This paper presents a comprehensive analysis of recent advancements in the mechanization of millet processing technologies. In the last decade, many researchers have worked on millet postharvest processing technologies and developed many machines; however, there is a lack of collective information. The design, development, and performance aspects of millet threshing, dehulling/pearling, and cleaning are comprehensively reviewed and discussed in this review. Various studies are examined, which explore these machines' operational parameters and performance. The findings highlight the significant improvements in threshing and pearling efficiency, grain damage reduction, and ergonomic benefits in comparison to traditional manual methods. This comprehensive review of millet machinery helps to identify the research gap and establish a platform for optimum design and development for the future. Additionally, this helps to improve the level of mechanization in millet processing. The paper contributes valuable insights into improving postharvest processing methods for various millet varieties, thus aiding in promoting the utilization and commercialization of these nutritious and sustainable crops.Practical applicationsUnderstanding of engineering properties of millets for further development and improvement of available millet dehulling machinery. The knowledge of factors involved in millet dehulling and pearling helps in testing and evaluation of millet processing machinery. The comprehensive information about the millet machinery improve mechanization of the millet-based industries. Review of engineering properties of the millets, available machinery for pearling, comparison of dehulling mechanisms, pretreatments for better kernel recovery, and research gaps for further research work. image

Abstract Background Arterial hypertension (aHT) is a major cause for premature morbidity and mortality. Control rates remain poor, especially in low- and middle-income countries. Task-shifting to lay village health workers (VHWs) and the use of digital clinical decision support systems may help to overcome the current aHT care cascade gaps. However, evidence on the effectiveness of comprehensive VHW-led aHT care models, in which VHWs provide antihypertensive drug treatment and manage cardiovascular risk factors is scarce. Methods Using the trials within the cohort (TwiCs) design, we are assessing the effectiveness of VHW-led aHT and cardiovascular risk management in two 1:1 cluster-randomized trials nested within the Community-Based chronic disease Care Lesotho (ComBaCaL) cohort study (NCT05596773). The ComBaCaL cohort study is maintained by trained VHWs and includes the consenting inhabitants of 103 randomly selected villages in rural Lesotho. After community-based aHT screening, adult, non-pregnant ComBaCaL cohort participants with uncontrolled aHT (blood pressure (BP) ≥ 140/90 mmHg) are enrolled in the aHT TwiC 1 and those with controlled aHT (BP < 140/90 mmHg) in the aHT TwiC 2. In intervention villages, VHWs offer lifestyle counseling, basic guideline-directed antihypertensive, lipid-lowering, and antiplatelet treatment supported by a tablet-based decision support application to eligible participants. In control villages, participants are referred to a health facility for therapeutic management. The primary endpoint for both TwiCs is the proportion of participants with controlled BP levels (< 140/90 mmHg) 12 months after enrolment. We hypothesize that the intervention is superior regarding BP control rates in participants with uncontrolled BP (aHT TwiC 1) and non-inferior in participants with controlled BP at baseline (aHT TwiC 2). Discussion The TwiCs were launched on September 08, 2023. On May 20, 2024, 697 and 750 participants were enrolled in TwiC 1 and TwiC 2. To our knowledge, these TwiCs are the first trials to assess task-shifting of aHT care to VHWs at the community level, including the prescription of basic antihypertensive, lipid-lowering, and antiplatelet medication in Africa. The ComBaCaL cohort and nested TwiCs are operating within the routine VHW program and countries with similar community health worker programs may benefit from the findings. Trial registration ClinicalTrials.gov NCT05684055. Registered on January 04, 2023.

The main focus of the study is to investigate the integration of Agriculture in *Bharat* with tools, machinery, understanding market trends as business Student to achieve sustainability Profitable objectives Specifically, the study aims to identify the benefits and challenges of using Agriculture Machinery, assess the impact of machinery method, benefits including costs, emissions, and operational efficiency, provide recommendations for optimizing the role of agriculture with solution, evaluate the perceptions and experiences of marketing and business professionals regarding the use of Agriculture machinery.It purely helps the business professionals and the stake-holders of *Agriculture* of how to utilize the scares, limited resources at a sustainable rate with steady improvement.

