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Millets are physiologically and therapeutically healthy with high nutritious value and are in rising demand in emerging markets like India, China, Africa, and other developing countries including the Western world. Germinated Millets have high digestibility and are used as healthy food for children’s growth and development. Climate change resilience technology, high nutritional value, and the announcement of the year 2023 as “International Millet Year” have made it very popular. Bakery items based on Millet, particularly cookies, are becoming more popular in both urban and rural areas. Jaggery is raw sugar prepared from sugarcane juice and is considered superior to white sugar. It offers numerous nutritional and therapeutic benefits, including anti-carcinogenic with antitoxic actions. Hence, this study aimed to prepare healthy food items with germinated finger and pearl Millets for better nutritional quality that are attracting the attention of health-conscious people on a worldwide scale. Cookies made from blends of germinated wheat flour (GWF), germinated finger millet flour (GFMF), and germinated pearl millet flour (GPMF) were examined for their physicochemical qualities, in vitro digestibility, antioxidant activity, and overall acceptability by consumers. In vitro protein digestibility (62.24-82.34%), starch digestibility (47.48-62.41%), total phenolic content (11.45–49.12 mg GAE/100 g), and antioxidant activities significantly increased as the proportion of GFMF and GPMF flour increased in the cookie samples, whereas total starch, dietary fiber, carbohydrate, and phytic acid decreased. The physical qualities of the cookies were also improved by the addition of GFMF and GPMF flours. Cookies with acceptable sensory properties, including taste, aroma, appearance, mouthfeel, crispiness, and overall acceptability, were produced by blending 60% GWF, 20% GFMF, and 20% GPMF (T2). This study demonstrated that GFMF and GPMF flour blends may be used as functional ingredients to create superior goods.

Background: Cancer treatment frequently depends on the intricate and potent effects that are acknowledged for their potential to save lives. Chemotherapy can have adverse effects on both the central and peripheral nervous systems, posing significant challenges.Objective: •    To assess the causative agent, development, and timing of occurrence.•    To improve management of neurological complications.•    To discriminate the iatrogenic effects of cancer therapy and neurological progression.Method: A prospective observational study was conducted in a hospital setting, focusing on the neurotoxic effects of chemotherapy in cancer patients over a span of six months. The research involved participants from both the oncology in-patient and daycare departments. After obtaining informed consent, individuals in the study population were interviewed to gather information about any neurological symptoms they encountered following their chemotherapy sessions.Results and discussion: Within our study population, a predominant 67% comprised female patients, while male patients constituted 33%. Of the total participants, 66% reported experiencing neurological symptoms. Among these symptoms, the majority of patients encountered sensations such as tingling, numbness, and a burning sensation. Other reported symptoms included headaches, distal weakness, myalgia, seizures, and ataxia.Conclusion: In this current study, 66% of the study population encountered neurological side effects. Generally, the presence of comorbidities, vitamin deficiencies, and advanced age can significantly contribute to the development of peripheral neuropathy. Depending on the severity of neuropathy, recommendations for interventions include the prescription of vitamin supplements, calcium supplements, duloxetine, and pregabalin.

Essential oils (EO) are extracted from different plant species and can be present in different plant organs. Rosemary-pepper EO is composed of around 50% to 70% thymol, a phenolic compound proven to be active against fungi and bacteria. The active components present in these compounds can affect the vital functionality of bacterial cells, leading to protein denaturation and cell lysis. Therefore, the present study aims to evaluate in vitro the antibacterial potential of Lippia origanoides EO against gram-negative bacteria. This is an exploratory study, with a technical-experimental procedure, with a quantitative approach, carried out at the Federal University of Campina Grande. The strains used were Pseudomonas aeruginosa ATCC 27853, Proteus mirabilis ATCC 25933, and Escherichia coli ATCC 25922, using concentrations of 1024, 512, 256, and 128 μg/ml using the disc diffusion method in triplicate. After the incubation period, the formation of halos of bacterial growth inhibition was not observed. There are possible causes for the lack of antibacterial activity of the EO concerning the strains of gram-negative bacteria used in the study, including the possibility of not containing components with antibacterial properties in concentrations sufficient for the expected activity at the concentrations tested. Based on the results obtained, the Rosemary-Pepper EO (Lippia organoids) did not demonstrate antimicrobial activity against the gram-negative bacteria used in the study. Therefore, the development of new research with Lippia origanoides essential oil with gram-positive bacteria is suggested.

