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The COVID-19 pandemic has adversely affected students pursuing higher education, but limited studies highlight student's psychological experiences, especially from Western India. The present study aimed to understand psychological experiences, coping behaviors, and the perceived role of tele-counseling services among final-year students of Masters of Business Administration from leading business schools (B-schools) in Western India. A qualitative research design was adopted for the study. A semi-structured interview guide was utilized to conduct in-depth interviews with 35 students. Students were reached via personal networks and social media, and data was gathered after the second wave of the COVID-19 pandemic. A thematic analysis technique was employed to analyze the data. The findings showed that management students had upsetting psychological experiences. Key stressors that emerged in the study were job concerns, lifestyle changes, concerns about their own and parents' health and safety, uncertainty about the future, and social isolation. They expressed the need for mental health help; however, they were reluctant to utilize tele-counseling services. The authors present an integrated psychological well-being model for promoting positive mental health among students in higher education institutions. The study explains the psychological toll on management students. Enhancing mental health literacy through awareness sessions and other innovative means would be critical to addressing myths around mental health and mental healthcare-seeking behavior in higher education institutions. An integrated approach to promoting positive mental health and well-being is needed.

Abstract Background: Primary extranodal lymphomas (pENL) are lymphomas with minimal nodal involvement and dominant extranodal disease. We aimed to study the prevalence and clinicopathological characteristics of pENL presenting at our center over 5 years from January 2015 to January 2020. Methods: This is a cross-sectional study of pENL patients in which relevant clinical and laboratory data was collected including demography, site, stage, international prognostic index-revised, imaging findings, hematological, and biochemical parameters and comorbidities including underlying immunodeficiency. The paraffin blocks were subjected to routine hematoxylin and eosin stain and immunohistochemistry with standard lymphoma panel. Results: Of 341 lymphomas, 73 (21.4%) were pENL with commonest site being gastrointestinal tract (31.5%) followed by head and neck (23.2%) and soft tissues (9.6%). Diffuse large B-cell lymphoma (DLBCL) (39.7%) was the commonest histological type (germinal center type-48%, nongerminal center-52%) followed by marginal zone lymphomas (MZL) (23.3%) and primary CNS lymphoma (8.2%). Primary breast lymphoma, primary bone marrow lymphoma, and follicular lymphoma constituted 4.1, 5.4, and 4.1% of pENL, respectively. There was a case of high grade B cell lymphoma of ileum with features intermediate between DLBCL and Burkitt. Other unusual pENL were anaplastic DLBCL of tonsils, DLBCLs of bone marrow with M band, MZL of base of tongue, Richter's transformation of tonsillar small lymphocytic lymphoma, and follicular lymphoma presenting as pericardial mass. Of 12 cases of T-non-Hodgkin lymphoma, commonest were mycosis fungoides (4/12) followed by mediastinal T-lymphoblastic lymphoma (2/12) and peripheral T-cell lymphoma (2/12). Conclusion: pENL has unique clinical presentation depending on the location with site-specific distribution of histological subtypes.

Agronomic biofortification of staple food crops with external supply of micronutrients offers a viable solution to alleviate the plant diet-based micronutrient deficiency, without any yield trade-off. Zinc (Zn) has been one of the key targeted micronutrients in the biofortification program of Sub-Saharan Africa, Middle East and South-East Asia. Agronomic Zn biofortification, while promising for addressing Zn deficiencies in humans, raises valid concerns regarding its potential impact on grain iron (Fe) content. This is because Zn and Fe can interact at multiple levels, within soil, plant root, shoot, leaves and grains during transport and translocation. Emerging evidences suggest that biofortifying crops with Zn may trigger systemic responses that alter Fe homeostasis, potentially lowering Fe accumulation (antagonistic) in edible tissues of staples. Nevertheless, there is a lack of clarity in the field studies on the effects of Zn biofortification on Fe levels. This review article aims to synthesize a robust narrative on Zn-Fe interactions in biofortified crops and possible causes of negative interaction within plant body. Though, the additive or synergistic interaction between these two essential micronutrients is advantageous in a Zn biofortification program; but such interaction may be highly local stress specific. On the contrary, any loss of Fe during the process is undesirable, as the nutritional significance of Fe is comparable to that of Zn in human health. Yet, unlike other nutrient interactions (e.g., phosphorus (P) × Zn, nitrogen (N) × Zn), their interaction (Zn-Fe) is much less examined. But now, amid reports on unwitting depleting trend in grain micronutrients content in cereals, observed across the globe over the past 70 years, Zn - Fe interaction should apparently be given importance. In this review, we also highlighted on some possible interventions, agronomic or genetic or integrated approaches, to discard such negative interactions between Zn and Fe for future biofortification program. Addressing this trade-off (Zn-Fe interactions in crops) is the key to ensure that biofortification strategies do not inadvertently raise other micronutrient deficiencies. A focus on feasible management practices to curb such negative interaction between Zn and Fe will determine the success of agronomic Zn biofortification.

