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The functionalization of materials for ultrasensitive detection of heavy metal ions (HMIs) in the environment is crucial. Herewith, we have functionalized inexpensive and environmentally friendly Fe3O4 nanoparticles with D-valine (Fe3O4–D–Val) by a simple co-precipitation synthetic approach characterized by XRD, FE-SEM, and FTIR spectroscopy. The Fe3O4–D–Val sensor was used for the ultrasensitive detection of Cd+2, Pb+2, and Cu+2 in water samples. This sensor shows a very low detection limit of 11.29, 4.59, and 20.07 nM for Cd+2, Pb+2, and Cu+2, respectively. The detection limits are much lower than the values suggested by the world health Organization. The real water samples were also analyzed using the developed sensor.

This research aims to determine the in-vitro antioxidant, antidiabetic, hemocompatibility, and anticancer properties of phyto-synthesized ZnO NPs using root aqueous extract of Cichorium intybus (CIRAE-ZnO NPs). The CIRAE-ZnO NPs were subjected to various characterization techniques (UV, FTIR, XRD, zeta potential, DLS, FE-SEM, and HR-TEM). The HR-TEM analysis showed the average size of ZnO NPs as 26.66 ± 0.84 nm. The CIRAE-ZnO NPs were quasi-spherical with IC50 values in DPPH, phosphomolybdate, Fe chelating, and anti-inflammatory assays as 60.63 ± 0.4, 62.11 ± 0.14, 58.79 ± 0.5, and 52.63 ± 0.3 μg/mL, respectively. The CIRAE-ZnO NPs exhibited less haemolytic activity (0.80 mg/mL) and moderate thrombolytic activity (56.57%). The IC50 value for CIRAE-ZnO NPs in A549 and 3T3-L1 cells cytotoxicity was 26.56 ± 0.7 and 51.62 ± 0.36 μg/mL, respectively. The CIRAE-ZnO NPs had an LC50 reading of 0.506 μg/mL, which renders them at a lower risk to Artemia salina. The CIRAE-ZnO NPs exhibited antidiabetic activity with IC50 values of 62.63 ± 0.12 and 41.74 ± 0.15 µg/mL for α-glucosidase and α-amylase inhibitory activity, respectively. The NPs showed promising results in glucose uptake, glucose diffusion assay, and amylolysis kinetics. Thus, there are several uses for CIRAE-ZnO NPs in biomedical research.

This article aims to develop a mathematical model for peristaltic transport of magnetohydrodynamic flow of biofluids through a micro-channel with rhythmically contracting and expanding walls under the influence of an applied electric field. The couple stress fluid model is considered to represent the non-Newtonian characteristics of biofluids. The velocity slip condition at the channel walls is taken into account because of the hydrophilic/hydrophobic interaction with negatively charged walls. The essential features of the electromagnetohydrodynamic flow of biofluid through micro-channels are clearly highlighted in the variations of the non-dimensional parameters of the physical quantities of interest such as the velocity, wall shear stress, pressure gradient, pressure rise per wave length, frictional force at the channel walls and the distribution of stream function. It reveals that the flow of biofluid is appreciably influenced by the sufficient strength of externally applied magnetic field and electro-osmotic parameter. The velocity slip condition reduces the frictional force at the channel wall. Moreover, the formation of the trapping bolus strongly depends on electro-osmotic parameter and magnetic field strength.

Objective This study aimed to evaluate and compare the predictive accuracy of five established clinical scoring systems - CURB65, BAP65, qSOFA, DECAF, and NEWS - in forecasting in-hospital mortality and the need for mechanical ventilation among patients presenting with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in the emergency department. Methods An observational, cross-sectional study was conducted over a 12-month period (January to December 2023) in the emergency department of Indira Gandhi Institute of Medical Sciences, Patna. A total of 200 patients aged 18 years and older with AECOPD were enrolled. Clinical, laboratory, radiographic, and electrocardiographic data were collected to calculate the prognostic scores. The primary outcome was in-hospital mortality; the secondary outcome was the requirement for mechanical ventilation. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, NY, USA) and included logistic regression, receiver operating characteristic curve analysis, calibration assessment, and evaluation of seasonal variations in score performance. Results Among the five scoring systems, the DECAF score showed the highest predictive accuracy with an area under the curve (AUC) of 0.80, followed by BAP65 (0.75), NEWS (0.72), CURB65 (0.70), and qSOFA (0.65). DECAF had the strongest association with hospital mortality (OR: 2.8, 95% CI: 1.7-4.5) and need for mechanical ventilation (OR: 2.3, 95% CI: 1.5-3.6). It also achieved the highest sensitivity (0.85) and specificity (0.75). ANOVA revealed significant differences in AUC values across scores (F = 4.76, p = 0.002). Calibration curves indicated accurate prediction for DECAF and BAP65. Seasonal analysis demonstrated consistent performance for both DECAF and BAP65 throughout the year. Conclusions The DECAF score was the most reliable predictor of hospital mortality and mechanical ventilation needs in AECOPD patients presenting to the emergency department. BAP65 also performed consistently well and may serve as a practical alternative, particularly in resource-limited settings. Condition-specific scores like DECAF should be favored over general severity indices for effective risk stratification in COPD.

