Awareness and Attitude Towards Tobacco Products and Tobacco Industry and Perception about Government's Role in Tobacco Control among the Adult Rural Population: A Cross-sectional Study in the Indian State of Bihar.

Background: Attitudes and impressions toward the tobacco industry and tobacco products among the general public are important determinants for curbing the menace of the tobacco epidemic. Accordingly, this study aimed to assess the knowledge and perceptions about the tobacco industry and tobacco products and analyze attitudes towards social denormalization (SD) of tobacco use and tobacco industry denormalization (TID) among the rural population of Bihar, India. Methods: This community-based cross-sectional survey was conducted on 421 adults aged 18 to 65 years who were selected using multistage systematic random sampling in a rural area of Bihar State in India from January to March 2022. Results were presented as proportions and the factors associated with support for TID and SD were identified using the chi-square test and binary logistic regression. Findings: Out of 421 participants, 342 (81.2%) did not consider smokeless tobacco to be very dangerous. Nearly half (192, 45.6%) of the individuals believed that tobacco companies never tell the truth about the ill effects of tobacco use on health. Maximum, 345 (89.5%) also believed that the tobacco industry is responsible for adverse health effects of tobacco use and that the government should sue them. The prevalence of favorable attitudes toward TID and SD was found to be 55.1% [95% CI: 50.3% - 59.8%] and 38.2% [95% CI: 33.7% - 42.9%], respectively. Conclusion: One out of every two and one out of every three individuals showed favorable attitudes toward TID and SD, respectively. There is a need to inform and educate the public on the ill effects of tobacco and the deceptive strategies used by the tobacco industry to help them choose health over tobacco.

Risk Factors for Stroke in Children with Tuberculous Meningitis: A Prospective Observational Study.

OBJECTIVE: The purpose of the study is to establish the prevalence of stroke as well as the clinical and radiological correlates of stroke in children with tuberculous meningitis (TBM). METHODS AND MATERIALS: A prospective observational study was conducted at the Pediatric Department, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India. Using a computed tomography (CT) scan/brain magnetic resonance imaging (MRI), patients were divided into stroke and non-stroke groups. Demographic characteristics, clinical presentations, cerebrospinal fluid examination, basal meningeal enhancement, hydrocephalus, tuberculoma, and clinical outcome were compared between the two groups. RESULTS: Seventy-eight TBM patients, aged between 6 months and 14 years, were included. Out of 78 enrolled patients, 3 (3.8%) had definite TBM, 73 (91%) had probable TBM, and 4 (5.1%) had possible TBM (LCS). As per the Medical Research Council (MRC) staging, 13% had Stage 1 TBM, 26% had stage 2, and 61% had stage 3 TBM. Out of 78 patients with chest X-ray findings, 42 (53%) had findings suggestive of tuberculosis (TB), which included 33 (42%) with hilar lymphadenopathy and 9 (11%) with a miliary pattern. On neuroimaging, hydrocephalous was seen in 62.8% of cases, basal meningeal enhancement in 64.1%, tuberculoma in 6.4% of cases, and infarction in 53.8% of cases. There was no statistically significant association found between the staging of TBM and the presence of infarction as the majority of cases involved were in stage 3 of the disease (61.5%). TBM patients with stroke had poor clinical outcomes. CONCLUSION: Age, altered sensorium, focal neurological deficits, vomiting, and basal meningeal enhancement can predict the occurrence of stroke in young adults with TBM.

Pragmatic strategies to address health disparities along the continuum of care in chronic liver disease.

Racial, ethnic, and socioeconomic disparities exist in the prevalence and natural history of chronic liver disease, access to care, and clinical outcomes. Solutions to improve health equity range widely, from digital health tools to policy changes. The current review outlines the disparities along the chronic liver disease health care continuum from screening and diagnosis to the management of cirrhosis and considerations of pre-liver and post-liver transplantation. Using a health equity research and implementation science framework, we offer pragmatic strategies to address barriers to implementing high-quality equitable care for patients with chronic liver disease.

Diode Laser Frenectomy: A Torch of Freedom for Ankyloglossia.

