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BACKGROUND: Female agricultural workers contribute to 37% of the total agricultural workforce in India, however, most self-propelled machinery is designed for male agricultural workers. OBJECTIVE: The primary objective was to determine the impact of the ergo-refined operator's workplace on various aspects of operator performance and comfort, including actuating force, posture, and physiological parameters. METHODS: Experiments were carried out in real field conditions using a full factorial randomized design. Twelve female operators participated in the study, and measurements were taken for control lever actuating force, operator posture, heart rate, and other relevant parameters. RESULTS: The ergo-refined operator's workplace intervention resulted in significant reductions in actuating force for various control levers, angles of joints, working heart rate (WHR), oxygen consumption rate (OCR), muscle load, and whole-body vibration (WBV) acceleration. These reductions were observed under different operating conditions. CONCLUSION: The findings suggest that the ergo-refined operator's workplace is effective in enhancing operator comfort and reducing physical strain during the operation of riding type self-propelled machines. It contributes to improved safety, comfort, and operational efficiency for operators working in field conditions. ANOVA and MANOVA analyses confirmed the positive impact of operating conditions and engine speed on the measured parameters when using the ergo-refined operator's workplace. [ABSTRACT FROM AUTHOR]

Introduction: There is an unmet need for high-quality data for Robot-assisted partial nephrectomy (RAPN) in the Indian population. Indian study group on partial nephrectomy (ISGPN) is a consortium of Indian centers contributing to the partial nephrectomy (PN) database. The current study is a descriptive analysis of perioperative and functional outcomes following RAPN. Methods: For this study, the retrospective ISGPN database was reviewed, which included patients who underwent RAPN for renal masses at 14 centers across India from September 2010 to September 2022. Demographic, clinical, radiological, perioperative, and functional data were collected and analyzed. Ethics approval was obtained from each of the participating centers. Results: In this study, 782 patients were included, and 69.7% were male. The median age was 53 years (interquartile range [IQR 44-62]), median operative time was 180 min (IQR 133-240), median estimated blood loss was 100 mL (IQR 50-200), mean warm ischemia time was 22.7 min and positive surgical margin rates were 2.5%. The complication rate was 16.2%, and most of them were of minor grade. Trifecta and pentafecta outcomes were attained in 61.4% and 60% of patients, respectively. Conclusions: This is the largest Indian multi-centric study using the Indian Robotic PN Collaborative database to evaluate the outcomes of robot assisted PN, and has proven its safety and efficacy in the management of renal masses. [ABSTRACT FROM AUTHOR]

A diagnosis of autism typically depends on clinical assessments by highly trained professionals. This high resource demand poses a challenge in low-resource settings. Digital assessment of neurodevelopmental symptoms by non-specialists provides a potential avenue to address this challenge. This cross-sectional case-control field study establishes proof of principle for such a digital assessment. We developed and tested an app, START, that can be administered by non-specialists to assess autism phenotypic domains (social, sensory, motor) through child performance and parent reports. N = 131 children (2–7 years old; 48 autistic, 43 intellectually disabled and 40 non-autistic typically developing) from low-resource settings in Delhi-NCR, India were assessed using START in home settings by non-specialist health workers. The two groups of children with neurodevelopmental disorders manifested lower social preference, greater sensory interest and lower fine-motor accuracy compared to their typically developing counterparts. Parent report further distinguished autistic from non-autistic children. Machine-learning analysis combining all START-derived measures demonstrated 78% classification accuracy for the three groups. Qualitative analysis of the interviews with health workers and families of the participants demonstrated high acceptability and feasibility of the app. These results provide feasibility, acceptability and proof of principle for START, and demonstrate the potential of a scalable, mobile tool for assessing neurodevelopmental conditions in low-resource settings. Autism is diagnosed by highly trained professionals– but most autistic people live in parts of the world that harbour few or no such autism specialists and little autism awareness. So many autistic people go undiagnosed, misdiagnosed, and misunderstood. We designed an app (START) to identify autism and related conditions in such places, in an attempt to address this global gap in access to specialists. START uses computerised games and activities for children and a questionnaire for parents to measure social, sensory, and motor skills. To check whether START can flag undiagnosed children likely to have neurodevelopmental conditions, we tested START with children whose diagnoses already were known: Non-specialist health workers with just a high-school education took START to family homes in poor neighbourhoods of Delhi, India to work with 131 two-to-seven-year-olds. Differences between typically and atypically developing children were highlighted in all three types of skills that START assesses: children with neurodevelopmental conditions preferred looking at geometric patterns rather than social scenes, were fascinated by predictable, repetitive sensory stimuli, and had more trouble with precise hand movements. Parents' responses to surveys further distinguished autistic from non-autistic children. An artificial-intelligence technique combining all these measures demonstrated that START can fairly accurately flag atypically developing children. Health workers and families endorsed START as attractive to most children, understandable to health workers, and adaptable within sometimes chaotic home and family environments. This study provides a proof of principle for START in digital screening of autism and related conditions in community settings. [ABSTRACT FROM AUTHOR]

