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Background: Falls are common in the elderly and can lead to adverse consequences, like injuries, hospitalization, disability even mortality. Successful ageing emerged in sight to assess physical, psychological and social status of older adults. This study is conducted to explore the association between them in a large Indian community-dwelling population. Methods: Data were based on the wave 1 survey of the Longitudinal Ageing Study in India (LASI). People aged 60 and above with complete information were included. The elderly met five standards including absence of chronic diseases, freedom from disability, high cognitive ability, free from depressive symptoms and active social engagement, were classified into successful agers. The assessment of falls, fall-related injuries and multiple falls depended on interview. Multivariate logistic regression was conducted to find the associations between falls, fall-injury, multiple falls and successful ageing after adjusting both socio-demographic and biological covariates. The log-likelihood ratio test was calculated interactions in subgroups. Results: 31,345 participants in LASI were finally included in our study. Of them, 20.25% reported fall, and 25% were classified into successful agers. After full adjustment, successful ageing was negatively associated with falls (OR 0.70; 95%CI 0.65–0.76) and multiple falls (OR 0.70; 95%CI 0.63–0.78). And the association did not show the significance in older adults with fall-related injuries (OR 0.86; 95%CI 0.72–1.04). Conclusions: Successful ageing was negatively associated with falls and multiple falls, but not fall-related injuries in older people in India. Future studies are demanded to explore the causal relationship and to reveal the underlying mechanism. [ABSTRACT FROM AUTHOR]

The present study attempts to understand what happens to conventional values like obedience in a changing socio-cultural milieu. There are two possible courses. Either the society tends to move towards the values of autonomy, independence, and individuality from the conventional values of obedience and interdependence (Lerner in The passing of traditional society: modernizing the middle east, Press Identifier Glencoe, 1958 and Schramm in Mass media and national development. The role of information in developing countries, Stanford University, California, 1964), or old values are aptly modified by interacting with new values (Trommsdorff, in: Noack (Ed) Psychological responses to social change: Human development in changing environments, de Gruyter, Berlin, 1995). Indian studies demonstrate that co-existence is a preferred strategy of Indians to accommodate cultural changes (Mishra, In: Sharan and Suar (Eds) Psychology matters: development, health, and organization, Allied Publishers, New Delhi, 2007, Mishra, Sinha and Berry in Ecology, acculturation, and psychological adaptation: a study of Adivasis in Bihar, Sage Publication, New Delhi, 1996, Chaubey in Psychol Dev Soc 14:201–220, 2002, Mishra and Sinha in Soc Sci Int 28:159–175, 2012). Testing these ideas regarding obedience, a study was conducted in Varanasi, with 30 participants (15 boys, 15 girls) aged 18–19 years randomly selected for the sample. They were given a questionnaire with ten open-ended questions assessing obedience's meaning, significance, flexibility, and context. Thematic analysis showed that the value of obedience is very significant in the lives of young people. It serves four functions, viz., knowledge function, self-enhancement function, harmonising function, and other miscellaneous functions for them. However, signs of acculturation are also evident in increased demands for autonomy and independence. This makes obedience more flexible and context-bound than before. In an attempt to balance autonomy with relatedness, a guided autonomy model has emerged in India which helps Indian youth accommodate cultural change without getting uprooted. [ABSTRACT FROM AUTHOR]

Objective: MODY (maturity onset diabetes of the young) is a rare, monogenic, autosomal dominant form of diabetes occurring in young (< 25 years) individuals. It has a wide phenotypic variability and can be misdiagnosed as type 1 diabetes mellitus (T1DM). Appropriate detection of MODY has therapeutic and genetic implications. This study aimed to detect MODY among long standing, clinically diagnosed T1DM patients with preserved C-peptide levels. Methods: This was a hospital-based cross-sectional study from central South India which included 100 clinically diagnosed T1DM patients (according to ADA criteria), with a duration of > 3 years. MODY probability score, urinary C-peptide to creatinine ratio (UCPCR), and relevant biochemical investigations were performed. Targeted next-generation sequencing (NGS) for MODY-related genes (13 genes) was done for individuals with UCPCR > 0.2. Results: A UCPCR value of > 0.2 (suggestive of preserved endogenous insulin secretion) was observed in eight individuals. The mean HbA1c values were lower, and the MODY probability score was higher in individuals with preserved endogenous insulin (8.07% vs 9.53% and 2.8% vs 1.5%; p-value: 0.005 and 0.004 respectively). One of the eight individuals (12.5%) had a non-pathogenic gene variant in KLF11. Conclusion: In a South Indian cohort of T1DM with preserved C-peptide, we could not find any case of MODY through targeted NGS. UCPCR can be used as a screening tool to identify cases needing genetic testing for MODY. Larger studies utilizing whole exome sequencing should be conducted to know the actual prevalence of MODY among T1DM. [ABSTRACT FROM AUTHOR]

The article discusses the role of Black West Indian women in the construction of the Panama Canal and their contributions to the U.S. imperial project. These women played a crucial role in sustaining the Black male canal workers and caring for white families through their domestic and care labor. Despite their essential contributions, they faced discrimination and disparagement from both officials and white female employers. The author highlights the resilience and agency of these women, as well as their ability to navigate between the social reproduction of imperial racial capitalism and the social reproduction of West Indian lives. The book provides a more accurate account of the Panama Canal by utilizing non-U.S. based sources and contextualizing women's migration to Panama within their preexisting traditions and practices. Overall, the book makes significant contributions to the scholarship of the Panama Canal, Caribbean diaspora, post-emancipation labor in the Caribbean, and imperial history. [Extracted from the article]

Drawing on the authors' joint activism on the rights of refugees and stateless people in India and Myanmar, this article considers how digital ID systems can be used to exclude minorities. [ABSTRACT FROM AUTHOR]

Background: Parental practices and neighbourhood environmental factors may influence children's movement behaviours. We aimed to investigate the cross-sectional and prospective associations of parental practices and neighbourhood environmental factors with accelerometer-measured 24-hour movement behaviours (24 h-MBs) among school-aged children in Singapore. Methods: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) study collected information on dimensions of parental practices and neighbourhood environment at age 5.5 years. Confirmatory factor analyses were performed to generate latent variables and used to compute overall parental practices [involvement in PA + support for PA + control of screen viewing context] and environmental scores [facilities for active play + active mobility facilitators + barriers*-1]. Children wore an accelerometer on their non-dominant wrist for seven consecutive days at ages 5.5 and 8 years. The R-package GGIR 2.6 was used to derive moderate-to-vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), inactivity, and total-sleep (napping+night sleep) minutes per day. Associations were determined using compositional data analysis with multivariate linear regression models, taking into account potential confounders. Results: Among 425 children (48% girls, 59% Chinese), higher parental involvement in PA, parental support for PA and overall parental practices were associated with 24 h-MBs at ages 5.5 and 8 years, specifically with greater time spent in MVPA and less time being inactive relative to the remaining movement behaviours. The corresponding mean changes in the overall 24 h-MB for increasing parental practices from lowest to highest scores (− 2 to + 2 z-scores) indicated potential increases of up to 15-minutes in MVPA, 20-minutes in LPA, 5-minutes in sleep duration, and a reduction of 40-minutes in inactivity at age 5.5 years. At age 8 years, this could translate to approximately 15-minutes more of MVPA, 20-minutes more of LPA, a 20-minute reduction in sleep duration, and a 20-minute reduction in inactivity. Parental control of screen viewing contexts and neighbourhood environmental factors were not associated with 24 h-MBs. Conclusions: Parental practices but not environmental factors were associated with higher MVPA and lower inactivity among Singaporean children, even at a later age. Further research may provide insights that support development of targeted public health strategies to promote healthier movement behaviours among children. Study registration: This study was registered on 4th August 2010 and is available online at ClinicalTrials.gov: NCT01174875. [ABSTRACT FROM AUTHOR]

