Bistriazolotriazole-tetramine: commendable energetic moiety and cation.

CONTEXT: Various 7H,7'H-[6,6'-bi[1,2,4]triazolo[4,3-b][1,2,4]triazole]-3,3',7,7'-tetramine (A) based nitrogen-rich energetic salts were designed and their properties explored. All energetic salts possess relatively high nitrogen content (> 48%), positive heats of formation (> 429 kJ/mol) and stability owing to a significant contribution from fused backbone. The cationic component shows a very high heat of formation (2516 kJ/mol); therefore, it is highly suitable for enthalpy enhancement in new energetic salts. The cation was paired with the energetic anions nitrate (NO3-), perchlorate (ClO4-), dinitromethanide (CH(NO2)2-), trinitromethanide (C(NO2)3-), nitroamide (NHNO2-), and dinitroamide (N(NO2)2-) to improve oxygen balance and detonation performance. Designed salts show moderate detonation velocities (7.9-8.7 km/s) and pressures (23.8 - 33.1 GPa). The distribution of frontier molecular orbitals, molecular electrostatic surface potentials, QTAIM topological properties, and noncovalent interactions of designed salts were simulated to understand the electronic structures, charge distribution in molecules, hydrogen bonding, and other nonbond interactions. The predicted safety factor (SF) and impact sensitivity (H50) of designed salts suggest their insensitivity to mechanical stimuli. This work explored the 7H,7'H-[6,6'-bi[1,2,4]triazolo[4,3-b][1,2,4]triazole]-3,3',7,7'-tetramine as a suitable cationic component which could be promising and serve exemplarily in energetic materials. METHODS: The optimization and energy calculations of all the designed compounds were carried out at the B3LYP/6-311 + + G(d,p) and M06-2X/def2-TZVPP levels, utilizing the Gaussian software package. The molecular surface electrostatic potential, quantum theory of atoms in molecules (QTAIM), reduced density gradient (RDG), and noncovalent interaction (NCI) analysis were performed by employing Multiwfn software. The EXPLO5 (v 7.01) thermochemical code and PILEM web application were used to predict the detonation properties.

Osteoporosis and its associated factors among patients attending Manakamana Hospital, Chitwan, Nepal.

BACKGROUND: Osteoporosis is the most common skeletal disorder that weakens bones and increases their susceptibility to fractures. It is becoming an urgent and serious global epidemic. Early diagnosis and treatment are essential to reduce morbidity and mortality associated with it. This study aimed to find out the prevalence of osteoporosis among patients attending at Manakamana Hospital, Bharatpur, Chitwan, Nepal. METHODS: A cross-sectional study was adopted and 623 patients attending at orthopaedic outpatients department (OPD) of Manakamana Hospital were selected using non-probability consecutive sampling technique. Data were collected from 15th October 2021 to 15th April, 2022, by using interview schedule, chart review and Bone Mineral Density (BMD) measurement through calcaneal ultrasonography. Ethical approval was obtained from Nepal Health Research Council Ethical Review Board prior to study procedures. Obtained data were analysed using descriptive statistics. Association between the variables were measured using chi-square test. RESULTS: The mean age of the patients was 43.5 (±14.26) years. Nearly half (44%, n = 274) were middle aged adults, 59.7% were female and 56.0% were involved in agriculture and household chores. Nearly half of the patients (45.7%) were overweight/ obese, 7.9% were smokers and 13.5% had habit of alcohol use. Osteopenia or low bone density was detected in 58.9% patients and 19.4% had osteoporosis. The prevalence of osteoporosis was significantly associated with age group (p = <0.001) and educational status (p = 0.013) of the patients. CONCLUSIONS AND RECOMMENDATIONS: Osteoporosis and osteopenia are prevalent in patients attending in the hospital. Hence, awareness, early screening, and treatment are necessary for the hospital attended patients to enhance their health and, minimize the risk of osteoporosis and the consequences associated with it.

Effect of self-management intervention on patients with chronic obstructive pulmonary diseases, Chitwan, Nepal.

