Background: Cervical ripening is a pivotal step in the induction of labor (IOL), particularly in term pregnancies with an unfavorable cervix. While prostaglandins remain the cornerstone agents for this purpose, interest has grown in exploring the synergistic role of estrogen.
Purpose: This study aimed to compare the efficacy and safety of dinoprostone followed by misoprostol (MC group) versus estradiol followed by misoprostol (ME group) in primigravida women undergoing IOL at term.
Methods: A single-blind randomized controlled trial was conducted on 172 primigravida women (86 per group) at term with singleton, cephalic presentation and Bishop score ≤6. The MC group received intracervical dinoprostone gel followed by up to three misoprostol doses; the ME group received vaginal estradiol followed by misoprostol similarly. Primary outcomes included change in Bishop score, number of misoprostol doses, and onset of active labor.
Results: The mean pre-induction Bishop score was lower in the MC group (2.77 ± 1.15) compared to the ME group (3.17 ± 0.86; p = 0.009), though final scores were similar (9.70 ± 1.53 vs. 9.73 ± 1.29; p = 0.872). Only 36% of women in the MC group required a third dose of misoprostol versus 100% in the ME group (p = 0.001). Successful ripening was achieved in 84.9% (MC) and 83.7% (ME), while establishment of active labor occurred in 86% (MC) and 90.7% (ME). Rupture of membranes was more frequent in the MC group (33.7% vs. 20.9%; p = 0.043). Maternal and neonatal outcomes, including cesarean section rates and NICU admissions, were comparable between groups.
Conclusion: Both protocols demonstrated comparable efficacy for cervical ripening and showed similar obstetric outcomes within the limits of this study. Dinoprostone may reduce the need for repeated misoprostol dosing. Agent selection should be tailored based on clinical context.
Background: Mobile phones are essential tools for healthcare workers (HCWs) but may act as reservoirs of multidrug-resistant (MDR) bacteria, contributing to hospital-acquired infections (HAIs).
Purpose: This study investigates bacterial contamination on HCWs’ mobile phones, their resistance patterns, and associated usage practices.
Methods: A six-month cross-sectional study was conducted at SGT Hospital, Gurugram. A total of 120 mobile phones (100 HCWs, 20 non-HCWs) were swabbed from commonly touched areas. Samples were cultured on standard media, and isolates were identified by morphological and biochemical methods. Antibiotic susceptibility testing of Staphylococcus aureus was performed using the Kirby-Bauer disc diffusion method. PCR assays targeting 16S rRNA and mecA genes were used for molecular confirmation of bacterial isolates and methicillin-resistant S. aureus (MRSA). A structured questionnaire assessed participants’ mobile phone usage and hygiene practices.
Results: Of the 120 phones, 95 (79.1%) showed bacterial contamination. Predominant isolates included diphtheroids (37.5%), S. aureus (27.5%), Micrococcus (26.6%), Bacillus (13.3%), and Acinetobacter (5.8%). Among 33 S. aureus isolates, 16 (48.5%) were MRSA by culture, while PCR confirmed 14 as mecA-positive. Resistance was highest to penicillin, erythromycin, and cefoxitin. Contamination correlated significantly with risk behaviors such as phone use in washrooms and lack of cleaning practices (p < 0.05).
Conclusion: Mobile phones of HCWs are major reservoirs of MDR bacteria, particularly MRSA, posing a hidden risk of nosocomial transmission. Implementation of standardized phone-cleaning protocols and behavioral guidelines is essential to reduce device-mediated infection spread.
Background: Depression, anxiety, and stress are common mental health challenges among university students that may negatively influence their academic performance.
Purpose: This study aims to examine the association between depression, anxiety, stress, and academic performance among university students.
Methods: A quantitative cross-sectional design was employed to gather data from 85 students from De Montfort University (Leicester and Dubai campuses) selected through purposive sampling (77.6% female; M_age = 20.4 years). Participants completed the Depression, Anxiety, and Stress Scale (DASS-21) and the Academic Performance Scale (APS). Pearson correlation analyses were used to assess relationships among variables, and simple linear regressions examined the predictive effects of depression, anxiety, and stress on academic performance.
