Search

This paper assesses students' perceptions concerning the level of campus placement activities of their higher education institution (HEI) and determines the order of importance of various factors, as perceived by students, relating to employers' selection criteria. Primary data based on the responses of 621 students in 29 HEIs operating in the National Capital Region of India, were analysed using statistical tools such as average, t-test and Garrett Ranking. The t-test results indicated that students' perceptions across the five demographics under study were significantly different. Further, the Garrett Ranking method revealed that students perceived performance in the interview as the most important factor affecting their selection or rejection by employers during campus placements. The findings should assist educational institutions in formulating an effective campus placement process and students in preparing for their transition to the labor market. Moreover, companies engaging in campus placements will obtain a better understanding of students' perceptions regarding their hiring decisions. The major implication of the study is that the gap in perception between students and employers needs to be bridged through collaboration between HEIs and industry.

Purpose: The COVID-19 pandemic resulted in a dramatic downturn in the global stock markets. Investors look for safe stocks that can provide better risk-adjusted returns. Stocks with higher Environmental, Social, and Governance (ESG) scores can be good choices for investors. This study focuses on this argument by examining the relationship between ESG indicators and stock returns while considering financial and macroeconomic variables. Design/methodology/approach: In this study, 39 non-financial firms listed in Nifty-50, for which data is available, have been included. Panel data from 2018 to 2021 is collected to examine this relationship in the presence of COVID-19. Additionally, the panel regression method is used. Findings: The empirical findings indicate a positive relationship between ESG scores and stock returns. This relationship holds even when the control variables like Return on Assets (ROA), Gross Domestic Product (GDP), Return on Equity (ROE), age, size, leverage of the firm, inflation, and crisis period are used in the model. Originality/value: This study contributes by examining the linkage between ESG indicators and stock return while controlling the impact of the financial and macroeconomic variables in Indian markets, which has not been undertaken so far. Moreover, this is the first study to use the ESG score data of S&P Global, which gives more weight to the material factors of a firm. Peer review: The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-10-2023-0819. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the factors influencing health-related quality of life (HRQoL) in patients experiencing adverse drug reactions (ADRs) at a tertiary care public sector hospital. A cross-sectional study was conducted over a period of 18 months, and included both male and female patients aged 18 years and above. Patients who visited the outpatient and inpatient departments with complaints associated with ADRs were included in this study. HRQoL data were collected using the EuroQol—5 Dimension—5 Level (EQ-5D-5L) questionnaire to assess five dimensions of health on a five-level scale. Descriptive statistics, t-tests, and analysis of variance were used to analyze the data. Multivariate regression analysis was performed to identify the potential determinants of HRQoL. Results: A total of 316 patients were included in the study among these participants, of which 54% were female, and 65% were from rural areas. The majority (68%) of the patients had moderately severe ADRs, and 63% of the participants had an income < 2.5 lakh Indian rupees (3009 USD). The mean EQ-5D-5L and EuroQoL Visual Analog Scale (EQ VAS) scores of the study participants were 0.714 and 69.73, respectively. The variables ADR severity, income, and age showed a significant difference (p < 0.05) in HRQoL. Conclusion: This study provides insights into HRQoL among patients with ADRs and identifies the determinants of HRQoL. The findings of this study will contribute to improving patient-centered care and optimizing patient outcomes. [ABSTRACT FROM AUTHOR]

Sustainable development is essential for the survival of the planet. The massive increase in GHG emissions due to human activities has put the world in unrest. The Indian construction industry is emerging and evolving at a rapid rate and has understood the grave situation, and for saving the environment has come up with innovative solutions for developing green buildings or sustainable construction. In this paper, the two different (the GRIHA Rating System and the IGBC Green New Building Rating System) of India were studied. The sample size was 40 construction professionals working on green building projects. An interview schedule was used for data collection. The data was subjected to a suitable analysis and the AHP method was applied. Based on the research findings, strategies to go green has been suggested for the IGBC and GRIHA rating system which may serve as a ready reckoner for enhancing the effectiveness and efficiency of the construction management process. Therefore, keeping in mind the above view this research paper "Review of Indian Green Building Rating Systems by Using Analytical Hierarchy Process (AHP) on Various Parameters" becomes indispensable. Hence, this research study can be considered an effort to empower construction professionals to create an extensive analysis of green building concepts and develop sustainably in India. [ABSTRACT FROM AUTHOR]

Background: Preterm neonates are repeatedly exposed to many stressors in initial days of life such as environmental stressor (light and noise) and caregiver interventions (weighing, oral and tracheal suctioning, drawing blood samples, etc.). If preterm neonates' stress is not recognized and left untreated, there may be long-term effects. Objective: To assess the neonatal stress behavior among preterm neonates admitted in neonatal intensive care unit (NICU), Nehru Hospital, PGIMER, Chandigarh. Methodology: A descriptive study was conducted to assess neonatal stress behavior among preterm neonates admitted in NICU, Nehru Hospital, PGIMER, Chandigarh. Ethical clearance was taken from Institutional Ethics Committee of PGIMER, Chandigarh. Total 100 participants admitted in NICU during the period of July–December 2022 were enrolled for the study using consecutive sampling technique. Data was collected by interviewing mother using interview schedule. It comprised of sociodemographic cum clinical profile of the preterm neonate. Observation was made by using—(a) modified infant positioning assessment tool (IPAT), (b) neonatal stress scale, and (c) preterm neonate's behavior assessment scale. Results: The present study shows that 88% of the preterm neonates show moderate stress and 70% of preterm neonates exhibit suspected abnormal behavioral response in terms of autonomic visceral subsystems, while 54% of the preterm neonates show suspected abnormal behavioral response in terms of state regulation attention interaction subsystem. Conclusion: The present study concluded that moderate stress level and suspected abnormal behavioral response were found among hospitalized preterm neonates. [ABSTRACT FROM AUTHOR]

Background and Objectives: The second peak of coronavirus disease-2019 (COVID-19) experienced by India in April-May 2021 overwhelmed the health care system. A severe shortage of oxygen was experienced, and it was realized that some method of estimating the oxygen consumption should be available in order to streamline the distribution network of oxygen. Methods: In this paper, the authors propose a method of estimating the daily oxygen consumption for a hospital based on different formulae used to calculate oxygen consumption by various oxygen therapy devices. The proposed method was tested for its accuracy by measuring the actual oxygen consumption during the same period on the basis of pressure gauge readings difference observed on the liquid oxygen tank. The estimated and actual oxygen consumption was calculated each day for a period of 10 days. Results: The mean estimated oxygen consumption was 1.26±0.11 metric Tonne (MT), and the actual consumption was 1.34±0.08 MT. The estimated and actual consumption had a positive and significant correlation between them (correlation coefficient of 0.699). Reliability analysis performed using the Cronbach’s alpha revealed a factor of 0.94 as a coefficient between both variables indicating that the actual and calculated oxygen consumptions are nearly equal. The Bland and Altman analysis revealed a good agreement. Interpretation and Conclusions: It is concluded that the total oxygen requirement can be reliably estimated based on the proposed formulae, which can be useful to estimate the oxygen consumption of different hospitals, and plan the distribution of oxygen in a city or a district as a part of preparedness to deal with future surges of COVID-19 infections, if any. [ABSTRACT FROM AUTHOR]

Background: Moderate acute malnutrition (MAM) affects over 30 million children aged < 5 years worldwide. MAM may confer a greater risk of developing severe malnutrition and even mortality in children. Assessing risk factors for MAM may allow for earlier recognition of children at risk of deleterious health outcomes. Objective: To determine risk factors associated with the prevalence and development of MAM among children aged 6 to 59 months with acute diarrhoea who received treatment with oral rehydration solution and zinc supplementation. Methods: We conducted a secondary analysis of data from a randomized, dose-finding trial of zinc among children with acute diarrhoea in India and Tanzania. We used regression models to assess risk factors for prevalent MAM at the start of diarrhoea treatment and to identify risk factors associated with the development of MAM at 60 days. MAM was defined as weight for length (or height) Z score ≤—2 and > -3 or mid-upper arm circumference < 12.5 and ≥ 11.5 cm. Results: A total of 4,500 children were enrolled; 593 (13.2%) had MAM at the baseline. MAM at baseline was significantly less common among children in Tanzania than in India (adjusted risk ratio [aRR] 0.37, 95% confidence interval [CI]: 0.30, 0.44, P < 0.001), in children aged 24- < 60 months versus 6- < 12 months (aRR 0.46, 95% CI: 0.38, 0.56, P < 0.001), and in families with household wealth index higher than the median (aRR 0.79, 95% CI: 0.68, 0.92, P = 0.002). Sixty days after outpatient treatment and follow-up, 87 (2.5%) children developed MAM. When compared to children aged 6- < 12 months, children aged 24- < 60 months had a 52% lower risk of developing MAM. Every one unit increase in weight for length (or height) Z score at enrolment was associated with a 93% lower risk of developing MAM during follow-up. Conclusions: Among children with diarrhoea, younger children and those from households with lower wealth were at greater risk of MAM. These children may benefit from targeted interventions focusing on feeding (targeted nutrition support for at-risk households) and follow up in order to reduce the occurrence of MAM and its consequences. [ABSTRACT FROM AUTHOR]

