with glaucoma, the onset interval of adverse events was shorter among those who received the BNT162b2 and rAd26.COV2.S vaccines compared with mRNA-1273. Most glaucoma cases were reported within the first week following vaccination in female patients and from the fifth to seventh decade. This study provides insights into the possible temporal association between reported glaucoma events and SARS-CoV-2 vaccines; however, further investigations are required to identify the potential causality link and pathological mechanisms.

Introduction: We present the short-term voiding patterns and functional and urodynamic outcomes of W-shaped ileal orthotopic neobladder (ONB) following radical cystectomy (RC). Materials and Methods: Forty-one patients who underwent RC and W-shaped ONB creation between July 2015 and January 2018 were enrolled. Data were analyzed in terms of voiding patterns, urodynamic findings, and functional outcomes at 6 months after surgery. Pouch-related quality of life (QoL) was assessed using European Organization for Research and Treatment of Cancer (EORTC) Generic (QLQ C30), Bladder Cancer-Specific Instruments (QLQ BM30), and IONB–Patient-Reported Outcome (IONB-PRO). Results: The mean length of follow-up was 19.4 months. At first follow-up, three patients had developed acidosis and rising serum creatinine, and one of them required temporary hemodialysis. One patient developed urethral-pouch anastomotic stricture, which required bladder neck incision. Balloon dilatation was performed for ureteroileal anastomotic stricture and mesh repair for incisional hernia was required in one patient each. Upper tract changes were observed in two patients. During the first and second follow-up, maximum flow rate, voided volume, and postvoid residual urine were 12 ± 4.7 mL/s, 212 ± 120 mL, and 72 + 81 mL and 14.7 ± 5.3 mL/s, 254 ± 168 mL, and 123.7 ± 42.5 mL, respectively. The mean pouch capacity and compliance were 436 ± 103.5 mL and 50.6 ± 17.8 mL/cm H2O. No patient required clean intermittent catheterization for bladder emptying. In EORTC QLQ-C30 questionnaire, the “Cognitive” domain had the highest and “global QoL” domain had the lowest level of functional scores. “Nausea and vomiting and abdominal bloating and flatulence” domain had the lowest level and “financial difficulties and urinary symptoms” had the highest level of symptomatology in EORTC QLQ questionnaire. The IONB-PRO questionnaire showed the highest level of functioning in “relation life” and the lowest level in “emotional life” domain. Conclusion: The Ghoneim pouch has a low complication rate with near-normal voiding patterns with an acceptable QoL impairment.

Fungal diseases not only influence the economic importance of the plants and its products but also abate their ecological prominence. Mango tree, specifically the fruits and the leaves are highly affected by the fungal disease named as Anthracnose. The main aim of this paper is to develop an appropriate and effective method for diagnosis of the disease and its symptoms, therefore espousing a suitable system for an early and cost-effective solution of this problem. Over the last few years, due to their higher performance capability in terms of computation and accuracy, computer vision, and deep learning methodologies have gained popularity in assorted fungal diseases classification. Therefore, for this paper, a multilayer convolutional neural network (MCNN) is proposed for the classification of the Mango leaves infected by the Anthracnose fungal disease. This paper is validated on a real-time dataset captured at the Shri Mata Vaishno Devi University, Katra, J&K, India consists of 1070 images of the Mango tree leaves. The dataset contains both healthy and infected leaf images. The results envisage the higher classification accuracy of the proposed MCNN model when compared to the other state-of-the-art approaches.

