Background: Adnexal masses are increasingly detected during pregnancy due to the widespread use of routine obstetric ultrasonography. Transvaginal ultrasonography (TVUS) combined with Color Doppler imaging has become the preferred first-line imaging modality. Objective: To determine the diagnostic accuracy of transvaginal ultrasonography combined with Color Doppler in differentiating benign from malignant adnexal masses during pregnancy using histopathological examination as the reference standard. Methods: A prospective observational diagnostic accuracy study was conducted among pregnant women diagnosed with adnexal masses at a tertiary care teaching hospital. Eligible participants who underwent transvaginal ultrasonography with Color Doppler evaluation were consecutively enrolled. Sonographic characteristics were systematically documented. The diagnostic performance of TVUS combined with Color Doppler was evaluated by calculating sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy. Results: A total of 132 pregnant women with sonographically diagnosed adnexal masses were included in the study. Histopathological examination identified 118 (89.4%) benign and 14 (10.6%) malignant lesions. The imaging modality demonstrated a sensitivity of 92.9%, specificity of 95.8%, positive predictive value of 72.2%, negative predictive value of 99.1%, and an overall diagnostic accuracy of 95.5%. Conclusion: Transvaginal ultrasonography combined with Color Doppler demonstrated excellent diagnostic performance in differentiating benign from malignant adnexal masses during pregnancy. As a safe, non-invasive, readily available, and cost-effective imaging modality, TVUS with Color Doppler can support timely referral, individualized clinical management, and improved maternal and fetal outcomes.
Introduction: Recurrent aphthous ulcers are one of the most frequent painful conditions affecting the oral mucosa in young adults. Psychosocial stress has been recognized as a contributing factor to the causation of recurrent aphthous ulcers. Aim: To assess the occurrence rate of recurrent aphthous ulcers and their correlation with levels of psychosocial stress among dental students. Materials and Methods: The present cross-sectional study included 383 undergraduate and postgraduate students of a dental college. Google Forms was used for collecting the responses from the participants. In this survey, a questionnaire was used. Two parts were developed for data collection. Part one covered demographic details as well as some prerequisite information on recurrent aphthous ulcers. Psychological stress was evaluated through the second part of the questionnaire using the Perceived Stress Scale (PSS-10). Results: Among the 383 participants, 80.9% (n=310) had moderate stress, 11.2% (n=43) had high stress and 30 participants had no to minimal stress according to the PSS-10 scale. Conclusion: Recurrent oral ulcers are prevalent among dental students, with stress emerging as a major associative factor. Early identification of stress-related triggers and incorporation of stress-management strategies may play a vital role in tackling their stress levels.
Objective: To compare the efficacy of step-up and top-down treatment approaches in paediatric inflammatory bowel disease. Study Design: Randomised controlled trial. Duration and Place of Study: Conducted from 29 October 2025 to 29 March 2026 at the Department of Paediatrics Combined Military Hospital, Rawalpindi. Methodology: A total of 68 children aged 2 to 17 years with Crohn disease were included. Group A received step-up therapy and Group B received top-down therapy. Clinical remission was assessed after 4 weeks using paediatric Crohn disease activity index score less than 10. Data were analysed using IBM SPSS version 26. Chi square test and Fisher exact test were applied and p-value less than 0.05 was considered significant. Results: Mean age was 9.21 ± 4.48 years in Group A and 7.76 ± 3.46 years in Group B. Males were 20 (58.8%) in Group A and 19 (55.9%) in Group B. Overall efficacy was significantly higher in top-down group with 26 (76.5%) compared to 7 (20.6%) in step-up group (p<0.001). Treatment failure was 27 (79.4%) in Group A and 8 (23.5%) in Group B. Significant associations of efficacy were observed with age (p=0.003), gender (p=0.001), weight (p=0.001), residential status (p=0.001), socioeconomic status (p=0.001), and disease duration (p<0.001). Conclusion: Top-down therapy show more effective results in achieving clinical remission in paediatric inflammatory bowel disease as compared to step-up therapy.
