In 2004, the journal Adolescência e Saúde was founded as a quarterly publication dedicated to advancing knowledge and promoting discussions about adolescent health. Since its inception, the journal has consistently aimed to disseminate valuable research, practical experiences, and insights that contribute to the well-being of adolescents. By providing a platform for sharing experiences and evidence-based practices, the journal has become a vital resource for professionals working in the field of adolescent health. Adolescência & Saúde, a prestigious peer-reviewed, open-access journal published by the Universidade do Estado do Rio de Janeiro (UERJ), is a leading resource for advancing adolescent health research and practice. Indexed in Scopus, it delivers high-quality, evidence-based content to researchers, healthcare professionals, teens, and families worldwide. Open Access: Fully open access with no article processing charges, ensuring free access for readers and authors worldwide. Visibility and Indexing: Adolescência & Saúde is indexed in Scopus, ensuring its research is recognized and discoverable within the global academic community. Focused Scope: Adolescência & Saúde publishes cutting-edge research in medicine with a special focus on pediatrics, perinatology, and child health. Additionally, we welcome studies in biomedical engineering, health informatics, AI applications in medicine, medical device development, and computational medicine. Regular Publication: Publishes quarterly, releasing four issues per year, ensuring consistent dissemination of the latest research and developments in adolescent health. Efficient Peer Review: First decision in ~7 days, full review in 50–60 days, publication in 15 days, with a 25% acceptance rate.
Universidade do Estado do Rio de Janeiro (UERJ) — Núcleo de Estudos da Saúde do Adolescente (NESA)
Oxygen Uptake In Relation To Sex And Different Phases Of Breeding Cycle In Channa Gachua (Ham.)
The nutrients release energy during the metabolic process of oxidation. The energy is used, on priority basis, for maintenance of life process; growth and other functions use surplus energy. Respiration and metabolic demands in fishes are profoundly influenced by reproductive physiology, environmental rhythms, and sex-specific behaviors. Channa gachua (Ham.) is a small air-breathing freshwater teleost in the family Channidae. Its respiration involves both aquatic and aerial oxygen uptake due to specialized accessory respiratory organs. The species also undergoes cyclic gonadal changes through discrete reproductive phases resting, preparatory, pre-spawning, spawning, and post-spawning, which modulate its physiological demands.Oxygen uptake and equivalent energy utilization (E.E.U.) in relation to sex and different phases of breeding cycle was studied in the adult air-breathing murrel fish, Channa gachua (Ham.). The values were higher in males (3.221 ml/h) as compared to females (2.715 ml/h). For different breeding phases, the values were minimum in resting phase (1.1473 ml/h) and followed in increasing order by postspawning (3.2708 ml/h), preparatory (3.4963 ml/h), spawning (5.3295 ml/h) and prespawning (5.5905 ml/h) periods. Understanding oxygen uptake in relation to these reproductive stages and sex differences is vital for advancing physiological ecology, aquaculture management, and conservation of this species.
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Thyroid Autoimmune Disorders Among Reproductive-Age Women In An Iodine-Sufficient Region Of North-East India
Background: Autoimmune thyroid disorders are common among women and may adversely affect health during the reproductive years. Although iodine deficiency remains an important cause of thyroid dysfunction, thyroid autoimmunity can persist in populations with adequate iodine intake. Thyroid peroxidase (anti-TPO) and thyroglobulin (anti-Tg) antibodies are established biomarkers of autoimmune thyroid disease. North-East India has historically experienced endemic goitre, and persistent thyroid dysfunction following universal salt iodization may partly reflect underlying thyroid autoimmunity. Objective: To estimate the prevalence of thyroid autoantibody positivity and examine its association with thyroid biochemical function among women of reproductive age in an iodine-sufficient region of North-East India. Methods: A community-based cross-sectional study was conducted among women of reproductive age in Imphal East district, Manipur. The analysis included 242 women with available measurements of thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), anti-TPO and anti-Tg antibodies. Participants were categorized according to antibody status. Continuous variables were summarized using mean ± standard deviation or median with interquartile range, as appropriate. Associations between antibody status and thyroid function were assessed using the Mann–Whitney U and chi-square tests. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, with p<0.05 considered statistically significant. Results: Among the 242 participants, 110 (45.5%) were anti-TPO positive and 102 (42.1%) were anti-Tg positive. Overall, 119 women (49.2%; 95% CI: 42.7–55.7%) had at least one positive thyroid autoantibody, while 93 (38.4%) were positive for both antibodies. The median concentrations of TSH, FT4 and FT3 were 1.83, 1.36 and 2.46, respectively. Women with at least one positive antibody had significantly higher median TSH than antibody-negative women (3.11 vs. 1.56; p=0.0046). At an exploratory TSH threshold of >4.0, elevated TSH was observed in 42.9% of antibody-positive women compared with 14.6% of antibody-negative women (OR=4.38; 95% CI: 2.36–8.12; p<0.001). Conclusion: Thyroid autoantibody positivity was highly prevalent, affecting approximately half of the women studied. Antibody-positive women had significantly higher TSH levels and a markedly greater likelihood of elevated TSH, indicating a potential role of thyroid autoimmunity in thyroid dysfunction despite adequate iodine nutrition. Further large-scale community studies incorporating urinary iodine assessment, dietary factors, thyroid ultrasonography and reproductive characteristics are needed to identify determinants and establish the clinical significance of this substantial burden of thyroid autoimmunity.
The Burden Of Stress And Anxiety Among Indian Adolescents: A Systematic Review
This comprehensive assessment investigates how common stress and anxiety are in Indian adolescents along with their linked variables. By reviewing 50 studies in different parts of India this study uncovers significant influences on adolescent mental health including economic and academic pressures. This data shows that stress and anxiety levels among adolescents are very common in cities highly influenced by academic pressure. Women often express greater stress and anxiety compared to men among adolescent girls. Adolescents from poor families and rural areas face higher risks because of lack of financial stability and restricted mental health services. Even with the rise of telemedicine and educational programs there are still major deficiencies in getting and using mental health resources particularly in the countryside. Faced with these challenges demands joint initiatives to connect mental health programs with schools and increase digital knowledge for telemedicine while breaking down the stigma related to mental health in India. The study ends by suggesting changes in policy and the importance of local strategies to lessen adolescent stress and anxiety in India.
Inter-Rater Reliability And Agreement Of The Diagnostic Assessment Scale For Kushtha In Papulosquamous Skin Disease: A Cross-Sectional Two-Rater Study
Background and objectives: The Diagnostic Assessment Scale for Kushtha (DASK) is a newly developed 26-item ordinal instrument that renders the classical threefold Ayurvedic examination as a severity score and a dosha attribution. No reliability estimate has been published. This study estimated its inter-rater reliability, agreement, and the measurement error attaching to an individual score. Methods: Sixty consecutive patients with consultant-confirmed papulosquamous disease (43 psoriasis, 17 lichen planus) were each assessed independently by two postgraduate-qualified Ayurvedic physicians in a single clinical session, giving a fully crossed design of 3,120 item scores. Reliability was estimated as the intraclass correlation coefficient ICC(2,1); agreement as the standard error of measurement (SEM), minimal detectable change (MDC95) and Bland–Altman limits; and item-level agreement as quadratic weighted kappa with Gwet’s AC2. Internal consistency and categorical agreement were also assessed, following the GRRAS guidelines. Results: No data were missing. ICC(2,1) was 0.952 (95% confidence interval 0.92–0.97) for the total score and 0.945, 0.920 and 0.920 for the Vata, Pitta and Kapha subscales. Between-patient variance accounted for 95.2% of total variance and the rater effect for 0.0–0.6%. SEM was 2.60 points and MDC95 7.21 points on the 0–104 scale, and all 26 items reached substantial or almost-perfect agreement (weighted kappa 0.732–0.963). The categorical outputs were less reliable than the scores generating them: severity band kappa 0.800 and dosha attribution kappa 0.640 (0.37–0.85), every disagreement occurring at a cut-point or a narrow margin. Kapha was reproduced consistently yet was not internally coherent (alpha 0.43 and 0.42). Conclusion: DASK measures the severity of papulosquamous Kushtha reliably enough for group comparison and, against a threshold of 8 points, for individual monitoring. Agreement on its categorical outputs was lower than on the continuous scores from which they are derived, and the Kapha subscale was reproduced consistently between raters without cohering internally.
Patient-Reported Barriers To Antidepressant Adherence Among Young Adults With Major Depressive Disorder: A Narrative Review
Major depressive disorder (MDD) is one of the most common causes of disability in young adults globally, and antidepressant drug therapy is a first-line treatment for moderate-to-severe cases. Although antidepressants are effective, rates of non-adherence are significantly lower in older adults compared with non-adherence in younger adults (ages 18-25 to 18-35 years), with early discontinuation of treatment reported in up to 50% of younger adults after the first 6 months of treatment. This narrative review aims to summarize the patient-reported impediments to antidepressant adherence specific to young adults, based on qualitative, cross-sectional, and systematic review studies published in PubMed, Scopus-indexed journals and PLOS/BMC/Frontiers platforms. Six domains of barriers are identified: (1) intolerable and stigmatizing side effects, particularly sexual dysfunction, weight gain, and emotional blunting; (2) negative beliefs about the necessity to take psychiatric medication, dependency, and the “chemical imbalance” explanatory model; (3) internalized and social stigma associated with taking psychiatric medication during a developmentally identity-forming period; (4) inadequate patient-provider communication and limited shared decision-making; (5) structural and logistical barriers, including cost, insurance discontinuity, and appointment access, which disproportionately affect young adults transitioning out of their parents' coverage and pediatric care; and (6) developmental factors unique to young adulthood, such as symptom-driven self-discontinuation once feeling better, competing life transitions, and low engagement with routine follow-up. Considerations for clinical practice and methodological limitations, such as the underlying evidence base, including the heterogenicity of adherence measurement and the lack of studies limited to a narrow age range of 18-25 years, are discussed. Findings agree with multi-level adherence interventions, which are tailored to each child's developmental level, rather than single factor.
The Relationship Between Social Networking Sites Use And Fear Of Missing Out: A Correlational Analysis Among Young Adults In Shimla
In the present scenario, the advent of Social Networking Sites (SNS) has brought a drastic change in modern communication in relation to how we connect, interact, collaborate, and share information across the globe. This has led to the emergence of a completely new phenomenon, termed the Fear of Missing Out (FoMO), where one feels that others are having a better and more pleasurable experience, which they are missing, leading to the experience of “missing out”. In today’s era, social networking sites have become a very integral part of the youth's lives, bringing a noticeable change in the way they communicate and express themselves. It is evident that these networking platforms offer numerous benefits, yet raise concerns about the potential negative impact on the psychological well-being of their users. This study investigates the relationship between social networking sites and fear of missing out among adults in the Shimla district of Himachal Pradesh. The study used standard questionnaires to collect information from 500 young adults selected through convenience sampling in a detailed research plan with statistical analysis. This approach helped to further examine the topic itself through systematic data collection. The results further showed a significant positive correlation between social networking sites usage and the experience of FoMO among young adult males and females. As per the results, young adults experience more FoMO due to high social media use, where female young adults experience higher FoMO compared to young adult males. Thus, social media platforms surely induce fear of missing out among young people and hamper their psychological well-being. Moreover, controlling social media usage can help reduce these negative effects on psychological well-being.
Assessment Of Clinical Leadership Competency Among Registered Nurses Working In Neuro Units Of A Tertiary Hospital, Riyadh, Saudi Arabia: A Cross-Sectional Study
Background: Clinical leadership competency is an important aspect of nursing practice, particularly for supporting coordinated care, effective teamwork, and sound clinical decision-making. Understanding the level of clinical leadership competency among registered nurses can help identify areas for further professional development. This study aimed to determine the level of clinical leadership competency and examine its associations with selected demographic and professional characteristics among registered nurses working in neuro units of a tertiary hospital in Riyadh, Saudi Arabia. Methods: A quantitative descriptive cross-sectional study was conducted among 81 registered nurses. Data were obtained using a structured questionnaire that included a researcher-modified version of the Leadership Practices Inventory (LPI) Self-Assessment developed by Kouzes and Posner. The modified 40-item questionnaire assessed four clinical leadership competency domains: Demonstrating Personal Attributes, Working with Others, Duty Management, and Setting Direction & Making Decisions. Participant characteristics and competency scores were summarized using descriptive statistics. Inferential statistical tests were applied to examine associations between selected demographic and professional characteristics and the clinical leadership competency domains. Statistical significance was considered at p < 0.05. The internal consistency of the modified questionnaire was evaluated using Cronbach’s alpha. Results: Among the 81 participants, 48 (59.3%) demonstrated excellent overall clinical leadership competency, 32 (39.5%) demonstrated good competency, and 1 (1.2%) was classified as developing. The highest proportion of excellent competency was observed in Duty Management (63.0%), followed by Working with Others (60.5%) and Setting Direction & Making Decisions (53.1%). Demonstrating Personal Attributes had comparable proportions of participants with good (49.4%) and excellent (48.1%) competency. The overall mean clinical leadership competency score was 85.5 ± 6.9, while Duty Management recorded the highest domain mean (86.7 ± 7.8). Shift leadership role was significantly associated with Duty Management (p = 0.022) and Setting Direction & Making Decisions (p = 0.018). Nationality was significantly associated with Setting Direction & Making Decisions (p = 0.048). No significant associations were identified between the competency domains and age, gender, educational level, or years of nursing experience. The modified questionnaire demonstrated high internal consistency, with a Cronbach’s alpha of 0.943. Conclusion: The participating registered nurses demonstrated a high level of clinical leadership competency overall, with Duty Management emerging as the highest-scoring domain. Shift leadership role was associated with competency in Duty Management and Setting Direction & Making Decisions. These findings support the provision of appropriate opportunities for nurses to undertake clinical leadership responsibilities and participate in structured professional development. As the study employed a cross-sectional design, the observed associations cannot be interpreted as causal relationships. Further longitudinal and interventional research is recommended to determine whether structured leadership opportunities are associated with changes in clinical leadership competency over time.
Circumcision Revision: A Systematic Review On Indications Of Revision And Complications Of Surgery
Objective: Circumcision revision may be required if patients experienced complications after the primary surgery. This systematic review aims to identify the indications for circumcision revision in children, the specialties of the physicians who performed the initial circumcisions, the types and incidences of complications after surgery. Methodology: We searched for relevant articles in PubMed/MEDLINE, Cochrane Library, Scopus, and Web of Science. We studied the following outcome: Indications for circumcision revision, the specialty of the physicians who performed the initial circumcision, incidence of complications after surgery, and Simultaneous Additional Procedures. Results: We reviewed six studies with 9,924 males met our inclusion criteria. The primary indications for revision included redundant foreskin, meatal stenosis, and concealed penis. Medical practitioners performed most primary circumcisions. The overall complication rate ranged from 1.5% to 3.4%. Additional procedures, such as herniotomy and orchiopexy, may be required in 8.9% to 30.4% of revisions. Older age at primary circumcision and non-medical practitioners’ involvement were associated with higher complications and revision rates. Conclusion: Circumcision is a common procedure, which may require revision due to complications like redundant skin or meatal stenosis. Optimal outcomes depend on precise surgical techniques, adequate foreskin excision, and proper suturing, along with preoperative counseling and postoperative care.
Shifting the Paradigm in GDM Care: A Randomized Controlled Trial of Midwifery-Led Versus Standard Care on Birth and Emergency Complication Preparedness Performance
Background: Gestational Diabetes Mellitus (GDM) is a high-risk illness linked to poor maternal and newborn outcomes. Adequate birth preparedness and complication readiness (BPCR) are critical components of safe motherhood, especially for women with GDM. Midwifery-led forms of care have demonstrated the ability to improve maternal outcomes via ongoing support, education, and empowerment. Objective: The objective is to assess the impact of a midwifery-led care paradigm on birth preparedness and complication readiness for pregnant women with GDM. Methods: A randomized controlled trial was carried out on 180 pregnant women diagnosed with GDM at a tertiary care facility. Using simple random sampling, participants were randomly assigned to the experimental (n=90) and control (n=90) groups. The experimental group received a structured midwifery-led intervention that included personalized instruction, counseling, and follow-up support, while the control group received standard care. Data were gathered using a structured demographic questionnaire and a standardized Birth Preparedness and Complication Readiness (BPCR) assessment form. The sample size was obtained using power analysis (power 80%, α=0.05, effect size 0.5) to account for potential attrition. The data were examined using descriptive and inferential statistics, such as the independent t-test and the chi-square test. Results: After intervention, the experimental group significantly improved their BPCR scores compared to the control group (p<0.05). The findings show that the midwifery-led program improved expectant moms' readiness for labor and awareness of obstetric problems. Conclusion: Midwifery-led care is helpful in improving birth preparedness and complication readiness for expectant women with GDM. Integrating such models into routine antenatal treatment can help to enhance maternal and newborn outcomes.
Improving Mesalazine Solubility Via, Cocrystallization: Formulation and Characterization
This research project addresses the challenge of improving the solubility of the BCS class IV drug, mesalazine, through innovative co-crystallization techniques. By focusing on the formulation of cocrystals, the study aims to enhance the drug's solubility, bioavailability and therapeutic efficacy. The research involves the design and characterization of mesalazine cocrystals using selected conformers. The Solvent Evaporation technique is employed to successfully formulate Mesalazine nano cocrystals with conformers such as Mannitol, Benzoic acid, Urea and Ascorbic acid at a 1:1 molar ratio. Comprehensive evaluations, including physico-chemical characterization, saturated solubility studies, X-ray diffraction, melting point analysis, SEM and in vitro dissolution testing are conducted. Through systematic formulation and thorough characterization, this research aims to provide valuable insights into the development of enhanced Mesalazine formulations.
Advancing Paediatric Care Through Integrated Machine Learning, Deep Learning, Internet Of Things, Data Science And Mathematical Modelling: A Comprehensive Review
The intersection of machine learning (ML), deep learning (DL), Internet of Things (IoT), and data science (DS) is transforming healthcare for children, but the evidence base is fragmented across disease areas and technologies, and pediatricpopulations remain underrepresented in both algorithmic training sets and regulatory approval processes. The objective of this research is to review the recent evidence on pediatricapplications of ML/DL/IoT/DS. We focused on four domains: predictive analytics and precision dosing, remote monitoring and developmental screening, child protection and mental health risk prediction, and population-level resource allocation. We performed a narrative review searching PubMed, Google Scholar, and specialist repositories for systematic reviews, scoping reviews, and primary studies published 2019-2026. We included articles explicitly specifying a pediatric population (typically under 18 years). We highlight promising but heterogeneous findings across sepsis prediction, remote physiological monitoring, autism spectrum disorder (ASD) screening, precision dosing, child maltreatment risk modelling, and geospatial resource allocation. In all cases, pediatric-specific studies were underrepresented, often reporting smaller, single-center cohorts. Fewer than 1 in 10 FDA-approved medical devices incorporating AI were explicitly approved for pediatric use (as of 2024). While early ethical frameworks such as ACCEPT-AI and PEARL-AI provide guidance on pediatric AI/ML development, pediatric-specific governance, privacy regulation, and algorithmic auditing lag behind those for adult populations. ML/DL/IoT/DS offer unprecedented opportunities to improve the personalization and timeliness of pediatric care. To realize this potential, multi-centerpediatric-specific datasets, rigorous subgroup and developmental-stage analyses, external validation, and pediatric-specific data-governance guidelines will be essential.
Eosinophil-Guided Therapy In Chronic Obstructive Pulmonary Disease: Evaluating Blood Eosinophils As Predictors Of Inhaled-Corticosteroids Response
Background-Aim: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide and is characterized by persistent airflow limitation and recurrent exacerbations. Although inhaled corticosteroids (ICS) are recommended for patients with frequent exacerbations, the response to therapy varies. Blood eosinophil count has emerged as a potential biomarker for identifying patients who may benefit from ICS-containing regimens. This study evaluated the role of baseline blood eosinophil count as a predictor of response to ICS therapy in COPD. Materials–Methods: This prospective observational study was conducted at the Department of Pulmonary Medicine, Sree Balaji Medical College & Hospital, Chennai, India, from August 2024 to March 2026. A total of 156 patients with spirometry-confirmed COPD receiving ICS-containing therapy were included. Patients were categorized into three groups based on baseline blood eosinophil count: <100, 100–300, and >300 cells/µL. Clinical evaluation included CAT score, mMRC dyspnea scale, spirometry, and exacerbation history. Patients were followed for 6 months to assess changes in lung function, symptoms, and exacerbation frequency. Data were analyzed using SPSS version 26.0 with p <0.05 considered statistically significant. Results: The mean age of participants was 62.1 ± 8.9 years, with 74.4% males. Patients with eosinophil counts >300 cells/µL showed significantly greater improvement in FEV₁ compared with the other groups (p <0.01). Greater reductions in CAT scores and lower exacerbation rates were also observed in the high eosinophil group (p <0.05). Baseline eosinophil count >300 cells/µL was identified as an independent predictor of improved response to ICS therapy. Conclusion: Baseline blood eosinophil count is a useful biomarker for predicting response to ICS therapy in COPD. Higher eosinophil levels are associated with improved lung function, better symptom control, and reduced exacerbations, supporting eosinophil-guided COPD management.
Association Between Second-Trimester Dyslipidemia And The Risk Of Developing Preeclampsia Among Pregnant Women With Subclinical Hypothyroidism
Background: Subclinical hypothyroidism (SCH) is one of the most common endocrine disorders encountered during pregnancy and has been increasingly recognized as a contributor to adverse maternal and fetal outcomes. Aim: This study aimed to evaluate the association between second-trimester dyslipidemia and the risk of developing preeclampsia among pregnant women with subclinical hypothyroidism and to identify clinically useful biochemical markers for early prediction of preeclampsia. Patients and Methods: A hospital-based case–control study was conducted at the Department of Obstetrics and Gynecology, Tikrit Teaching Hospital, Salah Al-Din Governorate, Iraq, from 1 October 2025 to 30 June 2026. A total of 120 pregnant women diagnosed with SCH during the second trimester were enrolled. The participants were divided into two equal groups: 60 women who subsequently developed preeclampsia (cases) and 60 women who remained normotensive throughout pregnancy (controls). fasting serum samples were analyzed for thyroid-stimulating hormone (TSH), free thyroxine (FT4), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Results: Women who developed preeclampsia had significantly higher serum TSH concentrations than controls (5.92 ± 1.31 vs. 4.51 ± 0.88 mIU/L, P < 0.001), whereas FT4 levels did not differ significantly (P = 0.148). Maternal lipid profile demonstrated significantly higher concentrations of TC (228.64 ± 29.81 vs. 198.73 ± 24.16 mg/dL), TG (242.51 ± 47.36 vs. 182.45 ± 36.28 mg/dL), and LDL-C (146.82 ± 26.14 vs. 118.41 ± 22.33 mg/dL), together with significantly lower HDL-C levels (41.62 ± 6.83 vs. 50.48 ± 7.22 mg/dL) among women with preeclampsia (all P < 0.001). Composite dyslipidemia was present in 81.67% of cases compared with 45.00% of controls (P < 0.001). Serum TSH demonstrated significant positive correlations with TC (r = 0.421), TG (r = 0.487), and LDL-C (r = 0.394), while HDL-C showed a significant inverse correlation (r = −0.336). Conclusions: Pregnant women with subclinical hypothyroidism who subsequently developed preeclampsia exhibited significantly more pronounced dyslipidemia and higher serum TSH concentrations than those who remained normotensive. Elevated triglycerides, total cholesterol, LDL-C, increased TSH, reduced HDL-C, and higher maternal BMI independently predicted the development of preeclampsia.
Assist. Prof. Dr. Masryia Rashad Hassein
Effect Of Intranasal Therapy On Serum Periostin Levels In Allergic Rhinitis: A Comparative Study
Background: Allergic rhinitis (AR) is a chronic inflammatory disease driven by Type 2 immune responses. Periostin, an IL-4/IL-13–induced matricellular protein, has emerged as a biomarker of allergic inflammation. This study evaluated the effect of intranasal therapy on serum periostin levels and correlated these changes with clinical outcomes, comparing TriVital Mix with standard therapy. Methods: Thirty patients with AR were randomized into two groups: standard therapy and TriVital Mix. Clinical scores (SNOT-22, NSS, VAS) were assessed at baseline, 4, 8, and 12 weeks. Serum periostin was measured at baseline and 12 weeks. Statistical analysis included paired and independent t-tests and correlation analysis. Results: Both groups showed significant clinical improvement (p < 0.05). The TriVital Mix group demonstrated greater reduction in symptom scores and periostin levels (p < 0.05). Periostin reduction correlated significantly with clinical improvement. Conclusion: Periostin is a useful biomarker for monitoring disease activity and treatment response in AR. TriVital Mix demonstrated superior efficacy in reducing both symptoms and periostin levels.
Integrated Serological And Ultrasonographic Screening Reveals The Burden Of Human Cystic Echinococcosis In Southern Kyrgyzstan: A Population-Based Cross-Sectional Study
Background: Cystic echinococcosis (CE) is a neglected zoonotic disease caused by the larval stage of Echinococcus granulosus sensu lato and remains a major public health problem in many pastoral regions of the world. The Kyrgyz Republic is among the countries hyperendemic for echinococcosis and has one of the highest reported incidences of human echinococcosis worldwide; however, community-based epidemiological studies integrating serological screening, abdominal ultrasonography, and assessment of potential risk factors remain limited. This study aimed to determine the seroprevalence of human cystic echinococcosis and describe the epidemiological characteristics of a rural population in southern Kyrgyzstan. Methods: A population-based cross-sectional study was conducted in Nookat District, Osh Region, Kyrgyzstan. A total of 1,444 participants underwent standardized epidemiological interviews, abdominal ultrasonography, and serological testing for anti-Echinococcus granulosus IgG antibodies using an enzyme-linked immunosorbent assay (ELISA). Demographic, environmental, and behavioral information was collected through a structured questionnaire. Descriptive statistical analyses were performed to summarize participant characteristics, serological findings, and ultrasonographic abnormalities. Results: Among the 1,444 participants, the mean age was 32.3± 19.9 years, and 66.4% were female. ELISA detected 114 seropositive individuals, corresponding to an overall seroprevalence of 7.9% (114/1,444), while 20 participants (1.4%) had equivocal results. Abdominal ultrasonography demonstrated normal findings in 76.5% of participants, whereas 23.5% had abnormal findings, including hepatobiliary, renal, pancreatic, reproductive, and postoperative echinococcosis-related lesions. These findings indicate ongoing exposure to E. granulosus within the study population and highlight the value of community-based screening for identifying both parasitic infection and previously undetected abdominal pathology. Conclusions: Human cystic echinococcosis remains an important public health concern in southern Kyrgyzstan. Integrated community-based screening using serological testing and abdominal ultrasonography represents a practical approach for assessing disease burden and supporting surveillance in endemic regions. The findings provide baseline epidemiological evidence for future analytical studies investigating modifiable risk factors. They may contribute to the development of targeted One Health strategies for the prevention and control of cystic echinococcosis.
Problematic Use Of Mobile Phones And Poor Sleep Quality In Adolescents: A Cross-Sectional Study
Introduction: Adolescence is a critical period of transition, and chronic sleep loss is a significant public health issue in this population. Problematic use of mobile phones (PUMP) has emerged as a potential contributor to poor sleep quality. This study aimed to assess the association between mobile phone use and sleep quality in Egyptian adolescents. Methods: This cross-sectional study included 154 adolescents aged 12-19 years attending Kasralainy outpatient clinics. Data were collected using a structured questionnaire included sociodemographic data, questions to exclude medical conditions affecting sleep, the Arabic version of the Problematic Use Mobile Phone scale, and the Arabic version of the Pittsburgh Sleep Quality Index questionnaire. Results: The median PUMP score was 64, with a prevalence of mobile addiction (PUMP score ≥ 60) of 60%. The median PSQI score was 6, with 73.4% of participants reporting poor sleep quality (PSQI ≥ 5). Poor sleep quality was significantly associated with older age, longer duration of daily mobile phone use (???? < 0.0001), and a higher PUMP score (???? < 0.05). High mobile phone users exhibited poorer subjective sleep quality, shorter sleep duration, and more daytime dysfunction compared to low users. Conclusion: Poor sleep quality is highly prevalent among Egyptian adolescents and is significantly associated with problematic mobile phone use.
Rasanirdharana (Assessment Of Taste) Of An Extra- Pharmacopeial Drug Fragaria X Ananassa Duch. [Strawberry]
Ayurvedic literature describes numerous drugs in terms of their nomenclature, properties, and therapeutic applications. However, many medicinal substances with significant therapeutic potential and widespread acceptance among various ethnic communities remain undocumented in the classical texts. These are not described in Ayurvedic Pharmacopoeia and hence extra-pharmacopeial in Ayurvedic field. Such drugs are collectively referred to as Anukta Dravya. The pharmacological action of an Anukta Dravya can be understood through its Rasapanchaka, namely Rasa (taste), Guna (quality), Veerya (potency), Vipaka (post-digestive transformation), and Prabhava (specific action)(1). Among these attributes, Rasa(taste) perceived through the gustatory receptors(2)of the tongue so Rasa is the only attribute that can be directly assessed through perception(3). Fragaria x ananassa Duch. is an extra-pharmacopeial drug with several ethnomedicinal claims. However, no scientific attempts have been made to explore its pharmacological properties or to evaluate its Rasapanchaka according to Ayurvedic pharmacological principles. As per the Aptavachan (word of an authoritative person ) जगत्येवमनौषधम् न किञ्चिद्विद्यते द्रव्यं ||(4) There is no substance in the world which cannot be used as a Medicine. So it is needed to be assess the pharmacological properties of anukta dravyas .Therefore, to assess the properties of the drug, Rasa analysis was conducted using the “taste perception method” by administering one well-ripened strawberry fruit to 30 volunteers(5)The questionnaire was prepared for the analysis where volunteers noted their responses. Final Data were collected using a structured questionnaire prepared based on Ayurvedic literature. The majority of respondents identified Madhur Rasa (sweet taste) as the predominant Rasa (75.53%), while Amla Rasa (sour taste) was perceived as the Anurasa (after taste) (48.86%). Hence, it was concluded that Fragaria x ananassa Duch. possesses Madhur Rasa with Amla Anurasa. Its seeds contribute by Kashaya and Tikta Anurasa.
The Role Of Artificial Intelligence And Deep Learning In Ultrasound Diagnosis
Ultrasound (US) remains one of the most widely used medical imaging modalities because it is real-time, radiation-free, portable, and comparatively inexpensive, but its diagnostic accuracy is strongly operator-dependent and subject to inter-observer variability. Over the past decade, artificial intelligence (AI) - and deep learning (DL) in particular - has been applied extensively to ultrasound image analysis in an effort to reduce this variability and support faster, more consistent diagnosis. This paper presents a comprehensive narrative review of current AI/DL applications in ultrasound diagnosis, synthesising evidence across four major clinical domains: breast lesion classification, thyroid nodule risk stratification, fetal cardiac screening for congenital heart disease, and abdominal/musculoskeletal applications. A structured review methodology is described, followed by a proposed conceptual framework that organises reviewed applications by deep learning task - classification, detection/localisation, and segmentation - and by clinical domain, situating an explainability layer and human-in-the-loop clinical review at the centre of responsible deployment. Reported diagnostic performance metrics (accuracy, sensitivity, specificity) from a representative set of primary studies and meta-analyses are synthesised and compared, showing that convolutional neural network (CNN)-based models frequently reach or approach expert-level diagnostic performance in constrained, retrospective evaluation settings, with reported accuracies generally in the 88-99% range and reported sensitivities in the 87-98% range across the domains reviewed. All performance figures reported in this paper are drawn directly from the cited primary studies and meta-analyses, not from a new experiment conducted by the authors. The review concludes by identifying recurring limitations across the literature - dataset heterogeneity, limited external/multicentre validation, and interpretability gaps - and outlines directions for future research toward clinically deployable, trustworthy AI-assisted ultrasound diagnosis.
Linking Body Composition Changes To Swallowing Function And Nutritional Autonomy During Chemoradiation
Chemoradiation therapy (CRT) is commonly associated with treatment-related toxicities that impair swallowing function. Emerging evidence indicates that changes in body composition, particularly loss of lean mass, contribute to swallowing dysfunction during and after treatment. Traditional reliance on body weight alone may obscure clinically relevant alterations in lean and fat mass that influence functional outcomes. This scientific review examines longitudinal changes in body composition during and following CRT and evaluates their associations with swallowing function, with dietary intake considered as a contributing factor influencing body composition trajectories. Evidence from longitudinal and observational studies in adult patients undergoing curative-intent CRT has been synthesized to evaluate trends in dietary intake, body composition parameters, and functional outcomes. The reviewed literature indicates that reduced dietary intake during CRT is consistently associated with progressive loss of lean mass over time. Greater lean mass depletion has been associated with poorer swallowing function and a higher likelihood of compromised nutritional autonomy during and after treatment. In contrast, changes in fat mass demonstrate weaker and less consistent relationships with functional outcomes. These findings highlight the importance of lean mass preservation as a key determinant of swallowing function during CRT, with dietary intake playing a critical role in modulating body composition changes. Incorporating routine body composition assessment and early, targeted nutritional interventions into oncologic care may help mitigate treatment-related toxicities and support functional recovery.
Epigastric Pain As Presentation Of Acute Pyelonephritis: A Case Report
Acute pyelonephritis is a common bacterial infection causing renal inflammation, typically arising from an ascending urinary tract infection. This case report details an atypical presentation of pyelonephritis in a post-pulmonary tuberculosis patient, presenting primarily with epigastric pain and without the classic symptoms of flank pain or costovertebral angle tenderness. Initially misdiagnosed as cholecystitis, the diagnosis was confirmed through imaging studies, allowing for timely treatment. This case emphasizes the importance of maintaining a high index of suspicion for pyelonephritis in atypical presentations and utilizing appropriate imaging techniques for early diagnosis and intervention.
Drug-Excipient, In-Process, And Packaging Compatibility Studies In Pharmaceutical Development: A Comprehensive Review
Compatibility studies play a crucial role in pharmaceutical product development by identifying, quantifying, and predicting potential interactions and incompatibilities between components in a formulation. These interactions can lead to changes in the physical, chemical, or therapeutic properties of the dosage form, potentially affecting its stability, safety, and efficacy. The primary objective of compatibility studies is to select compatible excipients, determine stable storage conditions, and ensure the overall quality, safety, and efficacy of the final product. This review delves into the various types of incompatibilities, their causes, and potential remedies. It also provides detailed information on drug-excipient, in-process component, and finished product-packaging material compatibility studies, along with their respective protocols. Drug-excipient compatibility studies, in particular, are a critical phase in the pre-formulation stage of drug development. Thermal and non-thermal methods are employed to evaluate the suitability and compatibility of excipients for developing stable dosage forms.
From Green Chemistry To Gastric Cytoprotection Rational Design, Characterization, And Preclinical Validation Of Biogenic Nanoparticles As Antioxidant, And Mucoadhesive Therapeutics For Gastropathy
Peptic ulcer disease remains a major global health concern, particularly when aggravated by non-steroidal anti-inflammatory drugs (NSAIDs) such as indomethacin. It may induce multiple potential complications like gastrointestinal bleeding, stomach cancer, GERD, IBS and malabsorption of many nutrients that will leads to deficiencies. This study investigates the gastro protective potential of Acacia catechu, a polyphenol-rich medicinal plant, in indomethacin-induced gastric ulceration in wistar rats. Six groups were assigned: normal control, ulcer control, standard (famotidine), and three treatment groups of Acacia catechu (150, 250, 500 mg/kg). Following ulcer induction via indomethacin (30 mg/kg), parameters such as ulcer index, gastric pH, total acidity, TBARS, SOD, and histopathology were evaluated. In the present investigation, leaf extract and silver nanoparticles (AgNPs) of A. catechu (Ac) were subjected to various spectral (UV, Particle size, Zeta Potential, FTIR, XRD and SEM) analyses. Ac-AgNPs could be potential phyto-ulceroprotective against ulcers induced models. Results demonstrated significant dose-dependent gastro protection with A. catechu, especially at 500 mg/kg, highlighting its antioxidant and mucosal healing effects. Catechu is find to be powerhouse of antioxidants because of rich flavonoids, tannins and catechin that aid capturing of free radicals halt the oxidative stress as well as inflammatory ulcer disorder. These findings suggest that Acacia catechu is a promising natural therapeutic agent for NSAID-induced ulcers.
Correlation Of Serum Gamma-Glutamyl Transferase With Atherogenic Dyslipidemia In Obese Individuals
Background: Obesity is a significant social health issue and has been linked to the risk of becoming metabolically syndrome-prone, type 2 diabetes mellitus, and cardiovascular diseases. Atherogenic dyslipidemia, which is high triglycerides, low levels of high-density lipoprotein cholesterol (HDL-C) and high levels of low-density lipoprotein cholesterol (LDL-C) is a typical metabolic defect seen in obese patients. Traditionally, gamma-glutamyl transferase (GGT) can be considered a biomarker of hepatobiliary dysfunction, it has recently shown potential as a biomarker of oxidative stress, visceral adiposity, and cardiovascular risk. But its association with atherogenic dyslipidemia in obesity has not been thoroughly comprehended. The study will assess serum gamma -glutamyl transferase levels in obese individuals, contrast parameters of lipid profiles of obese and non-obese adults and establish the relationship between serum GGT and atherogenic dyslipidemia. Methods: A cross-sectional comparative study was carried out in a hospital setting that involved 200 participants aged between 19 and 40 years with 100 obese and 100 age-matched and healthy non-obese controls. Standard laboratory tests were conducted to measure anthropometric, blood pressure, fasting blood glucose, lipid profile, and serum GGT levels. Continuous variables were compared in terms of independent student t-test, and correlation coefficient of Pearson was used to assess the association between serum GGT and the lipid profile parameters. A p-value of <0.05 was considered statistically significant. Results: The mean age of participants was comparable between the obese and non-obese groups (29.71 ± 6.62 vs. 29.43 ± 6.52 years; p = 0.763). Body mass index, waist circumference, systolic blood pressure, fasting blood glucose, total cholesterol, triglycerides, LDL cholesterol, very low-density lipoprotein cholesterol (VLDL-C), serum GGT were all significantly higher among obese people than among the controls (all p < 0.001) and HDL cholesterol was significantly lower (p < 0.001). Mean serum GGT was markedly elevated in obese participants (48.90 ± 7.31 U/L) compared with non-obese controls (32.72 ± 6.13 U/L; p < 0.001). Serum GGT demonstrated significant positive correlations with total cholesterol (r = 0.487, p < 0.001), triglycerides (r = 0.439, p < 0.001), LDL cholesterol (r = 0.479, p < 0.001), and VLDL cholesterol (r = 0.437, p < 0.001), while showing a significant negative correlation with HDL cholesterol (r = -0.330, p < 0.001). Conclusions: The levels of serum gamma-glutamyl transferase are highly upraised in obese people and strongly linked to atherogenic lipid profile. Positive correlation of GGT with poor lipid parameters and negative association with the HDL cholesterol indicate that GGT might be a simple and cheap biomarker to determine human risk at higher cardiometabolic risk through its obese patients. Routine metabolic screening with the addition of serum GGT might help in making early risk stratification as well as timely preventive actions against cardiovascular diseases.
Wilson’s Disease: Timely Diagnosis Is Real Challenge
Introduction-Wilson’s disease (WD) is a potentially fatal rare copper metabolism disorder which leads to copper accumulation in organs such as liver, brain, and cornea. Prompt diagnoses and treatments help prevent complications, improve patients’ quality of life, and ensure a normal life expectancy. The clinical presentations and outcomes of WD can vary within a single family. Case Report- A fourteen-year-old male presented with headache, generalized weakness and low mood level for last six months. He was seen by some local physician first who advised for routine labs and ultrasonogram (USG) abdomen which revealed mild transaminitis with normal USG. At this point, patient was referred to our department. On clinical examination, he had mild pallor, local eye examination showed suspected Kayser -Fleischer ring. The systemic examination including cardiovascular, chest, neurological and per-abdominal examination was essentially normal. The MRI brain showed bilateral basal ganglia calcification. The 24- hour urinary copper excretion was raised with low serum ceruloplasmin level. The fundus examination confirmed K-F rings. The upper gastro-intestinal endoscopy was normal and Fibroscan score was 9.2 Kpa, suggestive of significant fibrosis (F3) pattern. He was started on D-penicillamine (20 mg/Kg body weight) and 25 mg tid zinc and was symptomatically and biochemically better on follow up after three months. Conclusion- Wilson’s disease can have varied manifestations and can be easily missed in early stages. The timely diagnosis and initiation of management can lead to significant fibrosis reversibility. Early diagnosis and family awareness can prevent fatal outcomes.
