How Does Tobacco Use Affect the Cognition of Older Adults? A Propensity Score Matching Analysis Based on a Large-Scale Survey.

INTRODUCTION: Tobacco is a well-established risk factor for cancer, but its association with other morbidities needs consideration. The low-income and middle-income countries (LMICs) with unprecedented demographic transformation lack evidence on tobacco use and its impact on cognitive health. AIMS AND METHODS: Using a propensity score matching approach, we utilized data from the Longitudinal Ageing Study of India. Study employed 1:1 nearest neighbor matching with the replacement methodology. We estimated the odds of the poor cognitive score and tobacco use among older adults based on five different models for ever tobacco user, former tobacco user, current tobacco user, current smokers, and current smokeless tobacco users with reference to never tobacco users. RESULTS: The estimated average treatment effect for the treated and the untreated group has shown a higher likelihood of cognitive decline among ever (OR -0.26; 95%CI -0.43 to -0.09), current (OR -0.28; 95%CI -0.45 to -0.10), and former (OR -0.53; 95%CI -0.87 to -0.19) tobacco users compared to never tobacco users. The finding further suggests the odds of lower cognitive scores among older adults who were smokers (OR -0.53; 95%CI -0.87 to -0.19) and smokeless tobacco users (OR -0.22; 95%CI -0.43 to -0.01) as compared to never tobacco users. CONCLUSIONS: Interventions designed to prevent the incidence of cognitive impairment should focus on limiting the use of tobacco. Strategies under the tobacco-free generation initiative should be amplified in order to prevent future generations from productivity loss, premature ageing and to promote healthy aging. IMPLICATIONS: Evidence of a definitive association between tobacco consumption and cognition among older adults is sporadic in LMICs. Though tobacco is a risk factor for various diseases including cancer, the extent of its impact on cognitive health among the older population is limited. This study contributes to the existing literature by highlighting poor cognitive outcomes among older adults who smoke tobacco and/or consume smokeless tobacco as compared to never-tobacco users. Our findings emphasize the need to accelerate programmes related to tobacco-free generation in LMICs to reach a higher quality of life and healthy aging in pursuit of achieving the sustainable development goal of "good health and well-being."

Blockchain-enabled architecture for lead acid battery circularity.

Widespread use of lead acid batteries (LABs) is resulting in the generation of million tons of battery waste, globally. LAB waste contains critical and hazardous materials, which have detrimental effects on the environment and human health. In recent times, recycling of the LABs has become efficient but the collection of batteries in developing countries is not efficient, which led to the non-professional treatment and recycling of these batteries in the informal sector. This paper proposes a blockchain-enabled architecture for LAB circularity, which ensures authentic, traceable and transparent system for collection and treatment of batteries. The stakeholders-battery manufacturers, distributors, retailers, users, and validators (governments, domain experts, third party experts, etc.)-are integrated in the circular loop through a blockchain network. A mobile application user interface is provided to all the stakeholders for the ease of adoption. The batteries manufactured and supplied in a geographical region as well as the recycled materials at the battery end-of-life are traced authentically. This architecture is expected to be useful for the battery manufacturers to improve their extended producer responsibility and support responsible consumption and production.

Comparison of Functional Outcomes of an Anterior Cruciate Ligament (ACL) Reconstruction Using a Peroneus Longus Graft as an Alternative to the Hamstring Tendon Graft.