Background: Environmentally sustainable diets are represented in the EAT‐Lancet recommendations developed by the Lancet Commission on Planetary Health in 2019. Very few studies have compared Indian diets with the EAT‐Lancet recommendations. The present study performed such a comparison using primary dietary consumption data from adults in north and south India. Methods: Data from 8762 adults (52.4 ± 11.7 years) residing in Sonipat and Vizag India were collected on sociodemographic characteristics, wealth index (household assets) and dietary intake (food frequency questionnaire: nine food groups). The quantity consumed and energy from each food group was compared with the EAT‐Lancet recommendations. We investigated the likelihood of deficit or excess in consumption compared to the EAT‐Lancet recommendations by different sociodemographic factors. Results: Half of the participants were women and half resided in rural areas. Vegetables and fruits were consumed in lower quantity, whereas dairy and added fats were consumed in higher quantity than recommended by the EAT‐Lancet recommendations. For whole grains, female gender and poorest wealth index were the factors associated with deficit or no consumption, whereas, for vegetables and fruits, it was poorest wealth index and residence in rural areas (p < 0.05, all). Rural residence and poorest wealth index were associated with excess consumption of dairy and added fats (p < 0.05, all). Conclusions: The diets of the study participants were mainly plant‐based, and high in dairy but lacking in nutrient‐rich foods such as vegetables and fruits. Appropriate policy actions for making healthy sustainable diets and micronutrient‐rich foods available and affordable to all with a particular focus on the poor and rural populations are warranted. Very few studies have compared Indian diets with the EAT‐Lancet dietary recommendations. The present study performed such a comparison using primary dietary consumption data, finding that Indian diets were mainly plant‐based, being high in dairy but lacking in nutrient‐rich foods such as vegetables and fruits. Highlights: Compared with the EAT‐Lancet recommendations, Indian diets were deficit in fruits and vegetables consumption but exceeded in dairy and added fats.Female gender, rural residence and poorest wealth index were associated with lower nutrient rich foods consumption.To ensure sustainable and healthy diets in India, the EAT‐Lancet recommendations should be adopted considering Indian Council of Medical Research guidelines.Urgent policy actions are needed to make healthy and sustainable diets locally available accessible and affordable to all. [ABSTRACT FROM AUTHOR]

Introduction: Testicular Germ Cell Tumor (GCT) is a disease of young adults and is also highly curable. But in India, most of the patients present in an advanced stage and succumb to the disease as compared to the Western nations where patients present at an earlier stage and are mostly cured. Also, there is a scarcity of literature on testicular GCT from the Indian subcontinent. We present our experience from the Tata Memorial Centre of North-east India. Methods: This retrospective study was conducted at Tata Memorial Centre - BBCI, Guwahati for the period of 5 years from January 2018 to December 2022. The study focused on epidemiology, clinical presentation, and treatment outcomes. Results: Seventy-two cases of testicular GCTs were studied (28 cases were seminoma, and 44 were non-seminoma). Most common presenting stage was stage I in seminoma (53.6%), and stage III (77.2%) in non-seminoma. As per the International Germ Cell Cancer Collaborative Group (IGCCCG) classification, 25%, 35%, and 40% of patients were good-risk, intermediate-risk, and poor-risk in non-seminoma. In patients with seminoma, 54% and 46% were in good and intermediate-risk, respectively. Seventy-two percent and 21% had achieved a radiologic complete response (CR) and partial response (PR) with conventional chemotherapy in patients with seminoma. Radiologic CR and PR rates were 20% and 61% among non-seminoma patients. The median recurrence-free survival (RFS) was 43 months. RFS was better in seminoma versus non-seminoma, stage I versus stage III, and good-risk versus high-risk group. Conclusion: Most of our patients presented with an advanced stage of the disease and a high nodal burden. In patients with non-seminoma GCT, the best response to conventional chemotherapy was a partial response. The use of an alternative chemotherapy regimen to improve outcomes for such patients can be further explored. [ABSTRACT FROM AUTHOR]

