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In this case study, we explore the intricate surgical experience of a 45-year-old woman who post laparoscopic total hysterectomy for fibroid uterus, presented with persistent surgical site discharge. Despite multiple courses of antibiotic therapy, the symptoms persisted, and the infective organism remained unidentified
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The study assesses the biological properties of methanolic extracts derived from the leaves, stems, and roots of Begonia malabarica, a native plant species in the mountainous area of southern India. The GC-MS was used to analyze the phytochemicals in the solvent from Begonia malabarica that had been extracted with methanol. The antioxidant activity was evaluated using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method and as reference solution is ascorbic acid. The cytotoxicity activity was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) approach. The GC-MS analysis effectively revealed 35 distinctive phytomolecules. The primary constituents, namely tert-butylbenzene (23%), 2-methylnaphthalene (6.2%), ethyl ester of octadecanoic acid (0.9%), and (Z,Z)-9,12-octadecadienoic acid (0.9%), are noted. The results, the methanolic extracts from B. malabarica are antioxidants that have significant levels (P < 0.05) of DPPH radical scavenging activities at different doses. The detected radical scavenging activities exhibited a higher proportion in the stem of B. malabarica. The IC50 values for the methanolic extracts were found to be 0.77 mg/ml, 0.49 mg/ml, and 0.68 mg/ml, respectively. The MTT analysis demonstrated that the methanolic extracts exhibited a considerable increase in cytotoxic activity against the pancreatic cancer (PANC-1) cell line, resulting in a cell viability percentage of 69.63% at a concentration of 31.25µg/ml. These findings confirm the possible biological effects of B. malabarica and its prospective use in different pharmaceutical pursuits in the future.
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Aims@#Jambu batu (Psidium guajava Linn.) is a phytotherapic plant used in folk medicine that has active components to treat various diseases. An earlier study has reported on the analysis of its pharmacological properties and was found to possess antibacterial, antifungal, anti-inflammatory and antioxidant activity. The present study aimed to determine the antibacterial activities of P. guajava Linn. leaves extracts on the vegetative cells of Bacillus cereus ATCC33019, Bacillus megaterium ATCC14581, Bacillus pumilus ATCC14884 and Bacillus subtilis ATCC6633 and to evaluate its effects of different temperatures and pHs on antibacterial activity.@*Methodology and results@#The susceptibility test used to determine the bacterial growth inhibition were well diffusion assay (WDA), minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and time-kill curve assay. The effects of various parameters on temperatures at 10 °C, 28 °C, 30 °C, 50 °C and 80 °C and pH at 3.0, 5.0, 6.7, 7.0 and 11.0 were investigated. WDA assay of the extracts resulted in 13.75 ± 0.95 and 16.25 ± 0.95 mm of inhibition zone on B. subtilis and B. cereus, respectively. The extracts can inhibit the growth with MICs value range of 0.195 to 0.781 mg/mL for B. megaterium and B. pumilus, respectively, and can kill all tested Bacillus spp. with MBCs values of 0.781 mg/mL. The killing time analyses showed that Bacillus spp. can be killed completely within 4 h at 4× MIC (0.781 to 3.124 mg/mL). The extracts remained stable under a wide range of temperatures and pHs, as there was no significant difference in the MIC and MBC values.@*Conclusion, significance and impact of study@#Psidium guajava Linn. ethanolic leaves extract yielded good antibacterial activities, suggesting that the extract can be utilised or explored as a potential anti-Bacillus agent in food applications.
