Assessment of prevalence and distribution of congenital missing teeth among patients visiting tertiary care hospital: A radiographic study.

Introduction: Dental Agenesis is the usual developmental dental anomaly involving both primary and permanent dentition but most commonly it affects the permanent teeth. Genetic mutations in genes like MSX, PAX9,TGFA and AXIN2 are the likely primary contributors to tooth agenesis. Identifying the prevalence and distribution of congenital missing teeth allows for early detection and intervention which is crucial for preventing or mitigating potential dental issues that may arise due to missing teeth. Aim & objectives: To assess the prevalence and distribution of congenitally missing teeth across different quadrants of the jaw among patients visiting to the Dental out patient department at Tertiary Care Centre of Lucknow city. Material & method: A Questionnaire and orthopantomogram based cross-sectional study was conducted on both male and female patients aged between 15 and 30 years, coming for evaluation of their dental health problems to the hospital. Written informed consent was obtained. Results: The overall prevalence of CMT was found to be 33.3 %. The significant difference was observed in proportion of CMT between Maxilla and Mandible sites (p = 0.008). Higher prevalence was in females compared to males for both maxillary and mandibular congenital missing teeth. (p = 0.020). Conclusion: The most common CMT were third molars followed by lateral incisors. The insights derived from the study would aid dental professional in gaining a deeper comprehension of tooth agenesis.

Predictors of Timely Initiation and Completion of Adjuvant Chemotherapy in Stage II/III Colorectal Adenocarcinoma.

Background: Adjuvant chemotherapy (AC) for colorectal cancer (CRC) has led to substantial improvement in survival. Several clinical trials advocate the initiation of AC within 6-8 weeks of surgical resection based on evidence of improved survival with early initiation of AC. We aim to evaluate factors that predict initiation and completion of AC, subsequently improving survival. Methods: We identified 451 patients who underwent resection for CRC between 2014 and 2022. One hundred ten patients had stage II/III colorectal cancer who underwent resection followed by AC. Multivariable logistic regression analysis was performed to identify factors significantly predicting delay in AC >8 weeks. Secondary outcomes included chemotherapy completion rate, recurrence-free survival, and overall survival. Results: The final analysis included 110 patients. The median time to initiation of adjuvant chemotherapy (TIAC) was 6.9 weeks (IQR: 5.8-9.5). In total, 36.4% of patients had a delay >8 weeks to initiation of AC, and only 40% completed treatment. The surgical approach (open vs laparoscopic vs robotic) had no effect on the TIAC. On multivariable logistic regression analysis, preoperative albumin ≥3.5 (OR = .31; 95% CI: .12-.80) was an independent predictor of timely initiation of AC. Completion of AC was associated with a higher overall survival. Discussion: Preoperative nutritional status predicted delay in initiation of AC. Patients with a delay in AC beyond eight weeks had a lower rate of AC completions and worse survival. It is imperative to optimize this aspect of treatment as it correlates with survival.

Social Media Impact on Self-Perceived Oral Health Practices Among Patients Visiting Tertiary Care Hospital in Lucknow: A Cross-Sectional Study.

Background Social media is widely used in the medical field, and people often utilize it to learn about their symptoms prior to consulting with a healthcare professional. Hence, the study aims to investigate the influence of social media on self-perceived oral health practices among patients. Methodology A cross-sectional study design was adopted, with a questionnaire comprising 15 closed-ended questions. The sample size was estimated to be 451 participants based on the findings from the pilot study. The face validity of the questionnaire was assessed by a subject matter expert (0.83%), and the reliability was measured using Kappa statistics (0.86). The percentile was determined to assess the overall self-perceived oral health practices of the participants. The data was analyzed using descriptive analysis, chi-square test, and multivariate regression analysis at statistical significance (p ≤ 0.05). Results The majority of participants belonged to urban areas (66.5%), with an average age of 38.19 ± 6.70. The participants in urban 184 (61.3%) and rural 102 (67.5%) believed that social media provided better knowledge regarding oral health, which was statistically significant (p = 0.046). The majority of the participants, 267 (59.2%), spent more than 30 minutes to three hours per day on social media. It was found that participants who possessed professional occupations had increased odds of having good oral health practices on social media (p = 0.043). Conclusion The participants believed that social media provided better knowledge regarding oral health, and self-perceived practices among the participants were found to be poor. Social media platforms provide new educational possibilities in the dentistry sector, but their potential is neglected and unappreciated.