Background Ever since the arthroscopic reconstruction of the anterior cruciate ligament (ACL) has begun, the use of the peroneus longus (PL) graft for primary ACL reconstruction (ACLR) has never been thought of. There is very little literature on it. Hence, our study aims to compare the functional outcomes, knee stability, donor site morbidity, and assessment of thigh muscle wasting in patients with ACL injury managed by arthroscopic single bundle reconstruction with peroneus longus tendon (PLT) and hamstring tendons (HT), respectively. Methods All adults aged 16-50 years of either gender presenting with symptoms of symptomatic ACL deficiency were admitted for arthroscopic single-bundle ACLR and allocated into two groups (peroneus longus and hamstring tendon). Functional scores (International Knee Documentation Committee (IKDC), Lysholm score), clinical knee evaluation (anterior drawer, Lachman, and pivot shift test), donor site morbidity (American Orthopedic Foot and Ankle Society ankle hindfoot score (AOFAS)), and thigh circumference were recorded preoperatively and at six months and one year postoperatively. The same post-op rehabilitation protocol was followed in both groups. Results One hundred and ninety-four patients (hamstring n = 96, peroneus n = 98) met the inclusion criteria. There were no significant differences between the preoperative, six-month postoperative, and one-year postoperative scores between the hamstring and peroneus longus groups in the IKDC (p=0.356) and Lysholm knee score (p=0.289). The mean for the AOFAS was 99.05 ± 3.56 and 99.80 ± 0.70 in the PLT and HT groups, respectively, showing no statistical difference, with a significant improvement in thigh muscle wasting among the PLT group at final follow-up (p < 0.001). Conclusion We observed similar knee stability and functional outcomes and no obvious donor site morbidity among both groups. These patients also had better responses to physiotherapy in recovering from their thigh muscle wasting. So, we can recommend that a PL graft can be a safe, viable, and effective option for usual arthroscopic single-bundle ACL reconstruction.

Odd presentations of skeletal tuberculosis: A case series.

Tuberculosis has been afflicting mankind since times immemorial and yet can still present itself in such a disguised manner that even the bests of experts may be duped. Any site from head to toe can be affected but certain sites are far less common than the others. We came across three inconspicuous manifestations at atypical sites-parapharyngeal abscess, wrist joint and foot ulcer. No other primary site could be identified in any case. Two cases were diagnosed microbiologically and one with radiological evidence. All the three cases were medically managed and depicted positive response.

Validation of Quantitative Ultrasonography for Osteoporosis Diagnosis in Postmenopausal Women Compared to Dual-Energy X-Ray Absorptiometry (DEXA).

Introduction Bone mineral density (BMD) is an essential indicator for diagnosing osteoporosis and evaluating the success of osteoporotic treatment. Dual-energy X-ray absorptiometry (DEXA), quantitative ultrasonography (QUS), and quantitative computed tomography (QCT) are frequently used for measuring BMD. The objective of the study was to evaluate the ability of QUS to screen for osteoporosis and bone density in postmenopausal women by calibrating it against DEXA.  Methods This cross-sectional study was conducted at the Department of Orthopedics and Trauma Center of the tertiary care center, Lucknow. A total of 90 patients visited this department from August 2017 to July 2018 for the present study. BMD in the same patient was evaluated by using DEXA and ultrasonography methods. Data were entered in Microsoft Excel and analyzed by using SPSS Software.  Results According to linear regression analysis, T neck was found statistically significant with T QUS (p<0.001) and z QUS (p<0.001). T lumbar and T wrist were found statistically significant with T QUS (p<0.001) but not with z QUS (p>0.001). Z neck was found statistically significant with T QUS (p<0.001) and z QUS (p<0.001). Z lumbar was found statistically significant with T QUS (p<0.001) but not with z QUS (p>0.005). Z wrist was not found statistically significant with T QUS (p>0.005) or with z QUS (p>0.005). Conclusion In the present study, we found that QUS can be used as a screening tool for detecting osteoporosis by measuring BMD in contrast to DEXA. QUS also can be used to predict the DEXA values for osteoporosis and to detect osteoporosis.

The Effect of Timing of Debridement and Surgical Intervention in Open Fractures on the Rate of Infection and Surgical Outcomes: A Prospective Study in a Tertiary Care Setup.