Background: Cancer patients are vulnerable to infections due to immunosuppression caused by cancer itself and its treatment. The emergence of antimicrobial-resistant bacteria further complicates the treatment of infections and increases the mortality and hospital stays. This study aimed to investigate the microbial spectrum, antimicrobial resistance patterns, risk factors, and their impact on clinical outcomes in these patients. Methods: A prospective study was conducted at a tertiary care cancer hospital in Patna, Bihar, India, which included cancer patients aged 18 years and older with positive microbial cultures. Results: This study analysed 440 patients, 53% (234) of whom were females, with an average age of 49.27 (± 14.73) years. A total of 541 isolates were identified, among which 48.01% (242) were multidrug resistant (MDR), 29.76% (150) were extensively drug resistant (XDR), and 19.84% (112) were sensitive. This study revealed that patients who underwent surgery, chemotherapy, were hospitalized, had a history of antibiotic exposure, and had severe neutropenia were more susceptible to MDR and XDR infections. The average hospital stays were 16.90 (± 10.23), 18.30 (± 11.14), and 22.83 (± 13.22) days for patients with sensitive, MDR, and XDR infections, respectively. The study also revealed overall 30-day mortality rate of 31.81% (140), whereas the MDR and XDR group exhibited 38.92% and 50.29% rates of 30-day mortality respectively (P < 0.001). Possible risk factors identified that could lead to mortality, were cancer recurrence, sepsis, chemotherapy, indwelling invasive devices such as foley catheter, Central venous catheter and ryles tube, MASCC score (< 21) and pneumonia. Conclusions: This study emphasizes the necessity for personalized interventions among cancer patients, such as identifying patients at risk of infection, judicious antibiotic use, infection control measures, and the implementation of antimicrobial stewardship programs to reduce the rate of antimicrobial-resistant infection and associated mortality and hospital length of stay. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic outbreak created a challenge to manage the health, especially the mental health of various care providers involved in treating the patients infected with the virus. Previously published literature has shown a significant effect of the pandemic on the psychological health of healthcare workers (HCWs) globally; so, this study aimed to describe the psychological health outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among Indian HCWs. Methods: An extensive literature search was conducted in databases including PubMed and Google Scholar. The search was restricted from the COVID-19 outbreak until June 2022. Cross-sectional studies and other studies (telephonic interviews and survey-based studies) reported the prevalence of anxiety and depression among frontline HCWs since the onset of the COVID-19 pandemic. All the studies were critically evaluated by two individual authors in terms of screening and methodological quality evaluation. A total of 16 studies were included in the final meta-analysis. Results: The prevalence of depression among n = 12231 participants of 14 studies was 0.37 CI 95% [0.28--0.48]; the prevalence of anxiety among n = 9467 participants of 12 studies was 0.39 CI 95% [0.29--0.49]. The results of the overall meta-analysis indicate that 37% and 39% of HCWs in this study experienced mild-to-severe depression and anxiety, respectively. During the COVID-19 pandemic, a significant number of HCWs developed mental health issues, with a reported prevalence of depression (37%) and anxiety (39%). Conclusion: Frontline HCWs' mental health should get full consideration during public health emergencies, screening should be actively conducted, and specific steps should be taken to lower the fear associated with the risk of infections. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to discover and analyze the challenges hampering blockchain technology's (BT's) implementation in the Indian health-care sector. A total of 18 challenges have been prioritized and modeled based on an extensive literature search and professional views. Design/methodology/approach: An integrated multi-criteria decision-making approach has been used in two phases. Best worst method (BWM) is used in the first phase to prioritize the challenges with sensitivity analysis to validate the findings and eliminate a few challenges. In the second phase, interpretive structural modeling is applied to the remaining 15 challenges to obtain relative relationships among them with cross-impact matrix multiplication applied to classification analysis for their categorization. Findings: The study's results reveal that limited knowledge and expertise, cost and risk involved, technical issues, lack of clear regulations, resistance to change and lack of top management support are the top-ranked or high-intensity challenges according to the BWM. Interpretive structural modelling findings suggest that the lack of government initiatives has been driving other challenges with the highest driving power. Research limitations/implications: This work has been conducted in the Indian context, so careful generalization of the results is needed. Practical implications: This work will give health-care stakeholders a better perspective regarding blockchain's adoption. It will help health-care stakeholders, service providers, researchers and policymakers get a glimpse of the strategies for eradicating mentioned challenges. The analysis will help reduce the challenges' impact on blockchain's adoption in the Indian health-care sector. Originality/value: The adoption of BT is a novel concept, especially in developing countries such as India. This is one of the few works addressing the challenges to BT adoption in the Indian health-care sector. [ABSTRACT FROM AUTHOR]

Purpose: Malnourished adults with knee osteoarthritis (OA) have a lower propensity for physical activities, leading to post-surgical stress and poorer clinic-functional outcomes. The study is aimed to propose an integrative screening procedure for patients and to identify a subset of patients who are undernourished or at risk of undernutrition in the Indian population. Methods: A hospital-based cross-sectional study was conducted at a tertiary care, a university-level teaching hospital for seven months, which included knee OA patients above the age of 45 years, and the following criteria were evaluated anthropometric measurement and blood biochemical parameters and nutritional scoring system. Results: The current study reports a high prevalence of malnutrition (69.5%) in patients with knee OA in the Indian population based on blood biochemical levels, and late presenters are associated with poor nutritional status of an individual. A single gold standard blood biochemical test, serum albumin alone, reports many malnourished individuals in the population, and the remaining blood biochemical parameters may not yield any additional information. Mini nutritional assessment, mid-arm circumference, and mid-calf circumference are poor predictors of malnutrition, and we need a revised cut-off for our group of patients. Conclusion: In the cohort of OA Knee, the prevalence of malnutrition is high (69.5%) in the Indian population. Serum Albumin is the best parameter to detect the presence of malnutrition preoperatively, and MNS is not applicable to detect malnutrition in our subset of patients. The study recommends routinely measuring serum albumin levels in all patients to correct the nutritional abnormality preoperatively, resulting in better surgical outcomes and reduced post-operatively complications. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

The use of technology in teaching and learning process for children is gaining importance. Children with specific learning disabilities have shown positive results with assistive technology tools. Dyscalculia is a specific learning disability in which an individual faces problem in mathematical skills. Around 3–7% of the world population is affected with it. The aim of the current research study is to determine the effectiveness of an assistive technology tool, Mathlete on children with dyscalculia's early numeracy skills. Such assistive technology tools can serve as a boon for these children. A total of 40 children with dyscalculia (Mage = 6.8 years) were a part of the study. The group of 40 children were randomly divided into two groups: experiment group using mathlete for improving their learning (30 children) and a control group using only traditional teaching for learning (10 children). The children were screened for dyscalculia using the screening module of mathlete. The two groups showed no significant difference in terms of their socio-economic status, gender and parents education level. Children in the experiment group showed improvement from pre-test to post-test after using mathlete. Also, there was significant difference in learning of both the groups, children in experiment group could understand the concepts better than the ones in control group. Mathlete helped improve the mathematical learning of children with dyscalculia from pre-test to post-test. Despite a huge prevalence of dyscalculia globally, this specific learning disability has always been overlooked due to lack of awareness and evident research. Assistive technology in form of computer aided instructions are the need of hour as children with special needs are usually neglected by many EdTech platforms, dyscalculia being a prominent one. An adaptive tool can give the child a customised experience thus developing interest in using the tool. Mathlete, focuses on early numeracy skills among children and helps them work on their deficit areas in their initial stages. [ABSTRACT FROM AUTHOR]

