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Additive manufacturing is emerging as one of the manufacturing technologies, which affect the traditional supply chain management. The traditional supply chain is based on a push system, whereas an additional supply chain is based on a pull system. In this work we have found the impact of 3D printing on supply chain management, what the risks and opportunities of 3D printing on the supply chain are and, also what the companies are doing to leverages these opportunities and risks. It has been concluded that the additive supply chain has drastically changed the traditional supply chain in four key ways i.e. time, quality, speed, and environmental impact. It will result in the effective management of resources, which is of immense importance, keeping in mind the sustainable development goals of a blue-chip organization. It will be cost-effective and will reduce the lead-time of the supply chain. It will result in increased customer satisfaction, as the product will be produced by mass customization and improved quality. Moreover, this will lead to flexibility in the manufacturing process, which will enhance industrial efficiency. Therefore, we can say that this research will give us the vision of different industries in India in the coming years. [ABSTRACT FROM AUTHOR]

Background: Pigeon pea is affected by the cyst nematode Heterodera cajani limiting the production. H. cajani can be managed by biological agents such as Trichoderma harzianum. Thus, the determination of this experiment was to estimate native strains of T. harzianum isolated from pigeon pea fields in India on population of cyst, eggs and juveniles of H. cajani. Pots experiment was conducted at the playhouse of Sam Higginbottom University of Science and Technology, Prayagraj (UP), India, during the year of 2018–2020. Earthen pots were filled with sterilized soil @ 10 kg/pot for each replicate of the treatments. Ten days before sowing of the pigeon pea seed, about 5000 spores of T. harzianum were amended in to the soil for proper colonization. Fifteen days after seed germination, 200 cysts/pot were inoculated near the root zone of pigeon pea plant. The pots were irrigated when required. Observations were recorded of cyst population, eggs and second juveniles of H. cajani/500gm of pigeon pea rhizospheric soil at 90 days after sowing. Results: Among all the isolates of T. harzianum, the treatment (T 7) reduced of cyst population (12), eggs population (234) and juveniles' population (153) as compared with all other treatments including control at 90 days after sowing of pigeon pea seeds in the year 2018–2019. Similarly, in 2019–2020 reduction in cyst population (11), eggs population (189) and juveniles population (160) was observed at 90 days after sowing in Trichoderma isolates (T 7) as compared to control. Conclusions: The findings of this study are very relevant since seven isolates of native T. harzianum were promising to suppress the number of cysts in 79.31 and 83.07%, eggs in 22.00 and 38.83% and juveniles' population in 17.74 and 20.39% of the nematode H. cajani, besides promoting the pigeon pea plant growth. [ABSTRACT FROM AUTHOR]

The library and information services of the twenty first century are rapidly changing education learning patterns because of the rapid development of electronic publishing libraries. However, the literature reveals the considerable unpredictability in experience, challenges, and awareness about E-resources among college students during and after the COVID-19 Pandemic scenario. In the aftermath of the pandemic, everyone has been forced to learn and teach E-resources in educational institutions worldwide. Along with their academic demands, college students are confronted by a lack of knowledge of handling e-learning resources and low network connectivity in remote regions. In this aspect, this study commenced to describe the experience, challenges, and awareness about e-learning resources. A descriptive and diagnostic research design was adopted and primary data was collected from college students through Google Forms with participant consent. The basic information about respondents, experience, challenges, and awareness of E-resources are tools of the study. The statistical analysis is to be carried out based on the study's objective. This analysis was used to identify influential factors and to explore the relationships between e-learning experience, and resource awareness. Subsequently, the analysis is used to discuss recommendations for enhancing the utilization of e-learning resources based on the study's findings. [ABSTRACT FROM AUTHOR]

Undifferentiated pleomorphic sarcoma (UPS) is a rare entity found in the oral cavity which involves the mandible in only 3% of all UPS bone lesions. The correlation of the clinical presentation of the neoplasm with the histopathological and immunohistochemistry findings is very important for appropriate diagnosis. Its incidence in membranous bone like mandible is rare. According to our literature search in the PubMed database, there are only four reported cases from India some of which does not have any immunohistochemistry findings to confirm the diagnosis. We present a rare case of UPS of mandible which was clinically mimicking squamous cell carcinoma. Upon immunohistochemical analysis, we found vimentin, KI67, CD68 positive and desmin, Melan A, LCA, S100 and myogenin negative, which lead us to the diagnosis of UPS. [ABSTRACT FROM AUTHOR]