Urothelial cancer patients are prone to recurrence, and there is no marker to predict which cases become refractory to the immunotherapy given to these patients. Tumour behaviour is decided by the dynamics between the pro- and anti-tumorigenic cytokines. In this study, 27 cytokines were estimated in serum and urine of 72 urothelial cancer patients and 42 healthy volunteer controls. Serum cytokines IL-1RA, IL-4 and RANTES were in significantly higher concentration in serum of patients compared to controls, while IL-2 was significantly less in concentration. Patients were found to have significantly high concentrations of 12 urinary cytokines (IL-2, IL-4, IL-8, IL-10, GM-CSF, IFN-γ, IP-10, MIP-1a, PDGF, MIP-1b, RANTES and VEGF) in comparison to healthy controls. Serum VEGF and urinary IL-1ra, IL-4, IL-10, GM-CSF, IP-10, MIP-1a and MIP-1b concentrations were found significantly higher in concentration in high-grade tumours compared to low-grade tumours. There was no difference in either the serum or urinary cytokines between non-invasive and muscle-invasive cases. Serum IL-1ra, IL-6, IL-10, TNF-α and VEGF and urinary IL-1ra, IL-4, IL-8, IL-10, GM-CSF, IP-10, MIP-1a, PDGF, MIP-1b and VEGF were found to be significantly higher in recurrent patients compared to non-recurrent patients. Of these, high concentrations of urinary IL-1RA, IL-4, IL-10, IP-10, PDGF and VEGF and serum IL-1ra, IL-6, IL-10, VEGF and TNF-α were associated with poor recurrence-free survival. Poor recurrence-free survival was also seen with increasing number of cytokines showing high concentrations. The study shows that the estimation of a combination of these cytokines in minimally or non-invasive samples may act as a prognostic indicator.

Annona muricata (soursop), a traditional medicinal plant renowned for its anticancer properties due to annonaceous acetogenins, was investigated to identify potent phytochemicals targeting colon cancer. Considering the significant role of genetic mutations such as MLH1 in colorectal carcinogenesis, this study aimed to explore natural compounds with therapeutic potential. Gas chromatography-mass spectrometry (GC-MS) analysis identified 52 phytochemicals from A. muricata , which were filtered through Lipinski’s rule of five to select 14 drug-like candidates. Molecular docking using PyRx prioritized seven compounds—alpha-tocopherol, 4,6-O-benzylidene-D-galactose, methyl 3-(3,5-di-tert-butyl-4-hydroxyphenyl)propionate, (5 S)-2(3 H)-furanone dihydro-5-methyl-5-phenyl-, (2R,3R,4aR,5 S,8aS)-2-hydroxy-4a,5-dimethyl-3-(prop-1-en-2-yl)octahydronaphthalen-1(2 H)-one, naphthalene 1,2,3,4,5,6-hexahydro-4,7-dimethyl-1-(1-methylethyl)-, and isobutyl phenylacetate. Pharmacokinetic properties (ADMET) were evaluated, and electronic characteristics were analyzed via density functional theory (DFT). Molecular dynamics (MD) simulations over 100 ns confirmed the stability of drug-protein complexes through RMSD, radius of gyration (Rg), SASA, RMSF, and hydrogen bonding patterns. Results demonstrated that these phytochemicals exhibited superior binding affinities compared to standard therapy, 5-fluorouracil, with alpha-tocopherol notably outperforming it. ADMET analyses verified favorable pharmacokinetics, indicating non-toxicity and non-carcinogenicity. Stability assessments showed consistent parameters throughout the simulation. Overall, the prioritized phytochemicals from A. muricata , especially alpha-tocopherol, exhibit significant anticancer potential and stability, supporting further experimental validation and development as therapeutic agents for colon cancer.

