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Post-COVID pulmonary fibrosis has emerged as a significant long-term complication among survivors of severe SARS-CoV-2 infection. This review highlights the underlying pathophysiology, diagnostic modalities, and recent advances in the diagnosis and management of post-COVID pulmonary fibrosis. As global cases of COVID-19 continue to evolve, understanding and addressing this emerging chronic respiratory condition is critical for long-term patient care.

Rationale: Pulmonary Arterial Hypertension (PAH) is a progressive vascular remodeling disease with elevated pulmonary vascular resistance that is lethal. While therapeutic progress was recently made with endothelin, nitric oxide, and prostacyclin pathway-based therapy for the treatment of PAH, the disease is currently incurable with a high cost of morbidity and mortality. Sotatercept, a new activin receptor IIA-Fc fusion protein, may prove to be a game-changer as a therapeutic agent for the treatment of PAH by regulating the growth factor signaling aberration of PAH.Methods: It is a narrative review of evidence for the drug Sotatercept for Group 1 PAH from a systematic literature search for clinical trials, mechanism studies, and regulatory data up to 2024. Pivotal clinical trials such as PULSAR, SPECTRA, STELLAR, and ZENITH were evaluated for efficacy, safety, and comparative results.Results: Sotatercept is a TGF-β family member ligand trap that rebalances activin/BMP signaling to target vascular remodeling. Clinically, striking effects were shown with exercise (40.8 m improvement in STELLAR 6MWD), pulmonary hemodynamics (PVR reduction of 146-240 dyn·s·cm-5 in PULSAR), as well as clinical measures (76% reduction of composite morbidity/mortality through ZENITH). On the background with an acceptable drug safety profile of predominantly hematologic effects, as well as injection site reaction, benefits were achieved. Comparison with analyses implies at least similar, if superior in some dimensions, efficacy of current PAH therapies.Conclusion: Sotatercept is a new therapeutic option for PAH as the first drug to act on the activin/BMP pathway. With its strong effect on several clinically relevant end points, it is a “fourth pillar” of PAH therapy. Clinical trials will determine its place in the algorithm, ascertain other combinations, and potentially identify its utility for other types of pulmonary hypertension.

Objectives: Hospitalization following a head injury is associated with high rates of disability that have a strong correlation with depression, anxiety, and low self-esteem. Well-being is related to life satisfaction, quality of life, happiness, personal growth and flourishing, competence, self-acceptance, positive relationships, and autonomy. The well-being of patients and their primary caregivers is important when a patient is left with impaired mobility after neurosurgery. The aim of this study is to examine whether the well-being of patients and their primary caregivers will differ before and after neurosurgery, and whether well-being differs between patients with motor disability (WMD group) and those without, compared to those who are not - NMD group (non-motor disability).Methodology: 123 patients and their main caregivers were recruited. Of these, 62 were in the before neurosurgical group, 31 Patients and 31 caregivers. 61 in the after neurosurgical group, 30 Patients and 31 caregivers, of which there are 16 from WMD group and 15 from NMD. Main outcome measures: Two analyses of Variance (ANOVA) were conducted: for WMD and NMD separately. The results reveal a significant decrease in wellbeing for both, patient and main caregivers, but a stronger decline in well-being was observed among WMD, as indicated by a larger effect size (η² = 0.74) compared to the NMD (η² = 0.38). In addition, no significant effect between group and time of measurement was found, indicating that the decrease in wellbeing was not different among patients compared to their main caregivers. Conclusion: The findings highlight the multifaceted impact of neurosurgery on well-being, particularly for patients who remain with motor disabilities and their primary caregivers.The decline in well-being after neurosurgery highlights the need for improved social support and the importance of developing treatment programs that can help ease the process of coping with these phenomena and provide appropriate support for both patients and their primary caregivers.

Objective: Comparison of visual field progression in patients with Primary Open-angle Glaucoma (POAG) and Pseudo Exfoliative Glaucoma (PEXG).Methods and materials: This is a 2-year longitudinal prospective study including 60 glaucomatous eyes with VA CF ≥ 3 m, IOP ≥ 20 mmHg, CDR ≥ 0.6 and those with Shaffer’s grade 3 or above were categorized as POAG along with signs of Pseudo exfoliative material as PEXG.Patients on anti-glaucoma medications and those who have undergone cataract and glaucoma surgeries are also included in this study. 24-2 visual field test was performed using Humphrey Field Analyzer & the progression was assessed based on 3 parameters- Mean Deviation (MD), Visual Field Index (VFI) & Guided Progression Analysis (GPA).Results: The difference in MD & VFI was higher in PEXG (-5.77 dB) (10.88%) than in POAG (-1.56 dB) (7.17%) respectively & was significant statistically (t - test, p = < 0.001). The GPA showed fast progression in 53.30% of cases in PEXG, 13.30% in POAG (Chi-square, p = < 0.001) about 63.30% of POAG & 46.70% of PEXG showed slow- moderate progression, but 23.30% of POAG subjects had no progression.Conclusion: Compared to POAG, the study showed that PEXG had frequent & faster visual field worsening. Therefore, PEXG patients require more stringent management & treatment than those with POAG.