In the biopharmaceutical production field, the purification process is a crucial step in order to obtain Drugs with an impurity profile according to the regulatory agency requirement.The aim of this work is to verify some relevant and recent literature and after analysis to submit to the researcher new Solutions in order to improve global safety and the toxicological profile: Submit a project related to the continuous testing of the purified materials using Raman spectroscopy – with pre-treatment of the sample: using solvents.Nanolipis Payload of Biopharmaceutical is not efficiently detected by direct Raman spectroscopy allowed by the regulatory agency for PAT process analytical technology.

This study aimed to examine the disparities of childhood cancer survival among different racial and ethnic groups in Texas. The analysis was mediated by socioeconomic status (SES) and spatial accessibility to Children Oncology Group (COG) hospitals. The relationship between race-ethnicity and overall survival was measured using the Cox proportional hazards model with a robust variance estimator. The counterfactual model measures the total effect of race-ethnicity on survival through all mediating pathways while adjusting for baseline confounders (age, sex, and stage at diagnosis), which are then decomposed into natural direct and indirect effects. Considering all cancer site groups, African Americans showed a statistically significant higher hazard ratio in death (HR = 3.63; 95% CI = 1.87 - 6.62) compared with non-Hispanic White children. At the same time, the mortality hazard ratio among Hispanic children is not significant (HR = 1.23; 95% CI = 0.80 - 1.93) when compared with non-Hispanic White children. Analysis results also suggested that both mediators significantly contribute to racial-ethnic survival disparities for specific cancer site groups such as Leukemia for African American children. This study builds knowledge and understanding about underlying factors (mediators) responsible for the disparities in the outcomes among childhood cancer patients.

Background: This case study explores an integrated approach to managing a complex cardiac condition, presenting a comprehensive single-session intervention. This includes balloon valvuloplasty using a Nucleus 18 mm balloon, complex angioplasty with rotational atherectomy (rotablator) targeting calcified lesions in the left main and left anterior descending artery, and Transcatheter Aortic Valve Implantation (TAVI) with a 23 mm Sapien 3 valve, all performed on an 81-year-old woman. Furthermore, this report underscores the strategic left atrial appendage closure conducted three months post-procedure due to the patient’s elevated hemorrhagic risk.Case presentation: Facing critical coronary and valvular pathologies, the patient underwent a meticulously planned, single-session intervention. The process began with a balloon valvuloplasty using a Nucleus 18 mm balloon to address the aortic stenosis. This was followed by a high-risk angioplasty, during which the Impella CP device provided hemodynamic support and rotational atherectomy was employed to address the calcified coronary artery disease effectively. The same session saw the successful execution of TAVI using a 23 mm Sapien 3 valve. The comprehensive approach notably diminished procedural complications, illustrating the benefits of an integrated treatment pathway in managing high-risk patients. Three months later, the patient underwent a left atrial appendage closure, a critical move considering her high risk of hemorrhage. This procedure also provided an opportunity to assess the favorable outcomes of the previous angioplasty.Conclusion: This case validates the feasibility and efficacy of performing multiple advanced percutaneous interventions in a single session for high-risk cardiac patients. It underscores the crucial role of innovative and personalized treatment strategies in improving patient outcomes, particularly in complex clinical scenarios. Moreover, the case exemplifies the essential relationship between immediate, comprehensive intervention and subsequent follow-up procedures in ensuring optimal long-term patient care.

Background: Bile duct injuries have been substantially increased after the introduction of laparoscopic cholecystectomy (LC). These are accompanied by major morbidity and mortality. Studies have shown varying degrees of success in the reduction of bile duct injury (BDI) using the Critical View of Safety (CVS) technique. The aim of this study was to see the efficacy of the CVS technique as the sole method of dissection in laparoscopic cholecystectomy. Methods: 1647 cases of LC were done between January 2012 and January 2022 for a period of 10 years in two hospitals. All were operated by the CVS dissection technique and none by the infundibular technique. Cases included acute cholecystitis, chronic cholecystitis, gangrenous cholecystitis, empyema, and Gallbladder (GB) polyp. Results: The average operating time was 42 minutes and the range was 13 to 80 minutes. In 92% of cases, all 3 criteria of CVS were achieved. In the remaining 8% cases were either converted to open or operated by a division of GB or subtotal cholecystectomy was done. There was only one case of cystic duct stump leak requiring drainage and common bile duct stenting.Conclusion: The excellent outcome of our study suggests that the CVS method will be the gold standard technique in the dissection of the gallbladder in LC. Further dissemination of the technique is necessary to improve safety in LC.

