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Goa, a biodiversity hotspot, is also a major iron ore producing state in India. This study investigated total heavy metal (HM) contamination in 65 georeferenced soil samples through inductively coupled plasma atomic emission spectrophotometer (ICP-AES) for assessing risk of mining activity on agricultural soils. The mean concentrations of copper (Cu), zinc (Zn), lead (Pb), nickel (Ni), chromium (Cr), cadmium (Cd), manganese (Mn), iron (Fe) and cobalt (Co) were 125.60, 75.60, 96.40, 51.20, 69.30, 25.77, 2091, 162638 and 21.20 mg kg−1, respectively. Lower pH, higher organic carbon (OC) and fine-textured soil augmented metal accumulation processes. Boxplot of geoaccumulation index (Igeo) values indicated that lead (Pb) metal had more variation in the study area. Mean Igeo values of metals in descending order are Fe (4.24) > Mn (3.08) > Cu (2.84) > Co (2.47) > Pb (1.85) > Cd (0.7) > Zn (0.58) > Ni (0.45) > Cr (0.16). Mean values of modified degree of contamination (mCdeg) (10.4) and pollution load index (PLI) (6.19) revealed high contamination with deteriorating soil quality. Combined approach of correlation, principal component (PC) and cluster analysis indicated the source of origin by describing association of metals with Fe. PC biplot showed that impact of mining was more on lowland agro-ecosystem rather than natural due to slope factor which led to clogging of pores by mining overburden mixed soil deposition from uphill as evidenced from the presence of waterlogged fallow lands. Fuzzy k-mean clustering yielded three contamination zones (CZs) of low (CZ2), moderate (CZ1) and high (CZ3) degree of contamination. The CZs-based site-specific land management plan might lead to a sustainable ecosystem through coexistence of both mining and agricultural activity by arresting contamination and restoring fallow lands. [ABSTRACT FROM AUTHOR]

Gastrointestinal Stromal Tumours (GISTs) are rare tumours of the Gastrointestinal Tract (GIT), consisting of <1% of all primary GIT neoplasms. Recent studies show an increased incidence, which may be due to improved diagnostic facilities. In contrast to the literature's judgement and the findings of many Western research, which state that the stomach is the most common place, it was observed that the small intestine was more common. Consequently, the goal of this case series was to characterise the clinicopathological, histomorphological, and immunohistochemical spectrum of GISTs as well as their risk categorisation in accordance with the modified Miettinen and Lasota's algorithm. Eight patients with GISTs diagnosed between January 2017 and December 2020 at tertiary care centre of Gujarat, India are presented in this case series. There was one young woman among the patients, others were middle or old age male or female and had a median age of 58.5 years. The most typical presentation was abdominal pain, albeit in one instance it was an unexpected discovery. One example of extra Extra GISTs (EGIST), where there were several retro and intraperitoneal masses, and one small intestinal GIST each had lymphoma as the tentative clinical diagnosis. Predominant spindle cell morphology was observed in contrast to other studies. Even if molecular studies are not available in resource-limited countries, the basic Immunohistochemistry (IHC) panel is the most useful in the final diagnosis. Risk stratification criteria are helpful for prognostication and further management with the use of appropriate targeted therapies. [ABSTRACT FROM AUTHOR]

Graft loss and rejections (acute/chronic) continue to remain important concerns in long-term outcomes in kidney transplant despite newer immunosuppressive regimens and increased use of induction agents. Global guidelines identify the risk factors and suggest a framework for management of patients at different risk levels for rejection; however, these are better applicable to deceased donor transplants. Their applicability in Indian scenario (predominantly live donor program) could be a matter of debate. Therefore, a panel of experts discussed the current clinical practice and adaptability of global recommendations to Indian settings. They also took a survey to define risk factors in kidney transplants and provide direction toward evidence- and clinical experience-based risk stratification for donor/recipient and transplant-related characteristics, with a focus on living donor transplantations. Several recipient related factors (dialysis, comorbidities, and age, donor-specific antibodies [DSAs]), donor-related factors (age, body mass index, type -- living or deceased) and transplantation related factors (cold ischemia time [CIT], number of transplantations) were assessed. The experts suggested that immunological conflict should be avoided by performing cytotoxic cross match, flow cross match in all patients and DSA-(single antigen bead) whenever considered clinically relevant. HLA mismatches, presence of DSA, along with donor/recipient age, CIT, etc., were associated with increased risk of rejection. Furthermore, the panel agreed that the risk of rejection in living donor transplant is not dissimilar to deceased donor recipients. The experts also suggested that induction immunosuppression could be individualized based on the risk stratification. [ABSTRACT FROM AUTHOR]

