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Background: Medication-related osteonecrosis of the jaw (MRONJ) is a rare, but significant adverse event primarily associated with the intake of antiresorptive and antiangiogenic medications. Although antiresorptive and antiangiogenic the-rapies improve life expectancy, particularly in cancer patients, MRONJ may hamper the patient's quality of life due to pain, discomfort, anxiety, depression, speech impairment, difficulty in swallowing and eating, frequent medical and dental evaluations and treatments, and the possibility of treatment discontinuation. Leukocyte and Platelet-rich Fibrin (L-PRF) is an autologous platelet aggregate that promotes wound healing by stimulating re-epithelialization, angiogenesis, and extracellular matrix production. Aim: The present systematic review aimed to compare the results in the published literature on whether L-PRF is an effective and predictable adjuvant to surgical debridement of necrotic bone for improving the healing efficacy in patients with MRONJ. Materials and Methods: The PubMed, Scopus, Cochrane, Science Direct, LILACS, and Web of Science databases were searched using the predetermined MeSH terms and eligibility criteria, and the search yielded a total of five articles. Two studies were retrospective, and three studies were case series. Results: Seventeen participants received a combination of surgical debridement, L-PRF membrane, and antibiotics. Complete wound healing was observed in 70% of the participants, and most of them healed without any complications. Conclusions: L-PRF as an adjuvant to surgical debridement of necrosed bone appears to have a positive association with the healing outcome in patients with MRONJ.
Introducción: La osteonecrosis mandibular relacionada con medicamentos (ONMRM) es un evento adverso raro pero significativo asociado principalmente con la ingesta de medicamentos antirresortivos y antiangiogénicos. Aunque las terapias antirresortivas y antiangiogénicas mejoran la esperanza de vida, particularmente en pacientes con cáncer, la ONMRM puede obstaculizar la calidad de vida del paciente debido a dolor, incomodidad, ansiedad, depresión, discapacidad del habla, dificultad para tragar y comer, evaluaciones y tratamientos médicos y dentales frecuentes, y la posibilidad de interrupción del tratamiento. La fibrina rica en plaquetas y leucocitos (L-PRF) es un agregado de plaquetas autólogo que promueve la curación de heridas al estimular la reepitelización, la angiogénesis y la producción de la matriz extracelular. Objetivo: La presente revisión sistemática tuvo como objetivo comparar los resultados en la literatura publicada sobre si L-PRF es un adyuvante efectivo y predecible al desbridamiento quirúrgico del hueso necrótico para mejorar la eficacia curativa en pacientes con ONMRM. Materiales y Métodos: Las bases de datos de PubMed, Scopus, Cochrane, ScienceDirect, LILACS y Web of Science se registraron utilizando los términos DeCS/MeSH predeterminados y los criterios de elegibilidad, y la búsqueda arrojó un total de cinco artículos. Dos estudios fueron retrospectivos, y tres estudios fueron series de casos. Resultado: Diecisiete participantes recibieron una combinación de desbridamiento quirúrgico, membrana L-PRF y antibióticos. Se observó curación completa de heridas en el 70% de los participantes, y la mayoría de ellos se curaron sin ninguna complicación. Conclusión: L-PRF como adyuvante para el desbridamiento quirúrgico del hueso necrótico parece tener una asociación positiva con el resultado de curación en pacientes con ONMRM.
