Teen pregnancy involvement among African, Caribbean and Black adolescent boys and girls: A scoping review.

OBJECTIVES: This study aims to investigate the incidence, associated factors and interventions to address teen pregnancy involvement (TPI) among African, Caribbean and Black (ACB) adolescents in North America. DESIGN: We conducted a scoping review of the literature, guided by the social-ecological model. DATA SOURCES: Studies were retrieved from databases such as Ovid Medline, Ovid Embase, CINAHL, CAB Direct and Google Scholar and imported into COVIDENCE for screening. ELIGIBILITY CRITERIA: The Joanna Briggs Institute scoping reviews protocol guided the establishment of eligibility criteria. Included studies focused on rates, associated factors and interventions related to TPI among ACB boys and girls aged 10-19 in North America. The publication time frame was restricted to 2010-2023, encompassing both peer-reviewed and non-peer-reviewed studies with diverse settings. DATA EXTRACTION AND SYNTHESIS: Data were extracted from 32 articles using a form developed by the principal author, focusing on variables aligned with the research question. RESULTS: The scoping review revealed a dearth of knowledge in Canadian and other North American literature on TPI in ACB adolescents. Despite an overall decline in teen pregnancy rates, disparities persist, with interventions such as postpartum prescription of long-acting birth control and teen mentorship programmes proving effective. CONCLUSION: The findings highlight the need for increased awareness, research and recognition of male involvement in adolescent pregnancies. Addressing gaps in housing, employment, healthcare, sexual health education and health systems policies for marginalised populations is crucial to mitigating TPI among ACB adolescents. IMPACT: The review underscores the urgent need for more knowledge from other North American countries, particularly those with growing ACB migrant populations.

Switchable metal extractant integrated miniaturized 3D-printed device: A semi-online multi-metal separation system for matrix-free ICP-MS analysis.

BACKGROUND: This study tackles the critical challenges in metal analysis by presenting an innovative miniaturized metal extraction device prototype. This device features a functional nanocomposite (FNC) enhanced 3D-printed polylactic acid (PLA) metal extractant (FNC@3D PLA). The research is motivated by the constraints of traditional solid-phase extraction (SPE) methods, specifically their limitations in handling competitive metal ion environments and matrix interference during inductively coupled plasma mass spectrometry (ICP-MS) analysis. The designed prototype aims to overcome these challenges and enhance the extraction efficiency of diverse metals. RESULTS: The FNC, designed to incorporate various functional groups critical for metal ion extraction efficiency, was meticulously engineered through the reaction of acid-treated and delaminated graphitic carbon nitride nanosheets (Thiol-gCN NSs) with 3-mercaptopropyl trimethoxysilane (MPTMS). The competitive metal ion extraction efficiency of FNC@3D PLA was demonstrated, showcasing notable limit of detection values of 3.2 ± 0.7 ng mL-1 and 8.57 ± 3.05 ng mL-1 for Cu and Ag, respectively. Furthermore, the miniaturized 3D-printed metal-preconcentration setup incorporating FNC@3D PLA exhibited favorable intraday relative standard deviation (RSD) percentage (%) values ranging from 1.23 to 8.6 for both Cu and Ag. Interday RSD % between 1.41 and 8.14 were observed under spiked real urine sample conditions. The sustainability and robustness of the proposed approach were underscored by substantial recovery % values exhibited by FNC@3D PLA, even after eight consecutive regeneration processes. SIGNIFICANCE: This study significantly contributes to the advancement of analytical methodologies by providing a reliable and efficient platform for metal extraction and preconcentration in practical metal analysis applications. Developed FNC@3D PLA system demonstrates its potential to address the challenges associated with SPE in metal analysis, especially in complex sample matrices. We believe implications of this research can be extended to various fields, from environmental monitoring to clinical diagnostics, where accurate and reliable metal analysis is paramount.

Comparison of cosmesis, mydriasis, fundus visibility, and anterior chamber depth following single-pass four-throw pupilloplasty in congenital and traumatic iris defects.