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Methods@#This study included patients who underwent all-posterior surgical deformity correction for dystrophic NF-1 curves. Coronal and sagittal Cobbs angles, apical rotation, and the presence of dystrophic features were evaluated before surgery. Postoperatively, sagittal, coronal, and axial correction, implant position, and implant densities were evaluated. The decline in curve correction and implant-related complications were evaluated at follow-up. Clinical outcomes were evaluated using the Scoliosis Research Society-22 revised index. @*Results@#This study involved 50 patients with a mean age of 13.6 years and a mean follow-up duration of 5.52 years. With a mean coronal flexibility of 18.7%, the mean apical vertebral rotation (AVR), preoperative coronal Cobb angle, and sagittal kyphosis were 27.4°, 64.01°, and 47.70°, respectively. The postoperative mean coronal Cobb angle was 30.17° (p <0.05), and the sagittal kyphosis angle was 25.4° (p <0.05). The average AVR correction rate was 41.3%. The correction remained significant at the final mean follow-up, with a coronal Cobb angle of 34.14° and sagittal kyphosis of 25.02° (p <0.05). The average implant density was 1.41, with 46% of patients having a high implant density (HID). The HID had a markedly higher mean curve correction (29.30° vs. 38.05°, p <0.05) and a lower mean loss of correction (5.7° vs. 3.8°, p <0.05). @*Conclusions@#Utilizing computer-assisted navigation, hybrid instrumentation, and multiple anchor point technique and attaining high implant densities, this study demonstrates successful outcomes following posterior-only surgical correction of dystrophic scoliosis in patients with NF-1.
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Background: Aim was to assess the level of awareness and practices related to climate change and its effects on health among urban population in metropolitan city. To recommend awareness programs regarding climate change and its health hazards for urban population based on results. Methods: Community based cross sectional study was conducted among 180 adults from January 2022 to March 2022. The data was entered in MS Excel and was analyzed by using SPSS-16 software. Results: The awareness about climate change was 63%. 76% of the respondents did not agree that climate change is related to extreme weather phenomenon. All the participants believed that climate change affects health, but none of them were aware that it is causing increased incidence of cancer. 73% of the participants always adopted climate friendly alternatives to using own motor vehicles. None of the participants practiced garbage segregation. Only 19% always used climate friendly alternatives to plastic bags. 74% respondents were unable to give concrete solutions to control climate change. 14% participants suggested planting more trees, 10% called for control of industrialization and population explosion. 66% obtained their information from newspapers. None of them viewed scientific journals. There was no significant association between educational status and awareness of climate change. Conclusions: The population is moderately aware of climate change. They are not well aware of its long-term impacts on health. There is an urgent need for them to be well informed with verified sources of information. Appropriate campaigns must be initiated.
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The widespread application of synthetic chemicals leads to the unintended negative impact to non-target organisms both directly or indirectly, as these chemicals can infiltrate new environments, disrupting established ecological niches. Laboratory experiments explored the effects of sublethal doses of Cs-O-Arg to the third instar grubs of Chrysoperla zastrowi sillemi when fed with treated and untreated larvae of diamondback moth (DBM). The results showed that when the untreated third instar C. zastrowi sillemi grub was fed with treated P. xylostella larvae at LC25, LC35 and LC45 concentrations, there was 6.67 per cent mortality of C zastrowi sillemi grub at all the concentrations, after 48 and 72 hours of exposure. but, when the treated C. zastrowi sillemi grubs (LC35 and LC45) were fed with untreated P. xylostella, there was only 3.33 and 10.00 per cent mortality of C. zastrowi sillemi grubs, respectively. Whereas, Cs-O-Arg caused 33.33 per cent mortality when LC45 treated grubs were provided with LC45 treated DBM larvae as feed, whereas the treatment with LC25 concentrations of Cs-O-Arg resulted in the highest pupation percentage (76.67%) and adult emergence rate (73.33%) in C. zastrowi sillemi grubs when fed with DBM larvae treated with the same concentration. Chitosan derivative insecticide causes a mild adverse impact on the survival of the economically significant insect predator C. zastrowi sillemi, which hold valuable implications for guiding decisions regarding the compatible utilization of insecticides alongside C. zastrowi sillemi or other natural predators within integrated pest management strategies.
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Background: Nurses play a pivotal role in our healthcare. It is therefore crucial to assess the job satisfaction levels of nurses for the proper functioning of the healthcare system. The present study was to assess the job satisfaction levels among nurses in Alappuzha district. Assessment of Job satisfaction levels will help to implement ergonomically beneficial policies in the healthcare system. Methods: A hospital based cross sectional study was conducted among the nurses during the months of October- November, 2022. Convenient sampling was done and persons who were willing to take part in the study were distributed with a pretested questionnaire. Job satisfaction was analysed using the Minnesota job satisfaction scale. Data was collected and entered in Microsoft Excel. It was analysed using SPSS version 26. Chi square test was used to find out the association between variables. Results: Totally 63 nurses responded to the questionnaire. Of the total study participants, 73% were satisfied with their job and 23% were having neutral level of job satisfaction. Level of job satisfaction was associated with sleep satisfaction, met financial needs, assault or abuse faced at work and perceived workload. The results also showed that there is no association between the level of job satisfaction and demographic factors. Conclusions: From this study, three-fourth of the participants were satisfied with their job. Only small portion of participants were satisfied with responsibility, advancement, moral values, working conditions, institutional policies and practices. They were dissatisfied with independence and compensation provided at job.