The diagnostic conundrum in necrotizing otitis externa.

Necrotizing otitis externa (NOE) is an aggressive and fast-evolving infection of the external auditory canal. Late diagnoses and untreated cases can lead to severe, even fatal consequences and so early diagnosis and treatment are paramount. NOE is a notoriously challenging diagnosis to make. It is therefore important to understand what diagnostic modalities are available and how otolaryngologists can use them to accurately treat such an aggressive disease. This review aims to evaluate the different diagnostic options available in NOE and discuss their advantages and limitations, thus, providing an up-to-date picture of the multimodal approach required in the diagnosis of this disease.

Low Rates of Colorectal Cancer Screening in Our Patients' First-Degree Relatives: Are We Failing Them?

BACKGROUND: Guidelines recommend screening those with a family history of early-onset colorectal cancer at age 40 or 10 years before the age of their relative's diagnosis. Currently, there is no literature reporting the screening rate in these individuals and no protocols are in place to identify and target this population for screening awareness. OBJECTIVE: Assess adherence to current screening guidelines among FDRs of patients with early-onset colorectal cancer. DESIGN: Retrospective and qualitative study involving a telephone survey where patients were asked about relative's screening status and barriers to screening. SETTINGS: Two community-based institutions between January 2018-December 2021. PATIENTS: Individuals diagnosed with early-onset colorectal cancer who had undergone surgery at our institutions. MAIN OUTCOME MEASURES: Rate of screening in first-degree relatives of our patients with early-onset colorectal cancer. Other factors measured included demographics, clinicopathologic characteristics and screening barriers. RESULTS: Thirty-six patients were identified. Survey response rate was 66.6% (n=24). A total of 88 first-degree relatives who met criteria for screening resulted, with 67.1% (n=59) having a known screening status. Of the 59 with known screening status, it was reported that only 44% (n=26) have undergone screening. Patients of African American race, stage III/IV disease, Medicare/Medicaid and living within Baltimore City County were more likely to have family members with unknown or no screening. Lack of insurance coverage was the most common barrier noted 12.5% (n=3); whereas 54.1% (n=13) reported no barriers to screening. LIMITATIONS: Retrospective design. CONCLUSIONS: Most first-degree relatives of patients diagnosed with early-onset colorectal cancer do not undergo colorectal cancer screening. This could be attributed to the lack of protocols that could guarantee these individuals are informed of their elevated risk and the different options available for screening. Furthermore, our study suggests that racial and socioeconomic disparities exist among high-risk patients who should pursue screening. See Video Abstract.

Low-dose atropine 0.01% for the treatment of childhood myopia: a pan-India multicentric retrospective study.

OBJECTIVE: The objective of this study was to assess the efficacy of low-dose atropine 0.01% in controlling myopia progression among Indian children over a 2-year period. METHODS: This retrospective study, conducted across 20 centres in India, monitored the progression of myopia over 2 years after initiating treatment with 0.01% atropine eye drops. This included children between 6 and 14 years with baseline myopia ranging from -0.5 D to -6 D, astigmatism≤-1.5 D, anisometropia ≤ -1 D and documented myopia progression of ≥0.5 D in the year prior to starting atropine. Subjects with any other ocular pathologies were excluded. RESULTS: A total of 732 children were included in the data analysis. The mean age of the subjects was 9.3±2.7 years. The mean myopia progression at baseline (1 year before starting atropine) was -0.75±0.31 D. The rate of myopia progression was higher in younger subjects and those with higher baseline myopic error. After initiating atropine, myopia progression significantly decreased to -0.27±0.14 D at the end of the first year and -0.24±0.15 D at the end of the second year (p<0.001). Younger children (p<0.001) and higher baseline myopia (p<0.001) was associated with greater myopia progression and poor treatment response (p<0.001 for both). CONCLUSION: Low-dose atropine (0.01%) effectively reduces myopia progression over 2 years in Indian children.

