Cutting-edge Approach of Carbon Nanostructures: Targeted Drug Delivery to Central Nervous System.

Drug delivery through the blood-brain barrier (BBB) is one of the key challenges in the modern era of medicine due to the highly semipermeable characteristics of BBB that restrict the entry of various drugs into the central nervous system (CNS) for the management of brain disorders. Drugs can be easily incorporated into carbon nanocarriers that can cross the bloodbrain barrier. Numerous nanocarriers have been developed, including polymeric nanoparticles, carbon nanoparticles, lipid-based nanoparticles, etc. Among these, carbon nanostructures could be superior due to their easier BBB penetration and strong biocompatibility. Several CDs (Carbon dots) and CD-ligand conjugates have explored effectively penetrating the BBB, which enables significant progress in using CD-based drug delivery systems (DDS) to manage CNS diseases. Despite the drug delivery applications, they might also be used as a central nervous system (CNS) drug; few of the carbon nanostructures show profound neurodegenerative activity. Further, their impact on neuronal growth and anti- amyloid action is quite interesting. The present study covers diverse carbon nanostructures for brain-targeted drug delivery, exploring a variety of CNS activities. Moreover, it emphasizes recent patents on carbon nanostructures for CNS disorders.

Graphene via Microwave Expansion of Graphite Followed by Cryo-Quenching and its Application in Electrostatic Droplet Switching.

Monoelemental atomic sheets (Xenes) and other 2D materials offer record electronic mobility, high thermal conductivity, excellent Young's moduli, optical transparency, and flexural capability, revolutionizing ultrasensitive devices and enhancing performance. The ideal synthesis of these quantum materials should be facile, fast, scalable, reproducible, and green. Microwave expansion followed by cryoquenching (MECQ) leverages thermal stress in graphite to produce high-purity graphene within minutes. MECQ synthesis of graphene is reported at 640 and 800 W for 10 min, followed by liquid nitrogen quenching for 5 and 90 min of sonication. Microscopic and spectroscopic analyses confirmed the chemical identity and phase purity of monolayers and few-layered graphene sheets (200-12 µm). Higher microwave power yields thinner layers with enhanced purity. Molecular dynamics simulations and DFT calculations support the exfoliation under these conditions. Electrostatic droplet switching is demonstrated using MECQ-synthesized graphene, observing electrorolling of a mercury droplet on a BN/graphene interface at voltages above 20 V. This technique can inspire the synthesis of other 2D materials with high purity and enable new applications.

Unlocking the role of Herbal Cosmeceutical in Anti-ageing and Skin Ageing Associated Diseases.

The process of skin ageing is a natural biological phenomenon characterized by the emergence of wrinkles, age spots, sagging skin, and dryness over time. The increasing significance of skin in physical attractiveness has heightened skincare concerns. Anti-ageing cosmetics play a pivotal role in nurturing the skin, enhancing its quality, and promoting overall health. Today, cosmetics have evolved beyond mere aesthetics and are now integral to individual wellness. The contemporary quest for perpetual youth has intensified, prompting a deeper exploration into the skin ageing process. This comprehensive exploration delves into various elements involved in skin ageing, encompassing cells such as stem and endothelial cells, blood vessels, soft tissues, and signaling pathways. The molecular basis of skin ageing, including biochemical factors like reactive oxygen species, damaged DNA, free radicals, ions, and proteins (mRNA), is scrutinized alongside relevant animal models. The article critically analyzes the outcomes of utilizing herbal components, emphasizing their advantageous anti-ageing properties. The factors contributing to skin ageing, mechanistic perspectives, management approaches involving herbal cosmeceutical, and associated complications (especially cardiovascular diseases, Parkinson's, Alzheimer's, etc.) are succinctly addressed. In addition, the manuscript further summarizes the recent patented innovations and toxicity of the herbal cosmeceuticals for anti-aging and aging associated disorders. Despite progress, further research is imperative to unlock the full potential of herbal components as anti-ageing agents.

A sustainable bioprocess technology for producing food-flavour (+)-γ-decalactone from Castor oil-derived ricinoleic acid using enzymatic activity of Candida parapsilosis: Scale-up optimization and purification using novel composite.