Primary immune deficiencies or inborn errors of immunity (IEI) are a heterogeneous group of disorders that predispose affected individuals to infections, allergy, autoimmunity, autoinflammation and malignancies. IEIs are increasingly being recognized in the Indian subcontinent. Two hundred and eight patients diagnosed with an IEI during February 2017 to November 2021 at a tertiary care center in South India were included in the study. The clinical features, laboratory findings including microbiologic and genetic data, and treatment and outcome details were analyzed. The diagnosis of IEI was confirmed in a total of 208 patients (198 kindreds) based on relevant immunological tests and/or genetic tests. The male-to-female ratio was 1.8:1. Of the 208 patients, 72 (34.6%) were < 1 yr, 112 (53.8%) were 1–18 years, and 24 (11.5%) were above 18 years. The most common IEI in our cohort was SCID (17.7%) followed by CGD (12.9%) and CVID (9.1%). We also had a significant proportion of patients with DOCK8 deficiency (7.2%), LAD (6.2%) and six patients (2.8%) with autoinflammatory diseases. Autoimmunity was noted in forty-six (22%) patients. Molecular testing was performed in 152 patients by exome sequencing on the NGS platform, and a genetic variant was reported in 132 cases. Twenty-nine children underwent 34 HSCT, and 135 patients remain on supportive therapy such as immunoglobulin replacement and/or antimicrobial prophylaxis. Fifty-nine (28.3%) patients died during the study period, and infections were the predominant cause of mortality. Seven families underwent prenatal testing in the subsequent pregnancy. We describe the profile of 208 patients with IEI, and to the best of our knowledge, this represents the largest data on IEI from the Indian subcontinent reported so far. [ABSTRACT FROM AUTHOR]

Upland cotton (Gossypium hirsutum L.) is a major fiber crop that is cultivated worldwide and has significant economic importance. India harbors the largest area for cotton cultivation, but its fiber yield is still compromised and ranks 22nd in terms of productivity. Genetic improvement of cotton fiber yield traits is one of the major goals of cotton breeding, but the understanding of the genetic architecture underlying cotton fiber yield traits remains limited and unclear. To better decipher the genetic variation associated with fiber yield traits, we conducted a comprehensive genome-wide association mapping study using 117 Indian cotton germplasm for six yield-related traits. To accomplish this, we generated 2,41,086 high-quality single nucleotide polymorphism (SNP) markers using genotyping-by-sequencing (GBS) methods. Population structure, PCA, kinship, and phylogenetic analyses divided the germplasm into two sub- populations, showing weak relatedness among the germplasms. Through association analysis, 205 SNPs and 134 QTLs were identified to be significantly associated with the six fiber yield traits. In total, 39 novel QTLs were identified in the current study, whereas 95 QTLs overlapped with existing public domain data in a comparative analysis. Eight QTLs, qGhBN_SCY_D6-1, qGhBN_SCY_D6-2, q G h B N _ S C Y _ D 6 - 3, q G h S I _ L I _ A 5, q G h L I _ S I _ A 1 3, q G h L I _ S I _ D 9, qGhBW_SCY_A10, and qGhLP_BN_A8 were identified. Gene annotation of these fiber yield QTLs revealed 2,509 unique genes. These genes were predominantly enriched for different biological processes, such as plant cell wall synthesis, nutrient metabolism, and vegetative growth development in the gene ontology (GO) enrichment study. Furthermore, gene expression analysis using RNAseq data from 12 diverse cotton tissues identified 40 candidate genes (23 stable and 17 novel genes) to be transcriptionally active in different stages of fiber, ovule, and seed development. These findings have revealed a rich tapestry of genetic elements, including SNPs, QTLs, and candidate genes, and may have a high potential for improving fiber yield in future breeding programs for Indian cotton. [ABSTRACT FROM AUTHOR]