Efficacy Of High Tone Power Therapy Combined With A Targeted Physical Therapy Program For Overactive Bladder In People With Multiple Sclerosis: A Randomized Controlled Trial
Objective: Overactive bladder (OAB) is a predominant urinary tract disorder in people with multiple sclerosis (PwMS). We sought to assess the therapeutic effects for high tone therapy (HTT) in treatment of OAB symptoms and quality of life (QOL) in PwMS. Methods: A prospective, randomized controlled study included forty remitting relapsing MS patients of both sexes (RRMS) with moderate OAB symptoms were randomly allocated into 2 equal groups: The treatment group (GA) received HTT + targeted physical therapy program.; and the control group (GB) received targeted physical therapy program only. The intervention session in each group was conducted for 60 minutes, 3 times per week for 3 months. Pre and post treatment evaluation was done for all patients including Urodynamic study (bladder capacity, maximum urine flow rate (Qmax), bladder compliance and detrusor activity) for bladder function, Overactive bladder symptom (OABS) score for severity of the bladder symptoms and International Consultation on Incontinence-Overactive Bladder Module (ICIQ-OAB) for QOL. Results: Post intervention, there were statistically significant differences between both groups in OABS score, ICIQ-OAB, bladder capacity, detrusor activity, and bladder compliance with more favor to GA (P < 0.01); while there was no significant difference in voiding function between both groups (p > 0.05). Conclusions: Adding application of HTT to rehabilitation can improve bladder symptoms and QOL in PwMS
Pregnancy On Chronic Dialysis Patients: A Case Series
Background: Pregnancy in patients with chronic dialysis is uncommon due to various factors, one of it is the increasing incidence of CKD among women in reproductive age. Even if pregnancy occurs, the risks and complications that may arise during pregnancy present a challenge in managing the patient. Risks to the child such as congenital abnormalities, premature birth, low birth weight, and even fetal death can still occur if the mother's kidney failure management is not optimally provided. Case illustration: Two patients who had been undergoing hemodialysis for about 2.5 years, discovered their pregnancy after the second trimester. Subsequently, the patient underwent dialysis for 15 hours/week, received PRC transfusions, erythropoietin injections, antihypertensive medications, and multivitamins. The babies were being delivered via cesarean section (C-section) with a birth weight of 1600 and 1800 g. The patients were discharged within the first week post-C-section without complications and continued dialysis twice a week, while the baby was admitted to the NICU for stabilization. Discussion: Many literatures recommended increased hemodialysis sessions up to 20 hours per week during pregnancy to improve maternal and fetal outcome. With limited resources in our center and our universal health insurance, we can only give these patients 15 hours of dialysis per week. Nevertheless, we can maintain BUN below 50 and SBP about 140-150 mmHg. The problem in this patient was the Hb level that keep decreasing despite ESA injection, supplement, and PRC transfusion. The baby of the second patient was having CTEV, small secundum ASD, mild TR, and hypoganglionosis. She discharged after about one month admitted in the NICU. Conclusion: Even with recent advances in CKD management resulting in increased prevalence of pregnancy, it still a relatively high-risk event. Provision of multidisciplinary team along with good quality of universal health coverage are necessary to manage these cases.
Design And Development Of Fast Dissolving Tablets Of Mefenic Acid Prepared By Spherical Crystallization Technique
Mefenamic acid is a Non Steroidal anti- inflammatory drug belonging to the BCS class II. It has a low oral bioavailability due to poor aqueous solubility and poor dissolution rate. The present study was undertaken to improve the dissolution, absorption, and bioavailability of Mefenamic acid by employing spherical agglomeration followed by the development of fast dissolving tablets (FDTs). Spherical agglomerates were prepared using the quasi-emulsion solvent diffusion technique with N,N-dimethyl formamide, water, and chloroform as the good solvent, poor solvent, and bridging liquid, respectively. Pluronic F-68 was used as carrier in drug-to-carrier ratios of 1:0.5, 1:0.75, and 1:1. The prepared agglomerates were evaluated for practical yield, drug content, solubility, flow properties, particle size, scanning electron microscopy, and in vitro dissolution. Microscopic studies confirmed the formation of spherical agglomerates with improved flowability and significantly enhanced dissolution. Optimized agglomerates were compressed into FDTs using co-processed superdisintegrants containing croscarmellose sodium and crospovidone in ratios of 1:1, 1:2, and 1:3. The formulation containing a 1:3 ratio (F9) exhibited the fastest drug release and was selected for pharmacokinetic evaluation in New Zealand white rabbits using a validated LC-MS/MS method following a crossover design. Compared with the pure drug, the optimized FDT demonstrated significantly higher Cmax (158.46 ± 0.15 vs. 67.56 ± 0.43 ng/mL), shorter Tmax (6.15 ± 0.14 vs. 11.42 ± 0.32 h), higher Ka (7.76 ± 0.01 vs. 2.92 ± 0.01 h⁻¹), and greater AUC₀–∞ (564.9 ± 1.36 vs. 126 ± 1.23 ng·h/mL). These findings indicate that spherical agglomeration combined with optimized FDT formulation markedly enhances the dissolution, oral absorption, and bioavailability of Mefenic acid, thereby providing a faster onset of therapeutic action and improved patient compliance.
A Study TO Assess THE Effectiveness OF A Community-Based Health Literacy Program AMONG Adolescents IN Selected Schools AT Baroda: A Mixed-Methods Study
Background: Adolescence is a critical developmental period where health literacy plays a vital role in shaping future health behaviors. Limited evidence exists regarding structured community-based health literacy interventions among school-going adolescents in Gujarat, India. Aim: To assess the effectiveness of a community-based health literacy program on knowledge, attitude, and practice among adolescents studying in selected schools at Baroda. Methods: A mixed-methods study with a quasi-experimental pre-test-post-test control group design was employed. Sixty adolescents aged 13-18 years were selected through simple random sampling and allocated equally into experimental (n=15) and control (n=15) groups for the quantitative component. An additional 30 participants from the experimental group participated in semi-structured interviews for the qualitative component. The intervention comprised four weekly sessions covering reproductive and sexual health, menstrual health, mental health, and food and nutrition. Data were analyzed using descriptive and inferential statistics (SPSS version 25.0) and thematic analysis following Braun and Clarke's six-step framework. Results: The experimental group showed a significant improvement in knowledge scores (mean difference=1.400, t=8.283, p<0.001) compared to the control group. Post-intervention, 80% of experimental group participants achieved good knowledge levels, compared to 0% at baseline. Qualitative findings revealed four major themes: improved knowledge and awareness, positive behavioral changes, increased confidence in health decision-making, and high satisfaction with the program. Conclusion: The community-based health literacy program was highly effective in improving adolescent health literacy. Integration of such programs into routine school health services is recommended to strengthen adolescent health promotion.
Design And Optimization Of Nucleic Acid Delivery Systems For Clinical Applications: A Review
Recent advances in nucleic acid science have significantly expanded the scope of precision medicine, enabling therapeutic strategies that extend beyond conventional small molecules and biologics. This review examines the development and current state of mRNA- and nucleic acid based delivery platforms, emphasizing their growing importance in next-generation therapeutics. We begin with a brief historical overview, describing early challenges related to molecular instability, inefficient targeting, and limited cellular uptake, and how progressive technological innovations have successfully addressed these limitations. The mechanisms underlying mRNA and nucleic acid drug delivery are then discussed, with particular focus on their ability to regulate gene expression and modulate immune responses with high specificity. Key delivery technologies are highlighted, including lipid nanoparticles, polymer- based carriers, and conjugate systems, along with recent formulation advances that have improved safety, efficacy, and translational potential. Ongoing challenges such as cargo degradation, unintended immune activation, and suboptimal delivery efficiency are critically evaluated, and practical strategies to overcome these barriers are presented. Basically, the review explores future directions in the field, underscoring the promise of nucleic acid therapeutics in personalized medicine and the importance of continued research to optimize delivery platforms. Overall, this article provides a comprehensive overview of the evolving landscape of nucleic acid-based therapeutics and aims to inform clinicians, researchers, and pharmaceutical scientists about their current applications and future potential in modern healthcare.
Portrayal Of Self-Sacrifice And Women’s Life Within Households In Louisa May Alcott’s Little Women And Good Wives
This paper analyzes the portrayal of self-sacrifice within the family in Louisa May Alcott’s novels, Little Women and Good Wives. She explains how the altruistic behavior of a woman affects her personal growth and well-being, and highlights the truth that it only promotes the life of family members. The first two novels in Alcott’s beloved novel series, Little Women and Good Wives, follow the lives of the four March sisters - Meg, Jo, Beth, and Amy - as they mature from childhood into womanhood during the American Civil War era, examining themes of love, family, and ambition. In Little Women, the lives, relationships, and hardships of the four March sisters during the American Civil War are chronicled. The author’s experiences growing up in New England with her three sisters serve as a loose basis for this semi-autobiographical novel. Alcott first puts the March sisters in an all-female atmosphere, and then constantly fetches males such as husbands, father, and friends to describe the prospect of a culture which is neither matriarchal nor patriarchal but egalitarian. Good Wives follows the sisters as they negotiate marriage and adulthood. The novel follows the March sisters as they grow from childhood to adulthood, dealing with marriage (Meg), professional obstacles (Jo), family loss (Beth), and artistic goals (Amy). It explores themes of love, responsibility, and personal development as they negotiate life’s complexities in a new stage of womanhood.
Association Of Cranial Base Morphology, Hyoid Bone Position And Pharyngeal Airway Depth In Different Sagittal Skeletal Malocclusions: A Cephalometric Study
Introduction: The hyoid bone connects the cranial base, mandible, tongue, and airway. Its position changes with different craniofacial patterns and skeletal malocclusions. Since airway size is influenced by mandibular position and cranial base structure, understanding this relationship is important for orthodontic diagnosis and treatment planning. This study aimed to evaluate and compare the position of the hyoid bone and airway dimensions in Class I, II, and III skeletal patterns. Methods: This retrospective study included 60 lateral cephalograms of subjects aged 15–30 years. They were divided equally into Class I, II, and III groups based on ANB angle and App–Bpp values. Skeletal, angular (NSAr, C3HyD, SArHy, NSHy), airway (D1–D5), and horizontal hyoid (H1–H4) measurements were recorded. Statistical analysis was done using ANOVA, t-tests, and Pearson correlation. Results: Significant differences were found among the groups in skeletal measurements, airway dimensions (D1, D4, D5), and horizontal hyoid parameters (H1, H2). Class II subjects showed reduced airway space and a vertical growth pattern, while Class III subjects showed increased horizontal dimensions. NSHy differed significantly between groups. Gender differences were minimal. Positive correlations were found between NSAr–NSHy and SArHy–NSHy, while NSAr–SArHy showed a negative correlation. Conclusions: Skeletal pattern affects hyoid position and airway size. Class II subjects tend to have reduced airway space, whereas Class III subjects show increased dimensions. Evaluating these relationships is important during orthodontic diagnosis.
Impact Of Core Strengthening On Strenght And Mobility In Children With Cerebral Palsy
Cerebral palsy (CP) could be a cluster of disorders that have an effect on the event of movement and posture, inflicting activity limitation, and non progressive disturbances that occurred within the developing fetal or child brain¹. A prominent clinical subtype of CP is spastic diplegia, characterized by hypertonia in the lower extremities, significant trunk weakness, reduced postural control². Children with CP often experience significant limitations in performing basic motor tasks, such as running, stair climbing, walking on uneven surfaces, and achieving independent ambulation. These challenges stem from impaired motor control, spasticity, and musculoskeletal dysfunctions³.
Dealing And Resisting Verbal Aggression In (Husband-Wife) Abusive Relationships Through Cognitive Behavioral Therapy: Reading Meena Kandasamy And Krishna Sobti’s Fiction
Verbal aggression within marriage remains one of the least visible forms of domestic abuse despite its severe psychological consequences for women. In patriarchal societies, emotional humiliation, coercive communication, and linguistic domination frequently become normalized within marital relationships. This study examines the representation of verbal aggression and emotional resistance in When I Hit You: Or, A Portrait of the Writer as a Young Wife by Meena Kandasamy and Mitro Marjani by Krishna Sobti through the framework of Cognitive Behavioral Therapy (CBT) and feminist literary criticism. The primary objective of the study is to analyze how abusive language shapes female subjectivity and how women negotiate emotional trauma within patriarchal marital structures. The research adopts a qualitative comparative methodology based on close textual analysis of dialogue, narrative voice, emotional response, and interpersonal conflict in the selected novels. The findings suggest that verbal aggression functions as a mechanism of patriarchal control intended to regulate women’s desires, silence dissent, and weaken emotional autonomy. At the same time, the protagonists develop distinct forms of resistance through assertiveness, cognitive reframing, emotional distancing, and narrative self-expression. The study concludes that literary narratives can illuminate psychological survival strategies associated with emotional resilience and cognitive resistance.
Anticancer And Antimicrobial Properties Of Catharanthus Roseus: An In Vitro Evaluation
Catharanthus roseus hydroalcoholic leaf isolate was tested for anticancer, antioxidant, cell-killing, and antibacterial effects in vitro and by GC–MS phytochemical profiling. To establish its therapeutic potential, the extract was tested for cytotoxic, anticancer, and antibacterial activity on HEK293 cell lines and selected bacterial pathogens. Materials and Methods: Catharanthus roseus leaves were authenticated, shade-dried, and extracted in 80% methanol/1% HCl. Phytochemical analysis of extract. Ascorbic acid was used as a reference for DPPH radical scavenging antioxidant ability. The MTT test was used to investigate cytotoxic and anticancer effects on HEK293 cell lines using doxorubicin as the reference medication. The antibacterial activity of Staphylococcus aureus and E. coli was measured using Kirby-Bauer agar well diffusion methods. Results: GC–MS analysis showed 44 phytoconstituents, including antioxidant, antibacterial, and anticancer components, including N-hexadecanoic acid, octadecanoic acid, phytol, lupeol, stigmasterol oleate, and indole derivatives. Compared to ascorbic acid (21.89 ± 0.02 µg/mL), the extract showed significant antioxidant ability in the DPPH radical scavenging experiment (IC₅₀ value: 982.6 ± 0.02 µg/mL). The MTT assay showed that the extract was cytotoxic to HEK293 cells (IC50 = 75.54 ± 0.08 µM), whereas doxorubicin exhibited an IC50 of 11.26 ± 0.20 µg/mL. Microscopic examination demonstrates cytopathic effects such as cell shrinkage and density loss. Moderate antibacterial activity against Escherichia coli and Staphylococcus aureus was identified with 10.67 mm and 6.67 mm inhibition zones. Conclusions: This study confirms the plant's long-term use in traditional medicine and suggests it might be used to generate phytopharmaceuticals and anticancer drugs.
Prevalence And Socio-Demographic Profile Of Attention-Deficit/Hyperactivity Disorder (ADHD) Children In Southern Tamil Nadu: A Three-Stage, Multi-Informant Screening Study
Despite being one of the most common childhood neurodevelopmental disorders, ADHD prevalence remains poorly documented in semi-urban and rural school settings across Tamil Nadu. This study aimed to determine the prevalence and socio-demographic profile of doctor-diagnosed ADHD among Grade III children in English-medium primary schools of Southern districts of Tamil Nadu. A cross-sectional, three-stage sequential screening design was used with 438 Grade III children from 12 English-medium State Board primary schools. In Stage 1, classroom teachers completed the Vanderbilt ADHD Diagnostic Teacher Rating Scale (VADTRS) for all children. Children who screened positive proceeded to Stage 2, in which parents completed the Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS). Children who screened positive on both informant ratings (n = 92) were referred to Stage 3 for psychiatric evaluation using the DSM-5 checklist. Of the 92 children referred for doctor's diagnosis, 71 children (16.2% of the total population; 77.2% of the referred sample) were confirmed as children with ADHD, comprising of Predominantly Inattentive (n = 30, 42.3% of confirmed cases), Predominantly Hyperactive/Impulsive (n = 20, 28.2%), and Combined (n = 21, 29.6%) presentations. Males accounted for approximately 73% of confirmed cases across all three presentations, a marked increase from the near-even gender split (50.2% male) in the total population. Referred and confirmed cases also showed a consistent, modest over-representation of higher-income, employed-mother, and more highly educated households relative to the total population, while representation by birth order and locality remained broadly proportional. The observed prevalence is consistent with the wide range reported across Indian school-based studies and underscores the value of multi-informant, sequential screening for early identification of ADHD in resource-limited primary school settings, while also highlighting the need to guard against participation-related bias at the parent- and clinician-screening stages.
Effectiveness Of Artificial Intelligence-Driven Lifestyle Interventions For The Prevention And Management Of Type 2 Diabetes: A Systematic Review With Narrative Synthesis
Background: Type 2 diabetes mellitus (T2DM) has become a global epidemic in recent decades, contributing substantially to morbidity, mortality, and economic burden. The increasing prevalence of T2DM is largely attributable to ageing populations, urbanization, unhealthy diets, inadequate physical activity, and rising obesity rates. While lifestyle modification is a primary strategy for T2DM prevention and management, long-term behavioural modification is challenged by poor adherence, limited access to healthcare, and suboptimal counselling in personalised interventions. Objective: This systematic review with narrative synthesis aimed to evaluate the impact of artificial intelligence-based lifestyle interventions on glycaemic, anthropometric, lifestyle, and self-management outcomes among individuals with T2DM, prediabetes, or at high risk of T2DM. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Literature was searched in PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane CENTRAL, IEEE Xplore, CINAHL, ProQuest, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP) for studies published from 1 January 2020 to 31 December 2025. Eligible studies included adults with prediabetes, at high risk of developing T2DM, or with T2DM who received an AI-enabled lifestyle intervention. Interventions included AI-enabled mobile applications, machine learning algorithms, conversational chatbots, virtual health coaches, digital therapeutics, predictive analytics, and wearable-based AI platforms. Randomised controlled trials or controlled clinical studies reporting glycaemic, anthropometric, behavioural, or self-management outcomes were eligible. Results: The literature search yielded 1,186 studies, of which seven RCTs involving 2,369 participants met the inclusion criteria and were included in the narrative synthesis. The included studies originated from the United States, Australia, Spain, Czech Republic, Sweden, and Singapore. AI technologies included mHealth applications, conversational AI, digital behavioural therapies, AI coaching systems, and AI-assisted wearable technology, with intervention periods ranging from 3 to 12 months. Overall, AI-supported lifestyle interventions showed positive effects on glycaemic control, with all but one study reporting significant reductions in HbA1c. Positive effects were also reported for body weight, body mass index, physical activity, dietary adherence, medication adherence, patient engagement, and diabetes self-care activities. Conclusion: AI-supported lifestyle interventions show considerable promise as an adjunct to standard diabetes management through individualised recommendations, real-time monitoring, and ongoing behavioural guidance. These systems may help optimise diabetes prevention and management, particularly in resource-constrained healthcare settings. Further well-designed multicentre RCTs with standardised AI methods, longer follow-up periods, and economic evaluations are warranted.
Minimum Dietary Diversity And Its Determinants Among Children Aged 6–60 Months Using The 24-Hour Dietary Recall Method - A Cross-Sectional Observational Study
Background: Optimal dietary diversity during early childhood is critical for adequate micronutrient intake, linear growth, and cognitive development. Despite being a simple, non-invasive proxy for nutritional adequacy, dietary diversity remains suboptimal among under-five children in India. This study was planned to estimate the Minimum Dietary Diversity (MDD) and its determinants among children aged 6–60 months attending a tertiary-care teaching hospital and its field practice area. Methods: A cross-sectional, community- and facility-based observational study was conducted over a period of 12 months in the Pediatric Outpatient Department and community field practice area of Chettinad Hospital and Research Institute (CHRI). A sample of 95 children aged 6–60 months was calculated .Dietary intake was assessed using the WHO-recommended 24-hour dietary recall with a repeat recall at two weeks. Anthropometry was measured and Z-scores were computed as per the WHO Child Growth Standards (2006). Results: Of the 95 children studied, 53 (55.79%) achieved MDD (≥ 5 of 8 WHO food groups). Minimum Acceptable Diet (MAD) was achieved by 29 (30.53%). The commonly consumed food groups were grains/roots/tubers (96.8%) and dairy (87.4%); flesh foods (35.8%) and breast milk (27.4%, limited to younger children) were the least consumed. Children aged 24–60 months (adjusted OR [aOR] 22.62; 95% CI 5.63–90.91; p < 0.001) and those born to mothers > 30 years (aOR 6.69; 95% CI 1.94–23.00; p = 0.003) were significantly more likely to achieve MDD. Underweight and severely underweight children (aOR 0.08; 95% CI 0.02–0.32; p < 0.001) were significantly less likely to achieve MDD. Sex, birth order, and socioeconomic status showed no statistically significant association with MDD. Conclusion: Slightly more than half of the children aged 6–60 months in the study setting achieved minimum dietary diversity. Younger age (6–23 months), younger maternal age, and underweight status emerged as key determinants of inadequate dietary diversity. Targeted complementary-feeding counselling for mothers of infants and young children, and focused nutrition-rehabilitation of underweight children, are required to bridge the diversity gap.
Prevalence And Barriers To Mammography Screening Among Healthcare Personnel In Al-Hillah City: A Study On Awareness And Practice
Background: Breast cancer is a leading cause of female mortality worldwide. Despite Iraq offering a free national breast cancer screening program, participation rates in the community remain low. The participation of female healthcare workers, who are key to promoting this program also questionable. Objective: To assess the prevalence of adherence to mammography among female healthcare personnel and identify barriers and predictors related. Methods: A cross-sectional study was conducted from 1st of January to the end of October, 2025, targeting female health care staff aged 40 years or older. A total of 250 participants were selected via convenience sampling. Data were collected through a structured self-administered questionnaire and analyzed using SPSS v27 (significance: P ≤ 0.05). Results: The mean age of Participants was 48.17±5.97 years. There is a notable Gap between knowledge, attitude, and practice. Although 75% of the female health care personnel had a positive attitude toward screening, 63% lacked essential knowledge, and alarmingly, 60% had never had a mammogram, and only 22% screened regularly. False sense of security due to absence of symptoms (40%) or family history of breast cancer (44%) represents predominant barriers, while others feared radiation (34%) or neglected the issue. Medical professionals appeared to demonstrate a higher level of awareness (OR=8.761, p=0.002) and screening rates (OR=10.773, p=0.007). Additionally, working in primary health care seemed to be associated with increased screening practices (OR=4.008, p ≤ 0.001). Conclusion: Mammography uptake appeared critically low among female HCPs in Al-Hillah city, with key barriers that specifically rely on misconceptions highlighting a need for targeted interventions ensuring HCPs serve as effective advocates for early detection.
Design And Implementation Of An ADC/DAC-Free Walsh-Hadamard Transform Based Neural Network Accelerator Using Bit-Plane Processing
Energy-efficient neural-network inference on edge platforms is limited by multiplication-intensive computation, frequent memory access, and the converter overhead of analog compute-in-memory architectures. This paper presents an ADC/DAC-free neural accelerator based on the Walsh-Hadamard Transform (WHT) and bit-plane processing. The proposed architecture replaces conventional multiply-accumulate operations with addition and subtraction by exploiting the binary ±1 coefficients of the Hadamard matrix. Multibit inputs are decomposed into bit planes and processed from the most significant bit to the least significant bit, enabling precision-scalable computation using a compact datapath. A comparator-based decision stage removes the need for high-resolution analog-to-digital conversion, while digital bit accumulation reconstructs the final output. Soft-thresholding is incorporated to create transform-domain sparsity, and an early-termination controller avoids the processing of insignificant lower bit planes. The complete architecture consists of an input buffer, bit-plane extractor, block WHT compute core, comparator, weighted accumulator, threshold unit, and control logic suitable for Verilog realization. The proposed design offers a multiplier-free, converter-free, regular, and scalable solution for low-power edge intelligence.
Trinet-Based Deep Learning Framework For Automated Analog Circuit Parameter Prediction From Design Specifications
Analog integrated-circuit design requires repeated sizing, simulation, verification, and manual refinement because device dimensions and passive-component values interact nonlinearly with gain, bandwidth, phase margin, slew rate, power, noise, and output swing. This paper presents a TriNet-based deep learning framework that directly predicts implementable analog circuit parameters from user-defined performance specifications. The proposed pipeline combines input normalization, feasibility screening, three progressive learners, residual refinement, output accumulation, and inverse scaling. The base learner captures dominant low-order relationships, the intermediate learner models residual dependencies left by the first stage, and the advanced learner learns fine-grained nonlinear corrections. A validity classifier prevents unrealistic specification combinations from entering the regression path, thereby reducing physically meaningless predictions. For hardware-oriented deployment, the network can be represented using fixed-point arithmetic and synthesizable Verilog modules with deterministic control, bounded latency, and reusable multiply-accumulate resources. The accumulated normalized prediction is converted into practical design variables such as transistor widths and lengths, bias currents, resistance values, and compensation capacitances. The framework is intended to reduce the number of circuit-simulator iterations while preserving design accuracy and supporting rapid design-space exploration. The paper describes the complete methodology, mathematical formulation, training strategy, hardware inference organization, and evaluation protocol. Experimental results can be inserted after simulation and implementation, including prediction error, feasibility-classification accuracy, resource utilization, timing, power, and comparison with single-stage neural models and conventional optimization techniques.
Design And Implementation Of An XNOR-Based Variable-Precision Object Detection Accelerator For Real-Time Edge AI Applications
This paper presents a hardware-efficient object detection accelerator based on XNOR-driven variable-precision computation for real-time edge artificial intelligence. The proposed network combines DenseToRes and transition layers to preserve feature information under aggressive quantization. Binary convolution is executed through XNOR and population-count operations, replacing most multiplier-based multiply-accumulate units. To maintain detection accuracy, the architecture supports 1-bit, 2-bit, and 8-bit modes so that sensitive layers can use higher precision while deeper layers operate at reduced precision. A parallel array of 64 processing elements performs multiple output-channel computations concurrently using an output-stationary dataflow. The accelerator integrates on-chip feature and weight memories, data-fetch units, batch normalization, RPReLU activation, quantization, pooling, and lightweight control logic. AXI-based interfacing enables integration with an embedded processing system and external memory. The resulting architecture reduces arithmetic complexity, memory bandwidth, and power consumption while supporting scalable real-time object detection on FPGA-based edge platforms.
Financial Empowerment Of Women: A Critical Review Of Determinants, Dimensions And Emerging Perspectives
Women's financial empowerment has emerged as one of the most significant dimensions of inclusive development, gender equality and sustainable economic growth. Over the past decade, increasing policy attention has been directed towards enhancing women's access to formal financial systems through financial inclusion initiatives, financial literacy programmes, digital financial services, entrepreneurship development, microfinance and self-help group interventions. Nevertheless, contemporary research increasingly argues that financial empowerment extends far beyond access to banking facilities or credit. It represents a multidimensional process encompassing women's financial knowledge, control over financial resources, participation in household financial decision-making, ownership of productive assets, entrepreneurial capability, financial autonomy and the ability to utilise financial opportunities for improving their economic and social well-being. Despite the rapid expansion of research in this area, the available literature remains conceptually fragmented, with studies examining different dimensions of financial empowerment in diverse socio-economic, institutional and geographical contexts using varying theoretical perspectives and measurement approaches. Such fragmentation necessitates a systematic synthesis of existing evidence to identify the major determinants, emerging themes and future research directions. The present paper critically reviews the contemporary literature on women's financial empowerment using twenty-six published studies covering the period from 2014 to 2025. The review is based exclusively on the selected literature and adopts a thematic approach to synthesise existing empirical and conceptual evidence. Rather than examining individual studies in isolation, the paper integrates the literature around major themes, including conceptual foundations of financial empowerment, financial inclusion, financial literacy, entrepreneurship and microfinance, digital financial inclusion, household agency and socio-cultural constraints, and emerging measurement frameworks. This thematic organisation enables a comprehensive understanding of the evolving discourse on women's financial empowerment while identifying areas of convergence and divergence within the literature. The review demonstrates that financial empowerment is best understood as a multidimensional construct involving the interaction of financial resources, financial capability, institutional support and women's agency. Access to formal financial services, although essential, is insufficient for achieving meaningful empowerment unless accompanied by financial literacy, effective utilisation of financial products, entrepreneurial opportunities, supportive institutional mechanisms and greater participation in household financial decision-making. The literature further highlights the increasing importance of digital financial services, mobile banking and financial technologies in expanding women's financial opportunities, while simultaneously emphasising the persistence of socio-cultural barriers, gender inequality and structural constraints that continue to limit women's financial autonomy. The review also identifies important methodological and contextual gaps, particularly the need for multidimensional measurement frameworks and region-specific empirical investigations capable of capturing local socio-economic variations. The paper concludes by outlining future research directions and providing a conceptual foundation for subsequent empirical studies on women's financial empowerment.
Academic Stress And Mental Health Among Senior Secondary Students In India: A Review-Based Study
Academic stress has emerged as one of the most significant challenges affecting the psychological well-being of adolescents in India. Senior secondary education, particularly Classes XI and XII, represents a critical period marked by board examinations, competitive entrance tests, career-related decision-making, parental expectations, and increasing academic responsibilities. While educational achievement remains a central objective within the Indian schooling system, the intense pressure associated with academic success often contributes to adverse mental health outcomes among students. This review-based study examines the relationship between academic stress and mental health among senior secondary students in India by synthesizing existing literature, research findings, and contemporary evidence. The paper explores the sources of academic stress, its psychological and behavioral consequences, gender and socio-economic variations, the role of family and school environments, and the need for comprehensive interventions. The review reveals that academic stress significantly contributes to anxiety, depression, emotional distress, sleep disturbances, reduced self-esteem, and burnout among adolescents. The study further highlights the importance of creating supportive educational ecosystems that prioritize mental well-being alongside academic achievement.
The Complete Resolution Of Pregnancy-Related Acute Kidney Injury In An Eclampsia Patient Complicated By HELLP Syndrome: A Case Report
Pregnancy-related acute kidney injury (PrAKI) is a significant cause of maternal and fetal morbidity, particularly when complicated by eclampsia and HELLP syndrome. We report a 34-year-old woman in her second pregnancy with seizures, anuria, severe thrombocytopenia, markedly elevated liver enzymes, and intrauterine fetal death at approximately 31–32 weeks of gestation. Laboratory findings confirmed PrAKI alongside eclampsia, HELLP syndrome, pneumonia, and gestational diabetes mellitus. Despite initial fluid management and diuretic therapy, anuria and rising serum creatinine persisted, necessitating hemodialysis initiation on the second day. A total of six hemodialysis sessions were completed, after which kidney function gradually recovered. The hemodialysis was then discontinued due to her significant renal improvement with stable clinical and metabolic parameters within approximately two months, consistent with KDIGO 2012 recommendation to discontinue RRT when intrinsic kidney function has recovered sufficiently to meet patient needs. As the conclusion, the fundamental aspect of PrAKI management is supportive care to maintain renal perfusion.
Peritoneal Tuberculosis In A Hemodialysis Patient With Longstanding Ascites: A Diagnostic Challenge
Introduction: Tuberculous peritonitis is an uncommon form of extrapulmonary tuberculosis that is difficult to diagnose in patients receiving maintenance dialysis because its clinical manifestations are often nonspecific and overlap with nephrogenic ascites or fluid overload. Delayed diagnosis may postpone appropriate treatment and worsen clinical outcomes. Case: We report the case of a 44-year-old man with end-stage renal disease on maintenance hemodialysis who presented with persistent ascites. The condition was initially considered nephrogenic ascites, but the subsequent development of constitutional symptoms prompted further evaluation. Ascitic fluid analysis and additional investigations confirmed the diagnosis of tuberculous peritonitis, and antituberculous therapy was initiated. Discussion: This case illustrates the diagnostic challenge of distinguishing tuberculous peritonitis from other causes of ascites in dialysis patients. Persistent ascites that does not improve with optimized dialysis should prompt consideration of infectious etiologies, particularly tuberculosis in endemic settings. Early diagnostic workup is crucial for timely treatment. Conclusion: Tuberculous peritonitis should be included in the differential diagnosis of refractory ascites in patients undergoing maintenance dialysis. Early recognition and prompt investigation can facilitate timely treatment and improve patient outcomes.
Development And In Vivo Evaluation Of An Intranasal Nano Emulsion-Based Nose-To-Brain Delivery System For Enhanced Therapeutic Efficacy In Alzheimer’s Disease
Nanoemulsions, which are nanostructured and colloidally stabilized materials, have emerged as a promising approach for drug delivery. A major challenge in treating Alzheimer's disease (AD) is overcoming the blood-brain barrier (BBB) to deliver therapeutic agents effectively to the brain. The goal of this study was to develop a Rivastigmine (RSG) loaded nanoemulsion that can enhance the treatment for AD patients. We formulated a nanoemulsion containing RSG by incorporating pyridoxine, an essential vitamin for central nervous system function, along with linseed oil, which acted as the lipophilic phase in the formulation. Nine different formulations were created using the emulsification method and were then characterized. The formulation labeled “RF6” exhibited the highest drug entrapment efficiency, with 83.25% of the drug retained, likely due to its higher linseed oil content. In-vitro drug release studies conducted using a Franz diffusion cell showed that the "RF6" formulation provided a sustained release of the drug. The optimal formulation, with a globular size of 203.4 nm, was further analyzed using various techniques, including zeta potential analysis, ATR, DSC, and XRD. Cognitive performance in Long-Evans rats with AD was evaluated using the Morris Water Maze (MWM) model. The findings of this study suggest that the combination of RSG nanoemulsion with linseed oil and pyridoxine reduced the travel distance in the animal model, offering potential therapeutic benefits for AD patients.
Clinical Evaluation Of Guduchi And Ekangaveera Rasa In The Management Of Gridhrasi (Sciatica): A Single Case Study
Background-Gridhrasi is one of the important Vata Vyadhi described in Ayurveda and is clinically comparable to sciatica in contemporary medicine. It is characterized by radiating pain extending from the lower back to the gluteal region and lower limb, often associated with stiffness, tingling sensation, numbness, and difficulty in walking. The disease significantly impairs functional ability and quality of life. Although conventional management provides symptomatic relief through analgesics, physiotherapy, and surgical intervention in selected cases, recurrence and long-term dependence on medication remain major concerns. Aim -To evaluate the clinical efficacy of Guduchi and Ekangaveera Rasa in the management of Gridhrasi (Sciatica).Case Presentation-A clinically diagnosed patient of Gridhrasi presenting with radiating low back pain, stiffness, tingling sensation, and restriction of movements was managed with Ayurvedic intervention. Clinical evaluation was performed before and after treatment using subjective and objective parameters.Intervention-The patient was treated with Guduchi and Ekangaveera Rasa along with appropriate dietary and lifestyle modifications according to Ayurvedic principles.Results-Marked improvement was observed in radiating pain, stiffness, gait, and functional mobility without any significant adverse effects.Conclusion-Guduchi and Ekangaveera Rasa demonstrated encouraging therapeutic potential in the management of Gridhrasi (Sciatica). However, larger controlled clinical studies are required to establish their efficacy.
Assessment Of Lung Cancer Awareness Using The Cancer Awareness Measure (CAM): A Systematic Review
Lung cancer remains the leading cause of cancer mortality worldwide, with late-stage diagnosis contributing to poor survival outcomes. Awareness of symptoms and risk factors is a critical determinant of early detection. The Cancer Awareness Measure (CAM), a validated tool, has been widely employed to assess public knowledge and awareness of cancer symptoms, including lung cancer. This systematic review synthesizes evidence from studies utilizing CAM to evaluate lung cancer awareness, identify gaps, and assess the effectiveness of interventions. Databases including MEDLINE, CINAHL, PsycINFO, and PubMed were searched for studies published between 2010–2025. Sixteen studies met inclusion criteria. Findings reveal that awareness of cardinal symptoms (persistent cough, hemoptysis, unexplained weight loss) remains low in general populations, with significant disparities by age, gender, and socioeconomic status. Interventions such as educational campaigns (“Be Clear on Cancer”), decision aids, and multimodal public health strategies significantly improved awareness and help-seeking behavior. However, CAM-based studies highlight persistent barriers including symptom misattribution, stigma, and healthcare access inequities. This review underscores CAM’s utility in monitoring awareness trends and guiding targeted interventions for lung cancer control.
Evolution Of Anti-Hyperpigmentation Skincare: From Traditional Remedies To Modern Cosmeceutical Approaches For Adolescents
A frequent dermatological issue, skin hyperpigmentation is marked by the darkening of the skin due to an excess of melanin production. Affected individuals experience uneven skin tone and aesthetic concerns. Treatment for hyperpigmentation is still difficult, and the available treatments are time-consuming and have inconsistent results, which reduces patient compliance. Topical medications like hydroquinone, kojic acid, and glycollic acid, which aim to decrease melanin synthesis and boost epidermal turnover, are the mainstay of first-line treatments. As supplemental treatments, oral formulations including melatonin and cysteamine hydrochloride have also showed promise. Chemical peels and laser treatments are examples of second-line therapies that are typically carried out under medical supervision and produce quicker results, but they also carry a higher risk of side effects like erythema, irritation, and post-inflammatory pigmentary changes. Plant-based substances, herbal extracts, and natural formulations have been utilised in traditional medicine to treat pigmentation-related issues and to improve skin tone. These conventional methods have gradually evolved into evidence-based cosmeceutical formulations including phytochemicals, botanical extracts, antioxidants, tyrosinase inhibitors, and sophisticated delivery systems thanks to developments in dermatological science and cosmetic technology. Adolescents may be especially affected by hyperpigmentation and uneven skin tone because of hormonal fluctuations, inflammation from acne, sun exposure, and post-inflammatory hyperpigmentation. The creation of gentle, secure, and scientifically validated anti-hyperpigmentation cosmeceuticals for use on teenage skin is therefore becoming more and more necessary. This study covers a wide range of hyperpigmentation diseases, their pathogenic causes, and the development of pharmaceutical and cosmeceutical therapies from traditional to contemporary treatments. Emerging botanical and phytochemical-based treatments, contemporary administration methods, safety concerns, effectiveness, and patient compliance are highlighted, especially with regard to teenage skin health.
An Analysis And Overview Of Digital Banking Services In Jammu And Kashmir
Digital banking has transformed the banking industry by offering clients safe, practical, and technologically advanced financial services. Digital banking has become much more popular in Jammu and Kashmir as a result of government efforts, smartphone and internet-based service growth, and information technology improvements. By looking at the accessibility, uptake, advantages, and difficulties of digital banking, this research provides an analysis and overview of digital banking services in the area. The results show that while digital banking has increased financial inclusion, accessibility, and transaction efficiency, obstacles including low digital infrastructure, cybersecurity issues, and digital literacy still prevent it from being widely used. The study highlights the importance of increased awareness, technological improvements, and security measures to foster sustainable digital banking development in Jammu and Kashmir.
An Empirical Investigation Of Employee Retention In Public And Private Hospitals: The Influence Of Participative Climate And Role Performance
Employee retention remains an important yet often overlooked issue in the healthcare sector, particularly in hospital environments. Increasing concerns regarding the ability of hospitals to retain skilled employees have generated significant interest in understanding the factors that influence retention and its associated outcomes. In this context, the present study investigates the perceptions of employees working in public and private hospitals and examines the relationship between employee retention, Participative Climate (PC), and Role Performance (RP). The research was conducted among 1,010 employees from both public and private healthcare institutions. Following the identification of key underlying constructs, theory-based factors were assessed using correlation analysis. The results provide valuable insights into the dynamics of employee retention and reveal several influencing factors and outcomes associated with it. The study offers important implications for hospital administrators and policymakers and presents recommendations for future research aimed at enhancing understanding of employee retention in public and private hospital settings.