Evaluating sustainable land management (SLM) practices have regional to worldwide implications. It is imperative to develop SLM under particular soil type, climate, and cropping sequence following area‐specific best management practices to harness maximum profitability. The alternative land‐use system (ALUS—natural forest, pasture, cashew, areca nut, coconut) on hills and agricultural land‐use system (AGLUS—rice–rice, rice–pulse) in the coastal plains of Goa State in west coast India were evaluated in this study. This study assessed the impact of sustainable land‐use management practices on different fractions of soil organic carbon (SOC), its stock, and soil quality index (SQI) under the ALUS and AGLUS. The total SOC stocks under different land‐use systems varied from 14.4 Mg C ha−1 in rice–rice rotations to 133.7 Mg C ha−1 in cashew. The lability index, available nutrients, and biochemical properties were higher in ALUS. The variation in the levels of SOC and soil quality was due to land use and management practices. The results indicated land use with areca nut (SQI = 0.8) on the hills and rice–pulses (SQI = 0.25) rotations on the coast had maintained soil quality of high order. We recommend promoting sustainable agriculture with ALUS on the hills and AGLUS on the coastal plains of Goa State to enhance SOC storage, improve soil quality, and increase farmers' income. [ABSTRACT FROM AUTHOR]

COVID has drastically impacted organ donation across the world, leading to untold misery for thousands of patients who have been waiting for organs. Early rules on the use of organs from COVID positive or affected donors were stringent due to the fear of spread of disease or thrombotic complications in patients who received these organs. However much has changed in the past two years. Most of our adult population has either been infected with COVID, or has received two doses of vaccine, or both. The current variant, despite being more infective, is associated with mild disease, especially in those who have been vaccinated Our armamentarium against severe COVID has improved dramatically in the past year- we have effective vaccines, monoclonal antibodies for treatment of mild COVID in high risk patients and post exposure and antiviral prophylaxis and treatment which can substantially reduce the risk of severe COVID requiring ICU admission. The risk of transmission of COVID infection has to be balanced against the risk of patients dying with end organ disease. We will have to learn to live with COVID- this also means investigating whether organs from donors who are, or have been COVID positive can be used with acceptable risk-benefit in selected patients with end stage organ failure. This document is a summary of evidence and information regarding donor screening for SARS-CoV-2 and considerations for organ acceptance from donors with a history of COVID-19. [ABSTRACT FROM AUTHOR]

Case studies were conducted on eight serial killers in India who were inmates in central prisons of Kerala and Tamil Nadu. The study is a pioneering one on serial killers in the locale of the study. All available information about the lives of offenders were collected through multiple sources, including in-depth interviews with serial killers in the prisons, interviews of relatives of the killers, surviving victims, Investigators, crime scene studies, etc. The collected data have been chronologically arranged to construct biographies of the offenders. The rich biographies were carefully analyzed to construct an inclusive motivation model that can explain the process of individuals evolving into serial killers from a life-course approach. The motivation in each of the eight cases was explained with the proposed motivation model. The constructed motivation model is unique from the existing models, which were mostly rigid and, therefore, not applicable to cases outside the studies. The model proposes three critical determinants for explaining the evolution of a person into a serial killer, "nature," "Deep Resting Life Factor," and "key Incidents." The study found a relatively short incident named "trigger" in the lives of six serial killers, which played a significant role in bringing out the dormant killer instinct and push the subjects toward the first murder. The comparative analysis of the motivation in different cases revealed that though there were recurring factors in the lives of serial killers, their interactions were more important than standalone factors. The study also found that there are no predetermined recipes for the making of a killer like some past researchers claimed. [ABSTRACT FROM AUTHOR]

Recent years have shown a significant increase in the occurrence of floods globally, with an impact on habitation and different sectors of the economy. This, in turn, necessitates the use of different flood mitigation strategies, wherein flood vulnerability assessment plays a significant role. The proposed work presents a methodology that combines vulnerability under physical-environmental and socio-economic domains to assess the overall flood vulnerability at the local self-government level. The methodology was illustrated to the case of Aluva municipality, located on the banks of River Periyar, in Kerala state, India. The spatial variation of hazard inducing factors and population statistics were analysed using Geographic Information System (GIS) tools. The machine learning algorithm, Random Forest, which uses hazard inducing factors as input was implemented for the evaluation of physical-environmental vulnerability. The social vulnerability of the region was analysed using the GIS Multi-criteria decision analysis approach (MCDA), with criteria weights to incorporate the interests of different stakeholders. The critical combinations of the two domains of vulnerability in the assessment of the vulnerability to flood, to have efficient flood management in local self-government was demonstrated in this study and can be made use of for any flood event. [ABSTRACT FROM AUTHOR]