Objective: Short stature homeobox (SHOX) haploinsufficiency underlies idiopathic short stature (ISS) and Leri-Weill dyschondrosteosis. The worldwide prevalence of SHOX variations in ISS varies from 2.5% to 15.0%. The aim of this study was to assess the implication of SHOX variation in ISS in North Indians and compare this with other cases of SHOX variations from Asian population. Methods: SHOX gene analysis was carried out by multiplex ligation-dependent probe amplification followed by Sanger sequencing in 54 patients with variable phenotypes. Comparison with other reports in a meta-analysis comprising the current study and 11 previous studies (n=979) was performed. Results: SHOX analysis resulted in 12.9% positivity (7.4% deletions and 5.5% duplications). SHOX association was seen significantly related to gender, with predominance in females (p=0.047). Short arms and forearms were the only significantly associated trait seen in 51.9% of children. The overall prevalence of SHOX variation was 15.2% in Asians with ISS. No significant difference was found in geographical region-specific analysis. Conclusion: This study summarises findings from the last decade and provides an updated picture of the prevalence of SHOX variations in Asians, emphasizing their potential as therapeutic targets in ISS patients. Further high quality, large investigations including functional validation is warranted to validate this association. [ABSTRACT FROM AUTHOR]

Hindus and Muslims represent the two largest religions in India, and also differ in nutritional status, health-related habits and standard of living associated with economic disparities. In this context, the present study considered estimated secular changes in body size, proportions, and weight status among Hindu and Muslim Indian men. The data are from anthropological surveys in the 1970s which included measurements of height, weight and sitting height of 43,950 males 18–84 years (birth years 1891–1957). Leg length was estimated; the BMI and sitting height/height ratio were calculated. Heights of men 35 + years were adjusted for estimated height loss with age. Weight status was also classified relative to WHO criteria for the BMI. Anthropometric characteristics of the two groups were compared with MANCOVA with age and geographic region as covariates. Linear regression of height on year of birth was also used to estimate secular change in each group. Heights, weights, and BMIs tended to be, on average, greater among Muslim than Hindu men at most ages, while distributions by weight status between groups were negligible. Sitting height was greater among Muslim men but estimated leg length did not differ between groups; the sitting height/height ratio thus suggested proportionally shorter legs among Muslim men. Results of the regression analyses indicated negligible differences in secular change between groups across the total span of birth years but indicated a decline in adjusted heights of men in both groups born between 1891 through 1930s and little secular change among those born in the 1930s through 1957. The variation in heights, weights and BMIs between Muslim and Hindu men at most ages suggested variation in socio-economic status and dietary habits between the groups, whereas the negligible estimated secular changes in height between groups likely reflected economic, social, and nutritional conditions during the interval of British rule and the transition to independence. [ABSTRACT FROM AUTHOR]

Background: Primary mental healthcare (PMHC) allows for complex mental health issues in old age to be addressed. India has sought to improve PMHC through legislation, strategies and programmes. This study analyses the challenges and opportunities involved in strengthening PMHC for older persons in India from the perspectives of key stakeholders. Methods: Semistructured interviews were conducted with 14 stakeholders selected from the PMHC system in India and analysed using thematic analysis. First, the analysis was organizationally structured in accordance with the six WHO mental health system domains: (1) policy and legislative framework, (2) mental health services, (3) mental health in primary care, (4) human resources, (5) public information and links to other sectors, and (6) monitoring and research. Second, for each building block, challenges and opportunities were derived using inductive coding. Results: This study highlights the numerous challenges that may be encountered when attempting to strengthen age-inclusive PMHC. Among these challenges are poor public governance, a lack of awareness and knowledge among policy-makers and other stakeholders, and existing policies that make unrealistic promises to weak primary healthcare (PHC) structures with an excessive focus on medicalizing mental health problems. Thus, the mental health system often fails to reach vulnerable older people through PHC. Established approaches to comprehensive, family- and community-oriented PHC support attempts to strengthen intersectoral approaches to PMHC that emphasize mental health promotion in old age. Targeting the PHC workforce through age-inclusive mental health education is considered particularly necessary. Experts further argue that adequate monitoring structures and public spending for mental health must be improved. Conclusions: In this study, we aim to elaborate on the mental healthcare developments that may serve to achieve equity in access to mental healthcare in India. Coordinated and collaborative efforts by public and private stakeholders involved in the care of older persons, both with and without lived mental health experiences, as well as their families and communities, are necessary to bring the vision of those policies for PMHC to fruition. The findings presented in this study can also inform future research, policies and practice in other low- and middle-income countries. [ABSTRACT FROM AUTHOR]

The present study found that ~80 million people in India, ~60 million people in Pakistan, ~70 million people in Bangladesh, and ~3 million people in Nepal are exposed to arsenic groundwater contamination above 10 µg/L, while Sri Lanka remains moderately affected. In the case of fluoride contamination, >120 million in India, .2 million in Pakistan, and ~0.5 million in Sri Lanka are exposed to the risk of fluoride above 1.5 mg/L, while Bangladesh and Nepal are mildly affected. The hazard quotient (HQ) for arsenic varied from 0 to 822 in India, 0 to 33 in Pakistan, 0 to 1,051 in Bangladesh, 0 to 582 in Nepal, and 0 to 89 in Sri Lanka. The cancer risk of arsenic varied from 0 to 1.64× 1-1 in India, 0 to 1.07 × 10-1 in Pakistan, 0 to 2.10 × 10-1 in Bangladesh, 0 to 1.16 × 10-1 in Nepal, and 0 to 1.78 × 10-2 in Sri Lanka. In the case of fluoride, the HQ ranged from 0 to 21 in India, 0 to 33 in Pakistan, 0 to 18 in Bangladesh, 0 to 10 in Nepal, and 0 to 10 in Sri Lanka. Arsenic and fluoride have adverse effects on animals, resulting in chemical poisoning and skeletal fluorosis. Adsorption and membrane filtration have demonstrated outstanding treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder and is closely linked to stress. Psychiatric morbidities such as anxiety and depression are common in IBS. Long-term follow-up studies on anxiety and depressive symptoms in IBS and the impact of treatment are lacking in the Indian scenario. Aims: This study aimed to assess the various subtypes of IBS according to the Rome IV criteria, assess anxiety and depressive symptoms in patients with IBS at baseline and also at various phases of follow-up over one year, and see the impact of the treatment of both IBS and associated anxiety and depressive symptoms if present, in the severity of IBS and other psychiatric symptoms. Materials and Methods: Patients with IBS, aged between 18 and 65 years, were enrolled for the study. Subtypes and severity of IBS were assessed. Anxiety and depressive symptoms were assessed by the Hamilton Rating Scale for Anxiety (HAM-A) and the Hamilton Rating Scale for Depression (HAM-D), respectively. The patients were treated with conventional treatment of IBS with concomitant treatment of anxiety and depressive symptoms and were followed up for 1 year. Results: Thirty-seven patients completed a 1-year follow-up. The mean age was 38.4 ± 11.6 years. The majority were males (81%), and IBS-D (84%) was the most common subtype. Stressful life events (67.6%) and chronic stressors (64.9%) were present in the majority of the patients. The patients had moderate-to-severe anxiety at baseline (HAM-A score 27.8 ± 6.4) and moderate-to-severe depression at baseline (HAM-D score 19.7 ± 6.6). The improvement over 1 year was statistically significant (P = 0.000, two tailed). A positive correlation between the severity score of IBS and HAM D (r = 0.604) and HAM A (r = 0.536) scores was present. Conclusion: There is a high prevalence of anxiety and depression in patients with IBS. With adequate treatment of both IBS and concomitant anxiety depressive symptoms, there is a significant decrease in the severity of IBS, anxiety, and depression. [ABSTRACT FROM AUTHOR]