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Humains , Ostéonécrose de la mâchoire associée aux biphosphonates/thérapie , Antibactériens/usage thérapeutiqueRÉSUMÉ
Background@#Distraction is a technique used to divert a patient’s attention from unpleasant procedures. This study aimed to evaluate the effectiveness of kaleidoscopy, virtual reality, and video games in reducing anxiety and pain during invasive dental procedures in children. @*Methods@#Sixty-six children aged 6 to 9 years were randomly assigned to three groups during local anesthesia administration: Group 1 (kaleidoscope), Group 2 (virtual reality), and Group 3 (mobile video games). The anxiety of the children was evaluated using physiological measures (heart rate) at three different time points: before, during, and after the procedure. The Raghavendra, Madhuri, and Sujata pictorial scale was used as a subjective measure before and after the procedure. Subjective measures of pain were assessed using the Wong–Baker Faces Pain Scale. The data were statistically analyzed using the Kruskal–Wallis and Wilcoxon signed-rank tests. @*Results@#In the intergroup comparison, there were no statistically significant differences in the physiological measures of anxiety scores between the three groups before, during, and after distraction. Raghavendra, Madhuri, and Sujata pictorial scale scores were assessed before and after distraction, but no statistically significant differences were observed. Among the three groups, the children in Group 2 showed a significant reduction in pain scores. @*Conclusion@#Compared with kaleidoscopes and video games, virtual reality is a promising distraction technique for reducing dental fear, anxiety, and pain during local anesthesia administration in children.
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ABSTRACT We present an unusual case of a 13-year-old male pediatric patient with a diagnosis of sphenoid sinus mucocele. The patient suffered a progressive loss of visual acuity over three months followed by a total recovery of his visual acuity after surgery. The patient presented at the emergency room complaining of progressive loss of visual acuity in his left eye which decreased to hand motion over the preceding months. Imaging studies revealed a cystic mass, suggestive of sphenoid sinus mucocele, which was causing compressive optic neuropathy and proptosis. The patient was scheduled for a sphenoidectomy and resection of the mass. Three days after surgery, the patient's visual acuity in the left eye was 20/20, indicating complete recovery from his symptoms. We suggest that the excellent outcome in this patient may be attributable to his age. His ongoing physical development might have been the decisive factor in the recovery of his visual acuity following compressive optic neuropathy secondary to sphenoid sinus mucocele. Further research is needed to verify this proposed explanation.
RESUMO Apresentamos um caso incomum de paciente pediátrico com diagnóstico de mucocele de seio esfenoidal, que apresentou perda progressiva da acuidade visual ao longo de três meses, resultando em recuperação total da acuidade visual após a cirurgia. Paciente do sexo masculino, 13 anos, procurou o pronto-socorro, queixando-se de perda progressiva da acuidade visual do olho esquerdo nos últimos três meses. Exames de imagem revelaram uma massa cística sugestiva de mucocele de seio esfenoidal, causando neuropatia óptica compressiva e proptose. O paciente foi agendado para esfenoidectomia e ressecção da massa. Três dias após a cirurgia, a acuidade visual do paciente no olho esquerdo era de 20/20, apresentando recuperação completa dos sintomas. Diante dos resultados de nosso paciente, sugerimos que a idade do paciente pode ser decisiva na recuperação da acuidade visual de uma neuropatia óptica compressiva secundária à mucocele de seio esfenoidal. Mais pesquisas são necessárias para verificação desses dados.
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Pilonidal sinus is the term first used by Hodges in 1880 to describe a granulomatous lesion containing hairs. It has been previously described as hair extracted from an ulcer andreferredtoasJeep's disease, in world war days. Pilonidal sinus is the condition in which a sinus or fistula is situated at a short distance from the anus and generally contains hairs. It is commonly observed in the sacrococcygeal region and a few other sites, such as the axilla, umbilicus, face, etc. Its presence elsewhere is uncommon. Predisposing factors are traumatized, hairy skin, which leads entry of the hair inside the wound, thus forming a sinus. A 31-year-old patient presented with discharging endoanal sinus tract, which, on exploration, turned out to be an endoanal pilonidal sinus containing hair tufts, a rare case. The patient complained of recurrent pus discharge and anal pain for 45 days, reporting history of travelling around 70 km daily in a two-wheeler vehicle. On first physical evaluation, a small endoanal bulge was found. It was located at 1 o'clock in lithotomy position (anterior), with purulent discharge and anterior anal fissure. For confirmation, an endoanal ultrasonography (USG) was performed, which showed a sinus tract containing internal echoes and gas bubbles with a small amount of pus. The sinus was explored, and a wide excision was made and left open for secondary healing. Pilonidal sinus of the anal canal is a rare entity, and it can be found in hairy patients who are used to going on long, daily rides on two wheeled vehicles. (AU)
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Humains , Mâle , Adulte , Sinus pilonidal/diagnosticRÉSUMÉ
ABSTRACT It is estimated that lymphatic malformations in children account for 6% of all benign vascular malformations. New medical therapies have been developed for the management of lymphatic orbital disease. The purpose of this article was to describe a clinical case of orbital venolymphatic malformation in a 10-year-old boy, causing proptosis and palpebral edema. The lesion was initially treated with local sclerotherapy. However, the lesion relapsed, and was successfully treated with oral sirolimus. Prospective studies are warranted to determine the appropriate dose and extend the indications of sirolimus in these patients.
