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Chronic wounds are associated with significant clinical, economic and quality‐of‐life burden. Despite the variety of wound imaging systems available in the market for wound assessment and surveillance, few are clinically validated among patients of Asian ethnicity. We aimed to clinically validate the accuracy of a smartphone wound application (Tissue Analytics [TA], Net Health Systems Inc, Florida, USA), versus conventional wound measurements (visual approximation and paper rulers), in patients of Asian ethnicity with venous leg ulcers (VLU). A prospective cohort study of patients presenting with VLU to a specialist wound nurse clinic over a 5‐week duration was conducted. Each patient received seven wound measurements: one by a trained wound nurse clinician, and three separate wound measurements using TA on each of the iOS and Android operating systems. Inter‐rater and intra‐rater reliability between clinical and TA‐based measurements were analysed using intra‐class correlation statistics, with values of <0.5, 0.5 to 0.75, 0.75 to 0.9, and >0.9 indicating poor, moderate, good and excellent reliability, respectively. 82 patients (51% males), with a mean age at 65.8 years, completed the 5‐week study duration. 25 (30%) had underlying diabetes mellitus. Chinese, Malay and Indian ethnicity comprised 68%, 12% and 11%, respectively. The VLU healed in 26 (32%) of patients within the study period. In total, 358 wound episodes with 2334 wound images were analysed. Inter‐rater reliability for length, width and area between wound nurse measurements and TA application measurements was good (range 0.799‐0.919, P < 0.001). Separate measurements of intra‐rater reliability for length, width and area within the iOS or Android systems were excellent (range 0.967‐0.985 and range 0.977‐0.984 respectively, P < 0.001). Inter‐rater reliability between TA used on the iOS and Android systems was also excellent (0.987‐0.989, P < 0.001). Tissue Analytics, a smartphone wound application, is a useful adjunct for wound assessment and surveillance in VLU patients of Asian ethnicity. [ABSTRACT FROM AUTHOR]

The nursing schedule generation is an important activity that takes a considerable amount of time for managers to prepare and amend. It involves the optimal allocation of nurses to shifts, factoring various constraints like shift timings, holidays, leaves, and emergencies. This paper provides the design and development details for an automated nurse scheduling system called "ROTA," implemented for a 2032 bed multi-specialty tertiary teaching hospital, having 1800 staff nurses and 98 wards. The system generates daily, weekly, monthly schedules, nurse face sheets, duty allocation charts, swapping schedules, and training details for nurses. The system improved managerial control and saved a considerable amount of time for nurses to prepare the schedule. A survey conducted to gauge the system's satisfaction level showed that 91% of nurses were satisfied with ROTA. Overall, the system saved 78% of nurse scheduling time, resulting in a 3% cost reduction for the hospital. [ABSTRACT FROM AUTHOR]

This paper analyzes patient-provider interaction (PPI). More precisely, it deals with the form-function relationship in questions used in counselor-patient interaction. The study is based on naturally occurring primary data collected at the Department of Pediatrics and the Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital (JNMCH), located in Aligarh Muslim University, India. The data are composed of audio-visual recordings of Hindi-Urdu interaction between 8 counselors and 27 patients. We identified compliance and condescension as the two unique functions the counselors seeks to accomplish and/or fulfill through the use of questions in their interaction with the patients. We also found four other functions – information seeking, recall, greeting, and diagnosis, which are sought by the counselors through their use of questions. The findings also suggest that these functions maintain and promote what can be termed as a counselor-centered interaction, and thus reflect asymmetrical power relationship between counselors and their patients. [ABSTRACT FROM AUTHOR]

Diabetic retinopathy(DR) is a health condition that affects the retinal blood vessels(BV) and arises in over half of people living with diabetes. Exudates(EX) are significant indications of DR. Early detection and treatment can prevent vision loss in many cases. EX detection is a challenging problem for ophthalmologists due to its different sizes and elevations as retinal fundus images frequently have irregular illumination and are poorly contrasting. Manual detection of EX is a time-consuming process to diagnose a mass number of diabetic patients. In the domain of signal processing, both SIFT (scale-invariant feature transform) and SURF (speed-up robust feature) methods are predominant in scale-invariant location retrieval and have shown a range of advantages. But, when extended to medical images with corresponding weak contrast between reference features and neighboring areas, these methods cannot differentiate significant features. Considering these, in this paper, a novel method is proposed based on modified KAZE features, which is an emerging technique to extract feature points and extreme learning machine autoencoders(ELMAE) for robust and fast localization of the EX in fundus images. The main stages of the proposed method are pre-processing, OD localization, dimensionality reduction using ELMAE, and EX localization. The proposed method is evaluated based on the freely accessible retinal database DIARETDB0, DIARETDB1, e-Ophtha, MESSIDOR, and local retinal database collected from Silchar Medical College and Hospital(SMCH). The sensitivity, specificity, and accuracy obtained by the proposed method are 96.5%, 96.4%, and 97%, respectively, with the processing time of 3.19 seconds per image. The results of this study are satisfactory with state-of-the-art methods. The results indicate that the approach taken can detect EX with less processing time and accurately from the fundus images. [ABSTRACT FROM AUTHOR]

Globally Cancer is the second leading cause of death and approximately 9.6 million deaths due to cancer in 2018. Approximately about 1 in 6 deaths is due to cancer globally. In low and middle-income countries approximately 70% of deaths are due to cancer. Some common cancers in Indian women are Breast, Cervix, Ovary, Mouth & Esophagus, Colorectal and other cancers. Breast cancer is the commonest cancer among women across the World as well as in India. Although rapid advancement, mammography & screening has increased rate of survival but women who survive continue to face medical, physical, social and psychosocial challenges. Evaluation of quality of life is also important for understanding the effect of treatment and how much different factors affect quality of life of the breast cancer patients. This paper aims to predict Quality of Life (QoL) in breast cancer patients using various physical, psychological, social and spiritual domains. This descriptive and cross sectional study was undertaken to determine the factors affecting quality of life (QOL) in breast cancer patients. Patient's response and hospital records analyses the dimensions which affects quality of life among breast cancer patients in the state of Uttar Pradesh. Findings suggest strong relationship between clinical and socio-demographical factors and breast cancer patients' QoL. This study demonstrates the strength of the relationship between education and physical well-being, education with social well-being and education with spiritual well-being. A strong relationship was found between marital status and spiritual well being. A strong relationship was found between clinical stage and spiritual well being. A good relationship was found between tumor stage and social and spiritual well being. A strong relationship was also found between type of treatment and physical, psychological and social well being. This study fills a gap in the literature related to QoL in Indian women suffering from carcinoma breast. [ABSTRACT FROM AUTHOR]

The Jammu & Kashmir (J&K) Consumer Protection Act, 1987 needs a closer scrutiny from the standpoint of medico-legal services in the wake of J&K Union Territories' (UTs) uneven health profiling and developmental progress. The doctor-patient's relationship needs an analysis in terms of access to health care and medical and para medical services. The consumer rights under Consumer Protection Act, 1986, Jammu and Kashmir Consumer Protection Act, 1987 and Consumer Protection Act, 2019 represents a trajectory of deficiency of medical service and lack of medical professionalism and capacity building among health personnel. The paper is a medico-legal profiling of Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar in regard to diligence and negligence of doctors and para legal medical inspectorate in auguring health care and medical services to patients. [ABSTRACT FROM AUTHOR]

Homicide is a brutal crime where one person kills another, robs them of their life. Forensic pathologists must distinguish between suicide, murder and accidents using autopsy. Homicides can involve various methods, including assault, strangulation, drowning, burns and poisoning. The rising incidence of homicides prompts a study to identify vulnerable age groups, sex incidence, motives, injury patterns, crime locations and survival periods. The study was conducted from January to December 2023 on 103 cases from 4172 autopsies in the Department of Forensic Medicine & Toxicology at B. J. Medical College, Ahmedabad. In this study we included the cases with alleged homicide history and those later converted to homicide. Most of the cases were in the age group of 21 years to 30 years and least in the age group of 0 to 10 years. Injuries were most common (36.89%) between 6 pm and 12 midnight and least common (17.48%) between 12 noon and 6 pm. The majority of homicidal deaths involved hard and blunt weapons (39.80%), followed by sharp and penetrating weapons (31.06%). Argument was the most common reason for homicidal death in 42.72% of instances. Homicides occurred most common on the street in 38.83% of cases. The majority of victims died within 30 minutes to 24 hours (45.63%) of infliction of injuries. 42.72% of incidents involved an acquaintance as the assailant. [ABSTRACT FROM AUTHOR]