According to the World Health Organization, 19.4 million people in India had diabetes in 1995, and this figure is projected to rise to 57.2 million by 2025, accounting for one-sixth of the global total. Saliva is referred to as the "mirror of the body" since it functions as a health indicator in the mouth and throughout the body. Since diabetes has been declared a pandemic of non-communicable diseases, a chair-side, non-invasive, less technique-sensitive, cost-effective approach should be considered. The study evaluated the association between salivary glucose levels and oral health status of healthy individuals. After obtaining the informed consent, an oral cavity was examined per the WHO oral health status form for adults (Annexure 1). The standard salivary glucose level was measured using the O-Toluidine reagent method using a double-beam spectrophotometer. The blood glucose levels were measured using an electronic blood glucose meter. On comparison of glucose levels according to CPI score and DMFT experience using ANOVA, a p-value of 0.08 (>0.05) and 0.95 (>0.05) was obtained, which was statistically non-significant. The bivariate correlation between Salivary Glucose Level (SGL) (ug/ml) and blood Glucose Level (BGL) (mg/dl) was checked using the Pearson correlation coefficient. There was a statistically significant moderate and positive correlation between Blood Glucose Levels (mg/dl) and salivary Glucose Levels (ug/ml). Within the limitation of the study, the study concluded that there is no significant association between salivary glucose levels and oral health status of healthy individuals. However, a positive correlation exists between salivary glucose levels and blood glucose levels in healthy individuals. [ABSTRACT FROM AUTHOR]

Background: High-intensity focused ultrasound (HIFU) and monopolar radiofrequency (MRF) are common treatment modalities that have shown significant results in skin tightening. Nevertheless, the novel combination of these two treatments is new to the Malaysian landscape. Thus, this study aims to investigate the safety and efficacy of this novel combination treatment for the Malaysian population. Methods: This retrospective study included data on HIFU and MRF combination therapy for skin tightening collected from an aesthetic clinic in Johor Bahru, Malaysia from June 2018 to May 2021. Efficacy was assessed using the Global Aesthetic Improvement Scale (GAIS) and Glogau classification, while the safety of the treatment was analysed using pain scores and adverse events (AEs). Results: A total of 56 patients with a mean age of 47.7 years old (SD 10.00) were included in this study. The majority of the patients had Fitzpatrick skin types III and IV. Most of the patients were Chinese, followed by Malay, Indian and others. Most patients (96.4%) showed clinically significant improvement in skin tightening after treatment, with 15 patients scoring 1 (very much improved) and 39 scoring 2 (improved). All patients reported transient mild erythema, with no serious AEs, such as burn, swelling, numbness or muscle weakness. Among the patients, 80% reported a pain score of 5, while 10% reported pain scores of 4 and 6. Conclusion: Combining HIFU with MRF therapy improved GAIS scores by 96.4%, indicating a secure and efficient skin-tightening method. Transient erythema was shown to be the most common side effect of this combination. [ABSTRACT FROM AUTHOR]

Background: To identify the relation between central corneal thickness and corneal curvature with refractive errors. To find out whether there is any relation between central corneal thickness and corneal curvature with variables such as age and refractive error mainly myopia and hypermetropia. Material and Methods: This is an Observational cross- sectional study done on hospital based population. Data collected from patient with refractive error visiting our outpatient department. 70 subjects who met the inclusion criteria were included in the study. Following examination were performed for all the patients, measuring best corrected visual acuity, central corneal thickness, corneal curvature by topography, subjective refraction done using retinoscopy. All patients underwent a complete slit-lamp examination. Correlation identified using Karl Pearson's and spearman correlation coefficient. Data analysis done with SPSS 20.0 software. Results: The mean central corneal thickness of our population is 536.9 microns. The mean age of our study population was 41.7 years. The mean corneal curvature is 44.82 D. Astigmatism and Hypermetropia has significant correlation with central corneal thickness and corneal curvature. Conclusion: CCT has got a negative correlation with age that is as age progress CCT decreases. Astigmatism has a negative correlation with central corneal thickness and corneal curvature. Hypermetropia has a positive correlation between CCT and corneal curvature. There is also no significant association between central corneal thickness and corneal curvature in our study. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand a collaborative learning model for developing 'training the trainer' courses • To develop training programmes on indigenising systematic reviews to local contexts • To gain insights into adult learning and teaching strategies Background: Developing a workforce with the skills to produce and make judicious use of evidence for policy and practice decisions requires trainers who can tailor evidence and training to policy and practice priorities. Aim: To describe how a collaborative learning model adapted a systematic review course to suit Indian nurse educators and research scholars in the conduct and use of systematic reviews. Discussion: A collaborative learning team of academics and research scholars brought together expertise in nursing education in India, and evidence synthesis in India and the UK. Participants found the course was highly beneficial, enhanced independent and critical thinking, and instilled them with the confidence and skills to deliver such courses to Indian researchers, nurses and other healthcare professionals. Conclusion: Contextualising materials and methods to participants' experiences made learning more relatable. The use of adult learning approaches enabled participants to apply the same approaches when leading training in their own institutions and underpinned long-term sustainable working relationships between facilitators and learners, leading to new studies and new resources to support evidence-informed decision-making. Implications for practice: An educational intervention on 'indigenising systematic reviews' with online collaborative learning can produce improvements in the knowledge and skills of participants. Advantages of this educational approach include its flexibility, active involvement of participants and sustainable partnership building. The principles and methods used could be replicated in any setting to train trainers. [ABSTRACT FROM AUTHOR]

Background and Objectives: Epidermal growth factor receptor (EGFR) mutation analysis has become an important part of the initial workup of non-squamous non-small cell lung cancer (NS-NSCLC) patients. This study is attempted as South Indians population is comprised of ethnic groups with diverse genetic makeup and only very limited data on EGFR mutation is available from south India. A detailed understanding of EGFR mutation profile will help in better planning of treatment strategies and resource allocation. Methods: A retrospective analysis of EGFR mutation frequency in 350 patients diagnosed with adenocarcinoma of lung and its association with pathological characteristics was done. Results: Out of 350 cases of pulmonary adenocarcinoma, within an age group ranging from 30 to 86 years. EGFR mutations were identified in 34.8% (n = 122) cases, out of which 35.24% (n = 43) were in non-smoker females (P = 0.001). Of the 14 cases with resistant type of EGFR mutations, nine were in smoker males and the remaining five in non-smoker females. Interpretation and Conclusion: Overall EGFR mutation frequency observed in our study was similar to other Indian studies. However, in our study, we observed that mutation in exon 21 was less frequent compared to other studies. A similar slightly increased frequency of rare mutations and double mutations were observed in our study. A detailed study of the molecular epidemiology of lung cancer and its association with different geographical zones of India is needed. This understanding will help in better planning of treatment strategies and resource allocation. [ABSTRACT FROM AUTHOR]

Background Boule, DAZLA, and DAZ are members of the Deleted in Azoospermia family of genes, which play signifi- cant roles in gametogenesis and are important fertility factors in humans. In a few studies, deletion of the Y chromosomal DAZ cluster and single nucleotide polymorphisms in the DAZLA gene were reported to affect male fertility, although this is paradoxical because they were found in both control and fertile men. As a result, the goal of this study was to check if Y chromosomal DAZ cluster deletion and SNPs in the DAZLA gene on chromosome 3 of humans are associated to male infertility in the population. For computational analysis, different bioinformatics tools such as SIFT, PolyPhen2, Mutation Taster, FATHMM, and PROVEAN were used to analyse mutations. Results Within the studied population, we found no association between DAZ deletion and the most prevalent DAZLA SNPs A260G (rs11710967) and A386G (rs1219183446). We also discovered two new deleterious genetic variations in exon 3 of the DAZLA gene, one nonsynonymous mutation that replaced Valine with Glutamate at the 66 codon position and the other a stop gain mutation at the 74 amino acid position. These genetic changes are found in the RRM domain of the DAZLA gene, which is confirmed by Motif scan analysis and results in a change in the DAZLA protein's secondary structure. The RRM domain is a highly conserved regulatory domain for mRNA transport and translation. Azoospermia and necrospermia infertility phenotypes were shown in infertile male samples with these genotypes. Conclusion We can conclude that further investigation of the aforesaid new mutations in the DAZLA gene may be valuable in understanding their significance in male infertility in different populations due to the multifactorial nature of male infertility and arrays of gene expression required at every stage of spermatogenesis. [ABSTRACT FROM AUTHOR]