Background: In India, 22% to 39% of the ageing population suffers from degenerative knee osteoarthritis (OA), making it the most prevalent joint disorder in the knee. MMP-1, MMP-3, and MMP-9 protein expression levels have all been associated with OA. The aim of the present study was to establish a relationship between synovial fluid levels of matrix metalloproteinases (MMP-1, MMP-3, and MMP-9), and tumour necrosis factor-alpha (TNF-α) with different Kellgren–Lawrence Grading scale as per the severity of knee osteoarthritis (OA). Methods: This hospital-based observational study included 87 individuals with knee osteoarthritis examined at the orthopaedics department outpatient clinic at the tertiary care teaching hospital in rural area of north India. In-person interviews were conducted to gather data, through a semi-structured, pretested interview schedule. To determine the degree and severity of OA, the levels of the enzymes matrix metalloproteinase MMP-1, MMP-3, and MMP-9 as well as tumour necrosis factor (TNF–α) were assessed in the synovial fluid of knee of each study participant. Results: The levels of MMP-1, MMP-3, MMP-9, and TNF-α in synovial fluid were significantly correlated with the severity of osteoarthritis as determined by the Kellgren–Lawrence Grading Scale. Age, duration of symptoms and BMI showed a strong positive and significant correlation with biochemical markers (MMP-1, MMP-3, MMP-9, and TNF-α) in synovial fluid of Knee. Conclusion: Level of biochemical markers (MMP-1, -3, -9, and TNF-α) in synovial fluid act as diagnostic markers and have a positive correlation with the severity of osteoarthritis knee, age, weight/BMI and duration of disease. However, no significant correlation was found between the level of aforementioned biochemical markers with sex, height, inflammation of the knee, morning stiffness, and age of onset of disease. [ABSTRACT FROM AUTHOR]

Spodoptera frugiperda, fall armyworm (FAW), is one of the notorious insect-pest that has invaded a large number of countries in a short span of time across the globe, causing huge economic losses. FAW has been in the news due to its damage potential and preference for maize crop. Besides maize, this pest is being observed moving to other crops such as sorghum, sugarcane, and many other crops. The damage to cotton caused by this insect has not been documented in any part of India. First, we describe the unusual damage symptoms caused by FAW on cotton during the pre-blooming stage. Typical damage symptoms include dead hearts, drooping main stem leaves, and burrowing. The phylogenetic analysis of the mtCOI gene sequences from the present studies along with earlier reported sequences confirmed their grouping into corn strains. Further bioassays of the F1 individuals with fruiting bodies of Bollgard-II cotton confirmed the high susceptibility of FAW to Cry1Ac and Cry2Ab toxins. [ABSTRACT FROM AUTHOR]

Objective: Though airway ultrasonography (USG) is used to assess difficult laryngoscopy (DL), there is still ambiguity about approach followed and parameters assessed. There is need of a simple, stepwise sonographic assessment with clearly defined parameters for DL prediction. The primary objective of this study was to find diagnostic accuracy of sonographic parameters measured by a stepwise Airway- USG in DL prediction (DLP). Methods: This prospective, observational cohort study was done in 217 elective surgical adult patients administered general anaesthesia with tracheal intubation using conventional laryngoscopy from 1st May 2019 to 31st July 2020, after ethical approval. A sagittal Airway- USG was done using 2-6 Hz transducer in three steps specifying probe placement and head position. Demographic, clinical and Airway- USG measurements were noted. Correlation of the clinical/sonographic parameters was made with Cormack-Lehane score on DL. After receiver operating characteristic curve plotting, the sensitivity, specificity, positive predictive value, negative predictive value (NPV) of DL was calculated for each parameter using open-epi software. Results: DL was observed in 19/217 patients. Airway-USG parameters of skin to epiglottis distance >2.45 cm, hyomental distance with head extension <5.13 cm, head neutral <4.5 cm, their ratio <1.18, maximum tongue thickness >3.93 cm and maximum skin to tongue distance >5.45 cm were statistically significant in predicting DL. DLP score with presence of >3 positive parameters showed 98% specificity, 98% NPV and 96% diagnostic accuracy to predict DL. Conclusion: DLP score derived from Airway-USG may be used as a screening and diagnostic tool for DL. [ABSTRACT FROM AUTHOR]

Background: Congenital hypothyroidism (CH) is the most common cause of preventable intellectual disability. Newborn screening (NBS) for CH has been in vogue in many parts of the world since 1970, but despite its well-known benefits, many developing countries including India have not been able to establish universal NBS for CH till date. Objective: The aim of this study was to review the clinical aspects of congenital hypothyroidism in a tertiary care university referral teaching hospital, focusing on aetiology of CH, predictors of permanence, optimal targeted dose strategies based on aetiology and the effect of newborn screening on the time to diagnosis. Material and Methods: The electronic medical records of 233 children with CH referred to our centre between January 2009 and December 2019 were analysed. A partial NBS was established in the state in 2012. Results: Dyshormonogenesis (57.5%) was the most common aetiology of CH. The incidence of transient CH in children with a gland in situ (GIS) was 35%. Levothyroxine (LT-4) dose of >2.75 μg/kg/day (sensitivity 76.5, specificity 72), >2.15 μg/kg/day (sensitivity 82.4, specificity 61.9) and >1.85 μg/kg/day (sensitivity 76.5, specificity 61.9) at years 1, 2 and 3, respectively, were predictors of permanent CH. An initial LT-4 dose ≥8 μg/kg was sufficient and very seldom led to undertreatment in children with dyshormonogenesis. On the contrary, even doses ≥13 mcg/kg/day led to frequent undertreatment in children with thyroid dysgenesis. After the introduction of newborn screening, the median age at diagnosis came down from 45 days (IQR 14–180 days) to ten days (IQR 3–12 days). Conclusion: Targeted dosing based on aetiology of CH may be more appropriate to optimise outcomes. The time to diagnosis of CH reduced significantly after the adoption of even a partial NBS program highlighting the urgent need for implementation of the same in resource poor settings. [ABSTRACT FROM AUTHOR]

