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Two major challenges face the practicing physicians and medical community regarding the management of hypertension. First is accurate diagnosis and finding who is the truly hypertensive patient in need of life-long treatment. Second is to improve blood pressure control through addressing hypertension risk factors, adherence to treatment and frequent monitoring. - Current Challenges in Management o Accurate diagnosis of hypertension o Improving blood pressure control - What Do We Need For The Future?

The concurrent emergence of dengue fever and the COVID-19 pandemic posed significant challenges to India’s healthcare system, particularly in Western Rajasthan, a region characterized by its arid climate and unique socio-demographic conditions. This study aimed to investigate the clinical and molecular characteristics of dengue during the COVID-19 pandemic, focusing on trends, diagnostic challenges, and serotype distribution. Conducted at Dr. S.N. Medical College, Jodhpur, in 2021, the study included 550 dengue-positive patients confirmed via rapid diagnostic tests and further analyzed using Dengue NS1 antigen and IgM antibody ELISA. Molecular characterization was performed using RT-PCR for serotyping.The results revealed a male predominance (72.36%) and a higher incidence in the 21–30-year age group (39.09%). Urban areas accounted for 67.73% of cases, with significant NS1 and IgM positivity (p = 0.042 and p = 0.004, respectively). Most cases (86.91%) were managed outpatient, though IgM positivity was significantly higher among hospitalized patients (19.19%, p < 0.001), indicating severe or prolonged infections. Platelet counts were above 100,000/mm³ in 86.91% of cases, with only 0.37% showing critically low counts (< 20,000/mm³). Seasonal analysis showed a peak in October (n = 325), correlating with post-monsoon vector breeding. Serotyping identified DENV2 as the dominant strain (97.42%), associated with severe dengue manifestations, including Dengue Haemorrhagic Fever (DHF).The study highlights the dual burden of dengue and COVID-19, emphasizing the need for enhanced vector control, improved diagnostic strategies and public health interventions during overlapping outbreaks. The predominance of DENV2 underscores the importance of serotype-specific surveillance and preparedness to mitigate future dengue epidemics in the region.

Background: Mechanical chronic neck pain is very common musculoskeletal dysfunction among people, manifesting one or more pain-induced movements and disability impairments. Clinical guidelines suggest passive cervical mobilization and thoracic manipulation as manual therapy interventions. Mulligan concept has positive effect in patients with lumbar and thoracic spine mechanical chronic pain. Study objective was to investigate possible clinical effects of Mulligan techniques in patients with cervical pain according to pain and disability status. Methods: forty participants diagnosed with mechanical chronic cervical pain, randomly assigned into experimental and control group. NAG, SNAG and self-SNAG joint mobilization in a nine-sessions protocol implemented to the study group, while SHAM-Mulligan techniques applied to control group. Self-reported questionnaires Numeric Pain Rating scale (NPRT) and Neck Disability Index (NDI) were used for the measurement of pain and disability levels respectively. Possible Interactions among Factors (TIME X GROUP) and simple effects in three-time measurements of pre, post and one-month follow-up concerning NDI and NPRS variables, were detected with Mixed-ANOVA test. Results: Baseline scores of pain and disability resulted in no differences between groups. A significant Group and Time factors interaction founded and simple main effects analysis showed that Mulligan concept-group had significant improvement in post-intervention NPRT and NDI scores (p<.001), compared to baseline scores. Follow-up also differed compared to post-treatment score (p<.001). SHAM-Mulligan control group had no significant differences in dependent variables at any level of TIME factor (p>.001). Significant differences were found between groups according to second and third measurement phase (p<.001). Conclusion: Our findings suggest that Mulligan concept techniques improve symptoms of pain and disability in chronic mechanical neck pain patients in short and mid-term effect level. Summary: Mobilization techniques of SNAGs, NAGS and self-SNAGs reduces pain and improve function in patients with mechanical neck pain. Taken into consideration the safety and simplicity of application, future studies are encourage to examine the underline mechanism of action.

Demyelinating peripheral neuropathy has been described in association with tumor necrosis factor (TNF) inhibitors. It is rarely developed after treatment discontinuation. We present the case of a child with juvenile idiopathic arthritis who developed peripheral neuropathy few months after TNF inhibitor withdrawal with clinical worsening of the neurological sequelae while undergoing treatment with abatacept.

This paper presents a laboratory experiment for the formation of hydraulic jump in a rectangular open channel flume to accurately explore the effect of flow structures on water resources. This experiment illustrates the behavior of super-critical flow under sluice gate for various flow rates and downstream depths. Several runs are carried out using Armfield Model No. C4-MKII-5.0-11 to investigate the former computations concerning both the downstream conjugate depth and the critical depth resulting within the jump. Moreover, the model is examined to explore the sensitivity of Froude number by adjusting the flow-meter and over-shot weir in the flume. Also, the type of jump attributed to flow velocity can thus be obtained. Furthermore, both location of hydraulic jump and energy dissipated are discussed under the influence of different gate openings

Background: Telerehabilitation has been identified as an effective treatment that promotes exercise rehabilitation in individuals with multiple sclerosis (MS). Social support is recognised as a core element of such interventions. However further research is needed to consider the role and value of different social support domains. Aim: Review available literature to assess and synthesise the use and value of social support within telerehabilitation interventions for individuals with MS. Method: A narrative synthesis was conducted. A systematic search of included articles was conducted. Electronic databases were searched from inception to January 2017. Other search methods were undertaken. Evaluation and synthesis of included articles utilised risk of bias assessment and a 4-stage synthesis process. Main Results: A total of fourteen studies, involving 718 participants (505 female, 213 male; aggregated mean age 47.6 years) with MS, were included. Esteem support was the most frequently reported method of social support, followed by informational, emotional and tangible. It would appear social support can be beneficial in assisting participants to adhere to treatment interventions. Visual feedback may be directly beneficial to improve impaired balance in individuals with MS. A model for future interventions is provided. Conclusions: Social support appears to increase the adherence of participants with MS to telerehabilitation interventions. Unique findings provide an indication for the direction and content of future interventions. Further research is necessary to ascertain the optimal types and frequencies of social support delivery and its effect on health outcomes for participants with MS.