The extant literature on mobile financial services indicates that the work on merchants' adoption of mobile wallets is sporadic and under-researched. Taking into account the critical role of merchants in the mobile payment ecosystem, this study intends to study the factors that impact merchants' intention to adopt mobile wallets. A comprehensive model combining the UTAUT model, TTF model, perceived trust, and price value was empirically tested using the PLS-SEM approach. The data was collected from 236 merchants in New Delhi, India. Among all the variables that are significant in impacting behavioral intention to use mobile wallets, the task-technology fit is the most important factor, followed by price value, perceived trust, performance expectancy, social influence, and facilitating conditions. Also, significant positive relationships were found between technology characteristics and task-technology fit, and task characteristics and task-technology fit. This study is an early attempt to elucidate merchants' perspectives toward mobile wallets in India. [ABSTRACT FROM AUTHOR]

In September 2022, Panchkula Civil Hospital reported an outbreak of acute febrile illness (AFI) in Pinjore, located in the Himalayan foothills, Haryana, North India. There was an upsurge of fever cases. Blood samples were taken from suspected patients (n = 58) with AFI and subjected to serology of dengue, chikungunya, Japanese encephalitis, leptospira and scrub typhus. The samples were also screened for West Nile & Zika virus RNA using real-time PCR. Viral strains were characterized by sequencing. Of the 58 cases of AFI, Dengue could be identified in 45 (77.58%) followed by JE and Chikungunya in 2 cases each (3.44%), respectively. Among Dengue positive cases, 44 had monoinfection (97.77%) and 1 patient had dengue and JE. None were positive for Zika, West Nile, Scrub typhus, and Leptospira with the testing protocol. Four patients developed dengue with warning signs, such as abdominal pain in one patient and recurrent vomiting in the remaining three. The dengue serotype could be determined in 17 samples and revealed serotype 2. Molecular evolution analysis based on the complete envelope gene revealed that all DENV-2 strains (n = 13) circulated in the outbreak area belonged to the DENV-2 cosmopoliton genotype. In the early stages of infection, relying only on clinical manifestations is ineffective, so both molecular and serological assays along with clinical diagnosis are noteworthy for determining the aetiology of AFI. [ABSTRACT FROM AUTHOR]

The study examined the relationship between the syllabus and books used in 20 pre-schools in Jammu city, India. Twenty principals of pre-schools in Jammu city were randomly selected for interview. The results of the study reveal that the 20 schools had the same kind of syllabus and the curriculum took the needs and interests of the children into account. The majority of the schools had set books and these books were published according to the syllabus. (Contains 1 table.)

Objective Our objective was to study the radiation exposure rate as function of time in the administration of radioiodine iodine-131 (I-131) for the treatment of thyrotoxicosis or Graves' disease and remnant ablation on an outpatient basis at the Department of Nuclear Medicine, and also, to study the impact of revised discharge criteria for radioiodine therapy enforced by the Atomic Energy Regulatory Board (AERB) of India. Materials and Methods This study included patients who underwent low-dose radioiodine therapy using I-131. Patients were classified into two different groups, that is, group A and group B. Group A included patients receiving low dose I-131 for the treatment of thyrotoxicosis, whereas group B included patients receiving I-131 therapy for the ablation of residual thyroid tissue after total thyroidectomy. The radiation exposure rate was measured using a radiation detector in milli roentgen per hour (mR/h) at 5 cm distance of stomach and neck levels and with the patient standing at the distance of 1 m after oral administration of I-131 at 0, 1, and 2 hours. Results A total of 134 (17 males and 117 females) patients were included in the study. Group A comprised 102 (14 male and 88 females) patients and group B of 32 (3 males and 29 females) patients. At the neck level, the average exposure rate in group A versus group B after 0, 1, and 2 hours was observed to be 6.9 versus 22.27 mR/h, 33.67 versus 43.39 mR/h, and 41.75 versus 48.90 mR/h, respectively. At the stomach level, the exposure rate was 23.65 versus 71.32 mR/h, 13.27 versus 48.45 mR/h, and 9.91 versus 39.43 mR/h after 0, 1, and 2 hours, respectively. At a distance of 1 m, the exposure rate was 1.31 versus 2.99 mR/h, 1.05 versus 2.58 mR/h, and 0.92 versus 2.21 mR/h, respectively. Conclusion Exposure rate measured for patients treated with up to 1,110 MBq (30 mCi) of I-131 was under permissible limits as per revised discharged limits, that is, 50 µSv/h (5 mR/h) prescribed by AERB, India. The patients undergoing radioiodine therapy I-131 (up to 1,110 MBq/30 mCi) can be discharged safely 2 hours postadministration following good work practice along with providing proper radiation safety instructions to patients. [ABSTRACT FROM AUTHOR]

Post kala-azar dermal leishmaniasis (PKDL) is a skin disease that usually occurs among individuals with a past history of visceral leishmaniasis (VL). PKDL cases act as a reservoir of parasites and may play a significant role in disease transmission. Hence, prompt detection and complete treatment of PKDL cases are crucial for the control and elimination of VL. The purpose of this review was to highlight the barriers to effective control and prevention of VL/PKDL as well as potential solutions in India. Main obstacles are lack of knowledge about the disease and its vector, poor treatment-seeking behaviours, ineffective vector control measures, lack of confirmatory diagnostics in endemic areas, limited drug choices, treatment noncompliance among patients, drug resistance, and a lack of an adequate number of trained personnel in the health system. Therefore, in order to control and successfully eliminate VL in the Indian subcontinent, early detection of PKDL cases, improved diagnosis and treatment, raising awareness, and effective vector control mechanisms are necessary. [ABSTRACT FROM AUTHOR]

Depression represents a significant comorbidity in people living with HIV and AIDS (PLWHA). The purpose of this study was to assess the prevalence of depression among PLWHA in India and to identify the factors associated with it. Following PRISMA guidelines, a thorough search of PubMed, Embase, Scopus, and Google Scholar was conducted to identify relevant records. The overall prevalence was determined using a random-effects model, at 95% confidence interval. Eighteen studies, encompassing a total sample of 5082 PLWHA, were examined. The pooled prevalence of depression among PLWHA in India was 39.1% (95% CI: 30.4; 48.5). Subgroup analysis demonstrated prevalence rates of 56.0% in the East, 47.7% in Central India, 45.5% in the North, 37.6% in the West, and 26.9% in the South regions of India (p < 0.01). Another subgroup analysis based on the assessment tool used revealed significantly varying prevalence rates of depression (p < 0.01): 56.5% in studies employing CES-D (Center for Epidemiologic Studies - Depression) scale, 48.5% with MADRS (Montgomery-Asberg Depression Rating Scale), and 18.1% using PHQ-9 (Patient Health Questionnaire-9). Female gender, lack of education and employment, low self-esteem, and experiencing negative stigma were identified as factors associated with depression among PLWHA. Depression is prevalent among PLWHA in India, highlighting the importance of regular screening and management of mental health conditions in this population. [ABSTRACT FROM AUTHOR]

The largest reservoir of drinkable water on Earth is surface water. It is crucial for maintaining ecosystems and enabling people to adapt to diverse climate changes. Despite surface freshwater is essential for life, the current research shows a striking lack of understanding in its spatial and temporal dynamics of variations in outflow and storage across a sizable country: India. Numerous restrictions apply to current research, including the use of insufficient machine learning techniques and limited data series. This work uses cutting-edge and SOTA-method to use the available data and machine learning to accurately understand spatial and temporal dynamics of variations in surface freshwater outflow and storage using extended data series. The authors did the examination of thematic maps produced using ArcMap 10.8 from June'2005 to June'2020 using JRC dataset to track changes in the intensity of surface water. Google Earth Engine in Python API has been devised to detect changes in surface water levels and quantifying shifting map trends. Raster image viewing, editing, and calculation are done with ArcMap. For determining the relationship between declines in Surface water levels, changes in rainfall intensity and land surface temperature, variables were averaged over 13 rivers for 15 years. The change in surface water is reliant on independent variables of change in land surface temperature and rainfall intensity. The authors use the correlation between these parameters to achieve an average R-squared adjusted value of 0.402. The study's findings contribute to a better understanding of the matter and can be used across the world. [ABSTRACT FROM AUTHOR]