Substances of abuse include alcohol, nicotine, cannabinoids, opioids, sedatives, volatile solvents, stimulants, and hallucinogens. With the increasing prevalence of drug abuse in India, intensivists are likely to encounter more cases of intentional and accidental poisoning due to drugs of abuse. We aim to sensitize the intensivists to challenges involved in diagnosing and treating poisoning with drugs of abuse. We also aim to provide a hands-on primer that can augment the usual protocols of "approach to life-threatening poisoning". A toxidrome approach along with urine drug testing can help in speedily arriving at a diagnosis and instituting definitive treatment. In this article, we discuss spurious alcohol poisoning (methanol poisoning), benzodiazepine, opioid, and stimulant poisoning in detail and poisoning due to other substances including newer psychoactive substances is discussed briefly. [ABSTRACT FROM AUTHOR]

Introduction: The use of smartphone is increasing day by day for personal as well as professional purpose. They are becoming a more suitable tool for advancing education in developing countries. Mobile access to information and many applications are successfully harnessed in health care. Smartphones are also becoming popular as an effective educational tool. Aim: The present study was conducted to evaluate the use of smartphones as an educational tool amongst the medical students. The study also aimed at identifying the common medical application used by the students. Materials and Methods: It was an observational cross-sectional study carried out amongst medical students of private medical institute in India. A validated 16 point, structured, open-ended, questionnaire regarding ownership and use of smart phones was self-administered to 446 medical students. Data were analysed using SPSS and open ended questions were analysed by summative content analysis. Results: Among the study population, 96% owned a smartphone -Android based 72.4%, i phone 13.0%, Windows based Nokia phones 7% and Blackberry 3.6%. Common medical applications used by the students were Anatomy and Medical Dictionary in First MBBS; Medical Dictionary, Medscape and Google/Wikipedia in Second MBBS; and Medscape, Google/ Wikipedia and Prognosis/Diagnosis in Third MBBS. More than 90% students, reported to have technological skills to use smartphones, for medical education, communication and instant access during bedside teaching. Advertently, 37.2% students felt if smartphones are used for clinical purposes, they will need to spend less time with patients. Almost 79.4% felt that smartphones should be introduced in MBBS course. Conclusion: Smartphone use amongst medical students as learning aid for various medical applications is rapidly advancing. But it will be worthwhile to study whether use of smartphones has any impact on the grades of the students before introducing them in medical schools. [ABSTRACT FROM AUTHOR]

Background: Through this cross-sectional study, we examined the demographic parameters, comorbidities, and antiepileptic drug (AED) utilization in patients with epilepsy.Materials and Methods: We collected data of 973 adult patients with epilepsy and analysed AED utilization according to the epilepsy type, age group and gender.Results: The study included 973 patients (males, 61.3%) with a mean age of 35.6 years. Only 3.6% patients were not educated whereas 45.3% patients were employed. Only 1.2% patients had a history of brain injury. The mean frequency of seizures during the previous 6 months was 24.0 ± 49.1 whereas the mean duration of epilepsy was 5.8 ± 5.8 years. Electroencephalogram was the most common (59.7%) investigation performed. A total of 109 (11.2%) patients had comorbid medical illness, with hypertension being observed in 3.3% patients. Levetiracetam was used in 583 (59.9%) patients whereas valproate, clobazam, and phenytoin were used in 16.3%, 14.8%, and 13.6% patients, respectively. Effectiveness and safety/tolerability profile were the two most important considerations for selecting the AED. A total of 924 (95%) patients had seizure control with the current therapy during the previous 6 months whereas the mean seizure-free interval was 7.1 ± 4.1 months. Levetiracetam was used in 34.9%, 45.7%, and 61.1% patients and valproate in 15.2%, 10.9%, and 4.6% patients in the age group of 18-30, 31-50 and 51-75 years, respectively. Levetiracetam was used in 57.7% and 63.4% whereas valproate was used in 19% and 12.2% male and female patients, respectively. The adverse event rate was only 0.1%.Conclusion: Epilepsy is common in adult patients. Hypertension is the most common comorbidity. Levetiracetam is the most commonly used AED across all studied age groups and both genders. Control of epilepsy with current treatment is satisfactory with no major adverse events. [ABSTRACT FROM AUTHOR]

A Helical Tomotherapy (HT) Hi-Art II machine, Hi ART (TomoTherapy, Inc., Madison, WI, USA) was installed at our center in July 2007, and was the first machine in India. Image-guided HT is a new modality for delivering intensity modulated radiotherapy (IMRT). Dosimetric tests done include (a) primary beam alignment (b) secondary beam alignment (c) water tank measurements (profiles and depth doses) (d) dose rate measurements (e) IMRT verification, and (f) Mega voltage Computed Tomography (MVCT) dose. Primary and secondary beam alignment revealed an acceptable linear accelerator (linac) alignment in both X and Y axes. In addition, it was observed that the beam was aligned in the same plane as gantry and the jaws were not twisted with respect to gantry. The rotational beam stability was acceptable. Multi-leaf collimators (MLC) were found to be stable and properly aligned with the radiation plane. The jaw alignment during gantry rotation was satisfactory. Transverse and longitudinal profiles were in good agreement with the "Gold" standard. During IMRT verification, the variation between the measured and calculated dose for a particular plan at the central and off-axis was found to be within 2% and 1 mm in position, respectively. The dose delivered during the TomoImage scan was found to be 2.57 cGy. The Helical Tomotherapy system is mechanically stable and found to be acceptable for clinical treatment. It is recommended that the output of the machine should be measured on a daily basis to monitor the fluctuations in output. [ABSTRACT FROM AUTHOR]