Objective This study was conducted to investigate medication-related problems after implementation of clinical pharmacy services at a speciality oncology care setting. Methods It was a prospective interventional study conducted for a period of three years at a private academic oncology care setting. Paper-based medical records and medication orders were reviewed and patients and care givers were interviewed to understand the treatment plan. All the medication-related problems were identified by clinical pharmacists by performing drug therapy review. Patients were also followed up at ambulatory care and in-patient units to ensure appropriate administration of anti-cancer drugs by nurses. All the medication-related problems were discussed with the concerned clinicians and then were resolved with the interventions of clinical pharmacists. Clinical significance of these interventions were assessed and classified as "Major", "Moderate "and "Minor". Educational, clinical and system-based interventions were developed and implemented to minimize medication-related problems at the study site. Results A total of 1359 medication-related problems were identified from 2120 medication orders reviewed of 1362 patients followed during the study period. The most common medication-related problems were lack of suboptimal supportive care (17.95%), inappropriate administration of medications (14.56%), untreated indication (14.20%), wrong dosing calculations (12.21%), drug–drug interactions (11.62%) and sub-therapeutic dose (11.11%). Clinical pharmacy interventions were made to resolve all the medication-related problems. Clinical significance of majority (n = 504, 37.08%) of medication-related problems was "Moderate" followed by "Major" (n = 434, 31.93%) and "Minor" (n = 421, 30.97%). Conclusion The study has demonstrated the importance of clinical pharmacy services in improving quality and safe use of medicines in oncology practice. Positive feedback of clinicians on clinical pharmacy services was a reflection of acceptance of clinical pharmacy interventions by clinicians. [ABSTRACT FROM AUTHOR]

Accident is an unexpected, unplanned occurrence which may involve injury or it may be defined as an unpremeditated event resulting in recognizable damage. Railway related injuries are not those uncommon occurrences in forensic practice. Among the varied presentation of injuries, superficial injuries along with fractures were commonly observed. Over the last 15 years many railway accidents have happened in Andhra Pradesh and in India. Following these train accidents, there has been a large amount of public debate about safety management on the Indian railways. These accidents have raised issues regarding the effectiveness of the safety management of the railway system. This paper presents a summary of the results of a preliminary systemic analysis of several rail accidents in and around Warangal City. The present study was conducted in the Department of Forensic Medicine, Warangal Medical College, Warangal, from January 2013 to June 2014 i.e., 18 months, during which the total postmortem cases were 74 occurred in the jurisdiction of the Govt. Railway Police Station, Warangal. The factors taken to enumerate the study are the incidence of deaths month wise, age and sex, marital status, scene of offence and habitat during railway accidents. [ABSTRACT FROM AUTHOR]

Prior to the advent of the Wasserman Test as a diagnostic tool for Syphilis, the identification rate for Syphilis at the Mysore Government Mental Hospital in Southern India was 1%. With the introduction of the test, there was a dramatic increase in the diagnosis of Syphilis, with 17% of the patients testing positive. This paper throws light on the early notions of Syphilis and GPI, societal responses to the disease, early misdiagnosis, the advent of the Wasserman test and treatment management as reflected in the records of the early 20th century at the Mysore Government Mental Hospital (currently known as NIMHANS). [ABSTRACT FROM AUTHOR]

Background: an unknown dead body always becomes a challenge to the Investigating officer and forensic expert. However, the problem of determining the identity gets aggravated and taxes for the experts, when the dead body is recovered in decomposed/ skeletonized and mutilated form. Materials and Methods: A standard proforma was designed to collect the information to ensure consistency for the whole sample. All dead bodies that were brought as unidentified were included however identified dead bodies were excluded from the study. Results: A total of 407 post-mortem examinations were conducted at the mortuary of the department during under study and amongst them, 56 cases (13.75%) were found unidentified. Of these unidentified cases, 69.64% (39 cases) were in decomposed and 30.35% (17 cases) were in fresh state. Unidentified cases comprised 80.35% males (45 cases) and 19.64% females (11 cases). Conclusion: Unidentified dead bodies were only 13.75% of the total dead bodies coming to the autopsy in the mortuary of the Department of Forensic Medicine and Toxicology, VCSGGIMS & R, Srikot, Srinagar, Pauri Garhwal, UTTARAKHAND during the study period of 5 years. [ABSTRACT FROM AUTHOR]

Background: User satisfaction in healthcare is an important measure of the quality of services provided to the patient and their carers. Since treatment of psychiatric patients requires long follow-up periods, and this long follow-up treatment patients depends on their initial experience with health service,therefor user satisfaction is of increasing importance in the mental health field. Aims and Objectives: Assess the user satisfaction and perceptions of the attitude of emergency health- care professionals (including paramedical staff and physicians of respective specialties) toward psychiatric and nonpsychiatric patients as experienced by the patients and carers. To compare the user satisfaction and perceived attitude of emergency staff in patients with psychiatric illness and nonpsychiatric illness. To determine the service users' decision to revisit the same health-care facility in case of the same problem. Materials and Methods: This study was done in the hospital wing of a tertiary care teaching university hospital in northern India, and ethics approval was obtained from the institutional ethics committee patients' sociodemographic details and psychiatric and other relevant medical history after obtaining informed consent. The psychiatric diagnosis was made according to the ICD-10. A self-report questionnaire, comprising 9 questions, and was designed to assess the perceived attitudes of health-care workers toward the patient of psychiatric illness. The questionnaire was designed in Hindi. Descriptive statistics for categorical variables were done. Inferential statistics were calculated using the Chi-square test. Results: Out of a total of 95 respondents, 69 patients were diagnosed with a psychiatric disorder and the remaining 26 patients had medical illness or other non-psychiatric disorders. Females were a majority in both groups. Our study majorly showed that service users perceived the attitudes of medical and paramedical staff in emergency units mostly as satisfactory or extremely satisfactory, as well as the majority of service users reported that they were satisfied with the reaction of emergency paramedical staff towards the emotional well-being of the patient. Conclusions: The major strengths of this study were the quantitative analysis of health workers' attitudes toward patients with psychiatric illnesses, which showed user-rated satisfactory attitudes. There was less stigma and more of a positive impact noted. The semi-structured questionnaire was designed in the local language and tailored to cover topics such as emotional well-being and psychoeducation that can all affect the user experience. [ABSTRACT FROM AUTHOR]

Background: The surgical management of urinary bladder exstrophy is challenging. This paper describes the personal experience in a tertiary care hospital over a period exceeding a quarter of a century. Methods: During the period 1984-2010, 248 patients of the epispadias-exstrophy complex have been treated. The cases of classical bladder exstrophy (n = 210) form the basis of this paper. The stages/procedures used in the surgical reconstruction of bladder exstrophy included bladder closure with anterior abdominal wall reconstruction, bladder neck repair, ureteric reimplantation, epispadias repair and augmentation colocystoplasty in various combinations. Some of these patients had their initial operations done prior to 1984 or in other hospitals. Evaluation methods included, amongst others, clinical evaluation and urodynamic assessment. Eight patients opted out of treatment; 15 patients underwent permanent urinary diversion by either ureterosigmoidostomy or colon conduit. The remaining 187 patients were treated with bladder reconstruction, and of these, 132 patients have had at least one attempt at bladder neck reconstruction with 56 of these patients having undergone an augmentation colocystoplasty. Results: A total of 105 patients had socially acceptable continence: 57 from the bladder neck reconstruction group and 48 from the bladder augmentation group. Further attempts at continence surgery have been offered to the inadequately continent patients. Conclusions: Surgical management of bladder exstrophy demands patience and perseverance. It is possible to provide all patients with socially acceptable continence with bladder neck division and catheterizable continent stoma as the last resort. Urodynamic assessment has emerged as an essential tool in the follow-up evaluation of these patients. Anticholinergic medication with imipramine or oxybutinin is a useful adjunct in the overall management. [ABSTRACT FROM AUTHOR]