RESUMO A incidência de malformações linfáticas em crianças é estimada em 6% de todas as malformações vasculares benignas. Têm sido desenvolvidos novos tratamento para doenças linfáticas orbitárias. Nosso objetivo é descrever um caso clínico de malformação venolinfática orbitária em um menino de 10 anos de idade, causando proptose e edema palpebral. A lesão foi tratada inicialmente com escleroterapia local. No entanto, a lesão teve recidiva e foi tratada com sucesso com sirolimo oral. Ainda são necessários estudos prospectivos para estabelecer a dose apropriada e a duração do tratamento com sirolimo nesses pacientes.
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ABSTRACT Introduction: Primary cardiac myxomas are rare tumors. Concurrent valvular lesion is a common finding on evaluation which is thought to be due to annular dilatation secondary to tumor movement across the valve, functional obstruction across the valve, and severe pulmonary hypertension secondary to chronic obstruction. A common belief among surgeons is that excision of myxoma leads to abatement of symptoms, and further valve intervention may not be warranted. Methods: A 10-year retrospective descriptive study was designed to analyze patients who underwent excision of cardiac myxoma at our center. Data was analyzed regarding presenting features, echocardiographic findings of myxoma and valve morphology, intraoperative assessment, and postoperative outcome with/without valve repair/replacement in all patients. Results: A total of 22 patients underwent surgery for myxoma. Six patients underwent successful mitral valve repair with ring annuloplasty, two had moderate mitral regurgitation, three had severe mitral regurgitation, and one patient had no mitral regurgitation on preoperative assessment, but moderate mitral regurgitation was found intraoperatively. Four of these patients had no residual mitral regurgitation in follow-up period while two had mild residual mitral regurgitation. One patient had severe mitral stenosis of concurrent rheumatic etiology and successfully underwent mitral valve replacement. Conclusion: Cardiac myxomas are rare benign tumors commonly associated with mitral valve insufficiency. Mitral valve should be assessed intraoperatively after excision of mass as preoperative assessment might often be insufficient. Concomitant mitral valve intervention might be needed with a case-specific tailored approach, and mitral valve repair with ring annuloplasty offers best surgical outcome in such cases.
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ABSTRACT When faced with questions about artificial intelligence (AI), many surgeons respond with scepticism and rejection. However, in the realm of cardiac surgery, it is imperative that we embrace the potential of AI and adopt a proactive mindset. This systematic review utilizes PubMed® to explore the intersection of AI and cardiac surgery since 2017. AI has found applications in various aspects of cardiac surgery, including teaching aids, diagnostics, predictive outcomes, surgical assistance, and expertise. Nevertheless, challenges such as data computation errors, vulnerabilities to malware, and privacy concerns persist. While AI has limitations, its restricted capabilities without cognitive and emotional intelligence should lead us to cautiously and partially embrace this advancing technology to enhance patient care.