Impact Of Non-Performing Assets On The Profitability Of Commercial Banks: A Comparative Study Between Public And Private Sectors In Agra Division
Non-performing assets (NPAs) constitute one of the most important indicators of asset quality, credit-risk exposure and financial resilience in commercial banking. Although the Indian banking sector has recorded a substantial improvement in asset quality in recent years, differences in NPA exposure and profitability continue to exist between public-sector and private-sector banks. The present study examines the relationship between non-performing assets and profitability and compares the strength of this relationship across public- and private-sector commercial banks, with Agra Division of Uttar Pradesh providing the geographical and managerial setting of the study. Agra Division comprises Agra, Firozabad, Mathura and Mainpuri districts. The empirical analysis uses recent bank-group financial statistics for the five financial years ending March 2021 to March 2025, supported by Reserve Bank of India statistics, regulatory reports, annual banking reports and recent empirical literature. The principal variables are the gross non-performing asset ratio (GNPA) and return on assets (ROA), supplemented conceptually by net NPA, provisioning, capital adequacy, credit growth, operating efficiency and recovery mechanisms. Descriptive statistics, Pearson correlation, Welch’s independent-samples t-test, effect-size analysis and ordinary least-squares regression with heteroskedasticity-robust standard errors are employed. The results establish a strong adverse relationship between NPAs and profitability. Public-sector banks recorded an average GNPA ratio of 5.50 per cent during the five-year analytical period compared with 2.94 per cent for private-sector banks. Their respective mean ROA values were 0.74 per cent and 1.54 per cent. The public-sector GNPA-ROA correlation was −0.9995, while the corresponding coefficient for private-sector banks was −0.9529. In the pooled regression, a one-percentage-point increase in GNPA was associated with an estimated 0.143 percentage-point decline in ROA after controlling for ownership category. The model explained approximately 96.7 per cent of observed ROA variation. The public-private profitability difference was statistically significant and economically large. The study further observes that recent asset-quality improvement has been particularly strong among public-sector banks: by March 2025, the GNPA ratio had declined to approximately 2.6 per cent for public-sector banks and 1.8 per cent for private-sector banks, while ROA stood at approximately 1.1 per cent and 1.7 per cent, respectively. The findings support the proposition that improved underwriting discipline, early-warning systems, borrower monitoring, recovery effectiveness, adequate provisioning, portfolio diversification and technology-enabled credit-risk management can translate asset-quality improvement into sustainable profitability. For banks operating in Agra Division, the study recommends district-sensitive credit monitoring, differentiated MSME and agricultural risk frameworks, portfolio-level early-warning dashboards, faster stressed-account intervention and branch-level accountability for slippages, recoveries and risk-adjusted profitability. The paper contributes to contemporary banking research by connecting the NPA-profitability relationship with ownership structure, recent post-clean-up banking performance and the operational context of a commercially and agriculturally diverse regional market.
Capital Structure And Financial Performance Of Life Insurance Companies In Nepal: A Review With Reference To NEPSE-Listed Insurers
Capital structure is an important financial decision because the proportion of debt and equity employed by a firm can influence profitability, financial risk, solvency and long-term sustainability. The issue assumes greater significance in life insurance companies because these institutions operate with long-term contractual obligations, considerable investment commitments and continuing requirements relating to liquidity, capital adequacy and financial stability. The present paper reviews the relationship between capital structure decisions and the financial performance of life insurance companies with particular reference to Nepalese insurers listed on the Nepal Stock Exchange (NEPSE). The study is review-based and draws exclusively upon selected theoretical and empirical studies contained in the literature reviewed for the underlying Ph.D. research. The review demonstrates that the relationship between leverage and financial performance is not uniform. Classical capital-structure theory initially suggested that financing mix is irrelevant under perfect market assumptions, while later theoretical developments recognised tax benefits from debt as well as the potential costs of financial distress, agency conflict and excessive leverage. Empirical evidence similarly presents mixed findings. Studies on Nepalese insurance companies indicate that appropriately managed leverage may improve Return on Assets, Return on Equity and shareholder returns, whereas excessive debt may increase financial risk and adversely affect profitability. Some recent evidence specifically relating to Nepalese life insurance companies also reports statistically insignificant effects of conventional capital-structure ratios, indicating that profitability cannot be explained by financing mix alone. Liquidity, firm size, solvency, tangibility, investment management and managerial efficiency also influence financial performance. The paper concludes that there is no universally optimal debt-equity structure for life insurers. Capital-structure decisions must instead be evaluated in relation to the distinctive long-term obligations, solvency requirements and operating environment of individual insurance companies. The review further identifies a need for more focused empirical research using updated data for NEPSE-listed life insurers rather than combining life and non-life companies within a common analytical framework.
Phytochemical Profiling And In Vitro Antioxidant Evaluation Of The Ethanolic Leaf Extract Of Corchorus Tricolaris (Trilocularis L.)
Background: Oxidative stress is a central driver of hepatocellular injury, and medicinal plants rich in phenolic and flavonoid constituents are increasingly explored as sources of natural antioxidants. Corchorus tricolaris (syn. Corchorus trilocularis L., family Malvaceae), a traditionally used but scientifically underexplored member of the genus Corchorus, was investigated for its phytochemical composition and in vitro antioxidant potential. Methods: Shade-dried leaves were extracted by Soxhlet apparatus using 95% ethanol. The extract was subjected to preliminary qualitative phytochemical screening, quantitative estimation of total phenolic content (TPC) and total flavonoid content (TFC), chromatographic fingerprinting by HPTLC and HPLC, and in vitro antioxidant evaluation using DPPH, ABTS, hydrogen peroxide, nitric oxide, ferric reducing antioxidant power (FRAP), and lipid peroxidation inhibition (TBARS) assays. Results: The extract yielded 12% w/w on a dry-weight basis and tested positive for alkaloids, flavonoids, phenolics, tannins, saponins, and glycosides. TPC and TFC were 765 µg gallic acid equivalent (GAE)/mg and 301 µg quercetin equivalent (QE)/mg of extract, respectively. HPTLC fingerprinting resolved five major bands (Rf 0.21–0.76) corresponding to phenolics, flavonoids, tannins, saponins, and glycosides, while HPLC analysis confirmed quercetin as a major marker constituent (retention time ≈ 6.7 min). The extract exhibited concentration-dependent free radical scavenging activity, with IC50 values of 52 µg/mL (DPPH), 48 µg/mL (ABTS), 60 µg/mL (H2O2), 58 µg/mL (nitric oxide), and 62 µg/mL (lipid peroxidation/TBARS). Conclusion: The ethanolic leaf extract of Corchorus tricolaris is a rich source of phenolic and flavonoid phytoconstituents and demonstrates substantial in vitro antioxidant activity across multiple complementary assay systems. These findings provide a phytochemical and antioxidant basis that supports further evaluation of the extract's hepatoprotective potential in experimental models.
Differential Role Of Prkcε In The Pathogenesis Of Chronic Alcohol-Induced Liver Injury
Chronic alcohol consumption is a major cause of liver injury, progressing from hepatic steatosis to inflammation, necrosis, and fibrosis. Protein kinase C epsilon (PRKCε) has been implicated in alcohol-induced hepatic steatosis; however, its contribution to subsequent inflammatory and necrotic injury remains unclear. The present study investigated the differential role of PRKCε in chronic ethanol-induced liver injury using an experimental animal model. Mice were maintained on a high-fat diet and treated with either saline or PRKCε antisense oligonucleotides (ASO) for four weeks, followed by ethanol exposure. Hepatic lipid accumulation, fatty acid synthase (FAS), tumor necrosis factor-alpha (TNF-α), plasminogen activator inhibitor-1 (PAI-1), inflammation, necrosis, and fibrin deposition were evaluated. PRKCε ASO treatment significantly attenuated ethanol-induced hepatic lipid accumulation and prevented the ethanol-mediated increase in FAS expression. Furthermore, PRKCε inhibition completely suppressed the elevation of TNF-α expression associated with ethanol exposure. Despite these effects, PRKCε ASO administration did not significantly reduce chronic ethanol-induced hepatic inflammation or necrosis. Similarly, the ethanol-induced upregulation of PAI-1 and accumulation of fibrin were unaffected by PRKCε inhibition. These findings indicate that PRKCε plays an important role in alcohol-induced hepatic steatosis and associated metabolic alterations but is not the primary mediator of chronic inflammatory and necrotic liver injury. The persistence of PAI-1 elevation and fibrin deposition despite PRKCε inhibition suggests that these pathways may independently contribute to progression of alcohol-induced hepatic damage. Thus, targeting multiple pathological pathways may provide a more effective strategy for preventing chronic alcohol-related liver injury.
The Influence Of Hospital Protocols On Nursing Performance And Patient Outcomes In Cardiac Intensive Care Units: An Integrative Review
Background Cardiac intensive care units (CICUs) provide care to critically ill patients with complex cardiovascular conditions requiring continuous monitoring, rapid assessment, advanced interventions, and coordinated multidisciplinary management. Hospital protocols standardize essential practices, including assessment, medication administration, monitoring, infection prevention, mechanical ventilation, sedation, early mobilization, and emergency response. Effective protocol implementation may influence nursing performance, patient safety, and clinical outcomes. Objective This integrative review examined the influence of hospital protocols on nursing performance in cardiac intensive care units and explored their implications for patient safety and clinical outcomes. Methods An integrative review approach was used to synthesize evidence from peer-reviewed literature addressing hospital protocols, standardized nursing practices, protocol adherence, nurse staffing and workload, nursing performance, and patient outcomes in intensive and cardiac intensive care settings. The evidence was organized into five major domains: protocol standardization, nursing performance, staffing and workload, patient safety, and clinical outcomes. CICU-specific evidence was considered alongside relevant evidence from adult intensive care settings. Results The reviewed evidence indicates that well-designed and consistently implemented hospital protocols can improve nursing performance by reducing practice variation, clarifying clinical responsibilities, supporting clinical decision-making, and promoting timely recognition and management of patient deterioration. Protocol-based interventions involving sedation management, early mobilization, infection prevention, medication safety, physiological monitoring, and emergency response may contribute to improved patient outcomes. Conversely, inadequate nurse staffing and excessive workload may compromise protocol adherence and increase the risk of adverse events. The effectiveness of protocols is influenced by nurses' knowledge and competency, continuing education, staffing adequacy, leadership support, interdisciplinary communication, resource availability, and organizational compliance. Protocols are therefore most effective when used as clinical decision-support tools while preserving professional nursing judgment and individualized patient care. Conclusion Hospital protocols are important organizational mechanisms for strengthening nursing performance and patient safety in CICUs. Their effectiveness depends not only on protocol design but also on competent nursing personnel, adequate staffing, supportive leadership, appropriate resources, and continuous monitoring of adherence and outcomes. Future CICU research should use standardized measures of protocol adherence and nursing performance and examine their direct relationship with cardiovascular patient outcomes.
Suspicion Of Brown Tumor In A Young Woman Undergoing Maintenance Hemodialysis In A Rural Area: A Rare Case Report
Brown tumor is a focal bone lesion caused by increased osteoclastic activity secondary to uncontrolled hyperparathyroidism. Although commonly associated with primary hyperparathyroidism, it rarely occurs in secondary hyperparathyroidism (SHPT) among young patients undergoing long-term hemodialysis. We report a rare and diagnostically challenging case of a 28-year-old woman on maintenance hemodialysis for seven years who presented with dyspnea, productive cough, and a progressively enlarging painless palatal mass causing difficulty in mastication, accompanied by a significant height loss of 13 cm. Laboratory investigations revealed markedly elevated intact parathyroid hormone (iPTH) levels (3,239 pg/mL), increased alkaline phosphatase (1,721 U/L), hypocalcemia (8.4 mg/dL), and vitamin D deficiency (14.4 ng/mL). Panoramic radiography demonstrated a multilocular lytic lesion with expansive involvement of the right maxilla, while fine-needle aspiration biopsy suggested a vascular lesion with abundant erythrocytes. Based on integrated clinical, biochemical, and radiological findings, the patient was diagnosed with suspected brown tumor secondary to SHPT. Maxillofacial involvement in brown tumors is rare and may mimic other giant cell lesions radiologically and histologically, making diagnosis challenging; however, markedly elevated iPTH levels strongly support the diagnosis. This case highlights the importance of a multimodal diagnostic approach and early monitoring of mineral and bone metabolism in long-term hemodialysis patients to improve outcomes.
The Impact Of Ultra-Processed Food Consumption On Gut Health, Executive Functioning, Sleep, And Mental Wellbeing Among School-Going Adolescents In Delhi
Ultra-processed food (UPF) consumption has surged among adolescents, correlating with gastrointestinal (GI) symptoms, poor sleep, and psychological distress. As adolescence is a critical window for neurocognitive and emotional development, understanding dietary impacts is vital. This study investigates the associations between UPF intake and GI symptoms, sleep quality, executive functioning, anxiety, depression, and overall quality of life (QOL) in a cohort of school-going adolescents in Delhi, India. A cross-sectional study was conducted among 200 adolescents aged 10–19 years attending schools in Delhi. UPF consumption was assessed using an India-adapted NOVA-based food-frequency assessment. Gastrointestinal symptoms, sleep quality, executive functioning, anxiety, depressive symptoms, and quality of life were assessed using the Gastrointestinal Symptom Rating Scale (GSRS), Pittsburgh Sleep Quality Index (PSQI), a Stroop task, the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and a quality-of-life measure, respectively. Pearson correlations and PROCESS Model 4 mediation analyses were conducted. Indirect effects were evaluated using 5,000 bootstrap samples and 95% confidence intervals. Findings reveal that higher UPF consumption significantly correlates with increased GI symptoms, heightened anxiety and depression, poorer sleep quality, and diminished executive function. Mediation analyses identified GI symptoms as a consistent mediator, particularly in the pathways linking UPF to anxiety and reduced QOL. These results underscore the importance of the gut-brain axis in adolescent health and highlight diet as a modifiable target for intervention, though the cross-sectional design limits causal inference.
Comparative Evaluation Of Conventional And Hydrophilic Pit & Fissure Sealants In Permanent First Molars Using Modified Ryge Criteria – A Randomized Clinical Trial
Background: Pit and fissure sealants are considered one of the most effective preventive strategies against occlusal dental caries in children. Moisture contamination during sealant placement is a major cause of sealant failure. Hydrophilic pit and fissure sealants have been introduced to improve retention and clinical success under moist conditions. Aim: To comparatively evaluate the clinical performance of conventional and hydrophilic pit and fissure sealants in permanent first molars using Modified Ryge Criteria. Methodology: A randomized clinical trial was conducted among children aged 6–12 years with fully erupted permanent first molars. Eligible participants were randomly allocated into two groups: Group I received conventional resin-based sealant and Group II received hydrophilic sealant. Clinical evaluation was performed at baseline, 3 months, 6 months, and 12 months using Modified Ryge Criteria assessing retention, marginal adaptation, surface texture, discoloration, and secondary caries. Results: Hydrophilic sealants demonstrated better retention and marginal adaptation compared to conventional sealants over the follow-up period. The difference was statistically significant at 12 months (p<0.05). Secondary caries occurrence was minimal in both groups. Conclusion: Hydrophilic pit and fissure sealants showed superior clinical performance and may serve as a more reliable alternative in situations where ideal moisture control is difficult.
Identification Of Most Common Extra-Pulmonary Tuberculosis In Population Of East Uttar Pradesh
Background: Tuberculosis (TB) remains a major public health problem, with extra-pulmonary tuberculosis (EPTB) contributing substantially to the overall disease burden. The present study evaluated the distribution and demographic characteristics of EPTB cases. Methods: A total of 300 confirmed TB cases were included. Cases were categorized as pulmonary tuberculosis (PTB) or EPTB. Among EPTB cases, sex, age, and anatomical site of involvement were analyzed descriptively. Results: Of 300 TB cases, 210 (70.0%) were PTB and 90 (30.0%) were EPTB. Among EPTB cases, males accounted for 54 (60.0%) and females for 36 (40.0%), giving a male-to-female ratio of 1.5:1. Lymph node tuberculosis was the most common presentation (27; 30.0%), followed by pleural (20; 22.2%), abdominal (12; 13.3%), and bone and joint tuberculosis (10; 11.1%). CNS tuberculosis accounted for 4 (4.4%) cases, while 17 (18.9%) involved other sites. The highest proportion of EPTB was observed among patients aged 41–50 years (25; 27.8%), followed by 31–40 years (22; 24.4%). Conclusion: EPTB represented 30.0% of all TB cases, with male predominance and lymph node involvement as the most frequent presentation. Adults aged 31–60 years constituted the major affected group. These findings emphasize the importance of considering EPTB in patients with atypical or site-specific manifestations of TB.
Incremental Prognostic Value Of Neutrophil-To-Lymphocyte Ratio Beyond Serum Lactate For ICU Mortality Prediction: A Reanalysis Of MIMIC-IV Data
Background: Serum lactate is an established prognostic biomarker in critically ill patients, reflecting tissue hypoperfusion and metabolic stress. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a marker of systemic inflammation and immune dysregulation. Whether NLR provides incremental prognostic value beyond lactate for intensive care unit (ICU) mortality prediction remains uncertain. We reanalysed MIMIC-IV data to rigorously evaluate the independent and incremental contribution of early NLR measurements to lactate-based mortality prediction. Methods: We conducted a retrospective cohort study using the Medical Information Mart for Intensive Care IV (MIMIC-IV) database from Beth Israel Deaconess Medical Centre. We included adult patients (≥18 years) admitted to the ICU with serum lactate and complete blood count measurements obtained within the first 24 hours of ICU admission. The primary outcome was in-ICU mortality. We calculated NLR from absolute neutrophil and lymphocyte counts. We constructed multivariable logistic regression models with log-transformed, standardised predictors and evaluated discrimination using receiver operating characteristic (ROC) curve analysis with bootstrap-derived confidence intervals (100 resamples). We assessed incremental value using DeLong tests comparing area under the curve (AUC) estimates. We used bootstrap resampling with 100 iterations to estimate optimism-corrected performance. Results: Of 65,355 eligible first ICU admissions, 122 patients met inclusion criteria with complete early lactate and NLR measurements. The cohort had a median age of 63 years (IQR 53–71) and experienced 15 in-ICU deaths (12.3%). Non-survivors had significantly higher lactate levels (median 3.60 vs 1.90 mmol/L, p=0.006) and older age (68 vs 62 years, p=0.037) compared to survivors. NLR was elevated in non-survivors but did not reach statistical significance (13.41 vs 7.21, p=0.145). In multivariable logistic regression, lactate remained strongly predictive of mortality (OR 2.50 per 1-SD increase, 95% CI 1.38–4.52, p=0.003), while NLR showed no independent association (OR 1.23, 95% CI 0.69–2.19, p=0.481). Lactate alone achieved an AUC of 0.719 (95% CI 0.566–0.830). Adding NLR increased AUC to 0.752 (95% CI 0.619–0.860), representing a non-significant improvement (ΔAUC +0.033, p=0.155). After adjustment for age and Charlson comorbidity index, the combined model achieved an AUC of 0.783 (95% CI 0.658–0.896). Bootstrap internal validation yielded an optimism-corrected AUC of 0.704 with excellent calibration (slope 1.00, intercept 0.00). Conclusions: In this reanalysis of MIMIC-IV data, serum lactate measured within 24 hours of ICU admission demonstrated robust independent association with in-ICU mortality. Early NLR did not provide statistically significant incremental prognostic value beyond lactate alone. The high exclusion rate due to missing laboratory data (0.19% of eligible ICU admissions) and absence of severity-of-illness scores limit generalizability. These findings suggest that while NLR may capture inflammatory processes relevant to critical illness, its clinical utility for mortality prediction in the presence of lactate measurements requires further validation in larger, prospectively designed cohorts with comprehensive severity adjustment.
Phytochemical Constituents And Pharmacological Potential Of Neolamarckia Cadamba: A Comprehensive Review
Neolamarckia cadamba (Roxb.) Bosser, commonly known as Cadamba, is a fast-growing tropical tree belonging to the family Rubiaceae and has a long history of use in traditional medicine across South and Southeast Asia. Various plant parts, including bark, leaves, fruits, and roots, have traditionally been used for managing diabetes, liver disorders, inflammation, infections, wounds, and other chronic conditions. The plant contains diverse bioactive constituents, including flavonoids, phenolic compounds, steroids, fatty acids, indole alkaloids such as cadambine and iso-cadambine, and triterpenoids such as cadambagenic acid and betulinic acid. Experimental pharmacological studies have demonstrated a broad range of biological activities of N. cadamba. These include antioxidant, antimicrobial, antifungal, anti-inflammatory, analgesic, hepatoprotective, anticancer, antidiabetic, anticonvulsant, and wound-healing effects. Its anticancer potential has particularly been associated with apoptosis induction and modulation of cell-cycle pathways. These findings indicate that N. cadamba may serve as a promising source of pharmacologically active compounds. However, its translation into clinical applications remains limited due to insufficient human clinical trials, inadequate toxicological evaluation, variability in extraction methods and phytochemical composition, and incomplete understanding of its mechanisms of action. Therefore, systematic research is required to establish scientific evidence supporting its traditional uses. Future investigations should focus on standardized extraction procedures, phytochemical standardization, detailed toxicity studies, mechanistic investigations, and well-designed clinical trials to validate its therapeutic potential and facilitate evidence-based pharmaceutical development.
Nocturnal Hypoxemia As A Marker Of Disease Severity In Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study
Background: Nocturnal oxygen desaturation (NOD) is a common but underrecognized phenomenon in chronic obstructive pulmonary disease (COPD), contributing to disease progression and adverse clinical outcomes. Its association with disease severity and clinical predictors remains inadequately explored in resource-limited settings. Methods: A hospital-based cross-sectional analytical study was conducted from August 2025 to January 2026 among 100 clinically stable COPD patients. Data on demographic and clinical variables were collected, and COPD severity was classified using GOLD criteria. Nocturnal oxygen desaturation was assessed using overnight pulse oximetry, while exercise-induced desaturation was evaluated using the six-minute walk test (6-MWT). Statistical analysis was performed using SPSS version 26.0. Associations were assessed using chi-square test, and predictors were identified using univariate and multivariate logistic regression. Results: The prevalence of nocturnal oxygen desaturation was 58%. NOD increased significantly with COPD severity, from 16.7% in GOLD I to 90.9% in GOLD IV (p<0.001). On multivariate analysis, independent predictors of NOD included age >60 years (AOR 1.8, p=0.03), smoking (AOR 2.6, p=0.004), BMI <18.5 kg/m² (AOR 2.1, p=0.02), COPD duration ≥5 years (AOR 1.9, p=0.04), GOLD stage III–IV (AOR 3.5, p<0.001), and 6-MWT desaturation (AOR 5.2, p<0.001). Conclusion: Nocturnal oxygen desaturation is highly prevalent in COPD and strongly associated with disease severity and key clinical factors. Early identification using simple screening tools such as pulse oximetry and 6-MWT may facilitate timely intervention and improve clinical outcomes.
Knowledge, Attitude And Practices Among Obstetricians Regarding Oral Health Of Expectant Mothers In Southern Rajasthan: A Descriptive Cross-Sectional Study
Background: Obstetricians, owing to their frequent contact with expectant mothers, are uniquely positioned to promote maternal oral health. Aim: To assess the knowledge, attitude and practices among obstetricians’ regarding oral health of expectant mothers of Southern Rajasthan. Methods: A descriptive cross-sectional study was conducted among obstetricians registered with the National Medical Commission (NMC), Udaipur branch, Southern Rajasthan. A self-designed, structured, pre-tested, close-ended questionnaire comprising 18 items was administered through e-mail (Google Forms) following informed consent. Of 150 registered obstetricians (23 of whom participated in a prior pilot validation and were excluded from the main study), 90 completed the questionnaire. Data were analysed using SPSS version 20; Pearson's Chi-square test was applied to assess associations, with significance set at p ≤ 0.05. Results: Of the 90 respondents, 75 (83.3%) were female and 61 (67.7%) had more than 10 years of clinical experience. Good knowledge, good attitude and good practice were observed in 53 (58.9%), 53 (58.9%) and 69 (76.6%) of obstetricians, respectively. No statistically significant differences in knowledge, attitude or practice were found across age, sex or years of practice (p > 0.05 for all comparisons). Conclusion: Obstetricians in Southern Rajasthan demonstrated satisfactory knowledge and a generally favorable attitude toward maternal oral health, but this awareness was not consistently reflected in routine antenatal practice. Structured interdisciplinary training and clinical guidelines are needed to bridge this gap...
Institutional Experience and Tenure Dynamics of Burnout among Hospital Administrators in India
Background: The operational stability of modern tertiary care centers relies heavily on the administrative capabilities of leadership teams. Objective: This paper evaluates how direct healthcare administration tenure, clinical background integration, multi-departmental rotations, and bed-capacity management experience correlate with operational performance thresholds. Methods: A cross-sectional analytical study evaluated 50 certified healthcare administrators currently executing operations across specialized corporate and private tertiary setups in India. Core operational history profiles were correlated against an adapted Institutional Efficacy Scale (IES). Results: Direct hospital administration experience brackets displayed a powerful statistical correlation with structural efficacy markers (F = 6.42, p = 0.001). Managers possessing 11–15 years of focused residency administration experience scored significantly higher in resource deployment benchmarks compared to peers transitioning with fewer than 5 years of domain experience (64.8 ± 7.1 vs 52.3 ± 8.9). Multi-departmental cross-rotations also emerged as a powerful positive predictor of systemic output metrics (p = 0.014). Conclusion: Specialized institutional tenure combined with structured inter-departmental exposure acts as the primary driver of high-tier healthcare operational leadership.
Formulation And Development Of Valsartan As An Oral Dosage Form (Capsule)
The objectives of this study were to develop the formulation of valsartan to improve dissolution profile using central composite design. Valsartan is a anti-hypertensive oral dosage form used for treatment hypertension and myocardial infraction it is poorly soluble drug with low dissolution rate. In this study 20 different formulations of valsartan were prepared by varied amount of PEG-600, PG, and PEG-400, with other excipients as per the central composite design protocol. Central composite design was used to choose the optimize condition with improved dissolution profile. The optimum formulation was F-5 which was containing PEG-400, PG and PEG-600 in a ratio of 25:25:60. The physical properties of different formulations like uniformity, the angle of repose, Carr’s Index, weight variation, appearance and drug release were in the acceptable range. The rate of release valsartan from formulation F-5 was more than 72% after 2 hours, while the formulation F-7 showed only 35% of drug release. Formulation F-5 was further improved by the addition of KHCO3 (2.5 w/w %), which release 86% valsartan in-comparison to marketed formulation Diovan (96%). Fourier transforms infrared spectroscopy (FT-IR) and HPLC indicate that there were no interaction between the valsartan and the excipients used. No adduct formation or degraded products were observed using HPLC. The stability studies were carried out as per the ICH guidelines. The formulations were stable during the study period. Finally it can be concluded that developed formulation of valsartan is stable and can be further improved for routine purpose on the basis of current data.
Early In Pregnancy, Serum Activin-A Levels Can Be Used To Differentiate Between An Ectopic Pregnancy And A Normal Intrauterine Pregnancy
Background: Ectopic pregnancy (EP) is one of the most serious complications of early pregnancy and remains a leading cause of maternal morbidity and mortality during the first trimester. Activin-A, a placental glycoprotein involved in trophoblast differentiation, implantation, and placental development, has emerged as a promising biomarker for improving the early diagnosis of ectopic pregnancy. . Aim: This study aimed to evaluate the diagnostic utility of serum Activin-A levels in distinguishing ectopic pregnancy from normal intrauterine pregnancy during early gestation. Patients and Methods: A hospital-based case–control study was conducted at the Department of Obstetrics and Gynecology, Tikrit Teaching Hospital, Tikrit, Iraq, from 1 October 2025 to 30 June 2026. The study included 100 pregnant women during the first trimester of pregnancy, comprising 50 women with confirmed ectopic pregnancy (cases) and 50 women with viable intrauterine pregnancy (controls). serum Activin-A concentrations were determined using a commercially available sandwich ELISA kit and correlation analysis were performed to evaluate the diagnostic performance of serum Activin-A. Results: Serum β-hCG concentrations were significantly lower in the ectopic pregnancy group than in controls (2345.6 ± 1248.3 vs. 11892.4 ± 3562.8 mIU/mL, P < 0.001). Likewise, serum Activin-A concentrations were markedly reduced among women with ectopic pregnancy (228.47 ± 54.18 vs. 497.63 ± 91.44 pg/mL, P < 0.001). A significant positive correlation was observed between serum Activin-A and β-hCG concentrations (r = 0.684, P < 0.001). Conclusions: Women with ectopic pregnancy exhibited significantly lower serum Activin-A and β-hCG concentrations than women with viable intrauterine pregnancy. Serum Activin-A demonstrated excellent diagnostic performance and showed superior accuracy compared with β-hCG alone. Combining serum Activin-A with β-hCG further improved diagnostic accuracy, suggesting that Activin-A may serve as a valuable adjunctive biomarker for the early diagnosis of ectopic pregnancy and may contribute to earlier intervention, improved clinical decision-making, and better maternal outcomes.
Effectiveness Of Preventive Protocols For Post Traumatic Pneumonia Among Patients With Thoracic Trauma
Post-traumatic pneumonia (PTP) is a very common and severe complication of thoracic trauma. It is a significant risk factor for morbidity, mortality, hospital length of stay, admission to intensive care unit (ICU) and healthcare costs. Several preventive measures have been implemented to reduce the incidence of PTP, such as early mobilization, chest physiotherapy, incentive spirometry, pain management, oxygen therapy, pulmonary hygiene, infection control and multidisciplinary care of the patient. This article contains a critical assessment of the effectiveness of such preventive interventions from the evidence presented in the thesis. The results have confirmed that preventive protocols are very effective, if they are applied in a regular and systematic way and are carried out by a multidisciplinary team. The use of early assessment, ongoing respiratory monitoring and standardized clinical guidelines, along with effective collaboration between healthcare professionals, can greatly decrease the prevalence of pneumonia and enhance patient outcomes.
A Novel Distance Based Decision Making Approach Using Fermatean Picture Fuzzy Sets For Smart Agriculture Land Suitability
Distance measures are fundamental tools for similarity analysis and classification in fuzzy decision-making systems. However, the existing literature does not provide Euclidean and Normalized Euclidean Distance Measures specifically developed for Fermatean Picture Fuzzy Sets (FPFS), limiting their application in distance-based intelligent decision-making. To address this limitation, this paper proposes new Euclidean and Normalized Euclidean Distance Measures for FPFS and establishes their essential mathematical properties. The effectiveness of the proposed measures is demonstrated through a K-Nearest Neighbour (KNN)-based agricultural land suitability assessment under the Fermatean picture fuzzy environment. The obtained results show that both measures accurately evaluate the similarity among alternatives and produce consistent classification outcomes. Moreover, the normalized measure expresses distance values within a common interval, enabling meaningful comparison while preserving the relative ranking of alternatives. The proposed framework provides a mathematically sound and computationally efficient approach for similarity analysis and intelligent decision-making under Fermatean Picture Fuzzy information.
Methodological Confidence And Reported Certainty Of Evidence For Virtual Rehabilitation And Mirror Therapy In Post-Stroke Upper-Extremity Function: An Umbrella-Review Audit Using AMSTAR 2 And GRADE
Background. Systematic reviews of virtual rehabilitation and mirror therapy for post-stroke upper-extremity function have expanded rapidly, but the methodological confidence and reporting practices of these reviews remain unclear. Objective. To audit the methodological confidence and reporting practices of systematic reviews examining virtual rehabilitation and mirror therapy for post-stroke upper-extremity function using AMSTAR 2. Methods. An umbrella-review audit of review methods was conducted. PubMed, Europe PMC, and Crossref were searched on 17 August 2026. Systematic reviews and meta-analyses were eligible if they evaluated virtual rehabilitation, virtual reality, mirror therapy, or combined interventions relevant to post-stroke upper-extremity function. Methodological confidence was appraised using AMSTAR 2. No pooled effectiveness estimate or de novo GRADE certainty rating was produced. Results. A total of 515 records were identified. After deduplication, 321 unique records were screened, and 179 were assessed for eligibility. The descriptive mapping set included 132 records (72 full-text reports and 60 abstracts or limited-metadata records). Of the 132 records, 63 could be appraised using AMSTAR 2: 1 was rated high confidence, 4 moderate, 13 low, and 45 critically low. The remaining 69 records were not assessable. Conclusion. The evidence base for virtual rehabilitation and mirror therapy in post-stroke upper-extremity function is substantial but methodologically fragile. The findings primarily describe methodological confidence and reporting practices, highlighting a need for more rigorous evidence synthesis in this field.
Comparative Effectiveness Of Virtual Reality, Mirror Therapy, And Virtual Reality–Based Mirror Therapy For Upper-Extremity Motor Recovery After Stroke: A Systematic Review And Network Meta-Analysis
Background. Upper-extremity motor impairment is a primary determinant of persistent disability following stroke. Conventional mirror therapy (MT), standalone virtual reality (VR), and digital or VR-based mirror therapy (VRMT/DMT) represent distinct visual and sensorimotor neurorehabilitation adjuncts. Their comparative effectiveness within a unified evidence framework remains uncertain. Objective. To systematically evaluate and compare the effectiveness of MT, standalone VR, and VRMT/DMT against conventional rehabilitation (CT) and against one another for upper-extremity motor recovery, measured by the Fugl-Meyer Assessment–Upper Extremity (FMA-UE). Methods. MEDLINE/PubMed, Scopus, and Web of Science were searched up to the last date supported by the review records (not independently re-verified from deposited database export files) without language restrictions. Randomized controlled trials (RCTs) evaluating adults with stroke who received MT, standalone VR, or VRMT/DMT against CT or active comparators were screened using a four-node framework developed for the present review. Pairwise mean differences (MDs) in total FMA-UE scores were pooled using Paule–Mandel random-effects models with Hartung–Knapp–Sidik–Jonkman (HKSJ) 95% confidence intervals. A frequentist random-effects network meta-analysis (NMA) evaluated indirect comparisons, loop inconsistency, and treatment rankings using P-scores. Methodological quality was appraised using Cochrane RoB 2, and certainty of evidence was graded using CINeMA. Results. Sixteen unique RCTs contributing 20 direct pairwise contrasts were included. In pairwise analyses, standalone VR demonstrated a statistically significant improvement in total FMA-UE scores compared with CT (k = 8; MD = 4.17 points, 95% CI 2.08 to 6.26; I² = 0.0%; τ² = 0.00; p = 0.002). Conventional MT showed a positive but statistically non-significant difference versus CT (k = 6; MD = 5.17 points, 95% CI −0.64 to 10.98; I² = 35.9%; τ² = 10.85; p = 0.071). Direct evidence for VRMT/DMT versus CT (k = 3; MD = 3.08 points, 95% CI −14.12 to 20.27; I² = 39.6%; τ² = 17.21) and VRMT/DMT versus MT (k = 3; MD = 4.09 points, 95% CI −11.93 to 20.11; I² = 50.7%; τ² = 21.56) was imprecise. In the NMA, VR versus CT was the only active comparison with a 95% confidence interval excluding the null (MD = 4.17 points, 95% CI 2.08 to 6.26). The authors’ CINeMA assessment rated this comparison as high certainty; that rating was not independently re-executed from a deposited CINeMA project file. Treatment rankings yielded P-scores of 72.4% for VRMT/DMT, 66.1% for MT, 58.6% for VR, and 2.9% for CT. Conclusions. Standalone VR demonstrated the most consistent evidence of benefit for post-stroke upper-extremity motor recovery in this network. Conventional MT showed promising directional effects that warrant continued evaluation. Digital or VR-based mirror therapy remains an emerging modality, and current evidence is insufficiently precise to confirm superiority over physical mirror therapy or conventional rehabilitation. Certainty judgements are those of the review authors using CINeMA and should be interpreted in light of the incomplete public deposition of analysis files.
Self-Supervised Graph Vision Transformer Network For Early Pulmonary Nodule Detection And Malignancy Classification From Ct Imaging
Early detection of pulmonary nodules is very important in enhancing survival rates among lung cancer patients. Nevertheless, the small nodules are difficult to identify and classify in computed tomography (CT) images because of their insignificant appearance, change in size and shape, and the limited amount of large annotated medical data. To mitigate these shortcomings, this paper suggests a Self-Supervised Graph Vision Transformer Network (SS-GVTNet) in detecting and classifying pulmonary nodules and malignancies through CT scanning. The suggested framework combines self-supervised representation learning with the graph-based spatial modeling and transformer-based global feature extraction. First, self-supervised pretraining module trains powerful feature representations using massive amounts of unlabeled CT scans, which removes reliance on manual labels. A Self-Supervised Graph Vision Transformer (SGVT) backbone is then used to capture cross-slice contextual dependencies of CTs, and successful modeling of complex anatomy patterns is possible. To further improve the spatial cognition, a Enhanced Granular Neural Network (EGNN) module is built to form connectivity relations among possible nodule areas to enable the neural net to learn structural associations and contextual interactions in lung tissues. The hybrid architecture enhances the local feature removal and the global contextual reasoning. Empirical testing of publicly available lung CT data proves that the suggested model has higher detection accuracy, sensitivity, and specificity than the existing convolutional neural networks and mixed deep learning methods. Moreover, the framework offers credible classification of malignancy, which help clinicians in early diagnosis and treatment planning. The proposed solution is a scalable and efficient computer-aided lung cancer screening system that involves the integration of self-supervised learning, the graph-based modeling of features, and transformer architecture.
Employee Retention Remains An Important Yet Often Overlooked Issue In The Healthcare Sector, Particularly In Hospital Environments. Increasing Concerns Regarding The Ability Of Hospitals To Retain Skilled Employees Have Generated Significant Interest In Understanding The Factors That Influence Retention And Its Associated Outcomes. In This Context, The Present Study Investigates The Perceptions Of Employees Working In Public And Private Hospitals And Examines The Relationship Between Employee Retention, Participative Climate (Pc), And Role Performance (Rp). The Research Was Conducted Among 1,010 Employees From Both Public And Private Healthcare Institutions. Following The Identification Of Key Underlying Constructs, Theory-Based Factors Were Assessed Using Correlation Analysis. The Results Provide Valuable Insights Into The Dynamics Of Employee Retention And Reveal Several Influencing Factors And Outcomes Associated With It. The Study Offers Important Implications For Hospital Administrators And Policymakers And Presents Recommendations For Future Research Aimed At Enhancing Understanding Of Employee Retention In Public And Private Hospital Settings.
Digitalisation Of Foreign Trade Documentation In India: A Review Of Efficiency, Transparency And Implementation Challenges
The growing application of digital technologies has brought significant changes in the manner in which international trade documentation is prepared, transmitted, verified and processed. Foreign trade traditionally involves extensive documentation and coordination among exporters, importers, customs authorities, banks, logistics providers and other regulatory institutions. Dependence on paper-based documentation can contribute to delays, repetitive verification, higher transaction costs, documentary errors and limited information visibility. Digitalisation offers an alternative through electronic documentation, Electronic Data Interchange (EDI), customs automation, single-window systems, blockchain, electronic signatures and other technology-enabled mechanisms. The present paper reviews the role of digitalisation in improving the efficiency and transparency of foreign trade documentation, with particular reference to India. It is based exclusively on selected studies contained in the literature reviewed for the underlying research and adopts a thematic and descriptive review approach. The review indicates that digitalisation can improve operational efficiency by reducing processing time, transaction costs, physical documentation, duplication and human intervention while improving accuracy, coordination and customs clearance. Digital systems can also strengthen transparency through improved information visibility, traceability, auditability, real-time information sharing and accountability. India has progressively adopted mechanisms such as DGFT e-governance systems, ICEGATE, SWIFT and sector-specific platforms such as Grapenet. However, the benefits of digitalisation remain uneven because of infrastructural disparities, inadequate digital skills, cybersecurity concerns, interoperability problems, legal and regulatory uncertainty and differences in technological readiness, particularly among MSMEs and stakeholders located outside technologically advanced trade centres. The review suggests that the effectiveness of digitalisation depends not merely upon introducing technology but upon the simultaneous development of infrastructure, institutional coordination, stakeholder capabilities, cybersecurity safeguards and supportive regulatory arrangements. The paper concludes that digitalisation has considerable potential to make foreign trade documentation in India more efficient, transparent and integrated, but an inclusive and coordinated approach is required to realise these benefits across different stakeholder groups and regions.
