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Background and Purpose: The zygomatic arch is important to maintain facial projection as well as width. Hence, restitution of its form by open reduction and internal fixation (ORIF) is indicated following its fracture, in certain clinical scenarios. The contemporary surgical approaches are cutaneous with associated complications. This observational clinical trial was designed to evaluate intraoral reduction and transbuccal fixation of zygomatic arch fractures. Materials and Method: Six patients requiring ORIF of the zygomatic arch were recruited for the study. The clinical parameters such as pain, swelling, mouth opening, facial nerve function, and scar were assessed in the pre-operative as well as post-operative period. Radiographic assessment of displacement and inter-fragmentary separation were studied on computed tomography (CT) images. Results: Mean pre-operative mouth opening was increased from 28.33 ± 6.80 to 36.83 ± 1.94 (P value 0.03). Mean pre-operative swelling was decreased from 34.63 ± 5.41 to 29.71 ± 2.73 (P value 0.02). The pain decreased by day 7 in all the patients (P value 0.01). No facial nerve injury (P value 1) or scar formation (P value 0.002) was encountered in our study. The inter-fragmentary separation as assessed by CT analysis revealed satisfactory outcome. Conclusion: Intraoral open reduction and transbuccal fixation is a simple, effective, and less invasive method to address zygomatic arch fractures with no complications.

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The main challenges for utilizing daily evapotranspiration (ET) estimation in the study area revolve around the need for accurate and reliable data inputs, as well as the interpretation of ET dynamics within the context of local agricultural practices and environmental conditions. Factors such as cloud cover, atmospheric aerosols, and variations in land cover pose challenges to the precise estimation of ET from remote sensing data. This research aimed to utilize Landsat 8 and 9 datasets from the 2022-23 period in the Udham Singh Nagar district to apply the modified Priestley-Taylor (MPT) model for estimating ET. An average ET was estimated 1.33, 1.57, 1.70, 2.99, and 3.20 mm day-1 with 0.29, 0.33, 0.41, 0.69, and 1.03 standard deviation for December, January, February, March, and April month, respectively. In the validation phase, a strong correlation was found between the evaporative fraction derived from MPT and that observed by lysimeter, with R2 = 0.71, mean biased error = 0.04 mm day-1, root mean squared error = 0.62 mm day-1 and agreement index of 0.914. These results collectively support the effectiveness of the MPT model in accurately estimating ET across Udham Singh Nagar district. In essence, this research not only confirms the MPT model's capability in ET estimation but also offers detailed insights into the spatial and temporal fluctuations of energy fluxes and daily ET rates.

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Second-order superlattices form when moiré superlattices with similar periodicities interfere with each other, leading to larger superlattice periodicities. These crystalline structures are engineered using two-dimensional materials such as graphene and hexagonal boron nitride, and the specific alignment plays a crucial role in facilitating correlation-driven topological phases. Signatures of second-order superlattices have been identified in magnetotransport experiments; however, real-space visualization is still lacking. Here we reveal the second-order superlattice in magic-angle twisted bilayer graphene closely aligned with hexagonal boron nitride through electronic transport measurements and cryogenic nanoscale photovoltage measurements and evidenced by long-range periodic photovoltage modulations. Our results show that even minuscule strain and twist-angle variations as small as 0.01° can lead to drastic changes in the second-order superlattice structure. Our real-space observations, therefore, serve as a 'magnifying glass' for strain and twist angle and can elucidate the mechanisms responsible for the breaking of spatial symmetries in twisted bilayer graphene.