To prepare the population for first aid in case of traumatic shock, algorithms for the fundamentals of didactics of the educational topic “First aid to the population in case of traumatic shock during accidents, disasters, natural disasters and terrorist attacks” of the subject “Life Safety” are proposed. 32 years of experience in teaching the subject in humanitarian state educational institutions of higher professional education of a non-medical profile in the city of Syktyvkar are summarized. Educational questions are considered: 1) The concept of shock; 2) Traumatic shock; 3) Mechanisms of injury that contribute to the development of traumatic shock. Predisposing factors. Complications. At-risk groups; 4) Classification, phases, and degrees of shock; 5) Universal first aid algorithm; 6) Basic anti-shock measures in the source of mass destruction and at the stages of evacuation; 7) Features of anti-shock measures in children; 8) Typical first aid mistakes for traumatic shock. For each of the educational issues considered, a summary of the material presented is given. Depending on the purpose of studying the topic, purpose, content of educational material, and form of organization of training, the number of hours allocated to its presentation and study in various forms of the educational process is established. Their distribution includes 1 lecture (2 hours), 1 seminar (2), 1 practical lesson (2), and 6 hours of independent work by students.

Peripartum cardiomyopathy is a rare case of heart failure with reduced ejection fraction and is considered a diagnosis of exclusion. The symptoms of heart failure in patients with peripartum cardiomyopathy can mimic the physiologic conditions of normal pregnancy. In an acute decompensated state, PPCM can present with acute severe upper abdominal or epigastric pain. We are presenting a 24-year-old female with no personal or family history of heart disease and no identifiable risk factor for PPCM. Based on her initial presentation in the emergency department, a diagnosis of acute severe pancreatitis was sought, and she was referred to the Intensive Care Unit. After further evaluation of the serological tests and imaging, she was eventually diagnosed as a case of PPCM. We emphasize the rare nature of the disease with a diverse presentation which poses a diagnostic challenge, especially in a resource-limited setting where advanced diagnostic tools may be restricted and socioeconomic condition poses a barrier to further patient evaluation. This case exemplifies the infrequent occurrence and atypical manifestation, presenting a learning opportunity for future clinicians.

Background: Obesity remains a global epidemic with over 2.8 million people dying due to complications of being overweight or obese every year. The low-carbohydrate and high-fat ketogenic diet has a rising popularity for its rapid weight loss potential. However, most studies have a maximal 2-year follow-up, and therefore long-term adverse events remain unclear including the risk of Atherosclerotic Cardiovascular Disease (ASCVD).Results: Based on current evidence on PubMed and Google Scholar, there is no strong indication ketogenic diet is advantageous for weight loss, lipid profile, and mortality. When comparing a hypocaloric ketogenic diet with a low-fat diet, there may be faster weight loss until 6 months, however, this then appears equivalent. Ketogenic diets have shown inconsistent Low-Density Lipoprotein (LDL) changes; perhaps from different saturated fat intake, dietary adherence, and genetics. Case reports have shown a 2-4-fold elevation in LDL in Familial hypercholesterolaemic patients which has mostly reversed upon dietary discontinuation. There is also concern about possible increased ASCVD and mortality: low (< 40%) carbohydrate intake has been associated with increased mortality, high LDL from saturated fats, high animal product consumption can increase trimethylamine N-oxide, and cardioprotective foods are likely minimally ingested.Conclusion: Ketogenic diets have been associated with short-term positive effects including larger weight reductions. However, by 2 years there appears no significant differences for most cardiometabolic risk markers. Therefore, this raises the question, excluding those who have a critical need to lose weight fast, is this diet worth the potentially higher risks of ASCVD and mortality while further long-term studies are awaited?