Seagrass beds are important marine ecosystems that provide significant ecological services. The global decline of seagrass beds is becoming severe due to the increasing pressure of human-induced factors and changing climatic conditions. Restoration of seagrasses is an evolving science that started in 1939. In this study, we report a remarkably successful restoration activity carried out in the Gulf of Mannar (GoM), Southeast India. This is the first wide-scale effort in Indian waters. After the initial experimentation, manual transplantation of seagrass sprigs was carried out near Vaan and Koswari islands in GoM. Transplantation was performed with PVC quadrats and jute twines in areas of 800 m2 in both the islands during February to May 2014. An increase from 16.4 ± 0.3 to 32.3 ± 0.6% in Vaan and from 15.1 ± 0.2 to 35.1 ± 0.9% in Koswari was observed in seagrass percentage cover during the period from June 2014 to May 2016. Area cover, shoot density, macrofaunal density and fish density increased at the restoration sites after the transplantation. Bottom trawling was found to be the most serious threat to the seagrass beds in these islands. This method of transplantation can be replicated in other areas of degraded seagrass in India to carry out wide-scale restoration of seagrasses. [ABSTRACT FROM AUTHOR]

The effect of coronavirus disease 2019 (COVID-19) on a developing nation is sparsely reported and, more importantly, the discrepancies in public and private sectors are underexplored. We retrospectively investigated the data on the effect of COVID-19 on renal transplantation between 2019 and 2020 in a nationwide analysis from 8 public and 10 private sector hospitals of India. On comparing the yearly data, the number of living-related transplants and deceased donor transplants declined by 48% (2610 vs 1370) and 49% (194 vs 99), respectively. The outpatient numbers and in-center admissions decreased by 40.4% (616,741 vs 367,962) and 30.8 % (73,190 vs 49,918). respectively. There was no increase in the number of renal or graft biopsies in the COVID-19 era. The number of waitlisted patients on hemodialysis was higher in public (304,898 vs 338,343) when compared with private (163,096 vs 150,292) in the last 2 years. Similarly, the number of waitlisted patients on peritoneal dialysis (4655 vs 3526) was higher in the public sector compared with private sector (932 vs 745). The decline in living transplants during the pandemic was higher in public sectors (58%) compared with the private (49%). However, the decline in deceased donation was higher in private (57.9%) relative to public (50.6%). COVID-19 has adversely affected the transplantation activities across the Indian transplantation centers, with a disproportionately higher impact on waitlisted patients in public sector programs. A sound prioritization of health care resources is mandated to safeguard the most deprived and high-risk waitlisted patients during the pandemic. [ABSTRACT FROM AUTHOR]

Azadirachta indica (neem) is a unique, versatile and important tree species. Many parts of the plant are traditionally used as pesticide, insecticide, fungicide and for other medicinal purposes. Azadirachta fruits and seeds, a good source of oil, are widely used for agriculturally important pest management. Neem oil and its derivatives also support multiple cottage industries in India. Past efforts have been mostly concentrated towards identifying, characterizing and synthesizing one of its principal components, i.e. azadirachtin from seed kernels. Despite diverse use of the neem plant, a modern drug-development programme which systematically exploits the therapeutic ability of Azadirachta fruits remains to be fully established. Next generation sequencing technology that helps decode genomes and transcriptomes has transformational impact on medicine, agriculture, bio-fuel and biodiversity studies. Here, we report sequencing, assembly and analysis of Azadirachta fruit transcriptome using next-generation sequencing technology. We believe that our study shall offer valuable insights towards realizing the larger vision of understanding the key medicinally active compounds and their pathways. [ABSTRACT FROM AUTHOR]