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Atlantic salmon aquaculture companies in British Columbia (BC) must report fish health events to Fisheries and Oceans Canada (DFO) as part of their licensing conditions. Our study aimed to summarize these fish health events reported by Atlantic salmon sites in BC to identify spatial and spatio-temporal clusters. We conducted descriptive, retrospective global, and local cluster analyses using Moran's I and scan statistics. Between 2016 and 2022, 265 fish health events were reported. The annual incidence ranged from 5.60 (95% CI: 3.90-7.80) to 6.86 (95% CI: 4.70-9.60) health events per 100 active site-months. The most common events were yellow mouth (60.75%; 161/265) and salmonid rickettsial septicaemia (SRS) (15.47%; 41/265). The Moran's I index was positive and significant for yellow mouth, SRS, and overall fish health events at different distance bands. Most of the spatial and spatio-temporal clusters were identified in the west-central and southwestern parts of Vancouver Island. Our study hypothesizes that management practices, environmental conditions, and water quality parameters may have influenced the increased reporting of fish health events in these regions. Overall, the study highlights the potential of publicly available data for practical risk mapping in understanding the patterns of farmed Atlantic salmon diseases in BC.

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BACKGROUND AND OBJECTIVE: Premature coronary artery disease (CAD) is an important cause of death in India. To identify risk factors in patients with premature CAD, we performed a registry-based study. METHODS: Consecutive patients admitted for percutaneous coronary intervention (PCI) from October 2020 to June 2021 were recruited. The patients were classified into three groups-group I (very premature CAD < 40 years), group II (premature CAD 40-59 years), and group III (nonpremature CAD > 60 years). Major risk factors were determined, and intergroup comparison was performed. RESULTS: A total of 627 patients were enrolled (men 541, women 86). Group I had 79 (12.4%), group II had 420 (66.9%), and group III had 128 (20.4%) patients. The prevalence of risk factors in groups I, II, and III, respectively, were-CAD family history in 45.1, 41.1, and 26.6% (p = 0.005), current smoking/tobacco use in 29.1, 21.0, and 10.2% (p = 0.002), hypertension in 31.6, 43.6, and 59.4% (p < 0.001), and diabetes in 22.8, 34.3, and 46.1% (p < 0.001). High total cholesterol (>170 mg/dL) was present in 50.0, 38.0, and 29.9% (p = 0.005), nonhigh-density lipoprotein (HDL) cholesterol (>100 mg/dL) in 76.9, 64.4, and 54.5% (p = 0.001), low-density lipoprotein (LDL) cholesterol (>70 mg/dL) in 85.9, 76.8, and 76.4% (p = 0.167), triglycerides (>150 mg/dL) in 56.4, 45.3, and 33.1% (p = 0.001), and very low density lipoprotein (VLDL) cholesterol (>30 mg/dL) in 24.4, 10.4, and 9.4% (p = 0.005). Age- and sex-adjusted odds ratios (OR) and 95% confidence intervals (CI) for smoking/tobacco use in groups I and II compared to group III, respectively, were 3.17 (1.60-6.27) and 2.59 (1.51-4.46); high total cholesterol 2.39 (1.29-4.13) and 1.42 (0.92-2.17); high non-HDL cholesterol 2.70 (1.45-5.03) and 1.48 (0.99-2.20); and high triglycerides 2.57 (1.44-4.58) and 1.64 (1.08-2.49). CONCLUSION: Important coronary risk factors in very premature and premature CAD in India are a family history of CAD, any tobacco use, and dyslipidemias (raised total, LDL, non-HDL, and VLDL cholesterol and triglycerides).

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In recent years, there has been a burgeoning interest in the utilization of microbial exopolysaccharides (EPS) because of the added advantage of their renewable, biocompatible, and biodegradable nature in addition to intended applications. The endowed properties of bacterial EPS make them valuable candidates for a wide array of industrial applications. Modification of native EPS is known to enhance various physico-chemical and functional properties. Various modifications such as physical, chemical, biological, and enzymatic modifications were practiced improving the bioactivity of EPS. This paper comprehensively aims to review the most recent chemical modification techniques employed to modify the physico-chemical and functional changes of bacterial EPS in comparison with the unmodified forms. Chemical modification entails strategic alterations to the structure and properties of EPS through various synthetic and semi-synthetic methodologies. Emphasis is given to the antioxidant potential and functional role of these EPS derivatives in human health. Antioxidant properties reveal a significant augmentation in activity compared to their native counterparts. Such enhancement holds a strong promise for potential benefits and therapeutic applications. Chemical derivatives of EPS with overwhelming functional benefits could surely encourage EPS application, particularly as potential hydrocolloids in industrial and biomedical contexts.