Introduction Open fractures remain one of the true orthopedic emergencies. Despite recent advances in orthopedic surgery, the management of compound fractures is still a challenge to an orthopedic surgeon. Open fractures are a result of high-speed injuries and are associated with several complications such as infections, non-unions, or sometimes an eventual amputation. Infection is the major problem associated with open fractures due to soft tissue damage, contamination, and neurovascular compromise. Presently, management of open fractures requires early aggressive debridement followed by limb salvage by definitive reconstruction or amputation, depending upon the extent and location of the injury. Early aggressive debridement of open fractures has always been the rule. However, it has been observed that open fractures managed even after six hours of injury fare well, and there are no definite guidelines available to decide the safe period of debridement following open fractures so as to prevent infection. The "six-hour rule" is a hotly debated topic with fervent perseverance of this dogma despite a gross lack of support from the literature. Objective The objective of this study was to analyze the relationship between the timing of operation/debridement on infection rates in open fractures, particularly if surgery is performed after six hours. Methods This is a prospective study of 124 patients (R=5-75 years) presenting with open fractures to the outpatient department (OPD) and emergency section of a tertiary care hospital from January 2019 to November 2020. Patients were divided into four groups based on the time to operation/debridement: groups A, B, C, and D, with patients operated within six hours, six to 12 hours, 12-24 hours, and 24-72 hours after injury, respectively. Infection rates were obtained based on the above data. ANOVA was applied using SPSS 20 software (IBM Inc., Armonk, New York). Results This study concludes that the infection rate for fractures treated in less than six hours was 18.75%; in the six to 12 hours group, it was 18.50%, and in the 12-24 hours group, it was 14.28%. The infection rate increased to 38.8% if surgery was performed after 24 hours of injury. On statistical analysis, the time to debridement was not found to be a significant factor. The infection rate in Gustilo-Anderson classification compound grade I was 2.7%, grade II 9.8%, grade IIIA 45%, and grade IIIB 61%. Also, in this study, the union rate in grade I was 97.22%, grade II 96.07%, grade IIIA 85%, and grade IIIB 66.66%. Thus, the degree of wound contamination and compounding gives a prognostic indication regarding the final outcome of the compound fracture. Conclusion Time to debridement is not a significant factor in the management of compound fractures, and these fractures can be safely debrided up to 24 hours after injury. Gustilo and Anderson's classification provides a prognostic indicator of the outcome of a compound fracture. Infection rates and non-union rates increase with increasing grades of compound fractures.

Nonunion of an Isolated Medial Condyle of a Femur Hoffa Fracture in a 21-Year-Old Male: A Case Report.

Isolated Hoffa fractures of the femur are often missed on initial radiographic evaluations. Routine CT scans for intraarticular fractures in suburban populations are not routinely done. Nonunion of medial condyle Hoffa fracture of the distal femur is a rare finding and presents late with pain in weight-bearing and painful flexion. This is a case report of a 21-year-old male who sustained trauma as a result of a motorcycle-car collision and was managed elsewhere conservatively on an above-knee slab. He presented after five months to our side with a limited range of movement at the knee and pain during ambulation. After radiological work diagnosis of isolated non-union of medal condyle Hoffa fracture of the distal femur was made, the patient was managed by freshening of fracture followed by rigid fixation with cancellous screws and reconstruction plate. At postoperative six weeks, the patient had a painless full range of motion at the knee joint.

Anatomical Variation in Quadriceps Angle With Regard to Different Anthropometric Parameters in a Tertiary Care Center in Northern India: A Descriptive Study.