We investigated spatiotemporal variations of microplastics (MPs) in Coromandel Coast, Palk Bay, Gulf of Mannar, and West Coast of Tamil Nadu, India. MPs abundance varies from 37 ± 1.52 to 189 ± 9.02 items/kg in sediment and 23 ± 15.25 to 155.25 ± 4.16 items/L in water. Highest abundance in monsoon by riverine inflow transports plastic waste to the ocean. MPs sizes 0.5-1 mm are dominant in summer with 16 polymers, while 3-4 mm dominates the monsoon with 23 polymers. Carbonyl Index shows high MP oxidation (>0.31), unrelated to spatiotemporal changes. SEM-EDAX shows weathered MPs carrying hazardous metals. High MP diversity (MPDII = 0.77) of Coromandel Coast points to many sources of pollution and the need for immediate control measures. Pollution load values indicate low degree of MP pollution (<10), polymer hazard index shows level III (10-100) and IV (100-1000), and ecological risk assessment shows minor risks (<150) at present., Competing Interests: Declaration of competing interest This is to inform that the authors have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Estuaries are transition zones between freshwater and seawater. There are only few studies on microplastic (MPs) pollution in estuaries. In this study, investigating the spatiotemporal variations of MPs in water, sediment and biota samples of 19 estuaries in Tamil Nadu, India, we assessed the chemical and human exposure risks of MPs. MPs extracted by digestion and density separation and characterized them using microscope, Fourier transform infrared spectroscopy and scanning electron microscopy with energy dispersive analysis of X-rays. MP abundancesin summer and monsoon range from 31.7 ± 3.8 to 154.7 ± 4.2 items/L in water and 51.7 ± 3.6 to 171.4 ± 9.1 items/kg in sediment. Highest MPs abundance is found in water and sediment of the urbanized Adayar estuary. MP levels are higher in monsoon than in summer (P < 0.05) due to the discharge of wastewater via storm water outlets. More small-size MPs are found in summer (<0.5-1 mm) while monsoon has a greater diversity of MP polymers (MPDII: 0.81). MP abundance in fish varies from 0.01 ± 0.003 to 0.15 ± 0.03 items/g, and in shellfish from 0.75 ± 0.12 to 9.7 ± 0.28 items/g. In fish, more MPs are found in intestine than in gill or muscle. Shell fishes contain more MPs than fishes. In all the matrices, fibers of different sizes, and polymers of polyethylene and polypropylene are commonly found. An average local person is likely to ingest 781 items of MPs via fish and 2809 items via shellfish annually. Polymer hazard index shows hazard levels of IV to V indicating the serious MP pollution trend, which poses a risk to the biota. In conclusion, MPs observed in this study show that estuaries are a major pathway for land-derived plastics to reach the ocean. The results will help implement remedial/clean-up measures for the estuary for better ecosystem conservation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: There is limited current knowledge on feasibility and safety of kidney transplantation in coronavirus disease-19 (COVID-19) survivors., Methods: We present a retrospective cohort study of 75 kidney transplants in patients who recovered from polymerase chain reaction (PCR)-confirmed COVID-19 performed across 22 transplant centers in India from July 3, 2020, to January 31, 2021. We detail demographics, clinical manifestations, immunosuppression regimen, laboratory findings, treatment, and outcomes. Patients with a previous diagnosis of COVID-19 were accepted after documenting 2 negative severe acute respiratory syndrome coronavirus 2 PCR tests, normal chest imaging with complete resolution of symptom for at least 28 d and significant social distancing for 14 d before surgery., Results: Clinical severity in patients ranged from asymptomatic (n = 17, 22.7%), mild (n = 36.48%), moderate (n = 15.20%), and severe (n = 7.9.3%) disease. Median duration between PCR positive to transplant was 60 d (overall) and increased significantly from asymptomatic, mild, moderate, and severe disease (49, 57, 83, 94 d, P 0.019), respectively. All recipients and donors were asymptomatic with normal creatinine after surgery at a median (interquartile range) follow-up of 81 (56-117) d without any complications relating to surgery or COVID-19. Patient and graft survival was 100%, and acute rejection was reported in 6.6%., Conclusions: Prospective kidney transplant recipients post-COVID-19 can be considered for transplantation after comprehensive donor and recipient screening before surgery using a combination of clinical, radiologic, and laboratory criteria, careful pretransplant evaluation, and individualized risk-benefit analysis. Further large-scale prospective studies with longer follow-up will better clarify our initial findings. To date, this remains the first and the largest study of kidney transplantation in COVID-19 survivors., Competing Interests: The authors declare no funding or conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: There is a scarcity of data on the consequences of coronavirus disease-19 (COVID-19) infections in kidney transplant recipients (KTRs) from emerging countries., Methods: Here, we present a cohort study