Ricinoleic acid (RA) from castor oil was employed in biotransformation of peach-flavoured γ-decalactone (GDL), using a Candida parapsilosis strain (MTCC13027) which was isolated from waste of pineapple crown base. Using four variables-pH, cell density, amount of RA, and temperature-the biotransformation parameters were optimized using RSM and BBD. Under optimized conditions (pH 6, 10% of microbial cells, 10g/L RA at 28°C), the conversion was maximum and resulted to 80% (+)-GDL (4.4g/L/120h) yield in shake flask (500mL). Furthermore, optimization was achieved by adjusting the aeration and agitation parameters in a 3L bioreactor, which were then replicated in a 10L bioreactor to accurately determine the amount of (+)-GDL. In bioreactor condition, 4.7g/L (>85%) of (+)-GDL is produced with 20% and 40% dissolved oxygen (1.0 vvm) at 150rpm in 72h and 66h, respectively. Further, a new Al-Mg-Ca-Si composite column-chromatography method is developed to purify enantiospecific (+)-GDL (99.9%). This (+)-GDL is 100% nature-identical as validated through 14C-radio-carbon dating. Thorough chemical investigation of enantiospecific (+)-GDL is authenticated for its use as flavour. This bioflavour has been developed through a cost-effective biotechnological process in response to the demand from the food industry on commercial scale.

Evaluating the Compatibility of New Recombinant Protein Antigens (Trivalent NRRV) with a Mock Pentavalent Combination Vaccine Containing Whole-Cell Pertussis: Analytical and Formulation Challenges.

Introducing new recombinant protein antigens to existing pediatric combination vaccines is important in improving coverage and affordability, especially in low- and middle-income countries (LMICs). This case-study highlights the analytical and formulation challenges encountered with three recombinant non-replicating rotavirus vaccine (NRRV) antigens (t-NRRV formulated with Alhydrogel® adjuvant, AH) combined with a mock multidose formulation of a pediatric pentavalent vaccine used in LMICs. This complex formulation contained (1) vaccine antigens (i.e., whole-cell pertussis (wP), diphtheria (D), tetanus (T), Haemophilus influenza (Hib), and hepatitis B (HepB), (2) a mixture of aluminum-salt adjuvants (AH and Adju-Phos®, AP), and (3) a preservative (thimerosal, TH). Selective, stability-indicating competitive immunoassays were developed to monitor binding of specific mAbs to each antigen, except wP which required the setup of a mouse immunogenicity assay. Simple mixing led to the desorption of t-NRRV antigens from AH and increased degradation during storage. These deleterious effects were caused by specific antigens, AP, and TH. An AH-only pentavalent formulation mitigated t-NRRV antigen desorption; however, the Hib antigen displayed previously reported AH-induced instability. The same rank-ordering of t-NRRV antigen stability (P[8] > P[4] > P[6]) was observed in mock pentavalent formulations and with various preservatives. The lessons learned are discussed to enable future multidose, combination vaccine formulation development with new vaccine candidates.

The Rise of Xene Hybrids.

Xenes, mono-elemental atomic sheets, exhibit Dirac/Dirac-like quantum behavior. When interfaced with other 2D materials such as boron nitride, transition metal dichalcogenides, and metal carbides/nitrides/carbonitrides, it enables them with unique physicochemical properties, including structural stability, desirable bandgap, efficient charge carrier injection, flexibility/breaking stress, thermal conductivity, chemical reactivity, catalytic efficiency, molecular adsorption, and wettability. For example, BN acts as an anti-oxidative shield, MoS2 injects electrons upon laser excitation, and MXene provides mechanical flexibility. Beyond precise compositional modulations, stacking sequences, and inter-layer coupling controlled by parameters, achieving scalability and reproducibility in hybridization is crucial for implementing these quantum materials in consumer applications. However, realizing the full potential of these hybrid materials faces challenges such as air gaps, uneven interfaces, and the formation of defects and functional groups. Advanced synthesis techniques, a deep understanding of quantum behaviors, precise control over interfacial interactions, and awareness of cross-correlations among these factors are essential. Xene-based hybrids show immense promise for groundbreaking applications in quantum computing, flexible electronics, energy storage, and catalysis. In this timely perspective, recent discoveries of novel Xenes and their hybrids are highlighted, emphasizing correlations among synthetic parameters, structure, properties, and applications. It is anticipated that these insights will revolutionize diverse industries and technologies.

Identification of Rare EIF3E::RSPO2 Fusion in Recurrent and Aggressive Urachal Adenocarcinoma.