Background The information-seeking behavior of the radiology residents on call has undergone modernization in the recent times given the advent of easy to access, reliable online resources, and robust artificial intelligence chatbots such as Chat Generative Pre-Trained Transformer (ChatGPT). Purpose The aim of this study was to conduct a baseline analysis among the residents to understand the best way to meet information needs in the future, spread awareness about the existing resources, and narrow down to the most preferred online resource. Methods and Materials A prospective, descriptive study was performed using an online survey instrument and was conducted among radiology residents in India. They were questioned on their demographics, frequency of on call, fatigue experienced on call, and preferred information resources and reasons for choosing them. Results A total of 286 residents participated in the survey. All residents had used the Internet radiology resources during on-call duties. The most preferred resource material was Radiopaedia followed by Radiology Assistant. IMAIOS e-Anatomy was the most preferred anatomy resource. There was significant (p < 0.05) difference in relation to the use of closed edit peer-reviewed literature among the two batches with it being used almost exclusively by third year residents. In the artificial intelligence-aided ChatGPT section, 61.8% had used the software at least once while being on call, of them 57.6% responded that the information was inaccurate, 67.2% responded that the information was insufficient to aid in diagnosis, 100% felt that the lack of images in the software made it an unlikely resource that would be used by them in the future, and 85.8% agreed that they would use it for providing reporting templates in the future. In the suggestions for upcoming versions, 100% responded that images should be included in the description provide by the chatbot, and 74.5% felt that references for the information being provided should be included as it reaffirms the reliability of the information. Conclusions Presently, we find that Radiopaedia met most of the requirements as an ideal online radiology resource according to the residents. In the present-day scenario, ChatGPT is not considered as an important on-call radiology education resource first because it lacks images which is quintessential for a budding radiologist, and second, it does not have any reference or proof for the information that it is providing. However, it may be of help to nonmedical professionals who need to understand radiology in layman's terms and to radiologists for patient report preparation and research writing. [ABSTRACT FROM AUTHOR]

Aims: To study the respiratory variation of right atrial (RA) pressures at baseline and during atrioventricular nodal reentry tachycardia (AVNRT). Methods: Of the 23 patients screened, 16 participants with typical AVNRT were included in the study. After ensuring adequate hydration, baseline RA pressures were measured as the height of 'a' and 'v' waves. The patients were asked to take deep breaths, and the measurements were taken in both inspiration and expiration. Results: Of the 16 participants, 14(87.5%) showed a normal fall in the height of 'a' and 'v' waves with inspiration, 1(6.25%) showed no change and 1(6.25%) showed a rise in height at baseline, p <0.01. During induced AVNRT, the 'a' and 'v' wave heights increased in 8(50%), remained same in 6(37.5%) and showed a normal fall in 2(12.5%), p = 0.07 for 'a' waves and p = 0.09 for 'v' waves. When the magnitude and direction of change in 'a' and 'v' wave height at baseline was compared with AVNRT, it showed a significant difference with 13(81.25%) participants demonstrating positive Pseudo-Kussmaul's sign, p <0.01. Mean age was numerically higher in those with a more considerable inspiratory rise in RA pressures but was not statistically significant, χ2(2) = 3.1, p = 0.21. Conclusions: Pseudo-Kussmaul's sign does occur in a substantial number of patients during AVNRT. Clinical appreciation of this phenomenon is possible in half to three-fourth of patients, provided the mean RA pressures are low enough for the variation to be visible in the neck. [ABSTRACT FROM AUTHOR]

Background: Cerebrospinal infections are the cause of poor prognosis among post-neurosurgery patients owing to delay in improvement of neurological functions, leading to increased length of hospital stay, proceeding to disability or death. Methods and materials: This retrospective observational study was performed at a tertiary care center in Northern India, where all patients with bacterial cerebrospinal infections from July 2019 to July 2022 were evaluated for post-neurosurgery cerebrospinal shunt infections, and all demographic data and risk factors were extracted from the hospital information system (HIS). Results: The study includes 150 (150/1986, 7.55%) culture-confirmed cases of bacterial meningitis out of 1986 cases of suspected bacterial meningitis patients. Ninety-six (96/150, 64.0%) post-neurosurgery patients with cerebrospinal fluid (CSF) leaks were managed using external ventricular drain (EVD) or ventriculo-peritoneal (VP) shunt. Seventy-four (74/96, 77.08%) patients were managed only on EVD, whereas 22 (22/96, 22.92%) patients were managed only on VP shunt. Eighty-two (82/96, 85.4%) multidrug-resistant microorganisms (MDROs)were isolated and 70 (70/82, 85.36%) were Gram-negative bacteria, of which 56 (56/74, 75.68%) Gram-negative bacteria showed extended-spectrum betalactamase (ESBL)-producing character in those with an EVD, 14 (14/22, 63.63%) with a VP shunt. Among Gram-negative bacteria, Acinetobacter baumannii showed high rates of resistance: 21 (21/23, 91.30%) and 8 (8/8, 100%) were ESBL-producing A. baumannii in patients managed on EVD and VP shunt, respectively. Conclusion: This study determines the risk factors, the spectrum of pathogenic microorganisms, multidrug resistance, and the nature of intracranial lesions isolated among the patients who developed bacterial cerebrospinal infections in post-neurosurgery patients. [ABSTRACT FROM AUTHOR]