Dr. Jo E Frencken is a stalwart in preventive dentistry and cariology. He has worked extensively in diagnosing, treating, and assessing outcomes related to dental caries. He developed the concept of a novel technique known as atraumatic restorative treatment (ART) in 1986 for caries management. ART for field settings, where only hand instruments are used for caries removal, is a benchmark discovery made in the field of dentistry. His idea of ART has been adopted by the World Health Organization and has been included as a part of the Basic Package for Oral Care (BPOC) and practiced globally. He has dedicated his research to dental public health, caries prevention, and treatment modalities in various settings for over 40 years.

Background Successful endodontic treatment relies on the effective removal of debris and the prevention of smear layer formation within the root canals. The choice of nickel-titanium (Ni-Ti) rotary instrument systems can significantly impact these outcomes. Aim This study aims to evaluate and compare the debris and smear layer formation in root canals of extracted mandibular second premolar teeth following instrumentation with the ProTaper Universal (Dentsply Sirona, Charlotte, NC) (Group II), Twisted File (Kerr Endodontics, Gilbert, AZ) (Group III), and XP Endo (FKG Dentaire, La Chaux-de-Fonds, Switzerland) (Group IV) Ni-Ti rotary instrument systems. Methods In this in vitro study, 60 extracted mandibular second premolar teeth were randomly divided into four groups, each containing 15 teeth. Group I served as the control with no instrumentation. Groups II, III, and IV were instrumented with the ProTaper Universal rotary file, the Twisted File, and the XP Endo file systems, respectively. Debris and smear layer formation were evaluated through scanning electron microscopy (SEM), and photomicrographs were scored using a standardized index. Results Group II (ProTaper) exhibited the highest mean debris and smear layer scores, with values of 3.50 and 2.70, respectively. Group IV (XP Endo) demonstrated the least debris and smear layer formation, with mean scores of 2.65 and 2.08, respectively. Statistical analysis confirmed significant differences among the groups for both debris and smear layer formation. Conclusion The results highlight the practical importance of selecting appropriate Ni-Ti rotary instrument systems to minimize debris and smear layer formation during endodontic procedures. The XP Endo file system showed promise as a favorable choice in this regard, but further clinical research is needed to validate these findings.

The study aimed to compare the clinical efficacy, safety, and acceptability of buffered lidocaine (8.4% sodium bicarbonate and 2% lidocaine with 1:80,000 adrenaline) versus non-buffered lidocaine (2% lidocaine with 1:80,000 adrenaline) during inferior alveolar nerve block. Fifty patients who required bilateral extractions in a single arch were included in this study. One hundred extractions were carried out, and all of the patients had nerve blocks during the procedure. We also took note of the patient's pain level as measured on a visual analog scale, as well as the start of the action, duration of postoperative analgesia, and occurrence of any problems. The duration of anesthesia was assessed by the feeling of numbness and the first sign of pain. All the patients in both study groups reported subjective numbness of the lips and tongue. The depth of anesthesia was evaluated by pain and comfort during the procedure with a visual analog scale and showed no significant difference between the two groups. The onset of action for the pterygomandibular nerve block was 1.240.31 minutes (buffered) and 1.710.51 minutes (non-buffered). When compared, the duration of anesthesia was 327.18102.98 minutes (buffered) and 129.0826.85 minutes (non-buffered). This study concludes that the buffered solution has a faster onset of action than the non-buffered solution. Both solutions exhibit similar intraoperative efficacy. The duration of postoperative anesthesia was prolonged with buffering. Buffering also reduced pain scores during the early postoperative period.