INTRODUCTION: Urachal cancer (UC) is a rare genitourinary malignancy arising from the urachus, an embryonic remnant of the placental allantois. Its diagnosis remains ambiguous with late-stage cancer detection and represents a highly aggressive disease. Due to its rarity, there is no clear consensus on molecular signatures and appropriate clinical management of UC. CASE REPORT: We report a 45-year-old man with recurrent urachal adenocarcinoma (UA) treated with cystectomies, chemotherapy, and radiotherapy. The patient initially presented with hematuria and abdominal pain. Imaging revealed a nodular mass arising from the superior wall of the urinary bladder and extending to the urachus. Biopsy results suggested moderately differentiated UA with muscle layer involvement. The tumor recurred after 20 months, following which, another partial cystectomy was performed. Repeat progression was noted indicating highly aggressive disease. Targeted next-generation sequencing revealed the presence of EIF3E::RSPO2 fusion, along with BRAF and TP53 mutations, and EGFR gene amplification. This is the first case reporting the presence of this fusion in UA. Palliative medication and radiotherapy were administered to manage the disease. CONCLUSION: Current treatment modality of surgery may be effective in the early stages of recurrent UA; however, a standard chemotherapy and radiotherapy regimen is yet to be determined for advanced stages. The detection of the rare EIF3E::RSPO2 fusion warrants further studies on the significance of this variant as a possible therapeutic target for improved clinical management.

Prediction of axial capacity of corrosion-affected RC columns strengthened with inclusive FRP.

The primary cause behind the degradation of reinforced concrete (RC) structures is the propagation of corrosion in the steel-RC structures. Nowadays, numerous retrofitting techniques are available in the construction sector. Fiber-reinforced polymer (FRP) is one of the efficient rehabilitation measures that can be implemented on corroded structures to enhance structural capacities. However, the estimation of axial strength of FRP-strengthened columns affected by corrosion has been a challenging and tedious task in the laboratory as well as on the site. Considering such shortcomings, the prediction of axial capacity can be done using various analytical methods and artificial intelligence (AI) techniques. In this study, a comprehensive dataset of circular columns was extracted from the literature to predict the axial strength of FRP-wrapped and unstrengthened RC corroded columns. The laboratory results from the assembled dataset were compared to corresponding values estimated using relevant design codes provided by American Concrete Institute (ACI 440.2R-17 and ACI 318-19), and Bureau of Indian Standard (IS 456:2000). Five machine learning models were employed on columns to predict the axial load carrying capacity of FRP-strengthened and un-strengthened RC corroded columns. The results discovered that the extreme gradient boosting (XGBoost) model achieves superior accuracy with the least errors and could be used by the scientific community and FRP applicators to forecast the axial performance of corroded columns strengthened with and without FRP. The findings from the design codes revealed that prediction errors were available in high margins. Furthermore, feature importance analysis was conducted using the Shapley Additive exPlanation algorithm to know the contribution and influence of each input parameter on axial capacity. The feature analysis found that unconfined compressive strength of concrete plays an important role in deciding the axial capacity of columns. Moreover, to enhance the precision of axial capacity computation and improving the overall efficacy in engineering practice, a web-based user-friendly interface was developed for FRP applicators and engineers to simplify the process.

Recent advances in food waste-derived nanoporous carbon for energy storage.

Affordable and environmentally friendly electrochemically active raw energy storage materials are in high demand to switch to mass-scale renewable energy. One particularly promising avenue is the feasibility of utilizing food waste-derived nanoporous carbon. This material holds significance due to its widespread availability, affordability, ease of processing, and, notably, its cost-free nature. Over the years, various strategies have been developed to convert different food wastes into nanoporous carbon materials with enhanced electrochemical properties. The electrochemical performance of these materials is influenced by both intrinsic factors, such as the composition of elements derived from the original food sources and recipes, and extrinsic factors, including the conditions during pyrolysis and activation. While current efforts are dedicated to optimizing process parameters to achieve superior performance in electrochemical energy storage devices, it is timely to take stock of the current state of research in this emerging field. This review provides a comprehensive overview of recent developments in the fabrication and surface characterisation of porous carbons from different food wastes. A special focus is given on the applications of these food waste derived porous carbons for energy storage applications including batteries and supercapacitors.

This review compiles very recent literature on the synthesis of porous carbon from food waste biomass and their efficient utilisation as electrode material for energy storage applications in supercapacitor devices.