BACKGROUND: The quadriceps angle, commonly known as the Q-angle, is the angle formed between the vectors of the pull of the quadriceps muscle and the patellar tendon. The literature varies in terms of the values of Q angles measured by various researchers. It is well appreciated that the normal Q-angle should fall between 12° and 20°, with males being at the lower end of this range and females having higher measurements. An increase in Q-angle beyond the normal range has been associated with knee extensor dysfunction leading to patellar instability. Keeping in mind the clinical and biomechanical importance of the Q-angle, the aim of this study was to compare and establish the range of the Q-angle in healthy individuals and evaluate its variations with respect to age, weight, height, gender, dominant side, and femoral bicondylar distance. These observations will be helpful for sports therapists in understanding the evaluation of Q-angle in athletes as a prognostic value for probable knee pathologies that may appear in the future. METHODS: The current study was conducted at a tertiary care center, and a total of 100 healthy adults between the ages of 18 and 35 were enrolled in the study (50 males and 50 females), following which their Q-angles, bicondylar distances, and femur lengths were measured. Individuals with any lower limb injury that resulted in a ligamentous, muscular, or bony defect; any spinal or neurological injury; any diagnosed knee disorder, such as a fracture, acute or chronic knee pain, patellar dislocation, or prior orthopaedic surgery in the lower extremities, were excluded from the study. Data were analyzed using paired t-tests, independent sample t-tests, ANOVA, and Pearson correlation coefficients. RESULT AND CONCLUSION: The mean Q-angle in males was found to be 11.14° ± 1.9° on the right side and 10.84° ± 1.86° on the left side. In females, it was found to be 13.68° ± 1.87° on the right side and 13.61° ± 2.04° on the left side. Among males, right and left Q-angles showed significant positive correlations with height, weight, BMI, right femur length, left femur length, right bicondylar distance, and left bicondylar distance (p<0.05). The highest correlation was found between weight and BMI. Among females, the right Q-angle showed significant positive correlations with weight and BMI (p<0.05). The highest correlation was found with weight.

Anatomical Variations in the Posterior Tibial Slope in the North Indian Population: A Hospital-Based Study.

BACKGROUND: The measurement of the posterior tibial slope (PTS) angle is crucial for various knee surgeries such as total knee replacement, high tibial osteotomy, and anterior cruciate ligament reconstruction. This hospital-based study aimed to determine the average PTS angle in the knee joints of the North Indian population and provided valuable data to aid knee surgeries in this region. METHODS: An analysis of 200 plain X-ray films, specifically the true lateral view of both knees in 20-degree flexion, was conducted on participants who exhibited skeletal maturity with no arthritis, tumours, or previous knee surgeries. The PTS measurements were performed manually. The data were analyzed statistically by matching them with variables such as gender, age, laterality, and body mass index (BMI). RESULTS: The study revealed the following findings for the posterior tibial slope in a section of the North Indian population: there was no significant laterality difference (right knee: 12.76±2.35°, left knee: 12.55±2.46°); no notable sexual dimorphism (males: right knee - 12.79±2.65°, left knee - 12.25±2.65°, females: right knee - 12.73±2.11°, left knee - 12.77±2.30°). However, as age advanced, there were significant differences observed (PTS: 14.27±1.28° and 13.84±1.80° in the 18-40 years age group, 11.36±1.76° and 11.31±1.97° in the 41-60 years age group, 10.32±2.82° and 10.56±3.04° in the >60 years age group for the right and left knee, respectively). No significant correlation was found with BMI (PTS: 13.12±3.13° and 12.59±3.14° for BMI <25, 12.88±2.15° and 12.80±2.34° for BMI 25-30, 12.00±2.09° and 11.66±2.99° for BMI >30 in the right and left knee, respectively). CONCLUSIONS: The study demonstrated significant variations in the posterior tibial slope based on age, emphasizing the need for individualized treatment in knee surgeries. The research provided valuable insights into normal PTS values specific to the North Indian population, offering regional data to inform knee surgery procedures.

Local Versus Systemic Tranexamic Acid in Total Hip Arthroplasty in Young Adults.