Impact of Surgical Resident Education and EMR Standardization in Enhancing ERAS Adherence and Outcomes in Colorectal Surgery.

OBJECTIVE: Our study aimed at investigating the degree of adherence to ERAS pathway at our institution and to evaluate the role of providing resident education and a standardized EMR order set in improving adherence and patient surgical outcomes. DESIGN: The study is prospective in nature and consists of two phases with a preintervention cohort to assess adherence to ERAS protocol and a postintervention cohort to evaluate improvement in adherence and patient outcomes. Adherence with the ERAS protocol was assessed across preoperative, intraoperative, and postoperative phases. SETTING: The study took place at MedStar Franklin Square Medical Center in Baltimore, Maryland, involving inpatient care at a surgical ward. PARTICIPANTS: During the preintervention phase, patients undergoing elective colorectal surgery were identified over 6 months (N = 77), and their adherence to the ERAS protocol was assessed. Following the intervention of surgical resident and faculty education sessions on the ERAS protocol and the implementation of a standardized order set in the Electronic Medical Record, a postintervention cohort (N = 54) was selected for comparison over another 6 months. RESULTS: Among 77 patients who underwent elective colorectal surgery, the adherence rate to ERAS protocol was notably below 80% for most elements of the postoperative phase. When pre- and postintervention cohorts were compared, there were no significant differences in the baseline demographics and perioperative variables. After the implementation of our intervention, adherence rates were significantly improved in 7 out of 8 ERAS protocol elements of the postintervention phase. Among primary outcome measures, readmission rate (24.7% vs.9.4%; p = 0.022) and length of stay (7.3 ± 4.5 vs. 5.5 ± 3.6; p = 0.014) were significantly lower in the postintervention cohort. Although the rate of postoperative complications did not decrease significantly (33.8% vs. 31.5%; p = 0.284), there were fewer patients with postoperative ileus and surgical site infections. Outcomes were evaluated based on an 8-point score of postoperative ERAS elements. A significant decrease in mean length of stay and readmission rates is observed when at least 5 elements are completed, emphasizing the ERAS pathway's importance as a complementary bundle. CONCLUSION: Our study highlights the impact of resident education and electronic medical record standardization on ERAS adherence in colorectal surgery. This multidisciplinary approach improves adherence, reduces hospital stay, and enhances communication among healthcare providers for better patient outcomes.

Evaluation of change in objective cyclotorsion after various inferior oblique-weakening procedures.

PURPOSE: To study the effect of four types of inferior oblique-weakening procedures on ocular torsion: inferior oblique recession (IOR), recession and antero-positioning (RAP), anterior transposition as practiced by Elliot and Nankin (EN), and anterior and nasal transposition (ANT). METHODS: The medical records of 72 consecutive patients >10 years of age undergoing inferior oblique weakening for primary or secondary inferior oblique overaction (IOOA) with or without horizontal rectus surgery were reviewed retrospectively. The 106 included eyes were assigned to one of the four groups according to the type of inferior oblique-weakening procedure. The severity of IOOA and the amount of V pattern guided the choice of procedure. IOOA, disk-fovea angle (DFA), and the amount of V pattern were recorded preoperatively. Measurements were repeated postoperatively at 1 week, 4 weeks, and 3 months. Change in the DFA was used to study the change in objective cyclotorsion in all four groups. RESULTS: A significant incyclotorsional shift was seen in all four groups at postoperative 3 months. The mean reduction in excyclotorsion 3 months postoperatively was 3.65° ± 4.84° for IOR, 5.31° ± 4.64° for RAP, 6.10° ± 3.89° for EN, and 16.62° ± 8.72° ANT; it was significantly higher in the ANT group compared with the other three groups. Reduction in DFA was also correlated with preoperative DFA overall, and for all procedures except IOR (P ≤ 0.005). CONCLUSIONS: All four inferior oblique-weakening procedures reduced excyclotorsion; the largest reductions in our study were seen in cases treated using ANT of the inferior oblique.

