ICARE Institute of Medical Sciences and Research

The biogenic synthesis of zinc oxide NPs (ZnO NPs) has emerged as a sustainable and eco-friendly alternative to conventional chemical and physical fabrication techniques. Microorganisms including bacteria, fungi, actinomycetes, and yeast serve as natural biofactories, enabling the controlled production of ZnO NPs with tailored sizes and morphologies. Among these, bacteria offer distinct advantages over plant-based systems due to their rapid growth, ease of cultivation, genetic tractability, and the ability to function as reproducible nano-factories under controlled conditions, secreting a wide range of biomolecules that facilitate NP synthesis. Biogenically synthesized ZnO NPs exhibit excellent biocompatibility and biodegradability, making them promising candidates for applications such as drug delivery, antibacterial therapy, bioimaging, biosensing, and nano-fertilizers in sustainable agriculture. Despite their potential, comprehensive toxicological assessments remain essential to ensure their safe integration into biomedical and environmental applications. This review highlights the mechanisms of microbial-mediated synthesis, with particular emphasis on bacteria-based approaches, explores their diverse applications, and underscores the importance of rigorous safety evaluations to guide their responsible use in nanotechnology. • Bacteria enable eco-friendly synthesis of ZnO nanoparticles. • Covers intra- and extracellular biosynthesis mechanisms. • Exhibits strong antimicrobial and antifungal potential. • Shows notable anticancer and antioxidant activities. • Promising candidate for drug delivery applications. • Safety and toxicity require further evaluation.

DVT and/or PE collectively constitute what is known as venous thromboembolism (VTE).Data on the clinical presentation, risk factors, and short-term outcomes of VTE in the Indian emergency care setting are limited.This observational prospective study recruited patients > 18 years with diagnosis of deep vein thrombosis and cerebral venous thrombosis confirmed on duplex ultrasonography and MRI/MR venography respectively over period of 15 months. Among 96 patients with radiologically proven acute DVT or CVT; 81.2

Background: Monitoring glucose levels in flap tissues can be a valuable indicator of flap viability and early detection of flap failure. This study aimed to analyze the utility of intra-flap glucose monitoring in predicting flap outcomes. Materials & Methods: It was a single centre, single arm, non-comparative longitudinal observational study done from May 2019 to October 2020. Thirty (31) patients, operated for reconstruction with various flap incorporating skin in the department of plastic and reconstructive surgery after taking informed written consent. Flap blood glucose levels have been measured at scheduled times by glucometer. At the same time blood glucose levels has been measured from adjacent normal skin (control site). In addition to blood glucose assessment simultaneous clinically findings have been noted and correlated. In the event of any indication of impending/frank ischemic changes appropriate measures have been taken by the surgeon in-charge. Capillary blood sample has been taken by pin prick method at the distal most part of flap. At the same time patient blood glucose level has been measured from normal skin adjacent to flap. Samples were taken in immediate postoperative period then after 1hr, 12 hr, 24 hr, 48 hr and 72 hr after operation. Results: Out of thirty-five patients, thirty were male and five were female. Among four free flaps, three were antero-lateral (ALT) fascio-cutaneous flap and one was free latissimus dorsi (LD) musculocutaneous flap. We have measured flap blood glucose and body blood glucose from control site simultaneously and then calculated flap blood glucose as a percentage of body blood glucose. Out of 35 flaps, 21 flaps have done well and no sign of ischemia was found in these flaps. Blood Glucose levels of these flaps were taken at regular intervals as per study schedule. Total 63 values have been recorded from clinically ischemic flaps. Blood glucose values of ischemic flaps were significantly low with a mean value of 35.81% of body glucose. At the intervals of immediate, 1hour, 6-hour, 24-hour, 48-hour, 72 hour, 5 days the mean values of glucose are lower in necrosed flap than survived flaps. It was found to be statistically significant (p<0.05). Conclusion: Intra-flap glucose monitoring is a reliable method for predicting flap viability. Higher glucose levels are associated with flap survival, providing a potential tool for early intervention in cases of impending flap failure.