Background Total hip arthroplasty (THA) is the most successful orthopedic elective surgical procedure for end-stage hip arthritis. THA is linked with significant blood loss, ranging from 1,188 to 1,651 mL, and a transfusion rate of 16-37%, which frequently results in postoperative blood transfusions. Postoperative blood transfusions can be avoided by using autologous blood transfusion, intraoperative blood saving, local anesthetic, hypotensive anesthesia, and antifibrinolytic medications such as tranexamic acid (TXA) administration. Methodology A double-blinded, placebo-controlled, randomized, controlled study was conducted with three prospective groups to investigate the efficacy of topical and systemic routes of a single intraoperative dose (1.5 g) of TXA. Patients were recruited from our center between October 2021 to March 2022 who were undergoing primary total hip replacement. Estimated blood loss was calculated and compared in groups, and a p-value of <0.05 was taken as significant. Results A total of 60 patients were recruited in our study. Estimated blood loss was similar in both treatment groups, 816.8 ± 219.9 mL in the systemic TXA group and 775.5 ± 107.2 mL in the topical TXA group. The placebo group had 1,066.3 ± 150.4 mL estimated blood loss, which was significantly higher compared to the treatment groups. Conclusions Administration of TXA (1.5 g) significantly lowers blood loss without increasing problems, which can eliminate concerns about intravenous TXA use. TXA reduces blood loss by 270 mL on average.

Protrusio acetabuli in tubercular hip: Outcome of femoral head as autologous bone graft used during total hip replacement.

Purpose: Here we present a study of a tuberculosis hip protrusion with a large acetabular defect treated by total hip replacement using a novel technique without the use of any protrusio ring, wire mesh, or cage. To our knowledge, such a technique has not been described in the literature previously. Methodology: 25 patients with a past treatment history of hip tuberculosis came to our medical college with complaints of worsening pain in the hip joint and limping. The hip pain and limping were progressive in nature and became more severe, and his affected lower limb shortened. Results: The average AK distance (horizontal distance between Kohlar line and the medial acetabular border) before surgery was 8 mm (range: 1-16). For the acetabular implant, the mean abduction angle was 45° (range: 41-48), and the mean anteversion angle was 18° (range: 13-24). The average preoperative shortening for limb length inequality was 4 mm (range: 0-11). The average HHS (Harris Hip Score) during follow-up was 87.6 points. Conclusion: In TB hip protrusio, an autograft of the femur head is used to fill the acetabular defect and provide a good approach for these patients without any extra economic burden or complications as seen in a metallic ring or cage.

Assessment of Nutrition Status and Its Effect on Outcomes in Patients With Limb Injuries Using the Subjective Global Assessment as a Screening Tool.

Background Malnutrition in hospitalized patients is a significant problem. This study aimed to assess the utility of the Subjective Global Assessment (SGA) in predicting the association between serum biomarkers and malnutrition in patients with limb injuries as well as the impact of malnutrition on clinical and radiological bone healing. Methodology This prospective study included 93 patients with limb injuries. Basic demographic details, serum biomarker levels, nutritional status assessed using the SGA, and the correlation of the Radiological Union Shaft Tibia (RUST) score with nutrition status were assessed along with the secondary outcomes. Results According to the SGA, patients were classified into Group A (well-nourished), Group B (moderately malnourished), and Group C (severely malnourished). Serum biomarkers (albumin, hemoglobin, platelets, and total leucocyte count) were significantly higher in Group A than in Group B + C (p < 0.0001). The nutritional status of patients from admission up to six months in Group A was significantly higher (p < 0.0001) compared to Group B + C. The radiological healing according to the RUST score had a negative correlation with C-reactive protein and a positive correlation with various parameters at six months. Conclusions The serum biomarker levels and the clinical and radiological bone healing, as measured by the RUST scoring system, showed a positive correlation with the nutritional status of the patients. Malnutrition significantly increases the chance of developing complications such as wound infection, decubitus, and infected implants.

A Glance at the Phytochemical and Ethno-pharmacological Understanding of Four Ocimum Species.