This study conducted a scientometric review on beta thalassemia research using HistCite, BibExcel, and VOS viewer from 2000 to 2019. A total of 10,002 articles were downloaded from the Web of Science core collection database. The study used several quantitative scientometric indicators to measure the performance of the global beta thalassemia research output. The purpose of this review study is to analyze and visualize the state-of-the-art on beta thalassemia in a systematic way. The research findings include research areas, types of documents, authors, journals, institutions, and countries, and how these are linked within the existing body of literature on beta thalassemia. The result reveals that organizations such as Mahidol University and the University of Athens have published numerous articles encouraged by specific R&D funding schemes and made a significant contribution to the development of beta thalassemia research. [ABSTRACT FROM AUTHOR]

Objective:A possible role of the APC/beta-catenin pathway in the pathogenesis of sporadic juvenile nasopharyngeal angiofibroma has been suggested. This paper presents its current status and clinical association in our patients.Method:A prospective observational study was conducted at King George Medical University and Central Drug Research Institute, in Lucknow, India. Western blot analysis was undertaken in 16 cases to examine beta-catenin expression. The clinical details were recorded along with follow up observations, to determine associations.Results:Up-regulation of beta-catenin expression was seen in 69 per cent of cases. The clinical variables did not reveal significant differences between patients with extremes of expression (extreme under- vs over-expression). However, absent expression was shown exclusively in young adults aged over 18 years, while enhanced expression was associated with an altered facial profile.Conclusion:Although a beta-catenin association was seen in a subset of our sporadic juvenile nasopharyngeal angiofibroma cases, its expression was not homogeneous. This is in contrast to the Western literature that suggests a universal (homogenous) enhanced expression in the majority. Hence, further research is required to better define its molecular cascade. [ABSTRACT FROM PUBLISHER]

Background: The WHO defines LBW as "Birth weight less than 2500 grams" regardless of gestational age. Being born with a low birth weight also incurs enormous economic costs, including higher medical expenditures and social service expenses, and decreased productivity in adulthood. Objective: To study distribution of newborns' according to pregnancy related factors and its association with newborns' birth weight. Methods: An institutional based cross-sectional study. New-borns delivered at study institute were considered as study participants. Estimated final sample size was 500. Guardians (mothers) were face-to-face interviewed and also recorded data were collected from the case file and Mother and Child Protection Card. Results: Prevalence of LBW newborns was higher in mothers with late ANC registration, <4 ANC visits, chronic medical conditions, infection during pregnancy, PIH, anemia, consuming tobacco, exposure to second hand smoke, LSCS/Assisted delivery, in female newborns', current pregnancy birth order number more than 2, in pre term newborns' and mothers with bad obstetric history. Conclusion: Create awareness and adoption of suitable family planning methods. Need to do early (within 12 weeks) ANC registration with minimum four ANC visits for better pregnancy outcome. Effective tracking and suitable intervention provided to improve current pregnancy outcome. Health care professional should pay special attention to high-risk pregnancy. Develop social culture in such a way that females are neither addicted nor exposed to any tobacco containing products in their life. [ABSTRACT FROM AUTHOR]

Background: Endotracheal intubation is an essential resuscitative procedure in the emergency setting. Airway assessment parameters such as the Mallampati classification are difficult to perform in an emergency setting. As point-of-care ultrasound (POCUS) assessment of airway parameters does not require patients to perform any mandatory action, ultrasound may become the potential first-line noninvasive airway assessment tool in the emergency department (ED). The use of POCUS in the ED has not been sufficiently studied. Using POCUS in airway assessment for predicting difficult intubation may be the next step in successful airway management. Methodology: The study was an observational study conducted at the ED of the All India Institute of Medical Sciences (Rishikesh). The treating emergency physician recorded the patient history and systemic examination along with an indication for intubation. The POCUS assessment of airway parameters pre-epiglottis to epiglottic vocal cord ratio (Pre-E/E-VC), tongue thickness, hyomental distance, and distance from skin to the hyoid bone was performed by the study investigator. During laryngoscopy, Cormack-Lehane (CL) grading was assessed. The data was entered and analyzed. Results: Seventy patients who required intubation in the ED were enrolled in the study. Among the study population, 48.6%, 28.6%, 14.3%, 1.4%, and 7.1% were classified with the following CL grading: 1, 2a, 2b, 3a, and 3b, respectively. At a cutoff of ≥ 1.86, Pre-E/E-VC predicts difficult laryngoscopy (AUC 0.835) with a sensitivity of 83% and a specificity of 94%. At a cutoff of ≥ 5.98 cm, tongue thickness predicts difficult laryngoscopy (AUC 0.78) with a sensitivity of 83% and a specificity of 88%. At a cutoff of hyomental distance ≤ 6 cm, it predicts difficult laryngoscopy with a sensitivity of 83% and a specificity of 88%. All parameters can act as a promising tool for predicting difficult laryngoscopy, with the single best parameter being Pre-E/E-VC. Conclusion: Assessment of the airway with POCUS may be helpful to the emergency physician when the clinical airway assessment parameters fail to predict difficult laryngoscopy as most patients requiring intubation are uncooperative. Assessment of the parameters in our study Pre-E/E-VC, tongue thickness, and hyomental distance can act as a promising tool for predicting difficult laryngoscopy in the emergency scenario. [ABSTRACT FROM AUTHOR]

Introduction: Sthaulyahara Ghana Vati (SHGV) is a polyherbal formulation, which is indicated in Sthualya (obesity) in Vaidhyasara sangraha. There are few clinical works carried out on this medicine, but no any researchers had evaluated this formulation for its quality control (QC) parameters. Pharmacopeia standards for this formulation are also not available till date. Aim: To evaluate SHGV through pharmacognostical, physiochemical parameters and high-performance thin-layer chromatography (HPTLC) fingerprinting. Materials and Methods: Preauthenticated raw drugs of SHGV were procured, and SHGV was prepared at pharmacy, Institute of Teaching and Research in Ayurveda (ITRA), Jamnagar. Organoleptic parameters and microscopic analysis of SHGV were carried out at the Pharmacognosy Department, ITRA, Jamnagar. Physiochemical analysis and HPTLC of SHGV were carried out at the Pharmaceutical Laboratory, ITRA, Jamnagar. Result: Microscopic features of SHGV were cross-checked with Ayurvedic pharmacopeia of India standards of individual ingredients, and it was found to have characteristics of all ingredients in it. In pharmaceutical parameters, pH value was 6.0, water-soluble extract was 16.2% w/w, methanol-soluble extract was 14.9% w/w, ash value was 11.8% w/w, and loss on drying was 3.9% w/w. HPTLC at 254 and 366 nm showed six and three spots, respectively. Conclusion: This study has generated preliminary data on pharmacognostical, pharmaceutical parameters, and HPTLC. This fingerprinting can be useful for future researchers to reproduce this formulation and to establish QC parameter of SHGV. [ABSTRACT FROM AUTHOR]