BACKGROUND: Self-management skills are important for patients with Chronic Obstructive Pulmonary Disease (COPD) who are responsible for their day to day care. Poor self-management behaviours have a significant influence on symptoms, functional impairments and quality of life. Evidence has shown that self-management interventions support patients to respond to changing symptoms and thereby make appropriate decisions regarding their self-management. OBJECTIVE: This study aimed to find out the effect of self-management interventions in patients with COPD in terms of self-management practice, inhaler practice, COPD symptoms burden, functional ability, self-perceived dyspnoea and emotional symptoms. METHODS: Quasi-experimental pre-test post-test design was carried out among patients with COPD attending respiratory units of Chitwan Medical College Teaching Hospital (CMC-TH), Nepal. Convenience sampling technique was used to select the 70 patients with COPD for the study. Baseline data was collected from the participants using (i) Semi-structured interview schedule for socio-demographic and clinical variables, (ii) COPD Self-Management Practice Questionnaire, (iii) Borg Dyspnoea Scale, and (iv) Six Minute Walking Distance (6MWD) Test (v) Pulmonary Function Test (PFT) and (vi) Observation Checklist. Self-management Intervention given was 2 ½ hour sessions per week for 6 weeks along with information booklets distribution. Participants were re-evaluated after 3 months of intervention using same tools. Data analysis was performed using IBMSPSS version 20.0 for window. Wilcoxon signed-rank test was performed to find the effectiveness of the self-management interventions on outcome parameters. RESULTS: Self-management interventions (2 ½ hour session per week for 6 weeks) elicited a statistically significant change on self-management practice (z = -7.215, p<0.001), inhaler practice (DPI practice z = -6.731, p<0.001, MDI practice, z = -1.816, p = 0.005), functional ability (z = -4.243, p<0.001), self-perceived dyspnoea (z = -4.443, p<0.001), COPD symptom burden (z = -7.009, p<0.001) and emotional symptoms (depression, z = -6.856, p<0.001, anxiety, z = -6.675, p<0.001) of patients with COPD. CONCLUSIONS: Self-management intervention acts as powerful equipment to improve self-management practice, COPD symptoms burden, functional ability, self-perceived dyspnoea and emotional symptoms of patients with COPD. Hence, clinician and policy maker need to plan and intervene the rehabilitation program for the patients with COPD to enhance the effectiveness of therapy, self-management practice and general longevity.

Bioremediation of hydrocarbon by co-culturing of biosurfactant-producing bacteria in microbial fuel cell with Fe2O3-modified anode.

The most common type of environmental contamination is petroleum hydrocarbons. Sustainable and environmentally friendly treatment strategies must be explored in light of the increasing challenges of toxic and critical wastewater contamination. This paper deals with the bacteria-producing biosurfactant and their employment in the bioremediation of hydrocarbon-containing waste through a microbial fuel cell (MFC) with Pseudomonas aeruginosa (exoelectrogen) as co-culture for simultaneous power generation. Staphylococcus aureus is isolated from hydrocarbon-contaminated soil and is effective in hydrocarbon degradation by utilizing hydrocarbon (engine oil) as the only carbon source. The biosurfactant was purified using silica-gel column chromatography and characterised through FTIR and GCMS, which showed its glycolipid nature. The isolated strains are later employed in the MFCs for the degradation of the hydrocarbon and power production simultaneously which has shown a power density of 6.4 W/m3 with a 93% engine oil degradation rate. A biogenic Fe2O3 nanoparticle (NP) was synthesized using Bambusa arundinacea shoot extract for anode modification. It increased the power output by 37% and gave the power density of 10.2 W/m3. Thus, simultaneous hydrocarbon bioremediation from oil-contamination and energy recovery can be achieved effectively in MFC with modified anode.

Azo-Bridged Triazole Macrocycles: Computational Design, Energy Content, Performance, and Stability Assessment.

Oxadiazole and triazole are extensively investigated heterocyclic scaffolds in the development of energetic materials. New energetic molecules were designed by replacing 1,2,5-oxadiazole with 2H-1,2,3-triazole in the reported conjugated macrocyclic systems to assess the influence on the energetic properties and stability. In addition, nitro groups were introduced in triazole units (N-functionalization) to improve the energetic performance. Energetic properties, including heat of formation, oxygen balance, density, detonation pressure and velocity, and impact sensitivity, were estimated for these triazole-based macrocycles. The replacement of 1,2,5-oxadiazole with 2H-1,2,3-triazole and 2-nitro-1,2,3-triazole significantly enhances the energy content, detonation performance, and noncovalent interactions. The theoretically computed energetic properties of triazole-based macrocycles reveal high positive heats of formation (1507-2761 kJ/mol), oxygen balance (-88.8 to -22.8%), high densities (1.87-1.90 g/cm3), superior detonation velocities (8.41-9.52 km/s), pressures (26.64-40.55 GPa), acceptable impact sensitivity (27-40 cm), and safety factor (51-290). The overall energetic assessment highlights triazole-based macrocycles as a potential framework that will be useful for developing advanced energetic materials.