Objective: To compare the serum calcium levels before and after haemodialysis in patients with end-stage renal disease. Study Design: A cross sectional study. Place and Duration of the Study: Department of Nephrology, Sir Ganga Ram Hospital, Lahore, Pakistan, from 18 February to 18 June 2026. Methodology: A total of 60 patients aged 30 to 75 years with end-stage renal disease receiving maintenance haemodialysis were included. Serum calcium was measured immediately before and after each haemodialysis session by using the Arsenazo III colorimetric method. Data were analysed using Statistical Package for the Social Sciences version 26. Paired t-test was used to compare the mean serum calcium levels before and after haemodialysis. Results: The mean age of the patients was 53.77 ± 9.36 years, while the mean body mass index was 23.88 ± 3.55 kg/m². Males were 44 (73.3%) and females were 16 (26.7%). The mean duration of end-stage renal disease was 32.02 ± 15.62 months and mean dialysis duration was 4.12 ± 0.33 hours. Mean serum calcium level increased significantly from 8.17 ± 0.25 mg/dL before haemodialysis to 8.53 ± 0.34 mg/dL after haemodialysis (mean difference -0.37, 95% confidence interval -0.42 to -0.32; p<0.001). Significant rise in serum calcium was also observed in all stratified groups (p<0.001). Conclusion: Serum calcium level increased significantly after haemodialysis in patients with end-stage renal disease. This improvement was seen in all patient groups, showing that haemodialysis has an important role in correcting calcium imbalance.
The gut microbiota, the dynamic community of bacteria, viruses, fungi, and archaea present in the gastrointestinal tract, has been studied under the perspective of the gut-brain axis. Recent studies, however, report that microbial interactions with host physiology are much more than neurological—microbial modulation of endocrine gland function is now well established. A summary of recent knowledge of the gut-endocrine axis, focusing on the role of metabolites of the gut microbiome, such as short-chain fatty acids, secondary bile acids, indole derivatives and lipopolysaccharide, in communicating to distant organs and immune pathways by vagal and humoral pathways. We discuss microbiota regulation of endocrine system tone and dynamics, including the hypothalamic-pituitary-adrenal axis, thyroid hormone synthesis, thyroid autoimmunity, pancreatic beta-cell function, sex steroid metabolism (estrobolome and testobolome), adipokine regulation, energy storage in fat, calcium-vitamin D homeostasis, and gut-derived melatonin production, with implications for PCOS and for fertility and growth hormone-IGF-1 axis dynamics. We also review the microbiome and metabolite related diagnostic biomarkers, sex- and age-dependent variations in gut-endocrine relationships, and evidence supporting probiotic, prebiotic, synbiotic, and fecal microbiota transplantations interventions. Although there is strong mechanistic evidence supporting the gut microbiota as an active endocrine regulator, as yet there are only small clinical trials available, with variable effects and with diet and medication as confounding factors. In conclusion, the gut-endocrine axis is a biologically coherent system that is not widely studied in clinical trials of humans, particularly one that needs to be sex-and age-stratified, and it is a system that is clearly interconnected and has therapeutic potential.
The design of multifunctional photocatalysts capable of simultaneously facilitating solar driven hydrogen production and organic pollutant degradation is pivotal for addressing global energy and environmental challenges. In this study, CuO/ZnO nanocomposites modified with 1% by weight activated carbon rings (ACR) were synthesized via a hydrothermal route and systematically characterized using XRD, SEM, FT-IR, UV-Vis, and photoluminescence spectroscopy. Among the prepared nanocomposites, the sample containing 1 wt% ACR demonstrated superior photocatalytic activity, achieving a hydrogen evolution rate of 29,500 ± 1215.4 µmol g-1h-1 using a 1:1 sacrificial agent mixture, and attaining 95% degradation of methylene blue within 60 minutes under simulated solar light. Enhanced performance is attributed to improved charge carrier separation, increased visible-light absorption, and the formation of efficient hetero junctions. These results underscore the critical importance of ACR loading to maximize the dual functionality of CuO/ZnO based photocatalysts for sustainable solar hydrogen generation and wastewater remediation.
