S.L. Raheja Hospital

Soil stabilization is a critical aspect of foundation engineering that improves subgrade soils' durability and load-bearing capacity. This study examines the effectiveness of two innovative stabilizing agents—waste plastic bottle fibers and Nano Zinc Oxide (ZnO)—in enhancing the geotechnical properties of Ulwe and Navi Mumbai soils. Waste plastic bottle fibers were added in proportions of 0.25%, 0.5%, and 0.75% by weight with length 3 cm, width 1 mm, and thickness 0.1 mm, while ZnO was incorporated in proportions of 1%, 2%, and 3% by weight of dry soil. Experimental tests such as the Standard Proctor, California Bearing Ratio (CBR), and Unconfined Compressive Strength (UCS) were performed to assess the soil's performance. Wet-dry and freeze-thaw cycle experiments, which mimic field conditions, were used to evaluate durability. According to the results, adding 0.5% waste plastic bottle fibers increased CBR values by 32%, while adding 2% ZnO improved CBR by 25%. Higher ZnO content, however, increased the soil's optimum moisture content (OMC) while decreasing its maximum dry density (MDD). These results emphasize the suitability of waste plastic bottle fibers and ZnO as cost-effective and environmentally friendly soil stabilizing agents, with significant improvements in CBR values.

Objective: This study aims to evaluate the efficacy and safety of oral semaglutide in managing type 2 diabetes (T2D) through a cardio-renal-metabolic approach tailored for the Indian context. Materials and methods: A literature review was conducted using PubMed and Google Scholar, focusing on systematic reviews, meta-analyses, and randomized controlled trials related to oral semaglutide. Findings were discussed at the 16th National Insulin and Incretin Summit (NIIS) on November 19, 2022, where an expert panel developed guidelines based on collective insights and live opinion polls. Results/Key findings: The expert committee recommends oral semaglutide for adults with T2D due to its effectiveness in lowering blood glucose and promoting weight loss. It can be used alone or with other oral anti-diabetic agents, except dipeptidyl peptidase 4 inhibitors (DPP-4i). The drug is safe for those with cardiovascular disease or chronic kidney disease (CKD). Common gastrointestinal side effects are typically mild. Administration requires fasting for 30 min after dosing. Gradual dose escalation is advised to minimize side effects, and patients should be counseled on potential interactions with other medications and pregnancy considerations.

The consumption of lo-fi music as a wellness and productivity-inducing product has become increasingly popular among young consumers in recent years. This pioneering article explores emerging evidence on lo-fi music consumption for young consumer wellness, using the positive design framework as a lens, and envisions an extensive future research agenda. Following a systematic approach to reviewing the literature, modeled on scoping review methodology, a thematic analysis of the literature is conducted, and theories from multiple disciplines support arguments. Key research gaps and current trends are identified, and a curated definition of the “lofi product” is provided. The study enhances the positive design framework of Desmet and Pohlmeyer with significant contributions from the themes generated, providing product strategists with a framework to design products that optimize young consumers’ wellness. The findings reveal that consumption of the “lofi product” may intensify positive affect, accelerate goal attainment, and improve health and performance while fostering the development of character strengths in young consumers. Intentionally designing products for young consumers using the proposed framework may also result in similar wellness outcomes. This study would empower marketers to leverage the lofi product effectively in their marketing strategies. Consultation with industry experts informs the future research directions proposed. This study calls out a pressing need for robust scientific investigation and academic discussion.

Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) includes EUS-guided hepaticogastrostomy (EUS-HGS), EUS-guided choledochoduodenostomy (EUS-CDS), EUS-guided gallbladder drainage (EUS-GBD), EUS-guided antegrade stenting (EUS-AG) and EUS-guided rendezvous (EUS-RV). While EUS-HGS, EUS-CDS and EUS-GBD are transluminal drainage procedures, EUS-AG is a traspapillary drainage procedure and EUS-RV is a procedure intended to facilitate endoscopic retrograde cholangio pancreatography (ERCP) in instances of failed cannulation. These procedures were initially developed as options for endoscopic salvage of failed ERCP, but have evolved to become first-line interventions also for select indications over time as the technique and expertise improved. Several randomised controlled trials have demonstrated EUS-BD, especially EUS-CDS has similar or even better outcomes as compared to ERCP in malignant biliary obstruction. However, widespread adoption of these modalities is limited by the availability of expertise, steep learning curve, lack of standardization of techniques and cost. In this review, we aim to provide an overview of various EUS-BD procedures including the indications, accessories, technique, outcomes and follow-up of each of these procedures.

A survey-based approach to managing antibiotic-resistant infections in the intensive care unit (ICU) setting, with a focus on carbapenem-resistant Enterobacteriaceae (CRE) cases, was conducted. Among CRE, New Delhi metallo-β-lactamase 1 (NDM-1) is a carbapenemase that is resistant to β-lactam antibiotics and has a broader spectrum of antimicrobial resistance than other carbapenemase types. The article explains that healthcare-associated infections (HAIs) are a significant problem, particularly in low- and middle-income countries, and that carbapenem in combination with other antibiotics are the most potent class of antimicrobial agents effective in treating life-threatening bacterial infections, including those caused by resistant strains. The survey aimed to gather critical care healthcare professionals (HCPs') opinions on their current practices in managing infections acquired in the hospital and ICU settings, with a focus on CRE cases, specifically NDM-1 and other antibiotic-resistant infections. Responses from critical care healthcare professionals, including online surveys and in-person interviews, to gain insights into the management of infections caused by multidrug-resistant bacteria. The findings related to the insights on the prevalence of bacterial flora, clinical experiences on efficacy and safety of meropenem sulbactam ethylenediaminetetraacetic acid (EDTA) (MSE) in CRE cases, and various combination therapies of antibiotics used to treat antibiotic-resistant infections in ICU setting were evaluated. Klebsiella pneumoniae bacteria were the most common bacteria in cultures, followed by Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii. NDM-1 was the type of carbapenemase found in around 50% of CRE patients. MSE is among the most preferred antibiotics besides colistin, polymyxin B, and ceftazidime avibactum for CRE cases and specifically for NDM-1 cases due to its high rate of efficacy and safety. The article concludes with a discussion on the antibiotics used in response to CRE cases, reporting that critical care HCP considers MSE with high efficacy and safe antibiotic combination and was used as both monotherapy and in combination with other antibiotics. The survey highlights the need for exploring and better understanding the role of MSE in the management of CRE infections, especially in NDM-1.