Purpose: Aging has detrimental effects on elders due to their physical health and financial hardship. Elders face neglect, insult and abuse in society due to causes related to physical health and financial issue from caregivers. This study aims to identify the measures of physical health and financial hardship and classifies elders under neglect, insult and abuse categories. Design/methodology/approach: The propositions of existence and classifying elders under neglect, insult and abuse categories were tested by using discriminant analysis and their profiling was done by perceptual mapping technique. Findings: The elder neglect category identified as a prominent category due to physical health while elder insult and abuse were caused by physical health and financial hardship both. The present study portrays the multi-dimensional facets related to elders' ill-treatment. The elder's ill-treatment categories were profiled to imply the measure of elevating elders' dignity and care at a personal level and society at large. Originality/value: This study classifies elders under neglect, insult and abuse categories. This classification may facilitate the medical practitioners, academicians and government and non-government social welfare agencies in understanding elder abuse with new perspectives. [ABSTRACT FROM AUTHOR]

Background: Literature suggests that the COVID-19 pandemic has resulted in poor sleep quality, especially among the infected population. However, literature regarding the effect of COVID-19 pandemic and SARS-CoV-2 infection on occurrence of insomnia, restless legs syndrome and dream enactment behavior is either scarce or unavailable. Methods: This study was planned to assess the effect of SARS-CoV-2 infection on the occurrence of insomnia, restless legs syndrome (RLS) and dream enactment behavior (DEB). For this cross-sectional study, a questionnaire comprising of items related to demographic details, past medical history, and information related to SARS-CoV-2 infection was distributed through social media. Insomnia was diagnosed using clinical criteria. RLS, DEB, sleep quality, depression and anxiety were assessed using a validated questionnaire. Information regarding the use of hypnotic medications was also gathered. Results: Of the 1596 respondents, 37.2% reported disturbed sleep while insomnia was reported by 22.6% respondents. 27.3% of respondents reported RLS and 17.4% suffered DEB. The odds of insomnia were greater among males (OR = 1.27; 95% CI: 1.03–1.58; P < 0.02) and among those who had SARS-CoV-2 infection (OR = 1.76; 95% CI = 1.42–2.19; P < 0.001). Similarly, SARS-CoV-2 infection was also associated with increased odds of RLS (OR = 2.48; 95% CI = 1.98–3.11; P < 0.001) and DEB (OR = 1.58; 95%CI = 1.21–2.06; P < 0.001). Insomnia, RLS and DEB were more frequent among respondents who required oxygen therapy, those who experienced loss of taste and/or smell, depression and anxiety. Prevalence of insomnia, DEB and RLS was higher than said prevalence among respondents with no history of SARS-CoV-2 infection, but lower than that of those with positive history of SARS-CoV-2 infection. 5.3% of respondents reported taking hypnotic medications before infection, 7% during infection and 5.3% after infection. Conclusion: SARS-CoV-2-infection-related factors in association with environmental factors have increased the prevalence of insomnia, DEB and RLS among subjects having infection. SARS-CoV-2-associated immunological changes, hypoxia and neurotropism may play a role in occurrence of insomnia, DEB and RLS. [ABSTRACT FROM AUTHOR]

Introduction: Adolescence as a life stage is associated with physical and psychological changes with an interplay of biological, social, and environmental factors. The aim of this study was to determine the prevalence of aggression among children and the factors associated with aggression. Methods: This was an analytical cross-sectional study conducted in schools of Bhopal, Madhya Pradesh, India, between 2017 and 2019 among higher and higher secondary class children. All children from high and higher secondary classes were included, resulting in a sample of 192. Information on sociodemographic, family, psychosocial, lifestyle, addiction factors, aggression (Buss–Perry Aggression Questionnaire), self-esteem (Rosenberg self-esteem scale), and resilience (Nicholson McBride Resilience Questionnaire) were obtained. Results: The prevalence of aggression among children from Classes 9th to 12th was 49.5%; physical aggression was 42.7%, verbal aggression was 31.8%, anger was 44.3%, and hostility was 44.8%. Almost half (44.3%) of the children had self-esteem and only 1.6% of children had an established level of resilience. Of the sociodemographic factors considered, type of school, gender, parents' education; of the family factors considered, family members taking alcohol/drugs, parents having frequent arguments, parents hitting children and using abusive language; of the psychosocial, lifestyle and addiction factors considered, feeling neglected, grade, watching TV and practice of reading books were significantly associated with the presence of aggression in children (P < 0.05). Conclusion: Overall findings suggest the need for strengthening life skills education, positive immediate environment, coping at the individual level, social intelligence, and cautious approach toward boosting self-esteem. [ABSTRACT FROM AUTHOR]

