Objectives: Second-hand tobacco smoke (SHS) is a risk factor for adverse health outcomes, particularly among pregnant women. This study aimed to address the research gap concerning the prevalence and correlates of SHS exposure at home and in public settings among non-smoking pregnant women in India. Methods: The dataset from the Global Adult Tobacco Survey (2016-17), India, was utilised to evaluate the prevalence of SHS exposure in pregnant women both at home and in public spaces. Multivariable logistic regression analysis was employed to identify the determinants of SHS exposure among this population. Results: The prevalence of SHS exposure at home was 36.9%, while exposure outside the home was 26.5%. Among non-smoking pregnant women, 10.0% were exposed to SHS on public transport. The risk of SHS exposure at home was significantly higher in the North (adjusted odds ratio [aOR], 5.33; 95% confidence interval [CI], 2.45 to 11.60), Central (aOR, 4.46; 95% CI, 1.98 to 10.02), and Northeast (aOR, 4.18; 95% CI, 1.78 to 9.81) regions compared to the South. Pregnant women aged 25-34 (aOR, 0.61; 95% CI, 0.39 to 0.93) and those aged 35 and above (aOR, 0.48; 95% CI, 0.27 to 0.86), as well as those with secondary (aOR, 0.50; 95% CI, 0.30 to 0.85) or higher education (aOR, 0.30; 95% CI, 0.15 to 0.58), had lower odds of SHS exposure at home. For SHS exposure outside the home, the North region (aOR, 2.53; 95% CI, 1.19 to 5.36), employment status (aOR, 1.99; 95% CI, 1.13 to 3.47), and belonging to scheduled tribes (aOR, 3.20; 95% CI, 1.25 to 8.21) were associated with higher odds. Conclusions The prevalence of SHS exposure among pregnant non-smoking women was notably high both at home and in external environments.

Background and Objectives: The timing of the reinstitution of warfarin after cesarean section (CS) delivery was not adequately addressed in the literature. This study aims to evaluate the risks of early versus late initiation of warfarin post-CS in patients with mechanical heart valves. Methods: This randomized, open-label cohort study included 114 pregnant women with mechanical heart valves planned to be delivered by CS at or after 28 weeks of gestation.Patients were randomly divided into two groups: Day-2-group, where warfarin was started on day 2, and Day-5-group, where warfarin was started on day 5 after CS. Maternal postoperative bleeding complications, mechanical valve thrombosis, need for blood transfusion or reoperation, and maternal mortality were identified. Results: Ten women (8.8%) had 11 bleeding complications, of whom 2 patients (20%) had intraperitoneal hemorrhage (none in Day-2-group and 2 in Day-5-group), 3 patients (30%) had subcutaneous hematoma (none in Day-2-group and 3 in Day-5-group), and 6 patients (60%) had sub-rectus hematoma (3 in Day-2-group and 3 in Day-5-group). No mechanical valve thrombosis, other thromboembolic events, or in-hospital maternal mortality were reported. Conclusion Despite the small number of events, the bleeding risk was lower in the group with early post-CS warfarin introduction than in the group with late warfarin introduction in patients with prosthetic heart valves.

Purpose: The purpose of the study is to examine the efficacy of intravenous injections of tranexamic acid (TXA) in reducing perioperative blood loss in patients scheduled for open reduction and internal fixation for pelvic fractures (Tile B and C). A study population with greater homogeneity was selected to minimize confounding variables related to fracture and fixation methods that may reflect an accurate result. Materials and Methods: A prospective randomized controlled trial including 100 patients who received either 15 mg/kg of TXA added to 40 mL saline twice separated by 3 hours interval or a similar volume of normal saline (~50 mL twice in same manner) intravenously. Measurement of hemoglobin was performed preoperatively and postoperatively. Blood loss in drain, blood units transfused, and complications were recorded. Results: The mean decrease in hematocrit levels (preoperatively and postoperatively) was 3.2% in the trial group versus 3.7% in the control group (P>0.05). Mean total blood loss was 1,106 and 1,340 mL (trial vs. control group [P<0.05]). The mean operative time was 122.5 and 130.3 minutes (trial vs. control group [P>0.05]). Mean collected blood from the drain was 155 and 170 mL (trial vs. control group [P>0.05]). The transfusion rate was 28% and 76% while the mean for transfused units was 0.72 and 1.1 units (trial vs. control group [P<0.05]). There were no venous thromboembolic events. Conclusion Intravenous injection of TXA in pelvic fractures was effective in reducing blood loss and the rates of blood transfusion. There were no associated thromboembolic complications.