of 13 transplant centers in India including 250 KTR (226 living and 24 deceased donors) with polymerase chain reaction-confirmed COVID-19 positivity from March 23, 2020, until September 15, 2020. We detailed demographics, immunosuppression regimen, clinical profile, treatment, and outcomes., Results: Median age of transplant recipients was 43 years, and recipients presented at a median of 3.5 years after transplant. Most common comorbidities (94%) included arterial hypertension (84%) and diabetes (32%); presenting symptoms at the time of COVID-19 included fever (88%), cough (72%), and sputum production (52%). Clinical severity ranged from asymptomatic (6%), mild (60%), and moderate (20%) to severe (14%). Strategies to modify immunosuppressants included discontinuation of antimetabolites without changes in calcineurin inhibitors and steroids (60%). Risk factors for mortality included older age; dyspnea; severe disease; obesity; allograft dysfunction before COVID-19 infection; acute kidney injury; higher levels of inflammatory markers including C-reactive protein, interleukin-6 level, and procalcitonin; chest X-ray abnormality, and intensive care unit/ventilator requirements. Overall patient mortality was 11.6% (29 of 250), 14.5% (29 of 200) in hospitalized patients, 47% (25 of 53) in intensive care unit patients, and 96.7% (29 of 30) in patients requiring ventilation. KTRs with mild COVID-19 symptoms (n = 50) were managed as outpatients to optimize the utilization of scarce resources during the COVID-19 pandemic., Conclusions: Mortality rates in COVID-19-positive KTR appear to be higher than those in nonimmunosuppressed patients, and high mortality was noted among those requiring intensive care and those on ventilator., Competing Interests: The authors declare no funding or conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: There is lack of data on feasibility and safety of kidney transplants from living donors who recovered from COVID-19., Methods: Here, we present a retrospective cohort study of 31 kidney transplant recipients (KTR) from living donors who recovered from polymerase chain reaction confirmed COVID-19 across 19 transplant centers in India from July 3, 2020, to December 5, 2020. We detailed demographics, clinical manifestations, immunosuppression regimen, treatment, and outcomes. Donors with a previous diagnosis of COVID-19 were accepted after documenting 2 negative polymerase chain reaction tests with complete symptom resolution for at least 28 days and significant social distancing for 14 days before surgery., Results: COVID-19 clinical severity in donors ranged from completely asymptomatic (71%, n = 22) to mild infection (29%, n = 9). None progressed to moderate or severe stages of the disease in the entire clinical course of home treatment. Patient and graft survival was 100%, respectively, with acute cellular rejection being reported in 6.4% (n = 2) recipient. All recipients and donors were asymptomatic with normal creatinine at median follow-up of 44 days after surgery without any complications relating to surgery and COVID-19., Conclusions: Our data support safety of proceeding with living donation for asymptomatic individuals with comprehensive donor, recipients screening before surgery, using a combination of clinical, radiologic, and laboratory criteria. It could provide new insights into the management of KTR from living donors who have recovered from COVID-19 in India. To the best of our knowledge, this remains the largest cohort of KTR from living donors who recovered from COVID-19., Competing Interests: The authors declare no funding or conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Lysyl oxidase (LOX) is a copper amine oxidase which belongs to the LOX multigene family and is normally involved in cross-linking of stromal collagen fibers. LOX expression has been found to be associated with increased episodes of recurrence, metastasis and overall poor prognosis in renal cell carcinomas and melanomas. This study aimed to assess the effects of LOX on the prognosis of oral squamous cell carcinoma (OSCC), which is one of the most common cancers in India., Methods: The immunohistochemical expression of lysyl oxidase using LOX2 primary antibody was assessed at the tumor proper, invasive tumor front and peritumoral stroma in tissue sections from 40 cases of histologically proven OSCC., Results: LOX expression was elevated in OSCC patients who had lymph node metastasis and in those who died of disease. No significant variation was seen with histological grade., Conclusions: LOX has a 'pro-neoplastic' effect as it modulates the host stroma to favor increasing tumor mass and worsening prognosis. Increased expression of LOX causes increased collagen fiber cross-linkage that stiffens the stromal matrix. This increases compressive stresses contributing to tissue hypoxia that elevates Rho GTPase-dependent cytoskeletal tension leading to erratic tumor cell morphogenesis that in turn confers motility to these cells resulting in metastasis. Inhibitors of LOX can potentially down-regulate LOX levels in the tumor micro-environment by controlling tissue hypoxia and curtailing the production of hypoxic LOX molecules.