Context: Fine needle aspiration cytology (FNAC) plays an important role in the diagnosis of breast carcinoma. However, its role as a prognostic tool needs to be explored. This can be achieved by studying its correlation with an established prognostic marker such as axillary nodal metastasis. Aims: This study was undertaken to correlate the cytological features of invasive ductal carcinoma (IDC) of breast with axillary lymph node status. Settings and Design: Tertiary care hospital, retrospective analytical study. Materials and Methods: The study group included 150 cases of IDC of breast diagnosed on FNAC, who had subsequently undergone modified radical mastectomy. Cytologic grades were assigned as per Robinson's grading system. Histopathological sections of axillary lymph nodes were assessed for metastasis. Statistical Analysis Used: The cytologic grade and each feature of the cytologic grade were correlated with the lymph node metastasis using χ2 test. Values of P < 0.05 were considered significant. Result: A statistically significant correlation was noted between cytologic grade of tumor and axillary lymph node metastasis (P < 0.05). In addition, a positive correlation was found between two of the individual features of cytologic grade, namely, nuclear size and cell uniformity with axillary lymph node metastasis (P < 0.05). Conclusion: Robinson's cytologic grade of breast carcinoma correlates well with the presence of axillary lymph node metastasis and hence can be used as a prognostic tool. As there is an increasing trend toward conservative approach to management of breast carcinoma, patients receive preoperative neoadjuvant therapy which may alter the nodal status on the resected specimen. Hence, a high cytological grade of primary tumor, as assessed on FNAC before initiation of therapy, should alert the treating team of the possibility of axillary lymph nodal metastasis.

Context: Fine-needle aspiration cytology (FNAC) is a proven diagnostic technique for establishing the benign or malignant character of breast lesions. Several cytological grading systems have been proposed for grading of carcinoma breast, with results similar to histologic grades. Aims: This study sought to evaluate the prognostic value of FNAC in invasive ductal carcinoma of breast by correlating it with histological grade. Settings and Design: Tertiary care hospital, retrospective analytical study. Patients and Methods: One hundred and fifty cases of breast carcinoma that underwent modified radical mastectomy consequent to an FNAC diagnosis were included in the study. Robinson's grading system and Elston-Ellis modification of Scarff-Bloom-Richardson grading system were used to assign cytologic and histologic grades, respectively. Statistical Analysis: The cytological grades were correlated with the histological grades using χ2-test and Spearman's rank correlation coefficient. The individual features of the cytological grades were correlated with the histological grades using Kappa coefficient and χ2-test. Values were considered significant at P < 0.05. Results: A statistically significant association was observed between cytologic and histologic grades (r = 0.97; P < 0.01) with sensitivity and specificity, respectively, of 100% and 93.95% for cytological grade 1, 100% and 100% for cytological grade 2 and 100% and 100% for cytological grade 3. Also, a positive correlation was found between each feature of the cytologic grade and the histologic grade (P < 0.05). Among these, a better correlation was demonstrated by cytological features like cell uniformity (Kappa coefficient = 0.50) and appearance of nucleoli (Kappa coefficient = 0.52). Conclusions: Robinson's cytologic grading system is a reliable grading method on FNAC smears of cases of carcinoma breast. It correlates well with Elston-Ellis modification of Scarff-Bloom-Richardson grade in invasive ductal carcinoma of breast.

PurposeThe study aims to facilitate the medical tourists visiting emerging countries for various kinds of ailments by ranking the possible destinations to avail medical treatments.Design/methodology/approachA Fuzzy Analytical Hierarchical Process (FAHP) with a mixed-method approach is applied to analyze data collected from patients and substantiate it with medical tour operators in India to gain managerial insights on the choice-making patterns of the patients.FindingsIndia is a preferred emerging market location due to the low cost and high medical staff quality. India offers value for money, whereas Singapore and Thailand are preferred destinations for quality and technology.Research limitations/implicationsThe study will facilitate the emerging markets' governments, hospitals and medical tourists to understand the importance of various determinants responsible for availing medical treatment outside their country.Practical implicationsThe study recommends that cost and quality care are the patients' prime focus; government policies must provide clear guidelines on what the hospitals and country environment can offer and accordingly align the marketing strategies.Originality/valueThis study is the first attempt to rank various factors affecting medical tourism using the FAHP approach.

In the aftermath of the global #Metoo-movement, sexual harassment (SH) and other forms of gender-based violence (GBV) have emerged at the forefront of public debate and research. Higher education instituions (HEI) worldwide have responded with different preventive measures, targeting context-specific challenges and solutions. In India, post the enactment of the law on prevention and repatriation of SH of women at work in 2013, governing bodies in HE have issued several policies and guidelines. However, almost no empirical studies have explored the implementation and consequences of these initiatives. This pioneering study explores the Indian experiences of procedural change in this sense, through the challenges faced by internal complaints committee members. A specific focus in the analysis is on the members discourses on executing the quasi-legal and behavioural mandates of the law. In conclusion, ambiguities within the law as such, misrecognized cognitive biases in committee members narratives, and a lack of adequate conversation on GBV and SH sums up to identified bureaucratic grey zones. Several recommendations on context specific preventive measures are suggested as well as core recommendations on future research targeting prevention of GBV and SH in HEI more generally.