Results: Academic performance showed significant negative correlations with depression (r = −0.50, p < .01), anxiety (r = −0.47, p < .01), and stress (r = −0.47, p < .01). Depression, anxiety, and stress were strongly interrelated (r = 0.74–0.84), suggesting these psychological difficulties commonly co-occur. Simple linear regression analysis revealed that depression (β = −0.50, p < .001), anxiety (β = −0.47, p < .001), and stress (β = −0.47, p < .001) each significantly predicted poorer academic performance.
Conclusions: Mental health difficulties are prevalent among university students and can adversely impact their academic performance. The results highlight the importance of university-based interventions in supporting students’ emotional well-being and academic success. The findings can be relevant for psychologists, counselors, clinicians, educators, and parents; these stakeholders are encouraged to use strategies that address both cognitive and emotional challenges faced by students.
Background: Lower back pain (LBP) is a prevalent and common musculoskeletal issue that can affect both mobility and functional quality. Backward walking (retro-walking) has gained attention due to its ability to reduce pain and improve disability while maintaining strength, mobility, and balance in many other conditions. The aim of this study is to examine its therapeutic effectiveness in reducing the symptoms of pain related to postural low back pain and also improving functional abilities in adults aged 30–50 years.
Purpose: The purpose of the study is to evaluate whether backward walking (retro-walking) can effectively reduce pain and improve daily functional activities in adults (aged 30–50 years) who are suffering from postural low back pain (LBP).
Methods: Out of 69 individuals chosen on the basis of inclusion and exclusion criteria, a total of 34 participants with postural LBP were recruited and divided into Group A (control) and Group B (experimental). The six-week intervention for Group B included backward walking sessions three times per week, starting at 10 minutes per session and progressing to 30 minutes on a flat surface. Oswestry Disability Index (ODI) and Numerical Pain Rating Scale (NPRS) scores were recorded pre- and post-intervention. SPSS software was used for statistical analysis, with paired and unpaired t-tests assessing differences within and between groups.
Results: Statistical evaluation revealed a significant reduction in pain scores post-intervention (p<0.001) and an improvement in functional abilities in both groups. However, Group B experienced a greater decline in NPRS scores compared to Group A.
Conclusion: Backward walking is an effective, non-invasive, and cost-efficient intervention for individuals with postural LBP. The study had a relatively small sample size, which limits its generalization. Also, the study was done for a shorter period; therefore, long-term effects remain unpredictable.
Background: Prostatic diseases, including benign prostatic hyperplasia (BPH), prostatitis, and carcinoma, are common in elderly males and contribute significantly to morbidity. Serum prostate-specific antigen (PSA) is widely used as a diagnostic and monitoring tool, though its specificity for malignancy is limited.
Purpose: To evaluate the clinicopathological correlation of various prostatic lesions with serum PSA levels and age distribution.
Methods: This observational study was conducted in the Department of Pathology at a tertiary care center in Nashik from August 2019 to December 2021. A total of 110 prostatic specimens, including TURP chips, needle biopsies, and open prostatectomy specimens, were analyzed. Histopathological examination, Gleason grading, and serum PSA measurement were performed. Data were analyzed using EpiInfo 7.2, with p < 0.05 considered statistically significant.
Results: Among 110 specimens, TURP was most frequent (68.18%), followed by needle biopsy (26.36%) and open prostatectomy (5.45%). BPH was the predominant lesion (76.36%), while carcinoma accounted for 17.27% of cases. The 61–70-year age group had the highest incidence of both benign and malignant lesions (46.36%). Mean serum PSA was significantly higher in malignant lesions (89.82 ± 52.32 ng/ml) and atypical small acinar proliferation (54.93 ± 65.08 ng/ml) compared to BPH and PIN (7.56 ± 12.38 ng/ml). Gleason scores 7 and 8 were most frequent among carcinoma cases (31.57% and 31.57%, respectively).
Conclusion: BPH is the most common prostatic lesion in elderly males, while PSA levels correlate strongly with malignancy and atypical lesions. Histopathological evaluation and Gleason scoring remain essential for diagnosis and management.
Background: Spaceflight-Associated Neuro-Ocular Syndrome (SANS) is a major health threat to astronauts experiencing long-duration spaceflight. SANS is characterized by optic disc edema, globe flattening, choroidal folds, hyperopic shifts, and increased retinal thickness. These changes are primarily caused by cephalad fluid shifts and altered intracranial pressure (ICP), all of which have implications for visual function, mission safety, and long-term ocular health.