• To identifying and categorizing the barriers to the growth of roof top solar in India. • To assess and prioritize these barriers. • To deliver managerial and practical implications for these barriers. • Market based barrier most critical barrier to roof top solar. The adoption of rooftop solar in India is still relatively low, indicating substantial barriers. There is a lack of literature on comprehensively identifying various barriers to rooftop solar adoption. This research aims to fill the gap by creating a framework to identify and categorize the factors and sub-factors that stimulate the capacity of industrial and commercial rooftop solar in India. Thirty-five barriers were identified from an extensive literature review which is classified into five categories; Financial, Institutional & Regulatory, Location-based, Technical, and Market-based. Multi-criteria decision-making technique with a Fuzzy Analytical Hierarchy Process is used to prioritize these impediments. The analysis suggests that the most significant barriers materialized to thwart industrial and commercial rooftop solar growth in India are market-based and financial barriers. Institutional & Regulatory, Technical, and location-based barriers come next, respectively. This study is the first attempt to holistically inspect the barriers to identification, categorization, and prioritization of industrial and commercial rooftop solar in India. This investigation provides an important opportunity to advance the understanding of the significant barriers affecting the growth of industrial and commercial rooftop solar in India. [ABSTRACT FROM AUTHOR]

Background: Infertility is a very distressing condition. It is often associated with long-term stress, which can emerge as anxiety and depression. Aim: To understand the effect of socio-demographic variables, reproductive trajectories, and lifestyle variables on stress, depression, and anxiety independently and to understand the relationship of psychological variables with each other among infertile and fertile women. Methods: This cross-sectional study recruited 500 women which included 250 primary infertile cases and 250 age-matched fertile controls of the age group 22–35 years. A pretested modified interview schedule was administered which included demographic variables, lifestyle variables, and reproductive trajectories. In addition, psychological tools like PSS, GAD-7, and PHQ-9 were used to collect the data pertaining to Stress, anxiety, and depression, respectively. Data analysis was performed with the statistical software version SPSS, IBM version 24. Results: Infertile women are more prone to various psychological disorder (stress, anxiety and depression). None of the demographic and lifestyle variables were associated with stress, anxiety, and depression among infertile women. Only reproductive trajectories were found to be causing stress, anxiety, and depression respectively among infertile women. In addition, stress is leading to both anxiety and depression among infertile women but only to depression in fertile women. Conclusion: Infertile women should be counselled by medical experts regarding reproductive trajectories. Infertile couples should be guided and counselled to incorporate mental health screening and treatment in their routine check-up. [ABSTRACT FROM AUTHOR]

Background and Aims: Coronavirus has resulted in unique challenges to the healthcare professionals. The pandemic has affected the mental health of healthcare professionals, which may impact their ability to provide care to patients. We aimed to assess anxiety among healthcare professionals, and its relation to selected parameters. Methods: This online questionnaire-based study recruited Indian healthcare workers through convenience sampling. Anxiety was measured using the Generalized Anxiety Disorder 7 scale. The reasons of emotional distress were also ascertained. Results: The sample comprised of 677 healthcare professionals including resident doctors, consultants, interns, nursing personnel, and others. Moderate/severe anxiety was present in 24.4% of the respondents. Moderate/severe anxiety was more likely to occur among those who had a friend or family member affected by COVID-19 (odds ratio [OR] 2.74, 95% confidence intervals [CI] 1.61-4.69), or who themselves had a psychiatric disorder in the past (OR 2.44, 95% CI 1.36-4.38). Those who reported long working hours and inadequate sleep, fear of being infected by the virus, concerns about transmitting the virus to a family member, mob violence against doctors, and shortage of personal protective equipment had significantly higher odds of moderate/severe anxiety. Conclusion: A considerable proportion of healthcare professionals suffering from anxiety suggests the need for addressing their mental health concerns. [ABSTRACT FROM AUTHOR]

The advent of multimedia and its reach to everyone has made a massive change in life. Multimedia content enhances the learning trend and is playing a pivotal role in making the teaching and learning process more learners centric. In the present manuscript, authors use machine learning methods to find the impact of multimedia led teaching in government schools of Punjab, India. They promote the use of computer-based teaching in Punjabi for teaching the syllabus in schools. The secondary class students of Patiala and Mohali government schools affiliated to Punjab School Education Board are participants of this study. The students are divided in two groups. Twenty two topics of Punjabi grammar syllabus are taught to two student groups separately using different instructional strategies (multimedia presentations and traditional lectures). Achievement test, before and after the teaching, are conducted for all participants. The results support the hypothesis that multimedia does make a difference in the overall learning of the students. The descriptive statistics of achievement score shows the improvement in marks obtained by students after technology driven teaching. The average marks scored by students taught through multimedia system is 52.24% more than taught through traditional method. Nine machine learning models are used to find effectiveness of multimedia-based learning. Results shows that AdaBoost performs well with an accuracy of 99.8% respective to others based on student learning strategies. [ABSTRACT FROM AUTHOR]

Background: This study aims to determine the effects of kinesio tape (KT) application on acute-onset muscle soreness and the extensibility of the calf muscles in endurance athletes. Methods: A one-arm repeated-measures randomized cross-over controlled study design investigated 55 endurance athletes, including 10 cyclists, 30 badminton players, and 15 long-distance runners (mean age 16.40 ± 2.69) from different stadia in Delhi NCR, India. KT and sham tapes (ST) were applied randomly to right and left legs (prone position) in a cross-over manner with a gap of 72 h. Ankle dorsiflexion range of motion (ADFROM) and pain due to acute-onset muscle soreness were assessed immediately and 10 min and 30 min after treadmill running, using a universal goniometer and numeric pain rating scale (NPRS), respectively, along with the time to fatigue. Results: A statistically significant difference was observed for the NPRS when the mean scores obtained for the KT and ST groups were compared immediately after cessation of running; however, the difference was not statistically significant in the NPRS score that was recorded ten or thirty minutes after. The range of motion increased significantly after the application of both the KT and the ST. After running on a treadmill, the range of motion decreased significantly with both the KT and ST, and the decrease was similar. Conclusion: KT was more effective in reducing the pain intensity immediately after running and increased the time spent running on the treadmill before fatigue set in among endurance athletes. In addition, the two taping methods (KT or ST) were equally effective in enhancing calf muscle extensibility (for both right and left legs) immediately after application. However, both taping methods failed in limiting the decrease in ankle ADFROM after treadmill running. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the spiritual trajectories of promoting harassment-free workspaces. The paper develops a bilateral model of individual and organizational spirituality about both the intentionality and outcomes of spiritual modes of thinking, decision-making, and performance. Design/Methodology/Approach: The paper follows the case analysis method. It draws upon the experiences of an NGO working as an external change agent for instituting the spirit of the PoSH Act, 2013 in organizations. The authors have shortlisted 10 case studies from more than 100 sexual harassment cases handled by the NGO for addressing the larger issues of spirituality in organizations. The paper is interspersed with anecdotal and ethnographical references to continually juxtapose the letter and spirit of the legislation preventing harassment in India. Findings: As evangelists of harassment-free workspaces, the authors find that realization of this goal will not be possible with only passive, mechanistic compliance with the letter of law or the rules of the organization laid down in this regard. Research Limitations: The major limitation of this paper is that it only accounts the secondary information, the empirical investigation is missing. Managerial Implications: The aim of harassment-free workspaces as a building block of a harassment-free world is a collective journey of individuals, Internal Complaint Committees, organizations, and society as a whole. That organization where the spirit is given more importance than just the letter, and the closer an organization is to the principle of equality, as expected of us by the universe, the closer it is on its spiritual path to creating harassmentfree workspaces. Originality/Value: The paper draws on the first-hand experience of the NGO and is an original contribution to the further development of research in this area. [ABSTRACT FROM AUTHOR]

The global community is in a vulnerable and intricate state due to the COVID-19 pandemic given the lack of targeted drugs and extreme population making it an arduous journey to the public system of health care towards the extermination of the disease. The essentiality of newer compounds, novel medical instruments, and practices for diagnosis, cure, and prevention of the COVID-19 infection is the greatest concern. Since the persistent waves of COVID-19 are being observed at a variety of location across the globe, and the intensity and mutation of the virus is still possessing an inviolable threat to humanity. Along with conventional medicine, the application of traditional medicine practices using natural and herbal products has been proved effective in several disease conditions. The usage of Traditional Chinese medicine and ayurvedic medicine is used to treat COVID-19 infected patients in China and India respectively marks the contribution and effectiveness of traditional medical therapy in the restriction of the virus. The prominence of herbal products for prophylactic and symptomatic treatment for COVID-19 is notable and recommended by various organizations and governments in the world. All the pragmatic considerations and evidence to use ayurvedic practices on a large scale require further animal and robust human studies. This article reviews various practices, herbal products, effectiveness, case studies and the contribution of ayurvedic medicine, to be used to treat and restrict the viral epidemic and may further provide a forward insight into future learning, evidence compiling, and research in the respective domain. [ABSTRACT FROM AUTHOR]