Fundamental solutions of an extended hydrodynamic model in two dimensions: Derivation, theory, and applications.

The inability of the Navier-Stokes-Fourier equations to capture rarefaction effects motivates us to adopt the extended hydrodynamic equations. In the present work, a hydrodynamic model, which consists of the conservation laws closed with the recently propounded coupled constitutive relations (CCR), is utilized. This model is referred to as the CCR model and is adequate for describing moderately rarefied gas flows. A numerical framework based on the method of fundamental solutions is developed to solve the CCR model for rarefied gas flow problems in quasi two dimensions. To this end, the fundamental solutions of the linearized CCR model are derived in two dimensions. The significance of deriving the two-dimensional fundamental solutions is that they cannot be deduced from their three-dimensional counterparts that do exist in literature. As applications, the developed numerical framework based on the derived fundamental solutions is used to simulate (i) a rarefied gas flow between two coaxial cylinders with evaporating walls and (ii) a temperature-driven rarefied gas flow between two noncoaxial cylinders. The results for both problems have been validated against those obtained with the other classical approaches. Through this, it is shown that the method of fundamental solutions is an efficient tool for addressing quasi-two-dimensional multiphase microscale gas flow problems at a low computational cost. Moreover, the findings also show that the CCR model solved with the method of fundamental solutions is able to describe rarefaction effects, like transpiration flows and thermal stress, generally well.

Prevention and management of childhood progressive myopia: National consensus guidelines.

Myopia is a major public health problem worldwide, including India, with the global prevalence of myopia increasing rapidly over decades. The clinical and socioeconomic impact of myopia is also expected to rise with rising prevalence. Therefore, the focus has now been shifted to prevent the incidence and progression of myopia. However, there is lack of any standardized guidelines for myopia management. This document aims to generate a national-level expert consensus statement on the management of childhood myopia in the Indian scenario. The expert panel of pediatric ophthalmologists consisted of 63 members who met in a hybrid meeting. A list of topics deliberating discussion in the meeting was provided to the experts in advance and they were instructed to provide their opinions on the matter during the meet. The panel of experts then gave their views on each of the items presented, deliberated on different aspects of childhood myopia, and reached a consensus regarding the practice patterns in the Indian scenario. In case of opposing views or lack of a clear consensus, we undertook further discussion and evaluated literature to help arrive at a consensus. A written document is prepared based on recommendations explaining definition of myopia, refraction techniques, components and methods of workup, initiation of anti-myopia treatment, type and timing of interventions, follow-up schedule, and indications for revised or combination treatment. This article formulates evidence-based guidelines for progressing myopes and pre-myopes and also establishes uniformity in the management of childhood myopia in the country.

Effect of low-dose atropine (0.01%) on crystalline lens power among school-aged children with progressive myopia.