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Heavy metal exposure to lead is associated with severe neuronal impairment through oxidative stress mediated by reactive oxygen species. This study investigated the potential neuroprotective effect of esculin on the lead (Pb)-induced brain neurotoxicity C57bl/6 model. Four groups of mice were used for the study (control, lead acetate-treated (10 mg/kg), lead acetate and esculin (10 mg/kg +15 mg/kg) and esculin (15 mg/kg) alone treated for 14 consecutive days. Lead-induced alterations in the level of lipid peroxidation, nitric oxide, protein carbonyl, and enzymatic and non-enzymatic activity were measured in brain homogenates. Histological changes in the hippocampus and cortex were also examined. The results documented that PbAc significantly increased hippocampal and cortical lipid peroxidation and nitrite levels and decreased glutathione content, superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase activity. Histological observations of lead-induced neurotoxicity revealed severe damage and a reduction in neuronal density in the hippocampus and cortex. However, treatment with esculin rescued hippocampal and cortical neurons from PbAc-induced neurotoxicity by restoring the balance between oxidants and antioxidants and improvise motor coordination and memory activity. Esculin also attenuates the morphological damage and neuronal density in the hippocampal and cortex regions of C57bl/6 mice. Hence, the study suggests that esculin may be useful in combating lead acetate-induced neuronal injury.
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This study aimed to optimize irrigation scheduling for maize (Zea mays L.) using the crop water stress index (CWSI) to improve water use efficiency and yield. The study was conducted in the South farm of the School of Agricultural Sciences, Karunya Institute of Technology and Sciences, Coimbatore during the Kharif and Rabi seasons of 2022. A randomized block design was used with seven treatments, including a control T1 no irrigation). Irrigation at all critical stages (T2) and other five irrigation treatments (T3 to T7) based on different CWSI values ranging from 0.2 to 1.0. Infrared thermometry was used to measure canopy temperatures for estimating the CWSI. The results showed that irrigation at 0.2 CWSI (T3) had a significant positive effect on kernel and stover yield when compared with all the other treatments during both the seasons, with the highest kernel yield of 7138.83 Kg ha-1 and 8014.8 Kg ha-1, stover yield of 11134 Kg ha-1 and 12765 Kg ha-1, respectively and lowest kernel yield of 2267 Kg ha-1 and 2325 Kg ha-1, stover yield of 8156 Kg ha-1 and 6491 Kg ha-1, respectively. The other treatments had intermediate values and did not show any consistent pattern. Irrigation at 0.2 CWSI resulted in the highest water use efficiency (WUE) of 14.7 Kg ha-cm-1 and 17.6 Kg ha-cm-1, and irrigation usage of 31.73% and 22.26% during the Kharif and Rabi seasons of 2022, respectively and the lowest water use efficiency (WUE) of 7.72 Kg ha-cm-1 and 17.6 Kg ha-cm-1 was found in T7 during the Kharif and Rabi seasons of 2022, respectively. The results suggest that irrigation at 0.2 CWSI could be a promising option for achieving higher kernel and stover yields with minimal water use and maximum WUE and IUE.
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Background: Seroma formation after mastectomy with axillary dissection is a major source of morbidity and results in a significant delay in starting the adjuvant treatment. Many different strategies, including the usage of steroids, have been tried to reduce the incidence of seroma with varying outcomes. This study aimed to assess the effect of a single dose of intracavitary methylprednisolone (MP) on seroma formation in patients undergoing total mastectomy with axillary lymph node dissection (ALND). Methods: A randomized controlled trial was conducted at our institute, from January 2018 till June 2019. In the intervention group of 36 patients, 80 mg of MP solution was injected into the wound on post operative day 1. The drain was clamped for 8 hours and then released. In the control group of 36 patients, saline was administered and the drain output was compared between the groups. Results: The mean drain volume in the intervention group was 409.08 mL and in the control group it was 566.97 mL (P < 0.005). The mean drain removal time was 7.86 days and 10.33 days in the intervention and control group, respectively (P < 0.0004). Conclusion: A single dose of intracavitary MP significantly reduced seroma formation and facilitated early removal of drain in patients undergoing total mastectomy with ALND.