PURPOSE: To compare postoperative cosmesis, mydriasis, fundus visibility, and anterior chamber depth (ACD) in congenital and traumatic iris defects after single-pass four-throw pupilloplasty (SFTP). SETTINGS AND DESIGN: Hospital-based non-randomized interventional study. METHODS: SFTP was done along with phacoemulsification in six patients each with congenital and traumatic iris defects, and the patients were followed for a minimum period of 3 months. The postoperative pupil shape, size, mydriasis, and ACD were compared between the two groups. RESULTS: Tissue approximation was successful in 11 out of 12 patients (91.7%), whereas it failed to do so in one patient with traumatic iris tear (8.3%). A central round pupil was attained in all six patients with congenital defects (group 1), whereas in the traumatic group (group 2), a central round pupil was attained in four cases. Group 1 did not show a significant reduction in horizontal pupil diameter, but group 2 had a significant reduction in pupil diameter postoperatively. Mydriasis and fundus visibility were satisfactory in all cases. There was a significant deepening of ACD in both groups. CONCLUSION: Traumatic mydriasis usually requires SFTP at two opposite poles to achieve a central pupil with a significant reduction in pupil size, whereas congenital coloboma requires SFTP to be done at the site of coloboma with occasional enlargement at the opposite pole if the pupil is eccentric.

Evaluation of ganglion cell-inner plexiform layer thickness in the diagnosis of pre-perimetric glaucoma and comparison to retinal nerve fiber layers.

PURPOSE: Evaluation of ganglion cell-inner plexiform layer thickness in the diagnosis of pre-perimetric glaucoma (PPG) and comparison to retinal nerve fiber layers. METHODS: This study was a prospective hospital-based study. A total of 30 PPG and control patients were studied for retinal nerve fiber layer thickness (RNFL) and ganglion cell-inner plexiform layer complex (GC-IPL) by spectral-domain optical coherence tomography. PPG was defined as eyes with a normal visual field and one or more localized RNFL defects that were associated with a typical glaucomatous disc appearance. Diagnostic abilities of GC-IPL, optic nerve head (ONH), and RNFL parameters were computed using area under receiver-operating curve (AUROC), sensitivity, and specificity. RESULTS: GC-IPL parameters showed significant changes in PPG cases as compared to normal subjects in each region ( P value < 0.001). RNFL parameters also differed significantly from normal subjects in all quadrants ( P value 0.003 to < 0.001). Within GC-IPL parameters, the superotemporal region had the maximum area under the curve (AUC), followed by inferior, superior, and inferotemporal regions. Within RNFL parameters, the inferior quadrant had the maximum AUC, followed by superior and nasal quadrants. the GC-IPL parameters in PPG showed that the AUC of the GC-IPL parameters was much higher than those of the ONH and RNFL values. CONCLUSION: Although both the parameters RNFL and GC-IPL showed significant changes in PPG patients compared to healthy subjects, a higher AUC of GC-IPL points toward the higher sensitivity of GC-IPL than RNFL for detecting glaucoma in early stages.

Evaluation of salivary endothelin-1 as a biomarker for oral cancer and precancer.

CONTEXT: Oral cancer is highly prevalent in India. Lack of awareness and delay in diagnosis and treatment of patients with oral cancer leads to high mortality and poor survival of patients. Salivary endothelin-1 is proposed as a prospective biomarker for oral squamous cell carcinoma. AIMS: Aim of the study was to evaluate salivary level of endothelin-1 in oral cancer and precancer as a biomarker. SETTINGS AND DESIGN: We planned a case control study to evaluate salivary level of Endothelin-1 in oral cancer and precancer as a biomarker. MATERIALS AND METHODS: A total of 72 subjects were taken in study out of which 24 cases were of histopathologically confirmed premalignat oral lesion (oral leukoplakia and oral submucous fibrosis), 24 cases were of histopathologically confirmed oral squamous cell carcinoma, and 24 cases of healthy age and gender matched controls without any addiction to tobacco in any form from a tertiary care hospital were taken. Saliva was collected from all following standard guidelines and estimation of salivary endothelin-1 was done by ELISA. STATISTICAL ANALYSIS USED: SPSS software version 15. RESULTS: Salivary endothelin-1 values of controls ranged between 0.09 and 1.88 pg/ml while that of premalignant cases ranged between 1.16 and 16.135 pg/ml and of SCC cases ranged between 2.567 and 22.98 pg/ml. CONCLUSIONS: Salivary endothelin-1 is raised in oral squamous cell carcinoma compared to premalignant and controls therefore, shows capability to differentiate between premalignant lesion and oral cancer. So, it could be used as a biomarker for early diagnosis.