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ABSTRACT Introduction: Frailty and its association with chronic kidney disease (CKD) has been established previously. The present study examined this association further by studying the distribution of frailty among groups defined by different stages of the disease. It also identified associated health deficits and explored their association with estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR). Methods: A cross-sectional survey was conducted on 90 non-dialysis dependent CKD Stage 1-4 patients, recruited in three stratified groups of 30 participants each based on the stage of disease. Frailty was assessed using Fried's frailty criteria and associated health deficits were recorded using a pre-determined list. Depression was screened using a 4-point depression scale. Results: 21.1% of the participants were frail and 43.3% were pre-frail. The proportion of frailty in CKD groups A (Stages 1 and 2), B (Stage 3a), and C (Stages 3b and 4) was 10%, 13.3%, and 40%, respectively. The association of health deficits including co-morbidities, physical parameters, mental status, daily activities, etc. with UACR, eGFR, and CKD stages was not statistically significant. Nearly one in two frail participants was depressed compared with 14% among non-frail participants. Conclusion: The skewed distribution of 21% frail subjects identified in our study indicates an association between frailty and advancing kidney disease. Frail individuals had a lower eGFR, higher UACR, were more likely to be depressed, and had higher count of health deficits and poorer performance on Barthel Index of Activities of Daily Living and WHOQOL. Early identification of depression would improve care in these patients.
RESUMO Introdução: Fragilidade e sua associação com DRC foram estabelecidas anteriormente. O presente estudo aprofundou esta associação, estudando distribuição da fragilidade entre grupos definidos por diferentes estágios da doença. Também identificou déficits de saúde associados e explorou sua associação com taxa de filtração glomerular estimada (TFGe) e relação albumina/creatinina urinária (RAC). Métodos: Realizou-se uma pesquisa transversal em 90 pacientes com DRC Estágios 1-4 não dependentes de diálise, recrutados em três grupos estratificados de 30 participantes cada, conforme estágio da doença. Avaliou-se fragilidade usando os critérios de fragilidade de Fried e registraram-se os déficits de saúde associados usando uma lista pré-determinada. A depressão foi verificada utilizando a escala de depressão de 4 pontos. Resultados: 21,1% dos participantes eram frágeis e 43,3% eram pré-frágeis. A proporção de fragilidade nos grupos de DRC A (Estágios 1 e 2), B (Estágio 3a), e C (Estágios 3b e 4) foi de 10%, 13,3%, 40% respectivamente. A associação de déficits de saúde, incluindo comorbidades, parâmetros físicos, estado mental, atividades diárias etc. com RAC, TFGe e estágios da DRC não foi estatisticamente significativa. Cerca de um em cada dois participantes frágeis estava depressivo comparados com 14% entre não frágeis. Conclusão: A distribuição enviesada de 21% dos indivíduos frágeis identificados em nosso estudo indica associação entre fragilidade e doença renal progressiva. Indivíduos frágeis apresentaram menor TFGe, maior RAC, eram mais propensos a depressão, tinham maior índice de déficits de saúde e desempenho inferior no Índice de Atividades da Vida Diária de Barthel e WHOQOL. A identificação precoce da depressão melhoraria o atendimento desses pacientes.