Ankyloglossia, also known as tongue-tie, is a rare congenital anomaly of the oral cavity that not only causes difficulties in breastfeeding and teeth cleaning but also causes difficulty in speech articulation. Our patient faced difficulty in freely moving his tongue because of the short lingual frenulum wherein laser lingual frenectomy was indicated. The patient was treated successfully with a soft tissue diode laser having a wavelength of 445 nanometers. The use of a low-wavelength diode laser becomes relatively complimentary to standard scalpel surgery because of patient consolation, offers a blood-free area, reduces inflammation and edema, and is less damaging to thermal tissues.

Estimation of Sex From the Buccolingual Dimension of Tooth Among the North Indian Population.

INTRODUCTION: Identification is an important aspect of forensic medicine. Identification plays an imperative role, especially in highly decomposed bodies, mutilated bodies, and undisclosed and fragmentary human remains. The estimation of sex is an essential parameter of human identification. In forensic anthropometry, sex determination is related to morphometric characteristics of skeletal bones, such as the skull and mandible, clavicle, sternum, scapula, humerus, pelvic bone, sternum, and femur. Since teeth are decay-resistant, conscientious analysis of teeth can accredit reliable sex estimation of an individual, especially when other determinants are fragmented or destroyed. AIM: The aim of the study was to explore the association between sex and buccolingual crown dimensions of teeth. MATERIALS AND METHODS: The study sample consists of 100 volunteer subjects (50 male subjects and 50 female subjects) aged between 20 and 35 years. Alginate was used to take impressions of the teeth and the cast was prepared using pouring by dental stone. Measurements of buccolingual parameters of all the teeth (except the third molars) of both jaws were done on dental casts by using a digital caliper. RESULTS: Collected data were analyzed using SPSS software (IBM Corp., Armonk, NY) and were outlined as mean and standard deviation (SD). The male and female groups were compared using an independent Student's t-test or unpaired test. The results of this study revealed that 16 out of 28 odontometric parameters (except third molar) of the two groups (male and female) were higher in the male group as compared to the female group (p < 0.05). CONCLUSION: Buccolingual odontometric parameters can be used for sex estimation in the North Indian population.

Spectrum of vitriolage in India: A retrospective data record-based study.

Introduction: Vitriolage or acid attack or acid throwing is a gender-based terrible violent crime. There are many everlasting sequels of vitriolage which consist of permanent scarring of the face or body, blindness as well as socioeconomic and psychological intricacy. The sufferer of acid attack is competitor, hatred, enmity or jealousy. Vitriolage are most common in the Asian countries especially in south east Asian region followed by Europe and South America. Bangladesh, India, Pakistan, Colombia and Cambodia are the countries having the highest incidence of acid attacks. There is a sharp rise in vitriolage cases in India in the last few years as indicated by data from the National Crime Record Bureau (NCRB). Seventy per cent victims of vitriolage are women in India as indicated by the annual reports of the Acid Survivor Foundation. Aims and Objective: The aim of the study was to report incidence of acid attacks in India, Indian states and metropolitan cities. To analyse various police and court procedure and to discuss various steps to give justice to the victim of vitriolage. Materials and Methods: Present study is a retrospective data record-based study. Available data for the last 5 years (from 2017 to 2021) were taken from National Crime Report Bureau (NCRB). Available as per NCRB, data were analysed as per aims and objectives. Results: The trend of incidence of acid attacks in India was decreasing in the last 5 years, that is, the incidence was 244 in the year 2017 which become 176 in the year 2021. West Bengal and Uttar Pradesh were the states having the highest number of acid attack incidence during the last 5 years. Delhi city was the top most metropolitan city having the highest acid attack incidence in the last 5 years. Police investigation of cases of acid attacks against women and cases disposed of by the police decreased in the last 5 years. The chargesheeting rate was better in metropolitan cities than overall chargesheeting in India. There was an increased trial of cases of acid attacks against women and a decrease in cases disposed of by the court during the last 5 years. Conviction rate by the court was better in India than the metropolitan cities of India during the last 5 years. Case acquitted by the court in India was 24, 9, 10, 4 and 10, and in metropolitan cities it was 2, 1, 3, 0 and 2 during year 2017, 2018, 2019, 2020 and 2021, respectively. Conclusion: Vitriolage not only destroys physical health but also destroys mental health. Despite of strict action taken by the Indian government, vitriolage is still prevalent in India. Male dominancy and inadequate legal systems are responsible for this. Though there is a standard set by the Supreme Court for the sale of acid, it remains easily available as the guidelines are frequently violated by the preparator. Case investigation and chargesheeting should increase by the police. Trial of the case and conviction should increase by the court. Vitriolage victims must be sure of their scope to obtain education and job opportunity and societal fiction should be reviewed to support people to acknowledge why vitriolage is committed mainly against females.