Forensic odontology (FO) involves examination, proper evaluation and presentation of dental evidence before the court of law. Globally, forensic odontology(FO) has been a benchmark in advance teaching. Dentists are the oral health professionals who have a high chance of identifying bite marks and signs of abuse. Dentists in India were less into the field of forensic odontology than the western countries. Objectives: To assess the knowledge, awareness, attitude, and behavior on FO among dental undergraduate students in a dental institution. Materials and Method: A cross-sectional survey was conducted among 273 dental undergraduate students with a 15 itemed self administered questionnaire in a dental institution located in the state of Andhra Pradesh, South India. Result: The statistical analysis was carried out through descriptives and chi-square test with the statistical significance set as p<0.05 in SPSS software version 20.0. A total of 273 students participated in the survey, 83.9% of them aware that DNA can serve as identification. 93.1% know tooth can be used for dental age estimation. 61.9% of participants know the forensic odontology from the books. 60.8% of participants were aware of the application of forensic odontology in the investigation. 66.7% were lack of adequate knowledge of forensic odontology. 65.6% of participants agreed that they aware of bite mark patterns of teeth. 58.6% of participants aware that DNA can be collected from the bite mark. More than 85% of the students contracted that cheiloscopy is a study of lip prints. 67.4% of participants agreed on the forensic odontology as a department of its specialty rather than interdisciplinary. Conclusion: We observed a student's has good exposure to scope, importance, and opportunity about FO among UG students, This study stimulates further research to uplifting of forensic odontology in the future. [ABSTRACT FROM AUTHOR]

Introduction: Primary Hyperparathyroidism (PHPT) is an uncommonly diagnosed symptomatic disease that occurs in India. Unlike the Western countries where the disease is asymptomatic, the various manifestations that occur are skeletal, muscular, and renal. Studies on PHPT from developing countries like India, have shown that symptomatic PHPT is still common as compared to developed countries. Data on PHPT from Kerala (a state with health indices comparable to the Western world) are lacking. Aim: To compare the preoperative and postoperative calcium and Parathyroid Hormone (PTH) levels among the participants. Materials and Methods: A record-based retrospective study was conducted at Amrita Institute of Medical Sciences, Cochin, in the Department of Endocrinology. All 116 patients who had PHPT from January 2013 to December 2019 were included in the study. The data available in the hospital records were analysed for various laboratory values and imaging diagnoses. The preoperative and postoperative calcium and PTH levels were compared. Data were analysed by paired sample t-test. (Wilcoxon sign-rank test). The data analysis was done using coGuide. Results: The mean age was 53.42±14.89 years in the study population. Among 116 subjects, (46 (39.66%) were males and 70 (60.34%) were females) eighty-three (71.55%) had the symptomatic disease. The majority, 80 (68.97%) participants underwent single parathyroidectomy. The difference between pre-operative and post-operative calcium and PTH was statistically significant (p-value <0.001). Conclusion: PHPT largely occurs in the fifth decade of life, and the majority were symptomatic. Females were more affected compared to males in the present study. Preoperative imaging is recommended in routine practice. [ABSTRACT FROM AUTHOR]