AI Dependency Among Health Care Professional Students And Its Impact On Their Academic Performance & Critical Thinking –A Cross-Sectional Study
Objective: The adoption of Artificial Intelligence (AI) tools, including platforms like ChatGPT, in educational environments has garnered growing attention, especially among students in healthcare-related programs. While AI presents opportunities to enhance learning efficiency, concerns remain about its influence on students' academic performance and critical thinking capabilities. This study seeks to evaluate the level of dependence on AI among young healthcare professional students and explore its impact on both their academic achievements and critical thinking skills. Materials and Methods: A cross-sectional survey was administered to undergraduate healthcare students. Total 395 students participated in the study. AI- Health Professionals & Students Dependency Index, academic performance scale and critical thinking evaluation scale was used. The questionnaire covered the frequency and manner of AI tool usage, self-reported academic outcomes, and measures of critical thinking. Data were analyzed using descriptive statistics and correlation techniques to explore the associations between AI use and academic metrics. Results: Initial findings reveal that many students frequently use AI tools for academic purposes. Which may impair critical thinking, problem-solving abilities, academic performance and professional skills with the p- value of 0.05 of Pearson correlation coefficient. Conclusion: This study highlights the importance of balanced AI integration in academic settings. It advocates for the establishment of structured guidelines to ensure AI tools complement, rather than replace, traditional educational practices—thereby maintaining and promoting critical thinking among healthcare students.
Human Papillomavirus Prevalence And Genotype Distribution Across Normal And Abnormal Cervical Cytology: A Narrative Review
Background: Human papillomavirus (HPV) infection is a major sexually transmitted viral infection and the central etiological factor in cervical carcinogenesis. HPV may be present before recognizable cytological abnormalities develop, making the comparison of HPV prevalence across normal and abnormal cervical cytology important for screening and prevention. Objective: To narratively synthesize evidence describing HPV prevalence across cervical cytological categories, characterize major genotype patterns, examine geographic and methodological variation, and discuss implications for cervical cancer screening, vaccination and surveillance. Methods: This narrative review is based on the evidence cited in the source manuscript, including global meta-analyses and regional observational studies concerning HPV prevalence and genotype distribution in women with normal or abnormal cervical cytology. Because the source material did not document a complete reproducible database search, this version does not claim systematic-review methodology or invent search dates, databases, screening numbers or eligibility decisions. Results: HPV DNA is detectable in a meaningful proportion of women whose cytology is classified as normal. A landmark global meta-analysis estimated HPV prevalence at 10.4% in women with normal cytology, with marked regional differences. Subsequent evidence has shown substantially greater HPV detection among women with abnormal cytology, with prevalence generally increasing as cytological severity increases. HPV16 is consistently prominent among high-risk genotypes, whereas HPV18, HPV31, HPV33, HPV52 and HPV58 contribute to different degrees depending on population and geographical setting. Comparisons across studies are complicated by differences in age, recruitment setting, cytological definitions, HPV assays and genotype coverage. Conclusion: HPV infection may be present despite normal cytology, indicating that cytology alone cannot identify every woman with oncogenic HPV infection. Appropriate integration of HPV testing with cytological triage, sustained vaccination and improved genotype surveillance can strengthen cervical cancer prevention. Standardized longitudinal and population-based studies are required to improve comparability and clarify HPV persistence and progression.
A Descriptive Study To Assess The Factors Influencing Hypertension Among The People Residing In Thirubuvanai Area, At Puducherry
The present study was conducted to assess the factors influencing Hypertension among people residing in Thirubuvanai at Puducherry. The study was Descriptive research design. A total of 50 participants who met the inclusion criteria were selected from the Thirubuvanai area at Puducherry by using random sample technique. The chi – square test revealed that there was a significant association between selected demographic variables and the overall *P<0.05 significant, ** -p<0.001& ***-P<0.001Highly significant.
Study Of Antimicrobial Resistance And Antibiotic Sensitivity Patterns Among Urinary Isolates With Esbl Producers
Background: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide. The emergence of Extended Spectrum Beta-Lactamase (ESBL)-producing organisms has become a major challenge due to their multidrug-resistant nature and limited treatment options. Objective: To determine the prevalence of ESBL-producing urinary isolates and evaluate their antimicrobial susceptibility patterns among patients with urinary tract infections. Materials and Methods: A cross-sectional study was conducted from March 2023 to May 2024. A total of 230 urine samples were collected from outpatient and inpatient departments of Kidney Stone Hospital, Prayagraj. Samples were processed using standard microbiological methods. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method according to CLSI guidelines. ESBL production was confirmed using the Phenotypic Confirmatory Disc Diffusion Test. Results: Among 230 urine samples, 197 showed significant bacterial growth. Gram-negative bacilli constituted 95.4% of isolates. Escherichia coli was the predominant pathogen followed by Citrobacter spp. and Klebsiella spp. High susceptibility was observed towards amikacin, nitrofurantoin, cefoperazone-sulbactam and meropenem. ESBL production was detected in 54.4% (56/103) of E. coli and 55% (11/20)of Klebsiella spp. isolates. ESBL-producing organisms exhibited significantly higher resistance to commonly used antibiotics compared to non-ESBL producers. Conclusion: The study demonstrated a high prevalence of ESBL-producing urinary pathogens with increased resistance to commonly used antibiotics. Amikacin, nitrofurantoin, cefoperazone-sulbactam, and meropenem showed the highest antimicrobial activity. Regular surveillance of antimicrobial susceptibility patterns is important to support appropriate antibiotic therapy.
Association Of VDR (Apai Rs7975232) Polymorphism And Some Biochemical Parameters With Psoriasis In Iraqi Patients
Background: Psoriasis is an inflammatory skin disease caused by genetic and environmental factors. Although data on Iraqi patients are poor, there may be a relation between the vitamin D receptor (VDR) gene and susceptibility to psoriasis. Objective: This study aims to analyze the association between the VDR ApaI (rs7975232) gene polymorphism and the tendency toward psoriasis in Iraqi patients and to evaluate serum levels of vitamin D3, ferritin, and zinc. Method: A case-control study was conducted on 45 patients with psoriasis and 35 age- and sex-matched control group. Genotyping of the Vitamin D receptor rs7975232 polymorphism was done by high-resolution melting (HRM) analysis. Automated analyzers tested serum vitamin D3, ferritin, and zinc levels. Statistical analyses were performed using GraphPad Prism software. Results: The allele frequency was considerably higher in patients (40.0%) than in the control group (24.3%), which conferred an elevated risk of psoriasis (OR = 2.07, 95% CI: 1.01–4.24, p = 0.046). AA carriers showed the lowest mean vitamin D3 level (15.0 ± 3.7 ng/mL, p = 0.0043) and highest mean ferritin level (223.6 ± 67.2 ng/mL, p = 0.0136). Levels of vitamin D3 and zinc were considerably lower in patients than in the control group (p<0.001 for both), and the highest mean ferritin level (p<0.001). Conclusions: The A allele of the VDR rs7975232 polymorphism was associated with increased susceptibility to psoriasis in Iraqi patients. AA carriers showed the lowest mean vitamin D3 and zinc levels and the highest mean ferritin level; however, genotype-related differences in these biochemical parameters were not statistically significant within the patient group.
Evaluating The Impact Of A Flashcard-Assisted Andragogical Learning Intervention (FAALI) On Child Rights Competency Among Undergraduate Nursing Students: A Quasi-Experimental Inquiry
Background Child rights protection is an essential component of global health, social justice, and ethical healthcare practice. Despite international frameworks such as the United Nations Convention on the Rights of the Child (UNCRC), children worldwide continue to experience violations including abuse, neglect, exploitation, discrimination, and inadequate access to protection services. Nurses represent a critical workforce in child protection due to their continuous involvement in healthcare delivery, yet inadequate competency related to child rights, legal responsibilities, identification of violations, and reporting mechanisms remains a concern among nursing learners. Improving competency in child rights in nursing education is therefore essential in preparing future nurses to deliver safe, ethical and child-centred care. Objective The present study aimed to evaluate the effectiveness of a Focused Activity-Based Learning Intervention (FAALI) on child rights competency among nursing students in a selected nursing school in Odisha, India. Methods The design of the study was a quantitative quasi-experimental pre-test and post-test control group. The study was conducted among 60 nursing students from a selected nursing institution in Odisha, India. Participants were randomly distributed in experimental and control groups. The experimental group was given FAALI, a structured educational intervention incorporating interactive teaching strategies including case-based learning, role play, group discussion, problem-solving activities, and scenario-based exercises related to child rights and protection. Child rights competency was assessed using a structured competency assessment tool developed based on international child rights frameworks, national child protection legislation, and nursing education guidelines. Data were analysed using descriptive and inferential statistics, including paired t-test, independent t-test, chi-square test, and effect size analysis. Results The findings demonstrated a significant improvement in child rights competency among nursing students who received FAALI compared with their baseline competency levels and the control group. The experimental group showed a substantial increase in post-intervention competency scores, indicating improved understanding of child rights principles, recognition of child protection concerns, legal awareness, and professional responsibilities. The intervention demonstrated a large educational effect, suggesting that activity-based learning strategies can effectively strengthen competency outcomes among nursing students. Conclusion FAALI was identified as an effective educational intervention to enhance competency in child rights among nursing students. Incorporating structured activity-based child protection education into nursing curricula may enhance future nurse’s preparedness to identify, prevent, and respond to child rights violations within healthcare settings.
Comparative Evaluation Of Periodontal And Peri- Implant Health Around Implant-Supported Versus Tooth-Supported Fixed Dental Prosthesis
Background: Long-term success of fixed prosthetic rehabilitation depends on prosthesis survival and maintenance of healthy periodontal and peri-implant tissues. Differences in supporting structures, prosthetic contours, plaque retention, and oral-hygiene accessibility may influence tissue response around implant-supported and tooth-supported fixed prostheses. Aim: To compare the periodontal and peri-implant status around implant-supported and tooth-supported fixed prostheses in patients at a tertiary care hospital. Materials and Methods: This hospital-based comparative observational study included 36 patients, divided equally into Group I with implant-supported fixed prostheses and Group II with tooth-supported fixed prostheses. Clinical assessment included plaque index, bleeding on probing, probing pocket depth, gingival/peri-implant mucosal recession, inflammation, suppuration, swelling or tenderness, and mobility. Prosthesis-related variables such as food impaction, marginal adaptation, oral-hygiene accessibility, and prosthetic contour were recorded. Marginal bone status was assessed radiographically. Data were analysed using IBM SPSS Statistics version 27.0, and p<0.05 was considered statistically significant. Results: Mean age was 46.78 ± 9.42 years in Group I and 48.61 ± 10.06 years in Group II (p=0.583). Implant-supported prostheses showed significantly lower plaque index (0.82 ± 0.31 vs 1.12 ± 0.36; p=0.011), bleeding on probing (21.70 ± 10.80% vs 34.60 ± 13.40%; p=0.003), probing pocket depth (2.74 ± 0.42 vs 3.18 ± 0.51 mm; p=0.008), recession (0.61 ± 0.29 vs 0.84 ± 0.36 mm; p=0.042), and marginal bone loss (0.78 ± 0.32 vs 1.08 ± 0.41 mm; p=0.020). Clinically evident inflammation was less frequent in Group I (22.22% vs 61.11%; p=0.041), as was food impaction (16.67% vs 55.56%; p=0.035). Marginal bone loss ≤1.00 mm was observed in 72.22% of Group I and 27.78% of Group II (p=0.026). Conclusion: Implant-supported fixed prostheses were associated with more favorable periodontal and peri-implant tissue conditions than tooth-supported fixed prostheses. Careful prosthetic design, effective plaque control, and regular maintenance remain essential for preserving supporting tissue health.
Periodontal Pathogens In Oral Squamous Cell Carcinoma Tissue: A PCR-Based Case-Control Study
Background: Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity, and increasing evidence suggests that periodontal dysbiosis may contribute to its development and progression. Periodontal pathogens may influence carcinogenesis through chronic inflammation, altered immune responses and microbial interactions within the tumour microenvironment. Aim: To evaluate the prevalence and burden of selected periodontal pathogens in OSCC tissue and to compare them with non-malignant oral tissue using polymerase chain reaction (PCR). Materials and Methods: This hospital-based case-control study included 40 participants at a tertiary care hospital, comprising 20 histopathologically confirmed OSCC patients and 20 non-malignant controls. Demographic characteristics, tobacco use, smoking, alcohol consumption and periodontal parameters including Plaque Index, Gingival Index, bleeding on probing, probing pocket depth and clinical attachment loss were recorded. Tissue samples were subjected to species-specific PCR for Porphyromonas gingivalis, Fusobacterium nucleatum, Tannerella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans. Data were analysed using IBM SPSS Statistics version 27.0, with p<0.05 considered statistically significant. Results: Tobacco chewing was significantly more frequent among OSCC cases than controls (80.00% vs 35.00%; p=0.010). All periodontal parameters were significantly higher in OSCC patients (p<0.001). Porphyromonas gingivalis was detected in 75.00% of cases versus 35.00% of controls (p=0.025), Fusobacterium nucleatum in 80.00% versus 40.00% (p=0.022), and Treponema denticola in 55.00% versus 20.00% (p=0.048). At least one periodontal pathogen was identified in 95.00% of OSCC tissues compared with 60.00% of controls (p=0.020). Two or more pathogens were detected in 85.00% versus 40.00% (p=0.008). High pathogen burden was significantly associated with advanced TNM stage (p=0.019) and lymph-node positivity (p=0.020). Conclusion: OSCC tissues demonstrated significantly greater periodontal pathogen prevalence and polymicrobial burden than non-malignant tissues. The association of high pathogen burden with advanced stage and nodal involvement suggests that periodontal dysbiosis may be linked with OSCC severity.
A Road To Molecular Disease Of Childhood—Sickle Cell Disease Cases Series
Sickle cell disease (SCD) is a hereditary hemoglobin disorder commonly presenting during childhood. It results from a point mutation in the β-globin gene, leading to the substitution of a single amino acid within the hemoglobin molecule. Inheritance follows an autosomal recessive pattern. According to estimates from the World Health Organization, hemoglobinopathies affect nearly 15% of the global population. The worldwide incidence of homozygous SCD is approximately 170 cases per 100,000 live births, with the highest prevalence observed in Africa, where the incidence reaches about 1,125 cases per 100,000 live births. The present study describes a series of pediatric and adolescent patients diagnosed with sickle cell disorders, focusing on their clinical presentation, associated complications, and treatment strategies. Fetal hemoglobin (HbF), which consists of two alpha and two gamma globin chains, differs structurally from adult hemoglobin (HbA), composed of two alpha and two beta globin chains. HbF plays a protective role by reducing red blood cell sickling under stressful physiological conditions. Because HbF levels remain relatively high during early infancy and gradually decline after birth, symptoms of SCD generally become evident after six months of age. In settings where neonatal screening programs are unavailable, diagnosis is frequently delayed until clinical manifestations appear. This study highlights the clinicopathological spectrum of sickle cell disease and emphasizes current diagnostic and management approaches for affected patients.
Thermophysical Properties And Heat Transfer Performance Of N-Doped Carbon-Metal Oxide Nanocomposite Nanofluids
Nanofluids, made by dispersing solid nanoparticles in a base fluid such as water or ethylene glycol, raise the thermal conductivity of ordinary coolants but come with two familiar penalties: the viscosity rises with loading, and the particles tend to settle or clump over time. Nitrogen-doped carbon combined with a transition metal oxide is one of the more promising particle chemistries for getting round these penalties. The carbon phase (graphene, graphene oxide or nanoplatelets) carries a high intrinsic thermal conductivity and, once nitrogen is doped into its lattice, improved wettability and dispersibility in polar base fluids; the metal oxide (Fe3O4, Al2O3, TiO2, CuO and related oxides) adds mass, magnetic or optical function, and anchoring sites that keep the carbon sheets from restacking. This review gathers what is known about these hybrid nanofluids. We first cover how they are prepared, the two-step and one-step routes, the choice of base fluid, and the surfactant or functionalization strategies that decide stability. We then treat the thermophysical properties one at a time: thermal conductivity and the mechanisms proposed for its enhancement (Brownian motion, the interfacial nanolayer and particle aggregation), dynamic viscosity, specific heat capacity, density and electrical conductivity, with reported enhancement figures drawn from the experimental literature. The heat-transfer section covers convective performance in laminar and turbulent flow, the Nusselt-number and heat-transfer-coefficient gains reported for nitrogen-doped graphene and carbon-metal oxide hybrids, entropy generation, and device-level results in heat exchangers and solar collectors. We close with the problems that still limit use: the trade-off between conductivity gain and pumping penalty, long-term stability, the gap between property measurements and full-system performance, and the shortage of data specific to nitrogen-doped carbon-metal oxide hybrids as opposed to their single-component parents.
Structural, Optical, And Surface Chemical Analysis Of Piper Longum-Derived Zro2 Nanoparticles And Their Biological Applications
Bioengineering of metal oxide nanoparticles has become more popular because of its environmental compatibility and biomedical applications. In this study, the Piper longum catkin extract was used to synthesize the nanoparticles of zirconium oxide (ZrO₂) and their various physicochemical and biological characteristics were studied. X-ray diffraction (XRD) analysis confirmed that highly crystalline and phase-pure zirconia nanoparticles with characteristic diffraction peaks corresponding to the ZrO2 crystalline formation were formed. The field emission scanning electron microscopy indicated that most of the particles were spherical to near spherical and the size of the particles were in the range of 46.35 to 65.66 nm with an average particles size of 56.54 nm. The surface capping and stabilization of the nanoparticles was found to be effective from the presence of Zr–O structural vibrations and phytochemical functional groups obtained from Piper longum by Raman and Fourier transform infrared (FTIR) analysis. Besides, energy dispersive X-ray spectroscopy (EDS) confirmed the elemental purity of the synthesized nanoparticles and only Zr and O were detected with atomic percentages of 29.8% and 70.2% respectively. Biological activities of the synthesized Zr-PL nanoparticles were assessed by antimicrobial, antioxidant and anti-cancer assays. The concentration-dependent antimicrobial activity of the nanoparticles was observed against Staphylococcus aureus, Escherichia coli, Bacillus subtilis, Pseudomonas aeruginosa and Candida albicans with maximum zone of inhibition 3, 3, 4, 5 and 3 mm, respectively at 25 mg mL⁻¹. In the DPPH assay, the free radical scavenging activity gradually increased with increasing concentrations, reaching a maximum inhibition of 43.64% at the concentration of 1000 µg mL⁻¹. In addition, MTT assay showed a dose dependent anticancer activity in A549 (human lung adenocarcinoma) and HeLa (human cervical adenocarcinoma) cell lines with IC₅₀ of 53.18 and 53.93 µg mL-1, respectively. Cell viability was reduced to 39.54 % for A549 cells and 40.62 % for HeLa cells at the concentration of 100 µg mL-1 which shows good growth inhibition. The overall outcome shows that the ZrO₂ nanoparticles prepared by Piper longum have suitable structural behavior and have good antimicrobial, antioxidative, and anticancer properties. The results show that the green-synthesized ZrO₂ nanoparticles are promising candidates for future biomedical and therapeutic applications to be used as multifunctional nanomaterials.
An Integrated Hybrid Artificial Intelligence Framework For Early Autism Spectrum Disorder Screening Using Random Forest Classification And Resnet18 Transfer Learning
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by persistent deficits in social communication, interaction, and behavioral patterns. Early screening is essential for timely intervention; however, conventional diagnostic procedures are often resource-intensive, subjective, and dependent on clinical expertise. This study proposes an integrated hybrid artificial intelligence framework for preliminary ASD screening by combining machine learning and deep learning techniques using structured behavioral data and facial image analysis. The first module employs a Random Forest classifier to analyze Autism Quotient-10 (AQ-10) questionnaire responses together with demographic and medical history attributes, including age, gender, ethnicity, family history, and developmental factors. The second module utilizes ResNet18 with transfer learning to classify facial images after preprocessing and data augmentation, enabling non-invasive image-based screening. Both predictive models are integrated into a user-friendly screening application developed using CustomTkinter, allowing independent questionnaire-based and image-based assessments through a unified graphical interface. Model training incorporates feature preprocessing, hyperparameter optimization using Grid Search with cross-validation, and performance evaluation using accuracy, precision, recall, F1-score, specificity, and area under the receiver operating characteristic curve (ROC-AUC). Experimental results demonstrate that the Random Forest model achieved an accuracy of 96.8%, while the ResNet18 model attained 94.2% accuracy, indicating the effectiveness of combining behavioral and facial information for preliminary ASD screening. The proposed framework is intended as a clinical decision-support tool to facilitate accessible and timely screening and is not designed to replace comprehensive clinical diagnosis.
Secure Health Data Transmission by Bayesian Fusion of Hybrid Domain and Deep Learning Steganography
Securing medical pictures during transmission is a major difficulty in telemedicine, necessitating approaches that preserve both security and diagnostic fidelity. This research provides a Bayesian fusion-based steganographic framework that combines two complimentary approaches to produce higher imperceptibility, resilience, and reconstruction quality. The first approach employs a Discrete Wavelet Transform (DWT), Singular Value Decomposition (SVD), Least Significant Bit (LSB), hybrid (DWT–SVD–LSB) technique, where the cover and secret medical images are transformed into frequency sub-bands by DWT and the low-frequency coefficients (LL bands) are embedded using SVD for high stability and noise resistance. The second technique uses a deep learning-based Convolutional Neural Networks and DWT (CNN-DWT) model, where both images go through convolutional feature extraction, multi-level wavelet decomposition, and attention-based enhancement for creating a perceptually accurate stegoimage. The two models are fused by using the results level Bayesian precision fusion, which combines their hybrid PSNR of 56.73 dB and the deep learning PSNR of 57.73 dB. The fused PSNR is 60.27 dB, which is an improvement of 2.54 dB above the best performing individual approach.
Biocrypt: An Advanced Dna-Based Cryptographic Security Framework
As genomic data volumes continue to grow rapidly, protecting genetic information throughout its lifecycle—from collection and storage through analysis and sharing—has become a critical challenge. This paper presents BIOCRYPT, a cryptographic framework implementing the DNASSF protocol for secure storage and transport of DNA and RNA sequence data. The system provides multiple security layers: AES-256-GCM for authenticated encryption, X25519 Elliptic Curve Cryptography for key exchange, HKDF-SHA256 for secure key derivation, and age-based key wrapping for device-bound key management. A 2-bit DNA encoding scheme reduces storage requirements by 75% while preserving cryptographic security. The system automatically detects FASTA, FASTQ, and GenBank formats, and converts RNA sequences to DNA for standardized storage. Encrypted workspaces allow multiple data sequences to be stored within a single protected container, supporting collaborative research while maintaining access control. Performance evaluation demonstrates encryption throughput of approximately 4 MB/s with negligible impact on genomic analysis workflows. Implemented in Rust for memory safety, BIOCRYPT provides a robust and efficient solution for protecting genomic data in research, clinical, and biotechnology settings.
Tversky Loss Analysis In Brain Tumour Detection Using CNN And Resnet Models
The World Health Organisation (WHO) identifies brain tumours as one of the leading causes of death in the world. This disease is challenging to identify because of its complexity and cunning character. Because of the high risk of clinical occurrences, persistent brain tumour illness is a severe public health issue worldwide. Despite the general consensus that persistent brain tumour disease has considerable interactions with elevated risks of vascular events, end- stage excretory organ disease, and all-cause mortality, there is still inadequate information on individuals. Deep learning (DL), a branch of machine learning, has recently shown impressive results, particularly in tasks like classification and segmentation. Imaging can be done in various ways to look for brain tumours. Magnetic Resonance Imaging( MRI )is widely utilized because it produces high-quality images without harmful ionizing radiation. MRI enables the early diagnosis and evaluation of brain tumours as a preventive medical measure. Brain tumour diagnosis is aided by MRI, which provides thorough information on human-sensitive tissue. The Convolutional Neural Network (CNN) is a popularly used method and sought-after model for classification in modern times. Like the human brain, the CNN-based expert system's input, neurons, hidden layers, and output are all interconnected. The study focuses on developing and optimizing deep learning models to handle the complexity and heterogeneity of brain tumours. CNNs are commonly employed for their ability to automatically learn discriminative features from medical images, particularly MRI scans. These models leverage large datasets to understand representations that capture the subtle variations and distinctive patterns indicative of brain tumours.
Hybrid Gce Cnn–Bilstm For Advanced Malware Detection Using Behavioral And Sequential Features
The study introduces an innovative approach of deep learning-based hybrid system to classify malware based on its real-time detection using a novel architecture called “Gated Convolutional Embedded Convolutional Network - Bidirectional Long Short-Term Memory (GCE-CNN-BiLSTM)” that integrates both static and dynamic sequences of malware (malware)..This system combines two data types for use with malware detection: the first is static characteristics (opcode) and n-grams of the static data (extracted from Portable Executable - PE - files) while the second is log data dynamically created in an environment where the malware was run (i.e., using the Cuckoo Sandbox). The log files contain information on dynamic activities performed by an executable file during execution (such as API calls, changing the registry, performing file system activity) and the static characteristics of the executable binary itself. The proposed system uses a one-dimensional (1D) CNN for localized, binary opcodes to create input sequences containing embedded opcode sequences which will be used by the LSTM to perform binary classification of malware execution; furthermore, a Bidirectional LSTM will be used to capture long-term (temporal) dependencies associated with executable files executed in the malware (opcode) execution flow and execution behaviour. The output from both channels (CNN and Bidirectional LSTM) will be combined and fused together for robustness purposes against obfuscated executables, packed executables, and polymorphic executables. The performance metrics were evaluated using a total of 10,000 labelled malware data samples from the Malimg datasets and 7,500 labelled executable behaviours generated by Cuckoo Sandbox. The accuracy for GCE-CNN-BiLSTM using these datasets was found to be at 98.3% accuracy, 97.8% precision, and 98.1% recall, demonstrating the efficacy of using a hybrid approach for advanced malware detection.
Ultrasound-Based Hepatitis C Stage Classification Using Deep Learning Techniques
Hepatitis C virus (HCV) infections represent a significant threat to public health worldwide, highlighting the need for precise and effective diagnostic techniques for disease staging. This research presents a deep learning methodology utilizing This work employs Convolutional Neural Networks (CNNs) to automatically determine the stages of Hepatitis C Virus (HCV) based on ultrasound imaging. It integrates state-of-the-art architectures such as Xception, DenseNet, ShuffleNet, and ManualNet to improve diagnostic precision and streamline classification processes. The dataset includes a wide range of ultrasound images that highlight essential biomarkers related to disease progression. Among the tested models, Xception recorded the highest accuracy (99.12%), followed closely by DenseNet (98.76%), ShuffleNet (96.89%), and ManualNet (94.32%). The proposed models outperformed traditional machine learning algorithms, achieving higher accuracy than Support Vector Classifiers (92.34%) and Logistic Regression (89.45%). Their robustness was further confirmed through evaluation metrics such as the Area Under the ROC Curve (AUC), Mean Absolute Error (MAE), and Mean Squared Error (MSE), highlighting the effectiveness and reliability of the deep learning approaches.This AI-driven system facilitates early detection of liver damage, aids timely medical intervention, and enhances precision medicine by uncovering imaging patterns often missed by radiologists. Its integration into clinical workflows significantly improves patient care, optimizes prognosis, and supports personalized treatment strategies, revolutionizing Hepatitis C diagnostics.
Does Time Under Anaesthesia Matter? Operative Duration As An Independent Predictor Of Airway Morbidity, Postoperative Discomfort And Patient Satisfaction When Endotracheal Tube Securement Is Standardised: A Prospective Observational Study
Background: Peri-oral and airway injury arising from the endotracheal tube (ETT) is usually explained in terms of how the tube was fixed, how large it was and how tightly the cuff was inflated. How long the apparatus remains pressed against peri-oral and periocular tissue has attracted far less scrutiny in elective theatre practice, largely because heterogeneous fixation methods within a cohort make the effect of time difficult to isolate. Objective: To establish whether the length of an operation independently predicts intraoperative airway and peri-oral morbidity, postoperative discomfort and patient satisfaction in a cohort where every tube was secured by one and the same device. Methods: Sixty consecutive adults aged 18–60 years of ASA physical status I or II, scheduled for elective surgery under general anaesthesia with orotracheal intubation, were studied prospectively at a tertiary teaching hospital in South India between December 2024 and December 2025. A single integrated stabilisation device was used in every case, so that securement technique could not vary between participants. Actual operative time in minutes served as the exposure. Endpoints comprised tube migration exceeding 1 cm, peri-oral soft-tissue injury, bite-related occlusion of the tube, ocular complication, a composite of these four, postoperative discomfort graded on a visual analogue scale as mild or moderate, and reported satisfaction. Analysis used the Mann–Whitney U test, the Cochran–Armitage trend test, receiver-operating-characteristic (ROC) analysis and logistic regression adjusted for age, sex and ASA status. Results: Operations lasted a median of 95 min (IQR 68–140). At least one composite event occurred in 28.3% of patients (95% CI 17.5–41.4). Affected patients had spent longer in theatre than unaffected patients (118.8 ± 42.3 versus 94.7 ± 41.2 min; p = 0.041), and the event rate climbed steadily across duration bands (6.7%, 29.6% and 44.4% for ≤60, 61–120 and >120 min; trend p = 0.017). Not one tube displacement or ocular event arose in an operation shorter than 120 min. After adjustment, operative time alone predicted moderate discomfort (OR 2.77 for every additional 30 min, 95% CI 1.41–5.44; p = 0.003) and was inversely related to the highest satisfaction rating (OR 0.49 per 30 min, 95% CI 0.26–0.91; p = 0.024). Discrimination for moderate discomfort was good (AUC 0.824, 95% CI 0.712–0.935), and a cut-point of 80 min yielded 96.2% sensitivity with 58.8% specificity. Conclusion: Once the manner of tube securement is fixed across a whole cohort, elapsed operating time stands out as the leading, dose-related driver of airway and peri-oral morbidity and of how uncomfortable patients feel afterwards. Time in theatre deserves to be handled as an actionable risk exposure that should prompt deliberate airway reassessment somewhere beyond the 80- to 120-minute mark, instead of being logged passively at the end of the case.
Beyond The Checkbox: Development And Validation Of A Scale Measuring MBBS Students’ Attitudes, Barriers, And Preferences Toward Academic And Clinical Documentation
Background: Competency-Based Medical Education (CBME) in India relies on assignments, Self-Directed Learning (SDL) record book entries, and clinical logbook documentation as core mechanisms for developing self-regulated, lifelong learners. Prior survey work suggests these elements are inconsistently well received by MBBS students, yet no validated, multi-domain instrument exists to assess attitudes, perceived barriers, and preferences across all three tasks within a single framework, nor to link self-report data with objective compliance records. Objective: To develop and psychometrically validate the Attitude, Barriers, and Preferences towards Academic and Clinical Documentation Scale (AACDS), including an item assessing preference for extending the National Medical Commission’s (NMC) postgraduate e-logbook mandate to undergraduate level. Methods: The 48-item AACDS (40 Likert-scaled attitude/barrier items across four subscales, plus 8 preference/opportunity items) was evaluated across six validation strands: content validity (10-expert panel), face validity (pilot, n=15), internal consistency reliability (pilot, n=35), exploratory factor analysis (n=300), test–retest reliability (n=50, 2-week interval), and inter-rater reliability of a linked objective Entry Quality Rubric (2 raters, 20 entries). Results: Content validity was excellent (S-CVI/Ave = 0.902; all 48 items I-CVI ≥ 0.78). Face validity was strong (mean clarity = 87.8%; 0/48 items flagged). Internal consistency was acceptable to good across subscales (α = 0.783–0.824). Exploratory factor analysis (KMO = 0.85; Bartlett's χ²(435) = 2217.67, p < .001) supported by parallel analysis confirmed the hypothesized three-factor structure (Assignments, SDL Record Book, Clinical Logbook) with small cross-loadings (< .15 in magnitude), explaining 37.68% of variance. Test–retest reliability was good (ICC = 0.78). Inter-rater reliability for the objective Entry Quality Rubric was almost perfect (pooled κ = 0.90; ICC = 0.88). Conclusion: The AACDS's 40-item attitude/barrier core demonstrates robust, multi-method psychometric validation for assessing MBBS students' engagement with CBME documentation requirements; validation of the 8 Section E preference items remains pending. It is, to our knowledge, the first instrument to jointly capture attitudes, barriers, and preferences across assignments, SDL, and logbook documentation while linking self-report data to objective institutional records, positioning it as a practical tool for curriculum evaluation and for informing undergraduate digital documentation policy.
Money Laundering And Financial Crimes: A Comparative Study Of Indian And International Legal Frameworks
Money laundering has emerged as one of the most significant transnational financial crimes, posing serious threats to economic stability, national security, and the integrity of financial systems across the globe. The rapid globalization of financial markets, technological advancements, and the proliferation of digital payment systems have created new opportunities for criminals to disguise the proceeds of illicit activities. In India, the enactment of the Prevention of Money Laundering Act, 2002 (PMLA) marked a significant milestone in combating money laundering and aligning the country's legal framework with international standards, particularly the recommendations of the Financial Action Task Force (FATF). Over the years, the Act has undergone substantial amendments to strengthen enforcement mechanisms, expand the scope of scheduled offences, and enhance the powers of investigative agencies such as the Enforcement Directorate. Simultaneously, several landmark judicial pronouncements have shaped the interpretation and implementation of the Act, balancing the objectives of effective law enforcement with constitutional guarantees of personal liberty, due process, and fair trial. This research examines the legal and institutional framework governing money laundering in India while comparatively analysing anti-money laundering (AML) regimes in selected jurisdictions, including the United Kingdom, the United States, the European Union, and international instruments such as the United Nations Conventions and FATF Recommendations. The study adopts a doctrinal and comparative research methodology to evaluate the effectiveness of India's AML framework in addressing evolving financial crimes, including trade-based money laundering, cyber-enabled laundering, and cryptocurrency-related offences. It further examines judicial developments, enforcement challenges, and regulatory compliance obligations imposed on financial institutions and reporting entities. The study includes that although India's anti-money laundering framework has significantly evolved in response to international obligations and domestic security concerns, several issues relating to procedural safeguards, investigative powers, institutional coordination, and technological preparedness continue to require legislative and policy reforms. The paper recommends strengthening international cooperation, enhancing financial intelligence capabilities, promoting digital compliance mechanisms, and ensuring a balanced approach between effective enforcement and the protection of fundamental rights.
The Rise Of Digital Frugality: A Post-Pandemic Strategy For Lean Innovation And Resilient Business Models In Emerging Economies
The COVID‑19 pandemic accelerated digital transformation across global business landscapes, but emerging economies faced unique constraints due to limited resources and infrastructural disparities. Against this backdrop, the concept of Digital Frugality—innovating with minimal digital resources, open‑source tools, and agile practices—has gained traction among micro, small, and medium enterprises (MSMEs) in India. This research explores how digital frugality has shaped lean innovation and resilience in Indian SMEs post‑pandemic, using simulated primary data from a nationally representative sample. Through mixed quantitative and qualitative methods, we analyze the relationships between frugal digital investment, operational resilience, and performance outcomes. Findings reveal that firms adopting digital frugality frameworks exhibited higher survival rates, greater customer retention, and improved cost efficiencies compared to peers relying on conventional digital investments. The paper concludes with actionable recommendations tailored to managers, policymakers, and development practitioners aiming to harness digital frugality for resilient business models in emerging economies.
Delegated Legislation In India: A Critical Analysis Of Constitutional Limits, Judicial Control, And Administrative Accountability
Delegated legislation has become an indispensable component of modern governance, enabling the executive to formulate detailed rules, regulations, notifications, and by-laws within the framework established by the legislature. The increasing complexity of administrative functions, rapid technological advancements, and the expanding role of the welfare state have made it impracticable for legislatures to enact exhaustive statutory provisions for every aspect of governance. Consequently, the delegation of legislative powers has emerged as a practical necessity for ensuring administrative efficiency, flexibility, and timely implementation of public policies. However, the exercise of delegated legislative authority raises significant constitutional and democratic concerns relating to the separation of powers, legislative supremacy, accountability, transparency, and protection of fundamental rights. This paper critically examines the constitutional foundation, scope, and limitations of delegated legislation in India, with particular emphasis on the doctrine of excessive delegation, judicial control, and mechanisms of administrative accountability. It analyses the constitutional framework governing delegated legislation, relevant statutory provisions, and the evolving jurisprudence developed by the Supreme Court of India through landmark decisions. The study further evaluates legislative and judicial safeguards designed to prevent arbitrary exercise of delegated powers while ensuring effective governance. A comparative analysis with the legal frameworks of the United Kingdom and the United States highlights international approaches to delegated legislation and offers valuable insights for strengthening India's regulatory system. Adopting a doctrinal and analytical research methodology, the study relies on constitutional provisions, statutes, judicial precedents, parliamentary committee reports, and scholarly literature to evaluate the effectiveness of existing control mechanisms. The paper argues that while delegated legislation is constitutionally permissible and administratively indispensable, its legitimacy depends upon clearly defined legislative policies, adequate parliamentary oversight, effective judicial review, procedural transparency, and institutional accountability. It concludes by recommending legal and administrative reforms to reinforce constitutional governance, enhance democratic accountability, and maintain an appropriate balance between administrative efficiency and the rule of law in India's evolving regulatory landscape.
Freedom Of Speech And Expression In The Digital Age: A Critical Analysis Of Constitutional Rights, Social Media Regulation, And Emerging Technologies
Freedom of speech and expression constitutes one of the fundamental pillars of a democratic society. In India, Article 19(1)(a) of the Constitution guarantees every citizen the right to freedom of speech and expression, while Article 19(2) permits reasonable restrictions in the interests of sovereignty, security, public order, decency, morality, contempt of court, defamation, and incitement to an offence. The emergence of digital technologies, social media platforms, artificial intelligence (AI), algorithmic governance, and digital communication has significantly transformed the manner in which individuals create, disseminate, and consume information. These technological developments have expanded opportunities for democratic participation while simultaneously creating challenges such as misinformation, hate speech, cyber harassment, online radicalization, privacy violations, deepfakes, algorithmic censorship, and governmental surveillance. This research critically examines the constitutional dimensions of freedom of speech and expression in the digital age with particular reference to India. The study analyses constitutional provisions, statutory regulations, landmark judicial decisions, and international legal standards governing online speech. It evaluates the legal framework under the Information Technology Act, 2000, the Information Technology (Intermediary Guidelines and Digital Media Ethics Code) Rules, 2021, and recent developments concerning intermediary liability and content moderation. The paper further investigates the impact of emerging technologies such as artificial intelligence, machine learning, blockchain, virtual reality, and generative AI on constitutional freedoms.
A Study Of Faculty Attrition In Higher Education Institutions- A Review Based Study
Faculty members constitute an important human resource of higher education institutions because they are responsible for teaching, research, student development, academic administration, consultancy and several other institutional activities. The departure of experienced and qualified faculty members can therefore affect academic continuity, institutional effectiveness, research productivity and educational quality. Faculty attrition has consequently emerged as an important concern in higher education, particularly in an environment characterized by changing academic expectations, increasing workload, competition for qualified faculty and growing opportunities for professional mobility. The present paper reviews the existing literature on faculty attrition in higher education institutions. The review is based exclusively on the studies contained in the shared literature-review material. The literature covers different geographical and institutional contexts and examines faculty attrition through related concepts such as turnover intention, faculty retention, job satisfaction, organizational commitment, compensation, workload, career development, institutional support, organizational climate, work-life balance and professional autonomy. The review indicates that faculty attrition is not caused by a single factor. Instead, it results from the interaction of financial, organizational, professional and psychological conditions experienced by academic employees. Compensation and remuneration emerge as important determinants, although the literature also indicates that salary alone cannot guarantee faculty retention. Job satisfaction is consistently associated with lower turnover intention, while dissatisfaction with workload, compensation, promotion, recognition and working conditions tends to increase the desire to leave. Organizational commitment is another important factor, with several studies showing that satisfied faculty members develop stronger emotional attachment to their institutions and consequently demonstrate lower turnover intention. Career advancement, professional development, autonomy, institutional support, mentoring, recognition and transparent promotion systems also contribute to retention. The literature further highlights excessive workload, occupational stress, burnout and work-life imbalance as significant contributors to faculty attrition. Recent studies have expanded the discussion to include gender, career stage, institutional autonomy, employee poaching, resilience, psychological well-being and changing expectations of academic employees. Indian studies particularly emphasize compensation, workload, institutional support, organizational climate, promotion, career development and work-life balance. Overall, the literature demonstrates that faculty attrition is a multidimensional phenomenon and that effective retention requires a comprehensive institutional approach.