A phosphonium ionic liquid conjugated magnetic graphitic carbon nitride nanocomposite: an effective sample pretreatment tool for selenium separation and determination.

We established an innovative and easy-to-use methodology for selenium (Se) extraction and determination from real water samples utilizing a magnetic nanocomposite adsorbent (MNC-SPE) aided by an inductively coupled plasma mass spectrometry (ICP-MS) approach. The MNC-SPE adsorbent was fabricated by hybridizing Fe3O4 nanoparticles on the surface of carbon nitride nanosheets (GCN NSs) that were coated with 1-hexyl-3-methylimidazolium hexafluorophosphate ionic liquid (P-IL). A variety of techniques were used to thoroughly analyze the structural and chemical characteristics of MNC-SPE, and appear to have a great number of diverse active surface functional units (imidazole ring and -NH3+). In order to optimize the key factors affecting the Se extraction, parameters including the adsorbent dosage, contact time, eluent type, eluent volume, eluent time, and reusability of adsorbent were extensively studied. The proposed approach was validated under the optimal reaction conditions, and it showed good linearity between 0.15 and 100 pg µL-1 with a significant R2 value (R2 = 0.9994) toward Se metal. Besides, the Se limit of detection (LOD) and limit of quantification (LOQ) are 0.063 pg µL-1 and 0.147 pg µL-1, respectively. Further, by utilizing tap and river water samples, the applicability of the validated method was tested; the approach showed high Se recovery values in the range of 87.6-115.5% for the spiked real-world samples and the interday and intraday precision (RSD%) values of the approach were 4.8% (n = 6). The MNC-SPE can be regenerated and reused for four consecutive extraction-desorption cycles by employing 0.5 M NaOH eluent.

Rice lipases: a conundrum in rice bran stabilization: a review on their impact and biotechnological interventions.

Rice is a primary food and is one of the most important constituents of diets all around the world. Rice bran is a valuable component of rice, containing many oil-soluble vitamins, minerals, and oil. It is known for its ability to improve the economic value of rice. Further, it contains substantial quantities of minerals like potassium, calcium, magnesium, iron and antioxidants like tocopherols, tocotrienols, and γ-oryzanol, indicating that rice bran can be utilized effectively against several life-threatening disorders. It is difficult to fully utilize the necessary nutrients due to the presence of lipases in rice bran. These lipases break down lipids, specifically Triacylglycerol, into free fatty acids and glycerol. This review discusses physicochemical properties, mechanism of action, distribution, and activity of lipases in various components of rice seeds. The phylogenetic and gene expression analysis helped to understand the differential expression pattern of lipase genes at different growth phases of rice plant. Further, this review discusses various genetic and biotechnological approaches to decrease lipase activity in rice and other plants, which could potentially prevent the degradation of bran oil. The goal is to establish whether lipases are a major contributor to this issue and to develop rice varieties with improved bran stability. This information sets the stage for upcoming molecular research in this area. Supplementary Information: The online version contains supplementary material available at 10.1007/s12298-023-01343-3.

Teen pregnancy involvement among African, Caribbean and Black adolescent boys and girls: a scoping review protocol.

INTRODUCTION: African, Caribbean and Black (ACB) adolescents are disproportionately affected by teen pregnancy in North America. Teen pregnancy poses risks to the quality of life of adolescent boys and girls, including physical, psychosocial and socioeconomic risks. Our review aims to explore this public health concern for ACB adolescents within North America. We aim to identify and analyse available evidence on the incidence and prevalence of, associated factors of and interventions to curtail teen pregnancy involvement (TPI) among ACB adolescent boys and girls in North America. This review will explore TPI, rather than teen pregnancy, to ensure a review of men' involvement in teen pregnancy outcomes. METHODS AND ANALYSES: Health literature databases such as CINAHL, OVID (Medline and Embase) and CAB direct. Searches will be conducted for evidence published from 2001 to October 2021. Search results will be exported to Covidence for subsequent steps of the review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review guidelines will be used to ensure reproducibility and transparency. We will include all study designs focused on ACB boys and girls between 10 and 19 years old, residing in North America. Studies with a mixed racial sample will be included if sample consists of greater than 50% ACB individuals. ETHICS AND DISSEMINATION: TPI is a public health concern with socioeconomic and health consequences for ACB teens in North America. A scoping review such as this will provide direction for healthcare practice, policy changes, education and further research in reducing the incidence of TPI in North America. Study results will be disseminated via presentations at conferences, at target populations, communities and organisations and publications via peer-reviewed journals. As knowledge generated from this scoping review will stem from previously published evidence, an ethical approval is not needed.