Background: During the second wave of the COVID-19 pandemic, outbreaks of Zika were reported from Kerala, Uttar Pradesh, and Maharashtra, India in 2021. The Dengue and Chikungunya negative samples were retrospectively screened to determine the presence of the Zika virus from different geographical regions of India. Methods: During May to October 2021, the clinical samples of 1475 patients, across 13 states and a union territory of India were screened and re-tested for Dengue, Chikungunya and Zika by CDC Trioplex Real time RT-PCR. The Zika rRTPCR positive samples were further screened with anti-Zika IgM and Plaque Reduction Neutralization Test. Next generation sequencing was used for further molecular characterization. Results: The positivity was observed for Zika (67), Dengue (121), and Chikungunya (10) amongst screened cases. The co-infections of Dengue/Chikungunya, Dengue/Zika, and Dengue/Chikungunya/Zika were also observed. All Zika cases were symptomatic with fever (84%) and rash (78%) as major presenting symptoms. Of them, four patients had respiratory distress, one presented with seizures, and one with suspected microcephaly at birth. The Asian Lineage of Zika and all four serotypes of Dengue were found in circulation. Conclusion: Our study indicates the spread of the Zika virus to several states of India and an urgent need to strengthen its surveillance. [ABSTRACT FROM AUTHOR]

Background: The present study reports myeloablative total body irradiation (TBI) on an isocentrically mounted linac by laying the patient on the floor and management of abutting radiation fields and partial shielding of lungs. Dosimetrical efficacy of this novel technique was evaluated. Materials and methods: In this retrospective study, dosimetrical parameters from TBI plans on whole-body CT scans of 46 patients were analysed. The prescribed dose to TBI was 12 Gy in six fractions delivered over a period of 3 days for myeloablative conditioning. TrueBeam STx platform Linac (Varian Medical Systems Inc., Palo Alto, CA, USA) was used to deliver opposing fields. Radiation fields were abutted to form a single large field using an arithmetic formula at source-to-skin-distance of 210 cm. Results: Discrepancies in dose calculated by treatment planning system were within 1·6% accuracy, and dose profile at the junction of abutting radiation fields was reproduced within 3·0% accuracy. The real treatment time for each patient was ~30 minutes/fraction. Monitor unit was weighted for multiple sub-fields to achieve dose homogeneity within 5·0% throughout the whole body, and the mean dose to lung was ≤10 Gy. Conclusion: Our abutting radiation field technique for myeloablative TBI is feasible in any existing linac bunker. 'Island-blocking' is feasible in this technique using multi-leaf collimator. This technique is cost-effective as it does not require any costly equipment than the readily available equipment in any radiotherapy facility. In general, TBI requires laborious planning procedures and spacious linac bunkers; this novel technique has the potential to change previously held notions. [ABSTRACT FROM AUTHOR]

Fast growing arsenic menace is causing serious health hazards in Bihar, India, with an estimated 10 million people at risk. The exposed population is often unaware of the problem, which only amplifies the burden of arsenic health effects. In the present study, we have assessed the current situation of arsenic exposure in Chapar village of Samastipur district, Bihar. The health of the inhabitants was assessed and correlated with (1) arsenic concentrations in the groundwater of individual wells and (2) arsenic concentration found in their hair and urine. Altogether, 113 inhabitants were assessed, and 113 hair, urine and groundwater samples were collected. The health study reveals that the exposure to arsenic has caused serious health hazard amongst the exposed population with pronounced skin manifestations, loss of appetite, anaemia, constipation, diarrhoea, general body weakness, raised blood pressure, breathlessness, diabetes, mental disabilities, diabetes, lumps in the body and few cancer incidences. It was found that 52% of the total collected groundwater samples had arsenic levels higher than the WHO limit of 10 µg/l (with a maximum arsenic concentration of 1212 µg/l) and the reduced arsenite was the predominant form in samples tested for speciation (N = 19). In the case of hair samples, 29% of the samples had arsenic concentrations higher than the permissible limit of 0.2 mg/kg, with a maximum arsenic concentration of 46 µg/l, while in 20% exposed population, there was significant arsenic contamination in urine samples > 50 µg/l. In Chapar village, the probability of carcinogenic-related risk in the exposed population consuming arsenic contaminated water is 100% for children, 99.1% for females and 97.3% for male subjects. The assessment report shared to the government enabled the village population to receive two arsenic filter units. These units are currently operational and catering 250 households providing arsenic-free water through piped water scheme. This study therefore identified a significant solution for this arsenic-exposed population. [ABSTRACT FROM AUTHOR]

Introduction: Nonhematologic tumors in children differ biologically and histologically from adults in terms of incidence, type of tumor, and tendency to regress spontaneously. The study was aimed to evaluate the pattern, frequency, and histopathological spectrum of solid tumors and to correlate histopathological findings with immunohistochemistry (IHC) wherever feasible. Materials and Methods: This observational study was a retrospective analysis of all solid tumors of children less than 18 years, conducted over a period of 5 years. The specimens were analyzed grossly and microscopically with IHC wherever feasible. All leukemias and myeloproliferative neoplasms/myeloproliferative disorders were excluded from the study. Results: A total of 261 solid tumors were seen in the age of 2 days to 17 years with the median age being 10.41 years. The M: F ratio was 1.6:1. Benign tumors were more common (59.39%), with soft tissue tumors being more frequent. Lymphomas and reticuloendothelial cell tumors constituted the majority (27%) of malignant tumors. Conclusion: This institution-based study depicted the pattern of childhood tumors. As most of the studies have focused on malignant tumors, data on the prevalence of benign pediatric tumors is scarce. Pediatric tumors need to have a dedicated pediatric cancer registry for assessing the magnitude of the problem. This study provides useful insight into the pattern of benign and malignant pediatric tumors in the northwest region of India, which can be utilized in planning health policies. The present study also proves the importance of IHC in making the final diagnosis. [ABSTRACT FROM AUTHOR]

The growing health concerns on reused fried oils are addressed globally in terms of total polar materials (TPM) of frying oil (FO). However, consumer perspective mandates the monitoring of absorbed oil (AO). This prompted the evaluation of AO quality by collecting 100 samples of fried products from different cities in India. The TPM of AO extracted (3.96%–24.59%) revealed a strong negative correlation with price (0.58–0.97), while that of para‐anisidine (6.90–119.10) and TOTOX (13.67–126.8) showed a fairly negative correlation (0.45–0.95, 0.15–0.96, respectively) with price. No such trend was observed with the primary oxidation indicators. Furthermore, various products having different moisture contents were fried over 10 frying cycles and the oil extracted therefrom was evaluated. TPM of AO (17.75%) was higher than FO (14.89%) for high moisture raw materials and also increased with frying cycles. These results suggest the possibility of frying oil reuse and an urgent need to regulate the AO. Novelty impact statement: The health concerns on repetitive frying are addressed by evaluating the Total polar materials content (TPM) of frying oil, wherein hazards need to be monitored at the exposure site (absorbed oil). The outcome of oil quality evaluation of numerous commercial and experimental fried samples infers a strong correlation of TPM in absorbed oil with price, raw material moisture content, and frying cycles. Besides, the experimental trials also highlighted a significant increase in TPM in absorbed oil over frying oil for high moisture samples, suggesting an urgent need for regulating absorbed oil quality in fried foods. [ABSTRACT FROM AUTHOR]

The authors of this article explore the relationship between the cultural, unconscious and conscious dynamics in setting up infant observations in Delhi. The specific focus of the paper is the concept of 'Nazar', Evil eye, in India. The paper presents the experiences of a young woman observer in India, going in to observe an infant as a requirement of her psychotherapy training. The paper is an attempt to make sense of what happened five years ago in setting up the observation. It sheds light on how a cultural artefact such as 'Nazar' becomes a barrier to being able to undertake baby observation. The article also extends its understanding of what 'Nazar' can symbolise, both in the internal and the external world of both observer and observed. It goes on to explore the link between mother's ambivalence both towards her child and towards the young female observer. [ABSTRACT FROM AUTHOR]