Introduction: Percutaneous nephrolithotomy (PCNL) for stones in solitary kidney poses a significant challenge and potential threat for acute kidney injury or progression of chronic kidney disease (CKD). We present our experience of PCNL in solitary functioning kidney (SFK) to evaluate the safety, efficacy, and postoperative complications and highlight the differences between these outcomes with respect to the stage of CKD. Methods: We carried out a retrospective study of patients with SFK, who underwent PCNL at our center from April 2010 to March 2018. Patients who had a minimum of 6 months of follow-up were included. Patients were classified into CKD groups based on the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative. Group 1 included Stages 1, 2, and 3A and Group 2 included Stages 3B, 4, and 5. Postoperative complications and stone-free rate were recorded and graded according to the Clavien–Dindo classification and compared between the two groups. Results: We had a total of 128 patients (Group 1 – 84 and Group 2 – 44). Stone-free rate after the first PCNL was higher in Group 1 as compared to Group 2 (88.1% [n = 74] vs. 50% [n = 22],P= 0.02). Overall, 48 patients (37.5%) had postoperative complications, but most were minor. Clavien Grade 1 and 2 complications were seen in 34 patients (Group 1, n = 18 and Group 2, n = 16,P= 0.069), whereas Grade 3 and 4 complications were seen in 14 patients (Group 1, n = 2 and Group 2, n = 12,P < 0.001), respectively. Need for postoperative (number of sessions) dialysis was seen with increased frequency in patients with higher chronic kidney stages (Group 1 vs. Group 2; 6 vs. 22 sessions,P < 0.001). Conclusion: PCNL in SFK is safe, with satisfactory outcome, but patients with advanced CKD stage have higher risk of complications including need for dialysis and may require multiple sessions for complete stone clearance. Hence, they should be managed at high output tertiary centers.

The contribution of a plant is highly important for both human life and environment. Plants do suffer from diseases, like human beings and animals. There is the number of plant diseases that occur and affects the normal growth of a plant. These diseases affect complete plant including leaf, stem, fruit, root, and flower. Most of the time when the disease of a plant has not been taken care of, the plant dies or may cause leaves drop, flowers, and fruits drop. Appropriate diagnosis of such diseases is required for accurate identification and treatment of plant diseases. Plant pathology is the study of plant diseases, their causes, procedures for controlling and managing them. But, the existing method encompasses human involvement for classification and identification of diseases. This procedure is time-consuming and costly. Automatic segmentation of diseases from plant leaf images using soft computing approach can be reasonably useful than the existing one. In this paper, we have introduced a method named as bacterial foraging optimization based radial basis function neural network (BRBFNN) for identification and classification of plant leaf diseases automatically. For assigning optimal weight to radial basis function neural network we use bacterial foraging optimization that further increases the speed and accuracy of the network to identify and classify the regions infected of different diseases on the plant leafs. The region growing algorithm increases the efficiency of the network by searching and grouping of seed points having common attributes for feature extraction process. We worked on fungal diseases like common rust, cedar apple rust, late blight, leaf curl, leaf spot, and early blight. The proposed method attains higher accuracy in identification and classification of diseases.

In the digital world of today, global security issues have given rise to video surveillance devices. Gait-based human recognition is an emerging behavioral biometric trait for intelligent surveillance monitoring because of its non-contact and non-cooperation with subjects. Other benefits of gait recognition in video surveillance are that it can be acquired at a distance and help to identify an object under low-resolution videos. This paper surveys extensively the current progress made towards vision-based human gait recognition. This paper discusses historical research that performs analysis of gait locomotion and provides information on how gait recognition can be performed. This paper describes measuring metrics that can be used to measure the performance of gait recognition model under verification and identification mode. This paper also provides an up-to-date review of existing studies on gait recognition representations (model based and model free). We also provide an extensive survey of available gait databases used in state-of-art gait recognition models, created since 1998. Furthermore, it offers insight into open research problems that help researchers to explore unripe areas in gait analysis, such as occlusion, view variations, and appearance changes in gait recognition. This paper also identifies the future perspectives in gait recognition and also outlines the proposed work.