Holistic And Multidisciplinary Education In India: Reimagining Pedagogy And Curriculum Under NEP 2020
India’s education system has historically emphasized discipline-centric curricula, teacher-centered pedagogy, and high-stakes examinations, often limiting students’ holistic development. The National Education Policy (NEP) 2020 presents a transformative framework to address these challenges by promoting learner-centric, flexible, and multidisciplinary education. This study examines NEP 2020’s vision for holistic education, focusing on curricular reforms, pedagogical innovations, assessment strategies, and integration of knowledge, skills, and values. Employing a qualitative and conceptual research design, the study analyzes the NEP 2020 document, relevant UGC guidelines, and contemporary scholarly literature using thematic content analysis. The findings highlight a paradigm shift from rote learning and rigid disciplinary structures to experiential, competency-based, and outcome-oriented education. The policy emphasizes flexible curricular pathways, integration of Indian Knowledge Systems, continuous formative assessment, and teacher professional development, aligning India’s higher education system with global best practices. The study contributes to the understanding of holistic education reforms and provides practical and policy recommendations for effective implementation in Indian higher education institutions. Successful adoption of these reforms can enhance critical thinking, creativity, ethical reasoning, and employability, preparing learners for the challenges of the 21st century.
Law, Morality And Social Order: A Critical Examination
Law is a system of rules which is recognized by a particular country or community for regulating the actions of its members and enforce by the imposition of sanctions. Law and morality are interrelated. Law represents the formal rules and regulations established by a recognized authority. The relationship between law and morality continues to evolve, with ongoing debates on issues such as human rights, social justice, and the role of moral values in shaping legal frameworks. Some jurists argue that laws inconsistent with moral principles are unjust and may warrant disobedience or even resistance. This perspective underscores the idea that moral standards serve as a crucial measure for evaluating the legitimacy of legal systems. From a historical standpoint, it is widely acknowledged that laws often originated from moral principles. There was no difference between law and morality in ancient period.. The Rule of Law has a rich and diverse heritage, shaping modern understandings of governance and justice. The concept of rule of law has been refined by the contributions of numerous scholars and theorists.
Comparison Of Sarcopenia Prevalence In Patients With Colorectal Cancer Versus Benign Colorectal Diseases Undergoing Surgery
Objective: To compare the prevalence of sarcopenia among patients with colorectal cancer and benign colorectal diseases undergoing colorectal s urgery. Methods: This was a comparative cross-sectional analytical study of 176 patients who underwent colorectal surgery, 88 of whom had colorectal cancer and 88 had benign colorectal diseases. Demographic, anthropometric, clinical, and nutritional data were gathered. SMA was measured at the third level of the lumbar vertebra by computed tomography (CT) before surgery, and skeletal muscle index (SMI) was also computed. The chi-square test was used to compare the prevalence of sarcopenia between groups of people. Logistic regression was used to assess factors associated with sarcopenia. Results: Sarcopenia was significantly more prevalent among patients with colorectal cancer than those with benign colorectal diseases (p=0.003). The skeletal muscle index was significantly reduced in patients with CRC compared with the benign disease group (p=0.001). Older age, nutritional compromise, body mass index (BMI), weight loss, and colorectal cancer were related to sarcopenia. Multivariable analysis revealed that age ≥60 years, BMI <23 kg/m², weight loss, and colorectal cancer were all still independent of sarcopenia. There were statistically significantly increased odds of sarcopenia (p=0.020) with colorectal cancer. Conclusion: The prevalence of sarcopenia in colorectal cancer patients was significantly higher when compared with patients with benign colorectal disease. Sarcopenia may be identified preoperatively and help identify the patients who need the optimization of nutrition and rehabilitation before colorectal surgery.
Sign Voice: Real-Time Sign Language Recognition and Speech Translation System
Communication between deaf or hearing-impaired people and the rest of society is still quite a social and technological challenge. The main reason for this is the fact that a very small number of people understand sign language. Although sign language is a very good and expressive way of communicating, the lack of sign language translation tools in real-time is one of the main barriers for inclusive communication in everyday environments. To solve this problem, we have developed SignVoice, a system that recognizes sign language in real-time and converts hands movements into spoken words automatically through computer vision and machine learning. The system we propose exploits MediaPipe to attain the most precise, efficient, and robust hand landmark detection under varied lighting conditions and different backgrounds. A hybrid classification schema has been implemented which allows the system to easily recognize both static and dynamic gestures. Static hand gestures are detected using a K Nearest Neighbors (KNN) classifier, dynamic gestures are analyzed by Long Short-Term Memory (LSTM) networks to understand sequential hand movements based on the change of time. This two-model system increases the recognition accuracy without requiring high computational power. Experimental results demonstrate that the proposed method performs extremely well in terms of recognition accuracy and at the same time demands very little time, thereby establishing the method as highly suitable for assistive communication applications. In summary, SignVoice is a step forward in addressing accessibility issues and promoting social inclusion by enabling communication between hearing-impaired individuals and the rest of the community.
Patient-Reported Barriers To Routine Dental Care And Postoperative Maxillofacial Prosthetic Rehabilitation In Head And Neck Cancer Patients: A Cross-Sectional Study
Background: Survivors of head and neck cancer require sustained oral healthcare after cancer therapy; few cases may additionally need specialized maxillofacial prosthetic rehabilitation. Objective: To assess patient-reported barriers to routine dental care among post-treatment head and neck cancer patients and, among those requiring a maxillofacial prosthesis, to characterize barriers to postoperative prosthetic rehabilitation. Methods: A cross-sectional survey was conducted among 194 post-treatment head and neck cancer patients. The routine dental-care questionnaire assessed education and counseling, follow-up, financial access, provider availability, transportation, travel, and persistent oral symptoms. Forty-eight patients (24.7%) required maxillofacial prosthetic rehabilitation and completed an additional 16-item prosthetic-access module scored from 1 (not a barrier) to 5 (very major barrier); scores of 4-5 were classified as major barriers. Proportions were reported with Wilson 95% confidence intervals. Factors associated with unmet dental-care need were evaluated using multivariable logistic regression. Results: The cohort had a mean age of 59.8 ± 10.0 years, and 149 (76.8%) participants were male. Regular post-treatment dental follow-up was reported by 146 (75.3%), whereas 83 (42.8%) reported concern about dental-care costs and 69 (35.6%) reported an unmet dental-care need. Among the 48 patients requiring prosthetic rehabilitation, the most common major barriers were travelling distance (32; 66.7%), financial burden (31; 64.6%), and repeated appointments (29; 60.4%). Limited mouth opening was strongly associated with unmet dental-care need (adjusted odds ratio [aOR] 4.40, 95% CI 2.25-8.60; p<0.001). Cost concern (aOR 2.24, 95% CI 1.15-4.34; p=0.018) and difficulty finding an appropriate dentist (aOR 2.38, 95% CI 1.07-5.27; p=0.033) were also independently associated with unmet care. Conclusion: Substantial barriers to oral healthcare persisted after head and neck cancer treatment. Patients requiring maxillofacial prosthetic rehabilitation faced an additional burden related to travel, cost, specialist availability, etc. These findings support integrated dental and maxillofacial prosthetic pathways within survivorship care.
Docking And Pharmacological Antioxidant And Anti-Diabetic Activity Of Pyrazole Derivatives
The pyrazole is a privileged N-heterocycle that has enough structural flexibility to be used as enzyme inhibitors, radical scavengers and have good drug-like properties. This study reanalyzed compound-level data from open-access primary investigations to investigate whether pyrazole derivatives can be utilized to develop an effective dual approach to postprandial glucose control and oxidative-stress attenuation. The quantitative data included eleven acyl pyrazole sulfonamides tested against alpha-glucosidase and two pyrazole derivatives tested against alpha-glucosidase, alpha-amylase, five antioxidant endpoints, and molecular docking targets. The analytical unit was the reported compound-level mean IC50 or SC50 value as there were no observations of raw absorbance or concentration response. Descriptive statistics and Shapiro-Wilk, one-sample Wilcoxon signed-rank, exact sign testing, fold-potency estimation, bootstrapping, and exploratory rank-concordance analysis were performed. The median IC50 of the 11 compounds was 4.11 micromolar (interquartile range 3.03-13.55), while acarbose's median IC50 was 35.1 micromolar. All eleven compounds were more potent than the comparator; for this library level result (not replicate level) the one sided Wilcoxon test was significant (W=0, p=0.00049) but this is for exploratory purposes and not to replace replicate level inference. Acarbose showed 31.06-fold less activity than compound 5a, which was the most potent inhibitor with an IC50 of 1.13 micromolar. The results from DPPH assays, ABTS assays, FRAP assays, hydrogen-peroxide scavenging assays, and xanthine-oxidase assays are shown in the following comparisons: In all five comparisons, the inhibitory concentrations of Pyz-2 were lower than that of Pyz-1 (exact sign-test p=0.031); in all comparisons except for hydrogen-peroxide scavenging, Pyz-2 exhibited an inhibitory concentration that was either equal to or lower than that of another Pyz-3 group, indicating a conservative improvement of 1.00 to 1.98-fold. Docking rankings were shown to be in agreement with alpha-glucosidase activity but not in a consistent manner with alpha-amylase activity, thus suggesting that docking ought not to supplant the pharmacologic testing. The evidence is that the combined data sets suggest that acyl-pyrazole sulfonamides and triazole-thiol pyrazole hybrids are potential lead classes and that it is important to have consistent assays, toxicity studies, mammalian enzyme models, and in vivo validation.
Docking Studies On Antidiabetic And Antioxidant Activities Of Pyrazole Derivatives
Type 2 diabetes mellitus (T2DM) is a very common metabolic complication that remains challenging to treat effectively with nearly 537 million adults suffering all over the world today with the number expected to be at 783 million by the year 2045. Oxidative stress is central to the pathogenesis of T2DM and it is caused by an imbalance between the production of reactive oxygen species (ROS) and the antioxidant defenses systems of the body. The imbalance accompanies the major features of T2DM such as dysfunction of the beta-cell, insulin resistance, and macro- and microvascular complications. Designing of bifunctional molecules which target the antidiabetic and antioxidant effects should therefore present a promising therapeutic measure of management of T2DM. The pyrazole, a heterocyclic five-membered nitrogen molecule, has become a drug discovery scaffold of interest due to its versatility as a bioisostere, metabolic stability and its capacity to bind multiple enzymatic targets. Recent research on the use of pyrazole derivatives as dual-target agents in the treatment of T2DM has focused on the combinatory use of antidiabetic and antioxidant properties of these compounds. Here, the current study presents findings of the molecular (docking) studies of the eight pyrazole derivatives (P-1 to P-8) with three pharmacologically validated targets: α-glucosidase (PDB: 5NN8), protein tyrosine phosphatase 1B (PTP1B, PDB: 2HNP), and Kelch-like ECH-associated protein 1 AutoDock Vina 1.2.3 was used to conduct docking simulations and GROMACS 2023 was used to validate the simulations. The compound that exhibited the greatest binding affinity was P-5 (ethyl 1-(4-methylphenyl)-3-(4-nitrophenyl)-1H-pyrazole-5-carboxylate) with an energy of -10.67, -10.08, and -8.87 kcal/mol with α-glucosidase, PTP1B and Ke Such binding energies were quite similar to those of reference drugs that include acarbose, ursolic acid, and quercetin. Also, computation of ADMET with SwissADME and pkCSM was used to ensure the drug-likeness of these compounds and fit the Rule of Five and point to high predicted oral bioavailability. These results indicate the possible relevance of pyrazole derivatives as effective dual-target agents in treating T2DM.
The Action Research Edge: Driving Continuous Adaptation
This paper evaluates the utilization of Action Research (AR) as a strategic methodology to foster organizational change, knowledge acquisition, and workforce engagement within medium-sized Indian firms between 2023 and 2025. Employing a three-stage, mixed-methods action research design across the service, IT, and retail industries, this investigation assesses empirical data collected before and after the intervention through statistical and thematic analysis. The findings demonstrate statistically significant advancements in organizational learning capacity (Cohen's d = 0.65), employee engagement levels (r = 0.58, p < 0.01), and agile leadership practices. Ultimately, this research offers a verified, culturally attuned AR framework alongside actionable strategies for implementing participatory inquiry within fast-evolving corporate landscapes.
Macroeconomic Variables Vs. Stock Prices: An Analytical Study Of The BSE Sensex
Over the past few years, a multitude of investors have suffered significant financial losses due to erroneous stock market predictions. The inherent difficulty in forecasting market trends establishes the core objective of this research. Investor risk can be mitigated, and predictive accuracy enhanced, if market participants are equipped with comprehensive data regarding the fundamental determinants of equity pricing. Accordingly, this study aims to identify and analyze the critical factors driving stock price fluctuations. Specifically, this research examines the impact of selected macroeconomic indicators—namely foreign exchange rates, money supply, and foreign exchange reserves—on the Bombay Stock Exchange (BSE) Sensex. The empirical analysis utilizes monthly data sourced from authoritative repositories, spanning the period from April 2021 to March 2026. Following a comprehensive review of existing literature, the dataset was subjected to unit root testing to evaluate its stationarity. Furthermore, the widely accepted Johansen co-integration technique was employed to establish long-term relationships between the dependent and independent variables, while the Granger causality test was applied to assess the direction of causal linkages among these factors.
Psychological Stress And Occupational Performance Among Seafarers: A Systematic Review Of Verified Empirical Evidence
Background: Seafaring brings together several demanding features of work within a single occupation - long absences from family, cramped and shared living conditions, irregular sleep, mixed-nationality crews, and heavy workloads carried out with little outside support. A substantial body of research has examined how these conditions give rise to psychological stress, and how that stress in turn shapes seafarers' mental health, wellbeing, and ability to carry out their duties. Objectives: This review has two aims: first, to bring together what verified empirical research says about the main sources of psychological stress facing seafarers; and second, to examine what this research shows about the relationship between that stress and seafarers' occupational performance, safety, and mental health. Hypotheses: Two propositions guide the review. H1 holds that psychological stress arising from seafaring work is meaningfully linked to poorer occupational performance and safety outcomes. H2 holds that social and organisational support - including support from peers, contact with family, and personal resilience - helps to soften this negative relationship. Methods: The review draws on twenty-nine peer-reviewed studies, published between 2008 and 2026, each of which could be traced back to and confirmed against its original publication. Sources whose claims could not be verified against an accessible original text were left out, even where they appeared elsewhere in the wider literature. Results: The verified literature lends support to both propositions. Workload, long hours, and separation from family are repeatedly connected to fatigue, burnout, and weaker job performance, with at least one study demonstrating this relationship directly among Chinese seafarers. Depression, anxiety, and thoughts of self-harm appear more common among seafarers than is generally reported for the wider working population, and are most strongly tied to poor company culture, low job satisfaction, and how seafarers rate their own health. By contrast, resilience, psychological capital, peer support, and higher rank are consistently linked to better outcomes across a number of independent studies conducted in different countries. Conclusion: Taken together, the verified evidence points toward a fairly consistent picture: the psychological demands of seafaring work measurably affect wellbeing and performance, while supportive relationships and personal resilience act as a buffer against this harm. Two studies conducted specifically among Indian merchant navy officers and seafarers point in the same direction, though research on this particular population remains thin relative to its size within the global seafaring workforce.
Industrial Management In The Digital Era: Challenges And Opportunities
Digital transformation is fundamentally reshaping how industrial organizations plan, coordinate, and control production, supply chains, and human resources. This study examines the challenges and opportunities that digital technologies including the Industrial Internet of Things (IIoT), big data analytics, artificial intelligence (AI), cloud computing, and digital twins present for industrial management practice. Using a quantitative, cross-sectional survey design, primary data were collected from 410 managers and engineers employed in manufacturing and process industries through a structured, validated questionnaire. Data were analyzed using IBM SPSS 26 for descriptive and reliability statistics and SmartPLS 4 for Partial Least Squares Structural Equation Modeling (PLS-SEM) to test the hypothesized relationships among digital technology adoption, organizational readiness, workforce digital competency, and industrial management performance. Results indicate that digital technology adoption (β = 0.41, p < 0.001) and workforce digital competency (β = 0.33, p < 0.001) significantly and positively predict industrial management performance, while organizational digital readiness partially mediates this relationship. Cybersecurity risk, high implementation cost, legacy-system integration difficulty, and workforce skill gaps emerged as the most significant barriers, whereas predictive maintenance, real-time decision support, supply chain visibility, and productivity gains emerged as the most valued opportunities. The study contributes an empirically validated model linking digital capability to management performance and offers practical recommendations for industrial managers navigating digital transformation.
Green Marketing And Consumer Preference For Eco-Friendly Products In Chennai District
Green marketing has emerged as a critical strategic response to rising environmental consciousness among consumers, regulatory pressure, and the need for sustainable competitive advantage among firms. This study examines consumer preference towards eco-friendly products with specific reference to green marketing trends in Chennai District. Using a descriptive-cum-analytical research design, primary data were collected from 410 respondents across Chennai District through a structured questionnaire administered on a five-point Likert scale, supplemented by secondary data drawn from journals, reports, and websites. The study addresses five objectives: examining the level of consumer awareness of eco-friendly products; analysing the effectiveness of green marketing strategies in shaping consumer preference; identifying the key factors that drive preference for eco-friendly products; examining the relationship between green marketing strategies and consumer trust in eco-friendly brands; and identifying the challenges and barriers consumers face in adopting eco-friendly products. Advanced statistical tools, including reliability analysis (Cronbach's Alpha), Exploratory Factor Analysis (EFA), Pearson correlation, multiple linear regression, one-way ANOVA, the Chi-square test, Structural Equation Modeling (SEM), and Garrett's Ranking Technique, were applied using SPSS and AMOS. The findings indicate a moderate-to-high level of consumer awareness, a statistically significant positive relationship between green marketing strategies and both consumer preference and consumer trust, and price premiums, greenwashing scepticism, and limited product availability as the foremost barriers to adoption. The study concludes with practical implications for marketers, policymakers, and eco-conscious brands seeking to strengthen sustainable consumption in urban Tamil Nadu.
Study On Awareness Of Medical Negligence Among Medical Students
Background: Medical negligence litigation is increasing in India, reflecting evolving patient awareness and legal accountability in healthcare. Adequate understanding of medicolegal principles among medical students is essential, as they represent future practitioners responsible for maintaining standards of care. Objective: To assess the awareness and understanding of medical negligence and related medicolegal concepts among undergraduate medical students. Materials and Methods: A cross-sectional questionnaire-based study was conducted among 183 medical students. A validated structured questionnaire comprising 12 dichotomous (Yes/No) items assessed awareness of medical negligence, common clinical scenarios, preventive strategies, and specific legal concepts including the Bolam test and crosspathy. Data were analyzed using descriptive statistics. Results: Overall awareness of medical negligence was observed in 61.2% of participants. Understanding of common examples was noted in 69.3%, while 68.3% demonstrated knowledge of preventive strategies. Awareness of the Bolam test was comparatively low (40.2%), whereas awareness of crosspathy was higher (67.8%). Significant gaps were identified in conceptual clarity regarding standard of care, informed consent, and liability without harm. Conclusion: Although a moderate level of awareness exists among medical students, critical deficiencies persist in core medicolegal concepts. Integration of structured medicolegal education into undergraduate curricula is essential to enhance competency, reduce litigation risk, and improve patient safety.
Financing The Green Transition: Challenges And Opportunities In Sustainable Investment
The transition to a low-carbon global economy requires an estimated multi-trillion-dollar reallocation of capital toward renewable energy, clean technology, and climate-resilient infrastructure, yet the flow of private capital into sustainable investment vehicles remains constrained by informational, regulatory, and behavioral frictions. This study investigates the challenges and opportunities shaping the financing of the green transition, examining the determinants of investor willingness to allocate capital to sustainable investment instruments such as green bonds, ESG-themed funds, and renewable energy project finance. Anchored in Behavioral Finance Theory, Stakeholder Theory, and Signalling Theory, the study proposes and tests a structural model in which Green Financial Literacy, Policy and Regulatory Support, and ESG Disclosure Quality influence Sustainable Investment Decisions, with Investor Trust and Perceived Financial Risk serving as mediating mechanisms. Primary data were collected from a sample of 410 institutional and retail investors, financial analysts, and portfolio managers, selected through a stratified random sampling technique, using a structured questionnaire administered via a five-point Likert scale. The sample size was derived using Cochran's formula for large populations, adjusted for anticipated non-response. Data were analyzed using IBM SPSS Statistics v28 for descriptive and preliminary diagnostics, and SmartPLS 4 for Partial Least Squares Structural Equation Modelling (PLS-SEM), including measurement model assessment, bootstrapped mediation testing (5,000 resamples), and importance-performance map analysis (IPMA). Results reveal that ESG Disclosure Quality and Policy and Regulatory Support exert the strongest positive effects on Sustainable Investment Decisions, while Perceived Financial Risk, driven substantially by greenwashing concerns and regulatory uncertainty, exerts a significant negative effect that is partially offset by Investor Trust. The measurement model demonstrated satisfactory convergent and discriminant validity (AVE > 0.50; HTMT < 0.85), and the structural model achieved acceptable predictive relevance (Q2 > 0). The findings offer actionable insights for policymakers, financial institutions, and corporate issuers seeking to mobilize private capital at the scale required to finance the global green transition.
Relationships Between Acculturation Strategies And Psychological Resilience Among Mongolian Residents In The Republic Of Korea
This study aimed to examine the relationship between acculturation strategies and psychological resilience among young Mongolian adults residing, working, and studying in the Republic of Korea (ROK). A total of 206 Mongolian citizens aged 18-35 who had been residing in the ROK for more than six months were selected using a purposive sampling method. Intercultural adaptation was measured using Berry's (1997) Acculturation Attitude Scale (AAS), while psychological resilience was assessed using the Connor-Davidson Resilience Scale (CD-RISC-25) developed by Connor and Davidson (2003). Data were analyzed using SPSS, employing correlation analysis, one-way analysis of variance (One-Way ANOVA), and Tukey’s Honestly Significant Difference (Tukey HSD) post-hoc test. The results revealed that assimilation (34.0%) and integration (30.6%) were the predominant acculturation strategies among the participants. According to Berry’s (1997) model of intercultural adaptation, the integration strategy represents a balanced approach wherein individuals maintain their heritage cultural identity while actively participating in the host culture. One-way ANOVA demonstrated that participants utilizing the integration strategy exhibited statistically significantly higher levels of psychological resilience compared to other groups (p < .05), particularly those adopting assimilation or separation strategies. These findings confirm that maintaining a balanced bi-cultural position-preserving one’s native culture while adapting to the host culture-serves as a protective factor for individual psychological adjustment. Consequently, the results of this study carry important theoretical and practical implications for identifying the psychological and social needs of Mongolians living abroad, as well as for developing targeted psychological counseling and cultural adaptation support programs.
Independent Association Of Luteinizing Hormone, But Not Testosterone, With Attention-Domain Cognitive Performance In Women With Polycystic Ovary Syndrome: A Case-Control Study
Background Cognitive dysfunction in polycystic ovary syndrome (PCOS) has been variably reported and the hormonal correlates of attention-domain performance are poorly characterized. Aim To compare performance on the Attention subdomain of the Addenbrooke’s Cognitive Examination-III (ACE-III) and digit span between women with PCOS and controls, and to explore independent hormonal predictors of attention-domain performance after adjustment for metabolic, dyslipidaemic and inflammatory confounders. Methods This cross-sectional case-control study was conducted in 65 women with PCOS (Rotterdam criteria) and 65 age-matched controls, between 18 and 35 years old. The ACE-III Attention subdomain score and digit span were obtained. During the early follicular phase serum free testosterone, estrogen, LH and FSH were measured. Group comparisons were performed using Mann Whitney U test. Independent hormonal predictors were identified using multiple robust linear regression adjusted for age, BMI, dyslipidaemia, and hs-CRP. Results The ACE-III Attention subdomain score was significantly higher in PCOS than controls (18 [16–18] vs. 17 [15–18], p=0.034), but scaled digit span did not significantly differ (p=0.579). Adjusted regression showed LH to be significantly and positively associated with ACE-III Attention score (β=0.027, 95% CI 0.008 to 0.045, p=0.006) but significantly and negatively associated with scaled digit span (β=-0.030, 95% CI -0.048 to -0.013, p=0.001). Testosterone was not associated significantly. Conclusion LH was the independent hormonal correlate of attention-domain performance, with opposite directions of association between two different attention-related measures. This isolated, directionally-inconsistent finding warrants cautious hypothesis-generating interpretation, and suggests gonadotropin signalling as an under-investigated target for attention domain research in PCOS.
Effect OF Blackburn Stabilization Exercises In Patients With Subacromial Impingement Syndrome
BACKGROUND: Subacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain and functional limitation. Scapular stabilization exercises, particularly the Blackburn stabilization exercise program, have been proposed to improve shoulder function by enhancing scapular stability and movement coordination. AIM: To investigate the effects of Blackburn stabilization exercises on shoulder pain, function, and shoulder elevation range of motion (ROM) in patients with subacromial impingement syndrome. METHODS: A single arm clinical trial study was conducted on 15 patients with unilateral SIS . Participants underwent a 6-week Blackburn stabilization exercise program. Pain and Function were assessed using the Shoulder Pain and Disability Index (SPADI), and shoulder elevation ROM was measured at baseline, after 3 weeks, and after 6 weeks. Data were analyzed using repeated-measures ANOVA. RESULTS: Significant improvements were observed in SPADI scores and shoulder elevation ROM after both 3 and 6 weeks of intervention, with greater improvements evident at 6 weeks. These findings indicate progressive clinical benefits associated with the Blackburn stabilization exercise program. CONCLUSION: Blackburn stabilization exercises were effective in improving shoulder pain, function, and shoulder elevation ROM in patients with SIS. These findings support the use of Blackburn stabilization exercises as rehabilitation programs for patients with SIS.
A Study On Consumer Perception And Buying Intentions Towards Organic Food Products In Thanjavur District
This study evaluates consumer perception, buying behavior, and future purchase intentions regarding organic food products in Thanjavur District, Tamil Nadu. While regional agriculture is predominantly conventional, growing health consciousness and environmental awareness are driving shifts toward organic consumption. Utilizing primary data collected from 91 respondents across multiple talukas of Thanjavur District, the empirical analysis evaluates key factors influencing purchasing decisions, satisfaction metrics, and perceived market barriers. Utilizing Likert scale quantitative frameworks, Chi-Square tests, and Weighted Mean ranking analysis, the empirical results reveal strong positive perception toward organic foods primarily driven by long-term health benefits (4.30) and freedom from synthetic chemicals (4.19). However, market expansion faces notable constraints, primarily driven by premium pricing (4.15) and doubts regarding organic label authenticity (3.95). The paper concludes with targeted marketing and policy suggestions to resolve structural market barriers in the study area.
A Comparative Analysis Of Online And Offline Consumer Purchase Patterns Among Female Government School Educators In Chennai City
This study evaluates the operational purchase dynamics and channel shifts across digital and physical retail touchpoints among female government school educators in Chennai City, Tamil Nadu. While the rapid expansion of e-commerce platforms and quick-commerce networks offers unprecedented convenience, female public school educators balance unique socio-economic parameters, structural routines, and fixed compensation structures that shape their shopping preferences. Utilizing a stratified random sampling methodology, primary data was gathered from 400 female government school teachers across all three educational zones of Chennai City (North, Central, and South). The empirical framework applies a robust four-stage statistical testing architecture: the Chi-Square Test of Independence, Independent Samples t-test, One-Way ANOVA, and Multiple Linear Regression. The empirical results reveal substantial variations in channel adoption, driven primarily by age demographics, digital literacy, working hours, and product category requirements. While high-convenience online platforms show rapid adoption for apparel, consumer electronics, and personal care, brick-and-mortar retail retains dominance in fresh groceries and high-value traditional wear due to tactile evaluation needs. The paper concludes with strategic recommendations for retail marketers and digital platforms to optimize omni-channel delivery structures for working public-sector professionals.
Diagnostic Accuracy of Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) for the Rapid Diagnosis of Tuberculous Meningitis: A Prospective Hospital-Based Study
Background: Prompt treatment is crucial for tuberculous meningitis and diagnosing it through traditional cerebrospinal-fluid tests is either slow or of very low sensitivity. The purpose of this study is to assess the diagnostic accuracy and operational utility of cerebrospinal fluid (CSF) CBNAAT for the rapid diagnosis of TBM. We use a simulated dataset to carry out the study as no patient data were provided. In our sample of 160 analysable adult patients suspected for meningitis, a composite reference standard classified study participants into cases of TBM with varying degrees of certainty (definite [n=28], probable [n=44], and possible [n=26]), and non-TBM cases [n=62]. Definite and probable TBM cases were of primary interest. CBNAAT results showed a total of 49 true positives, 23 false negatives, 6 false positives, and 82 true negatives. In our study, the sensitivity and specificity of CBNAAT were 68.1% (95% confidence interval) and 93.2% (85.9% - 96.8%), respectively. Sensitivity improved from 50.0% to 79.5% if at least 4 mL CSF was submitted. Median turnaround time was 2.2 hours for CBNAAT, 6.2 hours for smear, and 18.2 days for culture. AUC was 0.864 for a model that included combined CBNAAT. In conclusion, CBNAAT is a rapid, relatively high-specificity test for TBM, that provides rule-in evidence, but is an incomplete test for the rule-out diagnosis of TBM. Clinical, CSF, and imaging data should also be used in conjunction with TBM CBNAAT and culture. All observations reported have been simulated and must be replaced with real data that is prospectively verified prior to any publication or clinical use.
Urban Livelihoods At The Crossroads: Assessing The Challenges And Opportunities Of Street Vendors In Chennai City
This study evaluates the operational challenges, economic viability, and institutional opportunities of street vendors across the urban landscape of Chennai City, Tamil Nadu. While street vending serves as an indispensable pillar of the informal economy by generating self-employment and offering low-cost goods to urban consumers, vendors face structural vulnerabilities including eviction threats, informal extortion, regulatory ambiguity, and limited access to formal credit. Utilizing a stratified random sampling framework, primary data was gathered from 400 street vendors across key municipal zones of the Greater Chennai Corporation (GCC). The empirical framework applies a robust four-stage statistical testing architecture: the Chi-Square Test of Independence, Independent Samples $t$-test, One-Way ANOVA, and Multiple Linear Regression. The empirical results reveal significant disparities in vendor income and regulatory compliance, driven primarily by vending zone designation, gender, social category, and access to institutional credit, such as the PM SVANidhi scheme. The paper concludes with targeted policy recommendations aimed at transitioning from punitive regulation to an inclusive, rights-based urban governance framework under the Street Vendors Act.
From Scroll To Cart: Assessing The Impact Of Algorithmic Personalization And Seamless Checkout On Unplanned Online Spending
This study evaluates the operational mechanics of digital impulse buying across modern social commerce environments. While personalized social platforms aim to enhance user experience and product discovery, consumers frequently experience psychological and environmental triggers that lead to unplanned financial expenditure. Utilizing a stratified random sampling methodology, primary data was gathered from $400$ active social media shoppers across four major platform environments (TikTok, Instagram, YouTube, and Facebook). The empirical framework applies a four-stage statistical testing architecture: the Chi-Square Test of Independence, Independent Samples $t$-test, One-Way ANOVA, and Multiple Linear Regression. The empirical results reveal substantial disparities in impulsive purchasing behavior, driven primarily by algorithmic personalization, dynamic checkout features, impulse control, and daily screen exposure. While seamless purchasing mechanisms like one-click checkout and live-stream shopping drive high conversion rates among younger, highly engaged users, digitally cautious consumers exhibit lower susceptibility due to cognitive friction and intentional delay tactics. The paper concludes with targeted self-regulation strategies and platform design recommendations aimed at moving from hyper-frictionless, impulse-driven monetization toward a balanced, intentional consumer ecosystem.
Quinoxaline Derivatives As Anticancer Agents: Molecular Targets And SAR
Quinoxaline is a versatile nitrogen-containing heteroaromatic scaffold with considerable potential in anticancer drug discovery because structural modifications of its fused benzene–pyrazine framework can produce compounds with diverse pharmacological activities. This review highlights recent advances in the anticancer potential of quinoxaline derivatives, emphasizing their broad molecular targets and structure–activity relationships (SAR). Quinoxaline-based compounds have demonstrated activity against topoisomerases, tubulin, DNA repair pathways, PARP, histone deacetylases, folate metabolism, reactive oxygen species, VEGFR-2, EGFR, HER2, c-Met, PI3K/Akt/mTOR, PIM kinases, BRD9, BET proteins, PFKFB3, and apoptosis- and metastasis-associated pathways. SAR studies demonstrate that substitution pattern, aromaticity, hydrogen-bonding capacity, electronic properties, linker configuration, and physicochemical characteristics strongly influence anticancer potency and selectivity. Emerging approaches include selective targeting of BRD9 and BD1, inhibition of PFKFB3, VEGFR-2 blockade in treatment-resistant tumors, and modulation of HIF-1α, VEGF, and p21. Despite these advances, most quinoxaline-based anticancer candidates remain at the preclinical stage, with limitations involving inconsistent experimental conditions, inadequate pharmacokinetic characterization, poor aqueous solubility, metabolic instability, and potential off-target toxicity. Future development should therefore emphasize target validation, structure-based optimization, advanced drug-delivery approaches, pharmacokinetic improvement, physiologically relevant disease models, and rational combination strategies. Overall, quinoxaline represents a flexible platform for developing multifunctional and target-directed anticancer agents with potential applications across diverse cancer-associated pathways.
Collection, Standardization And Phytochemical Evaluation Of Momordica Charantia Against Diabetes Mellitus
The present research work include the Anti-Diabetic, Anti-Oxidant and Anti-Hyperlipidemic activity of Momordica Charantia, focuses on the phytochemical investigation and antidiabetic potential of this same plant. Here in this study the collection and authentication of seeds were done and then finally extraction process of Momordica Charantia seeds plants was completed by maintaining temperature for various solvents. After extraction in various solvents and identification through applying various tests the presence was confirmed.Successive extraction of the plant materials was carried out, followed by detailed phytochemical screening. The extracts were found to contain several bioactive constituents, including tannins, phenolic compounds, carbohydrates, glycosides, terpenoids, proteins, amino acids, and flavonoids. Phenolic compounds and flavonoids, in particular, are widely recognized for their therapeutic value in controlling hyperglycemia and combating oxidative stress. The ethanolic extracts of Momordica Charantia showed a strong presence of these beneficial phytochemicals.The findings of the present investigation demonstrate that the ethanolic extracts of Momordica Charantia exhibit significant antidiabetic effects in streptozotocin (STZ)-induced diabetic rats. Their beneficial activity appears to be associated with improved glucose tolerance, enhanced utilization of glucose, and restoration of depleted liver glycogen stores at both tested doses (200 and 400 mg/kg).
Exploring Motor Coordination And Cognitive Performance In Children With Attention Deficit Hyperactivity Disorder: Insights From Assessment
This study focuses on investigating the severity distributions, cognitive and motor coordination performance characteristics and examine the demographic groups among children with Attention-Deficit/Hyperactivity Disorder (ADHD). This cross sectional observational study was conducted over six months at A.C.S Medical College and Hospital, Let’s speak Multispecialty and Rehabilitation center, and My First Steps, Pediatric Physiotherapy clinic. The time frame for this study was between June 2025 and November 2025. A total of 230 children with a diagnosis of ADHD between the ages of 7 and 12 years were included in this study. The cognitive-coordination abilities of each child were measured using the Developmental Coordination Disorder Questionnaire (DCDQ) and the Trail Making Test (TMT) - Child Modified Version. Each child was categorized according to age, gender, and subtype of ADHD (Inattentive, Hyperactive-Impulsive, Combined). The statistical analysis of the data collected from these cognitive and coordination tests indicated that boys are more affected by coordinate deficits than girls. Children aged between 9 - 10 years are more likely to exhibit poor coordination scores than children of either younger or older ages. Children with Combined subtype of ADHD are more impaired in their cognitive and motor skills compared to those with other subtypes. This study successfully highlighted the prevalence of and the distribution of cognitive-coordination difficulties among children with ADHD. Thus findings helped to contribute to the knowledge of the developmental skills of children with ADHD, and their potential need for intervention or rehabilitation.
Smart Wearable Embedded Systems For Al-Based Monitoring Of Children's Vital Signs And Health Conditions
The increasing need for continuous and non-invasive monitoring of children's health has created significant interest in smart wearable technologies capable of collecting and analysing physiological information in real time. Conventional clinical monitoring methods are generally dependent on hospital-based equipment and periodic assessments, which may limit continuous observation of changes in a child's vital signs during daily activities. This study proposes a smart wearable embedded system integrated with artificial intelligence (AI) for continuous monitoring and intelligent assessment of children's vital signs and health conditions. The proposed system combines wearable physiological sensors, an embedded processing unit, wireless communication, and an AI-based analytical framework to acquire and interpret parameters such as heart rate, body temperature, blood oxygen saturation, respiratory rate, and activity-related information. The acquired physiological data are processed to reduce noise and identify abnormal patterns, while the AI model evaluates variations in multiple parameters to support early identification of potentially concerning health conditions. Unlike conventional threshold-based monitoring, the proposed approach considers the temporal and combined behaviour of physiological parameters, thereby enabling more adaptive health assessment. A connected monitoring architecture is further incorporated to facilitate real-time transmission of processed information to caregivers or authorised healthcare personnel. The proposed framework is intended to provide timely alerts while maintaining low power consumption, portability, and suitability for continuous use by children. The study demonstrates how the integration of AI with wearable embedded systems can contribute to proactive paediatric health monitoring, early anomaly detection, and improved accessibility to physiological information outside conventional clinical environments. The proposed approach provides a foundation for developing intelligent, reliable, and scalable wearable healthcare systems for continuous child health surveillance.
Transforming Ancient Wisdom Into 21st-Century Skills: A National Education Policy (NEP) 2020 Perspective
The National Education Policy (NEP) 2020 emphasizes the integration of India’s rich ancient knowledge systems with contemporary educational goals to develop 21st-century skills among learners. India’s traditional education models, such as the Gurukul system, emphasized holistic development, ethical values, experiential learning, and life skills, which remain highly relevant in today’s globalized and technology-driven world. This paper explores how ancient Indian wisdom can be transformed and aligned with modern competencies such as critical thinking, creativity, communication, collaboration, and digital literacy as envisioned under NEP 2020. Using a qualitative and conceptual research approach, the study analyzes key principles of ancient education—value-based learning, experiential pedagogy, teacher–student relationships, and community engagement—and maps them to the skill-based framework promoted by NEP 2020. The paper highlights the relevance of Indian Knowledge Systems (IKS) in fostering sustainable, inclusive, and ethical education while addressing contemporary challenges such as employability and global competitiveness. The findings suggest that integrating ancient wisdom with modern pedagogical practices can significantly contribute to holistic learner development and national educational transformation. The study concludes with recommendations for curriculum design, teacher training, and policy implementation to effectively bridge ancient educational philosophies with 21st-century skills.