PURPOSE: To evaluate the change in crystalline lens power (LP) in a cohort of Indian children with progressive myopia receiving atropine (0.01%) compared with an untreated control group. DESIGN: Nonrandomised clinical trial. METHODS: The study included 120 children (70 in the atropine group; 50 in the control group) with progressive myopia (≥0.5 D/year) with a 1-year follow-up. The atropine group received 0.01% atropine eye drops once daily in both eyes, whereas the control group received no treatment. Changes in cycloplegic spherical equivalent, axial length (AL), keratometry (KER), anterior chamber depth (ACD) and lens thickness (LT) were recorded. LP was calculated using the formula proposed by Bennett. RESULTS: Mean myopia progression at year 1 was significantly less in the atropine group (-0.18 D [0.2]) than in the control group (-0.59 [0.21]; p < 0.001). The increase in AL was significantly different between the two groups (atropine: 0.21 mm [0.12]; control: 0.29 mm [0.11], p < 0.001). A significantly greater loss of LP was noted in the atropine group (-0.67 D [0.34]) than in the placebo group (-0.28 D [0.42]; p < 0.001). The change in LT was significantly different between the atropine and control groups (p = 0.02), whereas the change in ACD and KER was similar in the two groups. CONCLUSION: The greater loss of LP could contribute to the anti-myopia effect of atropine and should therefore be evaluated in studies reporting the efficacy of atropine on myopia to assess its actual effect on myopic progression.

Efficacy and safety of 0.05% micellar nano-particulate (MNP) cyclosporine ophthalmic emulsion in the treatment of moderate-to-severe keratoconjunctivitis sicca: a 12-week, multicenter, randomized, active-controlled trial.

BACKGROUND: Keratoconjunctivitis sicca or dry eye disease (DED) is a multifactorial disorder underpinned by a complex inflammatory cycle. Introduction of topical cyclosporine has been a significant advance in the management of DED. In recent years advancements in formulation technology have led to development of micellar nano-particulate (MNP) cyclosporine formulations that promise better penetration into ocular target tissues and potential for reduced ocular surface irritation. METHODS: We compared two dosing regimes of a proprietary MNP cyclosporine emulsion with the widely marketed topical cyclosporine formulation Restasis™ in a multicenter parallel-group randomised trial in patients with DED. Patients were randomised to one of 3 treatment groups with 90 patients eligible for the per protocol analysis: 30 in the higher dose test arm A; 32 in the lower dose test arm B; and 28 in the Restasis™ control arm C. All scored efficacy endpoints were tested for significance by comparing the mean change in scores from baseline in the test groups with that in the control group at 12 weeks, using the Student's t test. Wilcoxon's rank sum test was used to test individual symptom scores and clinician's global evaluation of treatment grades. RESULTS: Corneal fluorescein staining score, the primary efficacy endpoint, decreased by 6.8 ± 4.0, 5.7 ± 3.9, and 4.6 ± 3.6 points in the 3 groups respectively, indicating superior efficacy in test arm A in comparison to control arm C (p = 0.0026). Schirmer's tear test, conjunctival lissamine staining score, ocular surface disease index, and individual dry eye symptom scores also favoured higher dose MNP cyclosporine over Restasis™. The study failed to differentiate the treatment arms in terms of clinician's global evaluation of treatment, use of tear substitutes, best corrected visual acuity or safety and toleration. CONCLUSION: The results indicate that the dose of 1 drop of a 0.05% w/v ophthalmic emulsion of MNP cyclosporine administered topically twice daily yields better outcomes at 12 weeks than the lower dose tested in the study, and is more efficacious than an equivalent dose of Restasis™, the active control used in the study. TRIAL REGISTRATION: This trial was registered in the Clinical Trials Registry of India on 29/03/2019, and was assigned registration number CTRI/2019/03/018319.

Knowledge, Attitudes, and Practices Concerning Maternal Immunization Among Pregnant/Postpartum Women and Health Care Professionals in Peru.