Abstract Background There are no recent data on the prevalence of cardiovascular risk factors (CVDRFs) in Lesotho. This study aims to assess the prevalence of CVDRFs and their determinants. Methods We conducted a household-based, cross-sectional survey among adults ≥18 y of age in 120 randomly sampled clusters in two districts. Results Among 6061 participants, 52.2% were female and their median age was 39 y (interquartile range 27–58). The overall prevalence of overweight, diabetes, elevated blood pressure (BP) and tobacco use was 39.9%, 5.3%, 21.6% and 24.9%, respectively. Among participants, 34.6% had none, 45.2% had one and 20.2% had two or more CVDRFs. Women were more likely to have two or more CVDRFs (20.7% vs 12.3%). Overall, 7.5% of participants had elevated total cholesterol, 52.7% had low high-density lipoprotein cholesterol and 1.6% had elevated low-density lipoprotein cholesterol. Among younger participants (18–29 y), 16.1% reported tobacco use, 28.6% were overweight, 1.5% had diabetes and 3.5% had elevated BP. Household wealth positively correlated with the prevalence of elevated BP, overweight and diabetes, whereas tobacco use was higher among people in the lowest three wealth quintiles. Conclusions CVDRFs are highly prevalent in Lesotho across age and sex groups, underlining the importance of strengthening prevention and care programs in Lesotho and similar settings in southern Africa.

Background:Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or broken-heart syndrome, is a non-ischemic cardiomyopathy that presents as a transient regional systolic dysfunction of the left ventricle with minimal increase in troponins. The pathogenesis of takotsubo cardiomyopathy is not well understood. Some possible theories include increased catecholamines causing sympathetic overdrive, microvascular dysfunction, coronary spasm, or inflammation. The association of herpes simplex virus (HSV) encephalitis with takotsubo cardiomyopathy has rarely been reported with only two cases being described in literature. Case Description:We present a patient that came in with altered mental status who was found to have herpes simplex virus 1 (HSV-1) encephalitis. During his hospital stay, the patient had developed shortness of breath on hospital day 3. The patient's troponin was found to be mildly elevated and echocardiogram revealed takotsubo cardiomyopathy with left ventricle ejection fraction (LVEF) of 20% and severe hypokinesis of all left ventricle segments except the basal segments. His echocardiogram nine months prior revealed a LVEF 60-65%. He was treated with intravenous (IV) acyclovir and repeat echocardiogram three weeks following hospitalization revealed resolution of his takotsubo cardiomyopathy. Conclusions:Physicians should keep HSV encephalitis induced takotsubo cardiomyopathy in their differential diagnosis when patients present with HSV encephalitis along with shortness of breath and pulmonary vascular congestion on imaging.

Background and Objective: In Bangladesh, 21% of all adults aged >=18 years have hypertension but among hypertensives, only 14.1% have blood pressure (BP) controlled (<140/90 mmHg) .1 To improve hypertension control and prevent cardiovascular disease, the Non-Communicable Disease Control Program under the Ministry of Health & Family Welfare launched the Bangladesh Hypertension Control Initiative (BHCI) with technical support from the National Heart Foundation of Bangladesh and Resolve to Save Lives. Method: The BHCI gradually implemented the World Health Organization (WHO) HEARTS standardized hypertension control package in 172 sub-district facilities (35% of all sub-district facilities) & 10 district-level facilities in 23 districts from 2018 to 2024. BHCI facilities implemented a simple, evidence-based, step-by-step, and drug & dose-specific hypertension treatment protocol, a reliable supply of protocol medicines free of charge to patients, team-based care including non-physician members, and the Simple digital hypertension management app to collect real-time data and facilitate patient and program monitoring over time. A continuous quality improvement initiated in 2020 focused on lowering missed visit rate and raising blood pressure control. Missed visit rate was the proportion of all enrolled patients failing to attend a scheduled clinic visit in the prior three months; BP control was proportion with BP <140/90 mmHg at their last visit in the prior three months. Results: From March 2019 to February 2024, the BHCI had enrolled 364,038 hypertensive patients in treatment (Figure). Facility-based BP control increased from 37% in July 2020 when the quality improvement program started to 57% by April 2024. Missed visits decreased from 53% in July 2020 to 29% by April 2024. Conclusion: BHCI is on track for national scale-up in Bangladesh and can serve as a model for WHO-HEARTS hypertension control programs in other LMIC countries. Reference: 1. World Health Organization. National STEPS survey for non-communicable diseases risk factors in Bangladesh 2018. Panel A: number of hypertension patients enrolled in treatment. Panel B: rates of missed hypertension management visits and blood pressure controlled <140/90