The genus Ocimum comprises many species widely cultivated in different parts of the world for their pharmaceutical, neutraceutical and other commercial importance. Many biological activities such as antimicrobial, cytotoxic, anti-nociceptive, anti-inflammatory, hypoglycaemic, hepatoprotective and antioxidant have been ascribed to Ocimum, which can be linked to the occurrence of biologically active phytochemicals like phenolic acids, essential oil, flavonoids, and terpenes hence making it a potential source for discovery and development of novel drugs. The present review covers the successive advances in the traditional medicinal aspects, phytochemistry, bioactivities and the bioavailability of four Ocimum species, i.e., Ocimum basilicum L., Ocimum sanctum L., Ocimum gratissimum L. and Ocimum tenuiflorum L., to explore their applications in versatile industries. Furthermore, this thorough compilation will be used as a potential resource for further Ocimum-related medication development and research and to identify the research gaps to fill.

Novel cost-effective design for bio-volatilization studies in photosynthetic microalgae exposed to arsenic with emphasis on growth and glutathione modulation.

A novel laboratory model was designed to study the arsenic (As) biotransformation potential of the microalgae Chlorella vulgaris and Nannochloropsis sp. and the cyanobacterium Anabaena doliolum. The Algae were treated under different concentrations of As(III) to check their growth, toxicity optimization, and volatilization potential. The results revealed that the alga Nannochloropsis sp. was better adopted in term of growth rate and biomass than C. vulgaris and A. doliolum. Algae grown under an As(III) environment can tolerate up to 200 µM As(III) with moderate toxicity impact. Further, the present study revealed the biotransformation capacity of the algae A. doliolum, Nannochloropsis sp., and Chlorella vulgaris. The microalga Nannochloropsis sp. volatilized a large maximum amount of As (4,393 ng), followed by C. vulgaris (4382.75 ng) and A. doliolum (2687.21 ng) after 21 days. The present study showed that As(III) stressed algae-conferred resistance and provided tolerance through high production of glutathione content and As-GSH chemistry inside cells. Thus, the biotransformation potential of algae may contribute to As reduction, biogeochemistry, and detoxification at a large scale.

A Comparative Study of the Modified Baumann's Angle Between the Dominant and Non-Dominant Sides in a North Indian Pediatric Population.

Background The literature points towards the fact that paediatric elbow fractures happen more frequently and have greater variability when contrasted with adults. Between 65%-75% of pediatric fractures involve the upper extremity, and supracondylar humerus is the most common of them all. To know the exact site of injury and to estimate the degree of reduction after manipulation, the modified Baumann's angle, the Baumann's angle, the Humero-condylar angle, the Anterior humeral line, and the Radio-capitellar line are the parameters most commonly used. This study was carried out to compare the modified Baumann's angle between both upper limbs in the paediatric population. Methodology This cross-sectional study was conducted in a tertiary health care centre in Northern India for one year from September 1, 2021, to August 31, 2022. We included pediatric patients in the age group of 3-16 years. Age, sex, weight, height, BMI, secondary sexual characters, and handedness were noted in all the children enrolled in our study. In both the dominant and non-dominant sides, the mean arm length, the forearm length, the inter-epicondylar distance, the clinical carrying angle, the radiological carrying angle, and the modified Baumann's angle were calculated.  Results A total of 113 children were enrolled in the study. The majority of children (71.7%) had dominance on the right side. In both the dominant side and non-dominant side, mean arm length, forearm length, inter-epicondylar distance, clinical carrying angle, radiological carrying angle, and modified Baumann's angle values were calculated. On evaluating the data statistically, a significant difference between the two sides was observed for all the parameters (p<0.05), except forearm length (p-value -0.954). Multivariate analysis showed that only BMI was significantly negatively associated with modified Baumann's angle (p=0.016), and only age (0.019) and BMI (<0.001) were found to be significantly associated with the difference in modified Baumann's angle. Conclusions The findings of this study will be helpful in the management of elbow disorders and their reconstruction following trauma. A significant difference was found in the modified Baumann's angle between dominant and non-dominant sides, and it also showed a negative significant correlation with arm length, forearm length, and the presence of secondary sexual characteristics. The equations derived in this study will be helpful in the simple derivation of the modified Baumann's angle and its difference from simple measurements of the upper limb parameters.