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Background: Information on bullous pemphigoid in an Indian context is scarce. Aim: To report clinico-demographic profile, associated comorbidities and prescription pattern of bullous pemphigoid patients in India. Methods: This was a retrospective study, where past records of all bullous pemphigoid patients diagnosed and treated between November 2013 and October 2019 were accessed and analysed. Patients having a compatible clinical presentation with either histopathological and/or direct immunofluorescence evidence of bullous pemphigoid were included. Results: There were 96 bullous pemphigoid patients, with a male: female ratio of 1.6:1. The mean age at diagnosis was 62.5 ± 2.2 years, with mean duration of illness 27.5 ± 4.5 months before presentation. Comorbidities were present in 80 (83%) patients, with type 2 diabetes mellitus (38.5%), hypertension (36.4%) and neurological illness (16.7%) being the commonest ones. Clinically, blisters were the predominant presentation in 81 (84.4%) patients. The majority (87.5%) of patients showed a predominant eosinophilic infiltrate on histopathology. Direct immunofluorescence revealed immunoglobulin G deposits with complement C3 in 77 (80.2%) cases. The majority of patients (77.1%) were treated with oral prednisolone, either alone (11.5%) or in combination (65.6%) with other topical and systemic agents. Topical steroids were used in 29.1%, azathioprine in 28%, dapsone in 16.7% and omalizumab in 6.2% of patients. Limitations: The study is retrospective. Immunofluorescence on salt split skin, direct immunofluorescence serration pattern analysis, and immunoblotting were not performed. Hence, there is a possibility that a few included cases were suffering from other subepidermal autoimmune bullous diseases like epidermolysis bullosa acquisita or anti-p200 pemphigoid. Conclusion: Bullous pemphigoid patients in this study had a younger age of onset and showed male preponderance. Comorbidities like type 2 diabetes, hypertension and neurological disorders were freq
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Objective: To assess QT interval abnormalities among children with breath-holding spells. Methods: This case control study included 204 children (104 cases of breath-holding spells and 100 healthy children) younger than 3 years. Breath-holding spells were evaluated for age of onset, type (pallid/cyanotic), triggering factors, frequency and presence of family history. Twelve- lead surface electrocardiogram (ECG) was analyzed for QT interval (QT), corrected QT interval (QTc), QT dispersion (QTD) and QTc dispersion (QTcD) in milliseconds. Results: The mean (SD) QT, QTc, QTD and QTcD interval in milliseconds were 320 (0.05), 420 (0.07), 61.15 (16.20), 102.3 (17.24), respectively for breath-holding spells as compared to control group [300 (0.02), 370 (0.03), 38.6(14.28), 78.6 (14.28), respectively] (P<0.001). Similarly, pallid breathholding spells had prolonged mean (SD) QT, QTc, QTD and QTcD interval in milliseconds [380 (0.04), 520 (0.08), 78.88 (10.78), 123.33 (10.28), respectively] as compared to cyanotic spells [310 (0.04), 400 (0.04), 57.44 (14.64), 97.90 (15.03), respectively] (P<0.001). The mean QTc interval was 590 (0.03) and 400 (0.04) milliseconds in prolonged and non-prolonged QTc group, respectively (P<0.001). Conclusion: Abnormal QT, QTc, QTD and QTcD were observed among children with breath-holding spells. ECG should be strongly considered, especially in pallid, frequent spells occurring at younger age and having positive family history, to identify long QT syndrome.
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The continuous growth of the global human population and the depletion of natural energy resources are posing a threat to the environment and the sustainable supply of food and energy. To address this issue, a solution known as "green technology" has been developed, focusing on the use of eco-friendly approaches. One of these approaches involves harnessing the power of cyanobacteria, which are ancient microorganisms that have existed on Earth for a long time. This approach was used to probe the diversity of phototrophic microorganisms in Wheat samples. The presence of nif genes allows cyanobacteria to x nitrogen which plays a vital role in nitrogen cycle and biological processes such as plant growth and soil fertility. Wheat production test in current study evaluates the yield and quality of wheat crops. It shows factors such as improvement in growth, heat resistance and environmental adaptability, improvement in production; provide insights for optimizing cultivation practices and ensuring successful high yield. Identication of Cyanobacteria for their combination of nif and molecular identity is prior for production of bio fertilizers. Cyanobacteria can be cultivated on a large scale to produce biomass that has multiple uses, including biofertilizer, secondary metabolites, cosmetics, and medicines. In the eld of agriculture, production of healthy crop cyanobacterial biofertilizer are being increasingly used in eco-friendly and sustainable practices. These biofertilizer are produced through mass cultivation of cyanobacteria and offer several benets.