Bacteria has been known to grow in pipes of water distribution systems and bottled drinking water. Its growth in reusable drinking water bottles is not clear even though they have become more popular and used by children and adults daily everywhere. This study found that there is an extremely high level of bacteria content and a rapid microbial growth in reusable drinking water bottles. The bacteria content tested by heterotrophic plate count (HPC) is in a range of 0-2.4x105 CFU/mL with an average of about 34,000 bacteria counts/ml for bottles used by children and 75,000 bacteria counts/ml for bottles used by adults. Bacteria number can quickly increases to 1-2 million counts/ml in the bottles one day later. Considering the high level of HPC bacteria content in the reusable drinking water bottles, it may be necessary to have some control measures to reduce the bacteria level and to minimize the associated likely health risk of the disease spreading since many people use reusable water bottles every day. 

The analytical models are mainly combined with numerical equations for the problems of the pavement under the wheel load. Different assumptions can be considered, such as elastic asphalt and viscoelastic as well as static or dynamic load. Mainly on deformation at the bottom of asphalt and tension layers focus on subgrid. The pavement structure was considered as layers with uniform characteristics. Therefore, this analytical model calculates the three-dimensional contact tension between the wheel and the pavement and the shape of the contact area. Basis and subgrid are considered linear and the asphalt layers can be linear or viscoelastic. This model is based on the results of direct shear stress tests at an axial load constant. The curves obtained from this experiment can be defined by three parameters: the maximum shear stress (shear stress curve versus shear displacement), the interaction modulus between the layers (the same curve slope) and the friction coefficient after the failure. Due to the ability of ABACOUS software, this project is done with this software. One of the methods widely used to predict viscoelastic responses of asphalt mixtures is the finite element method. ABAQUS software is one of the tools that can simulate mixed asphalt behavior based on a finite element method, taking into account all the determinant parameters. The use of the Prony series is one of the common techniques for describing the viscoelastic behavior of asphalt mixtures in ABAQUS software. For this purpose, it is necessary to determine the parameters required for this field, including proven constants, moment elastic modulus, and asphalt mixture poison ratio. On the other hand, the determination of these parameters through testing in addition to spending time and costs requires laboratory equipment. Therefore, in this thesis, a three-dimensional finite element model with ABAQUS software was constructed to analyze the persistent pavement using theoretical relations without conducting the experiment. Also, viscoelastic behavior of common asphalt mixtures and time dependence of its responses at different temperatures can be modeled in ABAQUS software. After performing the shear stress test for different axial loads, different temperatures, with or without a single coil, they found that all parameters are temperature dependent and the coefficient of friction does not depend on the applied axial load. This new model improves the accuracy of the finite element model and its important role can be an analytic expression that includes all the variables that are effective in the problem.

Pigeonpea is one of the important legume crops with high protein content and nutritional traits. It has enormous potency for its widespread adoption by farming communities. It is affected by various kinds of biotic and abiotic stresses. In the context, of biotic stresses Sterility mosaic disease (SMD) is one of the severe diseases in pigeonpea which ultimately lead to the drastic yield loss. The virus belongs to the genus Emaravirus, family- Fimoviridae. SMD is associated with two diverse types of Emaravirus, Pigeonpea sterility mosaic virus1 (PPSMV-1) and Pigeonpea sterility mosaic virus 2 (PPSMV-2). It is transmitted by the mite (Aceria cajani), mainly environmental contributing to the feasibility for the mites for the inoculation of the virus. The SMD is mainly governed by two genes SV1 that includes the dominant allele and serves as an inhibitory action on the resistance of the SV2. Methods for identification of the virus include RT-PCR, DIBA and ELISA using alkaline phosphatase or penicillinase. To control SMV disease farmers generally adopted intercropping methods. There are few potential drugs have been identified for the administration of the disease such as 0.1% Fenazaquin, Dicofol, Imidacloripid, Carbosulfan; Spiromesifin includes the inhibition of the mite inoculation on the pigeonpea plant. The present review describes compressive and systematic insights on SMV protein targets and potential drugs that could be utilized as the presumed drug targets for the finding of true drugs against the SMD in pigeonpea.

Frequency specific microcurrent (FSM) has been used to treat myofascial pain syndrome [1,2] fibromyalgia associated with spine trauma [3], delayed onset muscle soreness [4], acute and chronic neuropathic pain [5] and chronic scarring in burn patients [6]. In this case, its use was modified to include not only the treatment of neuropathic pain but the treatment of neural adhesions in a patient with a ten year history of pain at rest and painful restricted range of motion following an ulnar nerve anterior transposition surgery in 2001. Eleven standard physical therapy sessions including augmented soft tissue mobilization using plastic tools, and muscle strengthening exercises and stretching failed to resolve symptoms. Three sessions of frequency specific microcurrent produced complete resolution of pain and symptoms. Patient remained symptoms free at one-year follow up.