Development of Highest Value of the Measured Efficiency of Mesoporous Petal Shaped Europium (III) Doped Cobalt Tetroxide@Cupric Oxide Hybrid Nanomaterials for Enhanced Room Temperature Photoluminescence and Fluorescence Decay Properties.

In our work, a novel series of europium (III) (Eu3+) (5, 10 and 15 wt %) doped cobalt tetroxide@cupric oxide (Co3O4@CuO) nanomaterials (NMs) were synthesized by facile coprecipitation method. The synthesized NMs were characterized by XRD (X-ray diffraction), FT-IR (Fourier transform infrared), UV (ultraviolet)-visible absorption spectra, XPS (X-ray photoelectron), BET (Brunauer-Emmett-Teller) analytical methods. Crystal structure studies revealed the formation of polycrystalline nature with monoclinic and cubic phase. The morphology studies of Eu3+x:Co3O4@CuO (x = 5, 10 and 15 wt %) showed petal shape nanoparticles (NPs) with agglomeration. Redshift in optical absorption spectra appeared with a significant impact on the optical band gap as Eu3+ concentration increases on Co3O4@CuO bimetallic oxide NMs. The chemical composition and valence state of the elements confirmed from XPS studies detected the presence of Eu, Cu, Co, O and C elements. An increase in the pore size and surface area resulted as the Eu3+ concentration increased on Co3O4@CuO NMs. However, room temperature photoluminescence (RTPL) spectra of Co3O4@CuO bimetallic oxide NMs at two different excitations (λ excitation = 280 nm, 320 nm) showed sharp, strong emission intensities located at near ultraviolet (NUV) region and weak emissions detected at far ultraviolet (FUV) regions of the RTPL spectrum. Further, visible range emission intensities were displayed by Eu3+:Co3O4@CuO (5, 10 and 15 wt %) NMs when exited at 280 nm. The characteristic white light emission peaks in the visible range of the RTPL spectra showed intense blue, green and orange colours. Emission intensity increases with an increase in Eu3+ concentration on Co3O4@CuO bimetallic oxide NMs. The fluorescence (FL) decay spectra of Eu3+ 10wt% and 15 wt%: Co3O4@CuO NMs showed a decay lifetime of 2.54 and 2.31 ns (ns) attributed to the dynamic, ultrafast excitation energy transfer between Eu3+ (dopant) and Co3O4@CuO (host) NMs. It is proposed that enhanced RTPL emission intensity and FL decay behavior of Eu3+x:Co3O4@CuO NMs closely related to the change in the optical band gap, variation in the crystallite size, formation of more number of oxygen vacancies in the crystal structure of hybrid nanomaterials.

Simultaneous microbial electrochemical degradation of methyl orange and bioelectricity generation using coculture as anode inoculum in a microbial fuel cell.

Methyl Orange, an azo dye, is a widely used colouring agent in the textile industry. The study aimed to investigate the efficiency of bioremediating bacteria in degrading methyl orange. Escherichia coli (E. coli), a Methyl Orange-degrading bacterium, was isolated from cow dung and its biochemical properties were analysed using 16S rRNA sequencing, and MALDI-TOF MS. A pre-cultured strain of Pseudomonas aeruginosa was co-cultured with E. coli in 1:1 ration in a microbial fuel cell (MFC) for simultaneous electricity production and methyl orange degradation. The degradation was combined with biological wastewater treatment at varying Methyl Orange concentrations, and the electrochemical characteristics were analysed through polarisation study, cyclic voltammetry, and electrochemical impedance spectroscopy. The impact of parameters such as anolyte pH, dye concentration, incubation time, and substrate concentrations were also studied. This study confirmed E. coli as an effective methyl orange degrading bacteria with a maximum % degradation efficiency of 98% after 48 h incubation at pH 7.0. The co-culture of isolated microorganisms at 250 mg/L of methyl orange concentration showed a maximum power density 6.5 W/m3. Further, anode modification with Fe2O3 nanoparticles on the anode surface enhanced power production to 11.2 W/m3, an increase of 4.7 W/m3.