During this COVID-19 pandemic, except steroid, none of the therapeutic measures have showed any evidence of efficacy. Traditionally jala-neti using lukewarm salted water remains a yogic way of maintaining upper airway hygiene. Saline irrigation decreases the concentration of inflammatory mediators (e.g. histamine, leukotriene etc.) in nasal secretions, reduces the severity and frequency of sinusitis, reduce need of antibiotic therapy and restores competency of nasal mucosa. Jala-neti is an integral part of six cleansing techniques of yogic kriyas practised in India since thousands of years. Jala-neti can clean the upper airways, prevents colonization of infectious agents, removes foreign bodies, prevents stasis of mucous and subsequently enhances the drainage of paranasal sinuses and maintain health. Regular practice of Jala neti improves nasal symptoms and overall health status of patients with sinusitis. Jala-neti sample can even be used for COVID-19 diagnosis. Povidone iodine (PVP-I) has been utilized as a time tested antimicrobial agent with broad spectrum coverage against wide range of bacteria and viruses. Anti-SARS-CoV-2 action of PVP-I was seen at a concentration as low as 0.45%. PVP-I is generally well tolerated upto 5%, however nasal ciliotoxicity is reported at this concentration, however, this toxicity is not reported with lower concentrations(1.25% and 0.5%). So, theoretically, by using neti-kriya with povidone iodine (0.5–1%) as irrigation solution can combine and enhance the protection against COVID-19 and this can be an important armor in the fight against COVID-19. However, this hypothesis needs to be validated in real life clinical trial scenario before implementing. [ABSTRACT FROM AUTHOR]

Background: India's neonatal and perinatal mortality is among the highest in the world. Intrapartum-related conditions contribute to a significant proportion of neonatal deaths and stillbirths. Fetal heart rate monitoring, a recommended norm to assess fetal well-bring, is not practiced as per standard guidelines in public health facilities. A standardized Doppler along with training on fetal heart rate monitoring was implemented across different levels of healthcare in three states. Methods: Facilities were selected purposively to implement the Doppler. Baseline data for 3 months were collected. Interviews of health providers and observation of labor were conducted quarterly. Data were analyzed through a comparison of baseline and intervention on a number of delivery and monitoring indicators. Results: Among 22,579 total deliveries, monitoring frequency increased along with increase in detection of abnormal fetal heart rate (FHR) while cesarean section and stillbirths reduced slightly. Cases never monitored reduced in the District Hospitals (7.98–2.07, P < 0.01) and in Community Health Centers (14.7–1.67, P < 0.001). Stillbirth rate reduced at the medical college (3.6–1.1, P < 0.001). Interviews with providers revealed acceptance of the device due to its reliable readings. Conclusion: The Doppler demonstrates acceptability and serves as a useful aid to improve intrapartum FHR monitoring. [ABSTRACT FROM AUTHOR]

Background: Digital learning tools have proliferated among healthcare workers in India. Evidence of their effectiveness is however minimal. We sought to examine the impact of the Safe Delivery App (SDA) on knowledge and confidence among frontline health workers (HW) in India. We also studied whether facilitation to address technical challenges enhanced self-learning. Methods: Staff nurses and nurse-midwives from 30 facilities in two states were divided into control and intervention groups through randomization. Knowledge and confidence were assessed at baseline and after 6 months. Three rounds of facilitation addressing technical challenges in downloading and usage along with reminders about the next phase of learning were conducted in the intervention group. A user satisfaction scale along with qualitative interviews was conducted in the intervention group at the endline along with qualitative interviews on facilitation. Results: The knowledge and confidence of the healthcare workers significantly increased from the baseline to endline by 4 percentage points (P < 0.001). The participants who received facilitation had a higher mean score difference in knowledge and confidence compared to those who did not receive facilitation (P < 0.001). The participants were highly satisfied with the app and video was the most-watched feature. They reported a positive experience of the facilitation process. Conclusion: The effectiveness and acceptability of the SDA indicate the applicability of mHealth learning tools at the primary healthcare level. In a time of rapid digitalization of training, facilitation or supportive supervision needs further focus while on-ground digital training could be invested in to overcome digital illiteracy among healthcare workers. [ABSTRACT FROM AUTHOR]

This post-authorization study was conducted to evaluate the safety of insulin degludec/insulin aspart (IDegAsp) in adult patients with diabetes mellitus (DM) during routine clinical care under a real-world setting in India. Eligible patients received IDegAsp for a minimum of 12 months during routine clinical management. Data were collected at 0, 3, 6, and 12 months. In total, 1029 adult patients with DM were included; 65.2% (n = 671) were men; mean age was 55.0 ± 12.2 years, and the mean duration of diabetes mellitus was 10.8 ± 7.4 years. Thirty adverse events were reported in 23 patients (2.2%) during the follow-up: two adverse events in two patients were serious with fatal outcomes, which were unrelated to IDegAsp use. At baseline, there were 176 confirmed hypoglycemic events in 67 (6.7%) patients while they were on their previous treatment options. At 12 months of treatment with IDegAsp, 11 confirmed hypoglycemic events were reported in 11 (1.1%) patients since the previous visit; there were no reported episodes of severe hypoglycemia. Mean glycosylated hemoglobin value reduced from 9.5% ± 1.8% at baseline to 7.7% ± 1.1% at 12 months. This study showed the safety of IDegAsp in patients with diabetes mellitus over a period of 1 year during routine clinical care. [ABSTRACT FROM AUTHOR]