Background: Quality management in healthcare is critical for hospitals and everyone in the loop —from physicians to support staff—needs to be aware of and involved in this process. Objectives: To assess the perception of employees about the quality management system (QMS) implemented at a tertiary care eye hospital in north India and to use it to identify scope for further improvement. Methods: This cross-sectional mixed-method study involved both questionnaire-based survey and an in-depth interview by a third party. The questionnaire had 12 questions to assess the changes in culture, infrastructure, environment, system, operation theatre and outpatient department. Employees shared their opinion about improvements brought by the QMS in eight years. Respondents were divided into five groups based on their job description: (i) doctors, (ii) technical staff (nursing/operation theatre/laboratory), (iii) optometrists/opticians/audiologists, (iv) patient care executives and (v) human resources/administration/others. Results: Of the 73 employees interviewed, 94.5% perceived an improved treatment and care process and 91.8% perceived improved treatment results. According to 83.6% of the employees, they were encouraged to report patient safety concerns and 71.2% saw improved incidence and adverse event management. The QMS has increased patient satisfaction according to 83%, while 91.8% felt it improved the profile of the hospital. The employees stated no negative effects of the QMS except a long waiting time of the patients and the duplication of paperwork. Conclusion: QMS has brought many positive changes across the hospital. Still, there is scope to reduce the patient waiting time and paperwork duplication. [ABSTRACT FROM AUTHOR]

Background: The pattern of post-stroke aphasia in speakers of Bengali language has not previously been reported in the literature. Furthermore, the inter-relationship between age, gender, and level of education and aphasia typology has remained unsettled thus far. Aims: To investigate the incidence and type of aphasia in first-ever acute stroke patients who were speakers of Bengali language. Methods & Procedures: Bengali version of Western Aphasia Battery was used for language assessment in our study participants. Lesion localization was done by using magnetic resonance imaging(3T) for ischemic stroke (if not contraindicated) and computed tomography for hemorrhagic stroke. Among 515 screened cases of first-ever acute stroke, 208 presented with aphasia. Language assessment was done between 7 and 14 days in all study participants. Outcomes & Results: The incidence of post-stroke aphasia in our sample was found at 40.39%. Types of aphasia were – Broca's (38.5%) followed by global (27.9%); Wernicke's (12.5%); transcortical motor (9.6%); anomic (4.3%); transcortical sensory (3.8%); isolation (1.9%); and conduction (1.4%). Mean number of years of formal education was significantly higher in fluent aphasia group in comparison with non-fluent group (10.51 years versus 7.01 years, p = 0.003). In logistic regression analysis, location of lesion (posterior perisylvian) (p = 0.007, OR = 5.406, 95% CI, 1.602–18.240) and education (p = 0.044, OR = 1.097, 95% CI, 1.003–1.199) were two independent predictors favoring fluent aphasia. Conclusions: Aphasia among post-stroke Bengali patients is quite frequent. The commonest type of aphasia in our sample was Broca's aphasia. Bengali-speaking people with higher education were more likely to present fluent aphasia. [ABSTRACT FROM AUTHOR]

Objective  This study aimed to compare the preductal oxygen saturation (SpO 2) and heart rate (HR) in newborns during the initial 5 minutes after birth with delayed cord clamping (DCC) and early cord clamping (ECC) practices at sea level. Study Design  This prospective observational study included newborns born at >34 weeks vaginally (Dharampur, Gujarat) or through caesarean section (CS) (Kolkata, West Bengal). In Dharampur, the newborns received ECC practice (8 weeks) followed by DCC practice (10 weeks). In Kolkata, the newborns received ECC practice only (8 weeks). Results  The newborns with DCC (n  = 170) had significantly higher SpO 2 (3–8%) throughout than those with ECC born either vaginally (n  = 178) or through CS (n  = 101). The newborns with DCC had slower rise in HR during the first 2 minutes than those with ECC. The 5th and 10th percentile values of SpO 2 for newborns with DCC practice were higher than those with ECC practice. Conclusion  The trends of SpO 2 and HR during the first 5 minutes after birth indicate a relatively smoother cardiopulmonary transition by delaying cord clamping till placental delivery compared with early clamping. The reference ranges can be used for Indian newborns born by uncomplicated vaginal delivery with DCC during the first 5 minutes. [ABSTRACT FROM AUTHOR]

Purpose: In the present era of modernization, the social group members interact with each other with selfish and unselfish intents. However, the unselfish means and ends build a long term relationship among people. On the other hand, selfish ends bud out unethical means such as abuses, violence and fights. The situation becomes tough when the same becomes evident among the family relationship and as a consequence the elderly are being treated unfairly. Out of such cases, some are reported and the majority of them remain unreported, which eventually becomes the cause of concern for the social welfare agencies. Thus, this paper aims to examine the elder abuse (EA) tendency in metro, non-metro and religious cities. Design/methodology/approach: For this study, a mixed-method approach is used to develop survey instruments, validate findings using qualitative and quantitative data sources for better generalization of results. The present study explored and confirmed the related factors using exploratory factor analysis and confirmatory factor analysis for the establishment of a valid scale of EA. Further, the difference of perceptions among the elders for abuse across the metro, non-metro and religious cities was statistically checked using the ANOVA and post hoc techniques. Findings: The present study identified the traces of EA and created a comprehensive understanding of it. The present study manifests the prevailing practices of EA in society by discussing the demerits of dependency and modernization. Moreover, the present study assesses the pervasiveness and the repercussion of dependency and the impact of modernization on EA followed by a discussion on how the victim elders may handle the situation. In the present study, a scale is developed to identify EA because of the dependency of the elderly and the modernization of society. Originality/value: Some exclaiming thoughts such as the dependency of elders elevate the chances of EA on one side, while modernization of society hampers the social/family bonding leading to EA. The inconsistent development across the region has created modernization as a significant factor for EA. The level and depth of modernization across locations such as metro, non-metro and religious cities are the cause for varying degrees of EA. Based on the literature review, the present study has sensed the presence of EA in society at large by developing a scale for the aforesaid purpose. [ABSTRACT FROM AUTHOR]