The industrially important genus Kaempferia: An ethnopharmacological review.

Kaempferia, a genus of the family Zingiberaceae, is widely distributed with more than 50 species which are mostly found throughout Southeast Asia. These plants have important ethnobotanical significance as many species are used in Ayurvedic and other traditional medicine preparations. This genus has received a lot of scholarly attention recently as a result of the numerous health advantages it possesses. In this review, we have compiled the scientific information regarding the relevance, distribution, industrial applications, phytochemistry, ethnopharmacology, tissue culture and conservation initiative of the Kaempferia genus along with the commercial realities and limitations of the research as well as missing industrial linkages followed by an exploration of some of the likely future promising clinical potential. The current review provides a richer and deeper understanding of Kaempferia, which can be applied in areas like phytopharmacology, molecular research, and industrial biology. The knowledge from this study can be further implemented for the establishment of new conservation strategies.

Major phenolic compounds, antioxidant, antimicrobial, and cytotoxic activities of Selinum carvifolia (L.) collected from different altitudes in India.

Antibiotic resistance poses a serious threat to public health, raising the number of diseases in the community. Recent research has shown that plant-derived phenolic compounds have strong antimicrobial, antifungal, and cytotoxic properties against a variety of microorganisms and work as great antioxidants in such treatments. The goal of the current work is to evaluate the anticancerous, antibacterial, antifungal, antioxidant, and cytotoxicity activities in the extracts of the different plant parts (leaves, stems, and roots) of S. carvifolia (L.) L. This is a medicinally important plant and has been used for different kinds of diseases and ailments such as hysteria and seizures. The phenolic compounds from the different plant parts were analyzed using HPLC and the following were found to be present: chlorogenic acid, gallic acid, rutin, syringic acid, vanillic acid, cinnamic acid, caffeic acid, and protocatechuic acid. Gallic acid was found to have the highest concentration (13.93 mg/g), while chlorogenic acid (0.25 mg/g) had the lowest. The maximum TPC value, which ranged from 33.79 to 57.95 mg GAE/g dry extract weight, was found in the stem. Root extract with 9.4 mg RE/g had the greatest TFC level. In the leaf and stem extracts, the RSC ranged from 0.747 mg/mL to 0.734 mg/1 mL GE/g dry extract weight, respectively. The 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay was used to measure in vitro antioxidant activity. In a concentration-dependent way, promising antioxidant activity was reported. Moreover, 3,5-dinitrosalicylic acid (DNSA) and the Folin-Ciocalteu phenol reagent technique were used to determine reducing sugar content and total phenolic content, respectively. Antibacterial activity against eight strains (MIC: 250-1,000 µg/mL) was analyzed, and the stem extract exhibited maximum activity. Antifungal activity was also assessed, and potent activity was reported especially in the extract obtained from the stem. Cytotoxicity was evaluated using an MTT assay in the A549 cell line, where different doses (0.0625, 0.125, 0.25, 0.5, and 1 mg/mL) of leaf, root, and stem extracts were used. Treatment with these extracts reduced the cell viability, indicating that S. carvifolia may possess anticancer potential, which can be of great therapeutic value.

A Study of Factors Associated With Carrying Angle of the Human Elbow in Pediatric Age Group.