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Mitochondria are central to cellular energy production, and their dysfunction is a major contributor to oxidative stress and chronic inflammation, pivotal factors in aging, and related diseases. With aging, mitochondrial efficiency declines, leading to an increase in ROS and persistent inflammatory responses. Therapeutic interventions targeting mitochondrial health show promise in mitigating these detrimental effects. Antioxidants such as MitoQ and MitoVitE, and supplements like coenzyme Q10 and NAD + precursors, have demonstrated potential in reducing oxidative stress. Additionally, gene therapy aimed at enhancing mitochondrial function, alongside lifestyle modifications such as regular exercise and caloric restriction can ameliorate age-related mitochondrial decline. Exercise not only boosts mitochondrial biogenesis but also improves mitophagy. Enhancing mitophagy is a key strategy to prevent the accumulation of dysfunctional mitochondria, which is crucial for cellular homeostasis and longevity. Pharmacological agents like sulforaphane, SS-31, and resveratrol indirectly promote mitochondrial biogenesis and improve cellular resistance to oxidative damage. The exploration of mitochondrial therapeutics, including emerging techniques like mitochondrial transplantation, offers significant avenues for extending health span and combating age-related diseases. However, translating these findings into clinical practice requires overcoming challenges in precisely targeting dysfunctional mitochondria and optimizing delivery mechanisms for therapeutic agents. Continued research is essential to refine these approaches and fully understand the interplay between mitochondrial dynamics and aging.

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Purpose: Perception that extra-medullary fixation of these fractures are fraught with difficulties and deficiencies is becoming inappropriate. This device provides angular stable fixation retaining fracture biology with minimum interference to osseous and soft-tissue vascularity and it does not require reaming which destroys 80% of endosteal vasculature for 6-12 weeks. PFLCP averts iatrogenic fracture in lateral trochanteric wall (LTW) which is frequent with DHS, protects LTW from secondary fracture in post-operative period. Aim is to assess outcome of unstable proximal femur fracture fixation by PFLCP. Methods: Study included 64 from 2016 to 2020, divided in two groups. (A) Unstable intertrochanteric fracture and (B) subtrochanteric fracture (Seinsheimer types II-V). All fractures fixed by MIPO with PFLCP. Loss of reduction, infection, cut-out, cut-through, backing of screws, bending or breaking of plate and screw, malunion, non-union and revision were evaluated. Fracture healing and functional recovery assessed by Reborne Score and Parker Mobility Score (PMS) respectively. Results: Out of 64, 24 achieved pre-injury PMS, 32 declined by 1 point, 6 declined by 2 points and 1 by 3 points, one required revision. Using various parameters 37.5% patients had excellent results and 50% had good results, 9.38% had average and 3.12% had poor result. None reported non-union or breakage of plate. Conclusions: PFLCP provides angular stable fixation, torsional stability with high biomechanical strength to resist deforming stresses. MIPO avoids soft-tissue stripping reducing blood-loss, retains periosteal blood supply to inter-fragmentary bone fragments, enhancing fracture healing, reducing complications, such as delayed healing, nonunion, infection and implant failure.

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Introduction: Permanent pacemaker implantation (PPI) in neonates is challenging with respect to indications, device selection, implantation technique, and long-term outcomes. Complex anatomy, the need for long-term pacing with high rates, and a problematic postoperative period are the major problems. Methods: We prospectively followed up 22 newborns who underwent PPI below 28 days of life at our institute. Results: The median age at implantation was 2 days (interquartile range 1-9 days), and 9% were born preterm. The average heart rate before implantation was 46.4 ± 7.2 bpm. Maternal lupus antibodies were positive in 8 (36.4%) neonates, whereas 11 (50.0%) had associated congenital heart disease. Nineteen neonates underwent single chamber (VVI) and three underwent dual chamber (DDD) pacemaker implantation. Over a median follow-up of 46 months (range 2-123 months), the average ventricular pacing percentage was 87.5 ± 24.9%, with a stable pacing threshold. Seven children underwent pulse generator replacement due to battery depletion at a median age of 47 months. Pacing-induced ventricular dysfunction was seen in five children at a median age of 23.6 months, and two underwent upgradation to cardiac resynchronization therapy. Overall mortality was 13.6%, all due to tissue hypoperfusion and lactic acidosis in the postimplantation period. Conclusions: PPI in neonates has a favorable outcome with excellent lead survival. Overall mortality is 13.6%, which is predominantly in the postimplantation period and related to myocardial dysfunction.