Background: Limited evidence on diabetes prevalence trends from the Indian subcontinent prompted this study to estimate the trends in diabetes prevalence using the National Family Health Survey (NFHS) data. Method: A cross-sectional survey carried out between 2015–2016 (NFHS-4) and 2019–2021 (NFHS-5) in a nationally representative sample of adults (aged 20 to 54 years) was used. Diabetes was defined as the presence of: diagnosed diabetes (self-reported), fasting plasma glucose (FPG) ≥ 126 mg/dl, or a random plasma glucose (RPG) ≥200 mg/dl. ”Fasting” was defined as the last food intake >8 hours and ”random” as irrespective of the last meal. Diagnosed diabetes was defined as the presence of ”self-reported diabetes” and undiagnosed diabetes was defined as FPG > 126 mg/dl or RPG ≥200 mg/dl. Findings: The crude prevalence of total diabetes increased from 3.5% (95% confidence interval (CI): 3.46–3.55) in 2015–2016 to 3.99% (95% CI: 3.94–4.04) in 2019–2021, a relative change of 14%. The increase was more in the poorest (1.77% vs 2.48%; P < 0.001) as compared to the rich (5.35%% vs· 5.43%; P = 0.847), rural areas (2.71% vs 3.38%; P < 0.001) as compared to urban (4.95% vs. 5.26%; P = 0.051), in normal weight individuals (1.87% vs. 2.16%; P < 0.001) as compared to obese (7.12% vs. 7.03%; P = 0.384). Interpretation: While the absolute prevalence of diabetes is highest amongst individuals residing in urban areas belonging to the rich wealth centile, the relative increase in the prevalence is disproportionately higher in those residing in rural areas, belonging to the poorest wealth centiles and having normal weight.

Background:Salivary gland tumors (SGTs) present a diagnostic challenge due to their diverse histological subtypes and variable clinical behavior. Methods:This research conducted a retrospective analysis of SGT cases diagnosed and managed at a tertiary care center between 2017 and 2022. Clinical and pathological data were retrieved from medical records and histopathology reports. Statistical analysis was performed to identify factors associated with recurrence and survival outcomes. Results:A total of 150 SGT cases were included, comprising 70% benign and 30% malignant tumors. Pleomorphic adenoma and adenoid cystic carcinoma were the most prevalent benign and malignant subtypes, respectively. Surgical resection was the primary treatment modality, with varying recurrence rates observed among different treatment groups. Conclusion:The current study provides insights into the histological variations and clinical outcomes of SGTs. Surgical resection remains the mainstay of treatment, with adjuvant therapy reserved for cases with adverse prognostic factors. Further research is needed to optimize therapeutic strategies and improve patient outcomes.

Background: This study aimed to assess the status of knowledge and practice aspects regarding infection control and prevention among Health care workers in a tertiary health care facility of Uttar Pradesh. Methods: It was an observational cross section study conducted between April 2023 to June 2023 in a government medical college involving 179 health care workers. Data was collected on the basis of pre tested questionnaire through interview of health care workers. Questionnaire was divided into three-part, first part containing question related to demographic parameter of study participants and second and third part contained questions regarding knowledge and practice of standard infection control measures respectively. Results: Majority of participants were above 34 years (66.66%) female health worker (73.6%).72% participants were in the category of faculty member and nursing staff with average experience of more than 9 year. Study shows that100% of faculty members, resident doctors, and nursing staff were having the knowledge regarding steps of hand wash before surgical procedure and hand hygiene procedure before and after patient care. 100% of faculty members, resident doctors and nursing staff said that they perform all steps of hand wash before surgical procedure, perform hand hygiene before and after patient care. Conclusion: This study demonstrates a commendable level of adherence to infection control measures among healthcare workers. The high levels of compliance observed in our study may be attributed to institutional policies, ongoing training, or other factors unique to our setting.