Non-vitamin K antagonist oral anticoagulants (NOACs) are a new class of anticoagulant drugs used in the prevention and treatment of venous thromboembolism (VTE) and atrial fibrillation (AF). Anticoagulation requires the integration of the correct type and dose of oral anticoagulants based on patient characteristic, and therefore therapy needs to be individualized for each patient. Growing scientific evidence from studies on NOACs has led to a better understanding of their benefits and safety. A large amount of available data creates a necessity for an adaptable practical document for the usage of NOACs in India. The current consensus, developed by experts from India, aims to give recommendations on various frequently raised clinical questions with regards to NOACs and its usage. This practical document provides a platform upon which future guidelines, policies, training, and education for the use of NOACs can be tailored. [ABSTRACT FROM AUTHOR]

Genetic resistance in rice through native traits is an important tactic to manage Brown planthopper (BPH), Nilaparvata lugens Staal (Homoptera: Delphacidae) which is one of the most dreaded pests in the farmer's field causing serious crop losses. Many sources of resistance, both from cultivated and wild accessions, are known with almost 36 resistance genes mapped to different chromosomes through phenotypic and genotypic selections. A majority of resistance genes identified are effective for BPH biotypes prevailing in Southeast Asia and China. For South Asia, very few BPH resistance genes are effective but without their utilization for the development of commercial hybrids and varieties. A new source of resistance HSPP 6417 has been identified in the present paper, which displayed resistance to 11 populations of BPH collected from different rice ecologies of India. The new source HSPP 6417 had an adverse effect on the population dynamics of BPH by inhibiting the population build-up on the plants. The resistance of HSPP 6417 was equivalent to the only source of resistance in India, G7253 used to develop a commercial rice hybrid AZ8433 DT. On crossing HSPP 6417 with other prolific restorer lines of the commercial hybrids, the major genes were found to control its modes of inheritance. Field trials with F4 generation revealed that resistance was stable with good agronomic performance under infestations. The implications of using such a source of resistance for developing BPH resistant hybrids are discussed in the paper. [ABSTRACT FROM AUTHOR]

Background: Maternal and child health implementation plan development in districts of India lacks systematic process and capacity resulting in suboptimal health improvements. There is ineffective and limited participation and lack of autonomy to effect changes in district priorities. Objectives: Primary objective was to demonstrate a systematic planning approach to develop evidence-based district implementation plans for mothers and children. Methods: A planning tool named RAASTA (RMNCH + A Action Agenda using Strategic Approach for evidence-based district work plans) adapted from WHO (World Health Organization) program review tools was used in the states of Uttarakhand and Jharkhand. The tool was implemented in the two states for the development of implementation plans in a 6-step process by prioritizing district health goals; reviewing maternal, neonatal, child, and family planning intervention coverage; and linking them with activity implementation status; assessing strengths, and weaknesses of previous implementation plans and developing solutions based on current gaps in intervention coverage's. Results: Tool was used for capacity building of 59 participants and also identification of prioritized activities based on their available data. Several newer activities were identified. The districts mainstreamed them as action plans, many of which were incorporated in the state Program Implementation Plan for budgetary provisions under state NHM (National Health Mission) funds. Conclusion: The use of a tool facilitated the systematic development of evidence-based district implementation plans. [ABSTRACT FROM AUTHOR]

Objectives: To address pneumonia, a major killer of under-5 children in India, a multimodal pulse oximeter was implemented in Health and Wellness Centers. Given the evidence of pulse oximetry in effective pneumonia management and taking into account the inadequate skills of front-line healthcare workers in case management, the device was introduced to help them readily diagnose and treat a child and to examine usability of the device. Design: The implementation was integrated with the routine OPD of primary health centers for 15 months after healthcare workers were provided with an abridged IMNCI training. Monthly facility data was collected to examine case management with the diagnostic device. Feedback on usefulness of the device was obtained. Setting: Health and Wellness Centers (19) of 7 states were selected in consultation with state National Health Mission based on patient footfall. Participants: Under-5 children presenting with ARI symptoms at the OPD. Results: Of 4846 children, 0.1% were diagnosed with severe pneumonia and 23% were diagnosed with pneumonia. As per device readings, correct referrals were made of 77.6% of cases of severe pneumonia, and 81% of pneumonia cases were correctly given antibiotics. The Pulse oximeter was highly acceptable among health workers as it helped in timely classification and treatment of pneumonia. It had no maintenance issue and battery was long-lasting. Conclusion: Pulse oximeter implementation was doable and acceptable among health workers. Together with IMNCI training, PO in primary care settings is a feasible approach to provide equitable care to under-5 children. [ABSTRACT FROM AUTHOR]