Introduction: Burning Mouth Syndrome (BMS) is a condition which is characterised by xerostomia, stomatopyrosis, dysgeusia and primarily affects the women of perimenopausal age. Despite the plethora of trials that have been going on since decades for management of this condition, there seems to be no definitive cure till date, which is mainly attributed to the ambiguity of this condition. Oil pulling is a simple, ancient technique which can be used as an adjunctive or supplemental therapy in a number of conditions, including BMS. Aim: To assess the efficacy of oil pulling therapy using sesame oil on xerostomia and stomatopyrosis in patients suffering from primary BMS. Materials and Methods: This is a prospective study conducted at I.T.S. Dental College, Greater Noida, Uttar Pradesh, India, between April 2016 to April 2017 and included a total of 25 patients. On the basis of the detailed case history and complete haemogram, patients clinically diagnosed with primary BMS were advised oil pulling therapy once daily for a period of three months and symptoms of xerostomia and stomatopyrosis were assessed at the end of every month using Visual Analog Scale (VAS). Paired t-test was applied. The level of significance was set at p

OBJECTIVE: The aim of this study was to compare the efficacy, safety and tolerability of Dutasteride vs Finasteride in a fixed dose combination, with a uro-selective a-blocker Tamsulosin, in the management of symptomatic BPH associated with LUTS. MATERIALS AND METHODS: 105 males between 40-80 years, clinically diagnosed as Benign prostatic hyperplasia (BPH) having a baseline evaluation of their IPSS, UFR, PSA, LFT, KFT, sex health, ultrasound of prostate and PVUV, were randomized to receive a fixed dose combination therapy of Tamsulosin (0.4 mg) with Finasteride (5 mg), vs Tamsulosin (0.4 mg) with Dutasteride (0.5 mg), daily for six consecutive months. Follow- up at the end of the 2nd, 4th, 8th, 12th and 24th week was done with IPSS, UFR, PSA, ultrasound of Prostate, PVUV and sex health. RESULTS: There were five dropouts, three from the Finasteride arm and two from Dutasteride arm, leaving a total of 100 patients for the final evaluation. Patients in both the groups showed improvement in their symptoms score and urine flow rate from the baseline, but those with the Dutasteride combination not only showed much better improvement in their symptoms score and urine flow, but were also relieved of their obstructive symptoms earlier (10-14 days) than seen in the Finasteride group (24-35 days). None of the patients had acute retention of urine (AUR) during the trial. The post void urine volume was decreased more in the Dutasteride group, than in patients with Finasteride. Sexual dysfunction incidence was same in both the groups. Approximately 50% reduction in the PSA level was seen in both the groups, while LFT did not show significant difference from the baseline, in either group. Both the drugs were well tolerated, with the patient′s good compliance and with no drop-out due to adverse effects. CONCLUSION : A combination of a-adrenergic blocker and 5-ARI is the best therapeutic option for medical management of BPH as it is safe, effective and well tolerated. A combination of Tamsulosin with Dutasteride results in early symptomatic relief and low PVUV, than seen with the Tamsulosin with Finasteride combination.

Objectives: Management of pT 1 G 3 TCC of urinary bladder is always a dilemma for urologists due to its high recurrence & disease progression rate. We evaluated the role of conservative management for this subgroup with TURBT and intravesical immunotherapy; and delayed cystectomy for progressive disease with an aim to salvage bladder. Patients & Methods: Between Jan.1996 to Dec.2002, 66 patients (15%) of pT 1 G 3 , out of a total 440 patients of superficial bladder cancer treated in this department were subjected to low dose BCG (40mg) and Interferon 3 million IU intravesically with maintenance therapy after complete TURBT and followed up for average 60 months. The mean tumor free interval was 26 months & 18 months in superficial recurrences & muscle progression disease respectively. Delayed cystectomy being preserved only for disease progression patients and the mean period of delayed cystectomy was 24 months (18-30 months). Results: 19 patients (29%) had no tumor recurrence, 35 patients (53%) showed superficial recurrence and 12 patients (18%) progressed to higher stage at end of five year follow up thereby giving a disease progression free interval of 60 months in 82% of our patients. Five patients of disease progression group died due to metastatic disease process and 7 patients are alive after delayed cystectomy at the end of follow up. Side effects from intravesical therapy were confined to local irritative symptoms only. Conclusion: Our data only confirms the benefit of adjuvant intravesical low dose immunotherapy in management of pT 1 G 3 tumor after TURBT with bladder salvage in 82% of patients, simultaneously not compromising the survival rate.