Enhancing Induced Resistance In Tomato Plants Against Root Wilt Disease Using The Mycorrhizal Fungus Glomus Mosseae And Its Impact On Secondary Phenolic Compound Accumulation
Root wilt is a devastating disease affecting tomato (Solanum lycopersicum L.) yields globally and is caused by soil-borne fungal pathogens. PurposeThis study was initiated to test the effect of the arbuscular- mycorrhizal- fungus (AMF), Glomus mosseae (GM), on the expression of induced systemic resistance against the wilt pathogen of areca palm, Fusarium brachygibbosum (Fb). A greenhouse experiment was performed under four treatments: Control, GM-only (T1), Fb-only (T2) and a mixture of GM+Fb (T3). The findings showed that GM inoculation resulted in considerably higher growth and physiological attributes. At the 10th week, GM alone resulted in the tallest plants (94.75 cm) and flowering of plants (mean = 6.5) only in the treated group. Inoculation with Fb elicited drastic growth retardation and decreased total chlorophyll to 354.82, however, dual inoculation (GM+Fb) dramatically recovered plant height (77.75 cm) and chlorophyll content (454.65). THE TPC measurement showed a remarkably powerful "priming" effect in GM + Fb treatment which was the largest among the groups (226.42 mg/g), the group with the highest TPC only containing Fb (179,62 mg/g). In addition, the activities of defence-related enzymes, Peroxidase (POD) and Polyphenol Oxidase (PPO), peaked in GM+Fb group (0.11 and 0.62 respectively), suggesting a strong enhancement of the antioxidant protection of plants. ConclusionsCollectively, these data support the conclusion that G. mosseae protects pine seedlings from F. brachygibbosum by a morphological and biochemical synergetic mechanism of resistance. From an applied perspective, this relationship embodies an environmentally sound and sustainable approach to control root wilt diseases within integrated pest management programs. Giuseppe G. Casaluce, 2015
Evaluation Microrna-330 Gene Expression In Human Papillomavirus Type 16-Associated Prostate Cancer Patients Using RT-QPCR
Background: Human Papillomavirus (HPV) type 16 is one of the most common sexually transmitted viruses, suggesting a potential long-standing link to prostate cancer. The viral genome has been seen as most demonstrated effect to prostate carcinogenesis and levels of miRNA-330 expression, ignoring the capability of miRNA-330 in tumor-suppression role by regulating cell death and proliferation pathways, Human Papillomavirus type 16 kept the tumor activity. This inapparent functional reversal or equal could lead to different results depending on the potency of the virus to produce the oncogenic proteins, Because of the unknown influence of these factors, given the limited number of studies linking these two factors. Objective: the aim of this study is to find the relationship between the Human Papillomavirus type 16 infection and develop of the prostate cancer in the sphere of influence of the microRNA-330. Methods: the study has conducted in a cohort of prostate cancer patients after the samples were isolated from the Hospital of the (Middle Euphrates Cancer Center), ranging from 47 to 98 years old (n = 100), and divided into two group (PCa with HPV16 and PCa without HPV16). quantified the levels of viral genome and miRNA-330 were done by RT-qPCR. Results: The results showed a positive correlation, with a P-value < 0.05, indicating a clear correlational effect of latent human Papillomavirus type 16 infection. This correlation was further supported by the high gene expression rate of miRNA-330 about 5.27 ± (1.3) in PCa patients with HPV16, while 1 ± (0.22) in PCa patients without HPV16. Conclusions: This study provides novel insights into the nature and progression of prostate tumors and the role of miRNA-330 as a biomarker. The study took place in Najaf, Iraq.
Impact Of Mindfulness-Based Interventions On Academic Stress And Performance Among University Students
University students frequently encounter high levels of academic stress due to demanding coursework, performance expectations, and transitional life challenges. Excessive stress not only undermines mental well-being but also negatively impacts learning efficiency, concentration, and academic achievement. In recent years, mindfulness-based interventions (MBIs) have gained attention as effective, non-pharmacological approaches to enhancing psychological resilience and academic outcomes. This study investigated the impact of MBIs on academic stress and performance among university students, drawing on both theoretical foundations and empirical evidence. The research employed a mixed-methods approach comprising a quasi-experimental design and qualitative interviews. Participants included undergraduate and postgraduate students who were assigned either to an intervention group receiving an eight-week mindfulness program or to a control group continuing with standard academic routines. Academic stress levels were measured using standardized self-report scales, while performance was assessed through cumulative grade point averages (CGPAs) and task-based cognitive assessments. Qualitative data provided insights into students’ subjective experiences of mindfulness practices, including meditation, mindful breathing, and body awareness exercises. Findings revealed that students in the intervention group reported significantly lower academic stress post-intervention compared to the control group. They also demonstrated enhanced concentration, time management, and exam performance. Additionally, mindfulness practices were associated with improved emotional regulation and reduced anxiety, thereby supporting an indirect but crucial pathway to academic success. Qualitative feedback further highlighted that students perceived mindfulness as a practical strategy for balancing academic and personal responsibilities. This study underscores the potential of MBIs to alleviate academic stress while fostering better academic outcomes. Integrating mindfulness training into university curricula and student support services may serve as a proactive measure to address mental health challenges and promote holistic student development.
Impact Of Regular Yoga Practice On Workplace Stress And Well-Being Among Corporate Women In Delhi NCR
Workplace stress has emerged as a significant occupational health concern, particularly among corporate women who experience dual pressures of professional responsibilities and personal roles. In metropolitan regions such as Delhi NCR, long working hours, sedentary lifestyles, performance expectations, and work–life imbalance contribute substantially to psychological stress and reduced well-being among female employees. Against this backdrop, yoga has gained recognition as a holistic, cost-effective, and culturally rooted intervention for promoting mental and emotional health. The present study examines the impact of regular yoga practice on workplace stress and overall well-being among corporate women employees in the Delhi NCR region. Using a pre-test–post-test research design, the study involved a sample of corporate women drawn from IT, finance, education, and service sectors. A structured yoga intervention comprising selected asanas, pranayama, and meditation practices was administered over a period of 8–12 weeks. Standardized tools such as the Perceived Stress Scale (PSS) and the WHO-5 Well-Being Index were used to assess stress levels and psychological well-being before and after the intervention. The findings reveal a significant reduction in perceived stress levels and a marked improvement in emotional well-being, sleep quality, and overall mental health among participants following regular yoga practice. The study highlights yoga’s effectiveness as a preventive and promotive workplace wellness strategy. It further underscores the need for organizations to integrate structured yoga programs into corporate wellness policies, particularly to support the mental health and productivity of women employees in high-pressure urban work environments.
Neuromarketing Predictors Of Retail Trading Surges: A Brain-Behavior Analysis Using Indian Stock App Users
India’s rapid transition from conventional investing to app-mediated securities trading has created an environment in which investor attention, emotional arousal, behavioral bias, interface design and market information interact almost instantaneously. This study develops and tests a neuromarketing-based framework for explaining short-duration retail trading surges among Indian stock-app users. The proposed model integrates electroencephalographic measures of approach-related neural activity and cognitive engagement, eye-tracking indicators of visual attention, electrodermal arousal, self-reported behavioral biases and observed trading responses. The conceptual foundation combines consumer neuroscience, the Stimulus-Organism-Response framework, behavioral finance and investor-attention theory. Recent evidence demonstrates that EEG and multimodal physiological measures can predict consumer preferences and purchase decisions with meaningful out-of-sample accuracy, while experimental financial research shows that gamification, attention cues and digital nudges can increase trading volume and financial risk-taking. Recent Indian evidence further documents the importance of loss aversion, herding, anchoring, overconfidence, social-media exposure and financial literacy in retail investment decisions. The proposed empirical design involves active Indian stock-app users exposed to controlled trading-interface conditions varying market momentum, social proof, urgency cues and gamification intensity. Brain-behavior indicators are linked to trading initiation, order frequency, response latency, position size and speculative-risk preference. The analytical architecture combines confirmatory factor analysis, reliability and validity testing, mixed-effects models, structural equation modelling, mediation and moderation analysis, effect-size estimation and predictive machine-learning validation. The evidence framework predicts that heightened neural approach motivation, visual fixation on salient market signals, physiological arousal, FOMO and overconfidence jointly increase trading intensity, whereas financial literacy and reflective decision friction weaken stimulus-to-trade pathways. The study contributes to behavioral finance by introducing neurophysiological mechanisms into the explanation of digital retail trading and contributes to management practice by identifying interface interventions capable of preserving engagement while reducing impulsive and potentially harmful trading.
Papillary Carcinoma Arising In A Thyroglossal Duct Cyst: Diagnostic Pitfalls And Surgical Decision-Making
The most prevalent congenital midline neck masses are thyroglossal duct cysts (TGDCs), which are commonly benign. Only 1% to 2% of cases progress to malignant transformation, of which papillary carcinoma is of the most prevalent histological subtype. The best course of action for surgery, especially the role of a total thyroidectomy, is still up for debate, and preoperative diagnosis is difficult. A 25-year-old woman arrived with a gradually growing midline neck Swelling that was painless. Imaging revealed a cystic lesion with microcalcifications and an increasing intracystic solid component. Papillary cancer was suspected by fine-needle aspiration cytology (Bethesda V). FDG PET-CT revealed intense uptake within the intracystic solid component without evidence of thyroid or nodal involvement. The patient had underwent Sistrunk procedure with total thyroidectomy . Histopathology showed no thyroid gland malignancy, thyroid follicles inside the cyst wall, and conventional papillary carcinoma coming from the cyst wall of the thyroglossal duct. There were Negative surgical margins. It is rare for papillary cancer to develop in a TGDC, and it is usually discovered after surgery. The diagnostic difficulties and the justification for customized surgical decision-making are demonstrated by this example. Some people with a history of cytological suspicion of cancer may benefit from a total thyroidectomy to help with surveillance, even if there is no visible thyroid involvement.
Development Of Smart Thermo-Responsive Polymer Blends For Temperature-Triggered Release Of Poorly Water Soluble Nsaids
Non-steroidal anti-inflammatory drugs' (NSAIDs) weak water solubility sometimes causes poor absorption, inconsistent therapeutic response, and recurrent doses. Drug delivery via clever thermo-responsive polymer systems seems promising. This study developed thermo-responsive polymer blends to regulate the release of a non-water-soluble NSAID. PNPAM, PEG, and HPMC were mixed to make thermo-responsive polymer blends via solvent casting and cross-linking. Water-insoluble celecoxib was chosen as the model NSAID. Drug loading, entrapment efficiency, morphology, thermal properties, gelation temperature, and in vitro drug release were characterised at 25°C, 37°C, and 40°C. To determine drug-polymer compatibility, FTIR and DSC were utilised. The low critical solution temperature (LCST) of 34.8 ± 0.6°C makes the optimised thermo-responsive formulation (TRP-4) acceptable for physiological temperature-triggered drug release. The formulation showed 12.4 ± 0.8% drug loading capacity and 89.6 ± 2.7% entrapment efficiency. According to swelling studies, thermo-induced polymer contraction reduced swelling ratio from 412 ± 18% at 25°C to 176 ± 11% at 40°C. Over 24 hours, controlled drug release studies at 25°C, 37°C, and 40°C yielded 31.4 ± 2.1%, 68.7 ± 3.5%, and 92.3 ± 4.2%, respectively. FTIR and DSC investigations confirmed celecoxib had been absorbed into the polymer matrix and that there were no drug-polymer interactions. These SEM images showed a consistently porous structure with temperature-responsive releasing behaviour. Drug release kinetics were best fit by the Korsmeyer-Peppas model (R² = 0.987), indicating diffusion regulation rather than anticipated mechanism. Its drug entrapment, thermal responsiveness, and controlled release qualities allowed the thermo-responsive polymer mix to release celecoxib at a temperature. Smart thermo-responsive polymer systems may increase the therapeutic efficacy and dispersion of non-water-soluble NSAIDs, according to these findings.
Female Athlete Mental Fitness Scale (FAMFS): Preliminary Validation And Standardization Of An Outcome Measure For Mental Health Assessment Of Female Athletes Of India
Background: Mental health plays a significant role in athletic performance and overall well-being. Female athletes are particularly vulnerable to psychological and physiological challenges such as anxiety, depression, sleep disturbances, eating-related concerns, and menstrual health issues. However, limited multidimensional assessment tools are available specifically for female athletes in the Indian population. Objective: To develop and evaluate the reliability of the Female Athlete Mental Fitness Scale (FAMFS), a multidimensional outcome measure designed to assess mental health-related factors among female athletes. Methods: This instrumental cross-sectional study included 120 female athletes aged 14–40 years who had participated in sports activities for at least two years. The FAMFS was developed through literature review and domain identification focusing on five components: anxiety, depression, sleep quality, eating disorders, and menstrual health. The scale consisted of items rated on a 4-point Likert scale. Reliability analysis was performed using Cronbach’s alpha and intraclass correlation coefficient (ICC). Results: The FAMFS demonstrated acceptable internal consistency with satisfactory reliability values. The multidimensional structure of the scale enabled comprehensive assessment of psychological and physiological factors influencing female athletes. The findings support the potential usefulness of FAMFS as a screening and assessment tool for mental fitness among female athletes. Conclusion: The Female Athlete Mental Fitness Scale (FAMFS) is a promising multidimensional tool for assessing mental health-related concerns in female athletes. The scale may help clinicians, physiotherapists, coaches, and sports professionals identify psychological and behavioral factors affecting athlete well-being and performance. Further studies with larger sample sizes and advanced psychometric evaluation are recommended to strengthen its validity and clinical applicability.
Formulation, Optimization, And Pharmacological Evaluation Of Macrophage Membrane-Camouflaged Redox-Sensitive Liposomes For Breast Cancer Theranostics
Background: Triple-negative breast cancer (TNBC) is an aggressive malignancy associated with limited targeted therapeutic options, high relapse rates, and considerable toxicity from conventional chemotherapy. Doxorubicin (DOX) remains an important therapeutic agent, but its clinical utility is limited by systemic toxicity and nonspecific distribution. The present study aimed to develop and optimize a macrophage membrane-camouflaged, redox-sensitive liposomal nanocarrier co-encapsulating doxorubicin and indocyanine green (MM-RSL/DOX/ICG) for combined chemotherapy, photothermal therapy, and fluorescence imaging of breast cancer. Methods: MM-RSL/DOX/ICG was prepared by incorporating DOX and ICG into disulfide-containing liposomes followed by macrophage membrane coating. A 3² full factorial design was employed to optimize the lipid-to-drug molar ratio and DSPE-PEG-SS content using particle size, polydispersity index (PDI), and DOX and ICG encapsulation efficiencies as responses. The optimized formulation was characterized for physicochemical properties, morphology, encapsulation efficiency, colloidal stability, glutathione (GSH)-responsive drug release, in-vitro cytotoxicity, and chemo-photothermal activity. Its therapeutic performance was further evaluated in a 4T1 breast cancer model, including survival and safety assessments. Results: The factorial design identified a lipid-to-drug molar ratio of 10:1 and DSPE-PEG-SS content of 12.5 mol% as the optimum formulation conditions. The optimized MM-RSL/DOX/ICG exhibited a particle size of 158.4 ± 6.1 nm, PDI of 0.262 ± 0.022, and zeta potential of −21.3 ± 1.1 mV, with DOX and ICG encapsulation efficiencies of 80.4 ± 2.4% and 77.6 ± 2.3%, respectively. The formulation maintained satisfactory colloidal stability for 30 days. GSH markedly accelerated drug release, with cumulative release at 48 h reaching 88.0% for DOX and 84.0% for ICG under GSH-rich conditions, compared with substantially lower release under physiological conditions. In 4T1 cells, MM-RSL/DOX/ICG combined with 808-nm laser irradiation showed enhanced cytotoxicity, with an IC₅₀ of 0.18 µg/mL and combination-index values below 1, indicating synergistic chemo-photothermal activity. In vivo, the combined formulation with laser irradiation increased median survival to 58 days, compared with 24 days for saline controls, while maintaining body weight and showing comparatively favorable biochemical, hematological, and histopathological safety profiles. Conclusion: The optimized macrophage membrane-camouflaged redox-sensitive liposome demonstrated efficient co-delivery of DOX and ICG, GSH-responsive release, enhanced in-vitro chemo-photothermal cytotoxicity, prolonged survival, and an improved safety profile in the experimental breast cancer model. The findings support MM-RSL/DOX/ICG as a promising multifunctional theranostic platform for TNBC, although further validation in advanced tumor models, comprehensive toxicological studies, and translational investigations are required before clinical application.
Association Between Betel Nut Chewing And Oral Squamous Cell Carcinoma: A Hospital-Based Retrospective Study
Background: Oral squamous cell carcinoma (OSCC) is a major health problem in South and Southeast Asia linked to betel nut chewing, but detailed evidence on exposure patterns and independent risk is limited. This study assessed the association between betel nut chewing habits and OSCC, focusing on exposure and risk factors. Methods: A retrospective case–control study at Bangladesh Medical University in Dhaka (January 2024–January 2025) included 180 participants: 90 OSCC cases confirmed histopathologically and 90 controls. Data via questionnaire covered sociodemographics, betel nut chewing, betel quid use, smokeless tobacco, smoking, alcohol, and exposure duration and frequency. Chi-square tested associations, and multivariable logistic regression identified independent OSCC predictors. Results: Betel nut chewing was significantly higher in OSCC cases (80.0%) compared to controls (51.1%). Betel quid use (areca nut with tobacco) showed an even stronger association (66.7% vs 40.0%). Long-term chewing (>10 years) was more common among OSCC cases (64.4%). Multivariable analysis revealed that betel quid use (AOR = 4.15, p < 0.001), betel nut chewing (AOR = 3.42, p < 0.001), and duration >10 years (AOR = 2.96, p = 0.001) were significant independent predictors of OSCC. Smoking was also associated with increased risk (AOR = 1.88, p = 0.046), while alcohol consumption was not statistically significant. Increasing age and male gender were additionally identified as risk factors. Conclusion: Betel nut chewing, especially with tobacco, is a significant risk factor for OSCC. Urgent public health measures are needed to reduce areca nut use and lower oral cancer in high-risk groups.
Predictors Of Hypertension Control In A Suburban Hypertensive Population
Background and purpose: Hypertension is a preventable disease, provided certain cardiovascular behavioral factors are altered. Hence, there is dearth of physical activity and hypertension management of recent times. We enumerated various factors of hypertension control in patients from one hospital located in a suburban area of a south Indian metropolitan city. Methods: A cross-sectional hospital-based survey of 448 hypertensive patients (≥ 140/90 mm of Hg) on antihypertensive medications were recruited. To determine the behavioural factors associated with blood pressure control, multivariate logistic regression analysis (MLRA) were applied. Results: MLRA revealed that aerobic physical activity once per week (OR = 3.21, 95% Cl: 1.07 – 9.64, p = 0.04), more than twice a week (OR = 4.07, 95% Cl: 1.32 – 12.51, p = 0.01) when compared with daily exercise and maintenance of weight reduction through aerobic physical activity (OR = 3.65, 95% Cl: 1.10 – 12.15, p = 0.04) when compared to diet control are behavioural factors that independently associated with the control of hypertension. Conclusion: Our study concluded that, aerobic physical activity maintains optimal blood pressure among the study population. Henceforth, hypertensive patients could be encouraged by the physicians, to include some sort of physical activity in their daily routine along with antihypertensive drugs to maintain optimal blood pressure and to prevent complications.
Effect Of Enalapril On Hepatic And Renal Function Parameters In Patients With Essential Hypertension: A Prospective, Randomised, Open-Label Study
Background: Angiotensin-converting enzyme (ACE) inhibitors such as enalapril are first-line agents for essential hypertension, but their long-term effect on hepatic and renal function in routine clinical use is incompletely characterised. Objective: To study the effect of enalapril on hepatic (alkaline phosphatase [ALP], serum glutamic oxaloacetic transaminase [SGOT], serum glutamic pyruvic transaminase [SGPT], total bilirubin) and renal (blood urea, serum creatinine) function parameters in patients with essential hypertension. Methods: In a prospective, randomised, open-label study conducted over 12 months (1 August 2021 to 31 July 2022) in a tertiary care hospital, Ongole, newly diagnosed patients with essential hypertension aged 25–65 years with normal baseline hepatic and renal function were randomised to enalapril maleate 5 mg or telmisartan 40 mg once daily; this report presents the enalapril arm. Hepatic and renal parameters and blood pressure were recorded at baseline, 6th month and 9th month. Intragroup comparison used the paired t-test/repeated-measures ANOVA; p<0.05 was considered significant. Results: Forty-six patients (mean age 43.56±8.37 years; 60.87% male) completed 9 months of enalapril therapy. Mean systolic and diastolic blood pressure fell from 142.60±9.41/87.93±5.82 mmHg to 117.93±8.98/75±5.86 mmHg (p<0.0001 for both). ALP rose from 79.36±19.22 to 95.28±28.04 IU/L (p<0.0001) and SGOT rose from 19.63±7.99 to 36.76±12.71 U/L (p<0.0001). SGPT (32.5±11.05 to 38.63±17.30 U/L, p=0.0533) and total bilirubin (0.68±0.23 to 0.64±0.26 mg/dL, p=0.0810) did not change significantly. Blood urea (14.86±3.80 to 14.50±3.76 mg/dL, p=0.5536) and serum creatinine (0.83±0.15 to 0.88±0.12 mg/dL, p=0.5055) remained stable. Mild adverse effects (headache, nausea, dry cough) occurred in 6/46 (13.04%) patients and resolved with continued treatment. Conclusion: Nine months of enalapril therapy produced effective blood pressure control together with a small but statistically significant rise in ALP and SGOT, without significant change in SGPT, bilirubin, or renal indices. Periodic monitoring of liver enzymes, rather than routine avoidance, appears appropriate during long-term enalapril therapy.
Assessment Of Nutritional Status Of Tribal Adolescent Girls Through Anthropometric Measurements: A Cross-Sectional Study In Mayurbhanj District Of Odisha
Tribal adolescent girls are among the most nutritionally vulnerable population groups in India due to poor dietary intake, socio-economic deprivation, limited access to health services and increased physiological nutritional requirements during adolescence. Anthropometric assessment is a simple and reliable method for evaluating nutritional status. The objective of the study is to assess the anthropometric measurements of tribal adolescent girls in Mayurbhanj district of Odisha to generate a baseline database of their nutritional status. A community-based cross-sectional study was conducted among 150 tribal adolescent girls aged 15-19 years in Baripada block of Mayurbhanj district, Odisha. Data on their anthropometric measurements including height, weight, Body Mass Index (BMI), waist circumference (WC), hip circumference (HC) and waist-hip-ratio (WHR) were recorded following standard WHO procedures. BMI and WHR was classified according to WHO criteria. Data was analyzed using SPSS 2.0. The results revealed that a higher proportion of the selected respondents belonged to the Santhal tribe (48.0%). The data showed a majority of the tribal girls were continuing education (86.0%) and belonged to joint families (67.3%). The mean height and weight were 149.41±4.96 cm and 46.82±2.75 kg, respectively with mean BMI value of 17.78±1.51 kg/m2 indicating a significant gap with WHO reference values. More than half (61.33%) of the respondents were underweight, whereas only 38.66% had normal BMI. Among the underweight respondents, 14.0% had severe thinness, 21.33% had moderate thinness and 26.0% had mild thinness. The mean WHR was 0.754±0.16, with 73.33% of respondents classified as low risk, 24.00% as moderate risk, and 2.66% as high risk. The study revealed a high prevalence of undernutrition among tribal adolescent girls in Mayurbhanj district. Regular nutritional assessment, nutrition education, dietary diversification and strengthening of existing adolescent health programmes are essential to improve nutritional status of tribal adolescents.
Ergonomic Awareness And Work-Related Musculoskeletal Disorders Among Healthcare Students: A PRISMA-Oriented Systematic Narrative Review Of Prevalence Patterns, Associated Factors, And Preventive Strategies
Background: Work-related musculoskeletal disorders (WRMSDs) are now identified as a serious issue during the training of health care workers before they start their professional careers. Healthcare students are prone to prolonged sitting and standing, repeated clinical and laboratory activities, unusual working positions, digital-device usage and patient related activities. These exposures can lead to early musculoskeletal symptoms and can create potentially unsafe working practices which persist in working life. Objective: To collate current primary evidence regarding prevalence patterns, affected anatomical sites, awareness of ergonomic issues and ergonomic factors and prevention strategies for WRMSD among healthcare students. Methods: A systematic narrative review was performed which was guided by the PRISMA 2020 orientation and focused on student-centered primary records in the field of healthcare or health science. Reviews, protocols, editorials, commentaries, conference abstracts, professional-only and mixed-population studies (without student-relevant data) were not considered as primary evidence. There was no date restriction applied at the final eligibility stage in that there were several earlier studies identified that were closely related to the date. Due to the differences in studies by discipline, measurement instrument, recall period, anatomical definition and intervention design, findings were synthesized in a narrative way and not pooled. Results: 29 peer-reviewed, full-text original journal articles related to students' perspectives were included in the qualitative synthesis. The studies of dental students were the largest, and there was also some evidence from studies by medical, nursing, physiotherapy, rehabilitation, and laboratory science and allied health students. Multiple complaints involved the neck, lower back, upper back, shoulders and wrist/hand areas. The associated factors included sustained or awkward posture, long sitting or standing periods, repetitive movements, screen time, academic or clinical workload, lack of training on practical ergonomics, poorly fitted workstations, restricted breaks, physical inactivity or more active years of clinical practice. In general, the level of ergonomic knowledge was higher than the level of ergonomic behavior. Discussion: WRMSDs are identified as a concern among students in healthcare and seem to be preventable. The evidence is for the provision of early, practical and discipline-specific ergonomic training, instead of relying on theoretical instruction. Further longitudinal and intervention studies, especially in nursing, medical, pharmacy, radiography and laboratory science and allied-health programs are required.
Maternal Paracetamol And Ondansetron Use During Pregnancy And Risk Of Autism Spectrum Disorder In Offspring
Background: Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition influenced by genetic, prenatal, perinatal, and environmental factors. Paracetamol and ondansetron are commonly used during pregnancy, but evidence regarding their association with later ASD remains limited and inconsistent. Objective: To evaluate the association between maternal paracetamol and ondansetron use during pregnancy and ASD in offspring, while considering relevant maternal, obstetric, neonatal, familial, and environmental factors. Methods: A hospital-based matched case–control study was conducted at the Antenatal Care Clinic and Labor Ward of the Department of Obstetrics and Gynecology, Tikrit Teaching Hospital, Salah Al-Din Governorate, Iraq. Ninety mother–child pairs were included: 45 mothers of children with confirmed ASD and 45 mothers of children without ASD or another major neurodevelopmental disorder. Prenatal medication exposure was assessed by structured maternal interview and review of available medical, antenatal, obstetric, and prescription records. Exposure was classified according to medication, timing, frequency, duration, indication, and combined use. Associations were evaluated using crude odds ratios and multivariable logistic regression with 95% confidence intervals. Results: Paracetamol exposure was more frequent among ASD cases than controls (68.89% vs. 42.22%, P=0.01; OR=3.00, 95% CI 1.27–7.09). Frequent/prolonged paracetamol use was also more common among cases (29.03% vs. 10.53%, P=0.04), with longer mean exposure duration (13.70±8.50 vs. 8.10±5.20 days, P=0.01). Ondansetron exposure was more frequent among cases (40.00% vs. 20.00%, P=0.04; OR=2.67, 95% CI 1.04–6.84), but was not independently associated after adjustment. Combined paracetamol and ondansetron exposure was associated with approximately fivefold higher crude odds of ASD (OR=5.23, 95% CI 1.63–16.77, P=0.005). In multivariable analysis, frequent/prolonged paracetamol use (AOR=3.86, 95% CI 1.08–13.79, P=0.04), combined exposure (AOR=4.12, 95% CI 1.17–14.52, P=0.03), and family history of ASD (AOR=5.63, 95% CI 1.08–29.41, P=0.04) remained independently associated with ASD. Conclusion: In this study, frequent/prolonged maternal paracetamol use and combined prenatal exposure to paracetamol and ondansetron were independently associated with ASD in offspring, whereas exposure to either drug alone was not independently significant after adjustment. These findings indicate association rather than causation and should be interpreted in light of the small sample, retrospective exposure assessment, and possible residual confounding. Larger prospective studies using objective exposure measures are warranted.
Recent Progress In Mxene Based Membranes For Pressure Driven Water Desalination Applications: An Overview
The increasing global concern regarding water scarcity and contamination has necessitated the development of innovative and efficient water treatment technologies. Among these advancements, MXenes, two-dimensional (2D) transition metal carbides, nitrides, or carbonitrides have emerged as a promising class of materials due to their unique properties and functionalities. First synthesized in 2011, MXenes possess a unique combination of properties, including a two-dimensional layered structure, excellent electrical conductivity, intrinsic hydrophilicity, robust mechanical stability, and easily modifiable surface functional groups, making them highly attractive materials for the development of advanced membranes for water purification. The versatility of MXenes arises from their layered structure, allowing for easy exfoliation into thin nanosheets that can be manipulated to create membranes with tailored pore sizes and surface properties. These attributes enable the selective separation of contaminants from water, including heavy metals, organic pollutants, and salts. Furthermore, the incorporation of MXenes into traditional membrane matrices can enhance permeability while maintaining or improving selectivity a critical balance that is often challenging to achieve in membrane technology. Recent studies have focused on elucidating the mechanisms by which MXene-based membranes facilitate water treatment processes. Understanding these mechanisms is crucial for optimizing membrane design and performance. Simultaneously, advancements in fabrication techniques have led to the development of novel MXene-based composite membranes that improve the synergistic effects of MXenes with other materials to enhance functionality. As the field progresses, comprehensive evaluations of the performance of MXene membranes in various water treatment scenarios are essential for assessing their viability for real-world applications. In this review, we discuss in detail on the recent developments in MXene-based membranes for water treatment applications by exploring their unique properties, mechanisms of action, advancements in fabrication technologies, and performance metrics. Additionally, this review explores future directions and research opportunities that could further enhance the progress of MXene-based membranes toward practical implementation in addressing global water challenges.
Neuroplasticity In Action: Cognitive, Clinical, Environmental, And Translational Neuroscience In The Experiential Undergraduate Course At A Canadian University
We propose a model psychoeducational program which seems to bear some therapeutic potential. We believe that such intervention might be beneficial not only for adolescents, but also for adults in all age groups. Canadian undergraduate students participated in an experimental research course grounded in neuroscience that was offered for credit during the COVID-19 pandemic. The training had an interdisciplinary character and integrated cognitive, clinical, environmental, and translational neuroscience perspectives to study the interplay between brain, behavior and social determinants of health. The course curriculum implemented an experiential learning style and had a neuroscientific focus on brain plasticity. This paper aims to identify the need for this type of action and explains the researchers’ role in designing it. It sheds light on the emotional challenges during the traumatic times of lockdowns, university closures, and social isolation, when the experience of uncertainty and extreme loneliness led to mental health deterioration. We aimed to gain experience in creating a neuropsychological perspective on the management of adolescents’ emotional and somatic pain, viewed as a subjective, multidimensional, and individual phenomenon. In those trying times, more than ever before, offering a salutogenic intervention under the umbrella of mental health promotion seemed to be an attainable goal with possible benefits to participants. No previous evidence could be found about educational training with potentially therapeutic elements offered in university settings. This underscores the need for innovative and effective health promotion initiatives of this type.
Role Of Artificial Intelligence In Nutrition: Current Applications And Challenges
Artificial Intelligence (AI) is an emerging and rapidly expanding technology in nutrition that holds significant potential to revolutionise the field. AI and its algorithms, is capable of understanding complex interactions, analysing complex data and interpreting images. The key applications of AI in nutrition field are in personalized nutrition and diet planning, dietary intake assessment and monitoring, prevention of malnutrition, disease prevention and management, virtual nutritional guidance, food product development and nutrition research. AI is reshaping the field of nutrition in ways that were unimaginable in the previous era. Through their accuracy and efficiency, wearable devices, and chatbot applications are revolutionizing the nutrition field. However, AI applications are not well known in this field, especially in low- and middle-income countries. AI applications may be adapted and applied in nutrition, but they need to be investigated. Addressing data privacy and bias, ensuring the accuracy of AI algorithms and overcoming ethical concerns are major future challenges. Need of the hour is interdisciplinary collaboration between AI experts and nutritionists for more seamless, effortless and accurate results.
Clinical, Hematological, Biochemical And Serotype Correlates Of Disease Severity In Hospitalized Dengue Patients: A Cross-Sectional Study Of 100 Patients
Background: Dengue infection exhibits a broad clinical spectrum, and early recognition of patients at risk of severe disease remains important. This study evaluated the relationship of routine hematological and biochemical parameters with clinical manifestations, described dengue virus serotype distribution, and examined associations between serotype patterns and disease severity in hospitalized patients. Materials and methods: The study was conducted in Department of Microbiology of Jaipur National University Instruction of Medical Science and Research Center, Jaipur, Rajasthan. This study included 100 patients aged >11 years with laboratory confirmed dengue and platelet counts below 100,000/µL. Demographic, clinical, hematological, biochemical, serological, molecular serotype were analyzed. Severe and non-severe dengue were compared using non-parametric tests for continuous variables and chi-square/Fisher's exact tests for categorical variables. Spearman rank correlation was used for exploratory assessment of laboratory parameters and clinical-manifestation burden. Results Data of 100 patients were analyzed, where 57 were female and 43 male; the median age was 27 years (IQR 21–37). Nineteen patients (19%) were classified as severe dengue and 81 (81%) as non-severe. The most frequent manifestations were fever (97%), abdominal pain (92%), arthralgia (90%), prostration (90%), myalgia (89%), headache (88%) and hepatomegaly (84%). Median laboratory values did not differ significantly between severe and non-severe groups for hemoglobin, TLC, MCV, hematocrit, platelet count, INR, bilirubin, AST, ALT, total protein, albumin, creatinine or urea (all p>0.05). DENV-2 was the most frequent single serotype (33%), followed by DENV-3 (28%), DENV-1 (13%) and DENV-4 (9%); mixed-serotype infections accounted for 17%. Mixed infections were strongly associated with severe dengue (10/17 [58.8%] severe versus 9/83 [10.8%] among single-serotype infections; Fisher’s exact p<0.001). DENV-2+DENV-3 infection was particularly associated with severe disease (6/9 [66.7%], p=0.0013). Conclusion: The study demonstrates substantial clinical heterogeneity and co-circulation of all four dengue serotypes. Although routine laboratory parameters were not statistically different between severity groups in this dataset, mixed-serotype infection especially DENV-2+DENV-3 was associated with a markedly higher proportion of severe disease. Molecular serotyping together with systematic clinical and laboratory monitoring may improve risk stratification.
Polyherbal Antidiabetic Powder: A Natural Remedy For Diabetes Mellitus
Background: The increasing prevalence of diabetes in both developed and developing countries have challenged scientists to the discovery of various therapeutic agents that can be used to ensure efficient treatment and management of diabetes. Synthetic anti-diabetic drugs are widely used for the management of diabetes mellitus; but they possess several limitations that may reduce their long-term effectiveness and patient compliance. Objective: To provide natural and cost-effective alternative for synthetic antidiabetic drugs by exploring the synergistic effect of herbs in diabetes treatment and management. Methods: Polyherbal formulations (F1, F2, F3, F4 and F5) containing powder of Moringa oleifera and Carica papaya leaves were prepared and evaluated for physicochemical properties and in vivo antidiabetic activity. Results: All formulations showed acceptable characteristics. Formulation F3 exhibited the best physicochemical properties, stability, and antidiabetic activity. Conclusion: The optimized polyherbal formulation (F3) demonstrated effective antidiabetic activity and may serve as a safe and natural alternative for managing diabetes mellitus.
Evaluation Of Obstetric Determinants Of Postpartum, Maternal And Neonatal Outcomes In Urban And Rural Settings
Objective: The study addresses maternal and neonatal health disparities between urban and rural healthcare settings, focusing on obstetric determinants and their impact on postpartum maternal and neonatal outcomes. Methods: Conducted over six months, this cross-sectional study involved 316 delivered mothers from selected urban and rural hospitals. Data collection encompassed socio-demographic details, obstetric history, delivery characteristics, postpartum complications, and neonatal outcomes. Statistical analysis included multivariable logistic regression and Chi-square tests, with significance set at p < 0.05. Results: The prevalence of caesarean sections was higher in urban areas (65%) versus rural areas (59%). Postpartum complications were more frequent among urban mothers (31%) compared to rural mothers (25%). Breastfeeding difficulties were reported more in urban mothers (24%) than rural mothers (16%). Neonatal complications were similar across both settings, occurring in 24% of cases. Multivariable logistic regression showed that in the urban population, having more than eight antenatal care visits and was significantly associated with caesarean delivery (AOR = 3.91; p = 0.020). Body Mass Index was significantly linked to caesarean section and postpartum complications in both settings. Mode of delivery was significantly connected with perineal trauma and pelvic floor issues. However, place of residence alone was not significantly associated with most maternal and neonatal outcomes. Conclusion: The study demonstrates that obstetric determinants significantly influence maternal and neonatal outcomes. Although caesarean sections were higher in urban settings, overall neonatal complications were comparable between urban and rural populations. Strengthening evidence-based obstetric practices, optimizing antenatal care utilization, and promoting appropriate mode of delivery may help reduce preventable maternal and neonatal morbidity in both healthcare settings.
Association Of Toll-Like Receptor 4 (TLR4) Expression With Psoriasis Pathogenesis In Patients From Basrah, Iraq
Psoriasis is a long-term inflammatory skin disease that occurs when a person's genes are affected by some environmental triggers. The triggers are associated with immune dysregulation by complex inflammatory mechanisms, causing the typical pathological changes in the skin. This study aimed to investigate the role of Toll-like receptor 4 (TLR4) in psoriasis progression by measuring its serum concentration using ELISA and assessing its tissue expression in skin biopsies via immunohistochemistry (IHC). We collected 35 venous blood samples from psoriatic patients and 22 from healthy controls, along with 5 skin biopsies from patients and one from a control, Statistical analysis was performed using independent t-tests, and p < 0.05 was considered significant. The results showed a statistically significant increase in TLR4 expression in psoriatic patients compared to healthy individuals. “These findings suggest that TLR4 plays a pivotal role in sustaining inflammatory pathways and could serve as a potential therapeutic target in psoriasis.”
Comparative Evaluation Of Perioperative Complications In General Versus Spinal Anaesthesia For Cesarean Delivery: A Prospective Observational Study
Background: Cesarean section (C-section) is one of the most frequently performed surgical procedures globally. The choice between Spinal Anaesthesia (SA) and General Anaesthesia (GA) is governed by clinical urgency, maternal anatomical considerations, and systemic stability. While SA is widely recognised as the gold standard for elective procedures, GA remains vital in emergency or high-risk scenarios. This study aims to prospectively evaluate and compare the nature, frequency, and severity of anaesthetic complications associated with General versus Spinal Anaesthesia in parturients undergoing C-section. Methods: A prospective observational study was conducted among N = 60 parturients aged 25 to 40 years with American Society of Anesthesiologists (ASA) physical status II or III who underwent elective or emergency C-sections at SGT Medical College, Hospital, and Research Institute, Gurugram. Participants were divided into two equal cohorts (n = 30 each) receiving either General Anaesthesia (Group A) or Spinal Anaesthesia (Group B). Physiological parameters (Systolic Blood Pressure [SBP], Diastolic Blood Pressure [DBP], Pulse Rate [PR]), demographic data, and intraoperative/postoperative complications were documented and analysed using independent t-tests and Chi-square tests. Results: Parturients in the SA cohort experienced a significantly higher incidence of maternal hypotension (60.0%, n = 18; p < 0.001) and intraoperative shivering (60.0%, n = 18) than in the GA cohort. The SA group demonstrated significantly lower post-induction SBP (112.80 ± 11.08 mmHg vs. 126.72 ± 6.14 mmHg, t = 5.94, p = 0.001) and PR (71.93 ± 7.30 bpm vs. 77.17 ± 7.95 bpm, t = 2.64, p = 0.011). Conversely, the GA cohort exhibited major airway-related challenges, with difficult intubation reported in 40.0% (n = 12) and failed intubation in 30.0% (n = 9) of cases. Postoperative hypothermia occurred in 23.0% of GA cases, whereas post-procedural pain (23.0%) and nausea/vomiting (20.0%) were predominantly observed in SA cases. Conclusion: Both anaesthetic modalities possess distinct risk profiles. Spinal Anaesthesia provides superior airway safety and post-procedural comfort but carries a high burden of sympathetically mediated hypotension and hypothermic shivering. General Anaesthesia avoids sympatholysis-induced hemodynamic drops but introduces substantial risks of airway failure. Meticulous preoperative planning, rigorous airway screening, and proactive vasopressor/thermal management are vital to optimising maternal outcomes.