Background: Skin mottling as a clinical perfusion marker in septic shock is significantly associated with severity and outcome in white-skinned population and its validity as a clinical sign in dark-skinned population is not known. The objectives of this study were to evaluate mottling in septic shock in the Indian ethnic population who has different skin color as compared to the white-skinned population and to assess mottling as an outcome predictor with capillary refill time (CRT) and other biochemical parameters which are the established clinical markers of perfusion in septic shock. Materials and methods: We conducted a prospective observational study of patients with skin color categories 21-34 on the von Luschan scale or Fitzprick type IV-VI who had septic shock needing a high dose of norepinephrine ≥0.2 µg/kg/min after fluid optimization. The study was conducted in a mixed medical-surgical ICU over 12 months. Two blinded experts (a Dermatologist and a plastic surgeon) independently classified the skin type, validated the occurrence of mottling, and scored mottling in our patients. We recorded the demographics, hemodynamic variables, and mottling score and observed the incidence of mottling and its correlation with predictors of the severity of septic shock. We also compared CRT, arterial lactate, central venous oxygen saturation, and venoarterial PCO2 gap with occurrence of mottling in septic shock patients. Results: We included 108 patients with age 61 ± 16 years. Mean Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II scores at enrolment were 10.3-21.9, respectively. Incidence of mottling was 20.3% (22/108). CRT >3 seconds was observed in 50.9% (55/108). Development of mottling was significantly associated with 90-day mortality; 20/22 (90.9%) patients died in the mottling group versus 58/86 (65.1%) in the non-mottling group (p = 0.028). Capillary refill time >3 seconds did not corelate with mortality; 40/55 (72.7%) Patients with CRT >3 seconds died versus 32/53 (60.4%) patients died in CRT ≤3 seconds group. Occurrence of mottling could predict mortality; positive predictive value of 90.9% which was comparable to positive predictive value of lactate levels >4 mmol/L, i.e., 94.1%. Conclusion: The incidence of mottling in septic shock is much less in patients of Indian ethnicity with brown skin color than in white-skinned population. Occurrence of mottling and not delayed CRT, is a better predictor of outcome in this setting. [ABSTRACT FROM AUTHOR]

This paper outlines the efforts at establishing observatories in India for modern astronomical observations made by aristocrats over the last century or so prior to Indian independence in 1947. The focus of this paper is therefore on three institutions only, the Royal Observatory at Lucknow, Trevandrum Observatory, and Nizamiah Observatory in Hyderabad. This demonstrates that the concept of 'patronage' was alive and well in nineteenth century India, just as it was in Britain, Europe and North America. These observatories primarily were established either to encourage educated Indians to gain a realistic knowledge of Western astronomy, or so that India itself could contribute to that body of research knowledge. One of these institutions, Nizamiah Observatory was India's sole observatory involved in the ambitious international Astrographic Catalogue and Carte du Ciel and Project. It is telling that quite early in its history this Observatory ended up with a university, while this fate later befell Trevandrum Observatory. It is notable that none of the observatories discussed in this paper has survived in its original form through to the present day as a forefront astronomical research facility. Moreover, relatively early in its history Trevandrum Observatory abandoned astronomy and shifted its focus to geomagnetism. Unlike the observatories discussed in the first paper in this series, none of the observatories reviewed in this paper was set up primarily to further Britain's colonial ambitions. All were local Indian initiatives, yet each received support, in one way or another, from British astronomers or observatories--so the colonial link was still there, but only as an underlying element. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical, radiological characteristics and outcomes of patients with Idiopathic intracranial hypertension (IIH) at 6 months in a cohort of South Indian patients. Methods: We did a prospective study on patients presented to our institute with the symptomatology of IIH. A detailed history regarding headache, visual symptoms were noted. A complete neurological examination including examination of the fundus, CSF opening pressure, MRI brain, and MR cerebral venography were performed for all subjects. The patients were followed-up for 6 months to assess treatment response. Results: We evaluated 49 patients, the majority were females, and 38.7% had grade 1 obesity. Headache was the most common clinical presentation. The most common MRI abnormality was empty sella turcica, noted in 47%. There was a significant positive correlation between CSF opening pressure and headache severity (R2= 0.165, p = 0.018), as well as between CSF opening pressure and the grade of papilledema (R2=0.245, p=0.001). Of the cases, 95% responded to medical management, and three patients of fulminant IIH underwent lumbar-peritoneal shunting. At 6 months, 60% had persistent headaches. Only 8.7% had persistent visual symptoms, and only one had optic atrophy. There was no significant correlation between the follow-up grade of papilledema and the patient's BMI. No significant correlation was found between the amount of weight lost and the improvement in the Numerical Rating Scale (NRS) score at 6 months. Conclusion: Headache in IIH is multifactorial and a significant cause of disability. The overall prognosis for vision is good. IIH should be suspected in any obese woman with headaches since it is one of the preventable causes of blindness. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome represents aggregation of risk factors associated with an increased risk of developing type 2 diabetes mellitus (DM) and atherosclerotic cardiovascular disease (ASCVD). Assessing its incidence is an effective way for estimating the future burden of DM and ASCVD and understanding their secular trends and effect of public health measures on halting the evolution of risk factors. The present study aimed to estimate the incidence of metabolic syndrome and its predictors using a population-based cohort. Methods: A subset of Chandigarh Urban Diabetes Study cohort (n = 1023) without diabetes or metabolic syndrome was prospectively evaluated after a mean of 10.7 years. Metabolic syndrome was defined as per International Diabetes Federation criteria and diabetes as per American Diabetes Association standards. The incidence was calculated in 1000 person years, and multivariate logistic regression was used to estimate the strength of association between incident metabolic syndrome and risk factors. Results: In the followed-up individuals (n = 303), incidence of metabolic syndrome was 32.1 per 1000 person years (95% CI 26.3–38.7 per 1000 person years). Amongst those developing metabolic syndrome, ≥4 components were present in 52% individuals, with low HDL-C being the most common abnormality. Those with metabolic syndrome had a five-time higher risk of diabetes (OR: 4.94; 95% CI: 2.27–9.96; p < 0.001) and a threefold higher risk of hypertension (OR: 2.67; 95% CI: 1.30–5.48; p = 0.006). Conclusion: Asian-Indians have a high incidence rate of metabolic syndrome, which is associated with sedentary lifestyle and consequent central obesity. [ABSTRACT FROM AUTHOR]

Background: Women's birthing experience is a sensitive indicator of the quality of childbirth care and can impact the physical and mental health of both women and their neonates. Negligible evidence exists on Indian women's birth experiences and–to the best of authors' knowledge–no questionnaire has been tested in India for measuring women's birthing experiences. This study aimed to test the construct validity and reliability of the Kannada-translated Revised Childbirth Experience Questionnaire. Methodology: A cross-sectional survey was carried out among postnatal women (n = 251, up to six months postpartum, with a live healthy neonate) who had given birth at a public or private health facility using the Kannada-translated CEQ2 in two districts of Karnataka. Data were collected at participants' homes after seeking written informed consent. Model fit was determined by Confirmatory Factor Analyses. Results: The 4-factor model of the CEQ2 showed good fit after deletion of one item (item 8, subcategory "participation") with CMIN = 1.33; SRMR = 0.04; GFI = 0.92, CFI = 0.98, TLI = 0.99, RMSEA = 0.037 and p value 0.002). The Cronbach alpha values were acceptable for the four subscales (0.92, 0.93, 0.97, 0.91) as well as for the overall 21-item scale (0.84). Conclusions: The Kannada-translated CEQ2 is a reliable tool to measure the childbirth experiences among Kannada-speaking women and can serve as a reliable ongoing evaluation of women's birth experiences. [ABSTRACT FROM AUTHOR]