Optimizing echo time (TE) and repetition time (TR) is crucial for enhancing tissue contrast in magnetic resonance imaging (MRI). Traditional approaches to TE/TR selection often rely on empirical methods or scanner-based adjustments, which can be limited by variability and lack of controlled conditions. This study leverages digital phantom simulations to systematically evaluate the effect of varying TE and TR on tissue contrast across common anatomical structures. A realistic digital phantom was constructed using established relaxation parameters for gray matter, white matter, cerebrospinal fluid (CSF), muscle, and fat. MRI signal evolution was simulated using Bloch equations, and contrast between tissue pairs was calculated across a wide TE/TR parameter space. The results demonstrate distinct contrast patterns for different tissue combinations, with optimal TE/TR regions identified for T1-weighted, T2-weighted, and proton-density-weighted imaging. Contrast maps and optimization tables derived from the simulations offer a structured, reproducible framework for protocol design, reducing reliance on empirical parameter selection. The findings validate known MRI contrast behaviors and provide scanner-agnostic TE/TR recommendations to accommodate practical clinical constraints. This work highlights the value of digital phantom-based modeling for enhancing MRI protocol development, enabling more consistent and contrast-efficient imaging outcomes. Future extensions, including advanced simulation platforms, experimental validation, and integration with emerging techniques, will further strengthen the translational potential of this approach.
Background: Acute necrotizing pancreatitis (ANP) is a severe complication of acute pancreatitis characterized by pancreatic and peripancreatic tissue necrosis, with high morbidity and mortality. This study aimed to evaluate the clinical presentation, etiology, imaging severity, management strategies, and outcomes among patients with ANP in a tertiary care setting in South India. Methods: This was a prospective cohort study conducted between October 2021 and September 2023 at GSL Medical College and Hospital, and Saveetha Medical College, India . Fifty inpatients diagnosed with ANP based on clinical, biochemical, and imaging criteria were enrolled. Data on demographics, etiology, CT Severity Index (CTSI), extent of necrosis, microbiological findings, initial and subsequent management, and outcomes were collected and analyzed using descriptive and inferential statistics. Results: The mean age of patients was 37.9 ± 9.9 years, with a male predominance (84%). The most common presenting symptom was abdominal pain (96%). Alcohol (50%) and gallstones (22%) were the leading etiologies. CTSI score of 10 was seen in 54% of patients, and 30% had >50% necrosis. Infection was documented in 36% of patients, with Staphylococcus aureus being the most frequent isolate. Initial management was conservative in 66%, followed by laparoscopic necrosectomy (22%) and pigtail drainage (12%). The overall mortality rate was 8%, and complications included pseudocysts (10%), recurrent pancreatitis (14%), and walled-off necrosis (8%). Conclusions: ANP commonly affects young adult males, with alcohol being the predominant cause. A CTSI score ≥10 and >50% necrosis were significantly associated with infected necrosis and adverse outcomes. Timely conservative management followed by minimally invasive interventions where needed can result in favorable outcomes.
Background: Intrathecal dexmedetomidine (Intrathecal Dexmedetomidine) is increasingly used as an adjuvant to hyperbaric bupivacaine (Hyperbaric Bupivacaine) to increase the extent and spinal anaesthesia’s quality. However, the optimal intrathecal dose for elective orthopaedic procedures on the lower limbs remains uncertain. Objective: To compare the safety and efficacy of 5 µg and 10 µg Intrathecal Dexmedetomidine as an adjuvant to 12.5 mg of 0.5% Hyperbaric Bupivacaine in patients undergoing lower limb orthopaedic surgeries. Methods: Sixty patients aged 18–60 years undergoing elective lower limb orthopaedic surgeries were randomized to receive either 5 µg or 10 µg Intrathecal Dexmedetomidine as an adjuvant to Hyperbaric Bupivacaine. Comparisons were made between block properties, postoperative analgesia, hemodynamic parameters, sedation, VAS Score, and adverse events. Results: Group D10 confirmed faster onset of sensory block (3.70 ± 0.50 vs. 4.53 ± 0.38 min) and motor block [5.50 (5.03–5.80) vs. 6.45 (6.20–6.88) min], along with longer sensory block duration (306.37 ± 26.15 vs. 259.07 ± 26.74 min) and motor block duration (259.77 ± 27.15 vs. 224.23 ± 28.08 min), compared with Group D5 (p < 0.001). Group D10 also had a lower VAS score and provided better postoperative analgesia, with acceptable sedation and a comparable incidence of adverse events. Conclusion: Intrathecal dexmedetomidine 10 µg provided superior spinal block characteristics and postoperative analgesia compared with the 5 µg dose while maintaining acceptable haemodynamic stability and a favourable safety profile. Therefore, 10 µg dexmedetomidine may be considered the preferred intrathecal adjuvant to 12.5 mg of 0.5% Hyperbaric Bupivacaine for elective lower limb orthopaedic surgeries.