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INTRODUCTION: Quality of life (QoL) is a subjective measure reflecting individuals' evaluations based on their personal goals and values. While global research shows the role of neighborhood factors like ethnic diversity and socio-cultural dynamics on QoL, these are unexplored in the Nepali context. Therefore, this study examined the relationship between neighborhood environment and QoL among Nepali older adults in eastern Nepal. METHODS: This cross-sectional study involved 847 non-institutionalized older adults (aged ≥ 60 years) from two districts in eastern Nepal. QoL was evaluated using the 13-item brief Older People's Quality of Life questionnaire, where a mean score of < 3 indicated low/poor QoL. The neighborhood environment, conceptualized across three domains (demographic, socio-cultural, and built environment), included ethnic diversity, connections with family, friends, and neighbors, cultural ties, residential stability, and rurality. Their association with QoL was examined using multivariable logistic regression. RESULTS: Around 20% of older adults reported poor QoL. Higher ethnic diversity (adjusted Odds Ratio [aOR] = 0.12, 95% confidence interval [CI]: 0.04-0.36), moderate contact with family and relatives (aOR = 0.26, CI: 0.11-0.61), and high contact with neighbors (aOR = 0.09, CI: 0.03-0.21) were associated with lower odds of poor QoL. Conversely, high contact with friends (aOR = 2.29, CI: 1.30-4.04) and unstable residence (OR = 6.25, CI: 2.03-19.23) increased the odds of poor QoL. Additionally, among the covariates, chronic disease, tobacco use, unemployment, and lack of education were also significantly associated with poor QoL. CONCLUSION: Overall, the demographic environment, socio-cultural factors, and the built environment of the neighborhood influence QoL. Therefore, diversifying the neighborhood's ethnic composition, promoting social connections such as frequent contact with family, relatives, and neighbors, and ensuring residential stability can enhance the QoL of older adults.

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This study examines the influence of planting mixture variations on the quality of the percolated water of the rain garden with and without plants. Six planting mixtures in experimental rain gardens have been used. It has been noted that pollutant removal efficiency of RG can exhibit variations based on specific parameters. Notably, RG6, utilizing a planting mix of 75% topsoil and 25% compost, demonstrated the highest performance. These results draw attention to the critical role of the specific planting mixtures in influencing the performance of vital parameters related to pollutant removal. The observation shows that RG5 exhibits exceptional removal efficiency in pH, Total Suspended Solids (TSS), Biological Oxygen Demand (BOD), and Chemical Oxygen Demand (COD), and RG6 performs best in electrical conductivity (EC), Total Dissolved Solids (TDS), Total Nitrogen (TN), and Total Phosphorus (TP) removal. In particular, when analyzing pollutant removal on a surface with Madagascar periwinkle plants, RG6 emerges as the most effective, achieving an impressive efficiency of approximately 49%. For the bare surface, pollutant removal efficiency is 40%. The study outcome will be useful in deciding the composition of the planting mixture, which will keep the rain garden to improve quality and quantitatively hydrological performance, lowering urban flooding magnitude.