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Purpose: Diseases affecting the cornea are a major cause of corneal blindness globally. The pressing issue we are facing today is the lack of diagnostic devices in rural areas to diagnose these conditions. The aim of the study is to establish sensitivity and accuracy of smartphone photography using a smart eye camera (SEC) in ophthalmologic community outreach programs. Methods: In this pilot study, a prospective non?randomized comparative analysis of inter?observer variability of anterior segment imaging recorded using an SEC was performed. Consecutive 100 patients with corneal pathologies, who visited the cornea specialty outpatient clinic, were enrolled. They were examined with a conventional non?portable slit lamp by a cornea consultant, and the diagnoses were recorded. This was compared with the diagnoses made by two other consultants based on SEC videos of the anterior segment of the same 100 patients. The accuracy of SEC was accessed using sensitivity, specificity, PPV, and NPV. Kappa statistics was used to find the agreement between two consultants by using STATA 17.0 (Texas, USA). Results: There was agreement between the two consultants to diagnosing by using SEC. Above 90% agreements were found in all the diagnoses, which were statistically significant (P?value < 0.001). More than 90% sensitivity and a negative predictive value were found. Conclusion: SEC can be used successfully in the community outreach programs like field visits, eye camps, teleophthalmology, and community centers, where either a clinical setup is lacking or ophthalmologists are not available.
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Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40–80. The best way to manage primary open?angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods: An open?label, real?world, multicentric, observation?based 3?month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first?line therapy. Diurnal IOP measurements, best?corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day?1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results: Four hundred and sixty?nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once?daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion: We found that netarsudil 0.02% w/v solution monotherapy when used as the first?line treatment in primary open?angle glaucoma and ocular hypertension was both safe and effective.
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Background: Birth Preparedness and Complication Readiness (BPCR) helps in improving the effective utilization of available maternal and newborn health care services through knowledge of danger sign, identifying birth place and attendant, means of transportation, managing fund for an emergency, birth companion and identification of blood donor. Aim: To find the association between socio-demographic characteristics and BPCR index indicators. Settings and Design: A cross-sectional study was conducted among the recently delivered and pregnant women in urban and rural areas of the Gandhinagar district of Gujarat. Methods and Material: Total 420 pregnant and recently delivered women from urban and rural areas were interviewed for study. A pretested semi-structured questionnaire was used to interview women at household setting. BPCR index is estimated by set of 7 quantifiable indicators and expressed in the percentage of women with specific characteristics. Results: Regarding ANC registration within 12th weeks of pregnancy and skilled birth attendant for delivery. Significant difference was observed with variable like APL/BPL status, education of women and their husband, parity and type of family. Conclusions: Hindu religion, APL economic status, higher education level, joint family, high parity and joint family were found important predictor of better BPCR practice.
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INTRODUCTION: Cellulitis is a bacterial infection of the skin and subcutaneous tissuethat is more generalized than erysipelas and associated with broken skin and pre-existingulceration. Mild cases of cellulitis are generally treated with oral antibiotics, GlycerinMgSO4 dressing & affected part elevation and severe cases required admission & higherantibiotics, skin & blood culture & sensitivity & in case of systemic symptoms & abscessoperative management is required.AIMS AND OBJECTIVES:• To observe the outcome of conservative and operative patients in view ofcomorbidity and after treatment complications.• Following factors are accounting before conclusive outcome.• To understand the patients characteristics, comorbidity and mode of presentation.• To study spectrum of organism isolated from patient undergoing conservative oroperative management.• To compare treatment modality and outcome in management of cellulitis.MATERIAL & METHODS: Data consists of primary data collected by the principalinvestigator directly from the patients who were admitted from OPD in the GCS medicalcollege and hospital. It was observational study for a period of six months from April2022 to September 2022 under sample size was 50 cases.CONCLUSION: We recommended Operative management over Conservativemanagement in cellulitis because single operative incision can release toxic fluid fromaffected part and can promote faster healing and better recovery and less hospital stay.Patient has less mental trauma, less pain and more economical benefits in Operativemanagement therefore study concludes Operative management is superior Compared toConservative management. However, conservative management is preferable in earlystages of cellulitis.