Background: High-risk pregnancy (HRP) puts current pregnancy at an increased risk of complications. In the absence of pre-existing HRP implementation model of the country, in collaboration with the Government of Himachal Pradesh, a new digital HRP model called the 'SEWA—A System E-approach for Women at risk' was developed. The current article demonstrates a model for the early identification and line listing of high-risk pregnant women (PW) with appropriate referrals and increased engagement with the healthcare workers using a digital tool in the form of the Android App. Methods: SEWA was implemented as a pilot intervention in two community development blocks of the Chamba district. The key implementation steps included finalizing protocols for the identification of HRPs, defining processes and roles, mapping health facilities, setting up the communication loop, and developing of digital solutions. The digital app, used by the auxiliary nurse midwife (ANM) and program officers, tracked PW for a year from October 19 to October 20 and recorded the ANC visits, referrals, and birth outcomes. A qualitative assessment was conducted among the health workers to find out their level of acceptance. Results: A total of 1,340 high-risk PW were identified. The intervention year saw a rise in the identification of HRP to 27.9% from 3.5% in the previous year. A total of 2,559 conditions were tagged to the identified 1,340 women categorized into current pregnancy (81%), previous pregnancy (16%), and any existing chronic illness (3%). A majority of the women who required urgent referrals were provided referrals. The application recorded 53% of the delivered HRP with a digital birth preparedness plan, prepared and shared with the PW and Accredited Social Health Activists (ASHA), by text message for compliance. Conclusion: The SEWA application is a feasible and sustainable solution to complement the competency of the care providers for early identification of the high-risk conditions and reduce the burden of preventable unprecedented deaths around the time of birth. [ABSTRACT FROM AUTHOR]

Management of differentiated thyroid carcinoma (DTC) patients with thyroglobulin (Tg) elevation and negative iodine scintigraphy (TENIS) and negative neck ultrasound scan causes considerable diagnostic and therapeutic dilemma, especially in resource-poor settings. The aim of this study was to evaluate clinicopathological features and outcome of TENIS patients with negative neck US attending a thyroid cancer clinic in India. From a DTC database of 722 containing 193 TENIS patients, subjects with negative neck US and negative Tg antibody (TgAb) were selected retrospectively and analyzed using appropriate statistical methods. The study group included 64 patients (male – 17, female – 47, mean age – 44.7 ± 12.8 years) with 54 papillary and 10 follicular thyroid carcinomas, American Thyroid Association (ATA) recurrence risk categorization (2009) – low – 16, intermediate – 28, and high – 2 0. Most of the patients became TENIS within 1 year of diagnosis with median Tg level of 6.5 ng/mL (1.2–996 ng/mL) and mean follow-up of 7.8 years. On follow-up, Tg dropped spontaneously in 27 patients, more among the low and intermediate-risk categories. For those with high or increasing Tg level, further imaging (fluorodeoxyglucose positron emission tomography/computed tomography) was done and 14 out of 18 were positive. Treatment included empiric radioactive iodine therapy-16, external beam radiation therapy (EBRT)-7, and lymph node dissection (LND)-10. A favorable outcome was seen in 36 patients and unfavorable in 28. Distant metastases were associated with unfavorable outcome and poor survival. Progression-free survival was significantly better in the Tg group of <10 at the time of TENIS (111 months) compared to the Tg group >10 (72 months). Tg level dropped spontaneously in nearly half the patients, especially if levels were <10 and more so among the low-risk category. Distant metastasis was predictive of unfavorable outcomes. Along with Tg level, the ATA risk category might help to predict clinical course and reduce unnecessary expensive imaging in resource-poor settings. [ABSTRACT FROM AUTHOR]