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Egyptian clover/Berseem (Trifolium alexandrinum L.) is the most popular winter leguminous multi-cut fodder crop widely cultivated in the northwest and central parts of India. Quality seed significantly impacts farm productivity, farmers' profitability, and socioeconomic welfare. Foundation and certified seeds enable high-quality seed production, making breeder seed (BS) the most important link in the seed supply chain. In India, berseem BS indent had increased from 1998 - 99 to 2012-13; afterwards, it followed a constant but decreasing trend. Of the 27 notified cultivars, 24 came into the seed supply chain between 1998-1999 and 2021-2022, indicating high varietal availability to stakeholders. The study examines the potential causes of the national decline in BS indent and production and the differences in these figures over time. The highest BS indent was received for the variety JB-1 (276.1 q), followed by BL-10 (205.1 q), Mescavi (165.6 q) and Wardan (153.7 q) from 1998 - 99 to 2021-22. The varietal replacement rate (VRR) is high, 43.30 %, for the varieties that have reached the age of five or less in the recent three years (2019-20 to 2021-22). Additionally, it has been calculated that if the seed chain operates at 100 % efficiency, the BS generated (48.1q) in 2021-22 can cover an area of almost 0.12 million hectares in 2024-25. The study offers an in-depth overview of berseem BS indent and production, an analysis of the difficulties encountered in BS production, and future directions for expanding variety and producing excess BS in the nation.

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BACKGROUND: Takayasu arteritis (TA) is a chronic inflammatory disease of unknown etiology characterized by a large vessel vasculitis involving the aorta and its branches. Myocardial involvement is extremely unusual in TA and is mostly in the form of myocarditis, ventricular hypertrophy, and ventricular dysfunction secondary to coronary ischemia. Submitral aneurysms have been reported in TA and has been attributed to the chronic inflammatory process in TA. CASE PRESENTATION: We report a novel instance of left ventricular apical aneurysm in a 37-year-old lady with TA and normal epicardial coronaries. She was diagnosed with a left ventricular apical aneurysm, moderate aortic regurgitation, and moderate pericardial effusion. The coronary arteries were normal. The patient had concomitant chronic active Epstein-Barr virus infection complicating patient outcome. CONCLUSIONS: Left ventricular apical aneurysm with normal epicardial coronaries is a rare cause of heart failure in Takayasu arteritis. Concomitant chronic active Epstein-Barr virus infection can potentially accentuate the inflammatory process in Takayasu arteritis and complicate management and patient outcomes.

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Pharmaceutical drugs, including antibiotics and hormonal agents, pose a significant threat to environmental and public health due to their persistent presence in aquatic environments. Colistin (KOL), fluoxetine (FLUO), amoxicillin (AMO), and 17-alpha-ethinylestradiol (EST) are pharmaceuticals (PhCs) that frequently exceed regulatory limits in water and wastewater. Current removal methods are mainly ineffective, necessitating the development of more efficient techniques. This study investigates the use of synthetic zeolite (NaP1_FA) and zeolite-carbon composites (NaP1_C), both derived from fly ash (FA), for the removal of KOL, FLUO, AMO, and EST from aquatic environments. Batch adsorption experiments assessed the effects of contact time, adsorbent dosage, initial concentration, and pH on the removal efficiency of the pharmaceuticals. The results demonstrated that NaP1_FA and NaP1_C exhibited high removal efficiencies for all tested pharmaceuticals, achieving over 90% removal within 2 min of contact time. The Behnajady-Modirshahla-Ghanbary (BMG) kinetic model best described the adsorption processes. The most effective sorption was observed with a sorbent dose of 1-2 g L-1. Regarding removal efficiency, the substances ranked in this order: EST was the highest, followed by AMO, KOL, and FLUO. Sorption efficiency was influenced by the initial pH of the solutions, with optimal performance observed at pH 2-2.5 for KOL and FLUO. The zeolite-carbon composite NaP1_C, due to its hydrophobic nature, showed superior sorption efficiency for hydrophobic pharmaceuticals like FLUO and EST. The spectral analysis reveals that the primary mechanism for immobilizing the tested PhCs on zeolite sorbents is mainly due to physical sorption. This study underscores the potential of utilizing inexpensive, fly ash-derived zeolites and zeolite-carbon composites to remove pharmaceuticals from water effectively. These findings contribute to developing advanced materials for decentralized wastewater treatment systems, directly addressing pollution sources in various facilities.