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Background: The transgender population is a marginalized social group often targeted for mistreatment and discrimination. This study specifically examined the experiences of transgender people across a range of cate-gories such as: education, employment outcomes, health awareness and mental health status. The study aimed to gain an understanding about the respondents’ unique experiences of discrimination being transgender and health awareness. Materials and Methods: The research applied descriptive qualitative phenomenology design. The study was conducted at Department of Community Medicine, Government Omandurar Medical College and Hospital, Chennai on Trans genders using in-depth interview with an open-ended question semi structured Question-naire after obtaining the informed consent among 4 Transgenders till the data saturation happens. The Tran-scriptions Data were then analyzed using the Colaizzi method. Results: Marginalized socially and economically, Family and peer rejections, Lack of Job opportunities, Con-tinuous rejection and omission leads to Begging and Active Night life (Survival Sex). Health Care Professionals has less knowledge about the transgender health, sex affirmation surgery is still least preferred among doc-tors. NGOs roles are very significant in their quality of life, Periodic medical examination including HIV. Conclusion: Transgender’s and the word are to be transformed as Third Gender. The Social acceptance from the public will do wonders in their life.
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The human brain is a distinctly complex structure with several interlinked neurons that transmit signals all over the body. The search for an excellent model mimicking the human mind has led to a sophisticated breakthrough in what's referred to as artificial intelligence (AI). AI methodologies have determined programs in numerous disciplines ranging from telecommunication, aerospace, robotics, medical analysis, alternate marketplace, law, science, or entertainment to name some. Medical clinical decision support system (CDSS), a factor of AI is being carried out in dentistry which includes Artificial neural networks (ANN), genetic algorithms (GA) and Fuzzy logic. Various fields of drugs such as diagnostic systems, biomedical analysis, image analysis, and drug development have utilized this complicated and tremendously advanced detail of AI. The AI systems along with virtual reality have been used now not handiest to lessen dental anxiety but also to appear as an effective tool for the non-pharmacological manipulation of pain. Ordinary, AI offers us a glimpse of the destiny tool to be able to assist dentists in an inconceivable manner.
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Background: In response to contain the spread of coronavirus disease 2019 (COVID-19) in India, the entire country was declared to be under lockdown from the midnight of 24 March 2020. In this study, we determined the economic impact and availability of health services during sudden lockdown. Methods: A cross sectional study was done in rural and urban health and training centres attached to rural medical college of Chengalpattu district of Tamil Nadu. Sample size was 424. Study participants were out patients, seeking health care services. Data was collected by trained medical social workers (MSW), using field tested semi-structured questionnaire. Percentages were calculated and for assessing difference between proportions, Pearson抯 chi-square test was used as a test of significance. Results: Out of 424 study participants, 223 (52.6%) were male and mean age of participants was 44 years. Socio economically, majority of them belonged to lower and lower middle-class families. 297 (70%) of households reported to have financial loss and 71.2% reported difference due to lockdown. In univariant analysis, the significant risk factors for difference in income were found to be type of house (0.029), loss of job (0.0001), loss of wages (0.0001), having bank loan (0.019) and issues in managing household expenses (0.0001), per capita income (0.008), farming business (0.018) and household with members having non-communicable diseases (0.013). Conclusions: Lockdown has huge economic cost. Underprivileged households were economically impacted. Most of the essential health services were available and accessible to the household even during the strict lockdown.
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Objective: To develop and validate a bedside dengue severity score in children less than 12 years for predicting severe dengue disease. Methods: We carried out an analysis of data on the clinical and laboratory parameters of patients with confirmed dengue, hospitalized in October, 2019 at our center. A comprehensive patient’s score was developed. Predictive models for severity were built using a forward step-wise method. This model was validated on the data of 312 children with dengue admitted during September- October, 2021. Results: Severe dengue was predicted by the dengue severity score with a sensitivity of 86.75% (95% CI 77.52%-93.19%), specificity of 98.25% (95% CI 95.56-99.52%), a positive predictive value of 95.34% (95% CI 92.18%-97.26%) and a negative predictive value of 94.74% (95% CI 87.16%-97.95%). The overall predictive accuracy was 95.2% (95% CI 92.19%- 97.28%). Conclusion: The proposed bedside dengue severity scoring system was found to have good validity. Validating the score in different settings and patient populations is suggested.