Objectives: To determine post‐COVID syndromes in the Indian population, correlating a wide spectrum of post‐COVID manifestations with acute disease severity and associated risk factors. Background: Post‐COVID Syndrome (PCS) is defined as signs and symptoms that develop during or after acute COVID‐19 infection. Design of Study: This is a prospective observational cohort with repetitive measurements. Methods: The study followed RT‐PCR confirmed COVID‐19‐positive survivors discharged from HAHC Hospital, New Delhi, for a period of 12 weeks. The patients were interviewed over the phone at 4 weeks and 12 weeks from the onset of symptoms for evaluation of clinical symptoms and health‐related quality of life parameters. Results: A total of 200 patients completed the study. At the baseline, 50% of the patients were categorised as severe based on their acute infection assessment. At 12 weeks after symptom onset, fatigue (23.5%), hair loss (12.5%) and dyspnea (9%) were the main persistent symptoms. The incidence of hair loss (12.5%), memory loss (4.5%) and brain fog (5%) were found to be increased as compared to the acute infection period. Severity of the acute COVID infection behaved as an independent predictor for the development of PCS, with high odds of experiencing persistent cough (OR = 13.1), memory loss (OR = 5.2) and fatigue (OR = 3.3). Further, 30% of subjects in the severe group experienced statistically significant fatigue at 12 weeks (p <.05). Conclusion: From the results of our study, it can be concluded that there is a huge disease burden of post‐COVID Syndrome (PCS). The PCS comprised multisystem symptoms ranging from serious complaints of dyspnea, memory loss and brain fog to non‐serious complaints of fatigue and hair loss. Severity of the acute COVID infection behaved as an independent predictor for the development of PCS. Our findings strongly recommend vaccination against COVID‐19, for protection from disease severity as well as prevention of PCS. Relevance to Clinical Practice: The findings of our study support the multidisciplinary approach required for the management of PCS with a team comprising of physicians, nurses, physiotherapists and psychiatrists working in close coordination for the rehabilitation of these patients. As nurses are considered the most trusted professionals in the community and the class of health workers associated with rehabilitation, focus should be given to educating them on PCS, which would prove to be an important strategy for efficient monitoring and long‐term management of COVID‐19 survivors. [ABSTRACT FROM AUTHOR]

Background: Contemporary valvular cardiac surgery has evolved with the adoption of expedited postoperative recovery, known as fast tracking. This paradigm shift results from advancements in anaesthetic agents, surgical techniques, and myocardial protection strategies. Fast track anaesthesia aims to reduce intensive care unit (ICU) stays and overall hospital length of stay (LOS), optimizing resource utilization. Cardioprotective properties of volatile anaesthetic agents, especially in mitigating ischemic myocardial damage, have garnered attention. Methods: A hospital-based, randomized, comparative study was conducted at the Department of Anaesthesiology, S.M.S Medical College, Jaipur. 70 undergoing valvular heart surgery under general anaesthesia, were randomly assigned to two groups: Group A (Sevoflurane) and Group B (Isoflurane). Inclusion criteria encompassed ASA grade II to IV patients aged 20 to 50 years, with a body weight of 30-65 kg, and willingness to provide written consent. Anaesthesia induction and maintenance involved the administration of Sevoflurane or Isoflurane based on group allocation. Hemodynamic parameters were recorded at various surgical stages. Results: Heart rate, systolic blood pressure, and cardiac output were statistically insignificant between groups at different surgical stages (p > 0.05). Intraoperative variables demonstrated no significant differences, except for a transient decrease in systolic blood pressure post-induction in both groups. Conclusion: The study underscores the comparable efficacy of Sevoflrane and Isoflurane in valvular cardiac surgery, supported by similar hemodynamic profiles. Understanding the nuances of volatile anaesthetic agents is crucial for their optimal clinical application, considering challenges like beta-blocker usage and perioperative hyperglycemia. [ABSTRACT FROM AUTHOR]

Background: Measurement of physical activity in epidemiological studies requires tools which are reliable, valid and culturally relevant. We attempted to develop a physical activity questionnaire (PAQ) that would measure physical activity in various domains over a year and which would be valid for use in adults of different age groups with varying levels of activity in urban and rural settings in low and middle income countries like India. The present paper aims to assess the reliability and validity of this new PAQ- termed the Madras Diabetes Research Foundation- Physical Activity Questionnaire (MPAQ). Methods: The MPAQ was administered by trained interviewers to 543 individuals of either gender aged 20 years and above from urban and rural areas in 10 states of India from May to August 2011, followed by a repeat administration within a month for assessing reliability. Relative validity was performed against the Global Physical Activity Questionnaire (GPAQ). Construct validity was tested by plotting time spent in sitting and moderate and vigorous physical activity (MVPA) against body-mass index (BMI) and waist circumference. Criterion validity was assessed using the triaxial accelerometer, in a separate subset of 103 individuals. Bland and Altman plots were used to assess the agreement between MPAQ and accelerometer. Results: The interclass correlation coefficients (ICC) for total energy expenditure and physical activity levels were 0.82 and 0.73 respectively, between baseline and 1st month. The ICC between GPAQ and the MPAQ was 0.40 overall. The construct validity of the MPAQ showed linear association between sitting and MVPA, and BMI and waist circumference independent of age and gender. The Spearman's correlation coefficients for sedentary activity, MVPA and overall PA for MPAQ against the accelerometer were 0.48 (95%CI-0.32-0.62), 0.44 (0.27-0.59) and 0.46 (0.29-0.60) respectively. Bland and Altman plots showed good agreement between MPAQ and accelerometer for sedentary behavior and fair agreement for MVPA. Conclusion: The MPAQ is an acceptable, reproducible and valid instrument, which captures data from multiple activity domains over the period of a year from adults of both genders and varying ages in various walks of life residing in urban and rural India. [ABSTRACT FROM AUTHOR]

Prolonged grief disorder (PGD) is a condition characterized by difficulty in coping effectively with the loss of loved ones. The proposed diagnostic criteria for PGD have been based predominantly on research from developed Western nations. The cultural variations associated with experience and expression of grief and associated mourning rituals have not been considered comprehensively. The current study aimed to understand the experience of prolonged grief in India through a qualitative enquiry with mental health professionals (focus group discussions) and affected individuals (key informant interviews). Several novel findings diverging from the current understanding of manifestation and narratives of PGD emerged from the study, including differences in the social contexts of bereavement and culture-specific magico-religious beliefs and idioms of distress. The findings point to limitations of existing diagnostic systems for PGD. The results of this study suggest that the assumption of content equivalence for psychiatric disorders across cultures may not be justified and that there is a need to develop culturally sensitive diagnostic criteria and assessment scales for PGD. [ABSTRACT FROM AUTHOR]

Aim- Metabolic fuel detectors regulate energy balance at peripheral and central levels. The aim of this study is to assess association of serum Orexin levels with Metabolic risk markers in women of reproductive age group. Material And Methods- The study was conducted in campus of King George Medical University (KGMU), Uttar Pradesh Lucknow, INDIA. 150 apparently healthy women of reproductive age group i.e. 20-40 years of age were randomly selected. Fasting serum orexin and Serum insulin levels were measured using ELISA and weight, Body mass index, Fasting blood glucose, Lipid prole and Blood pressure were estimated in women. Result- The results show that Serum orexin levels has signicant positive correlation with fasting blood glucose, weight, BMI and waist circumference along with a weak negative correlation with serum Insulin level. Conclusion- In present study Serum orexin levels signicantly correlate with weight, BMI, Fasting blood glucose and weak negative correlation with serum Insulin levels. serum orexin levels did not correlate with lipid prole of women of reproductive age group. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the current study was to measure grip strength along with correlates, to inform recommendations to protect students entering the nursing workforce and increase career longevity, as well as health, among working nurses.Participants and Methods: A convenience sample of nursing staff and students (18 to 59 years) at a large teaching hospital (N = 316) participated in a cross-sectional study. A brief survey included sociodemographic questions, the Perceived Stress Scale (PSS-4), and the Nordic Musculoskeletal Questionnaire (NMQ). Anthropometric measures included height, weight, waist circumference, and hand grip strength using a Jamar digital dynamometer.Results: Only 22.5% of the participants met Indian normative grip strength parameters by age and gender, and on average had a normal body mass index (M = 22.31, SD 4.15). Grip strength was significantly associated with BMI and waist circumference, which explained 76% of the variance in grip strength.Conclusion: This study provides a baseline measurement of grip strength among Indian nursing staff and students, and documents grip strength among young adults (18– 20 years of age) who were not included in published normative grip strength data among healthy Indian participants. Data from the current study demonstrates that very few participants met normative grip strength, thus indicating the need for strengthening. Variance in grip strength was largely explained by waist circumference, pointing to the importance of nutrition. Interventions are needed to improve physical performance of nursing duties and prevent on-the-job injuries. [ABSTRACT FROM AUTHOR]