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The low cost and ecological compatibility of green technology makes it superior to chemical approaches in the generation of metal nanoparticles. The current study shows the use of cranberry fruit extract in the environmentally friendly green production of palladium nanoparticles. It is well known that the fruit extract from cranberries has a rich phytochemical composition that makes it a useful bio reducing agent for the formation of PdNPs. Several spectroscopic techniques, including ultraviolet-visible spectroscopy (UV-vis), X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and energy-dispersive X-ray spectroscopy (EDX), were used to characterize the palladium nanoparticles (PdNPs). The diffractogram of the XRD analysis shows significant reflections at 39.98° (111), 46.49° (200), and 67.95° (220), which indicate the face-centered cubic (FCC) structure of PdNPs and demonstrate the crystallinity of the produced nanoparticles from the green method. The SEM and TEM structural and morphological analyses reveal that the synthesized nanoparticles have a spherical shape with size ranging between 2 nm to 50 nm. In addition, the synthesized PdNPs demonstrated possible antibacterial activity on both Gram-positive and Gram-negative bacteria as well as a cytotoxic effect on the MCF-7 breast cancer cell line. The degradation of Indigo Carmine (IC) and Sunset Yellow (SY) dyes can be effectively catalyzed by biogenic PdNPs, according to the results.

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Ecosystems and human health are being negatively impacted by the growing problem of electrical waste, especially in developing countries. E-waste poses a significant risk to ecological systems because it can release a variety of hazardous substances into the environment, containing polybrominated diphenyl ethers and heavy metals, brominated flame retardants, polychlorinated dibenzofurans and polycyclic aromatic hydrocarbons, and dioxins. This review article provides a critical assessment of the toxicological consequences of e-waste on ecosystems and human health and data analyses from scientific journals and grey literature on metals, BFRs, PBDEs, PCDFs, and PAHs in several environmental compartments of commercial significance in informal electronic trash recycling. The currently available techniques and tools employed for treating e-waste are sustainable techniques such as bioremediation, chemical leaching, biological leaching, and pyrometallurgy have been also discussed along with the necessity of implementing strong legislation to address the issue of unregulated exports of electronic trash in recycling practices. Despite the ongoing hurdles, implementing environmentally sustainable recycling methods have the potential to address the detrimental impacts of e-waste and foster positive economic development.

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Diabetic encephalopathy (DE), a significant micro-complication of diabetes, manifests as neurochemical, structural, behavioral, and cognitive alterations. This condition is especially dangerous for the elderly because aging raises the risk of neurodegenerative disorders and cognitive impairment, both of which can be made worse by diabetes. Despite its severity, diagnosis of this disease is challenging, and there is a paucity of information on its pathogenesis. The pivotal roles of various cellular pathways, activated or influenced by hyperglycemia, insulin sensitivity, amyloid accumulation, tau hyperphosphorylation, brain vasculopathy, neuroinflammation, and oxidative stress, are widely recognized for contributing to the potential causes of diabetic encephalopathy. We also reviewed current pharmacological strategies for DE encompassing a comprehensive approach targeting metabolic dysregulations and neurological manifestations. Antioxidant-based therapies hold promise in mitigating oxidative stress-induced neuronal damage, while anti-diabetic drugs offer neuroprotective effects through diverse mechanisms, including modulation of insulin signaling pathways and neuroinflammation. Additionally, tissue engineering and nanomedicine-based approaches present innovative strategies for targeted drug delivery and regenerative therapies for DE. Despite significant progress, challenges remain in translating these therapeutic interventions into clinical practice, including long-term safety, scalability, and regulatory approval. Further research is warranted to optimize these approaches and address remaining gaps in the management of DE and associated neurodegenerative disorders.