In this paper, Hibiscus rosa-sinensis is used as natural dye for the fabrication of natural dye solar cell (DSSC). The Hibiscus is utilized effectively as a dye sensitizer to turn solar energy into electricity. The DSSCs are fabricated using two dissimilar types of semiconductor electrodes: TiO2 P25 and R-5566 TiO2. The dye solar cell using TiO2 P25 as semiconductor shows a short circuit current of up to Jsc=1.58 mAcm-2, an open circuit voltage of Voc = 0.49 V, fill factor of 0.41 and power energy conversion efficiency of 0.11% was achieved. The UV-Vis absorption spectra show natural Hibiscus dye has maximum absorption at 545nm in visible range of solar spectrum. This study offers an intriguing preliminary analysis for the creation of alternative energy that promotes sustainable energy sources by utilizing abundant biodiversity. The capabilities of the various TiO2 structures, as well as the method and the limitations, are covered in this article.
Background: Prediabetes, characterized by impaired glucose regulation, affects 38% of adults and represents a crucial intervention opportunity before type 2 diabetes development. Exercise interventions demonstrate significant efficacy in improving glycemic control, while herbal supplementation shows glucose-lowering properties through enhanced insulin sensitivity and reduced glucose absorption. Limited research has evaluated the combined effects of these interventions despite their effects which is being targeted in current study. Methodology: 40 participants were selected based upon eligibility criteria for current pilot trial. After recruitment, the participants were equally randomized into 4 groups using sealed opague envelopes with group name. The participants in group A received aerobic exercises, in group B received herbal supplementation, in group C received combined intervention and group D received no intervention (Control group). The outcome measures were HbA1c and OGTT values at 30 minutes after 75 g glucose intake, assessed at baseline and Day 28 (Post test). The data was recorded, tabulated, analysed and results were interpreted. Results: Within the group analysis revealed significant differences between Day 0 and Day 28 for HbA1c and OGTT values in Group A, B and C but no differences were observed in Group D. In between the group analysis revealed significant differences for post test values between all the 4 groups for HbA1c (F = 14.865, p < 0.001) and OGTT (F = 15.559, p < 0.05). Conclusion: This pilot study provides promising evidence for the individual and combined efficacy of structured moderate to vigrous aerobic exercise and herbal supplementation in improving glycemic control among individuals with prediabetes, while highlighting the need for larger-scale, longer-duration studies to establish definitive clinical guidelines and optimal treatment protocols.
Globally, nowadays the population is growing increasingly, and engineers are focusing on constructing high-rise buildings. High-rise buildings should resist the lateral loads like earthquake and wind loads. Earthquakes are commonly occurring worldwide, releasing an immense amount of energy, which shows the impact on high-rise buildings that move laterally. To avoid these, high-rise buildings are designed by providing shear walls. In the present study is analyzing a G+12 building by providing it without and with a shear wall by using response spectrum analysis in ETABS software. A shear wall is a vertical cantilever beam that resists the lateral loads like seismic load. The main objective of this study is to examine the structural vulnerable factors such as story drift and story displacement. The analysis is carried out by considering seismic zone IV, which has a zone factor of 0.24, and the soil type is medium. IS 1893:2016 guidelines are used for response spectrum analysis. The random forest regressor outperformed other models in terms of accuracy in forecasting and generalization faults for important structural characteristics. ETABS evaluation found that story height and shear wall layout and RSA were the most relevant factors, supporting standard building engineering concepts. In the present study obtained R2=1 in two cases, then this investigation concludes that the best fitting for machine learning model.