Objectives. There are no valid instruments to measure disease activity in Takayasu arteritis (TA). We aim to provide a valid measure to assess clinical disease activity with or without incorporating acute phase reactants.Methods. The Indian Takayasu Clinical Activity Score (ITAS) was initially derived from disease manifestations scored in the Disease Extent Index (DEI.Tak). The ITAS was validated by a group of physicians scoring both live and paper cases for inter-rater reliability (IRR), convergence with BVAS, correlation with the Physician’s Global Assessment (PGA) and ESR/CRP. It was further validated at a single centre in 177 patients for its ability to discriminate between active and inactive disease state at first visit and sensitivity to change in 132 active patients measured serially at two follow-up visits. ITAS-A also included graded scores for ESR/CRP.Results. The final ITAS2010 contains 44 items with 33 features arising from the cardiovascular system. Seven key items are weighted to score 2 and all others score 1 only. Inter-observer variability was highly satisfactory (IRR 0.97). The ITAS showed superior inter-rater agreement compared with the BVAS (IRR 0.9) and PGA (IRR 0.82). In the single-centre study, median ITAS scores at first visit were significantly higher in active disease (5.62 ± 3.14) compared with grumbling (3.36 ± 1.96) and inactive disease (1.27 ± 1.26, P < 0.0001). The therapy induced a significant decrease in the ITAS2010 but the higher ITAS-A scores remained elevated.Conclusion. The ITAS2010, validated in over 300 TA patients and sensitive to change, is a useful measure of clinical disease activity for patient monitoring. Higher ITAS-A scores suggest poor control of active disease by current therapy. [ABSTRACT FROM AUTHOR]

Background:Frontal sinus involvement in aspergillosis associated with the nose and paranasal sinuses is a common occurrence, but the incidence of primary frontal sinus aspergillosis is rare, and there are few reports in the English literature.Objective:This study aimed to evaluate the role of the endonasal endoscopic surgical approach for isolated primary frontal sinus aspergillosis.Method:This paper describes a retrospective study of 16 cases of primary frontal sinus aspergillosis. The patients had presented to the out-patient services of the Department of Otolaryngology and Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, between January 1999 and July 2011.Results:The overall success rate of the endonasal endoscopic approach was 82.25 per cent. The disease recurred in three patients and was subsequently managed using the modified Lothrop procedure.Conclusion:Minimally invasive endonasal endoscopic sinus surgery was found to be an effective and a safe approach for managing primary frontal sinus aspergilloma, even in cases with larger bony defects involving the posterior table of the frontal sinus. [ABSTRACT FROM AUTHOR]

Background & Objective: There is an increasing demand for computer aided instruments in medicine to assist doctors and technicians. This paper presents a simulation of skeletal model of human upper extremity, which monitors position, orientation, trajectory, force and torque generated by upper limb movement. Materials and Methods: An artificial upper limb model is prepared with servo motors and aluminium T- section which moves in 2D vertical XY plane and whose control is through PC through user friendly software. In first phase: Values of time, power and torque were estimated for each joint after making the robot-model move in flexion and extension with different weights. In second phase: same values were estimated after strapping subjects arm and making the robot-model move in flexion and extension. Results: Values of Power and Time taken by joints to lift weight at different speeds showed that torque and power are higher for higher flexion angle as well as higher load value. Experimental values for flexion of wrist (p<0.05), elbow (p<0.01), shoulder (p<0.05) with subjects, showed that time taken by elbow was lesser than that taken by wrist and time taken by shoulder was still lesser than elbow for same amount of weight lifted. Results considering force sensor showed that motor torque rises when load is lifted against gravity. Conclusion: This model could be used as a tool in neuromuscular disorders for enhancing the functionality of robot assisted upper limb therapy and data from model could help the therapist to know about actual resistance force at each joint and quality of exercise trajectory achieved by each subject. [ABSTRACT FROM AUTHOR]

Objectives- To identify adrenal masses and characterize them based on imaging features and invasion using MDCT and MRI. Methods- Based on clinical suspicion of adrenal mass or ultrasonography indicating a adrenal mass, Patients underwent MDCT and MRI of abdomen. Multiple phases were acquired depending on nature of case and whether multiple phases are able to add to or rule out a diagnosis. Result- In the 40 patients who underwent the study-10(25%) were adrenal adenomas,4(10%) myelolipoma, 10(25%) were phaeochromocytoma of both benign and malignant type, 2(5%) were adrenocortical carcinoma, 7(20%) were metastatic lesions 1(2.5%) were teratoma, Infectious causes included adrenal tuberculosis in 2 patients (5%) 4 cases (10%) of adrenal hyperplasia. Conclusion- Due to fast acquisition, high spatial resolution, volumetric imaging with multiplanar and 3D reconstruction and better evaluation of vascular anatomy and their relation with the mass contrast enhanced MDCT is a good modality for evaluation and characterization of adrenal masses. MRI has better soft tissue contrast resolution and availability of multiple sequences like 'in phase and out phase imaging, GRE helps to understand characteristics of mass. [ABSTRACT FROM AUTHOR]

Objective:Abnormalities of the third branchial arch are less common than those of the second arch and usually present with left thyroid lobe inflammation. This paper describes 15 cases of pyriform sinus fistulae of third branchial arch origin usually presenting as recurrent thyroid abscess on the left side.Method:A retrospective review of 15 cases of third arch fistulae managed 2000 and 2008, diagnosed based on histopathology and radiological evidence of a fistulous tract, and treated with fistulectomy with left hemithyroidectomy.Results:All patients (six boys and nine girls, aged three to 15 years) presented with recurrent low neck inflammation. Pre-operative ultrasound, computed tomography fistulography and barium swallow demonstrated a third arch fistulous tract, left-sided in all cases. The fistula was detected intra-operatively and pathologically in all cases. Surgery (successful in all cases) emphasised complete recurrent laryngeal nerve and ipsilateral pyriform sinus exposure, to facilitate tract excision, with left hemithyroidectomy. There was no recurrence over three to five years' follow up.Conclusion:Paediatric recurrent low neck inflammatory episodes, due to thyroidal abscess, especially left-sided, should raise suspicion of pyriform sinus fistulae. [ABSTRACT FROM PUBLISHER]

Purpose of study Alignment of curricular objectives, teaching learning activities, and assessment tasks is essential for quality learning. The present study was done to assess the coverage of different topics in theory examinations of Community Medicine for medical undergraduates, in relation to the curriculum and allotted teaching hours. Methodology Question papers of final MBBS part I examinations in Community Medicine ( n = 10), between December 2008 and May 2012, of Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, were analyzed for coverage and weightage to content areas, and compared with number of hours of theory classes ( n = 127). Results The highest coverage was for topics like general epidemiology and epidemiology of specific diseases (20% each), followed by 11% from Reproductive and Child Health (RCH) and 10% from health planning and management. Coverage in exams and the hours of teaching did not correspond for a few topics (epidemiology, RCH). Certain topics were not covered in some question papers (Occupational health, sociology, concepts in health, school health). This could be due to unequal distribution of topics in two papers (with fixed marks) leading to overrepresentation of a few areas and vice versa. As the marking pattern was changed in the last two examinations with lesser number of segments carrying more marks, certain important topics were not covered. It was also observed that only 2.8% (10 out of 351 segments) assessed the ‘reasoning’ domain of learning, while the remaining 97.2% tested recall abilities of the students. Conclusions There is a mismatch between the topics covered in the syllabus and assessment process, mainly targeting at recall level of cognitive domain. [ABSTRACT FROM AUTHOR]

Background: Invention of fire was the greatest invention for the human from primitive matchlock system to the present automatic weapons. It has become the most dreaded killing tool used by human being. Proper examination of the victims of firearm injuries needs to ascertain the characteristics of wound and body part involved to correlate with fatalities. Methods: A total of 115 cases of gunshot injury were included in this study carried out at the Department of Forensic Medicine, SMS Medical College and Hospital, Jaipur over a period of 17 months from mid of May 2014 to beginning of August 2015, after seeking permission and ethical clearance. Results: During Study period total 115 cases were included in study. We observe finding after dividing human body in five body region for better understanding. The commonest targeted body parts were the peripheries including the upper and lower limbs (33.04%). The next to follow was the chest in 36 cases (31.30%). Abdomen including pelvis was targeted in 18.26% cases and head was the soft target in only 14.78% cases. Lease affected body part was neck with only 3 cases. Conclusion: In 73.04% (84) cases, only a single body region was inflicted upon by use of firearm weapon. In fatal cases (11) of firearm injuries, head (54.55%) was the most commonly targeted body part followed by chest (36.36%) and abdomen (9.09%). This study indicated that the most common victims of firearm injuries were young males of bread earning age. Certain changes may minimize mortality and disability due to firearm injuries, also reducing the costs to the community. So, there is a need to decrease the number of firearms used and sold in India. [ABSTRACT FROM AUTHOR]