Evaluation of bamboo derived biochar as anode catalyst in microbial fuel cell for xylan degradation utilizing microbial co-culture.

This study aimed to examine the microbial degradation of xylan through Bacillus sp. isolated from wastewater. Co-culture of Bacillus licheniformis strain and MTCC-8104 strain of Shewanella putrefaciens were employed in a microbial fuel cell (MFC) to facilitate energy production simultaneous xylan degradation under optimum conditions. Electrochemical properties of MFC and degradation analysis were used to validate xylan degradation throughout various experimental parameters. Degradation of the optimal xylan concentration using co-culture, resulting in a power density of 7.8 W/m3, the anode surface was modified with bamboo-derived biochar in order to increase power density under the same operational condition. Under optimum circumstances, increasing the anode's surface area boosted electron transport and electro-active biofilm growth, resulting in a higher power density of 12.9 W/m3. Co-culture of hydrolyzing and electro-active bacteria was found beneficial for xylan degradation and anode modifications enhance power output while microbial degradation.

Childhood Malignancies-Clinico-demographic Profile of Patients Attending the Department of Otorhinolaryngology at a Tertiary Care Centre in North-East India.

INTRODUCTION: Malignancies in children are different from those found in adults and are a significant cause of childhood mortality.They have varied clinical presentation depending on site and type of disease.It is essential to recognize the early signs and symptoms of malignancies in childhood, especially those involving head and neck region, so as to reduce childhood mortality and morbidity. MATERIALS: A total of 2384 children were admitted over a period of 7 years. Out of these, 1004 fulfilled the inclusion criteria and were chosen for further evaluation.They were thoroughly evaluated by undertaking a detailed history and clinical examination.Whenever required, additional investigations were performed.After carrying out the necessary investigations, the cases were accordingly managed. Data was evaluated using proper statistical tools. RESULTS: Out of 1004 cases fulfilling the inclusion criteria, 42 turned out to be malignant, with a male-to-female ratio of 1:1.2. Malignancies in children were more common in the age group of 11-18 years, followed by 1-5 years,6-10 years and 0-1 years,with rates of 59.5%, 21.4%, 16.7% and 2.4% respectively. A wide variety of tumour types were recorded,e.g.,Hodgkin's lymphoma,non-Hodgkin's lymphoma,acute leukemia,papillary carcinoma thyroid, nasopharyngeal carcinoma,Langerhans cell histiocytosis,rhabdomyosarcoma, olfactory neuroblastoma and salivary gland neoplasm. CONCLUSION: Incidence of head and neck tumors in pediatric age group was found to be 1.76% with lymphoma being the most frequent.Commonest age of presentation was above 10 years. There was an overall female predominance with a male:female ratio of 1:1.2. Awareness of a potential malignancy and careful follow-up of children with suspicious head and neck cancers is mandatory for early diagnosis and prompt treatment.

Association of quantitative measures of medial meniscal extrusion with structural and symptomatic knee osteoarthritis progression - Data from the OAI FNIH biomarker study.

OBJECTIVE: To study the association of quantitative medial meniscal position measures with radiographic and symptomatic knee osteoarthritis (OA) progression over 2-4 years. METHODS: The FNIH OAI Biomarkers study comprised 600 participants in four subgroups: 194 case knees with combined structural (medial minimum joint space width (minJSW) loss ≥0.7 mm) and symptomatic (persistent Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale increase ≥9 [0-100 scale]) progression; 200 knees with neither structural nor symptomatic progression; 103 knees with isolated structural and 103 with isolated symptomatic progression. Coronal double echo at steady state (DESS) MRIs were used for segmenting five central slices of the medial meniscus. Associations with progression were examined using logistic regression (adjusted for demographic and clinical data). RESULTS: Greater baseline medial meniscal extrusion was associated with combined structural/symptomatic progression (OR 1.59; 95%CI: [1.25,2.04]). No relationship was observed for tibial plateau coverage or meniscal overlap distance. The two-year increase in meniscal extrusion (OR 1.48 [1.21, 1.83]), and reduction in tibial plateau coverage (OR 0.70 [0.58,0.86]) and overlap distance (OR 0.73 [0.60,0.89]) were associated with combined progression. Greater baseline extrusion was associated with isolated structural and less extrusion with isolated symptomatic progression. The longitudinal increase in meniscal extrusion, and reduction in tibial plateau coverage and overlap distance were associated with structural, but not with symptomatic progression. CONCLUSION: Baseline measures of medial meniscal extrusion were consistently positively associated with combined radiographic/symptomatic progression and with isolated structural, but not with isolated symptomatic progression. These measures may therefore allow one to assess the risk of structural knee OA progression and to monitor interventions restoring meniscal position and function.