Aim: This study aims to determine the current status for estimation of radiation dose to blood vessels and components from medical imaging procedures.Methodology: A database search on internet via PubMed and Google Scholar was performed to find published papers in estimation of radiation dose to blood vessels and components from medical imaging procedures. Results: Few published papers were found; namely two published papers. Radiation dose to blood vessels and components were assumed to be included in total radiation dose estimation for organ or tissue, without considering different in radiosensitivity. Conclusion: It seems that effect of radiation on blood vessels and components is underestimated, in ICRP 60 and 103 recommendations reports. Recommendation: It is recommended to conduct more studies to estimate radiation dose for blood vessels and components from medical imaging procedures and revise the value of tissue weighting factor for bone marrow.

Traditional Chinese medicine (TCM) has been used to serve people since antiquity in China, and still has an important role in today’s healthcare. As the outbreak of coronavirus disease 2019 (COVID-19) globally, TCM has played an important role in the fight against COVID-19 in China and other countries. However, scientists outside China doubted TCM. The philosophy of TCM in the description of diseases and the use of herbal medicines is difficult to understand for Western scientists. This article explains the philosophy of TCM using chromatic analogies to make it easily understandable and visually intuitive.

Introduction: Menarche, the onset of a girl's first menstrual cycle, often introduces menstrual taboos in certain eastern cultures. These taboos may manifest as social isolation, dietary restrictions, and exclusion from religious spaces, which can adversely affect health and promote gender inequality.Case history: A 10-year-old girl developed gastroenteritis while in cultural confinement after reaching menarche. Her parents strictly adhered to traditional customs that limited her interactions with the outside world and deprived her of healthy foods. They believed that her fatigue was a result of hormonal changes associated with menarche. Although her condition worsened over four days, they did not seek medical treatment. The child succumbed upon admission. The autopsy revealed extensive cyanosis in the left hand due to multiple thrombotic occlusions of the brachial vein. Microscopic examination confirmed the presence of brachial venous thrombi. The cause of death was determined to be Multiple Organ Dysfunction Syndrome (MODS) as a consequence of hypovolemic shock.Discussion: Key medico-legal issues in this case include parental negligence and failure to provide medical care under Section 308A of the Penal Code, potentially leading to criminal liability for negligence-related death under Section 298. Violations of the child's rights, protected by the Children and Young Persons Ordinance (CYPO) and the Protection of Children's Rights Act, form the legal framework for child protection in Sri Lanka. The ISD has interviewed family members and collected witness statements from neighbors and teachers, referring the case to the police for further investigation and notifying the National Child Protection Authority for an additional inquiry. Additionally, Sri Lanka is a signatory to the United Nations Convention on the Rights of the Child (UNCRC), which guarantees children's fundamental rights.

Background & objectives: Mitochondrial DNA (mtDNA) contains valuable genetic information and plays a crucial role in missing person investigations, mass disasters, and forensic cases involving limited or degraded biological material. mtDNA is maternally inherited, with a highly variable control region divided into three hypervariable regions are generally used for forensic investigation. This study aimed to evaluate maternal inheritance patterns of mtDNA using PCR-RFLP techniques to confirm maternal relatedness. Method: The study was designed after prior permission from the institute’s ethical committee in which subjects were enrolled. This pilot study analyzed 50 voluntary participants (mother-child pairs). DNA was extracted from blood or saliva, and the mtDNA hypervariable region (HV region) was amplified by PCR using specific primers for the HV1 region. The amplified fragments (1024 bp) were subjected to RFLP analysis using seven restriction endonucleases (Alu I, BsuR I (Hae III), Hinf I, HsYF31 (Dde I), Mbo I, Rsa I, and SsPI) to reveal morphotypes. Results: The study identified five morphotypes for Alu I, three for BsuR I (Hae III) and Rsa I, two for Hinf I, and one each for HsYF31 (Dde I), Mbo I, and SsPI. There was minimal genetic polymorphism in the hypervariable region among unrelated individuals, but consistent restriction patterns were observed between mothers and their children in same pair. Conclusion: The findings demonstrate the low genetic polymorphism in the hypervariable region among unrelated individuals and consistent restriction patterns within maternal pairs, underscoring mtDNA's utility in forensic and genealogical applications. 