Behavioural support and nicotine replacement therapy for smokeless tobacco cessation in Bangladesh, India and Pakistan: A pilot randomized controlled trial.

BACKGROUND AND AIMS: Smokeless tobacco (ST) use in South Asia is high, yet interventions to support its cessation are lacking. We tested the feasibility of delivering interventions for ST cessation in South Asia. DESIGN: We used a 2 × 2 factorial design, pilot randomized controlled trial with a duration of 26 weeks, including baseline and follow-up (6, 12 and 26 weeks) assessments. SETTING: Two primary health-care facilities each in Dhaka (Bangladesh) and Karachi (Pakistan) and a walk-in cancer screening clinic in Noida (India) took part. PARTICIPANTS: Adult daily ST users willing to make a quit attempt within 30 days. Of 392 screened, 264 participants [mean age: 35 years, standard deviation = 12.5, 140 (53%) male] were recruited between December 2020 and December 2021; 132 from Bangladesh, 44 from India and 88 from Pakistan. INTERVENTIONS: Participants were randomized to one of three treatment options [8-week support through nicotine replacement therapy (NRT, n = 66), a behavioural intervention for smokeless tobacco cessation in adults (BISCA, n = 66) or their combination (n = 66)] or the control condition of very brief advice (VBA) to quit (n = 66). MEASUREMENTS: Recruitment and retention, data completeness and feasibility of intervention delivery were evaluated. Biochemically verified abstinence from tobacco, using salivary cotinine, was measured at 26 weeks. FINDINGS: Retention rates were 94.7% at 6 weeks, dropping to 89.4% at 26 weeks. Attendance in BISCA pre-quit (100%) and quit sessions (86.3%) was high, but lower in post-quit sessions (65.9%), with variability among countries. Adherence to NRT also varied (45.5% Bangladesh, 90% India). Data completion for key variables exceeded 93% among time-points, except at 26 weeks for questions on nicotine dependence (90%), urges (89%) and saliva samples (62.7%). Among follow-up time-points, self-reported abstinence was generally higher among participants receiving BISCA and/or NRT. At 26 weeks, biochemically verified abstinence was observed among 16 (12.1%) participants receiving BISCA and 13 (9.8%) participants receiving NRT. CONCLUSIONS: This multi-country pilot randomized controlled trial of tobacco cessation among adult smokeless tobacco users in South Asia demonstrated the ability to recruit and retain participants and report abstinence, suggesting that a future definitive smokeless tobacco cessation trial is viable.

From Detection to Protection: Antibodies and Their Crucial Role in Diagnosing and Combatting SARS-CoV-2.

Understanding the antibody response to SARS-CoV-2, the virus responsible for COVID-19, is crucial to comprehending disease progression and the significance of vaccine and therapeutic development. The emergence of highly contagious variants poses a significant challenge to humoral immunity, underscoring the necessity of grasping the intricacies of specific antibodies. This review emphasizes the pivotal role of antibodies in shaping immune responses and their implications for diagnosing, preventing, and treating SARS-CoV-2 infection. It delves into the kinetics and characteristics of the antibody response to SARS-CoV-2 and explores current antibody-based diagnostics, discussing their strengths, clinical utility, and limitations. Furthermore, we underscore the therapeutic potential of SARS-CoV-2-specific antibodies, discussing various antibody-based therapies such as monoclonal antibodies, polyclonal antibodies, anti-cytokines, convalescent plasma, and hyperimmunoglobulin-based therapies. Moreover, we offer insights into antibody responses to SARS-CoV-2 vaccines, emphasizing the significance of neutralizing antibodies in order to confer immunity to SARS-CoV-2, along with emerging variants of concern (VOCs) and circulating Omicron subvariants. We also highlight challenges in the field, such as the risks of antibody-dependent enhancement (ADE) for SARS-CoV-2 antibodies, and shed light on the challenges associated with the original antigenic sin (OAS) effect and long COVID. Overall, this review intends to provide valuable insights, which are crucial to advancing sensitive diagnostic tools, identifying efficient antibody-based therapeutics, and developing effective vaccines to combat the evolving threat of SARS-CoV-2 variants on a global scale.

Proteostasis in neurodegenerative diseases.