Metabolic syndrome and life style factors among diabetes patients attending in a teaching hospital, Chitwan.

BACKGROUND: Metabolic syndrome (MetS) is associated with an increased incidence of chronic complications and mortality of diabetes patients. Prevention and treatment of MetS is important means of lowering the risk of cardiovascular diseases and mortality. OBJECTIVE: This study aimed to find out metabolic syndrome and life style factors among diabetes patients. METHODS: A cross-sectional survey was carried out among 296 patients with type 2 diabetes mellitus attending Chitwan Medical College Teaching Hospital. Consecutive sampling technique was used to select sample. Data were collected from 15th December 2021 to 15th March, 2022 using Interview Schedule, bio-physiological measurement and record review. Obtained data were analysed in SPSS version 20 for window using descriptive and inferential statistics. Chi-square test was applied to measure the association between the variables. Logistic regression analysis was performed to identify the factors associated with metabolic syndrome. RESULT: Findings revealed that the prevalence of MetS was 66.2% and 58.4% in patients according to International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria respectively. The most common MetS parameters were raised fasting plasma glucose (94.6%) and abnormal waist circumference (78.4% in IDF criteria) while the least prevalent parameter was reduced HDL level (43.2%). Majorities of the patients were non-vegetarian (85.5%), had poor dietary compliance (poor-46.3%, very poor-32.1%), overweight/obese (65.5%), and suffered from moderate stress (90.1%). Bivariate analysis showed that MetS as per NCEP ATP criteria was significantly associated with gender (p = 0.006), occupation (p = 0.007), presence of other co-morbid condition (<0.001) and sleep problem (p = <0.001). However, MetS as per IDF criteria was significantly associated with age (p = <0.028), duration of diabetes (p = <0.001), follow-up visit (p = <0.030), blood sugar monitoring (p = <0.009) and physical activity of diabetes patients (p = <0.001). Further logistic regression analysis revealed that sleep problem (AOR = 21.812;95%CI = 8.512,55.894) and presence of other comorbidities (AOR = 4.024;95%CI = 2.220,7.295) were the significant factors of metabolic syndrome. CONCLUSION AND RECOMMENDATION: Metabolic syndrome is high in patients with type 2 diabetes mellitus. Therefore, treating physicians and other health workers need to monitor MetS parameters regularly to reduce the risk of cardiovascular diseases, stroke and premature death.

Exploration of spectroscopic, computational, fluorescence turn-off mechanism, molecular docking and in silico studies of pyridine derivative.

The present work reports pyridine-based chalones using spectroscopic techniques to use pyridine derivative analysis. The solvatochromic behavior of 3DPP in non-polar, polar protic and aprotic solvents has been investigated experimentally. The photophysical property of the compound in diverse solvents is attributed to the intra-molecular charge transfer interactions. The dipole moment of 3DPP is estimated theoretically and experimentally using various solvatochromic methods. It is observed that there is a bathochromic shift in the emission spectra of 3DPP, which confirms the π → π* transition. Fluorescence quenching of 3DPP is studied. The type of fluorescence quenching mechanism is found to be collisional quenching. A study of FRET theory on 3DPP was carried out with metal ions. There is a considerable energy transfer between 3DPP and metal ions. NLO behaviors of the compound have been revealed with the help of Kurtz-Perry powder technique. Additionally, the title molecule is docked, carried ADMET studies and drug-like activity using in silico tools. It is probed for antifungal activity through bioinformatics kit which showed potential information.