Introduction: Flow analysis in the apical view of transthoracic echocardiography is validated to assess fluid responsiveness at the bedside. Still, it is not always reachable, especially in mechanically ventilated patients and during surgery. We compared it to supra-sternal and sub-xiphoid views to evaluate their validity in assessing fluid responsiveness in critically ill patients.Method: A cross-sectional prospective monocentric pilot study of three months duration has been led in the critical care unit for surgical emergencies of Ibn Sina University Hospital of Rabat (Morocco). We used the time-velocity index (VTI) and peak velocity variation (∆Vpeak) values correlation between the three acoustic windows as the main judgment criteria. Measurement of data was made in the Left Ventricle Outflow Tract (LVOT) in the 5-chamber apical view, Descending Thoracic Aorta (DTA) in the supra-sternal view, and Right Ventricle Outflow Tract (RVOT) in the sub-xiphoid view.Results: There were 14 adult patients involved in the study, and the data presented are preliminary results. There was no significant difference in VTI and ∆Vpeak values between the three acoustic windows at each time of the study protocol, with a very high correlation for initial VTI value between 5-chamber apical view and supra-sternal view (r = 0.96, p < 0.001), and sub-xiphoid view (r = 0.86, p < 0.001). A very high correlation of initial ∆Vpeak value was also observed between the 5-chamber apical view and supra-sternal view (rho = 0.89, p < 0.001) and sub-xiphoid view (rho = 0.79, p < 0.001).Discussion: Supra-sternal and sub-xiphoid views showed high potential to predict fluid responsiveness, but further data are needed to validate their use for this purpose in ICU and in operating room.

Cerebral Autoregulation (CA)-directed therapy, or optimal cerebral perfusion pressure (CPPopt)-targeted therapy, is a tailored bedside method of resuscitation used in critical care that aims to achieve and maintain the CPPopt, to fit the precise cerebral hemodynamics and metabolic demand. Different processes and multiple tools are available to conduct a CA-directed therapy in acute brain-damaged adult admitted into critical care settings, but literature is limited and primarily focused on traumatic brain injury; however, for other brain conditions. By this scope review, we aim to describe the main procedures used by authors to achieve a CA-directed therapy, as well as its acquisition methods and its usefulness in acute non-traumatic brain-damaged adult in neurocritical care.

Cancer has long been recognized as a complex, multifactorial disease, in which genetic mutations and epigenetic alterations drive unchecked proliferation, tissue invasion, and metastasis.

Urinary Tract Infections (UTIs) are common opportunistic diseases, primarily caused by Escherichia coli, which utilizes various virulence factors, including the hlyA gene encoding hemolysin. Phenolic compounds in fruits and vegetables, known for their antimicrobial properties, were examined for their effects on E. coli. This study involved 60 E. coli isolates from Aleppo University Hospital, identified via biochemical and molecular tests. The hemolytic ability was assessed phenotypically, and the hlyA gene was detected using PCR. The impact of pyrogallol and catechol on these isolates was also evaluated. Results showed a 54.6% isolation rate of E. coli, with a higher rate in females (71.7%) than males (28.3%). The 20-40 age group was most affected, comprising 38.4% of cases. Hemolytic activity was observed in 45% of isolates, and the hlyA gene was present in 41.6% of cases. Pyrogallol exhibited a bactericidal effect at high concentrations and mild growth at lower levels, while catechol showed no antibacterial effects. These experimental investigations were validated by docking those polyphenols to the hlyA predicted, validated 3D structure where pyrogallol exhibited stronger binding affinity than catechol (-5.2 vs. -4.8 kcal/mol). The study underscores the significance of the hlyA gene in E. coli virulence and highlights the potential antibacterial properties of phenolic compounds at specific concentrations.