Purpose: This paper reviews the literature related to the cause, diagnosis, treatment, and optometric consequences of SANS and discusses the essential role of optometry in the eye care of astronauts, as well as possible translational applications for eye problems on Earth.
Methods: A systematic narrative review was conducted using the databases PubMed, Scopus, Web of Science, and Google Scholar over the period of 2010–2025. Studies focused on ocular changes in astronauts, imaging modalities (OCT, MRI, ultrasonography), and countermeasures. Results were categorized into diagnostic modalities, pathophysiology, interventions, visual performance, and optometric implications.
Results: Approximately 60–69% of long-duration astronauts exhibited visual changes compared to 29% for shorter missions. Similar studies failed to replicate the same direction of the SANS condition, although modeling found evidence of orbital fat edema and the risk of structural vulnerability to increased intracranial pressure or IOP. Diagnostic methods are noninvasive, thus potentially improving utilization in space. Diagnostic methods such as OCT, ultrasonography, fundus photography, and AI-facilitated algorithms likely have more sensitivity than traditional methods. Countermeasures such as artificial gravity, lower body negative pressure, and fluid-shifting garments partially mitigated the incidence of SANS. Functional performance included decreased contrast sensitivity, loss of stereoacuity, and transient refractive shift.
Conclusion: SANS is a multifaceted syndrome that encompasses intracranial pressure, fluid mechanisms, vascular and glymphatic drainage, anatomical considerations, and environmental stressors. Optometry plays a critical role in diagnosing, monitoring, and rehabilitation and can impart translational information related to disorders such as idiopathic intracranial hypertension and glaucoma.
Background: Glutaric aciduria type I (GA1) is a rare autosomal recessive neurometabolic disorder caused by a deficiency of glutaryl-CoA dehydrogenase, leading to the accumulation of glutaric acid, 3-hydroxyglutaric acid, and glutarylcarnitine. The condition predominantly affects the basal ganglia and cerebral cortex and is associated with acute neuroregression, dystonia, and macrocephaly. Early diagnosis and dietary management significantly improve outcomes, but delays are common in low-resource settings.
Purpose: This study aimed to describe the clinical spectrum, diagnostic challenges, neuroimaging features, treatment strategies, and short-term outcomes of children with Glutaric Aciduria Type I (GA1) managed at a tertiary care metabolic center in Rajasthan, India, thereby highlighting the importance of early recognition and timely dietary intervention in improving prognosis.
Methods: We conducted a retrospective review of children diagnosed with GA1 at a tertiary care metabolic center in Rajasthan, India, between June 2023 to September 2024. Diagnosis was based on clinical features, biochemical analysis using tandem mass spectrometry (TMS) and gas chromatography-mass spectrometry (GC-MS), neuroimaging, and where available, genetic testing. Clinical presentation, neuroimaging findings, treatment, and outcomes were analyzed.
Results: Out of 44 children with suspected inborn errors of metabolism evaluated during the study period, 7 (18.4%) were diagnosed with GA1. The mean age at symptom onset was 7.4 ± 2.3 months, and mean age at diagnosis was 21.5 ± 16.7 months. Macrocephaly was present in 85.7%, and 71.4% had acute encephalopathic crises triggered by infections. All children exhibited dystonia; two also had spastic quadriparesis. Neuroimaging showed frontotemporal atrophy with open opercula in all cases and basal ganglia changes in six. Biochemical testing confirmed elevated glutarylcarnitine (C5DC) in all patients, and urine organic acid analysis revealed elevated glutaric and 3-hydroxyglutaric acid in six. Genetic testing in three children identified GCDH mutations, including c.1204C>T in two. A lysine-restricted diet, carnitine supplementation, and emergency care procedures were used to treat every child. Three children remained severely disabled, two had moderate dystonia, and three had minimal deficits after an average follow-up of 18.2 ± 6.3 months.
Conclusions: In infants with dystonia, developmental delay or regression and macrocephaly, GA1 must be suspected, particularly when combined with distinctive neuroimaging findings. Results can be greatly enhanced by early diagnosis and the start of dietary and supportive therapy. Expanded use of genetic counseling, early dietary intervention, and newborn screening is necessary to lower the long-term morbidity linked to GA1 in settings with limited resources.