Proteostasis is essential for normal function of proteins and vital for cellular health and survival. Proteostasis encompasses all stages in the "life" of a protein, that is, from translation to functional performance and, ultimately, to degradation. Proteins need native conformations for function and in the presence of multiple types of stress, their misfolding and aggregation can occur. A coordinated network of proteins is at the core of proteostasis in cells. Among these, chaperones are required for maintaining the integrity of protein conformations by preventing misfolding and aggregation and guide those with abnormal conformation to degradation. The ubiquitin-proteasome system (UPS) and autophagy are major cellular pathways for degrading proteins. Although failure or decreased functioning of components of this network can lead to proteotoxicity and disease, like neuron degenerative diseases, underlying factors are not completely understood. Accumulating misfolded and aggregated proteins are considered major pathomechanisms of neurodegeneration. In this chapter, we have described the components of three major branches required for proteostasis-chaperones, UPS and autophagy, the mechanistic basis of their function, and their potential for protection against various neurodegenerative conditions, like Alzheimer's, Parkinson's, and Huntington's disease. The modulation of various proteostasis network proteins, like chaperones, E3 ubiquitin ligases, proteasome, and autophagy-associated proteins as therapeutic targets by small molecules as well as new and unconventional approaches, shows promise.

Schwannoma of the base of tongue in a 26-year old male: A rare case report with a short review of literature.

Schwannoma is a benign nerve sheath tumor that arises from Schwann cells of the peripheral nerve sheath with uncertain etiology. It is well-encapsulated and a slow-growing tumor. Approximately 25-48% of cases are seen in the head and neck region. Schwannoma of the oral cavity has an approximate incidence of 1%. Tongue base Schwannoma is a rare entity. It can affect all age groups and typically presents as a painless lump. However, when it grows larger than 3 cm, it may produce dysphagia, pain, or discomfort and change in the quality of voice. Hence, Schwannoma should be considered as one of the differential diagnoses of exophytic mass of the tongue. We report a rare case of Schwannoma of the base of the tongue in a 26-year-old male who presented with a complaint of lump, along with a review of the literature published in the last 64 years.

Acetaminophen induces mitochondrial apoptosis through proteasome dysfunctions.

Acetaminophen is a known antipyretic and non-opioid analgesic for mild pain and fever. Numerous studies uncover their hidden chemotherapeutics applications, including chronic cancer pain management. Acetaminophen also represents an anti-proliferative effect in some cancer cells. Few studies also suggest that the use of Acetaminophen can trigger apoptosis and impede cellular growth. However, Acetaminophen's molecular potential and precise mechanism against improper cellular proliferation and use as an effective anti-proliferative agent still need to be better understood. Here, our current findings show that Acetaminophen induces proteasomal dysfunctions, resulting in aberrant protein accumulation and mitochondrial abnormalities, and consequently induces cell apoptosis. We observed that the Acetaminophen treatment leads to improper aggregation of ubiquitylated expanded polyglutamine proteins, which may be due to the dysfunctions of proteasome activities. Our in-silico analysis suggests the interaction of Acetaminophen and proteasome. Furthermore, we demonstrated the accumulation of proteasome substrates and the depletion of proteasome activities after treating Acetaminophen in cells. Acetaminophen induces proteasome dysfunctions and mitochondrial abnormalities, leading to pro-apoptotic morphological changes and apoptosis successively. These results suggest that Acetaminophen can induce cell death and may retain a promising anti-proliferative effect. These observations can open new possible molecular strategies in the near future for developing and designing specific and effective proteasome inhibitors, which can be helpful in conjugation with other anti-tumor drugs for their better efficiency.

Estimating the Effect of Genital vs Extragenital Warts on Immunocompetent Indian Adult Patients; Quality of Life: A Comparative Cross-Sectional Study.

Introduction: Extragenital warts, often known as EGWs, affect between 7% and 10% of the population. Despite the plethora of research on the impact of genital warts (GWs) on "Quality Of Life", EGWs have received little attention. The purpose of this study was to conduct a cross-sectional investigation with the objective of contrasting the effects of GWs and EGWs on the health-related quality of life and other characteristics. Participants and Procedures: A cross-sectional clinical study was piloted at a tertiary care center. Participants in the study included two groups of healthy adults, each group consisting of 100 adult subjects. Those diagnosed with EGWs were included in group A, while patients diagnosed with GWs made up group B. The "Dermatology Life Quality Index" questionnaire was used to evaluate various parameters. Observations were compared for significance. Results: The majority of the subjects in both the groups were observed to have less than 10 warts. The Dermatology Life Quality Index score for the EGWs had an average of 8.66 ± 2.31 score; GWs had an average of 5.12 ± 3.25. This mean variance was statistically significant. The level of the dissatisfaction was highly significantly different among the groups and the subjects being more in the EGW group dissatisfied. Conclusion: The findings of this investigation indicate that EGWs have a significant and detrimental effect on the Quality Of Life. Medical experts must teach people how to prevent the disease's spread and recurrence due to its persistence. They must also consider the psychological and societal repercussions of the disease while discussing therapy choices.