Prejudice against gay and lesbian persons remains largely an unaddressed issue in India. This experimental study involved designing, implementing, and assessing the effectiveness of an intervention to foster positive attitudes toward the homosexual community among Indian college students. The experimental group (n = 60) received a three-component module including perspective taking, education, and direct contact with gay and lesbian persons. Attitudes toward homosexuals, empathy, and self-esteem were measured using standardized questionnaires 15 days before the intervention and immediately following the intervention. No intervention was carried out with the control group (n = 55). Their attitudes were measured 15 days apart, parallel to the experimental group. Results showed that attitudes toward homosexuality improved significantly in the experimental group. The control group also showed a significant, but small, improvement in attitudes. Further, levels of empathy were found to increase only in the experimental group. Limitations, future directions, and implications of the study are discussed.

In recent years, more conservative methods of surgery of the renal artery are coming up. Hence, a precise knowledge of renal vasculature has become a necessity. Knowledge of the existence of accessory renal arteries is important; otherwise, they may get inadvertently damaged during renal surgery. Furthermore, their presence must be considered while evaluating a donor's kidney for possible renal transplantation. The study may also be useful to clinicians performing invasive techniques, vascular surgeries, other uro-radiological procedures, and in cases of trauma. Keeping this in mind, this study was conducted on 530 adult cadavers. A total of 1060 kidneys obtained from these cadavers were dissected and accessory renal arteries were looked for; 24.99% of the specimens showed the presence of accessory renal arteries. In 20.75%, one accessory renal artery was found, and in 4.24% of specimens, two accessory renal arteries were seen.

Background: Community-based rehabilitation (CBR) programmes have been described as highly effective means of promoting the rights and opportunities of persons with disabilities (PwD). Although CBR is often the main way in which PwD in low-income and middle-income countries access rehabilitation services, there is little literature providing rigorous evaluation of their impact on people's well-being., Methods: Data were collected in the Mandya and Ramanagar districts (Karnataka state, India), between December 2009 and May 2010. In total 2540 PwD were interviewed using stratified random sampling: 1919 CBR beneficiaries (who joined the programme between 1997 and 2009) and 621 persons who were living in villages not covered by the programme. We controlled for the systematic differences between people joining and not joining the programme using the propensity score matching method controlling for covariates at individual and village level. We evaluated the impact of the programme on the subgroups of PwD who are disadvantaged on the dimensions of interest: access to pensions, use of aid appliances, access to paid jobs and improvement in personal-practical autonomy after 4 and 7 years of joining the CBR., Results: We observed a positive and significant impact of the programme on access to services, rights and opportunities of PwD. The results indicate that compared with the control group access to pensions and allowances, aid appliances, access to paid jobs and personal-practical autonomy increased by 29.7%, 9.4%, 12.3% and 36.2%, respectively, after 7 years., Conclusions: The CBR programme analysed has a positive impact on access to services and the well-being of PwD who are particularly deprived on outcomes of interest., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Chromosomal translocations have been reported in a number of women undergoing cytogenetic studies for amenorrhoea and gonadal dysgenesis. This study was taken up to emphasize the role of X chromosome and to know the frequency of X-autosomal translocations in women with amenorrhoea in Indian population. Cytogenetic analysis was carried out in 1567 subjects referred for amenorrhoea during the period 2002-2012. GTG-banding was performed from peripheral blood lymphocyte cultures to detect the chromosome abnormalities in all the cases. The karyotype results revealed 43.6% cases with chromosomal abnormalities (n = 683 of 1567 cases). The X-autosomal translocations was found in 2.64% (n = 18 of 683 cases). The common chromosomes involved with X were chromosomes 2, 4, 14 and 20. The translocations involved both p and q arms of the X chromosome.The break point "q26" of X was observed in the majority of the cases. Two interesting cases are discussed: one with three way translocation and another with two translocations. A high number of primary amenorrhoea (PA) and secondary amenorrhoea (SA) cases were involved in X-auto translocation which clearly reveals that chromosomal analysis plays an important role in the evaluation of amenorrhoea.

Purpose: In this paper, we measure the effectiveness of Community-Based Rehabilitation (CBR) programmes in promoting the well-being of people with disabilities and removing the barriers to their participation in family and community decision-making processes., Method: To evaluate the impact of the CBR programme, we use data from a large-scale control study in Karnataka, India. Propensity score matching is used to evaluate the impacts on disabled persons after 2, 4 and 7 years of entering the CBR. The theoretical framework for the analysis is based on the CBR guidelines, which are combined with the International Classification of Functionings (ICF), the United Nations Convention on the Rights of People with Disabilities (UN CRPD) and Amartya Sen's capability approach., Results: CBR has a positive impact on the well-being of persons with disabilities participating in the programme and particularly on their participation within the family and the society at large., Conclusions: CBR programmes have a multidimensional and positive impact on individual and collective capabilities; on individual, agency and social empowerment. Implications for Rehabilitation Community-Based Rehabilitation (CBR) can make a lasting difference in the life of persons with disabilities. CBR improves participation and inclusion of persons with disabilities in the family and in the community.

Rubella infection though a mild infection, may cause foetal death or a variety of congenital anomalies. Multiple sero-surveys confirmed that 5-10% women are unexposed to natural or vaccinated rubella virus and remain susceptible to rubella infection. The current study was conducted in 600 girls, aged 18-24 y from Symbiosis International University (SIU), Pune, India to assess their sero-status against rubella infection and to estimate the immunogenicity of rubella vaccine in achieving sero-protective antibody titres. Prior to administration of a single i.m. dose of rubella vaccine (R-vac®) to eligible participants, blood sample (pre-vaccination) was collected. During the 4-6 weeks observation period, adverse events were noted. Then, a second blood sample (post-vaccination) was collected. Significant increase was noted in sero-protection response, viz., 98.6% (post-vaccination) vis-à-vis 66.5% (pre-vaccination); Geometric mean titer (GMT) was significantly higher post-vaccination. Effective measures to introduce rubella vaccination on a larger scale need to be undertaken. An immunization policy with mandatory rubella vaccination for all girls in the reproductive age group and its inclusion in national immunization schedule is highly desirable.