Context: Empathy and self-esteem are essential in delivering quality health care, particularly for women in labor and giving birth. Aims: The aim of this study was to determine the empathy quotient and self-esteem of the second-year and final-year medical and nursing students and labor room staff. Settings and Design: This cross-sectional study was conducted at a teaching hospital in southern India between September and December 2021. Materials and Methods: The inclusion criteria for the study were (i) nursing or medical students currently in their second or final year and (ii) obstetrician or nursing officer or intern currently posted in the labor room. Empathy quotient and self-esteem were measured using the Cambridge Behavioral Scale and Rosenberg's Self-Esteem Scale, respectively. Statistical Analysis Used: The scale scores were summarized as mean (standard deviation), percentages, and 95% confidence intervals. The association between empathy quotient, self-esteem, age, gender, designation, and experience duration was analyzed. We performed multivariable analysis using binary logistic regression. P <0.05 was considered statistically significant. Results: Of the 400 participants included in the study, 36.8% (42.7% - medical, 26.2% - nursing personnel) had lower than average empathy quotient scores, and 13.3% (18.4% - medical, 4.1% - nursing personnel) had low self-esteem. Self-esteem had a statistically significant, independent effect on empathy quotient, as noted in the multivariable analysis among medical and nursing personnel. There was a significant difference between empathy quotient and self-esteem scores in medical and nursing personnel across various designations (P < 0.05). Conclusion: A third of the participants had empathy quotient ratings that were below average, and one-eighth of participants had low self-esteem. Self-esteem and empathy quotient are interdependent; hence has to addressed together. The empathy quotient and self-esteem vary across different designations emphasising the need to take measures to nurture it. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to map ongoing palliative care services and describe the characteristics of providers, recipients, level of care, and approach. Second, it seeks to investigate the difficulties encountered in implementing NPPC in the Puducherry district of UT Puducherry. This study aims to review the challenges in its implementation. Material and Methods: The study using both quantitative and qualitative design, including geospatial mapping of organisations, describing service delivery characteristics and exploring challenges faced in implementing NPPC, was conducted from July 2021 to January 2022. In-depth interviews were conducted with seven healthcare providers, four patients and three caregivers, as well as key informant interviews with six doctors in administration. Results: Thirteen organisations providing palliative care to population of Puducherry district of union territory Puducherry and neighbouring districts of Tamil Nadu were identified. Mapped organisations were primarily concentrated in urban areas. Morphine was available only at three medical colleges, providing outpatient palliative care services. Non-governmental organisations provided only home-based palliative care services and the hospices provided both in-patient and home-based services. Key barriers perceived by the health system were difficulty in procuring morphine, inadequate personnel and inadequate funding. Few barriers perceived by patients/family were stigma faced in community, psychological challenges and poor quality of care. Conclusions: Palliative care services are mainly available in urban areas and through private hospices. There is a need to implement palliative care program through the public health system to improve the accessibility in the rural areas. [ABSTRACT FROM AUTHOR]

Background: Surgical care is an essential component of health care of children worldwide. Incidences of congenital anomalies, trauma, cancers and acquired diseases continue to rise and along with that the impact of surgical intervention on public health system also increases. It then becomes essential that the surgical teams make the procedures safe and error proof. The World Health Organization (WHO) has instituted the surgical checklist as a global initiative to improve surgical safety. Aims: To assess the acceptance, application and adherence to the WHO Safe Surgery Checklist in Pediatric Surgery Practice at a university teaching hospital. Materials and Methods: In a prospective study, spanning 2 years, the checklist was implemented for all patients who underwent operative procedures under general anesthesia. The checklist identified three phases of an operation, each corresponding to a specific period in the normal flow of work: Before the induction of anesthesia ("sign in"), before the skin incision ("time out") and before the patient leaves the operating room ("sign out"). In each phase, an anesthesiologist,-"checklist coordinator," confirmed that the anesthesia, surgery and nursing teams have completed the listed tasks before proceeding with the operation and exit. The checklist was used for 3000 consecutive patients. Results: No major perioperative errors were noted. In 54 (1.8%) patients, children had the same names and identical surgical procedure posted on the same operation list. The patient identification tag was missing in four (0.1%) patients. Mention of the side of procedures was missing in 108 (3.6%) cases. In 0.1% (3) of patients there was mix up of the mention of side of operation in the case papers and consent forms. In 78 (2.6%) patients, the consent form was not signed by parents/ guardians or the side of the procedure was not quoted. Antibiotic orders were missing in five (0.2%) patients. In 12 (0.4%) cases, immobilization of the patients was suboptimal, which led to displacement of diathermy grounding pad. In 54 (1.8%) patients, the checklist was not used at all. In 76 (2.5%) patients the checklist was found to be incompletely filled. Conclusions: Our study supports the use of the checklist as an essential safety tool and reinforcement of the same. The checklist may act as a valuable prompt to focus the team, to ensure that even the simple things have been cared for. [ABSTRACT FROM AUTHOR]

Background: Age determination of individual is important in number of opportunities like education, sports, and medico-legal factors. Ossification centres of bones play vital role in age determination. It is accepted in court of law. Method: 45 Boys and 45 Girls (total 90) children aged between 11 to 18 years were studied radiologically and classified their numbers as per age and sex, Appearance and fusion of bones of elbow joints. Results: Equal number of boys and girls were selected from 11 years to 18 years of age. Appearance of trochlea at 11 years appeared only in girls. Fusion of trochlea was 14 to 15 years in boys, 12 to 14 years in girls. Appearance of lateral epicondyle was 11 to 12 year in boys and 11 year in girls. Fusion of lateral epicondyle was 13 to 16 years in boys and 13 to 14 years in Girls. Fusion of medial epicondyle 14 to 16 years in boys, 11 to 15 years in girls. Fusion of head of radius 11 to 16 years in boys and 11 to 13 in girls. Appearance of olecranon process- 11 to 13 years in boys and 11 years in girls. Fusionof olecranon process 17 to 18 years in boys and 15 to 16 years in girls. Conclusion: This pragmatic radiological study of elbow joint between 11 to 18 years has regional, environmental, anatomical, anthropological and medico-legal importance because morphometric values of mesodermal origin are uncertain. [ABSTRACT FROM AUTHOR]

Background: There is underutilization of long-acting injectable (LAI) antipsychotics for first-episode schizophrenia (FES) despite having convenient dosing and treatment retention. LAIs are predominantly used for patients with poor compliance, chronic course, and multiple relapses. Materials and Methods: Seventy-two treatment naïve patients with the first episode of Schizophrenia (DSM-5) were assessed for baseline severity of psychopathology using the positive and negative syndrome scale (PANSS) and quality of life (QOL) using the WHOQOL-BREF scale. Patients were randomized to receive either oral haloperidol or LAI haloperidol for a period of 12 weeks. Results: Both the groups had a significant reduction in PANSS scores and improvement in QoL over 12 weeks period (P = 0.0001). The LAI group showed greater adherence and significantly better quality of life than the oral group (P = 0.023). The mean numbers of side effects were less in the LAI group at week 2 as compared to the oral group. Conclusion: LAI haloperidol is similar to oral haloperidol in patients with FES with respect to treatment response and offers benefits in form of a lesser number of side effects during early treatment, overall better adherence rates, and better QOL. [ABSTRACT FROM AUTHOR]