Equine influenza (EI) is a highly contagious acute respiratory disease of equines caused by the H3N8 subtype of Influenza A virus i.e. equine influenza virus (EIV). Vaccination is an important and effective tool for the control of EI in equines. Most of the commercial influenza vaccines are produced in embryonated hen’s eggs which has several inherent disadvantages. Hence, subunit vaccine based on recombinant haemagglutinin (HA) antigen, being the most important envelope glycoprotein has been extensively exploited for generating protective immune responses, against influenza A and B viruses. We hypothesized that novel vaccine formulation using baculovirus expressed recombinant HA1 (rHA1) protein coupled with bacteriophage will generate strong protective immune response against EIV. In the present study, the recombinant HA1 protein was produced in insect cells using recombinant baculovirus having cloned HA gene of EIV (Florida clade 2 sublineage) and the purified rHA1 was chemically coupled with bacteriophage using a crosslinker to produce rHA1-phage vaccine candidate. The protective efficacy of vaccine preparations of rHA1-phage conjugate and only rHA1 proteins were evaluated in mouse model through assessing serology, cytokine profiling, clinical signs, gross and histopathological changes, immunohistochemistry, and virus quantification. Immunization of vaccine preparations have stimulated moderate antibody response (ELISA titres-5760 ± 640 and 11,520 ± 1280 for rHA1 and rHA1-phage, respectively at 42 dpi) and elicited strong interferon (IFN)-γ expression levels after three immunizations of vaccine candidates. The immunized BALB/c mice were protected against challenge with wild EIV and resulted in reduced clinical signs and body weight loss, reduced pathological changes, decreased EIV antigen distribution, and restricted EIV replication in lungs and nasopharynx. In conclusion, the immune responses with moderate antibody titer and significantly higher cytokine responses generated by the rHA1-phage vaccine preparation without any adjuvant could be a novel vaccine candidate for quick vaccine preparation through further trials of vaccine in the natural host.

This report presents a thorough examination of AXIS Bank's financial performance utilizing ratio analysis as the primary tool. Ratio analysis offers a quantitative method to assess the bank's financial health and operational efficiency by comparing key financial metrics over time and against industry benchmarks. The analysis begins by evaluating AXIS Bank's current ratio, which measures the proportion of current assets to current liabilities. A higher current ratio indicates a greater ability to cover short-term obligations, suggesting a healthy liquidity position. Conversely, a lower ratio may raise concerns about liquidity risk. In the case of AXIS Bank, the current ratio analysis reveals a robust position, indicating a prudent allocation of resources towards current assets. Furthermore, the report explores the quick ratio, also known as the acid-test ratio, which provides a more stringent assessment of liquidity by excluding inventory from current assets. This ratio helps determine the bank's ability to meet short-term obligations without relying on inventory liquidation. Comparing the quick ratio with the current ratio provides additional insights into the composition of AXIS Bank's current assets and its liquidity management practices. Additionally, the analysis considers the fixed/worth ratio, which assesses the proportion of fixed assets financed by owner's equity. A higher fixed/worth ratio suggests greater reliance on equity financing for fixed asset investments, indicating a lower financial risk. Conversely, a lower ratio may signal higher leverage and potential financial vulnerability. Evaluating this ratio provides valuable insights into AXIS Bank's capital structure and risk management strategies. Furthermore, the report examines the cash flow statement to assess the bank's cash generation and utilization across operating, investing, and financing activities. Analyzing cash flow patterns helps identify trends in cash generation, liquidity management, and investment decisions. In the case of AXIS Bank, the analysis reveals a positive trend in cash generated from operating and financing activities, indicating healthy cash inflows. However, negative cash flow from investing activities warrants further investigation into the bank's investment strategies and capital expenditure decisions. Overall, this comprehensive analysis of AXIS Bank's financial ratios and cash flow dynamics provides valuable insights into the bank's financial position, liquidity management, and operational efficiency. The findings offer a basis for strategic decision-making and recommendations to optimize performance and ensure sustained growth and stability.