AIM: CLINICAL AND ANGIOGRAPHIC PROFILE OF ACUTE CORONARY SYNROME IN YOUNG PATIENTS during COVID ERA Background: Cardiovascular diseases are becoming more prevalent in younger people in India, which is causing a demographic shift in the disease. In the Indian population, there is a dearth of data comparing the different aspects of acute coronary syndrome in young and old patients. The objective of this study is to assess the clinical and angiographic characteristics in both young and elderly individuals. Methods: This was a prospective cross sectional observational study which enrolled 90 patients <45 years and 34 patients > 45 years. Comparison of clinical presentation, electrocardiography, echocardiographic findings, conventional and non-conventional risk factors with angiographic findings were made. Results: A total of 90 patients under the age of 45 were enrolled in group 1, and 34 senior patients older than 45 were included in group 2. Mean age in Group 1 and 2 was 39.79 ± 5.15 years and 59.74±8.21 years. Male sex, smoking, family history of CAD, raised lipoprotein was more in younger population. Younger patients were more likely to have single vessel disease, while the elderly were more likely to have multi vessel disease. Conclusion: Younger patients with ACS have a good prognosis with a predominance of SVD. [ABSTRACT FROM AUTHOR]

Background: There is an existing debate regarding the use ofcarotidartery intima-media thickness (CIMT) for theearly risk prediction of atherosclerosis. Therefore, the present study was designed to assess the correlation between CIMT and the severity of coronary artery disease (CAD) on coronary angiography as assessed using SYNTAX (synergy between percutaneous coronary intervention with taxus and cardiac surgery) score. Materials and Methods: A cross sectional, observational study was conducted at a tertiary care center in India from June 2021 to May 2022. A total of 100 patients who were suspected to have CAD or having an indication to undergo coronary angiography were included in the study. Baseline clinical and demographic details were recorded. Blood and biochemical investigations were carried out and risk factors for CAD were recorded among all the patients. Carotid ultrasonography was performed to measure CIMT. The correlation between CIMT and the severity of CAD using SYNTAX score was evaluated. Results: Mean age of the study population was 55.89 ± 11 years and males were predominant over females (68% vs. 32%). Mean CIMT was 1.03 ± 0.32 mm and mean SYNTAX score was 16.07 ± 11. A strong positive correlation existed between CIMT and SYNTAX score (r=0.76; p<0.001). CIMT was higher among the patients with double vessel disease (p<0.001) and triple vessel disease (p<0.001) when compared to the patients with no CAD. Conclusion: We found a strong correlation between CIMT and SYNTAX score. Hence, CIMT measurement may be beneficial to diagnose early atherosclerosis. [ABSTRACT FROM AUTHOR]

Background: The higher prevalence of depressive symptoms among women demands an in-depth exploration of every possible mechanism through which depressive symptoms may prevail. Identifying any malleable mechanism may open a new pathway through which such symptoms could be targeted. We explored the association between neuroticism, rumination, anxiety, and depressive symptoms and tested a moderated mediation model with anxiety as a mediator in the relationship between neuroticism and depressive symptoms, and rumination as a moderator of the effect of neuroticism on anxiety. Method: This cross-sectional study was conducted on Indian women living in the state of Punjab. A total of 671 adult females responded to the translated versions of standardized questionnaires measuring the relevant constructs. Results: The mean (SD) age of the sample was 23.71 (6.09) years. As hypothesized, anxiety significantly mediated the relationship between neuroticism and depression, and the use of rumination moderated the effect of neuroticism on anxiety. Among women with a high score on neuroticism, those with low ruminating tendencies showed less anxiety and depression than others who scored high on rumination. Conclusion: The findings imply that a reduction in rumination may help women, especially those who are high on neuroticism, manage their vulnerabilities toward anxiety and depressive symptoms. Personality traits being not that malleable, targeting a reduction of rumination usage, which is both a trans-diagnostic factor and a malleable one, can help address the surging prevalence of common mental disorders such as anxiety and depression through appropriately devised interventions. [ABSTRACT FROM AUTHOR]

Introduction: Knee joint problems, such as Osteoarthritis (OA), primarily affect the upper weight-bearing end of the tibia. Total and unicompartmental knee arthroplasty are commonly performed as treatment options. However, existing studies on morphometric assessment of the knee joint mainly focus on the Western population, with a lack of data among the Indian population. Obtaining such data is crucial for designing tibial components of knee prostheses tailored to the Indian population. Aim: To compare the morphometric data of the upper end of the tibia between the North and East Indian populations. Materials and Methods: A cross-sectional observational study was conducted in the Department of Anatomy at FMHS Medical College, SGT University, Gurugram, Haryana, North India, involving 41 dry tibias, and at Medical College and Hospital Kolkata in East India, involving 43 dry tibias. Measurements of the Anteroposterior (AP) and Transverse Diameters (TD) of the Medial Tibial Condyle (MTC), Lateral Tibial Condyle (LTC), and Total Tibial Condyles (TTC) were performed using digital Vernier callipers with a least count of 0.01 mm. The data was statistically analysed using Statistical Package for Social Sciences (SPSS) (version 21.0), and Student's t-test was applied, with p<0.05 considered significant. Results: The mean TD and AP diameters of the tibial plateau were found to be greater in the East Indian population (TD: 65.47±5.46, AP: 44.29±4.36). In both samples, the AP diameter of MTC (North Indians: 38.30±3.54, East Indians: 40.63±3.46) was greater than that of LTC (North samples: 35.30±3.51, East samples: 35.70±3.96). When comparing parameters between the North and East samples using Student's t-test, significant differences were found on the right-side for the mean AP (p-value=0.0065) and TD (p-value=0.0213) of TTC, mean AP (p-value=0.0006) and TD (p-value=0.0219) of MTC, mean TD of LTC (p-value=0.0002), mean AP (p-value=0.0005) and TD (p<0.0001) of the Intercondylar area at anterior ends, and mean AP (p<0.0001) and TD (p-value=0.0017) of the Intercondylar area at posterior ends. On the left-side, significant differences between the North and East population were found for mean TD of LTC (p-value=0.0348), AP (p<0.0001) and TD (p-value=0.0207) of the Intercondylar area posterior end. When comparing the areas between the North and East populations, significant differences were found on the right-side only for the MTC (p-value=0.0013), LTC (p-value=0.0083), and TTC (p-value=0.0055). Conclusion: There are significant regional variations in the anthropometric measurements of the North and East Indian populations, emphasising the need to develop populationspecific tibial prostheses for improved surgical outcomes. [ABSTRACT FROM AUTHOR]

Background Sleep-disordered breathing (SDB) is common in heart failure, and is associated with increased morbidity and mortality. The aim of the study is to determine the prevalence and patterns of sleep apnea in Asian Indian patients with heart failure. Methods This was a prospective, observational study of consecutive 60 cases of heart failure. All these patients were clinically assessed and evaluated for sleep apnea with sleep study. Apnea-hypopnea index (AHI) was used to determine the severity of sleep apnea. Results In this study of 60 patients, the mean age was 62 ± 8 years, with a higher prevalence of sleep apnea observed in older age groups. There was a male predominance, but it was not statistically significant. Approximately 51.7% of patients had a co-morbidity, with diabetes and hypertension significantly associated with sleep apnea. 43 (71.7%) were found to have sleep apnea, with varying degrees of severity. Central sleep apnea was present in 60.5% of sleep apnea patients, while obstructive sleep apnea was present in 39.5% of patients. Higher NYHA class, atrial fibrillation, higher dyspnea class, and elevated heart rate were significantly associated with sleep apnea. Conclusion Our study identified significant rates of undiagnosed sleep apnea in patients with chronic heart failure, with a higher prevalence of central sleep apnea. Patients with more heart failure symptoms were more susceptible to developing sleep apnea. Routine screening for sleep apnea using polysomnography is crucial in chronic heart failure patients. This comprehensive approach holds promise due to the bidirectional relationship between sleep apnea and heart failure. [ABSTRACT FROM AUTHOR]