Introduction: The aim was to evaluate the outcome of tobacco cessation services. The primary objective was to find the association of early retention in services with tobacco cessation outcomes. Secondarily, it tried to find other sociodemographic, clinical, and treatment-related predictors of tobacco cessation. Methodology: The outcome would be evaluated through a retrospective-prospective design. The retrospective design was recorded based, while the prospective design was done telephonically by calling the patients and enquiring about their status after at least 6 months since their first visit. Patients with "No tobacco usage in last 1 month" were considered "abstinent." Those who "reduced their usage in last 1 month" by about 50% were considered to have "reduced" usage, whereas others who "continued their usage in same previous manner" were considered "same" user. Results: Out of 356 patients registered between June 1, 2021 and February 28, 2022, 81 (22.75%) could not be contacted, 221 (62.08%) had "reduced usage" after a tele-follow-up of at least 6 months, 50 (14.04%) patients have retained similar amount of usage and 4 patients expired. Of the 221 who reduced usage, 53 were abstinent (14.48%). "Initial retention in services" that is a single physical follow-up was significantly associated with "reduced usage" (P = 0.003) in the tele-follow-up with a median duration of 13 months. With regard to "abstinence," none could stand the test of significance after correction in the logistic model except "types of tobacco usage" which predicted a statistically significant effect with an odds ratio of 3.15 (P = 0.01). Conclusion: This study reveals important information regarding "type of tobacco" as a predictor of abstinence and "initial physical retention" as a predictor of "reduction in tobacco usage." Such studies need further clarification in future, more robust face-to-face studies with biochemical verification. [ABSTRACT FROM AUTHOR]

Background: Burns constitute a major cause of deaths, both suicidal & accidental in the world & our country. As per the National crime record bureau of India, burns one among the common method of suicide and the rate of fatal suicidal burns was 2.6% in 2021. In Tamil Nadu, the rate of suicide is 11.5%, and also, being the second highest among the other states.(1) This study is undertaken with the aim to study sociodemographic profile of burns case brought to autopsy at tertiary medical college, along with the pattern & outcome. Methods: A cross sectional study was done in a total of 53 cases of burns brought for medicolegal autopsy during the study period. Data including age, gender, socioeconomic status, manner of burns, % of burns, duration of survival were all collected based on pre structured proforma & further was analysed using standard statistical method. Results and Conclusion: Burns incidence is seen in mostly age group 31-40, with majority of them being females (62.27%).suicidal burns are more common (73.59%), with >75%(66.03% ) burns being more. About 35.8% survived for 1-7 days prior to succumbing death. Enhancing a better mental& physical environment should be the priority. Early & effective treatment can be useful in reducing the mortality due to burns. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has led to economic slowdown, loss of life, loss of livelihood, health complications, poor quality of life, deteriorated mental health, and poor education. One of the critical issues is decreased mental health among adolescents. Mental health was indeed a problem even before COVID-19, and the pandemic has substantially raised or catalyzed it to another level. Teachers reported that many college students who came to college after a long period of lockdown seem to be very confused, anxious, emotionally exhausted, and stressed. Parents are of the opinion that their children show irritation, anger, and frustrations at home. This study is an offshoot of this concern. Aim: This study aims to know the immediate effect of gratitude journals on mental well-being. Settings and Design: The study was conducted at the University Institute of Technology (UIT), Karuvatta, Alappuzha, Kerala. The experimental design was used for the study. Materials and Methods: One hundred and eight college students (F = 50 and M = 58) aged between 18 and 25 years from UIT, Alappuzha, Kerala, were selected randomly for this study. Students were divided equally into two groups, experimental group (n = 54) and control group (n = 54); both groups were tested to analyze mental well-being using Warwick Edinburgh Mental Well-being Scale. Experimental group was made to fill the gratitude journal immediately after the pretest and the control group was allowed to do their daily routine. Posttest was conducted to find if there was any significant difference in the experimental group. Statistical Analysis Used: Paired sample "t"-test and ANCOVA were used for the statistical analysis. Results: It shows a significant difference at a 0.05 level. When the outcome was compared between experimental and control group, the experimental group showed an increase in their mental well-being score (P < 0.01), whereas the control group did not show any difference in mental well-being, (P = 0.540). Conclusions: This implies that a gratitude journal could be a good intervention even in short run to improve the mental well-being among college students and hence students can be better prepared for learning. [ABSTRACT FROM AUTHOR]

Background: Myoclonus is a common problem during induction of anaesthesia with etomidate. A variety of drugs have been used to decrease the incidence of myoclonus. In this study we compared the effects on dexmedetomidine and midazolam pretreatment on the incidence and severity of EIM. Materials and Methods: Fifty adult patients (18 to 60 years age) of either sex, ASA-PS-I and II undergoing elective general surgeries under general anesthesia were randomly allocated into two groups. Group D patients received Inj. Dexmedetomidine (0.5ug/kg) and Group M received Inj. Midazolam (0.02mg/kg) in 10 ml normal saline over ten minute. After 2 minutes patients were induced with etomidate. The patients were observed for occurrence and severity of myoclonus for 3 minutes from the start of Injection of the induction dose and graded according to clinical severity (Grade 0-III). Results: In Group D, 14 out of 25(56%) patients did not have any myoclonus during induction with etomidate, and none of the patients had grade III (severe) myoclonus. 8 patients of 25 (32%) patients observed grade I and 3 out of 25(12%) had grade II EIM in group D. In group M-9(36%), 9(36%), 6(24%), and patients had grade O,I,II and III EIM respectively. Conclusion: Incidence and severity of EIM among patients who underwent pretreatment with dexmedetomidine was greatly reduced than those who underwent pretreatment with midazolam. [ABSTRACT FROM AUTHOR]

Background : Transesophageal electrophysiological study (TEEPS) is a minimally invasive procedure that helps in evaluating the risk of recurrence of supraventricular tachycardia based on the inducibility of the tachycardia. The purpose of this study was to evaluate the diagnostic capability, negative predictive value of noninducibility of tachycardia and safety of TEEPS among the Indian pediatric population. Methods : It is a retrospective single-center observational study of all patients who underwent TEEPS from January 01, 2014, to December 31, 2020. Results : Twenty-two TEEPS procedures were done in eighteen children with three children undergoing more than one procedure. The median duration of follow-up was 42.97 months (8.52--82.12 months). Out of the 22 procedures, four were conducted for acute tachycardia termination, two for tachycardia suppression assessment, and sixteen to assess tachycardia inducibility off medications. Tachycardia was noninducible in nine children and inducible in six children. Two children had clinical recurrence of tachycardia on follow-up. Out of these two children, one had noninducibility of tachycardia on TEEPS. The negative predictive value of TEEPS was 88.89% in this study. None of the children had any postprocedure complication. Conclusions : TEEPS is a safe procedure. It is used to assess the efficacy of medication in the suppression of arrhythmia. The noninducibility of tachycardia has a high negative predictive value and is a good indicator of nonrecurrence of clinical tachycardia on midterm follow-up. [ABSTRACT FROM AUTHOR]

Context: Adult population visiting COVID vaccination center is a potential teachable moment for screening and preventive advice on non-communicable diseases. Objectives: The objective of this study was to assess the proportion of vaccinees volunteering for screening and to know the proportion of newly detected hypertensives and diabetics among the screened vaccinees at COVID-19 vaccination center. Setting and Design: This descriptive, cross-sectional, operational research study was carried out at the COVID vaccination center at a medical college in central Gujarat from July to September 2021. Methods: After receiving the vaccine, the vaccinee was offered screening through a community-based assessment checklist for risk factors of non-communicable diseases, blood pressure, and blood sugar measurement. Those volunteering for this screening received a slip mentioning their risk score, blood pressure and blood sugar reading, and relevant health information and disease prevention advice. The study variables were acceptability (proportion of vaccinees volunteering for screening) and yield (newly detected hypertensives and diabetics among those screened). Results: Among vaccinees, 27.7% volunteered for risk scoring and blood pressure measurement, whereas 8.3% volunteered for blood sugar measurement. Around 15.5% of vaccinees had high-risk scores as per the community-based assessment checklist. The yield of freshly detected high blood pressure and high blood sugar was 19.3% and 10.5%, respectively. The yield was similar even among vaccinees under 30 years of age. Conclusions: Vaccinees demonstrated interest in undergoing screening for non-communicable diseases. Yield indicates that such screening is worth the effort. [ABSTRACT FROM AUTHOR]