Impact of learning effect on reliability factors and global indices in visual field testing by standard automated perimetry in normal healthy subjects and primary open-angle glaucoma patients to obtain an accurate baseline perimetry chart.

Purpose: To record and evaluate the reliability parameters (fixation loss (FL) %, false positive (FP) %) and global indices (mean sensitivity (MS), mean deviation (MD), pattern standard deviation in dB) in three visual field test sessions within two weeks to assess the learning effect in normal healthy subjects and POAG patients and comparison of learning effect gender wise and age wise in primary open-angle glaucoma (POAG) patients. Methods: This study was a prospective observational study. An oculus visual field testing was done and analyzed in 30 eyes of POAG patients and 30 eyes of normal healthy subjects in three visits. Results: There were 16 (53.3%) males and 14 (46.6%) females in the POAG group and 16 (53.33%) males and 14 (46.66%) females in the normal healthy subject group. A significant difference in data change between each visit in FL, FP, MD, MS was found though the difference was more pronounced in the second visit than in the third visit. The pattern standard deviation does not change significantly in subsequent visits in both groups. Gender wise and age wise no significant difference was found in the POAG group. Conclusion: Significant improvement in reliability parameters and global indices with each subsequent visit in both the POAG group and normal patients signifies the importance of learning effect on these parameters and the need to perform at least three tests to get the baseline perimetry chart, especially in POAG patients, while in normal subjects, second perimetric result can be accepted. It was also concluded that the learning effect is not influenced by age and gender.

Mandibular Teeth as Predictors in Forensic Age Estimation: A Cone-Beam Computed Tomography-Based Pulp Volume Regression Study.

Background: Age estimation is integral to science of forensic odontology and plays an important role in human identification. Pulp volume estimation using cone-beam computed tomography (CBCT) to derive age can be very useful as it is noninvasive and can be applied on individuals of all ages. Aims and Objectives: The study aimed to estimate the chronological age-based pulp and tooth volume (PTV) ratios in adults from Uttar Pradesh, India, using CBCT and voxel counting dental software. Materials and Methods: Thirty-six CBCT scans were allocated into three Groups, I, II, and III (12 in each group) randomly to study the pulp volume of lateral incisor, canine, and first premolar, respectively. PTV was calculated by image segmentation method using Xelis Dental software. A correlation between chronological age with PTV was established using derived regression equations. Statistical Analysis: All the data were subjected to statistical analysis using Statistical Package for Social Sciences version 16.0. Results: Estimated age and standard error were determined. Standard errors of estimates were 11.24 years (LI), 7.78 years (C), 9.89 years (PM) group, lowest being for canines. The estimated age was compared with the chronological age. The difference between the chronological age and the estimated age by the derived equation for the present study was statistically nonsignificant (P = 1.00). Conclusions: The results of the study show the feasibility of calculation of PTV ratios on CBCT to estimate the age for the set population with canine as the best predictor of age for the present study population.

Qualitative and quantitative assessment of diatom deformities and protoplasmic condition under metal and metalloid stress.

Metals and metalloids are toxic, persistent, and non-biodegradable and can be biomagnified (e.g., Hg), and therefore pose a serious threat to the algal flora of aquatic ecosystems. This laboratory study tested the effects of metals (Zn, Fe, and Hg) and a metalloid (As) on the cell wall morphology and protoplasmic content of living cells of six widespread diatom genera over 28 days. Diatoms exposed to Zn and Fe had a higher frequency of deformed diatom frustules (> 1%) compared to the As, Hg, and control treatments (< 1%). Deformities in the valve outline and striae were found in all treatments, including the control, whereas deformed raphes and more than one type of deformity were more prevalent under Zn and Hg stress. The order of toxicity is as follows: Zn > Fe > Hg≈As. Deformities were more frequent in Achnanthes and Diploneis (adnate forms) than in the motile genera of Nitzschia and Navicula. The correlation between the % healthy diatoms and % deformities in all six genera showed a negative relationship with the integrity of protoplasmic content (i.e., greater alteration in protoplasmic content was associated with greater frustule deformation). We conclude that diatom deformities can be a good indicator of metal and metalloid stress in waterbodies and are very useful in the rapid biomonitoring of aquatic ecosystems.

