Social Anxiety and Quality of Life: Mediating Role of Stigma Perception in Individuals Who Stutter

Children, adolescents, and adults who stutter widely experience anxiety and avoid social situations; hence stuttering negatively affects their quality of life (Yaruss & Quesal, 2004). The study aims to investigate the relation between social anxiety, stigma perception, and quality of life among individuals who stutter and to examine if stigma perception mediates between social anxiety and quality of life. Participants of aged 11- 25 years (Mage =18.83, SD = 4.74, N = 117) were recruited using purposive and snowball sampling technique. Participants were screened based on dysfluency using DSM-5 (2013) stuttering criteria. Results revealed significant association between social anxiety, stigma perception, and quality of life. Mediation analysis also showed that stigma perception partially mediated the relation between social anxiety and quality of life in individuals who stutter. Furthermore, significant age differences were found in social anxiety and quality of life in individuals who stutter. The study concluded that stigma perception partially mediates the relationship between social anxiety and quality of life; therefore, social anxiety and perceived stigma need to be reduced to enhance stuttering individuals’ quality of life. Results highlight the importance of multidisciplinary approach in the management of stuttering

Renal artery variants: a comprehensive cadaveric comparative study using morphological and corrosion casting technique

Background: Kidneys, crucial excretory organs, receive substantial blood supply through renal arteries. Variations in their anatomy are common, warranting detailed investigation. This study aims to comprehensively examine renal artery patterns using both gross dissection and the corrosion cast method. Methods: Thirty kidney pairs from cadavers were meticulously dissected at Subharti Medical College, Meerut, U.P. India. Gross features were carefully noted, and corrosion casts were meticulously prepared. Prevalence, origin, level, division, course, and variations were exhaustively recorded to provide a thorough understanding of renal vascular anatomy. Results: Main renal arteries were found to predominantly originate from the abdominal aorta in all specimens. Interestingly, a higher prevalence of origin of right renal arteries was observed, with 47% exhibiting a higher origin than their left counterparts. Further analysis revealed prehilar division in 38.3% and hilar division in 61.6% of specimens. Notably, a segmental pattern of renal arteries was observed. Accessory renal arteries (8%) were identified, including rare occurrences of bilateral and double accessory renal arteries. Of particular significance was the observation of an accessory renal artery passing anterior to the inferior vena cava, highlighting the intricacies of renal vascular variations. Conclusions: While reaffirming the conventional understanding of renal arterial anatomy, this study emphasizes the complexity and clinical relevance of variations in renal artery morphology. Such detailed insights are invaluable for surgical and radiological practice, underlining the importance of meticulous preoperative assessment to optimize patient outcomes

Comparison Of ALT In Type 2 Diabetics with And Without Fatty Liver Disease

Objective: To determine the association of alanine aminotransferase in type 2 diabetic patients with and without fatty liver disease. Materials and Methods: A cross-sectional study was done for six months at Sheikh Khalifa Bin Zaid Al-Nahyan Hospital Rawalakot. In our study, we included all the patients who presented to the outpatient department (OPD) having type 2 diabetes mellitus. Their age, gender, height, weight, and duration of diabetes mellitus were noted. Their liver function test (LFTS), fasting blood sugar and HBA1c, and fasting lipid profile were also done at the time of their OPD visit and results were noted. They were given an appointment for an ultrasound abdomen from the radiology department for detection of fatty liver disease and the results were noted on the next OPD visit. Results: Total study population was 90 patients and out of which 35 (38.8%) were male and 55 (61.1%) were female. 58 years was the mean age of our study population. Fatty liver was present in 50% of patients. ALT was raised from a baseline value of 36 in 61% of patients while fasting blood sugar was raised in 83% of patients. The mean fasting blood sugar was 208 mg/dl. ALT was not significantly different in patients with and without fatty liver disease. However, it was found that patients with uncontrolled blood glucose levels have significantly raised ALT which was also statistically proven as the P value was less than 0.05. Also, patients with high blood glucose have a higher incidence of fatty liver disease as compared with normal blood glucose level patients but the difference was not statistically significant as shown by a P value more than 0.05. Conclusion: Fatty liver disease is more common in Type 2 diabetic patients with uncontrolled blood sugar. There is a high rate of raised ALT in diabetic patients whose blood sugar control is not optimum

Synergistic biomedical potential and molecular docking analyses of coumarin–triazole hybrids as tyrosinase inhibitors: design, synthesis, in vitro profiling, and in silico studies

The tyrosinase enzyme has a vital role in the browning of vegetables and fruits and the biosynthesis of melanin. In this work, we synthesized a diverse library of coumarin–triazole hybrids, and these compounds were characterized by using suitable analytical techniques. Our research work extends beyond the synthetic effort to explore the therapeutic potential of these compounds. We put the synthesized compounds through meticulous in vitro screening against the tyrosinase enzyme, and these coumarin derivatives evinced good IC50 values in the range of 0.339 ± 0.25 µM to 14.06 ± 0.92 µM. In the library of synthesized compounds, six compounds were found to be more potent than standard ascorbic acid (IC50 = 11.5 ± 1.00), and among them, 17e and 17f, being the most active, exhibited remarkable anti-tyrosinase potential, with IC50 values of 0.339 ± 0.25 μM and 3.148 ± 0.23 μM, respectively. Furthermore, an in silico modeling study was carried out to determine the key interactions of these compounds with the tyrosinase protein (PDB ID: 2Y9X) and thus to authenticate our experimental findings. The quantitative SAR studies exhibited a good correlation between the synthesized derivatives of coumarin and their anti-tyrosinase activity. The docking studies verified the experimental results, and ligand 17e showed good interaction with the core residues of tyrosinase. This study not only expands the field of coumarin–triazole hybrid synthesis but also provides valuable insights for the development of novel tyrosinase inhibitors