BACKGROUND: Assistive technology has been a boon for children with specific learning disabilities (SLDs) as it bridges the gap between them and their peers without SLDs. Despite the vast emphasis on the use of AT and speedy propagation of AT tools, yet more research is required on actual usage of AT. OBJECTIVE: The purpose of the study is to identify the most significant barriers to the usage of AT by children with specific learning disabilities and suggest various measures to deal with it. METHODS: To accomplish the study interviews were conducted with special education teachers of schools in India to find out the major barriers toward the utilisation of AT. First, Qualitative analysis was performed using CAQDAS tool QDA Miner Lite to identify the barriers towards effective utilisation of AT. Further, ISM technique and MICAMAC analysis were used to corroborate the most significant barriers. RESULTS: The results revealed the most significant barriers to implementation of AT and also that timely managing these major barriers can lower the effect on other barriers. CONCLUSION: Eliminating the significant barriers would enhance the use of AT by the special education teachers, parents, and children with SLDs. Effective use of AT can prove to be benediction in the times of pandemic. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effect of glycemic control as estimated by glycated hemoglobin A1c (HbA1c) on gastric emptying in patients with type 2 diabetes mellitus (DM) using gastric emptying scintigraphy (GES). This was a cross-sectional study conducted at a tertiary health care center in Northern India. The study included 44 patients who underwent GES using a radiolabeled solid Idli meal containing 1 mCi of Tc-99 m Sulfur Colloid. Patients were divided into three groups based on glycemic control as Group A, B, and C with HbA1c <7%, 7%–9%, and >9%. Statistical analysis was performed using the IBM® SPSS® Statistics Version 23.0 The comparison of proportions was done using the Chi-square test and Fisher's exact test. Means were compared using the independent t-test and one-way analysis of variance. P < 0.05 was considered statistically significant. No statistically significant correlation was found between delayed gastric emptying and glycemic control (P = 0.09), gender (P = 0.228), dietary patterns (P = 0.91), symptoms of gastroparesis (P = 0.06), body mass index (BMI) (P = 0.267), and duration of type 2 DM (P = 0.565). No statistically significant association was also found between glycemic control and time taken for half gastric emptying (t1/2) (P = 0.225). Scintigraphy using Tc-99m Sulfur Colloid radiolabeled Idli meal can be effectively used for the assessment of gastric emptying. There is no significant correlation of delayed gastric emptying with glycemic control, gender, BMI, type of diet, and duration of diabetes mellitus. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to describe the effectiveness of goniotomy for childhood glaucoma in Indian eyes.Methods: Consecutive patients with pediatric glaucoma who underwent goniotomy between July 2017 and June 2020, in a single center in Northwest India were prospectively analyzed. Goniotomy was done as a primary procedure or a re-do surgery of the untreated angle in failed filtering surgery. Success was defined as intraocular pressure (IOP) ≦18 mm Hg with or without 2 topical medications.Results: A total of 172 eyes of 126 children underwent goniotomy during this period (37.9% of all pediatric glaucoma surgeries). Goniotomy comprised 132 of 211 (62.5%) primary pediatric glaucoma surgeries and 40 of 243 (16.5%) re-do surgeries. 145, 112, and 54 eyes had a six months, 1-year and 2-year follow-up, respectively. At 1 year, success rates in Primary Congenital Glaucoma (PCG) were 79.7% for primary surgery and 68.4% for re-do surgery. For non-PCG eyes, the success rate was 62% at 1 year. Among PCG subgroups, infantile and newborn glaucoma had 87.5% and 57.1% success rates, respectively. On logistic regression analysis, lower baseline IOP and lesser axial length at presentation were significantly predictive of successful outcomes (P = 0.03 and P = 0.02, respectively). At 1 year, in the primary surgery group, 50% had good vision (better than logMAR 0.5), 28.9% had moderate (better than LOGMAR 1.0) and 20% had severe visual impairment. There were no significant intraoperative or post-operative complications.Conclusion: Goniotomy appears to be an effective surgery for childhood glaucoma in Indian eyes. Being minimally invasive, it obviates the need for conjunctival and scleral dissection and antifibrotic agents. [ABSTRACT FROM AUTHOR]

Introduction: Malaria is one of the major life-threatening health problems in most of the tropical countries. Children are the most vulnerable group accounting for 67% of all malaria-associated deaths worldwide. Southern Haryana is typically endemic for malaria. Therefore, the present study was undertaken to describe the clinical presentation of complicated malaria and correlate clinical complications with malarial species. Materials and Methods: It was an observational cross-sectional study conducted in the Department of Microbiology along with Department of Pediatrics, Shaheed Hasan Khan Mewati Government Medical College, Nalhar, Nuh, Haryana. A total of 100 children with severe malaria admitted in the pediatric ward, confirmed by peripheral blood smear and rapid diagnostic test, were included. Results: Out of 100 cases admitted, majority were due to Plasmodium vivax (73%), followed by mixed (18%) and Plasmodium falciparum (9%) infection. Children below 5 years were more infected (57%). Male preponderance was seen (55%). Fever was the most common symptom observed (95%). Pallor was the most common sign observed (85%). Among severity parameters, the most common were severe anemia (41%), jaundice (17%), abnormal bleeding (17%), convulsions (15%), and acute respiratory distress syndrome (7%). The case fatality rate was 3%. Conclusion: P. vivax was previously known to cause benign malaria. The present study found that P. vivax mono-infection can cause severe malaria in children and should no longer be considered as benign malaria. [ABSTRACT FROM AUTHOR]

Purpose: : Retinoblastoma (RB) is the commonest intraocular tumor in children. Despite high cure rates, data on health-related quality of life (HRQoL) of RB survivors are limited. This study aimed to analyze parent's perspective and self-report of HRQoL of RB survivors, using healthy siblings as controls. It also evaluated the impact of socio-economic status (SES), gender, disease laterality, treatment modality, duration since diagnosis, and visual outcomes, on HRQoL.Methods: Ninety-two RB survivors were enrolled in this observational, cross-sectional questionnaire-based study conducted at a tertiary care center. QoL was analyzed in four dimensions: physical, emotional, social, and school, using both self-report (for children >6 years) and parent proxy report (for children 2-18 years) using Pediatric Quality of Life Inventory™ (PedsQLTM) 4.0 Generic Core Scale. Seventy-seven healthy siblings served as controls.Results: The mean age of both cohorts was 5.7 years. Thirty-six (39%) patients had bilateral RB. Of the 92 survivors, 43 (47%) had undergone enucleation. The HRQoL of RB survivors was significantly lower compared to sibling controls (P < 0.01) in all four domains, the physical domain being most affected followed by social domain. Parents reported an inferior QoL than patient's self-report. Vision <6/18 in the best eye and enucleation had a negative impact on HRQoL whilst gender, disease laterality, duration since diagnosis and SES had no impact.Conclusion: : QoL assessment is often neglected but an important aspect of survivorship. Results of our study will help in formulating awareness of the domains affected and allow timely advocacy of initiatives for addressing each issue individually. Remedial measures aimed at optimizing QoL should be incorporated as part of their rehabilitation. [ABSTRACT FROM AUTHOR]

This session was organized by renowned scientists including Prof. Jack Gilbert, University of California, San Diego, USA and Prof. Kenneth Timmis, Tech. Univ. of Braunschweig, Germany. Organizers would like to thank Prof. Sunil Pabbi, Treasurer, AMI, Prof. For the past 60 years, the Association of Microbiologists of India (AMI) has been bringing research scientists, scholars, academicians and students, working in microbiology and its allied sciences, to present their research and share new ideas on a common platform during its annual conference. [Extracted from the article]