Assessment of Right Ventricular Function by Strain Imaging in Patients Presenting with Acute Myocardial Infarction: An Original Research.

Objective: This study sought to determine the relationship between right ventricular (RV) function and clinical variables and prognosis in individuals with acute myocardial infarction (AMI) utilizing strain imaging. Materials and Methods: A prospective observational research involving 150 patients who had been admitted with AMI was carried out. Utilizing two-dimensional speckle-tracking strain imaging, RV function was assessed. Age, sex, risk factors, and comorbidities were recorded as clinical parameters. A 12-month follow-up was conducted to assess major adverse cardiovascular events (MACE). Results: 65% of the study's participants were men, with a mean age of 58.2 years. When compared to a healthy control group, individuals with AMI had significantly lower RV longitudinal strain (RVLS) (P 0.001). RVLS and left ventricular ejection fraction had a statistically significant connection (r = 0.642, P 0.001). Patients with compromised RVLS had a greater rate of MACE over the follow-up period compared to those with maintained RV function (P = 0.014). Conclusion: In conclusion, strain imaging offers useful information for evaluating RV function in patients with AMI. Reduced left ventricular performance and a higher likelihood of unfavorable clinical outcomes are linked to impaired RVLS. Utilizing strain imaging to detect RV dysfunction early can help direct treatment plans and enhance patient outcomes.

Analysis of Vocal Signatures of COVID-19 in Cough Sounds: A Newer Diagnostic Approach Using Artificial Intelligence.

BACKGROUND: Artificial intelligence (AI) based models are explored increasingly in the medical field. The highly contagious pandemic of coronavirus disease 2019 (COVID-19) affected the world and availability of diagnostic tools high resolution computed tomography (HRCT) and/or real-time reverse transcriptase-polymerase chain reaction (RTPCR) was very limited, costly and time consuming. Therefore, the use of AI in COVID-19 for diagnosis using cough sounds can be efficacious and cost effective for screening in clinic or hospital and help in early diagnosis and further management of patients. OBJECTIVES: To develop an accurate and fast voice-processing AI software to determine voice-based signatures in discriminating COVID-19 and non-COVID-19 cough sounds for screening of COVID-19. METHODOLOGY: A prospective study involving 117 patients was performed based on online and/or offline voice data collection of cough sounds of COVID-19 patients in isolation ward of a tertiary care teaching hospital and non-COVID-19 participants using a smart phone. A website-based AI software was developed to identify the cough sounds as COVID-19 or non-COVID-19. The data were divided into three segments including training set, validation set and test set. A pre-processing algorithm was utilized and combined with Short Time Fourier Transform feature representation and Logistic regression model. A precise software was used to identify vocal signatures and K-fold cross validation was carried out. RESULT: A total of 117 audio recordings of cough sounds were collected through the developed website after inclusion-exclusion criteria out of which 52 have been marked belonging to COVID-19 positive, while 65 were marked as COVID-19 negative/unsure /never had COVID-19, which were assumed to be COVID-19 negative based on RT-PCR test results. The mean and standard error values for the accuracies attained at the end of each experiment in training, validation and testing set were found to be 67.34%±0.22, 58.57%±1.11 and 64.60%±1.79 respectively. The weight values were found to be positive which were contributing towards predicting the samples as COVID-19 positive with large spikes around 7.5 kHz, 7.8 kHz, 8.6 kHz and 11 kHz which can be used for classification. CONCLUSION: The proposed AI based approach can be a helpful screening tool for COVID-19 using vocal sounds of cough. It can help the health system by reducing the cost burden and improving overall diagnosis and management of the disease.

Comparison of the LMA BlockBuster and intubating LMA as a conduit to blind tracheal intubation.