A Study on the Prevalence of HCV Genotypes and the Effect of Direct-Acting Antiviral Therapy on Clinical and Laboratory Parameters in HCV-Infected Patients at a Tertiary Care Center in North India.

Background: The purpose of this study was to investigate the prevalence and distribution of different HCV genotypes, as well as to evaluate clinical and laboratory parameters in HCV-infected patients before and after DAA treatment. Material and Methods: An open-label prospective study was conducted on 50 HCV-infected individuals. The HCV-infected patients underwent a baseline evaluation with complete history, examination, and other clinical investigations. These patients received the appropriate DAA according to the genotype for 3 months. At the end of 3 months, these patients were again evaluated clinically. Results: The majority of instances were among younger age groups. Genotype 3 (66%) was the most common. There was a statistically significant difference found in clinical parameters regarding total bilirubin (p=0.008), SGOT (p=0.001), SGPT (p=0.035), ALP (p=<0.001) and Blood Urea Nitrogen (p = 0.004). When 1a vs 1b intragroup comparison was drawn, there was a significant mean difference found in SGOT (p value= 0.053) and Creatinine (p=0.050) parameters while rest shows no significant difference when associated. In the comparison of 1a vs 3 or 4, none of the parameters shows significant difference while; when 1b vs 3 or 4 comparison was laid out, SGOT and Creatinine was found near to significant. Conclusion: This study concludes that with the availability of DAAs, highly effective, short-duration, and safe regimens have created better outcomes for patients with HCV infection, especially in those groups where SVR was low with prior therapies or in those where IFN-based treatment strategies were contraindicated.

Recent advances in sensing toxic nerve agents through DMMP model simulant using diverse nanomaterials-based chemical sensors.

Recent terrorist assaults have demonstrated the need for the exploration and design of sustainable and stable chemical sensors with quick reaction times combined with great sensitivity. Among several classes of chemical warfare agents, nerve agents have been proven to be the most hazardous. Even short-term exposure to them can result in severe toxic effects. Human beings inadvertently face the after-effects of these chemicals even several years after these chemicals were used. Due to the extreme toxicity and difficulty in handling, dimethyl methylphosphonate (DMMP), a simulant of nerve agents with much lesser toxicity, is frequently used in laboratories as a substitute. Having a chemical structure almost identical to those of nerve agents, DMMP can mimic the properties of nerve agents. Through this paper, authors have attempted to introduce the evolution of several chemical sensors used to detect DMMP in recent years, including field-effect transistors, chemicapacitors, chemiresistors, and mass-sensitive sensors. A detailed discussion of the role of nanomaterials as chemical sensors in the detection of DMMP has been the main focus of the work through a comprehensive overview of the research on gas sensors that have been reported making use of the properties of a wide range of nanomaterials.

Unravelling groundwater contamination and health-related implications in semi-arid and cold regions of India.

Groundwater, a vital global resource, is essential for sustaining life and various human activities. However, its quality and availability face increasing threats from both natural and human-induced factors. Widespread contamination, arising from both natural origins and human activities such as agriculture, industry, mining, improper waste disposal, and wastewater release, poses significant risks to human health and water security. India, known for its dense population and pronounced groundwater challenges, serves as a prominent case study. Notably, in most of its regions, groundwater resources have been found to be severely contaminated by various chemical, biological, and radioactive contaminants. This review presents an examination of contamination disparities across various states of semi-arid and cold regions, encompassing diverse assessment methods. The studies conducted in semi-arid regions of North, South, West, and East India highlight the consistent presence of fluorides and nitrates majorly, as well as heavy metals in some areas, with values exceeding the permissible limits recommended by both the Bureau of Indian Standards (BIS) and the World Health Organization (WHO). These contaminants pose skeletal and dental threats, methemoglobinemia, and even cancer. Similarly, in cold regions, nitrate exposure and pesticide residues, reportedly exceeding BIS and WHO parameters, pose gastrointestinal and other waterborne health concerns. The findings also indicated that the recommended limits of several quality parameters, including pH, electrical conductivity, total dissolved solids (TDS), total hardness, and total alkalinity majorly surpassed. Emphasising the reported values of the various contaminant levels simultaneously with addressing the challenges and future perspectives, the review unravels the complex landscape of groundwater contamination and its health-related implications in semi-arid and cold regions of India.