INTRODUCTION: For pregnant women, vaccination with inactivated influenza vaccine (IIV) and tetanus, diphtheria, acellular pertussis vaccine (Tdap) is recommended. In Peru, uptake is nonetheless low. A study was conducted to identify factors affecting maternal vaccination coverage. The study's primary objectives were to describe the knowledge, attitudes, and practices regarding maternal immunization among pregnant/postpartum women and health care professionals (HCPs). The secondary objective was to determine the vaccination coverage and the impact of Ministry of Health (MOH) recommendations. METHODS: An observational multicenter, cross-sectional survey study was conducted from February 1, 2021 to June 30, 2021 in five cities in Peru. Two surveys were conducted to assess knowledge, attitudes, and practices concerning maternal immunization: one among pregnant/postpartum women and one among HCPs. RESULTS: Participants were 668 pregnant/postpartum women with a mean age of 29.6 years and 219 HCPs-mostly midwives (46.6%) and obstetricians/gynecologists (44.7%). Of the pregnant/postpartum women, 66.9% knew that, in general, vaccinations are given for prevention, and 98.5% believed vaccines are important. Nonetheless, 69.6% of pregnant/postpartum women had poor or moderate knowledge of maternal vaccination. Disease knowledge of influenza (89.1%) and tetanus (87.0%) was high, while knowledge of pertussis (37.7%) was low. Women agreed/strongly agreed that they would get vaccinated with Tdap if a doctor (96.3%), midwife (88.9%), or nurse (72.0%) recommended it. Of the HCPs, 81.3% routinely recommended Tdap vaccination for pregnant women. CONCLUSIONS: To enhance vaccine acceptance in pregnant women in Peru, we must improve knowledge of the diseases, MOH recommendations, and benefits of the offered vaccinations. HCPs could provide this vaccination knowledge and information along with their vaccination recommendation as the pregnant/postpartum women indicated they would take the vaccines if recommended by their HCPs. Our findings are important for the successful implementation of maternal immunization programs in Peru.

Modified Whale Optimization Algorithm based ANN: a novel predictive model for RO desalination plant.

In recent decades, nature-inspired optimization methods have played a critical role in helping industrial plant designers to find superior solutions for process parameters. According to the literature, such methods are simple, quick, and indispensable for saving time, money, and energy. In this regard, the Modified Whale Optimization Algorithm (MWOA) hybridized with Artificial Neural Networks (ANN) has been employed in the Reverse Osmosis (RO) desalination plant performance to estimate the permeate flux (0.118‒2.656 L/h m2). The plant's datasets have been collected from the literature and include four input parameters: feed flow rate (400‒600 L/h), evaporator inlet temperature (60‒80 °C), feed salt concentration (35‒140 g/L) and condenser inlet temperature (20‒30 °C). For this purpose, ten predictive models (MWOA-ANN Model-1 to Model-10) have been proposed, which are capable of predicting more accurate permeate flux (L/h m2) than the existing models (Response Surface Methodology (RSM), ANN and hybrid WOA-ANN models) with minimum errors. Simulation results suggest that the MWOA algorithm demonstrates a stronger optimization capability of finding the correct weights and biases so as to enable superior ANN based modeling without limitation of overfitting. Ten MWOA-ANN models (Model-1 to Model-10) have been proposed to investigate the plant's performance. Model-6 with a single hidden layer (H = 1), eleven hidden layer nodes (n = 11) and the thirteen search agents (SA = 13) produced most outstanding regression results (R2 = 99.1%) with minimal errors (MSE = 0.005). The residual errors for Model-6 are also found to be within limits (span of - 0.1 to 0.2). Finally, the findings show that the screened MWOA-ANN models are promising for identifying the best process parameters in order to assist industrial plant designers.

Hypermetabolic Cerebellar Connectome in Alzheimer's Disease.