Histological and molecular insights in to in vitro regeneration pattern of Xanthosoma sagittifolium.

A study on the effect of various phytohormonal combinations on in vitro propagation of Cocoyam [Xanthosoma sagittifolium (L.) Schott] was conducted to develop an improved and efficient in vitro regeneration protocol for its mass multiplication. Histological analysis to understand the in vitro regeneration pattern and genetic fidelity assessment of regenerated plants were also carried out. Single shoots excised from in vitro established cultures of X. sagittifolium were used as explants. Among the 32 different phytohormonal combinations tested, indirect organogenesis with intervening callus phase was observed on majority of the media combinations. Meristematic clump formation was optimally achieved on all the tested media combinations with maximum 43.54 ± 0.51 shoot primordia on MS medium containing 0.2 mg/L BAP + 0.1 mg/L NAA followed by 36.44 ± 0.76 shoot primordia on MS medium having 2.5 mg/L TDZ. Micro-morphological analysis of different morphogenetic structures revealed that the regeneration of cocoyam is well executed via meristematic nodules, shoot primordia formation that may evolve in to proper shoots. Adventitious shoots (> 2 cm) were successfully (100.00 ± 0.00%) rooted on the half-strength MS medium containing IBA (0.05-1.0 mg/L) and IAA (0.05-0.5 mg/L). The number of roots ranged from 0.78 ± 0.31 on the control half-strength MS medium to 13.94 ± 0.46 on half-strength MS supplemented with 1.0 mg/L IBA. Considering somaclonal variations as a potential restriction to in vitro multiplication of plants, genetic stability was assessed using 40 ISSR primers. The PCR amplification profiles obtained from all the tested propagules (calli, meristematic clumps, regenerated plantlets) were similar to the mother plants indicating the homogeneity of the individuals raised through the regeneration protocol reported here.

Exploring the nitric oxide dioxygenation (NOD) reactions of manganese-peroxo complexes.

Here, we report the nitric oxide dioxygenation (NOD) reactions of two MnIII-peroxo (MIII-O22-) complexes, [(3PYENMe)MnIII(O22-)]+ (1) and [(N3PY)MnIII(O22-)]+ (2), bearing pentadentate ligands. Complexes 1 and 2 give MnII-nitrate (MnII-NO3-) complexes (3 and 4) when reacted with nitric oxide (NO), respectively. The mechanistic study explored by using 2,4-di-tert-butylphenol (2,4-DTBP) suggested that the NOD reaction of 1 and 2 occurs via a presumed Mn-peroxynitrite ([Mn-PN]+, [Mn-ONOO-]+) intermediate. Tracking the source of N atoms using 15NO revealed that the N-atoms in MnII-NO3- (3 and 4) are derived from the 15NO moiety. Furthermore, we have explored the MIII-O22- regeneration from NOD products (3 and 4), and we have observed the formation of MIII-O22- complexes (1 and 2) upon treatment with KO2 or H2O2/triethylamine (TEA), respectively.

Visible fluorescent sensing of Cu2+ ions in urine by reusable chitosan/l-histidine-stabilized silicon nanoparticles integrated thin layer chromatography sheet.

This study reports a facile approach for the fabrication of chitosan (CS, biopolymer)- and l-histidine (L-His, biomolecule)-stabilized self-assembled silicon nanoparticles (SiNPs) for sensing Cu2+ ions. Approached method yielded 3.8 ± 0.04 nm size CS/L-His-SiNPs particles, with high stability against harsh pH and temperature conditions. Besides, CS/L-His-SiNPs highly selective to Copper amongst different metal ions tested (Fe3+, Mg2+, Al3+, Cr3+, Cr6+, Cu2+, Mn2+, Cd2+, Pb2+, Zn2+, Hg2+, Ca2+, Li2+, Po42-, As3+, As5+). As compared to the blank-SiNPs (LOD = 96.49 ± 0.223 µM) and CS-SiNPs (LOD = 33.35 ± 1.004 µM); L-His ligand, enhanced the sensitivity of the CS/L-His-SiNPs toward Cu2+ with remarkable LOD value of 55.02 ± 0.42 nM. Applicability of CS/L-His-SiNPs was evaluated by coating CS/L-His-SiNPs on thin layer chromatography (TLC) sheets, CS/L-His-SiNPs-TLC sheets exhibited significant sensing capacity toward Cu2+ ions, with a detection range of 4.0-900 µM, making them suitable for on-site analysis of Cu2+ ions from both environmental and clinical samples. Finally, Cu2+ sensing practicality of CS/L-His-SiNPs-TLC sheets were challenged against real human urine samples. Expressively, CS/L-His-SiNPs-TLC sheets could be regenerated using ethylenediaminetetraacetic acid (EDTA), without losing their photostability, and can be reused further.