Recent Trends in Palliative Care Utilization in Patients With Decompensated Liver Disease: 2016-2020 National Analysis.

Background: Patients with end-stage liver disease (ESLD) have a poor quality of life, which often worsens as disease severity increases. Palliative care (PC) has emerged as a management option in ESLD patients, especially for those who are not candidates for a liver transplant. Objective: To assess the associated factors and trends in PC utilization in recent years. Design: We used the 2016-2020 National Inpatient Sample (NIS) database of the United States to identify patients with decompensated cirrhosis who suffered in-hospital mortality. Information regarding patient demographics, hospital characteristics, etiology and decompensations, Elixhauser comorbidities, and interventions was collected. The multivariate regression model was used to identify factors associated with PC use. Results: Out of 98,160 patients, 52,645 patients (53.6%) received PC consultations. PC utilization increased from 49.11% in 2016 to 56.85% in 2019, with a slight decrease to 54.47% in 2020. Patients with PC use had decreased incidence of blood transfusions (28.85% vs. 36.53%, p < 0.001), endoscopy (18% vs. 20.26%, p 0.0001), liver transplantation (0.28% vs. 0.69%, p < 0.001), and mechanical ventilation (46.22% vs. 56.37%, p < 0.001). African American, Hispanic, and Asian/Pacific Islander patients had 29%, 27%, and 23% lower odds of receiving PC than White patients. Patients in the two lowest income quartiles had 12% and 22% lower odds of receiving PC compared with the highest quartile. Conclusions: PC utilization in patients with ESLD is associated with decreased invasive procedures, shorter lengths of stay, and lower hospitalization charges. Minorities, as well as patients in the lower income quartiles, were less likely to receive PC.

Food waste to resource recovery: a way of green advocacy.

Due to the massive growth in population and urbanization, there has been a huge increase in the volume of food waste globally. The Food and Agriculture Organization (FAO) has estimated that around one-third of all food produced each year is wasted. Food waste leads to the emission of greenhouse gas and depletion of the soil fertility. Nevertheless, it has immense potential for the recovery of high-value energy, fuel, and other resources. This review summarizes the latest advances in resource recovery from food waste by using technologies that include food waste-mediated microbial fuel cell (MFC) for bioenergy production. In addition to this, utilization of food waste for the production of bioplastic, biogas, bioethanol, and fertilizer has been also discussed in detail. Competitive benefits and accompanying difficulties of these technologies have also been highlighted. Furthermore, future approaches for more efficient use of food waste for the recovery of valuable resources have been also offered from an interdisciplinary perspective.

Unmet Needs and Burden of Caregivers of Patients Being Evaluated for a Liver Transplant Are Similar to Those of Cancer Caregivers.

BACKGROUND: The caregivers (CG) of patients with serious illnesses often experience stress and psycho-social issues. High burden is expected for CG of patients for whom liver transplant (LT) is the only curative option. This study aims to measure the burden, unmet needs, and quality of life (QoL) of CG of patients being evaluated for LT. METHODS: This cross-sectional study enrolled CG of patients being evaluated for LT. CaTCoN (Caregiving Tasks, Consequences and Needs Questionnaire) was used to assess caregiving consequences and needs related to interactions with healthcare professionals (HCPs). ZBI-12 (Zarit Burden Interview) was used to assess CG burden, and PROMIS-29 (Patient Reported Outcomes Measurement Information System) to assess QoL. Caregivers completed the study instruments in person, while they were in the clinic. CaTCoN scores from our study were compared with cancer caregivers' historical data. RESULTS: 18 CG were enrolled, mean age 54 [14] years; 72% were white and 77% were women. 61% worked full time; 45% provided >20 hours of care per week. Two-thirds cared for patients with alcoholic liver disease. All CaTCoN scores were no different from CGs of cancer patients (all P > .05). The total ZBI score (mean SD 12.4 [8.3]) did not differ from published scores for CG of cancer patients (12.0 [8.5]). 44% had high (≥12) ZBI scores reflecting "high burden." Their PROMIS-29 T scores, compared to those with low burden, showed more anxiety (P = .01), depression (P = .04), fatigue (P = .02) and deteriorated social function (P = .009). Physical function and social function were diminished among these CGs compared to the general population (P < .0001). CONCLUSION: CGs of patients being evaluated for LT suffer from high burden similar to cancer CGs and have reduced physical and social function. Despite the small sample size, the data completion rate was almost 100%.