Background and Aims: Primary aim of the study was to evaluate the performance of Intubating LMA (ILMA) and blockbuster LMA in terms of first pass success rate, ease and duration taken for blind tracheal intubation. Material and Methods: The present prospective randomised study was conducted on 70 patients of either sex aged 18-60 years belonging to ASA physical status I or II. Patients were randomly allocated to either, group I and group B of n = 35 each. In group I and B patients were intubated using ILMA and LMA BlockBuster respectively. Insertion time and ease of placement of supraglottic device, total time taken for successful intubation, number of attempts for endotracheal tube (ETT) placement, and ease of placement of ETT, were recorded. Results: In both groups, the supraglottic device was placed on the first attempt in 88.6% patients. The first-attempt success rate for ETT placement was 71.4% in group I versus 94.3% in group B, (P = 0.01) with an overall success rate of 88.5% in group I and 100% in group. More failure rate was observed in group I (11.4%) compared to group B (0%). The total time taken for successful intubation in group I was 11.53 ± 6.410 sec and 9.17 ± 2.749 sec in group B (P = 0.04). Conclusion: We conclude that the modifications in the design of LMA Blockbuster (>95° angle, availability of the parker flex tube 27-30°angle of the emergence of airway tube) make it a more convenient, effective, simpler, and faster intubating device than ILMA.

A comparative study to evaluate the cervical spine movements during laryngoscopy using Macintosh and Airtraq laryngoscopes.

Background and Aim: Intubation with Macintosh requires flexing the lower cervical spine and extending the atlanto-occipital joint to create a "line of sight." Primary aim of study was to compare the extent of cervical spine movement during laryngoscopy using conventional Macintosh laryngoscope and Airtraq. Material and Methods: A total of 25 patients of either sex between the age group of 18 and 60 years, having American Society of Anesthesiologists (ASA) physical status of Grade-I and Grade-II, scheduled for elective surgery under image control requiring general anesthesia and intubation were enrolled. A baseline image of the lateral cervical spine including the first four cervical vertebrae was taken by an image intensifier. After administration of general anesthesia, laryngoscopy was first performed using a Macintosh laryngoscope and a second X-ray image of the lateral cervical spine was taken. The second laryngoscopy using a Airtraq laryngoscope was done and the third image of the lateral cervical spine was taken. Angles between occiput and C1; C1 and C2; C2 and C3; C3 and C4; and occiput and C4 were calculated. Atlanto-occipital distance (AOD) was calculated as the distance between occiput and C1. Results: Macintosh showed greater cervical movement as compared with Airtraq but a significant difference in the movement was observed at C2-C3 and C0-C4. Baseline mean AOD was 2.21 ± 1.25 mm, after Macintosh and Airtraq laryngoscopy was found to be 1.13 ± 0.60 and 1.6 ± 0.78 mm, respectively, and was found to be significant (P < 0.05). Conclusion: We conclude that Airtraq allows intubation with less movement of the upper cervical spine makes Airtraq preferred equipment for intubation in patients with a potential cervical spine injury.

Evaluation of the three different doses of cisatracurium during general anaesthesia: A prospective randomized study.

Background and Aims: The present study was conducted to determine the optimal dose of cisatracurium for intubating conditions and onset and offset of neuromuscular blockade. Data in Indian population are scarce, and hence, the present study was planned to evaluate different doses of cisatracurium. Material and Methods: The prospective randomized double-blind study was conducted on 180 patients of either sex in the age group of 20-60 yrs., having physical status class I to III, scheduled for surgery under general anesthesia. After exclusion 154 patients were randomly divided into three groups comprising 52, 51, and 51, respectively, in Group A, Group B, and group C. They received 0.1 mgkg-1, 0.2 mgkg-1, and 0.3 mgkg-1 of cisatracurium, respectively, to facilitate endotracheal intubation. Time of onset, intubating conditions, hemodynamic parameters, signs of histamine release, and recovery time were noted. Results: Mean time to onset was maximum in group A (4.37 ± 0.48 minutes) and minimum in group C (2.33 ± 0.43 minutes). Intubating conditions were found excellent in 88% patients in group. Change in HR was found to be non-significant at all time periods, but decrease in MAP was found between 2 and 10 minutes in group C. Duration of action was longest in group C. Conclusion: We conclude that cisatracurium in dose of 0.2 mgkg-1 and 0.3 mgkg-1 provides good-to-excellent intubating conditions within less than 3 minutes.