Modelling of Rhode Island Red chicken strains

To study the growth pattern in body weight of 3 strains of Rhode Island Red chicken Bertalanffy, gompertz and logistic nonlinear models were fitted. From the data on body weights of three strains of Rhode Island Red, we observed that average body weights of male chicken were higher than the female chicken. Based on the various measures of goodness fit criteria we have observed that in modelling of body weight of the Rhode Island Red chicken Bertalanffy was the best fitted model. In case of Rhode Island Control, Bertalanffy was the best fitted model and for Rhode Island Control male chicken logistic was the best fitted model. In case of Rhode Island White chicken logistic was the best fitted model and in case of Rhode Island White male chicken Bertalanffy was the best fitted model. In case of female chicken of Rhode Island Red, Rhode Island Control and Rhode Island White strains gompertz model was the best fitted model. From these fitted models one can determine the expected average body weight of a group of birds of three strains of RIR chicken at any given age under normal conditions

The potential of IFN-λ, IL-32γ, IL-6, and IL-22 as safeguards against human viruses: a systematic review and a meta-analysis

Many studies have investigated the antiviral activity of cytokines, including interleukin-6 (IL-6), interleukin-22 (IL-22), interleukin-32 gamma (IL-32γ), and interferon-lambda (IFN-λ) in diverse populations. This study aims to evaluate the role of these cytokines in inhibition of various human and animal viruses when administered exogenously. A comprehensive meta-analysis and systematic review were conducted on all the relevant studies from three databases. Standard mean differences (SMDs) of overall viral inhibition were used to generate the difference in the antiviral efficacy of these cytokines between control and experimental groups. A total of 4,618 abstracts for IL-6, 3,517 abstracts for IL-22, 2,160 abstracts for IL-32γ, and 1,026 abstracts for IFN-λ were identified, and 7, 4, 8, and 35 studies were included, respectively, for each cytokine. IFN-λ (SMD = 0.9540; 95% CI: 0.69–0.22) and IL-32γ (SMD = 0.459; 95% CI: 0.02–0.90) showed the highest influence followed by IL-6 (SMD = 0.456; CI: −0.04–0.95) and IL-22 (SMD = 0.244; 95% CI: −0.33–0.81). None of the cytokines represented heterogeneity (tau² > 0), but only IFN-λ indicated the funnel plot asymmetry (p = 0.0097). Results also indicated that IFN-λ and IL-32γ are more potent antivirals than IL-6 and IL-22. The collective findings of this study emphasize that exogenously administered pro-inflammatory cytokines, specifically IFN-λ and IL-32, exhibit a significant antiviral activity, thereby underscoring them as potent antiviral agents. Nonetheless, additional research is required to ascertain their clinical utility and potential for integration into combinatorial therapeutic regimens against viral infections

Alleviation of drought stress through foliar application of thiamine in two varieties of pea (Pisum sativum L.)

Drought stress poorly impacts many morphological and physio-biochemical processes in plants. Pea (Pisum sativum L.) plants are highly nutritious crops destined for human consumption; however, their productivity is threatened under drought stress. Thiamine (vitamin B1) is well-known essential micronutrient, acting as a cofactor in key metabolic processes. Therefore, this study was designed to examine the protective effect of foliar application of thiamine (0, 250, and 500 ppm) on two varieties of pea plants under drought stress. Here, we conducted the pot experiment at the Government College Women University, Faisalabad, to investigate the physio-biochemical and morphological traits of two pea varieties (sarsabz and metior) grown under drought stress and thiamine treatment. Drought stress was applied to plants after germination period of 1 month. Results showed that root fresh and dry weight, shoot fresh and dry weight, number of pods, leaf area, total soluble sugars, total phenolics, total protein contents, catalase, peroxidase, and mineral ions were reduced against drought stress. However, the application of thiamine (both 250 and 500 ppm) overcome the stress and also enhances these parameters, and significantly increases the antioxidant activities (catalase and peroxidase). Moreover, the performance of sarsabz was better under control and drought stress conditions than metior variety. In conclusion, the exogenous application of thiamine enabled the plants to withstand drought stress conditions by regulating several physiological and biochemical mechanisms. In agriculture, it is a great latent to alleviate the antagonistic impact of drought stress on crops through the foliar application of thiamine

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Assessment of satisfaction among OPD patients at Noor Hospital, Warudi, Badnapur

Background: Health care quality is a global issue. Consumer satisfaction is recognized as an important parameter for assessing the quality of patient care services, satisfaction regarding the attitude of providers towards the services is expected to affect treatment outcome and prognosis. Objective: To assess patient satisfaction with services provided in a tertiary care hospital in rural Jalna. Method: This cross sectional study was carried out in the outpatient department of, Noor hospital of Indian Institute of medical science and research Warudi Badnapur, District Jalna. A total of 250 patients were selected by systematic random sampling from 1 st march to 31 th August 2014 and interviewed. The data collected was analysed by applying appropriate statistical test. Results: The overall satisfaction rate in this study was 87.45%.Total 88.4% of patients are satisfied with the availability of essential medicine and 88% patients get medicine easily. Satisfaction with laboratory location was 93.6% and 90% of respondents agreed with investigation reports received in time. Regarding cleanliness of hospital 94.8% of respondents are satisfied. Total 85.6% of respondents were satisfied with the condition of the toilets. Satisfaction rate for availability of drinking water was 83.6%. About paramedical staff 95.6% of patients agree that paramedical staff talk politely with them and 94% of patients told they are helpful. Conclusion: Patient’s feedback is important as continuous quality improvement is linked to the use of timely and useful feedback from the clients