Zebrafish (Danio rerio) have emerged as an influential model for studying human epithelial pathology, particularly because of their genetic similarity to humans and their unique physiological traits. This review explores the structural and functional homology between zebrafish and human epithelial tissues in organs, such as the gastrointestinal system, liver, and kidneys. Zebrafish possess significant cellular and functional homology with mammals, which facilitates the investigation of various diseases, including inflammatory bowel disease, nonalcoholic fatty liver disease, and polycystic kidney disease. The advantages of using zebrafish as a model organism include rapid external development, ease of genetic manipulation, and advanced imaging capabilities, allowing for the real-time observation of disease processes. However, limitations exist, particularly concerning the lack of organs in zebrafish and the potential for incomplete phenocopy of human conditions. Despite these challenges, ongoing research in adult zebrafish promises to enhance our understanding of the disease mechanisms and regenerative processes. By revealing the similarities and differences in epithelial cell function and disease pathways, this review highlights the value of zebrafish as a translational model for advancing our knowledge of human health and developing targeted therapies.

this systematic review was conducted to assess the practical application of terbium radioisotopes, utilizing systematic search methodologies to identify relevant studies. Methods the databases of PubMed, Web of Science, and Scopus were systematically scoured, targeting the research on four terbium isotopes: 149Tb, 152Tb, 155Tb, and 161Tb. Various combinations of keywords related to terbium and its four radioisotopes were used in the search process. The search encompassed studies conducted up to July 27, 2024. Results following the removal of 335 duplicate research articles, a cohort of 429 papers was curated for potential inclusion in the study. Out of 429 articles reviewed, a mere nine addressed the potential uses of 161Tb and 152Tb. Notably, 155Tb and 149Tb have yet to be examined in human subjects. Conclusions the research trajectory is now veering towards clinical studies that provide in-human data, with the goal of advancing radiotheranostics and nuclear oncology. The preliminary outcomes are stimulating and have led to the initiation of several clinical trials. The success of these trials and the establishment of production facilities will be critical for the clinical adoption of these agents.

Objective: The objective of our study was to characterize the sperm parameters of men consulting for infertility in our fertility center. Methods: The study included 3,025 patients investigated from September 2021 to July 2023. Demographic data, infertility risk factors, and the primary or secondary nature of infertility were recorded for each patient. The sperm parameters were analyzed according to World Health Organization (WHO) criteria (2021). Results: The average age of the patients was 40 years. The average duration of infertility was 5.5 years. Primary infertility was noted in 2,736 patients (88.97%). The most common risk factors for infertility were occupational exposure, followed by varicocele. Lifestyle factors associated with male infertility included smoking (24.29%), alcohol consumption (12.49%), and high temperature exposure (30.08%). Spermogram abnormalities were observed in 78.71% of cases. Spermocytogram abnormalities were found in 63.1% of cases. Sperm count, morphology, total motility, and vitality below WHO (2021) reference values were found in 25.60%, 34.13%, 32.29%, and 62.46% of the analyzed samples, respectively. Seminal fluid analysis revealed oligozoospermia in 29.07% of cases, asthenozoospermia in 24.68%, and azoospermia in 17.56%. Oligo-astheno-necrospermia was the most frequently observed combined abnormality (10.0%). Conclusion This study showed a high rate of abnormal semen quality in male partners of infertile couples. Male infertility is often multifactorial and results in quantitative and/or qualitative sperm abnormalities.