stair climbing creates demands on activity of daily living, the ability to do it efficiently is important to an individual's quality of life. The biomechanical variation due to architectural barrier can cause changes on stair gait as a result of pain and/ or modifications on the range of motion. Objectives: (i) To measure kinematic knee ROM using coach's eye feedback tool, (ii) To identify the normal tread depth and riser height in relation to normal kinematics. Methodology: A group of 30 subjects including male and female having knee pain with the mean age 41.75 (±5.784) were analyzed. The groups underwent kinematic analysis while climbing up the stairs by step over step pattern in their own storey buildings. Reflective markers were attached. Videos were captured in the sagittal plane by the video recorder utilizing the coach's eye feedback tool. The level of pain was measured using visual analogue scale. Results: ROM over Riser--Height (r=0.8816, strong positive correlation), ROM over Tread--Depth (r=0.0933, weak positive correlation), ROM over VAS Score (r=0.694, moderate positive correlation). Conclusion: Stair dimensions, therefore, appeared to influence the angular kinematics of the lower limb during stair climbing. [ABSTRACT FROM AUTHOR]

Context: There is a need for a simple screening method for the detection of anemia that can be used by public health workers in the field. Aims: The aim of this study was to compare two methods for hemoglobin estimation, i.e., automated hematology analyzer and Digital Hemoglobinometer, and to find out the sensitivity and specificity of Digital Hemoglobinometer for the estimation of hemoglobin. Subjects and Methods: A hospital-based cross-sectional study was carried out for 6 months from April to September 2017 in a District Hospital of five High Priority Districts of Madhya Pradesh. Two hundred and sixty antenatal females per district were selected for the study. Results: The mean hemoglobin by autoanalyzer is 10.19, and that by Digital Hemoglobinometer device is 9.89. Overall, sensitivity of Digital Hemoglobinometer for hemoglobin estimation was calculated to be 89.4% and specificity was calculated to be 63.6%. Positive predictive value was found to be 82.6% and negative predictive value was 75.8% compared against AutoAnalyser (gold standard). Conclusions: As the Digital Hemoglobinometer device has high sensitivity and specificity and good diagnostic accuracy, it must be used at the community level in resource-poor setting for hemoglobin estimation. In primary health-care conditions, Digital Hemoglobinometer can significantly reduce misdiagnosis of anemia compared with clinical assessment alone. [ABSTRACT FROM AUTHOR]

Background: There has been little research conducted within developing nations examining the link between knowledge and diet-related perceptions and behaviors. In addition, prior investigations have rarely examined interrelationships between knowledge and other nutrition-related factors. Purpose: This study explored the relationship between nutrition knowledge, social/ informational factors, and diet-related outcomes among Indian adults with multiple chronic conditions. Methods: A snowball sampling technique was employed to recruit individuals. Hierarchical regression analysis was employed to examine mediating and moderating relationships. Results: Results from a cross-sectional survey indicated that knowledge only predicted use among those reporting greater pressure/concern from close others. Furthermore, social support and social trust were found to moderate the relationship between knowledge and diet-related perceptions and behaviors. Discussion: Results suggest that social factors may play a critical role in moderating the impact of nutrition knowledge on diet-related perceptions and behaviors. Translation to Health Education Practice: Public Health Education interventions targeting developing nations should aim to maximize consumers' nutrition knowledge while identifying valued close others who can help encourage positive health action. Furthermore, Health Educators as well as government and local communities must engage in outreach efforts to reinforce or, if necessary, change public perceptions regarding the food industry. [ABSTRACT FROM AUTHOR]

Many Indians is moving to other nations of the world in the search of employment, education or other reasons. The process of globalization along with the faster mode of traveling and communication has facilitated this movement in the hope of getting more opportunities and earning of easy money abroad, than in India. Unfortunately, sometimes they meet a tragic end and their families in India get only their dead bodies back from abroad. This study focuses on these kind of unfortunate tragic events faced by Indians in different countries and thereby raise a concern on their safety abroad and necessitate the need of relooking in to the quality of medical certification of death and medico legal investigations to find out the real reasons of deaths to avoid any kind of doubt in mind. Data was collected from medical death certificates and passports of the deceased Indians. There was a total of 711 dead bodies/human remains received in 2012 at IGI airport New Delhi. The Middle East countries together contributed a total of 398 (55.98 %) cases. The distribution as per manner of death shows that in maximum number of cases (269), the manner of death was ambiguous with unspecified aetiology. The study therefore recommends for upgradation of the level of medico legal investigations in form of 2nd autopsy in recipient country and proper medical death certification. [ABSTRACT FROM AUTHOR]