A review on versatile applications of biomaterial/polycationic chitosan: An insight into the structure-property relationship.

Chitosan is a versatile and generous biopolymer obtained by alkaline deacetylation of naturally occurring chitin, the second most abundant biopolymer after cellulose. The excellent physicochemical properties of polycationic chitosan are attributed to the presence of varied functional groups such as amino, hydroxyl, and acetamido groups enabling researchers to tailor the structure and properties of chitosan by different methods such as crosslinking, grafting, copolymerization, composites, and molecular imprinting techniques. The prepared derivatives have diverse applications in the food industry, water treatment, cosmetics, pharmaceuticals, agriculture, textiles, and biomedical applications. In this review, numerous applications of chitosan and its derivatives in various fields have been discussed in detail with an insight into their structure-property relationship. This review article concludes and explains the chitosan's biocompatibility and efficiency that has been done so far with future usage and applications as well. Moreover, the possible mechanism of chitosan's activity towards several emerging fields such as energy storage, biodegradable packaging, photocatalysis, biorefinery, and environmental bioremediation are also discussed. Overall, this comprehensive review discusses the science and complete information behind chitosan's wonder function to improve our understanding which is much needful as well as will pave the way towards a sustainable future.

Level of happiness among medical students in Bihar-An online survey.

BACKGROUND: Happiness is a state of mental well-being and influences the learning and performance of an individual. Medical education due to its academic culture and longer course duration affects the performance and happiness of the students. So, this study was done to assess the level of happiness and the factors associated with it among medical students in Bihar. MATERIALS AND METHODS: A cross-sectional online survey was conducted among 321 medical students of all academic years from various medical colleges in Bihar. This study used a self-administered study tool using the online Google Form platform for data collection and assessed the level of happiness using Oxford Happiness Questionnaire. A multivariable binary logistic regression analysis was done to find out the predictors of happiness. RESULTS: A total of 34.6% (95% CI: 29.5-39.9%) medical students were happy. Male (38.2%) students were found to be happier than female (29.2%) students. Age, place of stay, physical activity, meditation and yoga, frequent socialization, absence of psychiatric illness, and stressful situation in the family were the independent predictors of happiness. Around 42.4% of students had another career option, and 32.1% had a second thought about a career due to the COVID-19 pandemic. The presence of any psychiatric illness had a significant effect on the happiness level of the students. CONCLUSION: Only one in three medical students is happy. Promotion of physical activity, meditation and yoga, and socialization will improve the happiness and thereby learning among medical students.

Household-level food insecurity and its correlates in rural Bihar: A cross-sectional study.

Introduction: Bihar has experienced high nutritional public health problem among children and women over the years. In this background, this study was planned to find the level of food insecurity and identify contributing factors in rural Bihar. Material and Methods: We conducted community-based cross-sectional study among 255 families residing in villages catered by RHTC, Naubatpur. A pretested semi-structured interview schedule and HFIAS were used. Result: A total of 27.8% of the 255 households were food insecure, of which 73.3% were severely food insecure. Kutcha houses, dispossession of agricultural land, and lower SES were found to be predictors. Conclusion: Around one in three families experienced food insecurity, and it was more among families residing in kutcha houses, without possession of agricultural land and belonging to lower socioeconomic status.

Internet addiction and nomophobia among medical undergraduates of a tertiary care teaching institute in Patna, Eastern India.