Purpose: The Hijra community is a cultural and gender grouping in South Asia broadly similar to western transgender communities, but with literature suggesting some differences in gender experience and patterns of psychosocial adversity. The present study aims to describe patterns of mental illness and psychoactive substance use in Hijra subjects and study their association with gender experience and psychosocial adversity. Methods: Fifty self-identified Hijras availing HIV-prevention services in New Delhi, India, were interviewed. Data on mental disorders, psychoactive substance use, quality of life, discrimination, empowerment, violence and gender identity were assessed using structured instruments. Results: Subjects were mostly in their mid-twenties, and had joined the Hijra community in their mid-teens. More subjects (46%) were involved in begging than in traditional Hijra roles (38%). Sex work was reported by 28% subjects. The rates of lifetime mental illness was 38%, most commonly alcohol abuse (26%); others had anxiety or depressive disorders (8% each), somatoform disorders (6%) and bulimia nervosa (n = 1). Disempowerment was mostly experienced in domains of autonomy and community participation; 52% had experienced sexual or psychological violence. Discrimination was attributed to gender (100%), appearance (28%) or sexual orientation (28%). There were negative correlations between the physical domain of WHO-QOL and physical violence and depression scores; and between discrimination and WHO-QOL environmental, physical and psychological domains. Conclusions: This Hijra group showed high rates of mental disorder and substance involvement, related to QOL domains and experiences of discrimination and disempowerment. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine habitual visual acuity (HVA) in a large urban cohort in western India and identify factors associated with poor HVA.Methods: This was a prospective study conducted over 10 days in September 2018 to assess the HVA in individuals attending a 10-day festival in Western India. Participants who volunteered to undergo vision screening and also filled the questionnaire form pertaining to demographic information including their age, gender, address, income, and educational status were included in this study. HVA was recorded with the distance correction that the participants were wearing when they attended the screening. The study evaluated the prevalence of visual acuity 6/6 or <6/6, 6/12, and 6/18 and the factors associated with lower visual acuity.Results: Of the 6300 participants, 1660 (26.3%) were females. Majority of the participants were from urban background (6084, 96.6%) and were of younger age group (18-40 years--3786, 60.1%; 41-60 years--2187, 34.7%; >60 years--327, 5.2%). HVA was recorded as 6/6 both eyes in 4136 (65.6%), at least 6/12 both eyes in 5691 (90.3%), and at least 6/18 both eyes in 5974 (94.8%) individuals. Only 11 patients (0.17%) had VA worse than 6/60 with only 3 patients (0.003%) having bilateral VA <6/60. Older age, female sex, lower education status, and low annual income were significant risk factors for poor HVA.Conclusion: Poor education, lower income, female gender, and old age are significantly associated with poor HVA even in urban Western India despite relatively easy access to affordable eye care facilities. [ABSTRACT FROM AUTHOR]

Background: Progress has been made in the reduction of under-five mortality in India; however, neonatal mortality is reducing at a slower rate. Efforts are required to bring down neonatal mortality in order to attain the Sustainable Development Goal-3. Prevention of sepsis among the high-risk, vulnerable low birth weight neonates by a newer intervention with probiotic supplementation is promising.Methods: A phase III, multicenter, randomized, double-blind, placebo-controlled study is being conducted at six sites in India. A total of 6144 healthy low birth weight (LBW) infants fulfilling the eligibility criteria would be enrolled within the first week of life, after obtaining written informed consent from the parents of the infant. Randomization in 1:1 ratio, stratified by site, sex, and birth weight, would be done through an interactive web response system (IWRS) using a standard web browser and email service. Vivomixx®, a probiotic containing a mix of 8 strains of bacteria, in a suspension form standardized to deliver 10 billion CFU/ml, or an organoleptically similar placebo would be fed to enrolled infants in a 1-ml/day dose for 30 days. The follow-up of enrolled infants for 60 days would take place as per a pre-specified schedule for recording morbidities and outcome assessments at the six participating sites. Screening for morbidities would be conducted by trained field workers in the community, and sick infants would be referred to designated clinics/hospitals. A physician would examine the referred infants presenting with complaints and clinical signs, and blood samples would be collected from sick infants for diagnosis of neonatal sepsis by performing sepsis screen and blood culture. Appropriate treatment would be provided as per hospital protocol. The study would be implemented as per the MRC guideline for the management of Global Health Trials in accordance with ICH-GCP and Indian Regulatory guidelines. A contract research organization would be engaged for comprehensive monitoring and quality assurance. The final analysis would be conducted in a blinded manner as per the statistical analysis plan (SAP) to estimate the primary outcomes of sepsis, possible serious bacterial infection (PSBI), and secondary outcomes. The codes will be broken after DMC permission. The protocol has been reviewed by the Research Ethics Committee of the Liverpool School of Tropical Medicine (REC-LSTM), from Research Ethics Committees of the six subject recruitment participating sites.Discussion: This adequately powered and well-designed trial would conclusively answer the question whether probiotics can prevent neonatal sepsis in the high-risk group of low birth weight infants as indicated by a pilot study in 1340 LBW infants, evidence from systematic reviews of hospital-based studies, and a primary study on healthy newborns in Orissa. Results of the study would be generalizable to India and other low-middle-income countries.Trial Registration: Clinical Trial Registry of India (CTRI) CTRI/2019/05/019197 . Registered on 16 May 2019. [ABSTRACT FROM AUTHOR]

Background: India has made major progress in improving control of visceral leishmaniasis (VL) in recent years, in part through shortening the time infectious patients remain untreated. Active case detection decreases the time from VL onset to diagnosis and treatment, but requires substantial human resources. Targeting approaches are therefore essential to feasibility. Methods: We analyzed data from the Kala-azar Management Information System (KAMIS), using village-level VL cases over specific time intervals to predict risk in subsequent years. We also graphed the time between cases in villages and examined how these patterns track with village-level risk of additional cases across the range of cumulative village case-loads. Finally, we assessed the trade-off between ACD effort and yield. Results: In 2013, only 9.3% of all villages reported VL cases; this proportion shrank to 3.9% in 2019. Newly affected villages as a percentage of all affected villages decreased from 54.3% in 2014 to 23.5% in 2019, as more surveillance data accumulated and overall VL incidence declined. The risk of additional cases in a village increased with increasing cumulative incidence, reaching approximately 90% in villages with 12 cases and 100% in villages with 45 cases, but the vast majority of villages had small cumulative case numbers. The time-to-next-case decreased with increasing case-load. Using a 3-year window (2016–2018), a threshold of seven VL cases at the village level selects 329 villages and yields 23% of cases reported in 2019, while a threshold of three cases selects 1,241 villages and yields 46% of cases reported in 2019. Using a 6-year window increases both effort and yield. Conclusion: Decisions on targeting must consider the trade-off between number of villages targeted and yield and will depend upon the operational efficiencies of existing programs and the feasibility of specific ACD approaches. The maintenance of a sensitive, comprehensive VL surveillance system will be crucial to preventing future VL resurgence. [ABSTRACT FROM AUTHOR]

Background: In India, under-five children with Severe Acute Malnutrition (SAM) are referred to Nutritional Rehabilitation Centers (NRCs). NRCs screen the causes of SAM including tuberculosis (TB). The national TB programme recommends upfront testing with a rapid molecular test if TB is suspected in children. Objective: We estimated the yield of and adherence to the TB diagnostic guidelines (clinical assessment and assessment for microbiological confirmation) among under-five children with SAM admitted at NRCs (six in district Sagar and four in district Sheopur) of Madhya Pradesh, India in 2017. We also explored the challenges in screening from the health care providers' perspective. Methods: It was an explanatory mixed method study. The NRC records were reviewed This was followed by three key informant interviews and three focus group discussions among staff of NRC and TB programme. Manual descriptive thematic analysis was performed. Results: Of 3230, a total of 2665(83%) children underwent Mantoux test, 2438(75%) underwent physical examination, 2277(70%) were asked about the symptoms suggestive of TB, 1220(38%) underwent chest radiograph and 485(15%) were asked for recent contact with TB. A total of 547(17%) underwent assessment for microbiological confirmation. Of 547, a total of 229 gastric aspirate specimens underwent rapid molecular test (24% positive) and 318 underwent sputum microscopy (44% positive). A total of 223 were diagnosed as TB (195 microbiologically and 28 clinically confirmed) and 209 were initiated on anti-TB treatment. The treatment outcome was favourable (cure or treatment completed) for 70(31%) and not recorded for 121(54%). The main perceived challenges in screening for TB were poor team skills, lack of diagnostic facilities and poor understanding of the guidelines due to inadequate training. Conclusion: Though NRCs provided a unique window of opportunity for the screening and management of TB among under-five children with SAM, the utilization of this opportunity remained suboptimal. [ABSTRACT FROM AUTHOR]