Efficacy of Diode Laser Ablation and Low Level Laser Therapy on Healing and Bacterial Load Reduction at Intraoral Biopsy Site.

Statement of the Problem: Healing complications after the conventional surgical biopsy procedure along with bacterial colonization indicates scope for sophisticated techniques. Amalgamation of photo-disinfection along with healing properties of diode laser with practiced biopsy technique can help in dealing with post biopsy complications. Purpose: The present study will analyze the possibility of conjugation of conventional surgical biopsy technique with diode laser regarding its superior properties for achieving better healing and analgesia along with sterilization of the biopsy site. Materials and Method: A randomized control trial was done where punch biopsy procedure was performed for homogenous leukoplakia. Patients were randomly divided into laser group (Test group) and control group. Test group received laser ablation and low level laser therapy (LLLT) on surgical site along with warm saline rinses whereas control group was prescribed with systemic analgesic and antibiotics. Pain on visual analogue scale (VAS), erythema along with the size of defect was evaluated on day 0, 2 and 4. Swabs were collected from the biopsy site and culture was done for evaluation of bacterial load. Results: Highly statistical significant values indicating laser induced analgesia were obtained after analysis for 2nd and 4th day (p= 0.00). Erythema and biopsy defect size evaluation showed significant results for 2nd day (p value 0.023 and 0.004 respectively), which showed absence of erythema and enhancement of healing in test group compared to controls. Statistical significant results were obtained for estimation of bacterial colonization with p value as 0.00, 0.00 for 2nd and 4th day claiming laser supported bacterial disinfection. There was a significant percentage increase on 2nd (p= 0.013) and decrease on 4th post-operative day (p= 0.022). Conclusion: The results encourage the conjugation of conventional incisional punch biopsy with low level lasers to avoid systemic intervention for post biopsy complications.

Chitosan-based nanocomposites for removal of Cr(VI) and synthetic food colorants from wastewater.

Current study aims to synthesize chitosan/polyvinyl alcohol (CS/PVA), poly(ethyleneimine), and Fe3O4 impregnated beads for co-removal of Cr(VI) and toxic azo-dyes from wastewater. The mesoporous PEI@AC@Fe3O4 exhibits magnetism and enhanced physisorption by higher specific-porosity (2.1 nm) from Cr(VI) radii (0.044 nm). Moreover, surface functional groups (-OH, -NH, -NH2, -COOH etc.), especially amines enhance ionic bonding due to positive zeta potential. Hence, it is unique for anionic dyes removal under a wide pH range. It showed maximum adsorption capacity 98, 85.5, 85.8, and 91%, or 199.8, 148, 167, 176.5 mg g-1 respectively for Cr(VI), tartrazine, sunset yellow, and erythrosine. Surface adsorption of Cr(VI) and its transition into Cr(III) was confirmed by EDX. Langmuir isotherm and pseudo-first-order kinetics best fit the adsorption of Cr(VI) and azo-dyes confirming their monolayer physisorption on adsorbent surface. Synthesized adsorbent examined in wastewater purification prototype for efficient removal of different simulated wastewaters confirms its potential for real-world applications.

Current and Upcoming Treatment Modalities in Myasthenia Gravis.

ABSTRACT: Myasthenia gravis (MG) is one of the extensively studied autoimmune disorder. There has been a dramatic increase in research to further understand molecular pathogenesis of MG and clinical trials for new drugs in MG treatment in the past decade. This review article is to consolidate the available information in simple terms with students, residents, and fellows as target audience for easy learning and help application of this knowledge to clinical practice.

Satisfaction of Telehealth in Patients With Established Neuromuscular Disorders.