The Effect of Gestational Diabetes Mellitus on Hearing of Neonates in a Tertiary Healthcare Centre.

Congenital hearing loss is hearing loss present in a child at birth or soon after birth. It is a debilitating condition with the potential for lifelong disability. It is thought to be multifactorial in aetiology with both genetic (autosomal and X-linked) and acquired causes (such as maternal infections, drug intake, trauma). Gestational Diabetes Mellitus (GDM) is a relatively common condition found in pregnant females but is a rather understudied risk factor in terms of congenital hearing loss. GDM is easily treatable which makes the hearing loss due to it easily preventable. (1) Determine correlation between Gestational Diabetes Mellitus and congenital hearing loss in neonates. (2) Calculate the prevalence of Gestational Diabetes Mellitus related congenital hearing loss. A two-step screening process was used for hearing evaluation of neonates with normal mothers (non-exposed) and neonates with mothers suffering from GDM (exposed) through Otoacoustic emission (OAE) and Brainstem Evoked Response Audiometry (BERA). (1) The difference of neonates diagnosed with hearing impairment in exposed and non-exposed group was statistically significant with a p-value of 0.024. OR 2.1538 95% CI 0.6120-7.5796, p < 0.05. (2) Prevalence of hearing loss in neonates of GDM mothers: 13.3%. Through rigorous exclusion of the already known risk factors for congenital hearing loss, Gestational Diabetes Mellitus has been isolated as an independent risk factor for neonatal hearing impairment. We hope to identify additional cases of congenital hearing loss early leading to a decrease in disease burden.

Internet Gaming Disorder and Aggression among Students on School Closure during COVID-19 Pandemic.

BACKGROUND: The Corona Virus Disease (COVID-19) pandemic has significantly disrupted the regular school-going activities of the students, predominantly increasing internet gaming activities to endure significant stress. Excessive involvement in internet gaming brings deviant behaviour, especially aggression among the students. Hence, this study aimed to assess the internet gaming disorder and aggression among the students on school closure during COVID-19 pandemic in Chitwan, Nepal. METHODS: A web-based cross-sectional survey was conducted among 417 students from secondary and higher secondary level who studied in two private schools of Chitwan district. Sample were selected using simple random sampling technique and structured questionnaire, i.e. Internet gaming disorder scale- short form (IGDS9-SF) and Aggression questionnaire (Buss and Perry, 1992) were used to collect the data via web-based through Google Form. Obtained data were analysed using descriptive and inferential statistics. RESULTS: Out of 417 students, the mean age was 17 (±1.411) years, 278 (66.7%) were male and 150 (36.0%) were studying in twelve standard. Majority of students 405 (97.1%) were non-disordered gamers whereas only 12 (2.9%) students were disordered gamers. Students' overall aggression score was 57.79% where the verbal aggression score was higher (66.33%) followed by hostility (61.41%) and anger (56.80%). Further significant positive relationship was found between scores on online gaming disorders and aggression (r=0.239). CONCLUSIONS: Internet gaming disorder and aggression are common among the students during COVID-19 pandemic. Therefore, educational institutions and concern authorities need to organize awareness programs and effective psychosocial intervention approaches for students to enhance the knowledge regarding harmful use of internet game, IGD, to cope with stress and aggression as well as to enhance the adoptive behaviour.

Ralstonia Strains from Potato-Growing Regions of Kenya Reveal Two Phylotypes and Epidemic Clonality of Phylotype II Sequevar 1 Strains.

Bacterial wilt, caused by the Ralstonia solanacearum species complex (RSSC), is the most destructive potato disease in Kenya. Studies were conducted to (i) determine the molecular diversity of RSSC strains associated with bacterial wilt of potato in Kenya, (ii) generate an RSSC distribution map for epidemiological inference, and (iii) determine whether phylotype II sequevar 1 strains exhibit epidemic clonality. Surveys were conducted in 2018 and 2019, in which tubers from wilting potato plants and stem samples of potential alternative hosts were collected for pathogen isolation. The pathogen was phylotyped by multiplex PCR and 536 RSSC strains typed at a sequevar level. Two RSSC phylotypes were identified, phylotype II (98.4%, n = 506 [sequevar 1 (n = 505) and sequevar 2 (n = 1)]) and phylotype I (1.6%, n = 30 [sequevar 13 (n = 9) and a new sequevar (n = 21)]). The phylotype II sequevar 1 strains were haplotyped using multilocus tandem repeat sequence typing (TRST) schemes. The TRST scheme identified 51 TRST profiles within the phylotype II sequevar 1 strains with a modest diversity index (HGDI = 0.87), confirming the epidemic clonality of RSSC phylotype II sequevar 1 strains in Kenya. A minimum spanning tree and mapping of the TRST profiles revealed that TRST27 '8-5-12-7-5' is the primary founder of the clonal complex of RSSC phylotype II sequevar 1 and is widely distributed via latently infected seed tubers. [Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