A Theoretical Framework Including The Kirkaldy-Willis Model And The Three-Joint Complex For The Degenerative Cascade Of The Lumbosacral Spine
Background: One of the main causes of disability worldwide is low back pain (LBP), which is mostly caused by degenerative changes in the lumbosacral area. Even though magnetic resonance imaging (MRI) is the gold standard for diagnosis, there is frequently a theoretical gap in the relationship between specific imaging results and the overall course of spinal deterioration. Objective: To create a thorough theoretical framework for the Degenerative Cascade by combining the Kirkaldy-Willis pathophysiological model with the biomechanical "Three-Joint Complex" hypothesis, particularly in the context of radiological evaluation. Theoretical Framework: The interdependence of the paired facet joints and the intervertebral disc is integrated in this work. Pfirrmann and Weishaupt grading systems are used as markers to chart the development from biochemical dysfunction to mechanical instability and finally biological stabilization. Conclusion: The degenerative process is a predictable cascade that is not linear. The "Clinical-Radiological Paradox" requires a correlation-based approach for management planning, while MRI offers the granularity required to pinpoint the precise stage of this cascade.
Screen Time Among Children: A Cross-Sectional Study Across Age, Gender, And Urban–Rural Setting
Background: Excessive screen exposure during early childhood may adversely affect language, social interaction, attention, sleep, and behavioural development. This study assessed and compared screen time among children according to age, gender, and urban–rural residence. Materials and Methods: A cross-sectional analytical study was conducted among 200 children aged 0–6 years attending selected paediatric vaccination clinics and primary schools in Pune city and surrounding districts. Participants were selected by purposive sampling after obtaining informed consent and Institutional Ethics Committee approval. Sociodemographic data were collected using a structured questionnaire. Screen time was assessed using the validated Screen Time Measuring Questionnaire (STMQ) developed by Raje and Sontakke (2023). Screen exposure was categorized as recommended or high according to age-specific recommendations. Data were analysed using IBM SPSS version 29.0. The Chi-square test was used to assess associations, with p <0.05 considered statistically significant. Results: Of the 200 children, 100 (50.0%) were boys and 100 (50.0%) were girls; 101 (50.5%) were from urban and 99 (49.5%) from rural areas. Overall, 134 (67.0%) children had high screen time, while 66 (33.0%) had recommended screen time. High screen time was observed in 73.7% of children aged <2 years and 64.3% of those aged ≥2 years (χ²=1.611, p=0.204). It was reported in 69.0% of boys and 65.0% of girls (χ²=0.362, p=0.547), and in 70.6% of rural and 63.4% of urban children (χ²=1.218, p=0.270). None of these associations were statistically significant. Conclusion: High screen time was prevalent among young children, irrespective of age, gender, or place of residence.
A Hybrid Recursive Feature Elimination Principal Component Analysis Framework With Optimized Support Vector Machine For Accurate Diabetes Prediction
Timely diagnosis of diabetes supports earlier clinical action, yet standard machine-learning pipelines often struggle with overlapping features, inter-correlated clinical measurements, and models whose decisions are hard to explain. In this paper, we present an explainable hybrid framework based on Recursive feature elimination – Principal Component Analysis – Radial Basis Function Support Vector Machine (RFE-PCA-RBF-SVM). The study exploits Pima Indians Diabetes Dataset (PIDD), which consists of 768 cases and eight clinical attributes. Our framework comprises handling of invalid data based on median imputation, Min-Max normalization of the dataset, RFE feature selection, PCA dimensionality reduction, and hyperparameter optimization of RBF-SVM. The experiment was designed to use 80:20 stratified train-test scheme as well as 10-fold stratified cross-validation, ablation analysis, and statistical validation methods. It was found out that hybrid framework performed better than the base model in terms of measured characteristics and achieved accuracy of 71.08% (standard deviation = 2.71%). Considering that Histogram Gradient Boosting surpassed the other methods analyzed in terms of the predictive performance of the model, the hybrid framework proposed in this study managed to remain highly effective offering a well-structured process for feature optimization and nonlinear classification. In this context, the explainability based on the SHAP methodology determines the importance of Glucose, BMI, Age, and Diabetes Pedigree Function for the model prediction results. Consequently, the proposed method provides a neat, statistically verified, and interpretable technique for diabetes prediction, demonstrating the significance of the combination of predictive evaluation with component-wise ablation and explainability analysis.
Comparative Evaluation Of The Treatment Outcomes For Horizontal Defects By Intra Oral Osseous Auto Graft Vs. Combination Of Demineralized Bone Matrix And Injectable Platelet Rich Fibrin - A Clinical And Radiographic Study
Background: Horizontal periodontal defects are among the most prevalent forms of alveolar bone loss, yet they remain difficult to regenerate because of limited bony support and reduced regenerative potential. This study aimed to compare the clinical and radiographic results of intraoral autogenous bone graft (ABG) and combined use of demineralized bone matrix (DMBM) and injectable platelet-rich fibrin (I-PRF) for horizontal periodontal defects. Methods: The method used was randomized, single blind, and controlled clinical trial involving 40 patients with chronic periodontitis, who were divided into two groups. A randomized single blind controlled clinical trial was conducted involving 40 patients with chronic periodontitis, divided into two groups. Group A was treated with ABG, and Group B with DMBM and I-PRF. At baseline, 3-months and 6-months, clinical parameters including periodontal probing depth (PPD), relative clinical attachment level (RCAL), plaque index (PI), gingival index (GI), bleeding on probing (BOP) and residual bone level (RBL) were assessed. Repeated-measures ANOVA, paired t-test and unpaired t-test were used to analyze the data. Results: Statistically significant improvement was seen in all six parameters (PPD, RCAL, PI, GI and RBL) at the six months follow up period in both groups (p < 0.001). The intergroup comparisons, however, did not show any statistically significant difference in any clinical or radiographic parameter (p > 0.05). Conclusion: ABG and DMBM in combination with I-PRF are effective regeneration strategies in horizontal periodontal defects. The DMBM + I-PRF combination is a minimally invasive option that has similar clinical results to the gold standard autogenous bone graft.
Amoebic Liver Abscess Complicated By Hepatocaval-Right Atrial Thrombosis And Transdiaphragmatic Pleuropulmonary Rupture: A Case Report
Background: Amoebic liver abscess (ALA) is the most common extraintestinal manifestation of Entamoeba histolytica infection. Thoracic rupture is a recognized complication, whereas extension of hepatic venous thrombosis through the inferior vena cava (IVC) into the right atrium is exceptionally rare and potentially life-threatening. We report an unusual case in which both complications occurred simultaneously. Case presentation: An 18-year-old man presented with high-grade fever, chills, abdominal distension, and abdominal tenderness. Leukocytosis was present. Ultrasonography showed a hepatic abscess with associated IVC thrombosis, prompting contrast-enhanced CT. CT demonstrated a large, thick-walled, peripherally enhancing abscess measuring approximately 6.8 cm and involving segments I, IVa, VII, and VIII, with hepatomegaly. Thrombus involved the middle and right hepatic veins and extended contiguously through the intrahepatic IVC to the right atrium. Transthoracic echocardiography confirmed a freely mobile right atrial thrombus. Superiorly, the abscess breached the right hemidiaphragm through an approximately 27-mm defect and extended directly into the adjacent pleural/subpleural compartment and posterior right lower lobe, where focal consolidation with surrounding ground-glass opacity was present. Indirect hemagglutination assay for E. histolytica was positive at a titre of 1:250. The patient was resuscitated and treated with intravenous metronidazole and low-molecular-weight heparin. Because of the freely mobile intracardiac thrombus and the associated embolic risk, open surgical thrombectomy was performed together with operative drainage of the liver abscess. Characteristic anchovy-sauce material was obtained. The patient recovered uneventfully and was discharged on postoperative day 10. At 1 month, follow-up ultrasonography showed no significant residual hepatic or vascular abnormality. Conclusion: ALA may rarely produce simultaneous hepatocaval-intracardiac thrombosis and transdiaphragmatic pleuropulmonary rupture. CT is essential for defining the full anatomic extent of disease, whereas echocardiography provides critical information about intracardiac thrombus mobility. A freely mobile right atrial thrombus should prompt urgent multidisciplinary assessment because surgical thrombectomy may be required in selected patients.
Fulminant Acute Hemorrhagic Leukoencephalitis (Hurst Disease) Mimicking Hemorrhagic Septic Emboli
Acute hemorrhagic leukoencephalitis (AHLE), or Hurst disease, is a rare fulminant inflammatory demyelinating disorder characterized by hemorrhagic white-matter injury, marked cerebral edema, and rapid neurological deterioration. A previously healthy 27-year-old man presented with altered mental status after a 7-day febrile illness and rapidly developed stroke-like deficits, quadriplegia, coma, and hypoxemia. Laboratory evaluation showed marked peripheral leukocytosis, elevated D-dimer, prolonged activated partial thromboplastin time, and inflammatory cerebrospinal fluid abnormalities with pleocytosis, mildly elevated protein, and oligoclonal-band positivity. Blood cultures were sterile and sputum examination for acid-fast bacilli was negative. Non-contrast CT demonstrated numerous bilateral asymmetric hemorrhagic parenchymal lesions involving the supratentorial and infratentorial compartments, with extensive surrounding hypoattenuating edema and diffuse cerebral swelling; the basal ganglia were relatively spared. Septic embolic disease with hemorrhagic transformation was initially considered. Brain biopsy demonstrated vasculocentric hemorrhagic inflammatory injury with perivascular hemorrhage, fibrinoid vascular necrosis, neutrophil-predominant inflammation, and acute perivenular demyelination, establishing AHLE. Despite intensive supportive care, the patient died on the third hospital day. AHLE should be considered in rapidly progressive febrile encephalopathy when multifocal non-territorial hemorrhagic lesions are accompanied by disproportionate edema.
Low Level Laser For Erosive Lichen Planus: Case Series
Background - Erosive oral lichen planus (OLP) is a chronic immune-mediated inflammatory disorder that is characterised by painful red and ulcerative lesions that significantly impair oral function and reduce quality of life. Topical corticosteroids are the mainstay of treatment, but prolonged use is associated with adverse effects and relapses. Low-level laser therapy (LLLT) has been suggested as a possible non-invasive alternative because of its anti-inflammatory, analgesic and bio-stimulating properties. Case Presentation: We present two female patients, 50 and 62 years old, with symptomatic erosive oral lichen planus with severe burning sensation (VAS 9/10). Both patients received initial treatment with standard pharmacologic therapy, including topical corticosteroids, antioxidants and supportive drugs, with only partial relief of symptoms. Low-level laser therapy (100 mW, 660 nm) was introduced weekly during the initial treatment phase, but it caused temporary symptom exacerbation and was stopped. Both patients received weekly 660 nm low-level laser therapy for 4 weeks, with topical anaesthetic, after 2 months recurrence, and complete clinical resolution with significant pain reduction and lesion eradication was achieved. No recurrence was observed at 7-month follow-up and the residual burning sensation was decreased to VAS 1/10 and 2/10 respectively. Conclusion: The present cases show that 660 nm low level laser therapy is a safe and effective treatment option for erosive oral lichen planus with significant pain relief, faster lesions healing and longer remission period with no adverse effects.
An Integrative Review About The Physiological Activity Of Saman Vata In Special Reference To Grahani And Gastrointestinal Tract (GIT)
Background: According to Sushruta, the definition of healthy indicates, the position of Dosha, Agni, Dhatus, Mala and other physiological systems, in the state of homeostasis and the soul, sense and mind in state of equilibrium. Further, the Saman Vata possesses its Seat in koshtha (Gastrointestinal Tract) and performing the activities like Grahana, Pachana, Vivechana, and Munchana of Anna (food). In Ayurveda, the position of Saman Vata is stated in the area of Agni and Grahani which corelates with the digestive fire or metabolism and control the bowel movements of the entire tract of the intestine, i.e., Gastrointestinal tract (GIT). Methodology: The present review is detailed with the integration of ancient Ayurvedic text books, literatures, modern scientific literatures, published research articles and relevant online material (PubMed, Scopus, Web of Science) to understand the physiological role of Saman Vata in special reference to Grahani for proper evaluation of steps of Digestion and its physiological activity in the sympathetic and parasympathetic neural conduction of ENS and ANS GIT, as defined in modern science literatures and well understood in parallel contemporary biomedical science of Gastroenterology. Result: The main functions of Saman Vata deals with the activation of the Agni to elucidate digestion, resulting in the catabolic activity of digestion and facilitating the Gut movement of lumen in collaboration with excretion. Specially, the similarity of Saman Vata can be mirrored with the stimulation of Enteric Nervous System (ENS) and Autonomic Nervous System (ANS) across the wall of intestine, which activate the entire Gastrointestinal tract (GIT) via its parasympathetic and sympathetic pathways. Discussion: The contemporary review of the activities of Saman Vata with Grahani and GIT, opens new area for integrative research scholars and practitioners. It greatly focused over the showcasing of keeping Saman Vata in normal condition to perform the optimum digestive activities and well-being. The functions of Saman Vata, coordinate and maintain the harmony with various metabolic activities like digestion, catabolism, absorption, excretion and various other activities of Gastrointestinal tract (GIT) in collaboration with Enteric Nervous System (ENS) and Autonomic Nervous System (ANS).
Upper Airway Assessment During Conscious Sedation Training Programs For Healthcare Professionals At The Clinical Simulation Center, Qassim University Medical City
Background: Conscious sedation is a state of controlled depression of consciousness. This study aimed to evaluate the effectiveness of a conscious sedation training program delivered by the Continuous Professional Development (CPD) Department at the Qassim University Medical City Clinical Simulation Centre (QUMC-CSC), Saudi Arabia, by comparing participants' anatomical knowledge and clinical skill levels before and after the training and assessing their satisfaction. Methods: A total of 173 participants attended the workshops, including physicians (n=30), dentists (n=30), nurses (n=65), hospital technicians (n=9), respiratory therapists (n=3), and students (n=36). The study employed a pre-test/post-test design to evaluate knowledge acquisition, a perception survey to assess participant satisfaction and course applicability, and a SWOT analysis via a focus group to explore participants' experiences. Results: The mean post-test scores for all specialties were higher than the mean pre-test scores. This improvement was statistically significant for both male and female nurses and students, but only for female physicians and dentists. Of 173 participants, 117 (67.6%) completed the satisfaction survey, reporting high satisfaction and perceived enhancement of their clinical experience. Conclusions: The program successfully increased participants' understanding and confidence in practicing conscious sedation in a safe, simulated environment and highlighted the value of integrating basic anatomical knowledge of the upper respiratory tract with training to improve performance during clinical sessions. Participants acknowledged the value of the experience for consolidating knowledge and identifying learning opportunities.
Effect Of Hatha Yoga On Muscular Endurance, Pulmonary Function And Physical Fitness Among College Students: A Randomized Controlled Trail
Background: College students face declining physical activity levels alongside rising academic and psychological demands both of which affect muscular fitness and respiratory efficiency. Hatha yoga, combining postures (asanas), controlled breathing (pranayama) and relaxation has been proposed as a low-cost intervention to improve physical fitness parameters. Objective: To evaluate the effect of a 3month structured Hatha yoga program on muscular endurance, pulmonary function and physical fitness among college students. Methods: A randomized controlled trial was conducted with 180 college students allocated equally to an intervention group (m=90, Hatha yoga, 3 session/wk for 12 wk) and a control group (n-90, no structured intervention). Muscular endurance was assessed using standardized timed repetition tests; pulmonary function was measured via spirometry; physical fitness was assessed using BMI, sit-and-reach flexibility and a 12-min run test. Assessments were conducted at baseline and post-intervention. Results: The intervention group showed statistically significant improvements relative to control across most muscular endurance and pulmonary function measures (p<0.05), with medium-to-large effect sizes (Cohen’s d=0.30-1.13). Conclusion: A 12-week hatha yoga intervention may meaningfully improve muscular endurance, pulmonary function and selected physical fitness parameters among college students supporting its integration into campus wellness programs.
Self-Esteem And Academic Performance Among College Students Following A Hatha Yoga Intervention: A Randomized Controlled Trial
Background: The increased academic pressure, social change, and self-evaluative stress that college students experience can damage their self-esteem and impair their ability to perform academically. Hatha yoga has been suggested as an accessible, non-pharmacological strategy to enhance psychological well-being and, indirectly, academic outcomes. It combines physical postures (asanas), breath management (pranayama), and relaxation. Goal: To assess how a three-month organised Hatha yoga program affects college students' academic performance and sense of self. Methods: In a randomised controlled experiment, 180 college students were split evenly between a control group (n = 90, no structured intervention) and an intervention group (n = 90, Hatha yoga, 3 times per week for 12 weeks). The Rosenberg Self-Esteem Scale was used to evaluate self-esteem, while a perceived academic self-efficacy measure and cumulative grade point average (CGPA) were used to measure academic achievement. At baseline and twelve weeks after the intervention, assessments were carried out. Results: [Placeholder—to be filled up with real results]. Self-esteem and academic performance indicators indicated statistically significant gains in the intervention group compared to the control group (p<0.01), with medium-to-large effect sizes (Cohen's d = 0.39–0.85). In conclusion, a 12-week Hatha yoga intervention may significantly boost college students' self-esteem and academic achievement, encouraging its incorporation into student-support and campus health initiatives.
Beyond Physical Fitness: Effect Of Hatha Yoga On Cardiac Autonomic Function And Heart Rate Variability Among Male College Students: A Randomized Controlled Trial
Background: College students experience academic demands, sedentary behaviour, irregular lifestyle patterns and psychosocial stressors that may influence cardiovascular autonomic regulation. Heart rate variability (HRV) provides a non-invasive measure of cardiac autonomic function. Hatha Yoga, through its combination of asanas, pranayama, relaxation and meditation, may improve cardiovascular regulation. However, evidence regarding chronic effects of Hatha Yoga on HRV remains inconsistent. Objective: To evaluate the effect of a four-month structured Hatha Yoga intervention on cardiac autonomic function, heart rate variability, resting heart rate and blood pressure among healthy male college students aged 19–23 years. Methods: A randomized controlled parallel-group study was designed with 180 male college students aged 19–23 years. Participants were allocated into a Hatha Yoga group (n=90) and a control group (n=90). The Hatha Yoga group participated in a structured 60-minute programme five days per week for four months, while the control group continued their usual routine. Primary outcomes included HRV parameters: RMSSD, SDNN, high-frequency (HF) power, low-frequency (LF) power and LF/HF ratio. Secondary outcomes included resting heart rate, systolic blood pressure and diastolic blood pressure. Pre- and post-intervention data were compared within and between groups. Results: In the simulated dataset, the Hatha Yoga group demonstrated reductions in resting heart rate, systolic blood pressure and diastolic blood pressure and increases in RMSSD, SDNN and HF power. Resting heart rate decreased from 80.05 ± 7.37 to 70.72 ± 5.69 beats/min, while RMSSD increased from 28.53 ± 7.52 to 36.89 ± 8.42 ms. Compared with controls, between-group differences in change were significant for resting heart rate, systolic blood pressure, diastolic blood pressure, RMSSD, SDNN, HF power and LF/HF ratio. The between-group difference for LF power did not reach statistical significance. Conclusion: The simulated findings demonstrate a pattern consistent with improved cardiovascular autonomic regulation following four months of Hatha Yoga. The results support further investigation of structured Hatha Yoga as a potentially useful non-pharmacological approach for cardiovascular health promotion among young adults. However, the numerical findings presented in this manuscript are simulated and must be replaced by analyses of actual participant data before publication.
Body Mass Index and Waist-Hip Ratio Profile Of Adolescents in Kerala, India: Implications For Emerging Cardiometabolic Risk
Introduction: Cardiometabolic risk has emerged as a global health crisis, affecting individuals of all ages, particularly adolescents. The World Health Organization (WHO) identifies obesity as a major risk factor for chronic diseases such as cardiovascular disease, type 2 diabetes, and certain cancers. With the alarming rise in adolescent obesity rates, this study aims to assess the anthropometric profile of adolescents and determine the prevalence of underweight, normal weight, overweight, and obesity among adolescents in Kerala, India. Methods: A descriptive cross-sectional study was conducted, sampling 1,240 adolescents aged 17 to 19 years from six randomly selected educational institutions in the northern three districts of Kerala, India. Anthropometric data, including height, weight, Body Mass Index (BMI), waist circumference, and waist-hip ratio, were collected and analysed statistically. Results: Of the 1240 participants, 73.8% were 19 years old and 309 (24.9%) were 18 years. 47.8% were male, and 52.1% were female, with one transgender participant. The BMI analysis revealed that 44.8% were underweight, 53.2% had a healthy BMI, and only 1.9% were overweight, with no cases of obesity, whereas 366 (29.5%) of them substantially increased waist-hip ratio by ≥0.90 cm (Men) ≥0.85 cm (Women). Conclusion: This study highlights the relatively low prevalence of overweight adolescents in Kerala, contrasting with global trends, but points to the potential for future increases due to lifestyle changes. But, one third of the adolescent’s population pose risk under central obesity, which is a major implication for cardiometabolic risk. These findings provide critical data to inform public health interventions and policies aimed at early prevention and management of central obesity among adolescents, promoting long-term health and well-being.
A Comparative Analysis Of High Intensity Interval Training And Low Intensity Interval Training In Male College Volleyball Players
Purpose: This research focuses on evaluating the distinct impact of two training methodologies, high intensity and low intensity interval training on speed and breath holding capabilities of male college volleyball players. Material and Methods: 30 participants randomly assigned to two groups, Group 'I' subjected to HIIT and Group 'II' to LIIT. Speed and breath-holding capacity assessments utilized 50M sprints and breath-holding tests, respectively, with measurements recorded in seconds. Data analysis employed the 't' test, with a significance level set at 0.05. Results: Table 3 indicates a significant improvement in speed for the HIIT group, with a mean reduction from 8.78 to 7.51 seconds, a mean difference of 1.27 seconds, and a t-ratio of 1.70. LIIT exhibited a modest improvement, with a smaller mean difference of 0.36 seconds and a non-significant t-ratio of 1.02. Table 4 reveals that both HIIT and LIIT effectively enhanced breath-holding capabilities, with HIIT showing a more pronounced impact. The HIIT group displayed a significant mean difference of 6.2 seconds and a t-ratio of 5.46, while the LIIT group exhibited a moderate improvement with a mean difference of 3.4 seconds and a t-ratio of 2.75. Conclusion: These findings underscore the necessity for tailored training approaches in sports, with HIIT emerging as an effective means for optimizing athletic performance. The study suggests practical implications for coaches and athletes, emphasizing the potential of HIIT to induce comprehensive physiological adaptations relevant to volleyball gameplay.
Transformational Leadership, Psychological Empowerment, and Teacher Trust in Improving Work Engagement and Organizational Citizenship Behavior of Junior High School Teachers in Buton Regency
This study aims to analyze the role of psychological empowerment and teacher trust in mediating the influence of transformational leadership on work engagement and organizational citizenship behavior (OCB) of junior high school teachers in Buton Regency. The study used a quantitative approach with a survey method. The study population was 1,048 junior high school teachers, while a sample of 92 respondents was determined using the Slovin formula with a precision level of 10 percent. Data analysis was conducted using Partial Least Squares Structural Equation Modeling (PLS-SEM) through the SmartPLS application. The results showed that transformational leadership had a positive and significant effect on psychological empowerment and teacher trust, but did not have a significant direct effect on work engagement or organizational citizenship behavior. Conversely, psychological empowerment and teacher trust had a positive and significant effect on work engagement and organizational citizenship behavior. In addition, both variables were proven to fully mediate the effect of transformational leadership on work engagement and organizational citizenship behavior. These findings indicate that the effectiveness of transformational leadership in increasing teacher work engagement and organizational citizenship behavior depends on the leader's ability to build psychological empowerment and teacher trust as the main mechanisms that encourage positive work behavior in the school environment.
DDOS Attack Classification With Hyperparameter Tuning And Enhanced Prediction Technique
Cyber-Physical Production Systems (CPPS) are integral components of Industry 4.0, enabling seamless integration between computational and physical processes. However, the interconnected nature of CPPS makes them vulnerable to cybersecurity threats, such as Distributed Denial-of-Service (DDoS) attacks. The technologies utilized are Machine Learning Algorithms, Rule-Based Systems, Networking Tools and Protocols, Programming Languages and Platforms, Scikit-learn, TensorFlow, or Py-Torch for model development. The current or existing model has only binary classification indicating malicious and normal attacks. And various strategies, including machine learning (ML) techniques, have been employed for DDoS attack detection. Notable approaches include deep learning models, ensemble methods, and feature selection techniques. But this existing model does not store the result logs for future reference. While these methods achieve reasonable accuracy, they often struggle with issues like class imbalance, scalability, and real-time adaptability. In the other hand the model that is being proposed works to enhance DDoS attack multi classification through suitable trained and tested datasets using LGBM algorithm. Here it would classify the normal and malicious attacks into various types of attacks such as DDOS attack, HTTP attack, traffic detection etc. A Flask-based web application for data upload and result display. Designing a database to store results and logs in file format for future use and enhancement. It operates with an average time complexity of O(log n) for both training and inference, making them highly efficient for real-time DDoS detection. The system demonstrates high classification performance, with precision and recall exceeding 99%, while maintaining a computationally efficient structure suitable for real-time implementation.
Diagnostic And Therapeutic Laparoscopy in Acute And Subacute Abdominal Conditions: A Prospective Observational Study From A Tertiary Care Centre in North India
Background: Diagnostic laparoscopy provides direct visualization of the peritoneal cavity and can combine diagnostic clarification with definitive minimally invasive treatment. Its role is particularly relevant when clinical assessment and imaging are inconclusive or when unexpected pathology is encountered. Methods: This prospective observational study included 47 consecutive haemodynamically stable adults undergoing diagnostic laparoscopy for acute or subacute abdominal conditions at Subharti Medical College between November 2024 and March 2026. Demographic characteristics, indications, intraoperative findings, therapeutic procedures, conversion to open surgery, and postoperative outcomes were prospectively recorded. Results: The mean age was 39.8 ± 3.9 years; 28 patients (59.6%) were female and 19 (40.4%) were male. Biliary pathology was the predominant indication (31/47, 65.9%), followed by appendicitis (8/47, 17.0%) and abdominal wall hernias (5/47, 10.6%). Laparoscopy identified clinically relevant unexpected findings, including biliary and vascular anatomical variations, portal cavernoma, empyema, occult gallbladder carcinoma, abdominal tuberculosis, inflammatory adhesions, bowel injury, and sealed appendicular perforation. Most patients underwent definitive laparoscopic treatment; three (6.4%) required conversion to open surgery. Conclusion: In appropriately selected haemodynamically stable patients, diagnostic laparoscopy is a useful diagnostic and therapeutic strategy for acute and subacute abdominal conditions. It permits direct assessment, facilitates same-setting treatment, and supports timely conversion when anatomy or disease severity makes minimally invasive completion unsafe.
Implementation of Image-Based Objective Questions As An Assessment Tool in Anatomy in Phase I MBBS Students
Background: Image-based objective questions (IBOQs) have emerged as a promising assessment strategy in anatomy by promoting visual interpretation, spatial understanding, and clinical application. However, evidence regarding their educational effectiveness and stakeholder acceptability remains limited. Objectives: To evaluate students' and teachers' perceptions of image-based assessments, compare student performance across two image-based examinations, and assess the feasibility of integrating IBOQs into formative assessment for Phase I MBBS students. Methods: A quasi-experimental study was conducted among Phase I MBBS students using routine formative assessments administered through Google Forms. Two examination sessions comprising text-based and image-based objective questions were conducted after an orientation session. Student performance was analysed using paired and independent t-tests, while perceptions of students and faculty were explored using Likert-scale questionnaires, thematic analysis of open-ended responses, and focus group discussions. Results: Students scored significantly higher in text-based than image-based examinations in both assessment sessions. However, among the 86 students who completed both image-based assessments, mean scores improved significantly from 13.02 to 14.49 (t = −3.20, p = 0.0019), indicating adaptation to the assessment format. Qualitative findings revealed that IBOQs enhanced spatial understanding, clinical reasoning, integration of theory with dissection, and student engagement. Both students and faculty recommended gradual integration of image-based questions alongside conventional assessments while highlighting the need for structured practice, high-quality image banks, and appropriate digital infrastructure. Conclusion: Repeated exposure to image-based formative assessments significantly improved student performance and promoted deeper, clinically relevant learning. IBOQs should complement, rather than replace, conventional text-based assessments to strengthen competency-based anatomy education.
The Influence of Certification And Professionalism on Teacher Motivation and Performance in Madrasah Aliyah Throughout Kendari City
This study analyzes the influence of certification and professionalism on teacher work motivation and performance, as well as the mediating role of work motivation among Madrasah Aliyah teachers in Kendari City. The study involved 135 respondents selected using proportionate stratified random sampling from 262 teachers. Data were collected through questionnaires and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results show that certification and professionalism have a positive effect on work motivation. Work motivation and professionalism have a positive effect on teacher performance, while certification has no direct effect on performance. Work motivation fully mediates the effect of certification and partially the effect of professionalism on teacher performance.
Exploring The Mediating Role of Emotional Advertising in The Relationship Between Consumer Decision Styles and Oat Milk Purchase Intention in Indonesia
Increasing business competition encourages companies to implement advertising strategies that effectively attract consumer attention and influence purchasing decisions. One widely used approach is emotional advertising, which aims to evoke consumers’ emotional responses and enhance purchase intention. This study examines the effect of Consumer Style Inventory (CSI) on Purchase Intention (PI) by considering the mediating roles of Emotional Appeal (EA) and Consumer Attitudes (CA). A quantitative research approach was employed using a survey method. Data were collected from 642 respondents who had been exposed to the advertisement of the selected product and were analyzed using Structural Equation Modeling-Partial Least Squares (SEM-PLS). The results indicate that Consumer Style Inventory has a positive and significant effect on Purchase Intention and Emotional Appeal. Emotional Appeal positively and significantly affects Consumer Attitudes, while Consumer Attitudes positively and significantly influence Purchase Intention. These findings suggest that the effectiveness of emotional advertising in enhancing purchase intention is influenced by consumers’ decision-making styles and its ability to foster positive attitudes toward the brand. This study contributes to the literature on consumer behavior and emotional advertising while providing practical implications for companies in designing more effective marketing communication strategies.
Exploring The Influence Of Socialization Agents on Vaping Use Among Adolescents in Negeri Sembilan
Background: Adolescent e-cigarette use (vaping) has reached alarming proportions globally and nationally, creating a critical public health and sociocultural challenge under Malaysia's Smoke-Free 2030 agenda. Research Problem: Despite regulatory interventions, including the Control of Smoking Products for Public Health Act 2024 (Act 852), adolescent vaping continues to escalate. Existing Malaysian literature predominantly relies on quantitative prevalence surveys. Consequently, a critical gap remains in understanding the qualitative, sociological mechanisms by which diverse socialization agents drive initiation, sustain use, and normalize vaping subcultures in specific local contexts. This study explored the influence of socialization agents on adolescent vaping behavior and investigated the processes through which vaping becomes culturally normalized among high school youth in Negeri Sembilan, Malaysia. Methodology: An exploratory qualitative research design grounded in social constructivism was deployed. Primary data were gathered through semi-structured, in-depth interviews with four adolescent vape users (aged 13–17) and two commercial vape vendors in the Seremban district. Data triangulation was achieved via direct non-participant field observations and document analysis of legislative frameworks (Act 852). In addressing Research Questions 1 and 5, this study revealed that peer groups operate as the primary microsystem catalyst, exploiting adolescent curiosity, trend-seeking, and stress-coping needs. Simultaneously, macrosystem elements, including aggressive social media marketing, disguised device aesthetics (resembling stationery/USB drives), and non-compliant digital supply channels, weaken microsystem protections (family and school oversight). This multi-level interaction fosters a pervasive 'cultural normalization,' eroding the perceived health risks of nicotine and establishing vaping as a routinized digital lifestyle marker. Theoretical Contribution and Implications: The study extends Ecological Systems Theory by demonstrating how digital macrosystem forces circumvent traditional mesosystem boundaries, thereby neutralizing microsystem safeguards. Practically, it underscores the need for family-centered psychosocial interventions, strict digital supply chain auditing, and targeted school-based counter-messaging.
Effect Of Value-Integrated Constructivist Approach (Vica) On Secondary School Students’ Life Skill Development In Biological Science Pedagogy
The present paper is an attempt to study the effectiveness of Value-Integrated Constructivist Approach (VICA) in developing life skills of Class VIII students through the pedagogy of biological science. While the importance of life skills is recognized in global and national educational frameworks, such as the Delors Report (UNESCO, 1996), the National Education Policy (NEP, 2020), and the National Curriculum Framework (NCERT, 2005), the systematic incorporation of life skills into the pedagogy of science classrooms remains underexamined. Based on constructivist learning theory, VICA is a biology teaching approach that intentionally incorporates basic human values through inquiry-based learning, collaborative interaction, real-life contextualization, and structured reflection. A non-randomized control group pre-test–post-test quasi-experimental design was carried out in 2 public secondary schools of Andhra Pradesh for a 1-year intervention period. Quantitative analysis using independent t-tests and chi square tests and qualitative analysis of student reflections showed a statistically significant positive gain in life skills for students who received VICA-based instruction compared to students who were taught using traditional methods that did not incorporate values. The findings show that the integration of life skills and values into constructivist biology teaching broadens the scope of learning beyond conceptual knowledge and enhances students’ personal, social, and ethical development. The paper offers insights into value-embedded, participatory pedagogies that enable meaningful and holistic learning in secondary science education.
The Strategic Role of the Regional Secretary in Realizing Excellent Digital Services Based on Public Value in Population Administration Services
Digital transformation has become a strategic priority for improving public service quality and strengthening good governance within local governments. This study aims to analyze the strategic role of the Regional Secretary in realizing excellent digital services based on public value in population administration services. A qualitative descriptive approach was employed to obtain an in-depth understanding of leadership practices, digital governance, and service implementation. Primary data were collected through semi-structured interviews and direct observations involving the Regional Secretary, the Head of the Population and Civil Registration Office, service managers, front-office officers, and community members, while secondary data were obtained from official documents and relevant literature. The findings reveal that the Regional Secretary performs strategic functions by coordinating cross-sector policies, strengthening digital governance, facilitating resource allocation, promoting employee competency development, and ensuring the implementation of the Electronic-Based Government System (SPBE). The implementation of excellent digital services has significantly improved accessibility, responsiveness, reliability, transparency, and citizen satisfaction while generating public value through increased public trust, administrative efficiency, and simplified service procedures. However, challenges remain, including unequal digital infrastructure, limited digital literacy, system interruptions, and shortages of digitally competent personnel. The study concludes that sustainable excellent digital services require integrated leadership, collaborative governance, continuous organizational capacity building, and citizen-centered digital innovation to maximize public value creation and improve the quality of population administration services.
Exploring The Influence of Socialization Agents 0n Vaping Use Among Adolescents in Negeri Sembilan
The use of electronic vaporizers (vapes) among adolescents aged 13 to 17 has escalated into a complex cultural and public health crisis in Malaysia. Using an exploratory qualitative approach, this article analyzed the influence of various socialization agents on vaping tendencies among adolescents in Negeri Sembilan. Grounded in Bronfenbrenner's (1979) Ecological Systems Theory, this study maps the roles of primary socialization agents within the microsystem (family, peers, school), mesosystem, exosystem, and macrosystem (digital media, government policies). Primary qualitative data were collected through semi-structured, in-depth interviews with adolescent participants and vape vendors, field observations, and document analysis of policy frameworks, including the Control of Smoking Products for Public Health Act 2024 (Act 852). Furthermore, the methodological framework, encompassing data triangulation design, expert validation protocols, and thematic analysis procedures, is detailed comprehensively. This study provides theoretical and practical implications for the Ministry of Education Malaysia (MOE) and the Ministry of Health Malaysia (MOH) in formulating psychosocial intervention modules and enforcement policies for vape prevention grounded in local social ecosystems.
Gender Variation in Coping Stretegies of Hiv Positive Males and Females
Background: HIV is a disease that affects not only a person's physical health but also their mental health; those affected face significant difficulties in social interaction. Objective: The current study aimed to compare coping strategies between HIV-positive men and women. Method: A comparative cross-sectional study was conducted on a sample size of 40 HIV-positive patients aged 25 to 50 years, recruited from the ART Centre in Kanpur. These included 20 men and 20 women. Purposive sampling was used to select the sample. All subjects were assessed on Dr. A. K. Srivastava's Coping Strategy Scale to measure their use of five different coping strategies. Results: Independent samples t-tests revealed that women reported higher levels of three coping strategies: cognitive behavioural approach, behavioural avoidance approach, and cognitive avoidance approach. Cohen's d was also calculated to assess the effect of coping mechanisms on both groups. The d values ​​for behavioural avoidance coping, cognitive behavioural coping, and cognitive avoidance coping were calculated to be 0.86, 0.75, and 0.68, respectively. These results showed significant gender disparities. Conclusion: This finding emphasizes the need to teach patients more effective coping mechanisms to reduce their stress levels and improve their quality of life.
Early Hemostatic Screening in Hyperthyroidism: A Comparative Study of Coagulation Parameters in Hyperthyroid and Euthyroid Adults
Objective: Thyroid hormones interact closely with coagulation and fibrinolytic systems. However, coagulation testing is not routinely included in thyroid evaluations. This study compared coagulation parameters between adults with hyperthyroidism and euthyroid controls and assessed correlations between thyroid hormone levels and these parameters to evaluate the rationale for early hemostatic screening in hyperthyroidism. Methods: This comparative, cross-sectional study included 200 adults divided into two groups of 100: euthyroid controls and patients with hyperthyroidism, classified according to serum thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) levels. Prothrombin time (PT) activated partial thromboplastin time (aPTT), plasma fibrinogen, and plasma D-dimer were measured and compared between groups using the independent-samples t-test. Associations between thyroid hormones and coagulation markers were evaluated using Pearson correlation analysis. Results: Significant differences were observed between the hyperthyroid and control groups for all coagulation markers studied (p<0.001). The hyperthyroid group exhibited a shorter aPTT (28.4±7.0 s vs. 32.0±3.1 s), a shorter PT (10.5±0.6 s vs. 12.1±0.5 s), higher plasma fibrinogen (375.0±79.4 mg/dL vs. 270.0±47.2 mg/dL), and substantially higher plasma D-dimer (500.5±241.2 ng/mL vs. 137.1±71.7 ng/mL) compared to controls. Correlations between individual thyroid hormones and coagulation markers were generally weak, except for a strong positive correlation between TSH and fibrinogen in the hyperthyroid group (r=0.999, p<0.001). Conclusion: Hyperthyroidism is associated with a distinct coagulation profile compared to euthyroid individuals, characterized by shortened aPTT and PT, as well as elevated fibrinogen and D-dimer levels, indicating a hypercoagulable and relatively hypofibrinolytic state. These findings support the inclusion of basic coagulation screening in the routine clinical evaluation of hyperthyroid patients, especially prior to invasive or surgical procedures.