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Cadmium (Cd) is readily absorbed by tobacco and accumulates in the human body through smoke inhalation, posing threat to human health. While there have been many studies on the negative impact of cadmium in tobacco on human health, the specific adaptive mechanism of tobacco roots to cadmium stress is not well understood. In order to comprehensively investigate the effects of Cd stress on the root system of tobacco, the combination of transcriptomic, biochemical, and physiological methods was utilized. In this study, tobacco growth was significantly inhibited by 50 µM of Cd, which was mainly attributed to the destruction of root cellular structure. By comparing the transcriptome between CK and Cd treatment, there were 3232 up-regulated deferentially expressed genes (DEGs) and 3278 down-regulated DEGs. The obvious differential expression of genes related to the nitrogen metabolism, metal transporters and the transcription factors families. In order to mitigate the harmful effects of Cd, the root system enhances Cd accumulation in the cell wall, thereby reducing the Cd content in the cytoplasm. This result may be mediated by plant hormones and transcription factor (TF). Correlational statistical analysis revealed significant negative correlations between IAA and GA with cadmium accumulation, indicated by correlation coefficients of -0.91 and -0.93, respectively. Conversely, ABA exhibited a positive correlation with a coefficient of 0.96. In addition, it was anticipated that 3 WRKY TFs would lead to a reduction in Cd accumulation. Our research provides a theoretical basis for the systematic study of the specific physiological processes of plant roots under Cd stress.

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OBJECTIVE: The objective of this study is to investigate the occurrence and factors that influence the development of contrast-induced nephropathy (CIN) in high-risk patients undergoing angioplasty and to evaluate the effectiveness of the Mehran risk score in predicting CIN among this patient population. MATERIALS AND METHOD: This prospective, observational study enrolled patients undergoing elective coronary angiography or a percutaneous coronary intervention (PCI) procedure. The patients were stratified into four risk groups based on the Mehran risk score, a validated tool for predicting the risk of CIN. Univariate and multivariate analyses were conducted to evaluate the risk factors associated with the development of CIN. A p-value of <0.05 was considered to indicate statistical significance. RESULTS: During the study period, a total of 55 high-risk patients underwent PCI. The incidence of CIN was 25.5% (n=14). Univariate and multivariate analyses revealed that age >75 years and estimated glomerular filtration rate (eGFR) <60 (p<0.05) were independently associated with a significantly increased risk of developing CIN. A considerable proportion of patients (23; 41.8%) in the study were categorized as having an intermediate risk for CIN based on the Mehran risk score. CONCLUSION: This study observed a high incidence of CIN and encourages the use of predictive tools like the Mehran risk score to assess the risk of CIN occurrence, with age over 70 years and eGFR less than 60 emerging as significant.

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BACKGROUND AND OBJECTIVES: The study aimed to assess the control of asthma and the severity of chronic obstructive pulmonary disease (COPD) and evaluate the adequacy of treatment in patients presenting to the outpatient department (OPD) across India. The secondary aim was to assess the risk factors associated with poorly controlled asthma and severe COPD. MATERIALS AND METHODS: This is the analysis of Phase IV of the multicenter questionnaire-based point prevalence SWORD survey, conducted in May 2018, and designed to capture details on disease control and treatment as per the global initiative for asthma and the global initiative for chronic obstructive lung disease guidelines. RESULTS: Of the 5,311 respiratory disease patients presenting to the OPD, there were 1,419 and 412 patients with asthma and COPD, respectively, across 290 sites in India. There were 1,022 (72%) patients having well-controlled asthma, 293 (20.6%) patients with partly controlled asthma, and 104 (7.4%) patients with poorly controlled asthma. Of the 412 patients with COPD, there were 307 (74.5%) in A, 54 (13.1%) in B, and 51 (12.4%) in the E category. In spite of poor control or severe disease, 34.8% of asthmatic and 25.7% of patients in the B and E categories of COPD were not using any medicine. Risk factors for partly and poorly controlled asthma included rain wetting (adjusted odds ratio [AOR]: 1.59, 95% confidence interval [CI]: 1.02-2.47) and gastroesophageal reflux disease (AOR: 1.50, 95%CI: 1.08-2.10). CONCLUSION: This study identifies a gap in the treatment of both poorly controlled asthma and severe COPD. A substantial number of patients had poorly controlled asthma and severe COPD, and many were either not taking treatment or taking it inappropriately.