Introduction: Three-dimensional ultrasonography (3D US) and hysterosalpingography (HSG) are crucial, often complementary, imaging modalities for assessing the uterine cavity, specifically in infertility. 3D US is noninvasive and superior for diagnosing congenital anomalies (septate vs. bicornuate) and cavity lesions. The aim of this study is to establish the role of 3D transvaginal ultrasonography in the evaluation of various uterine cavity abnormalities in infertile patients in local population. Methodology: This study, done including total 158 patients of different age groups referred to the Department of Radio-diagnosis, Vivekananda Institute of Medical Sciences, Ramakrishna Mission Seva Pratishthan, Kolkata, West Bengal for radiological evaluation of infertility. All of these patients were imaged by conventional 2D and 3D volumetric ultrasound. Among these, 139 subjects further underwent hysterosalpingography, 27 underwent hystero-laparoscopy and 2 subjects were imaged with MRI. Results: The values were calculated for 2D USG, 3D USG and HSG separately for Mullerian duct abnormalities and for endometrial and sub-mucosal pathologies. The cases were taken to be true positive when they were confirmed by either hystero-laparoscopy or by MRI, which are taken to be gold-standard for the diagnosis. So only 28 subjects were taken into account for these calculations where either of these two modalities was available. The calculated sensitivity 2D USG in detection of mullerian duct abnormality is 57.14% (0.95 CI 18.41% - 90.10%), Specificity is 100% (0.95 CI 83.89% - 100.00%), positive predictive value 100% (0.95 CI 39.76% – 100.00%) and Negative predictive value 87.50% (0.95 CI 67.64% - 97.34%). The calculated sensitivity 3D USG in detection of mullerian duct abnormality is 100.00% (0.95 CI 59.04% - 100.00%), Specificity is 100.00% (0.95 CI 83.89% - 100.00%), positive predictive value 100.00% (0.95 CI 59.04% – 100.00%) and Negative predictive value 100.00% (0.95 CI 83.89% - 95.46%) (66). Conclusion: All the uterine cavities which are abnormal in 2D USG, needs evaluation with definite diagnostic modalities for further detailing. All the patients with infertility should have at least one 3D USG screening to exclude any uterine cavity abnormality, even if the conventional 2D scanning is negative. The routine use of invasive procedures like Hysterosalpingography should be gradually decreased and replaced by non-invasive volume USG, where only the uterine cavity abnormalities are in question. For Mullerian duct abnormalities; 3D USG, showing excellent sensitivity and specificity, may be taken as a definite diagnostic modality and when there is no expected therapeutic benefit, the invasive procedures like hystero-laparoscopy may be avoided on the basis of 3D USG diagnosis.

Total knee arthroplasty (TKA) is a widely accepted procedure for managing end-stage osteoarthritis. Optimal component alignment, particularly in the coronal and sagittal planes, is believed to influence postoperative function and implant longevity. This study prospectively evaluates the relationship between alignment parameters and early functional outcomes following primary TKA. A prospective observational study was conducted in 100 patients undergoing unilateral primary TKA for osteoarthritis. Coronal alignment (HKA) was measured on preoperative and 6-week postoperative long-leg radiographs, and sagittal parameters (posterior tibial slope and femoral component flexion angle) were measured on 6-week lateral radiographs. Functional outcomes (KSS and WOMAC) were recorded at baseline and 3 months, and analyses were performed using baseline-to-3-month change scores. Associations between alignment parameters and functional improvement were explored using correlation analyses. Significant improvements were observed in both Knee Society Score (KSS) and WOMAC outcomes at three months following TKA. Mean KSS knee scores improved from 49.55 ± 9.9 preoperatively to 85.30 ± 7.6 at three months, while KSS functional scores increased from 39.72 ± 11.8 to 78.00 ± 6.3 (both p < 0.001). Mean WOMAC total scores decreased from 65.2 ± 8.7 preoperatively to 18.6 ± 6.4 at 3 months (p < 0.001). Correlation analysis demonstrated a moderate negative association between postoperative coronal alignment deviation and improvement in both KSS knee (r = − 0.27, p = 0.006) and functional scores (r = − 0.29, p = 0.004), as well as WOMAC improvement (r = − 0.28, p = 0.005). Among sagittal plane parameters, posterior tibial slope showed a weak positive correlation with improvement in KSS functional score (r = 0.24, p = 0.010), whereas femoral component flexion angle did not demonstrate a significant association with functional or WOMAC outcomes. Coronal alignment deviation from neutral was modestly associated with smaller early functional gains after TKA, while sagittal parameters showed weaker and less consistent relationships. Alignment appears to be one of several contributors to early recovery.