Background: Absence of nocturnal decrease in Blood Pressure (BP) (“non-dipping”) has been shown to be a strong and independent predictor of cardiovascular events, target organ damage, cardiovascular sequela and cardiovascular mortality. Obstructive Sleep Apnea (OSA) has been associated with non-dipping with an estimated prevalence of approximately 50%, but factors associated with non-dipping in OSA patients remain poorly understood. In this study, we examined clinically relevant variables associated with non-dipping in OSA.Methods: Patients (n = 35) undergoing overnight valuation for OSA, laboratory-based polysomnography, structured clinical interviews, and comprehensive metabolic and anthropometric evaluations, and ambulatory BP monitoring for 24 hours. Patients were classified into a) dipping BP group or b) non-dipping BP group, based on (a) a nocturnal systolic BP decrease of 10% - 20% or (b) a systolic BP decrease of < 10%. Results: Patients had moderate and severe OSA (AHI = 34.8 ± 29.1), and 42.9% demonstrated a non-dipping BP pattern. The severity of OSA measures did not differ between dipping group and non-dipping group. However, Wake after Sleep Onset (WASO) and chronicity of insomnia predicts non-dipping BP independent of demographics, sleep stages, anthropometrics, metabolic measures, or arterial stiffness. Conclusion: These findings contribute to a better understanding of the cardiovascular impacts of OSA and indicate that sleep quality should be incorporated into clinical assessments and management of OSA patients.

The examination and the survey of how a person moves, particularly the way of life of walking and running. It entails studying and quantifying a person's gait in terms of their stride length, cadence, foot position, and movement of various body joints. Wearable technology makes it possible to monitor the gait pattern continually while moving about freely. The direction line, gait line, foot line, foot angle, principle line, step length, step breadth, and displacement value obtained from the gyro and accelerated sensors coupled to the shank and thigh are all used to analyze the gait pattern. There has been a lot of research on this method of recognizing people by the way they walk.The two most crucial facts are that OpenPose, a 2D multi-person posture estimation library, can detect 135 critical body locations without the requirement for fiducial markers, and that smartphone cameras can detect the gait pattern without the use of physical markers. In addition, lower extremity sagittal joint angles, spatiotemporal gait parameters, and timings of gait events were independently determined for motion capture. Gait analysis systems use portable, readily available cameras to measure gait characteristics. The pace of gait, length of steps, time of steps, cadence of steps, and the period of stance are the most crucial factors. Recently, the top standard for the examination of gait was used to evaluate the schemes based on two camera usage to evaluate the framework of different gait patterns.The precision of the examination of SCA is being increased by data scientists through the development of AI-based computer algorithms. To increase individualization, Bertillon measured the body and faces of several convicts in 1883.

Forensic science can significantly enhance criminal investigation equity and accuracy. In India, though, forensic experts remain underutilized as case investigations are predominantly performed by law enforcement agencies. This article documents findings of a survey of 230 respondents half of them being forensic experts and other non-forensic respondents like law enforcers exhibiting a wide perceptual gap. While forensic experts emphasize the need for independent intervention so that objective outcomes would be achieved, police respondents strongly favor conventional investigation methods. Systemic barriers like training constraints, availability limitations, and formalization of processes also discourage effective integration of forensic science. The research highlights efforts at policy reform that accord forensic experts a more active role, thereby strengthening the credibility and objectivity of India’s justice system.

Our evaluation and its outcomes/outcomes/hints spotlight that gaining a (having to do with measuring matters with numbers) knowledge of the proteome company in living cells, and its outcomes/consequences/tips for the (introduction and production/ organization of objects) of condensates and MLOs, is a critical assignment that the section separation field wishes to face/address. Our findings that dosage-sensitive (tiny chemical meeting commands interior of living things), insufficient (tiny chemical meeting commands internal of living things) and homologs especially, are overrepresented amongst human LLPS drivers, spotlight furthermore the needed component of preserving the mobile (oversupply/huge quantity) of the (bearing on everyone or issue) DNA/RNA merchandise at a great degree well suited with tightly managed LLPS conduct, to keep away from extreme (diseases/the have a look at of diseases) that unexpected errors in any direction may also cause. In-depth close interest of the records on DNA/RNA concentrations used in the LLPS experiments assisting our excessive self-belief dataset of human driver DNA/RNA s laid the uncertainties related with defining the frame-shape-related meaningful ranges of this essential restriction/guiding principle that leads and controls condensate (introduction and production/ organization of items), and recommended how those uncertainties can be lessened (something awful) and (ultimately) shortened.Graphical abstract: Computational Simulation of Phase-Molecular Separation-DNA/RNA-Related Function Based on Gene Ontology Using Combination of Computational Fluid Dynamics, Machine Learning and Membrane Systems.