BACKGROUND: Excess use of the internet and gadgets for learning, gaming, and socialization has resulted in addictive behavior and nomophobia, especially among college-going students. Thus, this study was designed to find out the proportion and predictors of internet addiction and nomophobia among medical undergraduates. MATERIALS AND METHODS: This cross-sectional study conducted on 367 medical undergraduates of a teaching hospital was carried out using a standard tool: the Internet Addiction Test Short Form for screening internet addiction and the Nomophobia Questionnaire for nomophobia. Results were tabulated and multivariable binomial logistic regression analysis was performed to find out the predictors of internet addiction and nomophobia. RESULTS: A total of 116 (31.6%, 95% CI: 27%-36.5%) students were addicted to the internet and 247 (67.3%, 95% CI: 62.3%-71.9%) were screened to have moderate-to-severe nomophobia. The age of the student (adjusted odds ratio (AOR): 0.83 [0.69-0.99]), male gender (AOR: 2.24 [1.33-3.79]), screen time (AOR: 1.24 [1.14-1.34]), checking the phone first in the morning (AOR: 1.98 [1.107-3.54]), non-leisure time usage of phone (AOR: 2.07 [1.25-3.4]), and altered reading habit (AOR: 2.51 [1.26-5.01]) were independent predictors of internet addiction. Increased screen time (AOR: 1.103 [1.016-1.23]), checking the phone first in the morning after waking up (AOR: 1.68 [1.05-2.81]), altered academic performance (AOR: 1.99 [1.079-3.68]), and presence of internet addiction (AOR: 8.17 [3.56-18.76]) were independent predictors of moderate-to-severe nomophobia among medical students. CONCLUSION: One and two out of every three medical students were found to have internet addiction and moderate-to-severe nomophobia, respectively. Increased screen time, altered academic performance, and the presence of internet addiction were independent predictors of moderate-to-severe nomophobia.

Palliative clinical trials in advanced chronic liver disease: Challenges and opportunities.

Patients with advanced chronic liver disease have a complex symptom burden and many are not candidates for curative therapy. Despite this, provision of palliative interventions remains woefully inadequate, with an insufficient evidence base being a contributory factor. Designing and conducting palliative interventional trials in advanced chronic liver disease remains challenging for a multitude of reasons. In this manuscript we review past and ongoing palliative interventional trials. We identify barriers and facilitators and offer guidance on addressing these challenges. We hope that this will reduce the inequity in palliative care provision in advanced chronic liver disease.

Post-Acute SARS-CoV-2 Symptoms are Fewer, Less Intense Over Time in People Treated with Mono-Clonal Antibodies for Acute Infection.

Introduction: Many with post-acute SARS-CoV-2 (PASC) have persistent symptoms impacting physical and cognitive function, decreased health and health-related life quality. Monoclonal antibody (mAb) treatment was available to acutely infected patients which might improve these outcomes. Purpose: To compare patient perception of PASC symptoms for those receiving bamlanivimab or casirivimab and imdevimab (mAbs) to those not receiving this treatment (non-mAbs). To compare changes between these groups in symptoms, function and quality of life over a 6-month follow-up. Patients and Methods: Consented adults >28 days post-infection with positive SARS-CoV-2 qPCR or antigen test and SARS-CoV-2 infection between March of 2020 and July of 2022 were enrolled. This prospective, repeated measure observational study reports baseline through 6-month follow-up. Extensive sociodemographic data, detailed medical history, COVID-19 symptom history, and standardized measures of well-being, depression, anxiety, stigma, cognition, symptom assessment, distress, and health status were collected. Results: 323 participants [101 mAb, 221 non-mAb, 52.7±15.5 years, 47.7% male, body mass index (BMI) 31.4±8.4] were analyzed. Fewer symptoms at baseline were reported in mAb versus non-mAb participants (1.06±1.31 vs 1.78±2.15, respectively p=0.0177) 6 months: (0.911±1.276 mAb vs.1.75±2.22 non-mAb, p=0.0427). Both groups showed significant within-group decreases in symptom number (52 to 21 mAb, 126 to 63 non-mAb) and symptom burden (p=0.0088 mAb, p<0.00001 non-mAb). mAb patients had significantly shorter infection-to-baseline interval (days) (120.4±55.3 mAb vs 194.0±89.3 non-mAb, p<0.00001); less frequent history of myocardial infarction (0.0 vs 3.9%, p=0.0464); headache (2.0% vs.11.8%, p=0.0046), rash (3.1% vs 9.9%, p=0.0377), and miscellaneous muscle complaints (2.0% vs 12.3%, p=0.0035), plus significantly better 6-month mood. (2.2% vs 13.2%, p=0.0390). Conclusion: mAb treated participants had reduced symptom burden and consistently reported fewer symptoms than non-mAb at all time points despite less time since acute illness. Both groups reported a statistically significant decrease in symptoms by 6-month visit with no statistically significant differences between them at follow-up.