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The field of nanotechnology is quickly developing and emerging since it has enormous potential for various human uses. With their unique, size-based physical and chemical attributes, nonmaterials generated and engineered through nanotechnology have many applications in biomedicine and agriculture. Theranostics is a branch of nanomedicine that uses small, highly surface-area nanoparticles to diagnose and treat diseases. Nanomaterials have a wide range of uses in agriculture, from fertilizers that improve soil nutrient uptake by plants to nano pesticides that control a variety of pests, including fungi, phytophagous insects, and weeds, increasing food output. Agriculture and food security are intimately connected, and many researchers are interested. Agriculture production depends on many difficulties due to the severe effects of climate change, water problems and changing the distribution of insect pests. Meanwhile, it faces tremendous challenges in maintaining food security for a massive population amid declining resources. Research is actively exploring the use of nonmaterial in agriculture due to their tremendous promise. Despite their good qualities, nonmaterial present risks to the environment and human health, necessitating risk assessment studies. Green nonmaterial synthesis may lessen the usage of toxic agrochemicals that pollute the environment and enter biological systems, providing an environmentally safe, environmentally friendly, and economically advantageous option. In this critical evaluation, nanoparticles are used in agriculture.
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In a country like India, oral metronidazole is the commonly prescribed drug of choice for entities such as amebiasis and visceral abscesses. Oral such cases, it is usually well tolerated and safe but can cause serious neurological adverse events. Peripheral neuropathy commonly encounters in practice but central nervous system toxicity is also well documented as it crosses the blood–brain barrier easily. Neurological toxicity of metronidazole may be due to prolonged administration, high doses, or high cumulative doses. Magnetic resonance imaging (MRI) of brain is the modality of choice to evaluate brain involvement. In the brain, the splenium of the corpus callosum, dentate nucleus of the cerebellum, and posterior pons involvement are commonly seen and diagnostic. Here, we have an interesting case report of a patient who was on oral metronidazole treatment for his large liver abscess, presenting with a complaint of neurological symptoms of unsteady gait, vertigo, dysdiadochokinesia, and difficulty in speech. Moreover, thus suspected as metronidazole drug toxicity and further investigated for the same, and MRI typically shows cerebellar and posterior corpus callosal involvement
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Right hepatic artery (RHA) is a branch of the common hepatic artery; however, there are cases documented in the literature showing anatomical variations. Accessory RHA is an incidental finding during hepatobiliary and pancreatic surgery. This artery should be identified, carefully separated, and preserved during these surgeries. We encounter the variation while doing Whipple’s procedure in a 61-year-old patient diagnosed with carcinoma of the head of the pancreas. Intra-operatively, accessory RHA was present which was arising from the superior mesenteric artery. It was identified, carefully separated, and preserved. Variations in the origin of the artery may make it vulnerable to injuries during surgical procedures if due care is not taken
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The National Education Policy 2020 is the rst education policy of the 21st century and aims to address the many growing developmental imperatives of our country. This Policy proposes the revision and revamping of all aspects of the education structure, including its regulation and governance, to create a new system that is aligned with the inspirational goals of 21st century education, including SDG4, while building upon India's traditions and value systems. The National Education Policy lays particular emphasis on the development of the creative potential of each individual. It is based on the principle that education must develop not only cognitive capacities - both the 'foundational capacities 'of literacy and numeracy and 'higher-order' cognitive capacities, such as critical thinking and problem solving – but also social, ethical, and emotional capacities and dispositions. The main objective of this study is to explore the National Education Policy 2020 in India. The paper describes the principles of National Education Policy and formation of the NEP 2020. This study examines the purpose of NEP and implementation strategy of National Education Policy in India. It is an attempt to understand the vision of National Education Policy and some major changes in education sector. The study would be useful for the Indian in planning and upgrading their educational system and improve quality of education in future