Meniscus position and size in knees with versus without structural knee osteoarthritis progression: data from the osteoarthritis initiative.

OBJECTIVE: To explore whether and which quantitative 3D measures of medial and/or lateral meniscus position and size are associated with subsequent medial femorotibial structural progression of knee osteoarthritis and to determine the correlation between central slice and total meniscus measures. MATERIALS AND METHODS: Knees with radiographic osteoarthritis from Osteoarthritis Initiative participants with longitudinal medial MRI-based cartilage thickness and radiographic joint space width (JSW) loss over 12 months were selected. These 37 structural progressor knees (64.7 ± 8.0y, 30.2 ± 4.6 kg/m2, 35% men) were matched 1:1 to 37 non-progressor knees (64.6 ± 9.8y, 30.2 ± 4.4 kg/m2, 35% men) without cartilage thickness or JSW loss. Quantitative measures of meniscus position and size were computed from manual segmentations of coronal baseline MRIs. Cohen's D was used as measure of effect size. RESULTS: Maximum extrusion distance of the total medial meniscus and mean extrusion in the central 5 and in the central slice were greater for progressor than non-progressor knees (Cohen's D 0.58-0.66). No significant differences were observed for medial tibial coverage or mean extrusion (entire meniscus). Among medial meniscus morphology measures, only mean height differed between progressor vs non-progressor knees (Cohen's D 0.40). Among lateral meniscus measures, height and volume were greater in progressor vs. non-progressor knees (Cohen's D 0.46-0.83). Mean extrusion measures were highly correlated between the entire meniscus and the central (r = 0.88) or the central 5 (r = 0.93) slices. CONCLUSIONS: 3D maximum and central medial meniscus extrusion may serve as predictors for subsequent structural progression. Central meniscus extrusion measures could substitute 3D extrusion measurement across the entire meniscus.

A Study on Acute Membranous Tonsillitis, Its Different Etiologies and Its Clinical Presentation in a Tertiary Referral Centre.

Membranous tonsillitis is the infection of the palatine tonsils where the exudation from the crypts coalesce to form a membrane over the tonsillar surface. It is a stage ahead of the acute follicular tonsillitis. There are different etiologies for membrane formation over the tonsils. The commonest cause in the present scenario is still Corynebacterium diphtheriae. A one year prospective study was conducted on patients presenting with membranous tonsillitis in a tertiary referral centre in North-East India. Proper history was taken, clinical examination and all the necessary investigations were done. The patients were managed conservatively, while a few patients required tracheostomy. In our one year study, we found that majority of the patients presenting with acute membranous tonsillitis were males (65%) and 35% were females. Most of the cases were seen in 6-12 years of age and belonged to the lower socioeconomic group, and also to the lower Assam belt. Most of the cases were seen in the months of November to January. This prospective study gives a view of the different etiologies of acute membranous tonsillitis, its presentation and how its management affects the outcome of the patients and also affects the mortality and morbidity. This study also shows that diphtheria is still prevalent in the current Indian scenario and thus, proper implementation of the vaccination programs and prompt reporting of the cases should be done to prevent outbreaks.

Impact of COVID-19 Pandemic and Pattern of Patient Care in Otorhinolaryngology Practice in a Tertiary Referral Centre.