Introduction This observational study explores the Peripheral Perfusion Index (PPI) as a predictor of hypotension and mortality in sepsis. By correlating PPI with clinical outcomes, it assesses its potential for early diagnosis and goal-directed therapy, aiming to improve sepsis management beyond traditional blood pressure-based methods for better patient outcomes. Objectives To evaluate the role of the PPI in the early diagnosis and targeted treatment of septic shock, providing insights for improving clinical management and early intervention. Material and method This prospective study conducted at a tertiary medical centre, a medical college in Bihar, compares septic shock outcomes between Group 1 (the PPI group), with septic shock diagnosed with PPI <1.4; treatment guided by PPI >2, and Group 2 (the control group), diagnosed by traditional shock criteria (systolic blood pressure <90 mmHg or >40 mmHg drop from baseline) with standard bundle treatment. Result PPI-guided therapy significantly improved hemodynamic stabilization, reduced hypotension (28% vs. 50%), decreased mortality (12.5% vs. 31.3%), and shortened ICU stays (5 ± 2 vs. 8 ± 3 days) compared to traditional shock criteria. PPI demonstrated strong predictive value for hypotension (area under the receiver operating characteristic curve (AUROC) 0.86) and mortality (AUROC 0.89), supporting its clinical utility in sepsis. Conclusion This study confirms PPI's reliability in septic shock management, advocating a shift from mean arterial pressure (MAP)-focused to PPI-guided therapy for better outcomes.

Acute myocardial infarction in individuals who have had a cerebrovascular accident or transient ischemic attack (CVA-TIA) is a medical emergency, which must be examined and treated as soon as possible. Physicians face a significant problem in managing this scenario because early treatment of one ailment would surely postpone treatment of the other. Early detection and treatment will have an impact on the patient's morbidity and mortality in the future, as well as aid in the patient's rehabilitation. On the basis of ECG alterations and cardiac biomarkers, a prospective observational study was conducted in 103 diagnosed CVA patients to investigate the incidence of myocardial infarction. Infarct and hemorrhagic CVA cases were evenly distributed. According to the age-based distribution, the highest rate of myocardial infarction (8%, 8) was observed in those aged 51-60 years. The male-to-female ratio is 1.86:1. Thirty-two patients had diabetes, among them 75% had only elevated creatine kinase MB (CKMB) with no myocardial infarction (MI), whereas 59 patients had hypertension of which 70% had only elevated CK-MB with no MI. ST-elevation myocardial infarction (STEMI) with high CKMB accounted for 14.78% (15) of the cases, but the majority (71%, 73) of the cases had elevated CKMB with no MI, and the rest presented with normal CKMB. Elevated CKMB with or without STEMI serves as a poor prognosticating factor. Therefore, these patients should be managed on a priority basis for a better outcome.

[This corrects the article DOI: 10.7759/cureus.29005.].

Mucormycosis has gained a huge number of cases in the second wave of post COVID-19 infection, which may be attributed to increased awareness, advancement in diagnostic techniques, and an increase in the prevalence of predisposing factors. This study evaluated the pattern, risk factors, and clinical profile of patients with mucormycosis during the second wave of the COVID-19 pandemic. A prospective observational study was conducted in the Department of Emergency Medicine of a dedicated tertiary care hospital for COVID-19. The Institutional Ethics Committee approved the study. One hundred five patients diagnosed with mucormycosis were included from June 2021 to December 2021. Informed consent was obtained from the patients. Data on demography, clinical features, predisposing factors, co-morbid conditions, and microbiological samples were obtained and analyzed.  Out of 105 patients, 71 were male, and 34 were female. The patient presented with mucormycosis between the 2nd and 3rd week of post COVID-19 infection. Incidence was mainly seen in patients in their fifties, mostly associated with diabetes mellitus (DM) (53.30%), oxygen administration (80%), and previous use of steroids (45.71%). Predominantly, males were more affected. The most common presentation was headache (50.47%), orbital pain with restricted ocular movement (47.67%), proptosis (42.85%), and diminished vision (41.90%). Rhino-orbital-cerebral mucormycosis (ROCM) was the most common presentation of mucormycosis, while only five cases of pulmonary mucormycosis were found. ROCM was the most common presentation of mucormycosis between the second and third week of post COVID-19 infection. Diabetes mellitus and inadvertent use of steroids were major predisposing factors. Therefore, a high degree of suspicion and early diagnosis with initiation of treatment is warranted in cases of mucormycosis in post COVID-19 infection.