Antimicrobial resistance (AMR) in aquatic environments represent an important environmental dimension of the global AMR load, specifically in the polluted river systems receiving diverse anthropogenic inputs. The present study investigated selected abundant AMR proteins identified at four sites (VR1-VR4) of the river Varuna using a whole-genome shotgun metagenomic approach. Further, a computational screening-ligand-associated study was performed. AMR protein sequences were subjected to BLASTp analysis for sequence-level identification, followed by conserved domain analysis to confirm their functional properties. The proteins identified were Sul1, Sul4, blaOXA, and blaVEB-9 from sites VR1, VR2, VR3, and VR4. Conserved domain analysis identified dihydropteroate synthase domain in Sul1 and Sul4, and a class D ß-lactamase domain in blaOXA and a class A ß-lactamase related serine hydrolase domain in blaVEB-9. Experimentally determined 3D protein structures were retrieved from the Protein Data Bank termed as 7S2I, 1TWS, 1M6K, and 6NVT. Comparative cavity-guided molecular docking was performed using CB-Dock2 with sulfamethoxazole (FDA-approved drug) and thymol (natural compound). Thymol showed predicted docking scores ranging from -6.3 to -8.1kcal/mol. The most favorable predicted interaction for both ligands was observed with blaVEB-9. This finding provides preliminary structural insights into ligand-binding patterns of environment-derived AMR (Antimicrobial resistance) proteins and identifies protein-ligand combinations to analyze further biochemical and microbiological validation.
Background: The retention phase in orthodontics involves the mechanical stabilisation of teeth to facilitate the reorganisation of alveolar bone, musculature, and periodontal tissues. Protocols are determined by the initial malocclusion, ranging from self-stabilising cases, such as corrected crossbites, to high-risk scenarios like diastema closures and severe rotations that often require permanent stabilisation. Objectives: This study assesses the long-term effects of fibre-reinforced composite (FRC) and multistranded stainless steel (SS) retainers on periodontal health, as well as the impact of one-step versus two-step bonding techniques on failure rates. Methods: Sixty participants were selected and divided into four groups (n=15 each) based on the retainer material and adhesive used. Periodontal parameters, including the Gingival Index (GI) and Plaque Index (PI), were assessed at different time points: baseline (T0), 1 month (T1), and 3 months (T2). Statistical analysis included the Friedman test, Wilcoxon signed-rank post-hoc tests, Kruskal-Wallis test, the Mann-Whitney U-test and Chi-square test. Results: A significant Reduction in GI and PI scores was observed across all groups post-debonding (p < 0.01). Intergroup analysis revealed no statistically significant difference in bond failure rates between materials or adhesive protocols (p < 0.05). Conclusions: Both materials and bonding protocols demonstrate clinical efficacy. One-step Universal adhesives can also serve as alternatives for orthodontic retention.
Background: Brexpiprazole is an atypical antipsychotic drug used to treat schizophrenia and agitation induced by Alzheimer's disease. Aim: The present study aimed to develop and validate a simple, rapid, sensitive, and stability-indicating UHPLC MS/MS method for measuring Brexpiprazole by using a dilute-and-shoot sample preparation technique. Method: Chromatographic separation was performed on a Shim-pack GIST C18 column using a mobile phase at 0.1% formic acid in water and acetonitrile. Electrospray ionization was performed in multiple reaction monitoring mode to detect the transition m/z 434.15 → 273.10. Result: The method showed excellent linearity between 1-100 ng/mL, with a correlation coefficient (r²) of 0.9976. Brexpiprazole has a retention period of 2.18 minutes, that allowed for rapid analysis. The limits of detection and quantification were found to be 0.45 and 1.0 ng/mL, respectively. Accuracy studies showed recoveries ranging from 89.0% to 96.8%, while precision tests achieved acceptable %RSD values. The Stability tests found that Brexpiprazole was stable under the investigated conditions, with no significant degradation. Conclusion: The novel UHPLC-MS/MS technique is rapid, sensitive, and reliable, excellent for routine pharmaceutical analysis, bioanalytical investigation, stability assessments, and pharmacokinetic applications.