Introduction: Regional hypermetabolism in Alzheimer's disease (AD), especially in the cerebellum, has been consistently observed but often neglected as an artefact produced by the commonly used proportional scaling procedure in the statistical parametric mapping. We hypothesize that the hypermetabolic regions are also important in disease pathology in AD. Methods: Using fluorodeoxyglucose (FDG)-positron emission tomography (PET) images from 88 AD subjects and 88 age-sex matched normal controls (NL) from the publicly available Alzheimer's Disease Neuroimaging Initiative database, we developed a general linear model-based classifier that differentiated AD patients from normal individuals (sensitivity = 87.50%, specificity = 82.95%). We constructed region-region group-wise correlation matrices and evaluated differences in network organization by using the graph theory analysis between AD and control subjects. Results: We confirmed that hypermetabolism found in AD is not an artefact by replicating it using white matter as the reference region. The role of the hypermetabolic regions has been further investigated by using the graph theory. The differences in betweenness centrality (BC) between AD and NL network were correlated with region weights of FDG PET-based AD classifier. In particular, the hypermetabolism in cerebellum was accompanied with higher BC. The brain regions with higher BC in AD network showed a progressive increase in FDG uptake over 2 years in prodromal AD patients (n = 39). Discussion: This study suggests that hypermetabolism found in AD may play an important role in forming the AD-related metabolic network. In particular, hypermetabolic cerebellar regions represent a good candidate for further investigation in altered network organization in AD.

Monitoring Alzheimer's Disease Progression in Mild Cognitive Impairment Stage Using Machine Learning-Based FDG-PET Classification Methods.

BACKGROUND: We previously introduced a machine learning-based Alzheimer's Disease Designation (MAD) framework for identifying AD-related metabolic patterns among neurodegenerative subjects. OBJECTIVE: We sought to assess the efficiency of our MAD framework for tracing the longitudinal brain metabolic changes in the prodromal stage of AD. METHODS: MAD produces subject scores using five different machine-learning algorithms, which include a general linear model (GLM), two different approaches of scaled subprofile modeling, and two different approaches of a support vector machine. We used our pre-trained MAD framework, which was trained based on metabolic brain features of 94 patients with AD and 111 age-matched cognitively healthy (CH) individuals. The MAD framework was applied on longitudinal independent test sets including 54 CHs, 51 stable mild cognitive impairment (sMCI), and 39 prodromal AD (pAD) patients at the time of the clinical diagnosis of AD, and two years prior. RESULTS: The GLM showed excellent performance with area under curve (AUC) of 0.96 in distinguishing sMCI from pAD patients at two years prior to the time of the clinical diagnosis of AD while other methods showed moderate performance (AUC: 0.7-0.8). Significant annual increment of MAD scores were identified using all five algorithms in pAD especially when it got closer to the time of diagnosis (p < 0.001), but not in sMCI. The increased MAD scores were also significantly associated with cognitive decline measured by Mini-Mental State Examination in pAD (q < 0.01). CONCLUSION: These results suggest that MAD may be a relevant tool for monitoring disease progression in the prodromal stage of AD.

Evaluation of awareness regarding pictorial warning on tobacco packets and its effect on cessation among tobacco users in Lucknow.

Introduction: Tobacco use has been identified as the leading cause of the preventable death worldwide and estimates that it currently causes 5.4 million deaths/year. In fact, India is suffering a phase of tobacco epidemic. Aim: The aim of the study was to evaluate the awareness regarding pictorial warning on tobacco packets and its effect on cessation among tobacco users. Materials and Methods: A study was conducted among 200 patients having tobacco habit, attending the outpatient department of Public Health Dentistry, KGMU, Lucknow. A self-structured questionnaire was made in English and Hindi language, pertaining to demographic details, type of tobacco products used, frequency, duration of tobacco habits, and awareness regarding pictorial warning. Results: Use of multiple tobacco habits was most prevalent 61 (30.5%) across all age groups, majority 185 (92.5%) of subjects had seen the tobacco warnings, and 113 (56.5%) participants had seen both types of warning (pictorial and written warning). One hundred and ten (55%) of subjects said that warning should be on both sides. Eighty-two (41%) study participants had never tried to quit tobacco habits, 43 (21.5%) of participants tried to quit tobacco habits because of peer pressure and 75 (37.5%) subjects said that after seeing a warning on tobacco packets, they will think to quit tobacco habit. Conclusion: Majority of study participants have observed the warnings on tobacco packets and most of them believe that they could recognize and understand warnings. The study participants believe that warnings on tobacco packets create alertness about various deleterious effects of all tobacco habits and help in dropping or give up these habits. Pictographic warnings were more effective than text warnings.