Background and Objectives: Epidermal growth factor receptor (EGFR) mutation analysis has become an important part of the initial workup of non-squamous non-small cell lung cancer (NS-NSCLC) patients. This study is attempted as South Indians population is comprised of ethnic groups with diverse genetic makeup and only very limited data on EGFR mutation is available from south India. A detailed understanding of EGFR mutation profile will help in better planning of treatment strategies and resource allocation. Methods: A retrospective analysis of EGFR mutation frequency in 350 patients diagnosed with adenocarcinoma of lung and its association with pathological characteristics was done. Results: Out of 350 cases of pulmonary adenocarcinoma, within an age group ranging from 30 to 86 years. EGFR mutations were identified in 34.8% (n = 122) cases, out of which 35.24% (n = 43) were in non-smoker females (P = 0.001). Of the 14 cases with resistant type of EGFR mutations, nine were in smoker males and the remaining five in non-smoker females. Interpretation and Conclusion: Overall EGFR mutation frequency observed in our study was similar to other Indian studies. However, in our study, we observed that mutation in exon 21 was less frequent compared to other studies. A similar slightly increased frequency of rare mutations and double mutations were observed in our study. A detailed study of the molecular epidemiology of lung cancer and its association with different geographical zones of India is needed. This understanding will help in better planning of treatment strategies and resource allocation. [ABSTRACT FROM AUTHOR]

Background: In India, the predominant way of tobacco consumption is by smoking cigarettes, which is a vital risk factor for atherosclerotic vascular disease, which in turn is affected by abnormality in the lipid profile. Aim: To evaluate the alteration in the serum lipid profile between young smokers and nonsmokers. Materials and Methods: The study included a total of 148 participants, who were divided into light (n = 25), moderate (n = 25), heavy (n = 24) smokers ("S" group), and nonsmokers ("NS" group, n = 74). Along with demographic data, blood samples were collected after overnight fasting under aseptic conditions. The samples were centrifuged and the lipid profile estimation of substances including serum cholesterol, triglycerides, high-density lipoprotein cholesterol, low- and very low-density lipoprotein cholesterol were performed. Independent sample t test and one-way analysis of variance were employed for statistical analysis, considering P ≤.05 as significant. Results: The mean years of smoking were 7.91 ± 4.67 years and average cigarettes smoked per day were 13.43 ± 6.66. The inter-group difference in the lipid profiles were significant (P <.001). An increasing trend of mean cholesterol, low-density lipoprotein cholesterol, triglycerides, and very low-density lipoprotein cholesterol with regard to lower to higher smoking index, while high-density lipoprotein cholesterol levels significantly showed decreasing trend with regard to lower to higher smoking index (P <.001). Conclusion: The present study reported abnormal lipid level in smokers in comparison to the nonsmokers, with the amount and duration of smoking also influencing dyslipidemia. [ABSTRACT FROM AUTHOR]

Background: The size and shape of the adult corpus callosum (CC) may vary with gender. There is, however, less literature available on data involving the morphometry of CC among the Indian population. Aims and Objectives: To measure the size of CC using magnetic resonance imaging (MRI) scans of normal Indian adult females and males and identify genderrelated differences, if any. Materials and Methods: The dimensions of CC were measured on MRI scans on a midsagittal section view belonging to 150 (59 females, 91 males) normal Indian adults (North India) using e-measurement tools. The measurements included the maximum length and height of CC, the thickness of various parts of CC, the CC index (CCI), and the distance of CC from the frontal and occipital poles of the cerebral hemisphere. The study was carried out in the Department of Anatomy in collaboration with the Department of Radiodiagnosis, King George’s Medical University, U.P., Lucknow, India. The data was analyzed using the statistical package for social sciences, 23rd version. Means were compared for significant differences using the independent unpaired t-test. Results: The mean length of the CC was found to be 6.94±0.63 cm; mean height was 2.57±0.43 cm; the mean thickness of the genu was 9.16±2.26 mm; the mean thickness of the body was 5.09±0.99 mm; the mean thickness of splenium was 9.10±2.22 mm; the mean distance from the frontal pole was 3.66±0.35 cm; the mean distance from the occipital pole was 5.70±0.74 cm; and the mean CCI calculations showed to be 3.37±0.56. All measurements were found to be greater in males as compared to females except mean height (males 2.56±0.47 cm; females 2.59±0.37 cm) and mean thickness of the body (males 5.04±0.94 mm; females 5.17±1.06 mm). A statistically significant difference was observed in the distance of CC from the frontal pole in our population with respect to gender (P=0.03). Conclusion: Based on observations made in the study, normative data of CC measurements was generated, and it was found that there was no significant gender-related difference in the morphology of CC; the only significant difference was in the distance of the genu from the frontal pole, which was greater in females as compared to males. [ABSTRACT FROM AUTHOR]

Purpose: To examine the association between self-managed abortion and the self-reported experience of abortion complications in India, a country with a high incidence of self-managed abortion.Patients and Methods: The study used a cross-sectional multivariable logistic regression analysis of data from the National Family Health Survey (NFHS-4) of 2015– 2016 to compare the odds of self-reported complications experienced during abortion between self-managed and clinician-managed abortions in India.Results: On average, self-managed abortions occurred earlier in gestation than clinician-managed abortions, 7.8 weeks and 11.3 weeks, respectively (p < 0.001). Self-managed abortion was associated with fewer self-reported abortion-related complications than clinician-managed abortions when adjusted for covariates not including gestational age (Adjusted Odds Ratio (aOR) 0.82, 95% confidence interval (CI) 0.69, 0.97). However, once adjusted for gestational age, there was no longer a clinically meaningful or statistically significant difference in the odds of self-reported complications between self-managed and clinician-managed abortions (aOR = 0.98, 95% CI 0.81, 1.18).Conclusion: These findings suggest that people in India are using safe methods to self-manage abortions and support the hypothesis that self-managed abortion can improve access to abortion and reproductive choice without increasing risk. [ABSTRACT FROM AUTHOR]

Objectives: There is insufficient evidence about the determinants of alcohol use amongst young people in India and other low‐and middle‐income countries, despite alcohol's high contribution to disease burden and increasing consumption in this population. We aimed to identify and estimate the determinants of alcohol use in a representative sample of 2716 young men from Bihar and Uttar Pradesh who participated in the 'Understanding the Lives of Adolescents and Young Adults' (UDAYA) study. Methods: First, we developed an exploratory conceptual framework of potential alcohol use determinants in the study settings based on available literature. We then estimated the effects of 35 potential alcohol use determinants identified in the conceptual framework (including 14 latent factors identified through exploratory factor analysis) on any alcohol use in the past 3 years and regular alcohol use amongst past three‐year drinkers, using mixed‐effects logistic models. The determinants explored were operationalised using longitudinal data from the UDAYA study. Results: Our adjusted models identified 18 determinants for past 3‐year alcohol use and 12 determinants for regular use. Distal determinants (e.g., socioeconomic status), intermediate determinants (e.g., parental alcohol use, media use), and proximal determinants (e.g., emotional regulation, early tobacco use) were identified. Geographical variations in both outcomes indicate potential differences in unmeasured community‐level determinants (e.g., alcohol availability and acceptability). Conclusions: Our findings extend the generalizability of several known determinants across settings, yet highlight the importance of addressing alcohol use in young people as a complex and context‐dependent issue. Many identified determinants (e.g., education, media use, poor parental support, early tobacco use) are amenable to intervention through multi‐sectoral prevention programs/policies. Such determinants should be the focus of ongoing policy/intervention development efforts in the region, and our revised conceptual framework may inform further research in India or similar South Asian settings. [ABSTRACT FROM AUTHOR]