Introduction: People living with human immunodeficiency virus (PLHIV) are known to have an increased prevalence of traditional cardiovascular risk factors and are at a higher risk of cardiovascular disease (CVD). This study was done to assess the CVD risk factors in treatment naïve PLHIV in a center of the national program. Methods: In this cross-sectional explorative study, traditional CVD risk factors were assessed, and 10-year Framingham and atherosclerotic cardiovascular disease (ASCVD) risk score were calculated in treatment naïve PLHIV attending the antiretroviral therapy (ART) center, IMS, BHU. Results: The study included 337 ART naïve patients. The prevalence of CVD risk factors in treatment naïve PLHIV - were low high-density lipoprotein cholesterol levels (81.4%), high triglyceride levels (32.7%), smoking (32.3%), obesity (13.6%), hypertension (5%), diabetes (2.7%), and high low-density lipoprotein cholesterol levels (2.1%). Moderate-to-high 10-year Framingham Risk Score and American Heart Association/American College of Cardiology 10-year ASCVD risk score were 10.8% and 8.9%, respectively. In Framingham Risk Score, age ≥40 years (odds ratio [OR] - 131) (95% confidence interval [CI] - 6.5–1043) alcohol intake (OR - 5.14 [95% CI - 1.82–14.46] and presence of tuberculosis (OR - 4.78) (95% CI - 1.48-15.40), while in ASCVD risk score history of alcohol intake (OR - 26.20 [95% CI - 3.1-216.8] were at higher risk of CVD in multivariate variate analysis. Conclusion: CVD risk factors were common among ART naïve patient. Thus, screening, education, and treatment of CVD risk factors should be done in these patients at initiation of care.

Dr. Waheeda Samady and Dr. Ruchi Gupta conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed and revised the manuscript for important intellectual content.

Objective: Left ventricular (LV) geometry and mass index (LVMi) including concentric remodeling (CR) and LV hypertrophy are important determinants of outcome in hypertension. Data concerning the association between standard blood pressure measurement (SBPM) and LVMi in sub-Saharan Africa populations are scarce, and data analysing this association with different BPM methods are even less. Aim of the study was to evaluate the association of LVMi with SBPM, unattended automated BPM (uABPM) and 24hr-ambulatory BPM (24h-ABPM) during a household-based screening program in Lesotho. Design and method: 6108 individuals with measurement of SBP were included into the screening program. For this nested study 639 received focused echocardiography for analysing LV geometry over different SBPM hypertension grades, and 209 additional uABP and 24h-ABPM to compare BPM methods. Pearson's correlation coefficient was used to determine linear correlations of LVMi with SBPM, uABP and 24h-ABPM. Logistic regression models with CR as dependent variable, and the three BPM approaches as primary independent variables were developed. C statistics were calculated for each logistic model as area under the receiver operating characteristic curve, and compared for the capacity of each BP measurement approach to discriminate the odds of CR. Results: Among the 639 participants (mean age 55+/-18 years), 59.6% were females and 53.4% had elevated SBPM values. Mean LVMi was 59.4+/-15.4 g/m2. For SBPM, mean LVMi increased across BP grades, starting at high normal (p<0.0001 compared to optimal/normal) (figure1a). CR, present among 56% of all participants, was evident among 34% participants with optimal BP and increased across BP grades (figure1b). Among participants with all three BPM, correlation between systolic BP and LVMi was highest for 24h-ABPM, followed by uABPM (figure1c). AUROC for prediction of CR was 0.66, 0.70 and 0.70 for SBPM, uABP, and 24h-ABPM respectively. Conclusions: LVMi increased at high normal BP compared to normal and optimal BP. CR was unexpectedly common with 1/3 participants with optimal and half of participants with normal BP values. 24h-ABPM showed higher correlation with LVMi than uABP and SBPM, with a numerically higher AUROC to predict CR than SBPM.