Background and objectives: Platelets are a source of numerous growth factors which facilitate repair and healing. Thus platelet rich plasma has been increasingly used as a treatment modality in the field of reconstructive surgeries for wound healing. This preliminary study was carried out to explore whether platelet growth factors from platelet rich plasma could be used for enhancement of split thickness skin graft survival. Materials and Methods: Twenty patients (13 males and 7 females) requiring split thickness skin graft for various clinical reasons were enrolled in the study. Platelet rich plasma was collected by apheresis and frozen at −80° C. It was thawed at room temperature immediately before its intended application. PRP was applied only on one half of the wound, while another half served as control. Patient was followed for 6 weeks. The effect was assessed at first dressing in terms of graft uptake and subsequently as time taken for complete healing. Results: There was 100% uptake of the graft in the area where platelet rich plasma was applied. In the control area, there was complete graft loss in 4 cases, partial loss in 7 cases and complete uptake in 9 cases. Conclusion: This study demonstrated promising results on application of PRP to split thickness skin grafts. Further randomized studies with greater sample size may be undertaken to establish platelet rich plasma as a validated treatment modality. [ABSTRACT FROM AUTHOR]

While increased serum phosphate concentration is a significant risk factor for vascular calcification, it is unclear whether serum phosphate is also a risk factor for increased arterial wall thickness in chronic kidney disease (CKD) patients. Using B-mode ultrasonography, we examined carotid intimal-medial thickness (CIMT) of CKD patients and analyzed risk factors for increased IMT with regard to the effect of serum phosphate. One hundred patients were enrolled (73 patients without diabetes, 27 patients with diabetes; 57 men, 43 women; age, 46.2 ± 15.3 years). CIMT of patients with diabetes was significantly greater than that of patients without diabetes (0.78 ± 0.250 versus 0.66 ± 0.178 mm; P < 0.0001). For the group of all patients, CIMT correlated strongly and significantly with serum phosphate (r = 0.911; P < 0.001). In multiple regression analysis serum phosphate level (β = 0.356; <0.0001) was found to be a significant independent risk factor for increased CIMT, in addition to other independent risk factors, including advanced age, higher systolic blood pressure, urinary albumin and the presence of diabetes (R2 = 0.956; P < 0.00001). In conclusion, high serum phosphate level is a significant and independent factor associated with advanced arteriosclerosis in CKD patients with and without diabetes in addition to advanced age. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to identify causes of maternal mortality at the facility and to assess the standard of care, deficiencies in health services and preventability of these deaths using facility-based maternal death reviews. Material and Methods This was a prospective study at a tertiary care hospital that included all women who died during pregnancy or within 42 days of being pregnant during 2005-2010. Results A review of 296 maternal deaths revealed that 59% of these occurred in medical wards. Indirect maternal deaths (54%) outnumbered the direct deaths (46%). Main causes were hepatitis (18%), hemorrhage (10%) and puerperal sepsis (10%). Only 5% of the women had received antenatal care at the facility. One-third (34%) were referred from other centers. The majority (74%) were critically sick at admission. Most of the women (62%) died postpartum. Substandard care and deficient health services were identified in 8% and 20% of the cases, respectively. Sixteen (5%) maternal deaths were deemed preventable and another 36 (12%) possibly preventable. Since most of the preventable deaths (12/16) were due to hemorrhage, measures to control postpartum hemorrhage were promoted at the facility. Findings of the maternal death reviews were regularly conveyed to the State Health Department for prioritization and resource allocation to prevent maternal mortality. Conclusion More maternal deaths occurred in the medical than in the obstetrics wards at the facility. The leading causes were hepatitis, hemorrhage and puerperal sepsis. Most of the deaths were non-preventable as the women were critically sick at admission; however, substandard care and health service deficiency were contributory in some of the cases. [ABSTRACT FROM AUTHOR]

Background: Several population based studies have demonstrated an association between hypo.or hyperthyroidism and dementia in last two decades. As a consequence, thyroid stimulating hormone has become part of the screening laboratory test for dementia. Aim: The aim of the present study was to evaluate the association between thyroid function and Alzheimer's disease (AD) and vascular dementia (VaD) and to determine the risk of AD and VaD in clinically euthyroid patients. Materials and Methods: A cross.sectional hospital based study was carried out in subjects diagnosed with AD/VaD and were assessed for thyroid status as routine screening test. Results: Free T3, free T4 and TSH were studied in 114 AD patients (mean age: 65 years), 35 VaD patients (mean age: 62 years) and 105 control subjects (mean age: 62 years). In AD group, TSH levels were significantly lower than controls (P = 0.00) and for each unit increase in TSH level, the odds of having dementia decreased by 37.1%. No such relation was seen in VaD. Conclusion: The results suggest a consistent association of subclinical hyperthyroidism and AD. [ABSTRACT FROM AUTHOR]