OBJECTIVE: South Asians are diagnosed with type 2 diabetes (T2D) more than a decade earlier in life than seen in European populations. We hypothesized that studying the genomics of age of diagnosis in these populations may give insight into the earlier age diagnosis of T2D among individuals of South Asian descent. RESEARCH DESIGN AND METHODS: We conducted a meta-analysis of genome-wide association studies (GWAS) of age at diagnosis of T2D in 34,001 individuals from four independent cohorts of European and South Asian Indians. RESULTS: We identified two signals near the TCF7L2 and CDKAL1 genes associated with age at the onset of T2D. The strongest genome-wide significant variants at chromosome 10q25.3 in TCF7L2 (rs7903146; P = 2.4 × 10−12, β = −0.436; SE 0.02) and chromosome 6p22.3 in CDKAL1 (rs9368219; P = 2.29 × 10−8; β = −0.053; SE 0.01) were directionally consistent across ethnic groups and present at similar frequencies; however, both loci harbored additional independent signals that were only present in the South Indian cohorts. A genome-wide signal was also obtained at chromosome 10q26.12 in WDR11 (rs3011366; P = 3.255 × 10−8; β = 1.44; SE 0.25), specifically in the South Indian cohorts. Heritability estimates for the age at diagnosis were much stronger in South Indians than Europeans, and a polygenic risk score constructed based on South Indian GWAS explained ∼2% trait variance. CONCLUSIONS: Our findings provide a better understanding of ethnic differences in the age at diagnosis and indicate the potential importance of ethnic differences in the genetic architecture underpinning T2D. [ABSTRACT FROM AUTHOR]

Introduction: To get a comprehensive idea about the transmission and epidemiology of TB globally and locally, the use of molecular typing methods has become imperative not only for understanding genetic diversity but also the population structure of Mycobacterium tuberculosis complex (MTBC). We aimed to investigate the drug resistance pattern and genetic diversity of MTBC among previously treated patients with sputum smear-positive pulmonary tuberculosis in a South Indian population. Methodology: 104 patients with sputum smear positivity and who had previously undergone treatment were selected. Drug susceptibility testing, Spoligotyping, MIRU-VNTR, and SNP typing were performed. Results: Mono-resistance to isoniazid 16 (15.38%) was the highest among all drugs. Out of 104 isolates, 24 (23%) isolates were classified as MDR strains. The distributions of most common lineages were: EAI3-Ind-20 (19.23%), EAI5-13 (12.50%), Beijing-12 (11.54%), CAS1-Delhi-9 (8.65%), and 7 (6.73%) each of T-H37rv, Unknown and Orphan types. MIRU-VNTR-based analysis revealed that there are two major groups: CAS1-Delhi and Beijing groups. Out of 104 isolates, 82 belonged to well-defined lineages and 6 clusters, and the remaining 22 were singletons. SNP analysis showed no mutations associated with five sets of genes in 33 strains. Conclusions: The occurrence of 11.54% Beijing strains in South India is an important finding. High frequency of Isoniazid mono resistance noticed. Spoligotyping along with MIRU-VNTR and SNP typing is the best approach to the identification of strain lineages. No mutation with Antigen85C gene represents, can be used for vaccine candidates. [ABSTRACT FROM AUTHOR]

Background: Questions of equitable access to primary mental healthcare (PMHC) for older persons in India have been examined mostly in terms of the coverage of services, although perceptions of mental health and old age and social norms at the community level should be considered in the shaping of PMHC approaches. The present qualitative study, therefore, examined how social perceptions and norms of mental health in old age are and should be considered in the design and implementation of primary healthcare approaches in India. Methods: A secondary thematic analysis of semi-structured interviews with key stakeholders (n = 14) of PMHC in India was conducted. Results: Four key themes emerged from the analysis, in which social perceptions and norms were discussed: (1) family participation and low threshold access to mental healthcare, (2) the position of community health workers as an important pillar of old age and mental health-sensitive community-based care, (3) the role of social cohesion and traditional values in fostering a positive and supportive community environment for old age mental health, and (4) the empowerment of communities, families and older persons through mental health education. Conclusions: PMHC, with its focus on mental health promotion, could be an important anchor for combatting negative attitudes about mental health and old age. The findings presented in this study can inform age-sensitive policies and programmes for mental health in India and could inform future research on the subject. [ABSTRACT FROM AUTHOR]

Genome-wide polygenic risk scores (PRS) for lifestyle disorders, like Type 2 Diabetes (T2D), are useful in identifying at-risk individuals early on in life, and to guide them towards healthier lifestyles. The current study was aimed at developing PRS for the Indian population using imputed genotype data from UK Biobank and testing the developed PRS on data from GenomegaDB of Indians living in India. 959 T2D cases and 2,818 controls were selected from Indian participants of UK Biobank to develop the PRS. Summary statistics available for South Asians, from the DIAMANTE consortium, were used to weigh genetic variants. LDpred2 algorithm was used to adjust the effect of linkage disequilibrium among the variants. The association of PRS with T2D, after adjusting for age, sex and top ten genetic principal components, was found to be very significant (AUC = 0.7953, OR = 2.9856 [95% CI: 2.7044–3.2961]). When participants were divided into four PRS quartile groups, the odds of developing T2D increased sequentially with the higher PRS groups. The highest PRS group (top 25%) showed 5.79 fold increased risk compared to the rest of the participants (75%). The PRS derived using the same set of variants was found to be significantly associated with T2D in the test dataset of 445 Indians (AUC = 0.7781, OR = 1.6656 [95%CI = 0.6127–4.5278]). Our study demonstrates a framework to derive Indian-specific PRS for T2D. The accuracy of the derived PRS shows it's potential to be used as a prognostic metric to stratify individuals, and to recommend personalized preventive strategies. [ABSTRACT FROM AUTHOR]

Maturity Onset Diabetes of the Young (MODY) is a monogenic form of diabetes which is detected by genetic testing. We looked at clinical and biochemcial variables that could help detect possible MODY among Asian Indians with youth-onset diabetes. From the diabetes electronic medical records of a diabetes care centre in Chennai in southern India, demographic, anthropometric, and biochemical details of 34 genetically confirmed MODY participants were extracted. They were compared with patients with type 1 diabetes (T1D) (n = 1011) and type 2 diabetes (T2D) (n = 1605), diagnosed below 30 years of age. Clinical and biochemical variables including body mass index (BMI), glycated hemoglobin, HDL cholesterol, and C-peptide (fasting and stimulated) were analyzed to determine whether cut points could be derived to identify individuals who could be sent for genetic testing to diagnose or rule out MODY in this ethnic group. The age at diagnosis was higher for T2D (26.5 ± 4.0 years) compared to T1D (18.2 ± 6.1 years) and MODY (17.8 ± 6.0 years). Individuals with MODY had BMI, glycated hemoglobin, total cholesterol, triglycerides, HDL cholesterol, and C-peptide levels which were intermediate between T1D and T2D. The identified probable parameters and their cut points to identify cases for MODY genetic screening were BMI 21.2–22.7 kg/m2, glycated hemoglobin 7.2–10%, HDL cholesterol 43–45 mg/dl, fasting C -peptide, 1.2–2.1 ng/ml and stimulated C-peptide, 2.1–4.5 ng/ml. Asian Indians with MODY have clinical features that are intermediate between T1D and T2D and selected biochemical parameters, especially stimulated C peptide cut points were the most useful to diagnose MODY. [ABSTRACT FROM AUTHOR]