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Spontaneous mutations and lack of replication fidelity in positive-sense single stranded RNA viruses (+ssRNA virus) result in emergence of genetic variants with diverse viral morphogenesis and surface proteins that affect its antigenicity. This high mutability in +ssRNA viruses has induced antiviral drug resistance and ability to overcome vaccines that subsequently resulted in rapid viral evolution and high mortality rate in human and livestock. Computer aided vaccine design and immunoinformatics play a crucial role in expediting the vaccine production protocols, antibody production and identifying suitable immunogenic regions or epitopes from the genome sequences of the pathogens. T cell and B cell epitopes can be identified in pathogens by immunoinformatics algorithms and methods that enhance the analysis of protective immunity, vaccine safety, immunity modelling and vaccine efficacy. This rapid and cost-effective computational vaccine design promotes development of potential vaccine that could induce immune response in host against rapidly mutating pathogens like +ssRNA viruses. Epitope-based vaccine is a striking concept that has been widely employed in recent years to construct vaccines targeting rapidly mutating +ssRNA viruses. Therefore, the present review provides an overview about the current progress and methodology in computeraided vaccine design for the most notable +ssRNA viruses namely Hepatitis C virus, Dengue virus, Chikungunya virus and Coronaviruses. This review also highlights the applications of various immunoinformatics tools for vaccine design and for modelling immune response against +ssRNA viruses.
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Von Willebrand disease (VWD) Type 3 is an uncommon bleeding disorder, resulting from the near absence of Von Willebrand factor (VWF) and extremely low factor-VIII levels. It is a close differential diagnosis of hemophilia. A wide heterogeneity of VWD mutations are reported in the literature. We report a 16-year-old girl with hemarthrosis, finally diagnosed with Type 3 VWD. Clinical exome sequencing confirmed the diagnosis, revealing a homozygous mutation c.4387G>T (p. Glu1463Ter) in exon 28 of the VWF gene, a unique mutation not yet reported in the literature.
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Objectives@#Insulin degludec (IDeg)/insulin aspart (IAsp; IDegAsp) is a co-formulation of 70% IDeg and 30% IAsp. According to several randomized controlled trials, IDegAsp is effective and safe for patients with type 2 diabetes mellitus (T2DM). A subgroup analysis of the ARISE study was conducted to explore the safety and efficacy of IDegAsp among Malaysian patients with T2DM in real-world settings.@*Methodology@#ARISE, an open-label, multicenter, non-interventional, prospective study was conducted between August 2019 and December 2020. Adult Malaysian patients with T2DM who were enrolled from 14 sites received IDegAsp as per the local label for 26 weeks. The primary endpoint was change in glycated hemoglobin (HbA1c) levels from baseline to end of study (EOS).@*Results@#Of the 182 patients included in the full analysis set, 159 (87.4%) completed the study. From baseline to EOS, HbA1c (estimated difference [ED]: –1.3% [95% CI: –1.61 to –0.90]) and fasting plasma glucose levels (ED: –1.8 mmol/L [95% CI: –2.49 to –1.13]) were significantly reduced (p<0.0001). The patient-reported reduced hypoglycemic episodes (overall and nocturnal) during treatment. Overall, 37 adverse events were observed in 23 (12.6%) patients.@*Conclusion@#Switching or initiating IDegAsp treatment resulted in significant improvements in glycemic control and a reduction in hypoglycemic episodes.