To study the effect of COVID-19 pandemic on patient load in a tertiary care centre and the innovations and methods used to improve the safety of the healthcare workers, to provide adequate treatment in the department of Otorhinolaryngology. This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, at a tertiary care hospital centre in North-East India. This study included data collected from the patient registers maintained in our department, and included data over a 4-month period, from April, 2020 to July, 2020. Age, gender, place of residence, clinical diagnosis and the operative procedure performed were included in the data profile for analysis. The above-mentioned registers were also reviewed to retrieve details about the rate of admission during the study period in the previous year. Data was collected and represented, in both descriptive and tabular forms, after proper statistical analysis. We found out that there is a drastic reduction in number of patients attending in our department of Otorhinolaryngology during this COVID-19 pandemic. Certain innovative methods for protecting healthcare workers from viral transmission were put into our practice based on the peer reviewed articles, from June, 2020 and the rate of elective procedures and in-patient admissions were thus increased. Knowledge of new innovative methods in Otorhinolaryngology will help overcome the difficulties faced during the current COVID-19 pandemic.

A survey on diabetes risk prediction using machine learning approaches.

Background: Diabetes mellitus (DM) is a chronic condition that can lead to a variety of consequences. Diabetes is a condition that is caused by factors such as age, lack of exercise, sedentary lifestyle, family history of diabetes, high blood pressure, depression and stress, poor food, and so on. Diabetics are at a higher risk of developing diseases such as heart disease, nerve damage (diabetic neuropathy), eye problems (diabetic retinopathy), kidney disease (diabetic nephropathy), stroke, and so on. According to the International Diabetes Federation, 382 million people worldwide suffer from diabetes. By 2035, this number will have risen to 592 million. Every day, a large number of people become victims, and many are ignorant whether they have it or not. It primarily affects individuals between the ages of 25 and 74 years. If diabetes is left untreated and undiagnosed, it can lead to a slew of complications. The emergence of machine learning approaches, on the other hand, solves this crucial issue. Aims and Objectives: The aim was to study the DM and analyze how machine learning algorithms are used to identify the diabetes mellitus at an early stage, which is one of the most serious metabolic disorders in the world today. Methods and Materials: Data was obtained from databases such as Pubmed, IEEE xplore, and INSPEC,and from other secondary sources and primary sources in which methods based on machine learning approaches used in healthcare to predict diabetes at an early stage are reported. Results: After surveying various research papers, it was found that machine learning classification algorithms like Support Vector Machine (SVM), K-Nearest Neighbor (KNN), and Random Forest (RF) etc shows the best accuracy for predicting diabetes at an early stage. Conclusion: Early detection of diabetes is critical for effective therapy. Many people have no idea whether or not they have it. The full assessment of Machine learning approaches for early diabetes prediction and how to apply a variety of supervised and unsupervised machine learning algorithms to the dataset to achieve the best accuracy are addressed in this paper.. Furthermore, the work will be expanded and refined to create a more precise and general predictive model for diabetes risk prediction at an early stage. Different metrics can be used to assess performance and for accurate diabetic diagnosis.

Lived Experiences of Mothers Raising Children with Autism in Chitwan District, Nepal.

BACKGROUND: Autism is a neurodevelopmental problem that is increasing at an alarming rate worldwide. Rearing and caring for children with autism depends upon the perception of mothers and various factors associated with it. There is a gap in the literature regarding the detailed accounts of mother's experiences regarding autism in Nepal. Hence, this study was undertaken to explore lived experiences of mothers raising children with autism. MATERIALS AND METHODS: Qualitative phenomenological study design was used and nine mothers with autistic children were selected using purposive sampling technique. Data were collected using in-depth interview guidelines and analyzed using Colaizzi's steps. RESULTS: Findings of the study revealed that mothers raising children with autism encountered numerous problems in their life. They felt physically exhausted due to the continuous supervision of their child. Emotional problems such as denial, upset/sadness, and worry were also common among them. In addition, all mothers faced social problems such as social blame, social isolation, and ignorance from their relatives and society due to the atypical behavior of their child. Furthermore, the economic problem was also acute among mothers due to job loss, costly medical treatment, and therapies. So, to deal with the stressors they faced, mothers adopted various coping strategies such as respite care, problem-focused strategies, religious coping, and positive coping in their everyday life. CONCLUSION: In conclusion, to the authors' knowledge, this is the first study documenting the experiences of Nepalese mothers having autistic children. Hence, health care professionals need to pay more attention to address the problems of mothers while treating their autistic children. The Government of Nepal also needs to formulate a policy for the rehabilitation of autistic children in society.