Do firstborn children have a height advantage? Empirical findings have found mostly that, yes, second or higher-order children often lag behind firstborns in height outcomes, especially in developing countries. However, empirical investigations of birth-order effects on child height overlook the potential impact that birth spacing can have. We provide an explanation for the negative birth-order effect on stunting outcomes for young Indian children and show it is driven by short preceding-birth spacing. We find that firstborn children are taller than children of higher birth order: The height-for-age gap for third (or higher)-order children is twice the gap for children second in birth order. However, this pattern is observed when spacing between later-born children and their immediate elder siblings is fewer than 3 y. Interestingly, the firstborn height advantage disappears when later-born children are born at least 3 y after their elder siblings. Thus, our findings indicate that spacing length between children explains differences in height, over birth order. Although India's family planning policy has resulted in a substantial reduction in total fertility, its achievement in spacing subsequent births has been less impressive. In showing that spacing can alleviate or aggravate birth-order effects on attained height, our study fills an evidence gap: Reducing fertility alone may not be sufficient in overcoming negative birth-order effects. To reduce the detrimental effects of birth order on child stunting, policy responses--and therefore research priorities--require a stronger focus on increasing the time period between births. [ABSTRACT FROM AUTHOR]

BACKGROUND There are limited studies on the seronegative celiac disease from the Indian subcontinent. The aim of this study was to assess the prevalence, pathological, genetic, and clinical profile of patients with seronegative celiac disease. METHODS This prospective observational study was conducted in the Department of Gastroenterology, SMS Hospital, Jaipur, between October 2017 to March 2019. Consecutive patients with seronegative celiac disease with age ≥ 3 years were enrolled for the assessment of demography, clinical features, histological findings, celiac serology, genetic analysis, and response to gluten-free diet. RESULTS Out of total of 312 patients with celiac disease, 13 (4.16 %) patients (median age 25 years [range 5-46 years], 10 female) were diagnosed as having seronegative celiac disease. Presenting symptoms were chronic diarrhea in nine (69.23%), abdominal pain in six (46.15%), weight loss in five (38.46%), and short stature in two (15.38 %) patients. On histological analysis, Marsh stage 2 was seen in five (38.46%), Marsh 3c in two (15.38%), Marsh 3a in three (23.07%), and Marsh 3b in three (23.07%) patients. On HLA analysis, HLA-DQ2.5 was seen in six (46.15%) patients, HLA-DQ2.2 in five (38.46%), and HLA-DQ8 in two (15.38%) patients. CONCLUSION The prevalence of seronegative celiac disease in our study was 4.16%. The most common symptoms were chronic diarrhea and abdominal pain, and the histological grade was Marsh stage 2. [ABSTRACT FROM AUTHOR]

This paper, partly written in the first person, describes the struggle and also the gains made by both an adolescent patient and her therapist when they had to move to a digital platform for their therapy sessions. The particular focus is on the shift in the countertransference and what became possible for both in their responses, when forced to move to digital work. [ABSTRACT FROM AUTHOR]

Reverse mortgage has always been viewed as a product meant exclusively for the elderly with financial hardship. However, there is a brighter side to it too. This article attempts to project reverse mortgage as a financial planning tool through a case study analysis. Using the coordinated strategy, this case explores how the line-of-credit option in reverse mortgage can meet the cash needs of a retiree during market downturns, allowing his portfolio to stay invested. The suggested strategy is a direct attack on investment risks, especially, sequence of return risk. Using this strategy, the depreciated assets are allowed to recover their original value and appreciate, ensuring better returns and longevity of investments. Dilemma: Is reverse mortgage a sustainable retirement plan? How can it be used as a financial planning tool to fund retirement? With the increasing proportion of elderly population in India (projected to be 19% by 2050), reverse mortgage has emerged as an efficient option to fund retirement days. Seeing its success in foreign countries, the dilemma, is: Is it an adequate solution to fund retirement in India? Theory: The premise of the present research is based on a coordinated strategy, used by Sacks and Lafaye (2016) where it is proposed that the client, using the line of credit option in reverse mortgage, would borrow only during market downturns, thereby leaving their market investments untouched and maximizing their gains. Basis of the Case: Phenomena-based case: financial planning for a retiree. Type of the Case: This is basically an applied decisional case, attempting to determine where reverse mortgage is an effective retirement plan or not. Protagonist Present: Mr Rajesh Sharma and Mr Anand Malhotra. Findings: After 20 years into retirement. Mr Rajesh Sharma who does not choose reverse mortgage ends up exhausting his complete investment portfolio value in the 19th year of his retirement life. Thus, he is in financial distress and has no resort to meet his financial needs except to fall back upon his children. On the contrary, Mr Anand Malhotra who opts for the line of credit option in reverse mortgage has positive net worth at the end of 20 years that can ensure a comfortable future for him. Discussions: The case recommends utilising reverse mortgage as financial planning tool for the elderly. Mr Rajesh Sharma is in financial distress and has no resort to meet his financial needs except to fall back upon his children. Mr Anand Malhotra by making the smart choice of reverse mortgage, ensured that his portfolio stayed invested longer, providing it sustenance and longevity. By opting for reverse mortgage, Mr Anand Malhotra not only shielded his investments from unnecessary withdrawals, but the option also gave him the confidence to tide over his financial exigencies The case concludes that reverse mortgage can provide greater probability of the investments/savings to survive the retirement period, coupled with a high probability of greater net worth at the end of the period. It can be safely concluded that reverse mortgage is definitely a golden walking stick for the elderly. If the government and the lending institutions take cognizance of this aspect of reverse mortgage and market it accordingly, it can turn out to be a vanguard product for the Indian elderly. [ABSTRACT FROM AUTHOR]

Firearm injuries are reported all over the world. From very basic thermodynamic structures to the most sophisticated semi-automatic and automatic guns of the present times, firearms are one of the common causes of significant mortality. In our country there is rampant use of unlicensed country - made firearms, particularly in rural areas. The present study was conducted at a teaching cum tertiary care hospital in Gwalior region of Central India, a region which is notoriously famous for the use of illicit firearms. The study was retrospectively done analysing the firearm injury cases brought to the mortuary of G.R. Medical College, Gwalior from January 2015 - December 2019 for post-mortem examination. All relevant information regarding autopsy cases were gathered from relatives, police paper; inquest reports, ballistic reports, crime scene findings, autopsy reports. A scientific tabulation of all relevant information was done to arrive at various epidemiological markers relating to firearm injury cases. In the present study it was concluded that young males were more vulnerable for firearm related deaths with 21-30 years age range showing maximal preponderance. While country made weapons and shotguns accounted for greater majority of cases, rifled weapons were involved either. A plethora of underlying social and psychological factors accounted for such death though region specific familial rivalries stood first in order. Maximum observed diurnal frequency of firearm deaths were reported in relatively calm hours of night, though no time segment was spared. While in most cases single shots were reported, few other had multiple inflictions. Head (including face) was the commonest site involved followed by thoraco-abdominal injuries. Homicide was the most common manner of firearm deaths. [ABSTRACT FROM AUTHOR]

Background & objectives: Diagnosis of myelodysplastic syndromes (MDS) is subjective in low-grade cases with <5 per cent blasts or <15 per cent ring sideroblasts. Flow cytometry (FCM) has been used to diagnose MDS; but, it still has only an adjunctive role. This study was conducted to evaluate the role of FCM to diagnose MDS and correlate the number of aberrancies with revised international prognostic scoring system (R-IPSS). Methods: This study included 44 consecutive clinically suspected cases of MDS with refractory cytopenia(s) and 10 controls. Patients were divided into two groups: (i) proven MDS cases (n=26), and (ii) suspected MDS (n=18). Ogata quantitative approach, pattern analysis and aberrant antigen expression were studied. Results: Ogata score =2 correctly diagnosed 80.7 per cent (21/26) while aberrant antigen and pattern analysis with flow score of =3 could diagnose 92.3 per cent (24/26) patients with proven MDS. Combination of both with flow score =3 could diagnose 100 per cent patients. Eight patients in suspected MDS group with persistent cytopenia on follow up were labelled as probable MDS. Ogata score =2 was present in 5 of 8 and pattern analysis score =3 was present in six probable MDS patients. Combination of both with flow score =3 was present in seven of eight patients. Spearman's correlation between Ogata score and R-IPSS, pattern analysis and R-IPSS and combination of both scores and R-IPSS showed significant positive correlation in proven MDS as well as when proven and probable MDS patients were combined. Interpretation & conclusions: Our results showed that combined Ogata approach and pattern analysis, demonstration of =3 aberrancies in >1 cell compartment could diagnose most MDS patients. Patients with high flow scores had high R-IPSS scores. Patient with flow score =3 and borderline cytomorphology should be observed closely for the development of MDS. [ABSTRACT FROM AUTHOR]