Adani Institute of Infrastructure Engineering

Primary nasal tuberculosis (TB) is an exceedingly rare form of extrapulmonary TB, often mimicking other granulomatous diseases and posing diagnostic challenges. We present a case of a 54-year-old female patient with persistent nasal obstruction and epistaxis, initially suspected to be chronic rhinosinusitis. Diagnostic evaluation, including nasal endoscopy and biopsy, revealed caseating granulomas with acid-fast bacilli (AFB), confirming primary nasal TB without pulmonary involvement. The patient was treated with a standard anti-tubercular regimen of two months of intensive phase (four drugs) and four months of continuation phase (three drugs), resulting in complete resolution of symptoms and no recurrence at one-year follow-up. This case underscores the importance of considering TB in atypical nasal presentations, especially in endemic regions, and highlights the efficacy of timely anti-tuberculous therapy.

Background: Chronic kidney disease(CKD) is a growing global health challenge, with hypertension being a leading cause of renal dysfunction across populations. A major yet underrecognized complication of hypertensive CKD (HTN-CKD) is anemia, which not only worsens renal outcomes but also amplifies cardiovascular risk through mechanisms like left ventricular hypertrophy and myocardial strain. Understanding its burden is critical, as anemia in this setting accelerates disease progression and contributes significantly to cardiovascular morbidity and mortality. Method: We estimated the global and regional burden of anemia attributable to HTN-CKD in 204 countries and its terriotories from 1990-2021 using standardized Global Burden of Disease Study 2021. Estimates of prevalence and years lived with disability(YLDs) were generated using DisMod-MR 2.1, a Bayesian meta-regression tool that integrates data from population-based surveys, cohort studies, hospital records, and vital registration systems. Age-standardized rates were calculated to facilitate comparisons across time and regions, and annualized percentage changes(APCs) were computed using log-linear regression. Results: Between 1990 and 2021, the global prevalence of anemia attributable to HTN-CKD more than doubled, rising from 2.6 million(95% UI: 2.4–2.9 million) to 5.6 million(5.2–6.1 million), with an APC of +2.46%. Correspondingly, YLDs increased from 74,819 (49,512–106,554) to 138,672 (92,028–198,889), reflecting an APC of +2.01%. The highest regional increase in prevalence was observed in South Asia (APC: +3.16%), followed by Latin America and the Caribbean (+2.94%), Sub-Saharan Africa (+2.80%), and North Africa and the Middle East (+2.71%). The greatest rise in age-standardized prevalence rate was seen in Fiji (APC: +0.80%), followed by the United States (APC: +0.74%), signaling a growing concern even in high-resource settings like the USA. Among adults aged 70 years and above in middle and low-middle SDI regions, both prevalence and YLDs showed annualized increases exceeding 2%, whereas younger age groups in high SDI regions exhibited stable or declining trends. Conclusion: The global burden of anemia due to HTN-CKD has escalated, with the sharpest increases concentrated in low- and middle-income regions where hypertension detection and management remain suboptimal. The burden is especially pronounced among older adults and men, accentuating widening disparities by age, sex, and socioeconomic status.

Background: Congenital circulatory anomalies remain a significant cause of mortality in the United States, especially among infants and young children. Understanding long-term mortality trends and disparities across demographics and geography is crucial for targeted public health interventions. Methods: Mortality data for congenital circulatory anomalies were extracted from CDC WONDER for the years 1999 to 2020. Annualized Percentage Change (APC) in absolute death counts was calculated using log-linear regression models, stratified by state, census region, urbanization, sex, age group, race, and Hispanic origin. Results: Nationally, deaths declined from 4,436 in 1999 to 3,011 in 2020, reflecting an APC of –2.14%. Among census regions, the Northeast experienced the steepest decline (APC: –2.37%), followed by the Midwest (–2.25%), South (–2.05%), and West (–2.02%). Urbanization-wise, the greatest reduction was noted in NonCore (–2.53%) and Large Fringe Metro areas (–2.01%), while Small Metro areas had a milder decline (–1.44%). State-level analysis showed that Alaska had an increasing trend (APC: +4.66%), while several states showed moderate-to-high declines, with California (–3.12%) and Texas (–2.84%) among the top. Age-specific trends revealed significant reductions in the 1–4 year age group (APC: –1.70%) and 75–84 year group (–1.56%), with relatively stable trends among those aged 55–64 (–0.04%). Sex-stratified analysis showed a sharper decline in females (–2.33%) compared to males (–1.97%). Racial disparities were evident: White individuals experienced the highest decline (–2.36%), followed by Black or African American (–1.82%), American Indian or Alaska Native (–0.60%), while Asian or Pacific Islanders showed a slight increase (APC: +1.02%). By Hispanic origin, deaths among Hispanic or Latino populations declined with an APC of –1.20%, while those not of Hispanic origin declined more steeply (–2.29%). The "Not Stated" category also declined (–2.13%). Conclusion: Despite overall declining mortality from congenital circulatory anomalies in the U.S. from 1999 to 2020, marked disparities persist across race, state, age, and urbanization level. Targeted efforts are needed to reduce the widening gaps and address the concerning upward trends observed in specific states and ethnic groups.