Background: One Health has swiftly moved from being a slogan to a pressing necessity. Over recent years, the converging threats of zoonoses, antimicrobial resistance (AMR), climate change, and environmental degradation have reinforced that the health of humans, animals, and ecosystems is deeply intertwined.
Purpose: As someone whose career has spanned veterinary medicine, public health, and community research, I believe that this concept is at a critical turning point: either we translate it into sustained action, or it will risk becoming just an academic framework.
Methods: Drawing on my own work and that of many others in the field, this editorial argues for four interlinked priorities: clear metrics, inclusive education and community engagement, ethical and equitable governance, and institutionalized, resilient systems for One Health practice.
Results: One Health has swiftly moved from being a slogan to a pressing necessity. Over recent years, the converging threats of zoonoses, antimicrobial resistance (AMR), climate change, and environmental degradation have reinforced that the health of humans, animals, and ecosystems is deeply intertwined.
Conclusion: As someone whose career has spanned veterinary medicine, public health, and community research, I believe that this concept is at a critical turning point: either we translate it into sustained action, or it will risk becoming just an academic framework.
Background: The coronavirus disease-19 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2), has a huge global impact.
Purpose: The only known preventive measures or therapies for COVID-19 at this time are physical segregation and aerial barriers between individuals. Researchers in the academic and industrial sectors are currently in urgent need of COVID-19 remedies, including vaccines to stop the virus’s spread. Even if the widespread vaccination campaign has helped to limit the rate of death, the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues three and a half years after the pandemic began and the anticipated endemic transition. After the health emergency state was declared to be over, we are seeing a global loosening of preventive measures, a return to pre-pandemic mobility patterns, and an ever more coerced coexistence with the virus.
Methods: In the present study, the ability of SARS-CoV-2 proteins to bind natural substances, which is essential for host cell interaction and infection was examined. Using in silico tools and techniques, the docking analysis of Dibutyl phthalate, Betulin and Stigmasterol against SARS-CoV-2 non-structural protein-12 (NSP-12) was done.
Results: It was observed that stigmasterol had the highest binding affinity (-8.1 kcal/mol) for NSP-12 protein of SARS- CoV-2 followed by betulin (-6.9 kcal/mol) and DIBP (Dibutyl Phthalate) had the lowest affinity (-6.3 kcal/mol).
Conclusion: Based on current research, it was suggested that stigmasterol is a potential phytochemical to be tests against NSP-12 protein of SARS CoV-2 and can be used as antivirus drug.
Background: Poor access to healthy foods as a result of poverty is becoming a public health challenge, particularly in many low-income countries, where many households are threatened with low purchasing power.
Purpose: The aim of the study was to evaluate the influence of maternal food insecurity on infant-feeding practices among caregivers attending State Specialist Hospital, Akure, Nigeria.
Method: The research was a cross-sectional study to assess maternal socio demographic characteristics, nutrition knowledge, and the influence of food insecurity status on breastfeeding and complementary feeding practices. A semi-structured questionnaire was used to collect information on socio-demographic characteristics of mothers, breastfeeding and complementary feeding practices, and food-insecurity-related situations in the previous 30 days of the survey. Data were analyzed using a statistical package.
Results: The maternal age was between 18 and 40 years, and a large percentage of the nursing mothers were Yoruba (75.1%). Most of the mothers had formal education (98.1%) and were self-employed (79.1%). Maternal-child-feeding knowledge showed that four-fifths (80%) had good knowledge on when to initiate breastfeeding, 68.9% on the duration of exclusive breastfeeding, 66.6% on the age at which to introduce complementary foods to infants, and 71.4% on the risks associated with late introduction of complementary food to the infants. Mothers experiencing mild food insecurity (20.2%), moderate food insecurity (15.2%), and severe food insecurity (8.9%) reported that they were not practicing exclusive breastfeeding, breastfeeding less than 3 times daily, and abruptly stopping breastfeeding, respectively. Besides, results showed that a high percentage of mothers were unable to feed their infants with a variety of complementary foods and quantity. The types of complementary foods used by the mothers varied from unfortified sorghum (36%), fortified sorghum (egg or soybean) (45%), and commercial infant formula (19%).
Conclusion: The findings of the study showed that almost half of the nursing mothers were food insecure, and the food-insecure mothers did not practice exclusive breastfeeding, and most of the mothers were using unfortified cereals as complementary foods for their infants due to low income and lack of food.
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