Milk and legumes are good source of protein foods used to sustain muscle mass, but their effects on postprandial glucose homeostasis and energy metabolism may be different. This is relevant, for example, in the dietetic response to obesity or diabetes, where the intake of high-quality protein is often increased significantly. The objective of this study was to characterize the acute effect of whey and soy protein (15% vs. 30%) on glucose homeostasis, energy metabolism, and satiety. Healthy, normal body mass index (BMI) Indian adult males aged 20–35 years (n = 15) received 4 test meals (2 proteins (soy vs. whey) and 2 doses (15% vs. 30% protein: energy ratio)). Blood samples were collected serially after the meal to calculate the incremental area under the curve for plasma glucose and insulin. Energy expenditure and substrate oxidation were measured after the meal. Satiety was measured with a visual analogue scale. The insulin response, represented by the incremental area under the curve, was significantly higher for the 30% whey compared to the 30% soy protein meal (p < 0.01) but was not significantly different between the 15% protein doses. There were no differences in the plasma glucose response across protein sources or doses. The mean peak fat and carbohydrate oxidation, satiety, and energy expenditure did not differ between the protein sources and doses. In conclusion, at higher doses, whey protein has a greater insulinogenic response, compared to soy protein, and exhibits a dose-response effect. However, at lower doses, whey and soy protein elicit similar insulinogenic responses, making them equally effective protein sources in relation to glucose homoeostasis. [ABSTRACT FROM AUTHOR]

Purpose: In the last decade over 17.46 million people in India died due to wrong medication and drug-drug interaction. In fact, Drug-drug interaction is the 4th leading cause of death in India. Medications used in COVID-19 management had resulted in one in five patients experiencing adverse drug reactions. Polypharmacy and self-medication are recognized as increasingly serious mortality and morbidity problem in the current healthcare system. Materials and Methods: Pharmasure software is scripted in HTML and JavaScript. It requires very less storage space, and thus the device with less storage can perform more efficiently and effectively without any internet bugs. In this model drug interaction are included on the basis of literature and pharmaceutical journals which show dispensing and prescription errors due to drug-drug interaction. The drug interactions were studied, reviewed and scripted in the programme. Results: Result of Pharmasure comes out as, it make easy for physician and pharmacists to check drug interactions. Pharmasure has different tabs featuring Drug interaction, Drug Food interaction, Herb Drug interaction and Pediatric dose calculation. Pharmasure is one of its kind which shows different healthcare aid at same place. Conclusion: The Present work corroborates that harm and death due to drug-drug interaction can be prevented. People should have information of drug interaction. Pharmasure has different healthcare features on one platform. [ABSTRACT FROM AUTHOR]

Background:- Coronavirus disease (COVID-19) is caused by SARS-COV2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. Based on the large number of infected people that were exposed to the wet animal market in Wuhan City, China, it is suggested that this is likely the zoonotic origin of COVID-19. Rates of infection and consequently, mortality have risen rapidly, resulting in a global pandemic. With no evidence- based treatments available, most countries have implemented quarantine measures to mitigate the spread of the virus. The world has largely focused on the physical suffering associated with COVID-19. However, the health sequelae of the pandemic are beginning to gain deserved attention. COVID-19 poses unique challenges to population mental health, given the colossal societal impact of nationwide lockdowns and health services struggling to cope. Mental health and well-being have been adversely affected by direct exposure to the virus (eg, depression, anxiety, grief, suicidality) and from the social and economic upheaval that is occurring at an individual and population level. Aim & Objectives: - The aim of study is to assess the stress disorder between 1st and 2 nd wave of covid-19 pandemic in Indian population. Material And Methodology:- An online study that was directed utilizing google form and link was sent utilizing WhatsApp, Facebook and Instagram and one to one interview was done. A self-answered questionnaire survey was utilized for the investigation. The study questionnaire took 4-5 minutes to finish. Total 461 responses were obtained in the specific time. Results & Discussion:- This study aims to understand the impact of stress disorder in COVID-19 infected patients in both the 1st and 2nd waves in India. This study reveals a high prevalence of anxiety and fear of COVID-19 among the people in India from 1 st wave to 2nd wave of pandemic. Among the risk factors, family members affected with COVID19 is one reason that has significantly increased the level of anxiety and stress in participants of the study. Conclusion:- Further analysis is required to help establish the syndrome's boundaries (e.g., are there other main aspects that must be included?) and to see if the syndrome varies significantly across cultures and populations. Additional measures must also be developed and tested. Currently, the COVID Stress Syndrome and Disorder can only be assessed using self-report measures. To enable a better understanding of COVID-19-related distress, clinician-administered question and answer session methods could be developed. [ABSTRACT FROM AUTHOR]

Introduction: Many Indians are at high risk of type 2 diabetes mellitus (T2DM). The blood glucose level can be improved through a healthy lifestyle (such as physical activity and a healthy diet). Yoga can help in T2DM prevention, being a culturally appropriate approach to improving lifestyle. We developed the Yoga Programme for T2DM Prevention (YOGA-DP), a 24-week structured lifestyle education and exercise (Yoga) program that included 27 group Yoga sessions and self-practice of Yoga at home. In this study, the feasibility of undertaking a definitive randomized controlled trial (RCT) was explored that will evaluate the intervention's effectiveness among high-risk individuals in India. Methods: A multicenter, two-arm, parallel-group, feasibility RCT was conducted in India. The outcome assessors and data analysts were blinded. Adults with a fasting blood glucose level of 100–125 mg/dL (i.e., at high risk of T2DM) were eligible. Participants were randomized centrally using a computer-generated randomization schedule. In the intervention group, participants received YOGA-DP. In the control group, participants received enhanced standard care. Results: In this feasibility trial, the recruitment of participants took 4 months (from May to September 2019). We screened 711 people and assessed 160 for eligibility. Sixty-five participants (33 in the intervention group and 32 in the control group) were randomized, and 57 (88%) participants were followed up for 6 months (32 in the intervention group and 25 in the control group). In the intervention group, the group Yoga sessions were continuously attended by 32 (97%) participants (median (interquartile range, IQR) number of sessions attended = 27 (3)). In the intervention group, Yoga was self-practiced at home by 30 (91%) participants (median (IQR) number of days per week and minutes per day self-practiced = 2 (2) and 35 (15), respectively). In the control group, one (3%) participant attended external Yoga sessions (on Pranayama) for 1 week during the feasibility trial period. There was no serious adverse event. Conclusions: The participant recruitment and follow-up and adherence to the intervention were promising in this feasibility study. In the control group, the potential contamination was low. Therefore, it should be feasible to undertake a definitive RCT in the future that will evaluate YOGA-DP's effectiveness among high-risk people in India. Feasibility Trial Registration: Clinical Trials Registry—India (CTRI) CTRI/2019/05/018893; registered on May 1, 2019. [ABSTRACT FROM AUTHOR]

Background: Global evidence-based recommendations for hypertension management are periodically updated, and ensuring adherence to the guidelines is imperative. Furthermore, the current high prevalence of hypertension effectuates a high health-care cost. Purpose: To evaluate the prescribing patterns of antihypertensive drugs and other factors affecting blood pressure (BP) with the objective of assessing the proportion of patients achieving the target BP and to perform a pharmacoeconomic analysis in a South Indian population. Materials and Methods: In a cross-sectional study, 650 patients previously diagnosed with hypertension and already on treatment with one or more drugs were included. A prospective interview of patients was done using a prevalidated questionnaire on various factors in BP control. Prescribing patterns and pharmacoeconomic analyses, namely, cost acquisition, cost of illness, and cost-effectiveness analyses were carried out. Results: Of 650 subjects, 257 (39.54%) achieved the target BP, while 393 (60.46%) did not. A significant association of age, occupational status, monthly family income, and area of residence in addition to physical activity and diet scores, with achieving target BP was noted. A significantly higher cost of anti-hypertensive drug treatment in achieving target BP (P = 0.02) was observed. Among patients who achieved target BP, 37.35% were on monotherapy and 48.25% on multiple drug therapy compared to 46.31% and 35.62%, respectively, in patients who did not. Average cost-effectiveness ratio were found to be Rs. 20.45 and Rs. 57.27, respectively, for single and multiple drug therapies, with incremental cost-effectiveness of Rs. 194.14 per additional patient treated with multiple free drug combinations. Conclusion: This study identified the anti-hypertensive prescribing pattern and provided insight into the various pharmacoeconomic factors that play a significant role in attaining target BP in the treated population. [ABSTRACT FROM AUTHOR]