Purpose This prospective cohort study aims to determine the factors that are associated with the carrying angle of the human elbow in the pediatric age group. Methods One hundred forty children up to 15 years of age were assessed for age, sex, forearm lengths of both sides, arm length of both sides, trans-trochanteric diameter, height, BMI, the inter-epicondylar distance of both sides, Baumann's angle of both sides, presence or absence of secondary sexual characteristics, clinical carrying angle (CCA) of both sides, and radiological carrying angle (RCA) of both sides. Unpaired t-test was used to compare the means of carrying angle in the unrelated groups, namely gender and secondary sexual characteristics. The strength and direction of the relationship between carrying angle and continuous variables were tested by calculating Pearson's correlation. Variables found to be associated with carrying angle at significance level >0.25 on bi-variable analysis were used to design a linear regression model to identify factors associated with carrying angle. Results The mean age was 5.84±4.76 years. Ninety-eight (70%) were males, and forty-two (30%) were females. The mean CCA on the right side was 8.55±2.01. The mean CCA on the left side was 8.77±2.03. The mean RCA on the right side was 8.85±2.09. The mean RCA on the left side was 9.07±2.13. On bi-variable analysis, the CCA was found to be associated with age, secondary sexual characteristics, weight, height, arm length, forearm length, inter-epicondylar distance, trans-trochanteric distance, and Baumann's angle. CCA was found to be significantly negatively correlated with BMI. On multivariate linear regression, the CCA was found to be associated with age and inter-epicondylar distance. Conclusion Age and inter-epicondylar distance are the true associations of carrying angle.

Correlation Between Morphometric Measurements and Carrying Angle of Human Elbow.

PURPOSE: This prospective cohort study aims to determine the correlation between morphometric measurements and the carrying angle of human elbow. METHODS: One hundred forty children were enrolled in the study. They were evaluated for age, sex, morphometric measurements, clinical carrying angle (CCA) and radiological carrying angle (RCA). The morphometric measurements included in the study were length of arms and forearms, inter-epicondylar distance of both sides, trans-trochanteric distance, height and body mass index. The mean of carrying angles in unrelated groups (gender and secondary sexual features) was compared using the unpaired t-test. Pearson's correlation coefficient was calculated to determine the strength and direction of the relationship between carrying angle and continuous variables (age, height, body mass index, forearm length, arm length, inter-epicondylar distance and trans-trochanteric distance). RESULTS: The mean age was 5.84±4.76 years. Ninety-eight (70%) were males, and forty-two (30%) were females. The means of RCAs of the left side and right side were 9.07±2.13 and 8.85±2.09, respectively. The mean values of CCA on the left side and right side were 8.77±2.03 and 8.55±2.01 each. A significant positive correlation was found between CCA and age, weight, height, arm length, forearm length, inter-epicondylar distance and trans-trochanteric distance. CCA was found to be significantly negatively correlated with body mass index. CONCLUSION: CCA is significantly correlated with age, BMI and morphometric measurements.

Assessment of National Program for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS): An observational study in rural Jaipur, Rajasthan.

Introduction: Non-communicable diseases (NCDs) are increasing in trend and associated with modifiable risk factors and subsequently reducing physical activity; hence the Government of India (GOI) has launched a National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 2010 to curb increasing prevalence. The present study was planned for assessment of the activities conducted under NPCDCS in rural Jaipur. Methods and Material: This observational study was conducted in rural Jaipur. NPCDCS reports, status of logistics and manpower were assessed for 1 year. Field level cross-checking survey was done to assess the gap between the actual screening work done and the work reported. All staffs were assessed for the level of awareness regarding NCDs as well as NPCDCS programs. Data were entered and analysed in Microsoft excel. Result: Around 48% (6674/13917) of persons >30 years were screened during 1 year study period. Around 51.5% of the screened persons had one or more NCDs (13.5% newly screened NCDs cases and 38% were prediagnosed of NCD cases). Status reports that 10 (83.33%) out of the total 12 expected reports were sent regularly on a monthly basis. Reason for not sending reports was a sudden lockdown due to COVID-19. Conclusion: The study concludes that the implementation of NPCDCS program activities is not in synch with the health staff awareness level. IEC activities were deficient and no work was done for adoption of behavioural change and healthy lifestyle. Actual cases of hypertension were more while cases of diabetes were less than the reported cases found on cross-check survey.