Introduction/aims: Determine established neuromuscular disease patients' satisfaction with telehealth during the COVID-19 pandemic. Methods: We received 50 completed Utah telehealth satisfaction surveys from a cohort of 90 from April 2020 to June 2020. Returning neuromuscular disease patients rated seven aspects from 1 (strongly disagree) to 5 (strongly agree): Communication, timeliness of physician, picture quality, sound quality, protection of privacy, the comfort of the physical exam, the ease of healthcare, and whether patients would prefer "in-person" visits despite safety precaution. A favorable response was defined as a response of "Agree" or "Strongly Agree" to the survey questions. An independent t-test, Fisher's or chi-square test were used to compare demographic factors on outcomes for each survey question. Results: The average age was 47.54 ± 20.63, 54% were female, 70% from rural areas, 60% had family present "webside," and 14% had family present remotely. The majority of patients reported "Agree" or "Strongly Agree" to each survey question assessing their telehealth satisfaction, except for whether patients preferred in-person appointments. Demographic factors, including location and clinical diagnosis, did not influence survey responses. Discussion: The vast majority of established neuromuscular disease patients responded favorably to their telehealth experience during the COVID-19 pandemic.

Zinc oxide nanoparticles using plant Lawsonia inermis and their mosquitocidal, antimicrobial, anticancer applications showing moderate side effects.

Microbes or parasites spread vector-borne diseases by mosquitoes without being affected themselves. Insecticides used in vector control produce a substantial problem for human health. This study synthesized zinc oxide nanoparticles (ZnO NPs) using Lawsonia inermis L. and were characterized by UV-vis, FT-IR, SEM with EDX, and XRD analysis. Green synthesized ZnO NPs were highly toxic against Anopheles stephensi, whose lethal concentrations values ranged from 5.494 ppm (I instar), 6.801 ppm (II instar), 9.336 ppm (III instar), 10.736 ppm (IV instar), and 12.710 ppm (pupae) in contrast to L. inermis treatment. The predation efficiency of the teleost fish Gambusia affinis and the copepod Mesocyclops aspericornis against A. stephensi was not affected by exposure at sublethal doses of ZnO NPs. The predatory potency for G. affinis was 45 (I) and 25.83% (IV), copepod M. aspericornis was 40.66 (I) and 10.8% (IV) while in an ZnO NPs contaminated environment, the predation by the fish G. affinis was boosted to 71.33 and 34.25%, and predation of the copepod M. aspericornis was 60.35 and 16.75%, respectively. ZnO NPs inhibited the growth of several microbial pathogens including the bacteria (Escherichia coli and Bacillus subtilis) and the fungi (Alternaria alternate and Aspergillus flavus), respectively. ZnO NPs decreased the cell viability of Hep-G2 with IC50 value of 21.63 µg/mL (R2 = 0.942; P < 0.001) while the concentration increased from 1.88 to 30 µg/mL. These outcomes support the use of L. inermis mediated ZnO NPs for mosquito control and drug development.

Rhino-orbital mucormycosis: Our experiences with clinical features and management in a tertiary care center.

Objective: To determine the prevalence, risk factors, and elaborate our experiences with diagnosis and treatment of patients with mucormycosis, enabling a better understanding of the disease and its management. Methods: This is a case series of patients with Covid-19 associated with Rhino-orbital-cerebral mucormycosis, managed in our tertiary care center from April 2021 to June 2021. Results: Six cases of Covid-19 associated with Rhino-orbital-cerebral mucormycosis have been analyzed in the study. The mean age of patients was 40.67 years with a male preponderance (83.3%). The most common complaint was headache (100%), while a minority (33%) came with ocular complaints. All the patients either had a previous history of diabetes mellitus or developed increased blood sugar levels following Covid infection, and were kept on insulin to control their blood sugar levels. 4 patients (66.67%) had a history of corticosteroid use during Covid-19 hospitalization. Treatment included intravenous liposomal Amphotericin B (100%), functional endoscopic sinus surgery (66.67%), maxillectomy (33.33%) and transcutaneous retrobulbar liposomal Amphotericin B (33.33%). Amphotericin B induced nephrotoxicity, which was seen in 1 patient (16.67%). Mortality occurred in only one patient (16.67%), 25 days following successful surgery. Conclusion: Diabetes Mellitus is the most important predisposing factor for the development of Covid-19 associated Rhino-orbital-cerebral mucormycosis. Early presentation, prompt diagnosis and timely initiation of treatment with liposomal Amphotericin B and surgical debridement along with strict blood sugar control can lead to a favorable outcome. However, regular follow-up and monitoring of serum electrolytes and kidney profile must be ensured for such patients.