Background: Children with idiopathic nephrotic syndrome (INS) are at risk of hearing impairment due to nephrotoxic drugs and biochemical impairments. Methods: Forty children with INS aged 5-16 years [20 patients with frequently relapsing nephrotic syndrome (FRNS)/steroid dependent nephrotic syndrome (SDNS) and 20 with steroid resistant nephrotic syndrome (SRNS)] and 20 normal healthy controls were enrolled in this study. Pure tone audiometry was done using the ALPS AD 2000 audiometer. Sensorineural hearing loss was diagnosed when the bone conduction level was >20 dB and the difference in air to bone gap was ≤15 dB. Based on the air conduction (AC) threshold, deafness was graded into the following categories: mild (26-40 dB), moderate (41-55 dB), moderately severe (56-70 dB), severe (71-91 dB) and profound (>91 dB). Results: Children with FRNS/SDNS had a higher threshold for hearing at frequencies of 250 and 500 Hz, respectively, than the controls. Of the children in the FRNS/SDNS category, three (15 %) had mild sensorineural hearing impairment. These children had a low serum calcium level ( P < 0.03) and received higher cumulative doses of furosemide ( P < 0.04). Children with SRNS had a higher threshold for hearing at frequencies of 250, 500, 1,000, and 2,000 Hz, respectively, than the controls. Of the 20 children with SRNS, ten (50 %) had sensoineural hearing impairment (8 mild, 2 moderate). Children with SRNS with a hearing defect had received a higher cumulative dose of furosemide ( P < 0.03). Conclusions: Children with FRNS/SDNS and SRNS are at risk of sensorineural hearing impairment. The risk factors associated with this impairment were higher cumulative doses of furosemide and hypocalcemia. Larger prospective cohort studies are required to evaluate this association. [ABSTRACT FROM AUTHOR]

The article focuses on a study which examined the prevalence of women at risk for peripartum depression and the associated risk factors in the Indian population. The study included 506 peripartum women who were interviewed using Edinburgh Postnatal Depression Scale (EPDS). Study authors found that the birth of female child, nuclear family structure and poor marital relationship are significantly associated with peripartum depression.

Background: Transfusion-transmissible malaria (TTM) is a major concern in malaria endemic countries. A study was therefore conducted to know sero-prevalence of malaria in blood donors and the risk of TTM to multi-transfused patients at our hospital. Materials and Methods: Study subjects were: eligible blood donors (n = 1000), donors deferred due to history of fever in the last 3 months (n = 100), and multi-transfused patients (n = 200). Screening for malaria was done by slide microscopy, immunochromatographic rapid diagnostic test (RDT) for malaria antigen, and anti-malaria antibody by enzyme linked immunosorbent assay. Results: Malaria antibody prevalence in eligible donors and donors with history of fever, thalassemia patients, and in other multi-transfused patients was 16.9%, 22%, 6%, and 15%, respectively. None of the donors were positive for malaria on microscopic examination. None of the blood donors except one donor with history of fever, tested positive with RDT. Conclusion: Malaria antibody prevalence in blood donors at our center is high. As blood units donated by such donors have high-risk potential, special processing may be undertaken to reduce the risk of TTM. [ABSTRACT FROM AUTHOR]

Background: Apart from inhibitor development in patients with hemophilia (PWH) the old problems of blood borne viral infections and red cell alloimmunization still persist in PWH from developing countries. This study was planned to detect the presence of inhibitors in our PWH and to determine the presence of transfusion transmitted infections (TTI) markers and clinically significant red cell alloantibodies in these patients. Materials and Methods: One hundred fourteen PWH were screened for various laboratory tests. Screening for inhibitors was done by mixing study. Blood grouping, TTI testing and red cell alloantibody detection were done as per the departmental standard operating procedures. Results: Out of 114 patients evaluated 98(86%) had hemophilia A and remaining 16(14%) had hemophilia B. Five (5.1%) patients of hemophilia A were positive on inhibitor screening. On Bethesda assay, one patient was high responder (14.4 BU/ml) and rest 4 were low responders (<5 BU/ml). Overall, 19 PWH were positive for TTI markers and two had clinically significant red cell alloantibody (anti-E and anti-Jk b ). Conclusion: This is probably first comprehensive study from our state on laboratory testing in PWH. The specialty of Transfusion Medicine can be a core part of hemophilia care. The overall prevalence of inhibitors in our hemophilia A patients was 5.1%, which is less as compared to majority of published studies. [ABSTRACT FROM AUTHOR]