Current concepts in the management of childhood myopia.

Myopia or short-sightedness is an emerging pandemic affecting more than 50% population in South-Asian countries. It is associated with several sight-threatening complications, such as retinal detachment and choroidal neovascularization, leading to an increased burden of visual impairment and blindness. The pathophysiology of myopia involves a complex interplay of numerous environmental and genetic factors leading to progressive axial elongation. Environmental factors such as decreased outdoor activity, reduced exposure to ambient light, strenuous near work, and role of family history of myopia have been implicated with increased prevalence of this refractive error. While multiple clinical trials have been undertaken to devise appropriate treatment strategies and target the modifiable risk factors, there is no single treatment modality with ideal results; therefore, formulating a comprehensive approach is required to control the myopia epidemic. This review article summarizes the epidemiology, dynamic concepts of pathophysiology, and evolution of the treatment modalities for myopia such as pharmacological (atropine and other agents) and optical methods (spectacles, contact lenses, and orthokeratology).

Role of Electrochemical Techniques for Photovoltaic and Supercapacitor Applications.

Electrochemistry forms the base of large-scale production of various materials, encompassing numerous applications in metallurgical engineering, chemical engineering, electrical engineering, and material science. This field is important for energy harvesting applications, especially supercapacitors (SCs) and photovoltaic (PV) devices. This review examines various electrochemical techniques employed to fabricate and characterize PV devices and SCs. Fabricating these energy harvesting devices is carried out by electrochemical methods, including electroreduction, electrocoagulation, sol-gel process, hydrothermal growth, spray pyrolysis, template-assisted growth, and electrodeposition. The characterization techniques used are cyclic voltammetry, electrochemical impedance spectroscopy, photoelectrochemical characterization, galvanostatic charge-discharge, and I-V curve. A study on different recently reported materials is also presented to analyze their performance in various energy harvesting applications regarding their efficiency, fill factor, power density, and energy density. In addition, a comparative study of electrochemical fabrication techniques with others (including physical vapor deposition, mechanical milling, laser ablation, and centrifugal spinning) has been conducted. The various challenges of electrochemistry in PVs and SCs are also highlighted. This review also emphasizes the future perspectives of electrochemistry in energy harvesting applications.

Augmented video consultations in care homes during the COVID-19 pandemic: a qualitative study.

BACKGROUND: The COVID-19 pandemic necessitated an unprecedented implementation of remote consultations in UK primary care services. Specifically, older adults in care homes had a high need for infection prevention owing to their existing health conditions. GP practices in the East Midlands incorporated augmented video consultations (AVC) with the potential to support remote healthcare assessments for older adults at care homes. AIM: To explore GPs' and care home staff's experiences of the use of AVC as a mechanism to perform remote examinations of older adults in care homes. DESIGN & SETTING: Qualitative interviews were conducted with GPs and care home staff in the East Midlands, UK, during May-August 2020. METHOD: A convenience sample of GPs (n = 5), nurses (n = 12), and senior healthcare assistants (n = 3) were recruited using a purposive approach. Data were collected through semi-structured telephone interviews and analysed using framework analysis. RESULTS: Findings from participants indicated that AVC enabled real-time patient examinations to aid diagnosis and promoted person-centred care in meeting the needs of older adults. The participants also discussed the challenges of video consultations for patients with cognitive impairment and those receiving end-of-life care. CONCLUSION: AVCs show great potential in terms of GPs providing primary care services for care homes. However, healthcare staff must be involved in the development of the technology, and consideration should be given to the needs of older adults with cognitive impairment and those receiving end-of-life care. It is also vital that training is available to encourage confidence and competency in implementing the technology.