The present research work deals with Quinoline Carboxylic Acid-3-Aminoacetophenone [QCAP] Complex synthesis and its inhibition against anti-diabetic activity with acarbose was compared. The same complex was characterized by FT-IR, 1H NMR, 13CNMR and UV-visible spectroscopic methods. Molinspiration and pre- ADMET are used to support the drug-likeness and prediction of biological activity. The experimental findings demonstrated promising biological activity, which was further supported by density functional theory (DFT) calculations and molecular docking studies. The computational results provided additional insights into the electronic properties, molecular stability, and ligand–target interactions of QCAP. In particular, the carboxylic acid and carboxylate functional groups appear to play a significant role in mediating molecular interactions with biological targets, thereby contributing to the observed bioactivity. These findings collectively suggest that QCAP possesses favorable structural and electronic characteristics for potential biological applications.
Background: Chronic obstructive pulmonary disease (COPD) is a progressive, largely preventable respiratory condition marked by persistent airflow limitation, chronic dyspnea, impaired secretion clearance, and reduced exercise capacity. Airway clearance strategies such as chest proprioceptive neuromuscular facilitation (PNF), postural drainage, and oscillatory positive expiratory pressure (OPEP) devices such as the Acapella are widely used in pulmonary rehabilitation, yet direct comparative evidence for combining chest PNF or postural drainage with an OPEP device remains limited. Objective: To compare the effectiveness of chest PNF combined with an Acapella device against postural drainage combined with an Acapella device on functional capacity, dyspnea, peak expiratory flow rate (PEFR), and arterial oxygen saturation (SpO₂) in patients with stable COPD. Methods: In this randomized, comparative, pre-post interventional trial, 60 patients with stable, moderate COPD were allocated by simple random (chit) sampling to two equal groups. Group A (n = 30) received chest PNF six days a week (twice daily) together with Acapella therapy five days a week, while Group B (n = 30) received postural drainage six days a week (twice daily) with the same Acapella regimen, over a one-week intervention period. Functional capacity (six minute walk test, 6MWT), dyspnea (modified Medical Research Council [mMRC] scale), PEFR, and SpO₂ were recorded before and after intervention. Between-group differences were analyzed using the independent-samples t-test and within group change using repeated-measures ANOVA; gender distribution was compared using the chi-square test (α = 0.05). Results: The two groups were comparable at baseline for age and gender (p > 0.05). Both groups improved significantly from pre- to post-intervention across all four outcomes (p < 0.001). On between-group comparison, Group A showed significantly greater post-treatment gains than Group B in PEFR (209.00 ± 37.91 vs 189.00 ± 31.44 L/min; improvement 82.67 ± 25.18 vs 69.67 ± 21.09 L/min, p = 0.034), SpO₂ (96.70 ± 1.74% vs 95.83 ± 1.49%, p = 0.043), and mMRC dyspnea score (0.80 ± 0.71 vs 1.47 ± 0.63, p < 0.001). Improvement in 6MWT distance was significant within both groups but did not differ significantly between them (p = 0.398). Conclusion: Both chest PNF with Acapella and postural drainage with Acapella produced clinically meaningful improvement in pulmonary and functional outcomes in stable COPD. Chest PNF combined with Acapella conferred an additional advantage over postural drainage with Acapella in reducing dyspnea and improving expiratory flow and oxygen saturation, suggesting it may be the preferable adjunct in short-term pulmonary rehabilitation protocols.
Drying of fruit and vegetables has become an important strategy of post-harvest handling in extending shelf life, reducing storage and transport costs through decreasing moisture content and improving storability and portability of product. Beside a process of drying for removing water and changing mass transfer process of this material, Drying induces complex cellular, biochemical and molecular responses affecting nutritional quality, antioxidant capacity, structure and storability of food product. Some of these methods e.g. Sun drying, solar drying and hot air drying still widely used owing to the low operating cost and simplicity; However, there may lead to undesirable consequences including significant losses of nutrients, oxidatvie damages, collapse of structure and detrimental changes in quality. Advanced drying technologies such as infrared, microwave, radio frequency, Refractance Window, vacuum and heat-pump drying may enhance the retention of bioactive compounds by optimizing the rate of heat and mass transfer. Combining some complementary methods i.e. Hybrid drying technologies may reduce drying time and energy consumption. Artificial intelligence (AI), machine learning (ML), sensors technology and Industry 4.0 provide the means to monitor the drying process in real time and achieve intelligent adaptive optimization. Additionally, recent development on molecular and omics technologies will be promising for deciphering the genotype-specific drying behaviour, regulating stress responses and controlling secondary metabolites synthesis and metabolic pathways in the dehydration process of fruit and vegetable. The present review thus presents an integrated view of fruit and vegetable drying technologies, focusing on the intersection between the mechanisms of drying and the responses at the cellular, molecular and genotypic levels as well as intelligence of drying processes.
Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition marked by ongoing airflow restriction, breathlessness, and declining functional capacity. Clinicians often pair inspiratory muscle training (IMT) with breathing-retraining approaches such as diaphragmatic breathing (DB) and pursed-lip breathing (PLB) to strengthen pulmonary rehabilitation outcomes, yet head-to-head evidence comparing these two pairings is sparse. Objective: To compare DB paired with IMT against PLB paired with IMT with respect to pulmonary function, dyspnea, blood oxygen levels, and walking capacity in people living with moderate COPD. Methods: This randomized, comparative, pre-post trial enrolled 60 patients with GOLD stage 2 COPD (ages 18–80) from a tertiary care hospital, split evenly by a chit-based random draw into two arms. Group A (n=30) practiced DB together with breather-device IMT, and Group B (n=30) practiced PLB together with the same device-based IMT, each for 15–20 minutes twice a day across two weeks. The six-minute walk distance (6MWD), Modified Borg Dyspnea Scale, peak expiratory flow rate (PEFR), and arterial oxygen saturation (SpO₂) were captured before and after the intervention period. Pre-post shifts within each arm were tested with the Wilcoxon signed-rank test, arm-to-arm differences with the Mann Whitney U test, and baseline-controlled comparisons with analysis of covariance (ANCOVA). Results: Both arms improved significantly from baseline across every measure (p<0.001). Group B's gains exceeded Group A's for PEFR (mean change 205.00±45.69 vs. 87.33±29.00 L/min), SpO₂ (7.93±2.83% vs. 3.00±1.49%), Modified Borg score (−1.80±0.78 vs. −0.93±0.58), and 6MWD (156.17±38.50 m vs. 85.83±21.50 m), with all between-arm comparisons reaching p<0.001. After controlling for baseline value, age, and gender, ANCOVA confirmed a statistically significant advantage for Group B on all four measures (all p<0.001). Conclusion: Both breathing strategies paired with IMT delivered clinically worthwhile short-term gains for people with COPD, but the PLB-plus-IMT combination outperformed DB-plus-IMT by a clear margin. Device-assisted PLB may therefore be a practical, inexpensive addition to pulmonary rehabilitation programs for patients with moderate COPD.
Background: The prevalence of infertility worldwide is approximately 1 in 6 and growing as a global menace. Couples who are unable to conceive find it as a personal failure and face mental trauma and social breakdown. Religion and socioeconomic traditions in our country link womanhood to motherhood, which causes stigma in infertile couples especially females. Aim: This study aimed to observe the socio-demographic factors and stigma scale among infertile tribal women’s from Deoghar district of Jharkhand, India. Methodology: The cross sectional study was conducted at few designated clinics at Deoghar. All the eligible couples seeking infertility treatment consenting to be a part of the study were included. A pre designed Performa was used to fill up the socio demographic profile of screened infertile couples. For observing infertility stigma scale (ISS) in female, FU et al., method was used. The present study used 22 supportive items ranked on a 5 point likert scale. The obtained result was statistically analyzed by Student’s t test. Results: Out of 175 infertile females recruited for the study, 127 gave consent for stigma study. Duration of infertility among the study group ranged between 2 to 7 years. The duration of infertility was 3.51±1.45 years. Most of the females were housewife (81.48%) and 62.96% respondents belonged to joint family. The overall stigma scale was 85.44±6.72. The average value was 2.61± 1.23. Out of four ISS factors, self devolution score was 2.92±1.1; public stigma score, family stigma and social withdrawal score was 2.51±1.26, 2.05±0.94 score 2.82±1.32 respectively. Conclusion: Present study showed that infertile females experience a high level of social stigma and self devolution. However, government policies and suitable public health educational, awareness programs can improve patient’s cognition and help coping with pessimistic experiences and obtain improved quality of life.