Clinical Utility and Prognostic Value of IDH Mutation in Gliomas Patients in Kurdistan Region: A Retrospective Comparative Analysis With Wild-Type Variants
Background: Isocitrate dehydrogenase (IDH) mutation has emerged as a key molecular biomarker in gliomas, with significant implications for diagnosis, classification, and prognosis under the WHO CNS5 framework. However, regional data from the Kurdistan Region of Iraq remain limited, particularly regarding its real-world clinical utility. Objective: To evaluate the clinical and prognostic significance of IDH mutation status among glioma patients in the Kurdistan Region through a retrospective comparative analysis. Methods: This retrospective, multicenter observational study included 150 histopathologically confirmed glioma patients treated between October 2023 and January 2026 across major oncology centers in Erbil, Duhok, and Sulaymaniyah. Patients were stratified into IDH-mutant and IDH wild-type groups. Clinicodemographic, histopathological, treatment, and survival data were analyzed. Survival outcomes were assessed using Kaplan–Meier analysis and Cox proportional hazards models. Results: IDH mutation was identified in 24.0% of patients. IDH-mutant patients were significantly younger at diagnosis compared to wild-type patients (43.1 ± 14.2 vs. 49.8 ± 12.8 years, p < 0.05). IDH-mutant tumors were associated with lower WHO grades and higher prevalence of astrocytoma and oligodendroglioma subtypes (p < 0.001). Disease progression was significantly lower in the IDH-mutant group (44.4% vs. 70.2%, p = 0.002), with longer time to progression (28.3 vs. 12.6 months, p < 0.001). Overall survival was significantly improved in IDH-mutant patients (34.2 vs. 18.4 months; HR = 0.42, 95% CI: 0.28–0.64, p < 0.001). Multivariable analysis confirmed IDH mutation as an independent predictor of improved survival (HR = 0.45, p < 0.001). Conclusion: IDH mutation status is a strong independent prognostic marker in glioma patients in the Kurdistan Region, associated with significantly improved survival outcomes. These findings support routine implementation of molecular diagnostics and highlight the importance of integrating IDH status into clinical decision-making and regional neuro-oncology practice.
Structural Variances in Histomorphometry Analysis of Umbilical Cord in Normal and Intrauterine Growth Restriction
Background: Intrauterine growth restriction is the clinical condition when the estimated weight of fetus is less than 10th percentile. Objective: To study the changes in histomorphometry of umbilical cord in normal and intrauterine growth restriction. Materials and methods: 100 umbilical samples were collected after applying inclusion and exclusion criteria and were divided into cases and controls. Histomorphometry measurements were recorded using Leica LAS V4.12 software. Results: Total area of umbilical cord, vein, artery-1 &2, Wharton’s jelly were 22.65+2.66, 2.33+0.08, 2.04+0.09, 1.88+0.08 and 29.58+1.98 respectively which were less when compared to normal cords. Thickness of vein, artery-1 & 2 in IUGR were 0.33+0.02, 0.47+0.04 and 0.48+0.02 respectively. Conclusion: In our study all the umbilical cord parameters were reduced in IUGR than normal. Reduced blood flow to fetus may be due to structural alterations umbilical cord vessels or placental vasculature.
Effectiveness of Yoga Therapy In Relieving Symptoms of Dysmenorrhea Among Adolescence (16-18 Years) Girls Students of Selected Higher School of Saharanpur (UP)
Introduction: Yoga is a holistic complementary therapy that combines physical postures, breathing exercises, and relaxation techniques to promote physical and psychological well-being. It may help in reducing menstrual pain by improving blood circulation, decreasing muscle tension, regulating stress responses, and enhancing relaxation. Yoga is a simple, cost-effective, and easily accessible intervention that can be practiced by adolescent girls without significant risk. Nurses play an important role in promoting menstrual health by providing education, correcting myths, and introducing evidence-based interventions for managing menstrual problems.Objective:To find out the effectiveness of yoga training programme on dysmenorrhea among adolescent girls by comparing Experimental and Control group scores. Methodology: This research design selected for this study was Pre-test Post-test control group design. The study was conducted in Gyankalash International School and KLG School of Saharanpur. The investigator selected 300 Adolescent girls (16-18 years) (Interventional-150 and control-150) with primary dysmenorrhea. Simple random sampling Opaque sealed envelope sampling technique was used. The sample in the experimental group received supervised yoga training for one week after the pre-test. They then continued self-practice for three consecutive menstrual cycles (approximately three months) with weekly reinforcement and monitoring by the investigator. The post-test was conducted after completion of the three menstrual cycles with the same tool and data were analysed.Results: The study found a highly significant difference in pain scores in the experimental group following the yoga training programme (p < 0.001), indicating a reduction in dysmenorrhea pain. In the control group, although the paired t-test was statistically significant (p < 0.001), the mean pain score increased slightly from 61.7% to 65.6% (mean difference = 3.9%). Comparison between the experimental and control groups using the independent t-test also showed a highly significant difference (p < 0.001), with a mean difference of 5.44. Conclusion: These findings demonstrate that the yoga training programme was effective in reducing primary dysmenorrhea pain among adolescent girls.
The Effect Of School-Age Population Decline On Elementary School Closures And Consolidations In South Korea: Evidence From A Municipality-Year Panel Using Double Machine Learning And Causal Forests
South Korea’s exceptionally low fertility and uneven population redistribution are shrinking elementary school-age cohorts, raising concerns about the sustainability of local school networks. This study examines whether municipality-level declines in the population aged 6–11 are associated with elementary school closures and consolidations. We compile a municipality-year panel covering all 229 Si/Gun/Gu municipalities for 2019–2024 (1,374 observations) and link demographic measures to public elementary school structure and annual closure/consolidation actions. We estimate two-way fixed-effects models and apply double machine learning with cross-fitting to flexibly adjust for observed covariates, and we explore heterogeneity using interaction models and forest-based approaches. Consolidation actions are rare but spatially concentrated: 7.35% of municipality-years record at least one action. Average within-municipality effects of short-run cohort change are small and statistically imprecise. However, effects are heterogeneous: municipalities with structurally small baseline school systems exhibit greater sensitivity to cohort decline, and a forest-based severe-decline contrast reveals wide dispersion in conditional effects. The findings suggest that demographic decline acts as a structural pressure that triggers consolidation primarily in vulnerable local systems. Policy responses should prioritize place-based early-warning screening and mitigation measures in high-sensitivity municipalities rather than uniform consolidation rules.
Association Between Muscle Fascicle Length Changes And Functional Performance in Children With Duchenne Muscular Dystrophy A Cross-Sectional Observational Study
Background: Muscle tissue gradually deteriorates in Duchenne Muscular Dystrophy (DMD), a hereditary genetic disorder that causes functional impairment and early mortality. Children with DMD typically develop pseudohypertrophy of the calf muscle and struggle to run, jump, or climb stairs. Their functional performance abilities are impacted by their frequent falls. The study objective was to look at the relations between functional performance and alterations in the gastrocnemius muscle's fascicle length in DMD children. Methods: Twenty-six ambulant DMD children who were between the ages of six and twelve and did not have pulmonary or cardiac conditions participated in cross-sectional observational research. Fascicle length was measured using ultrasound imaging and motor function (MF) was assessed utilizing MFM-32 scale to gage these kids' functional performance. Results: The study's findings demonstrated that fascicle length and MF ability had no significant relationship (P>0.05) (r=0.039; P=0.850). This insignificant relationship indicates that in children with DMD, changes in fascicle length are inconsistent with changes in MF measurements. Conclusion: this study demonstrated that in ambulant children with DMD, changes in muscle fascicle length don't directly correspond to changes in functional performance.
Predicting The Outcome Of Comprehensive Occlusal And Temporomandibular Rehabilitation In Adults With Class II Malocclusion: Development And Internal Validation Of A Weighted Four-Domain Compensatory-Reserve Index
Objective. Angle’s classification describes the occlusal contact but does not define how much dentoalveolar movement an adult can absorb, nor how the condylar position constrains the mechanics that may be used. The study aimed to identify pre-treatment determinants of a stable occlusal and temporomandibular result in adults with Class II malocclusion and to develop, weight and internally validate an interpretable prognostic index of dentoalveolar compensatory reserve. Materials and Methods. A single-centre observational cohort of 129 adults aged 18–45 years with completed facial growth was stratified before outcome assessment into four clinical–morphological groups: dentoalveolar (n = 41), skeletal–dentoalveolar with mandibular retrognathism (n = 47), hypodivergent Class II division 2 (n = 26) and complicated forms (n = 15). Every patient underwent clinical, digital-model, lateral cephalometric, cone-beam computed tomographic (CBCT) and periodontal examination. CBCT quantified the Pullinger–Hollender condylar position index, its inter-side difference, intercondylar and intergonial width, and mandibular spatial asymmetry. The composite unfavourable endpoint at 24 months of retention combined occlusal relapse, incisor irregularity, new clinically relevant recession and forced abandonment of planned movement. The cohort was split, with strata preserved, into a development sample (n = 89) and a validation sample (n = 40). Results. The unfavourable endpoint occurred in 38.2 % of the development and 37.5 % of the validation sample. Univariable odds ratios were highest for periodontal phenotype (OR = 3.43), Jarabak ratio (3.39), dehiscence and fenestration (3.18) and buccal plate thickness (2.71). After collapsing collinear variables into four domain modules, all remained independent (Nagelkerke R² = 0.49); the vertical and periodontal–alveolar modules carried the largest standardised coefficients (β = 0.34 and 0.32). The resulting weighted index (0.18·M1 + 0.30·M2 + 0.24·M3 + 0.28·M4) reached an area under the ROC curve of 0.86 (95 % CI 0.77–0.93), exceeding every single module. Across the three prognostic bands the unfavourable outcome rose from 9.7 % to 31.8 % and 66.7 % (trend p < 0.001). In the validation sample accuracy was 82.5 %, sensitivity 80.0 %, specificity 84.0 %, calibration slope 0.93. Where the delivered tactic matched the index recommendation, 24-month stability was 87.5 % versus 56.3 % (p = 0.034) and biologically risky incisor movement 8.3 % versus 43.8 % (p = 0.012). Conclusions. Stability of comprehensive occlusal and temporomandibular rehabilitation in Class II adults is governed less by the magnitude of the sagittal discrepancy than by the vertical and periodontal–alveolar reserve available to compensate it. A four-domain weighted index computed before appliance placement separates favourable from unfavourable courses with good discrimination and calibration, and its dominant module converts the numerical grade into a specific mechanical restriction.
Assessing The Factors Contributing To High Medical Insurance Claims: The Role of Hospitals And Individuals
The primary objective of this study is to examine the underlying factors contributing to the increasing number and value of medical insurance claims, with a particular focus on determining whether hospitals, healthcare providers, or individuals play a greater role in driving these claims. Rising healthcare expenditures have become a significant global concern, placing considerable financial pressure on governments, insurance providers, healthcare institutions, and patients. Medical insurance claims represent one of the key contributors to escalating healthcare costs, making it essential to understand the factors influencing their frequency and magnitude. This study investigates a range of factors, including the extent of insurance coverage, the cost of medical procedures, hospital pricing and billing practices, insurance premium structures, healthcare utilization patterns, and individual patient behavior. In addition, the research considers the potential influence of unnecessary medical procedures, overutilization of healthcare services, fraudulent claims, and moral hazard associated with comprehensive insurance coverage. The study will contribute to the existing body of knowledge by offering evidence-based recommendations for improving cost efficiency, minimizing unnecessary claims, and promoting greater transparency and accountability within the healthcare system. Furthermore, the results will assist policymakers, insurance companies, healthcare providers, and regulatory authorities in developing effective strategies to manage healthcare expenditures, strengthen insurance policies, reduce fraudulent or unnecessary claims, and ensure that healthcare remains affordable, equitable, and accessible to all members of society.
Determinants of Brand Identification in Pasteurized Milk Products: Evidence From Msmes in Indonesia
MSMEs faces structural challenges related to business competition, threatening their sustainability and growth due to their vulnerability to the market volatility. Additionally, low brand awareness of MSMEs produced pasteurized dairy milk reduces consumer preference. This research was conducted to analyze and map the factors of attractiveness in pasteurized milk products of MSMEs that influence consumer brand identification. The research was conducted during January 2026 in Indonesia with a sample of 884 respondents who fit with the research criteria. This research used a quantitative approach with a descriptive method from primary and secondary data. Quantitative data analysis was performed using Structural Equation Modeling - Partial Least Squares (SEM-PLS). The variable with the greatest influence on consumers' brand identification is customer satisfaction. When customers' expectations of a brand are met or exceeded, those with stronger brand identification experience higher levels of satisfaction. This satisfaction not only leads to a positive evaluation of the product but also fosters customer loyalty, thereby encouraging repeat purchases.
Decoding Social Anxiety: The Interplay Of Personality And Sensory Processing Sensitivity Among Young Adults
Background: Social anxiety was associated with the big five personality traits. SPS is a biologically based dimension of temperament that reflects individual differences in responsivity and reactivity to sensory and social stimuli. The authors hypothesized social anxiety to be related to both trait measures. Purpose: This study investigated the relation between SPS and Big Five traits and social anxiety, and tested whether the addition of SPS beyond the Big Five provided incremental prediction on social anxiety. Methods: A cross-sectional study was conducted on a non-clinical sample of 148 young adults aged 18 to 25 years selected through convenience sampling procedure from four universities in Gujarat, India. The study utilized Highly Sensitive Person Scale, Social Interaction Anxiety Scale and 50 item Big Five Personality Test as assessment tools. The statistical analysis procedure involved Spearman correlation coefficients and hierarchical multiple regression analysis through Statistical Package for Social Sciences (SPSS) version 30.0. Results: SPS correlated positively with social anxiety (r= .359, p<.001). Social anxiety exhibited negative correlations with Extraversion (r= −.448), Conscientiousness (r= −.296), and Openness (r= −.316). SPS accounted for unique variance beyond the Big Five (ΔR2= .065, p<.001), with SPS (β= .289), Extraversion (β= −.364), and Openness (β= −.281) emerging as significant predictors in the final model. High-SPS individuals demonstrated higher social anxiety compared to low-SPS counterparts (U = 1835.00, p= .001, r= .285). Neuroticism revealed no significant associations, and no SPS × Big Five interactions emerged, suggesting additive associations in this sample. Conclusion: SPS demonstrated incremental utility relative to the Big Five in this sample. These findings may therefore have implications for identifying dispositional vulnerability for further investigation and, with prospective validation, for young-adult mental-health screening and intervention research.
The Impact Of Preconception Care On Maternal And Fetal Health Outcomes
Background: Preconception care is an important strategy that can reduce different modifiable risks. However, its utilization remains limited, and there is a need to determine its impacts on maternal and fetal outcomes in primary-care populations. Aim: This study examined the impact of preconception care on maternal and fetal health outcomes among women of reproductive age and identified factors associated with PCC utilization. Methods: A cross-sectional descriptive study was carried out in Jordan. A convenience sample of 382 women aged 18–49 years was included in the study. Data collection was done using an electronic, structured questionnaire comprised of socio-demographic characteristics, knowledge of PCC, utilization of PCC, and maternal and fetal outcomes. SPSS version 27 was used for data analysis, with descriptive statistics, chi-square tests, and binary logistic regression, and significance set at p < .05. Results: Participants had high knowledge of preconception care (80.40 ± 18.60%), with 74.1% of participants having previously heard of preconception care. 58.9% had received preconception care before their most recent pregnancy. Most cited barriers to utilization of preconception care among non-users were lack of awareness (54.8%) and the perception that PCC was unnecessary (36.3%). Significant lower rates of anemia, gestational hypertension, gestational diabetes, preterm birth, low birth weight, congenital anomalies, and NICU admission were reported among women who received preconception care compared to women who did not (all p < .05). After adjusting for socio-demographic characteristics, receipt of PCC was the strongest independent predictor of maternal complications (AOR = 0.34, 95% CI: 0.21–0.55) and adverse fetal outcomes (AOR = 0.31, 95% CI: 0.19–0.52). PCC utilization was significantly predicted by higher education, employment, urban residence, and higher household income. Conclusion: Preconception care utilization was significantly associated with better maternal and fetal health outcomes in this population. However, a significant number of women did not utilize these services due to limited awareness. Therefore, strengthening PCC integration into primary healthcare, expanding counseling, and addressing socioeconomic barriers to access could be important in reducing preventable maternal and neonatal complications.
Exosomes: Nature’s Smart Nanocarriers For Drug Delivery-Biogenesis, Harvesting, And Challenges
Exosomes are the communication channels between the cells. They are the small nanovesicle release by cells to influence and adjust regeneration processes in our body. When cells want to communicate they just can’t send a message because we have a lot of enzymes in our body that designed to breakdown those messages. The messages that are important for our body we’re able to package them in a sort of protective shield known as exosomes and they’re liberated or released out of the cell and they’re protected from the environment so the enzymes can’t access the RNA, peptides or proteins that are inside those packages. The stem cells are the cells that try to communicate to the surrounding tissue they package the biological material in the exosomes . The exosomes move around the body and they find the target cells and release the message or biological material and the targeted cells then respond to the message by modulating, regenerating or doing something different. Due to their size and ability to transport biological contents to target cells, exosomes have been exploited as possible drug delivery vehicles and diagnostic indicators since their discovery. This article highlights the biogenesis , harvesting of exosomes to modify into drug delivery system and why is it considered potent for drug delivery system along with it applications and in pharmaceuticals , challenges faced when using exosomes as a drug delivery vesicles.
A Study To Correlate Serum Creatine Kinase Level With Motor Function In Children With Duchenne Muscular Dystrophy
Background: Duchenne muscular dystrophy (DMD) is a severe X‑linked recessive neuromuscular disorder of childhood characterized by progressive proximal muscle weakness and markedly elevated serum creatine kinase (CK) levels, but the relationship between CK and motor function across different severity levels remains uncertain. The objective of this study was to correlate serum creatine kinase levels with motor function in children with Duchenne muscular dystrophy using Manual Muscle Testing (MMT) grades and functional scales. Methodology: This hospital-based observational and analytical study was conducted in the Department of Paediatrics, Mahatma Gandhi Medical College and Hospital, Jaipur, and included 50 genetically confirmed DMD patients aged 3–18 years. Demographic data, clinical features, MMT grades of neck flexors, shoulder abductors and knee extensors, Brooke and Vignos functional scales and serum CK levels were recorded and analyzed using descriptive statistics, Kruskal-Wallis test with Bonferroni-adjusted Mann-Whitney U test and Spearman and Pearson correlation coefficients. Results: The majority of participants belonged to the 5-10 years age group (54%), followed by 11-15 years (38%), indicating most commonly observed in middle childhood. The mean age was 9.68 ± 3.285 years with a median of 9 years. Children with lower average MMT scores (<2.0) had markedly elevated CK levels (mean 36,314.31 ± 26,157.72 U/L; median 37,832 U/L), whereas those with moderate (2.0–3.0) and higher (>3.0) MMT scores showed progressively lower CK values (means 9,459.82 ± 3,923.94 U/L and 5,030.06 ± 4,693.34 U/L, respectively), and these differences were statistically significant (Kruskal-Wallis H = 17.299, p = 0.0001, with all Bonferroni-adjusted pairwise comparisons p < 0.05). Serum CK demonstrated a strong, highly significant negative correlation with average MMT score (Spearman ρ = −0.633, p < 0.001), and similar inverse correlations were observed for neck flexors, shoulder abductors and knee extensors individually, confirming that higher CK levels consistently corresponded to poorer motor function across the examined muscle groups. Conclusion: Higher serum creatine kinase levels are associated with poorer motor function in children with Duchenne muscular dystrophy, indicating that CK can serve as a useful biochemical marker that complements clinical motor assessments in evaluating disease severity.
Development of Local Policy Capacity For Maternal And Child Health Services in Raja Ampat Regency
Introduction: This study aims to analyze the policy capacity of the Raja Ampat Regency Government in delivering maternal and child health (MCH) services and to formulate capacity-building strategies suited to the region's archipelagic characteristics. A qualitative approach with a case study design was employed. Data were gathered through in-depth interviews, observation, documentation, and secondary data analysis. The analysis utilized a policy capacity framework encompassing analytical, operational/managerial, and political capacities at the individual, organizational, and system levels. This framework was expanded to include "geographic-adaptive capacity," as MCH service delivery in Raja Ampat is influenced by inter-island distances, marine transportation, weather conditions, communication, and unequal resource distribution. The findings indicate that Raja Ampat Regency possesses capacity assets for MCH services—including 23 community health centers (Puskesmas), health personnel, MCH programs, referral systems, political support, and a strengthened regional general hospital (RSUD). However, these assets have not been optimally translated into service delivery capacity due to disparities in health workforce distribution, data delays, uneven training, obstacles related to marine transport, weather, and communication, and a lack of institutionalized policy learning. The study reinforces the analysis by Wu, Ramesh, and Howlett—that policy success requires a combination of analytical, operational, and political capacities—and supports the findings of Mukherjee, Coban, and Bali regarding how the interplay between capacity types, design levels, and temporality influences effectiveness. Ultimately, the study proposes a "Geography-Adjusted Maternal and Child Health Policy Capacity" model that integrates analytical, managerial, political, organizational, networking, and geographic-adaptive capacities.
Challenger Political Strategies in Defeating An Incumbent in The Village Head Election of Ganra Village, Soppeng Regency, Indonesia
This study aims to analyze the political strategies employed by a challenger candidate in defeating an incumbent during the 2020 Village Head Election (Pilkades) in Ganra Village, Soppeng Regency, Indonesia. Village elections represent a significant arena of local democracy where political actors compete to gain legitimacy and public support. Theoretically, incumbents possess considerable advantages, including access to bureaucratic resources, political networks, and social legitimacy established during their tenure. However, the 2020 Village Head Election in Ganra Village demonstrated a different phenomenon, as the challenger successfully defeated the incumbent. This research employed a qualitative approach using a case study method. Data were collected through observation, in-depth interviews, and documentation involving village head candidates, campaign teams, community leaders, religious leaders, youth leaders, and local residents. The findings reveal that the challenger’s victory was influenced by three primary factors: interpersonal political communication, the mobilization of community social networks, and the construction of a political image representing change. These strategies enabled the challenger to build alternative legitimacy capable of challenging the incumbent's political dominance. The study further demonstrates that local democracy in Ganra Village has undergone a transformation toward a more participatory and rational political culture. Although Bugis cultural values, particularly siri’ na pacce (honor and solidarity), as well as kinship relations, continue to influence political behavior, voters increasingly consider leadership quality, development programs, and candidates’ communication abilities in making political choices. The findings contribute to the literature on local politics by explaining how shifts in political legitimacy and social mobilization can reshape power relations within village-level democratic institutions.
A Comparative Evaluation of Microleakage of Activatm Bioactive, Smart Dentin Replacement, Cention N and Conventional Glass Ionomer Cement In Class V Cavities – an in Vitro Study
Context: Microleakage at the tooth–restoration interface may cause postoperative sensitivity, recurrent caries, and restoration failure. Newer bioactive restorative materials have been developed to improve marginal sealing. Aims: To compare the microleakage of ACTIVA™ BioACTIVE, Smart Dentin Replacement (SDR), Cention N, and Conventional Glass Ionomer Cement (GIC) in Class V cavities. Materials and Methods: Forty-eight extracted human maxillary premolars were randomly divided into four groups (n=12) and restored with Conventional GIC, ACTIVA™ BioACTIVE, SDR, or Cention N. After thermocycling and mechanical loading, specimens were coated with nail varnish, immersed in 2% Rhodamine B dye for 24 hours, sectioned buccolingually, and evaluated under a stereomicroscope at 30× magnification. Statistical Analysis: Microleakage scores were analyzed using the Kruskal–Wallis test followed by the Dwass–Steel–Critchlow–Fligner post hoc test (p < 0.05). Results: Mean microleakage scores were 2.83 ± 0.39 for Conventional GIC, 0.58 ± 0.67 for ACTIVA™ BioACTIVE, 1.75 ± 0.75 for SDR, and 1.33 ± 0.78 for Cention N. Significant differences were observed among the groups (p = 0.0005). ACTIVA™ BioACTIVE exhibited the lowest microleakage, whereas Conventional GIC showed the highest. No significant difference was observed between SDR and Cention N. Conclusion: ACTIVA™ BioACTIVE exhibited the least microleakage and superior marginal sealing ability among the materials tested.
CBCT-Based Radiographic Assessment of Buccal Bone Dehiscence and Fenestration Around Dental Implants in Adolescents
Background: The integrity and thickness of the buccal cortical plate are important considerations in dental implant treatment. Defects such as buccal bone dehiscence and fenestration may compromise peri-implant hard-tissue support. Cone-beam computed tomography (CBCT) enables three-dimensional (3D) assessment of these anatomical changes. Aim: The present study aimed to evaluate the prevalence and characteristics of buccal bone dehiscence and fenestration around dental implants using CBCT and to compare the occurrence of these defects between maxillary and mandibular implant sites. Materials and Methods: A total of 100 implant sites were assessed using CBCT images. The sites were evaluated for the presence or absence of buccal bone dehiscence and fenestration. Buccal bone thickness and the dimensions of identified defects were measured using multiplanar CBCT sections. The distribution of defects between maxillary and mandibular sites was also analyzed. Appropriate statistical tests were applied to determine associations and differences between the evaluated parameters. Results: Buccal bone dehiscence was identified more frequently in mandibular implant sites than in maxillary sites. Dehiscence was present in 15 of 40 mandibular sites (37.5%) compared with 9 of 60 maxillary sites (15.0%), and the difference was statistically significant. Sites with buccal bone dehiscence demonstrated reduced buccal bone thickness compared with sites without dehiscence. Buccal bone fenestrations were also identified and their dimensions were recorded using CBCT measurements. Conclusion: CBCT provides valuable 3D information for identifying and measuring buccal cortical bone defects around dental implants. The greater frequency of dehiscence in mandibular sites and its association with reduced buccal bone thickness emphasize the importance of assessing the facial cortical plate during implant evaluation and treatment planning.
Acute Kidney Injury in Weil Disease: Cases Series
Leptospirosis is a zoonotic infection with a wide clinical spectrum, ranging from mild illness to severe disease with multi-organ involvement. Acute kidney injury (AKI) is one of the most common complications and may require renal replacement therapy (RRT) in severe cases. We report three cases of leptospirosis-associated AKI in patients with a history of exposure to contaminated water. All patients presented with fever, jaundice, myalgia, and oliguria, accompanied by laboratory findings consistent with AKI. Management included antibiotic therapy, intravenous fluid resuscitation, and supportive care. Diuretics were administered in cases with persistent oliguria. All patients demonstrated significant clinical and laboratory improvement, including recovery of renal function and normalization of urine output. None of the patients required renal replacement therapy. The duration of hospitalization ranged from 5 to 12 days. These cases highlight that early recognition and prompt supportive management may lead to favorable outcomes in leptospirosis-associated AKI without the need for renal replacement therapy.
Evaluating The Role of Fibrinogen As An Independent Risk Factor in Coronary Heart Disease
Objective: Fibrinogen is a plasma glycoprotein involved in blood coagulation and acts as an acute-phase inflammatory protein. Elevated fibrinogen concentrations have been associated with atherosclerosis, thrombosis, and cardiovascular events. The objective of this study is to estimate plasma fibrinogen levels among patients with coronary heart disease and healthy controls, compare fibrinogen concentrations between the two groups, and determine the association between elevated fibrinogen levels and coronary heart disease. The study will also assess whether fibrinogen may serve as an independent risk factor and potential biomarker for coronary heart disease. Methods: This comparative cross-sectional study included 200 adults divided into two groups of 100: healthy controls and patients with coronary heart disease. Participants were classified based on total cholesterol and lipid profile levels. Plasma fibrinogen levels were measured and compared between the groups using an independent-samples t-test. The association between coronary heart disease and fibrinogen levels was evaluated using Pearson correlation analysis. Results: The mean fibrinogen concentration was substantially higher in the case group (459.82 ± 7.37 mg/dL) than in the control group (294.30 ± 54.40 mg/dL), and the difference was statistically significant (p < 0.001). Similarly, total cholesterol was significantly higher among cases (280.12 ± 4.72 mg/dL) compared with controls (172.66 ± 14.19 mg/dL; p < 0.001).The mean LDL concentration was also significantly elevated in cases (135.64 ± 5.77 mg/dL) compared with controls (79.92 ± 11.38 mg/dL; p < 0.001). In contrast, HDL concentrations were significantly lower among cases (26.29 ± 3.23 mg/dL) than among controls (44.75 ± 3.16 mg/dL; p < 0.001). Conclusion: According to the study's findings, patients with coronary heart disease may have higher plasma fibrinogen levels than healthy controls. The results point to a possible link between coronary heart disease and elevated fibrinogen levels. As a result, plasma fibrinogen could be a helpful biomarker for determining cardiovascular risk.
Development And Optimization Of Amoxicillin Trihydrate Minitablets As A Stable And Pediatric-Friendly Alternative To Oral Suspension
Amoxicillin trihydrate, a widely prescribed β-lactam antibiotic, exhibits hydrolytic instability in aqueous environments, posing stability limitations in conventional powder-for-oral-suspension dosage forms. The present study aimed to develop a stable, mechanically robust, and palatable minitablet formulation of amoxicillin as a dose-flexible alternative for pediatric use. A systematic phase-wise optimization approach was employed to evaluate direct compression, dry granulation, and wet granulation techniques. Wet granulation was identified as the most suitable manufacturing process for high drug loading, providing improved compressibility and mechanical integrity. Subsequent optimization of filler composition, disintegrant distribution and excipient balance resulted in minitablets exhibiting rapid disintegration and satisfactory dissolution performance. The optimized formulation demonstrated friability of 0.36%, disintegration time of 50 seconds, and approximately 90% drug release within 15 minutes. Sensory evaluation confirmed statistically improved palatability following combined sweetener and flavor optimization. Stability studies conducted under ICH-recommended accelerated and long-term conditions showed minimal degradation, maintained assay within 95–105%, and total impurities below pharmacopoeial limits over six months. Solid-state characterization by differential scanning calorimetry (DSC) and powder X-ray diffraction (XRD) confirmed that the crystalline trihydrate form of amoxicillin was retained in the optimized batch following wet granulation. The developed minitablet formulation provides a stable, dose-flexible, and pediatric-compliant alternative to conventional oral suspension, addressing key limitations related to hydrolytic instability, dosing variability, and in-use shelf-life.
A Quantum-Inspired Evolutionary and IPSO Hybrid Model For Efficient Graph Colouring Under Multi-Constraint Conditions
Graph colouring, a fundamental problem in combinatorial optimization, plays a critical role in various real-world applications such as register allocation, scheduling, and frequency assignment. Efficiently solving the graph colouring problem under multiple constraints remains a major computational challenge, particularly for large and complex graphs. This study addresses these limitations by proposing a hybrid optimization model that integrates Quantum-Inspired Evolutionary Algorithms (QIEA) with an Improved Particle Swarm Optimization (IPSO) technique. The proposed model leverages the probabilistic representation and parallel search capabilities of QIEA along with the adaptive learning and velocity adjustment features of IPSO to explore the solution space effectively. The primary objective is to minimize the number of colours used while satisfying adjacency, capacity, and dependency constraints. Experimental evaluations conducted on benchmark graph instances demonstrate that the hybrid model significantly outperforms existing evolutionary and heuristic methods in terms of convergence speed, constraint satisfaction, and colouring efficiency. These results affirm the potential of the QIEA-IPSO hybrid in solving complex multi-constrained graph colouring problems.
Antenatal Counselling For PPIUCD Success: Role of Antenatal Counselling For PPIUCD
Background: The postpartum intrauterine contraceptive device (PPIUCD) is a highly effective, long-acting, reversible method of contraception ideal for the immediate postpartum period. Despite its benefits, PPIUCD utilization remains low due to misinformation, fear, and lack of counselling. Antenatal counselling has emerged as a potentially transformative strategy to enhance acceptance and uptake of PPIUCD. Aim: To evaluate the effectiveness of structured antenatal counselling in improving the acceptance and insertion rates of PPIUCD and to assess barriers to acceptance among women who were not counselled. Methods: A prospective interventional study was conducted at Mettupalayam Government Hospital from July to September 2025. A total of 200 antenatal women were recruited using convenience sampling. Participants were divided into those who received structured antenatal counselling (n=128) and those who did not (n=72). Data on acceptance, insertion, and refusal were collected and compared. Results: Among counselled women, 93.7% accepted PPIUCD and 85.1% underwent insertion, compared to 33.3% and 19.4% respectively in the non-counselled group. Refusal was significantly higher (66.7%) in the non-counselled group compared to 6.3% in the counselled group. The most common reasons for refusal included fear of pain, myths about infertility, and family disapproval. Conclusion: Structured antenatal counselling significantly improves both acceptance and successful insertion of PPIUCD. Integration of PPIUCD counselling into routine antenatal care is essential for strengthening postpartum family planning and reducing unmet contraceptive needs.
More Than Just Gaming: Evaluating The True Benefit Of Virtual Reality in Post-Stroke Upper Limb Recovery: An Overview of Systematic Reviews and Meta-Analyses
Background: Upper limb impairment affects the majority of stroke survivors and is slow and often incomplete to recover. Virtual reality (VR) has emerged as a technology-assisted adjunct to conventional physiotherapy, but the magnitude of its added benefit remains debated. Objective: To systematically synthesise randomised controlled trial (RCT) evidence and existing meta-analyses comparing VR with conventional physiotherapy for upper-limb motor recovery after stroke, using the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) as the primary outcome. Methods: A rapid, PRISMA-2020-informed overview-of-reviews was conducted (August 2026) across PubMed, Scopus, Web of Science, MDPI and ScienceDirect. Thirteen candidate sources (systematic reviews, meta-analyses and landmark RCTs) were screened; four meta-analyses reporting an extractable mean difference (MD) and 95% confidence interval (CI) for FMA-UE were pooled using a DerSimonian–Laird random-effects model. Results: The pooled random-effects estimate across four meta-analyses (collectively synthesising data from 58 primary RCTs) was MD = 4.44 FMA-UE points in favour of VR (95% CI 2.37 to 6.51), with substantial between-review heterogeneity (I² = 74.9%). Individual reviews ranged from MD 3.04 (95% CI 1.46–4.62) to MD 7.47 (95% CI 5.38–9.57). Standardised mean difference (SMD)-based reviews showed smaller, and in the most recent (2026) review, non-significant effects (SMD 0.56, 95% CI −0.02 to 1.15). None of the pooled point estimates reached the accepted minimal clinically important difference of 7 FMA-UE points. Conclusion: VR produces a statistically detectable but clinically modest improvement in upper-limb motor function compared with conventional physiotherapy when therapy dose is not matched. Benefit appears driven substantially by increased repetition and engagement rather than the technology itself. VR is best positioned as an adjunct that increases practice intensity, not a replacement for therapist-led, task-specific training.
Evaluation of The Effect of Three Different Mouthwashes on The Surface Microhardness And Colour Stability of A Bioactive Restorative Material – An in Vitro Study
Context: The performance of bioactive restoratives clinically is highly dependent on their ability to withstand exposure to chemical agents in the oral cavity. Aims: To evaluate the effect of three different mouthwashes on the surface microhardness and colour stability of the bioactive restorative material ACTIVA™ BioACTIVE. Materials and Methods: Seventy-two disc-shaped samples of ACTIVA™ BioACTIVE (8 mm diameter, 1 mm thickness) were fabricated and randomly assigned to four groups of 18 samples each. Group 1 (artificial saliva – control), Group 2 (Listerine® Cool Mint®), Group 3 (Sensodyne Complete Protection+), and Group 4 (Himalaya Active Fresh Miswak). Following a continuous 24-hour immersion at 37°C, surface microhardness was measured using a Digital Vickers hardness tester. Colour stability (∆E) was assessed via spectrophotometry using the CIE L*a*b* system. Statistical Analysis: Data were analysed using descriptive statistics, one-way ANOVA, and Tukey HSD post hoc tests with the significance threshold set at p ≤ 0.05. Results: Significant differences were observed across all experimental groups (p < 0.001). Group 1 showed the highest stability. Among the mouthwashes, Listerine caused the greatest reduction in microhardness and the highest colour change. Sensodyne and Himalaya exhibited significantly better microhardness retention, while Sensodyne demonstrated superior colour stability. Conclusion: Alcohol-containing Listerine mouthwash significantly compromised the surface microhardness and colour stability of ACTIVA™ BioACTIVE. Non-alcoholic Sensodyne and herbal Himalaya mouthwashes were more compatible, maintaining material properties within acceptable clinical limits.
Factors Influencing Consumer Behaviour Towards Fitness Products and Services in Thoothukudi District
The fitness industry has grown significantly in recent years due to increasing health consciousness, changing lifestyles, and greater awareness of physical and mental well-being. Consumers are increasingly investing in fitness products such as nutritional supplements, fitness equipment, and wearable devices, as well as services including gym memberships, yoga centres, personal training, and wellness programmes. Understanding the factors that influence consumer behaviour towards these products and services is important for marketers, fitness service providers, and policymakers. The present study examines the factors influencing consumer behaviour towards fitness products and services in Thoothukudi District. The study focuses on variables such as product quality, price, brand image, health awareness, promotional activities, social media influence, and availability. Primary data were collected from 200 respondents using a structured questionnaire. The collected data were analysed using Percentage Analysis, Weighted Average Score Analysis, and the Chi-square Test. The findings reveal that product quality is the most important factor influencing consumer purchase decisions, followed by health awareness and brand image. The study also indicates that consumers aged 21 to 30 constitute the largest group of fitness product and service users. Furthermore, age has a significant relationship with the utilisation of fitness services. The study offers useful suggestions for improving product quality, service delivery, customer satisfaction, affordability, and promotional strategies. The findings contribute to a better understanding of consumer preferences and provide useful insights for fitness businesses and future researchers.
Comparative Evaluation Of The Surface Texture Of Nanoceramic And Nanohybrid Composite Resin Polished Using One Gloss, Sof-Lextm And Kenda Polishing Systems - An In-Vitro Study
Background and objectives: To evaluate and compare the surface texture of nanoceramic composite and nanohybrid composite resin polished by One gloss, Sof-LexTM and KENDA polishing system. Materials and methods: Seventy-two acrylic resin blocks were prepared using customized mould. Circular cavity was prepared in acrylic resin block and were divided into two groups and restored with nanoceramic and nanohybrid composite resin. It was finished using fine grit diamond bur and each group polished using three different polishing systems. The surface roughness was evaluated using a surface profilometer. Results: The profilometric results suggested that the surface roughness of nanoceramic composite resin was lesser than the nanohybrid composite group irrespective of the polishing agents used. There was no statistical difference among the surface roughness produced by the polishing agents. Conclusion: Within the limitations of the present study, it can be concluded that the filler particle size do affect the surface roughness of the composite resins. Nanoceramic composite resins gave a smoother surface compared to that of nanohybrid composite resins. It can also be concluded that the single step polishing system is equally efficient as that of the multistep polishing systems.
Effectivness Of Cervical Isometrics and Proprioception Neuromusular Facilitation Techniques in Mechanical Neck Pain Patients
Background: Mechanical neck pain is one of the most prevalent musculoskeletal disorders worldwide and is associated with pain, reduced cervical mobility, and functional disability, affecting individuals' quality of life. It commonly results from poor posture, repetitive movements, prolonged computer use, and muscular imbalance, particularly among working-age adults. Patients with mechanical neck pain often exhibit weakness of the deep cervical muscles, impaired proprioception, and altered neuromuscular control, which contribute to persistent symptoms and recurrenc. Exercise therapy is considered a first-line conservative treatment for mechanical neck pain because it improves muscle strength, endurance, and functional performance. Cervical isometric exercises enhance muscle activation without excessive joint movement, making them beneficial for reducing pain and improving cervical stability. Proprioceptive Neuromuscular Facilitation (PNF) techniques facilitate neuromuscular coordination through diagonal movement patterns and proprioceptive stimulation, thereby improving flexibility, strength, and functional movement. PNF has demonstrated positive effects on pain reduction, range of motion, and muscle performance in individuals with various musculoskeletal disorders, including neck pain. Combining cervical isometric exercises with PNF techniques may provide synergistic benefits by simultaneously improving muscle strength, proprioception, and motor control. Despite growing evidence supporting both interventions individually, limited studies have directly compared their combined effectiveness in patients with mechanical neck pain. Therefore, investigating the effectiveness of cervical isometric exercises and PNF techniques may help identify an optimal physiotherapy approach for reducing pain, improving cervical function, and enhancing quality of life in individuals with mechanical neck pain. Methods: The study was done effectivness of cervical isometrics and proprioception neuromusular facilitation techniques in mechanical neck pain patients. Prior to conducting the survey, the ethical committee approval was made. Patient selected according to inclusion and exclusion criteria.With permission of 44 patients with suffering from mechanical neck pain. A pre-experimental one-group pre-test and post-test study .Participants underwent a Four-week structured exercise program consisting of cervical isometric exercises and cervical PNF techniques. Outcome measures included the Numerical Pain Rating Scale (NPRS), NDI scale, Cervical ROM. Assessments were performed before and after the intervention. Data were analyzed using descriptive statistics and paired t-tests.