Abstract The current report examined the potential of polyaniline modified Fe3O4-Delonix regia seed biochar nanocomposite to adsorb congo red from synthetic wastewater. In this study, biochar was synthesized through carbonization process at a peak temperature of 500°C. Fe3O4 nanoparticles were synthesized using aqueous extract of Delonix regia seed pod. The consequence of pH, concentration and stirring speed on removal of congo red is examined. A maximum removal efficiency of 91.63% was obtained at optimal conditions of pH − 8, initial CR concentration – 50 mg/L and agitation speed − 500 rpm. The adsorption result demonstrated that experimental consequences fit well with Langmuir adsorption isotherm and pseudo second order kinetics was followed. A maximum sorption ability of 384.615 mg/g was obtained. Thermodynamic results shown that the sorption is spontaneous, reversible and endothermic one. The adsorption mechanism was explored and electrostatic attraction is the major rate controlling one. The current study established the efficiency of polyaniline modified Fe3O4-Delonix regia seed biochar nanocomposite as an sorbent in removal of congo red. The solid agro waste is effectively transformed and applied in industrial wastewater treatment.

Background: Stroke is a leading cause of mortality and disability worldwide, with environmental factors such as air pollution increasingly recognized as significant contributors. This study aims to evaluate the burden of stroke attributable to air pollution in India over a 31-year period. Methods: We conducted a retrospective analysis using burden of disease study 2021 from 1990 to 2021. The study focused on particulate matter (PM2.5 and PM10) as primary pollutants. The population attributable fraction (PAF) of stroke due to air pollution was calculated using risk estimates from contemporary studies, adjusted for demographic changes. Results: Over the three-decade period, the total recorded deaths attributable to air pollution-induced strokes amounted to 8,533,316, with an average of 7,983 deaths per year. The total Disability-Adjusted Life Years (DALYs) accrued due to strokes were over 204 million, averaging around 205,890 DALYs annually. Additionally, the total Years of Life Lost (YLLs) summed up to about 14,836,982, with a mean annual YLL of 192,675. Maharashtra reported the highest burden with 56,407 deaths, around 654,246 DALYs, and 611,353 YLLs due to stroke, indicating it as the state most affected by air pollution-related stroke incidents. In contrast, Sikkim reported the lowest stroke burden, with the smallest numbers across all measures: 109 deaths, 1,436 DALYs, and 1,250 YLLs. Males experienced a slightly higher stroke burden due to air pollution with 168,709 deaths and about 4,040,735 Years of Life Lost (YLLs). Females had about 148,785 deaths and approximately 3,377,256 YLLs. The 65-69 years age group had the highest number of deaths at 51,944 and over 1.26 million YLLs. This was closely followed by the 70-74 years age group, with about 54,945 deaths and over 1.10 million YLLs. Conclusion: Our findings underscore the critical need for stringent air quality control measures and public health strategies to mitigate the impact of air pollution on stroke incidence in India. Younger age groups, particularly below 25 years, show significantly lower numbers, indicating that air pollution primarily impacts the elderly in terms of stroke burden. Addressing this environmental risk factor is crucial for reducing the future burden of stroke and improving public health outcomes.

Recent rapid developments in machine learning (ML) models have revolutionized the generation of images and texts. Simultaneously, generative models are beginning to permeate other fields, where they are being applied to the effective design of various structures. In the field of metamaterials, in particular, machine learning has enabled the creation of sophisticated architectures with unconventional behavior and unique properties. In this article, we review recent advancements in the ML-driven design of a particular class of artificial materials — phononic metamaterials — that are capable of programming the propagation of acoustic and elastic waves. This review includes an in-depth discussion of the challenges and future prospects, aiming to inspire the phononic community to advance this research field collectively. We hope this article will help readers understand the recent developments in generative design and build a solid foundation for addressing specific research problems that could benefit from the application of machine learning models. • Inverse design of acoustic and elastic metamaterials via machine learning is discussed. • The pros and cons of the specific models are analyzed. • The potential of physics-aware models is highlighted. • Future challenges are outlined and discussed.