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Objective To describe COVID-19 in children and the diferences between the two waves. Methods The electronic medical records of children younger than 16 y of age with laboratory-confrmed COVID-19 infection between June 1st 2020 and May 31st 2021 at Christian Medical College, Vellore were retrospectively reviewed. Demographic, clinical, and laboratory data were collected on a predesigned case record form and analyzed. Results A total of 988 children were diagnosed with confrmed COVID-19 during the study period. Of these, there were 585 children diagnosed during the 1st wave (June 2020–Feb 2021) and 403 children during the 2nd wave (March 2021–May 2021). It was found that loose stools and rash were signifcantly more frequent during the 1st wave and fever, cough, coryza, heart rate and temperature were signifcantly more during the 2nd wave. There was no signifcant diference between the two groups in terms of requirement of oxygen therapy, need for ICU admission, duration of ICU stay or hospital stay, or severity of illness. Mortality was signifcantly higher during the 2nd wave (0.3% vs. 2%). Conclusion The COVID-19 pandemic among children during the 1st and 2nd waves were similar in severity, though there was a higher mortality during the 2nd wave.
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SARS-CoV-2 pandemic has become a major threat to human healthcare and world economy. Due to the rapid spreading and deadly nature of infection, we are in a situation to develop quick therapeutics to combat SARS-CoV-2. In this study, we have adopted a multi-level scoring approach to identify multi-targeting potency of bioactive compounds in selected medicinal plants and compared its efficacy with two reference drugs, Nafamostat and Acalabrutinib which are under clinical trials to treat SARS-CoV-2. In particular, we employ molecular docking and implicit solvent free energy calculations (as implemented in the Molecular Mechanics -Generalized Born Surface Area approach) and QM fragmentation approach for validating the potency of bioactive compounds from the selected medicinal plants against four di?erent viral targets and one human receptor (Angiotensin-converting enzyme 2 -ACE-2) which facilitates the SARS-CoV-2entry into the cell. The protein targets considered for the study are viral 3CL main protease (3CLpro), papain-like protease (PLpro), RNA dependent RNA polymerase (RdRp), and viral spike protein-human hACE-2 complex (Spike:hACE2)including human protein target (hACE-2). Herein, thereliable multi-level scoring approach was used to validate the mechanism behind the multi-targeting potency of selected phytochemicals from medicinal plants. The present study evidenced that the phytochemicals Chebulagic acid, Stigmosterol, Repandusinic acid and Geranin exhibited efficient inhibitory activity against PLpro while Chebulagic acid was highly active against 3CLpro. Chebulagic acid andGeranin also showed excellent target specific activity against RdRp.Luteolin, Quercetin, Chrysoeriol and Repandusinic acid inhibited the interaction of viral spike protein with human ACE-2 receptor. Moreover Piperlonguminine and Piperine displayed significant inhibitory activity against human ACE-2 receptor. Therefore, the identified compounds namely Chebulagic acid, Geranin and Repandusinic acid can serve as potent multi-targeting phytomedicine for treating COVID-19
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Yellow mosaic virus (YMV) disease is known to cause severe damage in green gram in terms of yield loss. As the resistance is often governed by recessive genes, introgression of such resistance faces some difficulty. DNA molecular markers are reported to be effective in this process. However, validation of such markers is important. Here, we have made an attempt to validate DNA markers associated with YMV disease resistance gene from a diverse group of 26 green gram genotypes. A total of 19 molecular markers were used to assess the susceptibility or resistance against YMV disease. Results show that among the amplified 31 alleles, 21 were polymorphic, with a mean of 1.1.0 per locus. The polymorphism information content (PIC) values ranged from 0.32 to 0.80. Only five markers exhibited higher PIC value (>6.0) and were revealed to be polymorphic, suggesting its utility in marker assisted selection for breeding YMV resistant genotypes in greengram. Dice dissimilarity coefficient among the genotypes exhibited a range of 0.07 to 1.0 which show a wide genetic variation among the genotypes for YMV tolerance. Neighbor-joining cluster analysis has grouped 26 green gram genotypes into 4 main clusters which revealed the existence of genetic dissimilarities among the genotypes. The genotypes AUGG 6, VBN (Gg) 2 and CO (Gg) 8 carried the positive alleles for YMV disease resistance and the allele for susceptibility were found in the genotypes AUGG 12, AUGG 15, AUGG 17 and AUGG 19. Single marker analysis indicated that there was correlation between the markers and the disease reaction in the field with exceptions. The findings revealed that the SSR markers CEDG180 and YR4 could be used to screen germplasm in order to discriminate the YMV resistant genotypes from the susceptible genotypes in marker assisted selection.