Unlabelled: Abstract Purpose: The aim of this research was to understand the barriers faced by persons with disabilities in their daily lives and the role of CBR projects in overcoming them., Method: A group of persons with disabilities involved in CBR activities was identified and trained in participatory research methodologies. Research was carried out, with support from a scientific advisory group, through sharing of life stories in residential meetings focusing on specific themes. These meetings were attended by 368 persons with disabilities., Results: The barriers identified ranged from isolation, neglect, abuse and violence to lack of access to social, health, education and livelihood opportunities. People faced their first barriers in their own families. Families also played an important role in overcoming some barriers at the individual level. CBR projects assisted people in overcoming barriers mainly by providing information, by facilitating access to existing support and by helping persons in communities to take collective action against the barriers. The research also stimulated DPOs and CBR projects to identify some gaps in tackling the barriers and to start action to overcome them., Conclusions: CBR projects can play a role in overcoming some barriers faced by persons with disabilities. Emancipatory research yields rich data, facilitates ownership and possibly future sustainability. Implications for Rehabilitation Community-based rehabilitation (CBR) programmes can promote mainstreaming and helping in overcoming some barriers faced by persons with disabilities in the communities. CBR programmes can facilitate collective action by persons with disabilities in overcoming barriers to inclusion and participation. Participatory research approaches such as emancipatory research can play a role in understanding disability issues and at the same time, help CBR programmes to identify gaps and strengthen activities.

Objective: To prospectively report and grade the perioperative complications of ureteroscopy (URS) for stone removal using a semirigid ureteroscope with the modified Clavien classification system and to identify the determinants of the complications., Methods: From August 2010 to November 2011, the prospective data from 120 consecutive patients (71 men and 49 women) who had undergone primary unstented URS at a resident training center were analyzed. Patients with renal failure, pyonephrosis, diabetes mellitus, hypertension, and congenital ureteral abnormalities were excluded (n = 29). The data recorded included patient demographics, stone size and location, and complications according to the modified Clavien classification system., Results: Of the 120 patients, 36 (30%) experienced 79 complications. The stone size was ≤ 10 mm in 56 and >10 mm in 64 patients. The stone location was the lower, mid-, and upper ureter in 62, 58, and 3 patients, respectively. The latter 3 were excluded because of the small sample size. Grade 1, 2, 3a, 3b, 4a, and 4b complications were encountered in 46 (38.3%), 18 (15%), 3 (2.5%), 10 (8.3%), 1 (0.8%), and 1 (0.8%) patient, respectively. The incidence of complications was greater for stones >10 mm, a mid- versus distal ureteral location, impacted stones, and surgery performed by a resident. The incidence was not affected by patient sex, stone laterality, or lithotripter type. The patients with complications had a longer operative time (75 vs 46.5 minutes), longer hospitalization (4.8 vs 1.5 days), and lower stone-free rate (64% vs 97%)., Conclusion: Most complications were grade 1-3 (98%), and grade 4 complications were rare (<2%) with URS. The present study is probably the first to prospectively study the complications of URS using the modified Clavien classification system., (Copyright © 2012 Elsevier Inc. All rights reserved.)

A community-based, longitudinal interventional study was conducted in a slum in north-east (NE) Mumbai, using a pretested, semi-structured proforma and a pre- and follow-up interview schedule to assess the male health clinic (MHC) strategy as an approach for the control of sexually transmitted infections (STIs) in males. The focus groups that emerged for behavior change communication (BCC) activities were clients in second and third decades of life, unmarried and married but not staying with wife, clients with no permanent place of occupation, clients with habit of alcohol, and illiterate clients. Postintervention, there was an overall increase in STI knowledge score, alcohol habit score, and high-risk sexual activity score. Less than 50% of the clients received advice on substance abuse and information on consequences of STI/human immunodeficiency virus (HIV). The study concluded that MHC strategy is an effective approach for control of STIs in males and recommended strengthening of the weaker components of the strategy with focus on the important client groups.

A 40 year patient presented with pyrexia of one month duration. Routine work up for fever of unknown origin (FUO) was negative. Bone marrow aspiration and culture done yielded Brucella. Bone marrow cultures are recommended for patients for FUO for whom the routine workup turns out to be negative. Serological tests for brucellosis can be false-negative in some cases of brucellosis due to prozone phenomena.