Objective: Our study aimed to determine the association between high sensitivity-c reactive protein to albumin ratio (CAR) and in-hospital major adverse cardiovascular event (MACE) in patients with acute coronary syndrome and also to assess whether hs-CAR is a better marker than hsCRP or albumin alone in predicting MACE. Materials and Methods: We enrolled 110 cases who were hospitalized and major adverse cardiovascular event was defined as cardiogenic shock, acute heart failure, reinfarction and death. Blood sample for Serum albumin and hs-crp was taken at the time when patients were admitted. Results: The incidence of MACE was more in patients with high CAR (=1.8 group) as compared to those with low CAR (<1.8 group). Conclusion: The CAR is an independent predictor of MACE in patients who present with ACS. [ABSTRACT FROM AUTHOR]

Background: Bipolar affective disorders (BPAD) and Alcohol dependence syndrome (ADS) are globally found in the general population. These disorders are characterized by similar dysfunction in families like inadequate support system and poor quality of life. Aim: This study aims to explore the perceived social support and quality of life of the person diagnosed with BPAD and ADS (ICD-10 DCR) and find out its relationship with socio-demographic variables. Methods: This research study was done at the inpatient and outpatient department of Ranchi Institute of Neuropsychiatry and Allied Sciences (RINPAS), Kanke, Ranchi and data was collected by the purposive sampling technique from RINPAS, Ranchi. The sample consisted of 60 subjects, equally divided BPAD and ADS (subjects diagnosed as per ICD-10 DCR). A Socio-demographical Data-sheet, Multidimensional Perceived Social Support (MSPPS) and Quality of life scales were used in the study. Result: The result shows that the mean age of the participants was 30.36 ± 6.84 years for BPAD and 32.40 ± 5.73 years for ADS. Also, the study found that participants of ADS had poor quality of life (p < .001). Conclusion: The study indicates that the severity of Alcohol dependence syndrome affectsindividual quality of life. The study found that perceived social support is also affected similarly in both the disorders BPAD and ADS. [ABSTRACT FROM AUTHOR]

Hepatic cirrhosis is one of the leading causes of death worldwide, especially if complicated by ascites. This chronic condition can be related to the classical disease entity jalodara in Traditional Indian Medicine (Ayurveda). The present paper aims to evaluate the general potential of Ayurvedic therapy for overall clinical outcomes in hepatic cirrhosis complicated by ascites (HCcA). In form of a nonrandomized, uncontrolled, single group, open-label observational clinical study, 56 patients fulfilling standardized diagnostic criteria for HCcA were observed during their treatment at the P. D. Patel Ayurveda Hospital, Nadiad, India. Based on Ayurvedic tradition, a standardized treatment protocol was developed and implemented, consisting of oral administration of single and compound herbal preparations combined with purificatory measures as well as dietary and lifestyle regimens. The outcomes were assessed by measuring liver functions through specific clinical features and laboratory parameters and by evaluating the Child-Pugh prognostic grade score. After 6 weeks of treatment and a follow-up period of 18 weeks, the outcomes showed statistically significant and clinically relevant improvements. Further larger and randomized trials on effectiveness, safety, and quality of the Ayurvedic approach in the treatment of HCcA are warranted to support these preliminary findings. [ABSTRACT FROM AUTHOR]

Background: Blood group plays a vital role in the field of transfusion medicine. The relationship between bleeding time, clotting time, and blood group is important in certain clinical conditions such as epistaxis, surgery, and thrombosis. Researchers have shown that epistaxis is more often encountered in patients having blood group O probably due to lower expression of von Willebrand factor, and elevated levels are a risk factor for thrombosis. Thus, earlier studies found prolonged bleeding and clotting time in individuals with O blood group. Aims and Objectives: The objective of the study was to assess the relationship between bleeding time and clotting time among various blood groups and to identify any gender difference among the same. Materials and Methods: Our study included 150 MBBS students in the age group of 17-20 years. The blood grouping was carried out with the standard antisera, and bleeding time and clotting time were estimated by Duke method and capillary tube method respectively. Finally, bleeding time and clotting time of different blood groups were compared and statistical analysis was carried out. Results: Blood group B (40.7%) was the most common blood group in both genders followed by O (27.3%), A (20.7%), and AB (11.3%). Bleeding time was found to be prolonged 44 min in maximum number of group O (22%) followed by group B (18%), group AB (5.9%), and group A (3.2%) but the difference was statistically insignificant (p = 0.509). Similarly clotting time was 46 min in group B (14.8%) followed by group O (14.6%), group AB (11.76%), and group A (9.7%) but the difference was statistically insignificant (p = 0.885). Gender-wise bleeding time was more prolonged in females (15.7%) than males (13.1%) but the difference was statistically insignificant (p = 0.236), similarly clotting time too was prolonged more in females (16.9%) than males (9.8%) but again the difference was statistically insignificant (p = 0.662). Conclusions: In our study, blood group B predominated followed by O, A, and AB. Bleeding time was prolonged 44 min in blood group O followed by B, AB, and A whereas clotting time was prolonged 46 min in blood group B followed by O, AB, and A. Gender-wise bleeding and clotting time were higher in females than males. [ABSTRACT FROM AUTHOR]

Gestational Diabetes Mellitus (GDM) exposes women to a higher risk for development of type 2 diabetes mellitus in later years of life. Newborns of mothers with GDM are at increased risk for acute perinatal complications including hypoglycaemia, jaundice and being large for gestational age. One of the mechanisms underlying glucose metabolism in pregnancy are a group of substances, which includes leptin and adiponectin, produced mainly in the adipose tissue; in this paper we analyze the role of these mediators in women with GDM. This case control study was performed in 90 females (30 GDM patients and 60 control subjects without GDM) referred to a tertiary care hospital. Blood samples were analyzed for fasting blood glucose, leptin and adiponectin. Leptin and Adiponectin were analyzed using ELISA technique. In our study, the levels of fasting blood glucose were statistically significantly higher (p=0.000) in gestational diabetes patients as compared to controls. There was statistically significant positive correlation between blood glucose and leptin (p = 0.000, r = 0.585). There was statistically significant negative correlation between blood glucose and adiponectin(p = 0.000, r = -0.661). An amplification of the low-grade inflammation already existing in normal pregnancy may lead to increase in leptin and decrease in adiponectin. These factors may play a role in development of gestational diabetes mellitus. Further studies are required for establishing them as a marker for gestational diabetes mellitus. [ABSTRACT FROM AUTHOR]

To study the correlation between telomere length (TL) and long-acting injectable (LAI) and oral atypical antipsychotic (OAA) efficacy on schizophrenia (SCZ) severity and cognitive impairment. Sixty Schizophrenia patients of 18–50 years and of either sex were included in a 12-week study. Thirty patients were recruited in each group, LAI and OAA. Positive and Negative Syndrome Scale (PANSS) and National Institute of Mental Health and Neuro-Sciences (NIMHANS) neuropsychological battery tests were evaluated at baseline and 12 weeks. TL was estimated at baseline. Both groups showed a significant improvement in PANSS and NIMHANS battery test scores after treatment (p < 0.001) within the group, though not between the groups. Mean TL at baseline was 407.58 ± 143.93 and 443.40 ± 178.46 in LAI and OAA groups respectively. A significant negative correlation (r = −0.28, p = 0.03) of TL was seen with the mean change in negative PANSS score after treatment. LAI antipsychotics are similar to OAA in decreasing the disorder severity and improving the cognitive impairment in schizophrenia. Also, patients who have shorter TL show greater improvement in the negative PANSS score. Hence, TL holds the potential of predicting antipsychotic drug response in schizophrenia patients. Long-acting injectable antipsychotic was comparable to oral atypical antipsychotics in bringing out improvement in disorder severity, cognitive functions over 12 weeks. Shorter telomere length has been found to be associated with a greater response in negative symptoms of schizophrenia. [ABSTRACT FROM AUTHOR]