Objectives: Obsessive-compulsive disorder (OCD) is a prevalent mental health condition that impacts daily life. It is thought to be associated with genetic, biological, and structural brain changes, serotonergic abnormalities, altered neuromodulation, and environmental factors.Limited observational studies have examined cytokines in Bangladeshi patients with OCD. This study aimed to assess the levels of eotaxin-1 and interleukin (IL)-34 in individuals with this disorder. Methods: This case-control observational study included 58 patients with OCD and 30 healthy controls (HCs) matched for age, sex, and body mass index. The severity of OCD was assessed using the Yale-Brown obsessive-compulsive scale (Y-BOCS). Psychiatrists evaluated participants according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Serum levels of eotaxin-1 and IL-34 were measured using enzyme-linked immunosorbent assay kits. Results: Patients with OCD exhibited significantly higher serum eotaxin-1 levels (121.13 ± 7.84pg/mL) than HCs (85.52 ± 9.42 pg/mL). Conversely, IL-34 levels were considerably lower in patients than in HCs (119.02 ± 14.53 pg/mL vs. 179.96 ± 27.88 pg/mL). The Cohen d values for eotaxin-1 and IL-34 were 0.55 and −0.48, respectively. Among patients with OCD, a significantpositive correlation was found between serum eotaxin-1 level and Y-BOCS score, along with a negative correlation between serum eotaxin-1 and IL-34 levels. Conclusion The findings suggest that altered eotaxin-1 and IL-34 levels may be associated withOCD. These chemokines and cytokines could serve as primary tools for assessing the risk of OCD, warranting further clinical investigation. This could potentially support more extensive research and the development of diagnostic and therapeutic strategies targeting these pathways.

As many countries implement different programs aimed at eliminating malaria, attention should be given to asymptomatic carriers that may interrupt the progress. This was a community-based cross-sectional study conducted in Tanzania from December 2022 to July 2023 within 4 villages from each of the 3 regions, Geita and Kigoma, which are high malaria transmission, and Arusha, which is low transmission. Malaria was diagnosed in asymptomatic individuals aged 1 year and older using the malaria rapid diagnostic test and light microscope. A total of 2,365 of 3,489 (67.9%) participants were enrolled from high-transmission villages. The overall prevalence was 25.5% and 15.8% by malaria rapid diagnostic test and light microscope, respectively. Using the respective tools, the prevalence was significantly higher at 35.6% (confidence interval (CI)=23.6–49.9) and 23.1% (CI=16.2–35.1) in the high-transmission regions (Geita and Kigoma) compared with 2.9% (CI=1.1–3.5) and 1.1% (CI=0.7–1.8) in the low-transmission region (Arusha). Children younger than 15 years and males accounted for the greatest proportion of infections. In the study area, the prevalence of asymptomatic cases was higher than that of reported symptomatic cases in health facilities. We hypothesize that these parasite reservoirs may contribute to the persistence of malaria in the country. Therefore, to achieve comprehensive malaria control in the country, the surveillance and screening of asymptomatic malaria cases are vital.

Purpose: It is important for emergency physicians to be able to evaluate and manage pediatric respiratory distress, which is rare in general emergency departments. Despite this importance, the emergency departments show inconsistency in pediatric readiness, while emergency medicine (EM) residents express discomfort in caring for critically ill children due to limited exposure during their residency training. The purpose of this study was to meet this educational need by developing and implementing a curriculum to prepare EM residents to provide safe care for pediatric respiratory distress. Methods: We prospectively assessed 20 senior EM residents after undergoing a 3-hour simulation-based curriculum at Indiana University School of Medicine. The curriculum was developed using the Kern’s methodology by content experts. Pre- and post-curriculum confidence, knowledge, competency, and situational awareness were assessed using the 5-point Likert scale, multiple-choice questions, checklists of a pediatric acute respiratory distress scenario, and a novel modified video version of the situational awareness global assessment technique, respectively. Results: From the pre- to post-intervention phases, the confidence improved from 3.2 ± 0.4 to 3.9 ± 0.2 on the Likert scale (P < 0.001). The knowledge improved from 50.3% ± 12.9% to 75.3% ± 10.6% on the multiple-choice questions (P < 0.001). The competency improved from 46.8% ± 16.0% to 73.6% ± 10.6% (P < 0.001) with significant improvements in 7 of the 14 checklist items. The situational awareness raised both data perception (P < 0.001) and comprehension (P = 0.004) with no significant improvements in data extrapolation (P = 0.120). Conclusion Preliminary findings suggest that a 3-hour simulation-based curriculum for EM residents, including implementation of a novel situational awareness assessment tool, can improve learner’s confidence, knowledge, competency, and situational awareness of pediatric respiratory distress.