Bruxism, characterized by involuntary, repetitive jaw-muscle activity including clenching and grinding of teeth, can lead to significant dental and muscular complications. Conventional treatments—such as occlusal splints and behavioral therapy-may not fully address muscular hyperactivity. Botulinum toxin type A (BoNT-A), a neurotoxin that inhibits acetylcholine release at neuromuscular junctions, has emerged as a promising therapeutic option. This article reviews clinical studies regarding the efficacy of BoNT-A injections into masticatory muscles for bruxism management, with a focus on clinical outcomes, safety, and practical considerations.

This study explores the effectiveness of Homeopathy in managing infectious diseases, focusing on its integration with nanoscience. The key objectives include assessing the role of homoeopathic treatments in reducing morbidity and mortality from various infections, such as respiratory, gastrointestinal, and mosquito-borne diseases, and examining the scientific mechanisms behind its therapeutic effects.Key findings from the study include evidence of nanoparticles in highly diluted homoeopathic solutions, suggesting that these remedies may retain measurable amounts of the original substances. This nanoparticulate perspective bridges traditional homoeopathic practices with modern nanomedicine. Historical evidence, such as Hahnemann’s work on scarlet fever and recent studies during the 2006 Chikungunya epidemic, supports the effectiveness of homoeopathic treatments, demonstrating improved recovery rates and reduced complications with integrated homoeopathic and allopathic approaches.The main conclusion of the study is that Homeopathy, particularly when combined with nanoscience, holds significant promise as a complementary approach in the management of infectious diseases. The presence of nanoparticles in homoeopathic remedies may explain their therapeutic effects, positioning Homeopathy as a valuable component of holistic healthcare strategies, especially in developing countries.

This study explores the dynamics of social exclusion in healthcare settings within the rural Ganderbal district of Kashmir, focusing on the availability of health facilities and the health-seeking behaviors of socially disadvantaged populations. Through a mixed-methods approach, combining quantitative data from interviews and qualitative insights from observation, the research reveals significant disparities in healthcare access between rural and urban areas. Key findings indicate that rural residents face exclusion due to a scarcity of hospitals, unavailability of 24-hour medical staff, inadequate infrastructure, staffing shortages, and systemic biases, compounded by environmental and occupational challenges. Communicable diseases predominate, with majority of respondents affected, and traditional healers and medical shops serve as primary care sources over formal institutions like government hospitals. Socio-economic factors, including low literacy, reliance on agriculture, and poverty, exacerbate these issues. The study highlights higher infant mortality and malnutrition rates in rural areas compared to urban centers, underscoring the need for attitudinal shifts among healthcare providers and systemic improvements in infrastructure and policy to enhance health equity. By addressing an underexplored gap in rural health research in India, this work aims to inform strategies for inclusive healthcare delivery, potentially yielding broader societal benefits through improved well-being and demographic dividends.

Aim: To compare the vision related quality of life before and after prescription of refractive glasses in school-aged children. Design: A prospective, comparative, and hospital-based interventional study was conducted at the Regional Institute of Ophthalmology, PGIMS, Rohtak between May 2021-May 2022. It involved assessment of vision-related quality of life (VRQoL) in 200 school-going children of the 5-16 age group, then comparing outcomes in children with URE versus those corrected with eyeglasses. Those with significantly low visual acuity (≤ 6/9) on Snellen’s were enrolled in the study after obtaining written informed consent from parents. The Modified SREEQ was used to assess VRQoL. Various parameters of comparison included age, gender, demography, education, and improvement in VRQoL within individual study groups over time. Comparison was done before and after using prescription refractive eyeglasses with a follow-up period of 3 months. Results: The correction amongst hypermetropes, 40 out of total 200 students (20%), correction among myopes (153 of 200 students), correction amongst students with astigmatism (7 out of 200 students) resulted in changing categories from mild/moderate/severe visual impairment to normal category of visual acuity i.e., 6/6 on immediate correction with refractive glasses prescribed to them post refraction. Students with astigmatism showed an improvement in symptoms like distorted images post-refractive correction at 3 months. Thus, proving a positive role of refractive eyeglasses in reducing the burden of refractive errors in our study population and improving the visual outcome. Conclusion: VRQoL was better in students after they got their refractive errors corrected with prescription eyeglasses at 3 months as compared to their QoL evaluated at their first visit to our centre with URE. This study focused on having a holistic approach towards improvement in QoL by taking into consideration the academic, psychological, cost-effectiveness aspects of VRQoL among students in the age group 5-16 years old.