Background: A family-centered care (FCC) parent participation program that ensures an infant is not separated from parents against their will was developed for the caring of their small or sick newborn at a neonatal intensive care unit (NICU) in Delhi, India. Healthcare provider sensitization training directed at psychosocial and tangible support and an audio-visual training tool for parent-attendants were developed that included: 1) handwashing, infection prevention, protocol for entry; 2) developmentally supportive care, breastfeeding, expression of breastmilk and assisted feeding; 3) kangaroo mother care; and 4) preparation for discharge and care at home. The study aimed to examine the feasibility and acceptability of the FCC model in a NICU in India.Methods: A prospective cohort design collected quantitative data on each parent-attendant/infant dyad at enrollment, during the NICU stay, and at discharge. Feasibility of the FCC program was measured by assessing the participation of parent-attendants and healthcare providers, and whether training components were implemented as intended. Acceptability was measured by the proportion of parent-attendants who participated in the trainings and their ability to accurately complete program activities.Results: Of 395 NICU admissions during the study period, eligible participants included 333 parent-attendant/infant dyads, 24 doctors, and 21 nurses. Of the 1242 planned parent-attendant training sessions, 939 (75.6%) were held, indicating that program fidelity was high, and the majority of trainings were implemented as intended. While 50% of parent-attendants completed all 4 FCC training sessions, 95% completed sessions 1 and 2; 60% of the total participating parent-attendants completed session 3, and 75% completed session 4. Compliance rates were over 96% for 5 of 10 FCC parent-attendant activities, and 60 to 78% for the remaining 5 activities.Conclusions: FCC was feasible to implement in this setting and was acceptable to participating parent-attendants and healthcare providers. Parents participated in trainings conducted by NICU providers and engaged in essential care to their infants in the NICU. A standard care approach and behavior norms for healthcare providers directed psychosocial and tangible support to parent-attendants so that a child is not separated from his or her parents against their will while receiving advanced care in the NICU. [ABSTRACT FROM AUTHOR]

Objective: An innovation of structured community based followup of SNCU discharged babies by ANM and ASHA was piloted under Norway India Partnership initiative. The current study describes the survival status and other outcomes among newborns discharged from SNCUs and followed at community level in first 42 days of life. Methods: It is a retrospective cohort study on newborns discharged from SNCUs from 13 districts across four states of India. Routine health systems data have been utilized to record key parameters like birth weight, sex, weights during follow-ups, any illnesses reported, status of feeding and survival status. These were compared between normal and low birth weight babies. Newborns discharged from special newborn care units (SNCUs) and followed up at community level at 24 hours, 7 days after first visit, and at 6 weeks of life. Results: Follow up of 6319 newborns were conducted by the ANM (25.4%), ASHAs (4.7%) or both (69.8%); 97% of the babies were followed-up at all the visits. The median duration of follow-ups were 1 day post-discharge, 13th day and 45th days of life. Majority (97%) of them were breastfed, and were warm to touch at the time of the visit. More than 11% of the babies needed referral at every visit. Mortality rate in the cohort of babies discharged from SNCUs till 6 weeks of follow up was 1.5%. Among normal birth weight newborns, it was 0.4% while it was 2.02% among LBW babies. The proportion of girls among those who died increased from 20% in the first follow up to 38.1% at second follow up and 41% at 6 weeks. Conclusions: Babies with LBW were at higher risk of death as compared to babies with normal birth weight. Follow-up at critical timepoints can improve survival of small and sick newborns after discharge from SNCUs. [ABSTRACT FROM AUTHOR]

Objective: To generate evidence on the current situation of hospital care (emergency, inpatient and outpatient), for managing children presenting with diarrhea and pneumonia at 13 district hospitals in India. Design: Facility-based assessment of district hospitals. Settings: 13 district hospitals in four states of Bihar, Madhya Pradesh, Odisha and Rajasthan. Participants: Staff nurses and doctors. Intervention: None. Methods: An assessment was done across 13 district hospitals in four states by a group or trained assessors using an adapted quality assurance tool developed by Government of India where each aspect of care was scored (maximum score 5). Emergency services and triage, case management practices, laboratory support, and record maintenance for diarrhea and pneumonia were assessed. Results: Separate diarrhea treatment unit was not earmarked in any of the DHs surveyed. Overall score obtained for adequate management of diarrhea and pneumonia was 2 and 2.2 which were poor. Pediatric beds were 6.8% of the total bed strength against the recommended 8–10%. There was a 65 percent shortfall in the numbers of medical officers in position and 48 percent shortfall of nurses. There were issues with availability and utilization of drugs and equipment at appropriate places with cumulative score of 2.8. Triage for sick children was absent in all the facilities. Conclusion: The standards of pediatric care for management of diarrhea and pneumonia were far from satisfactory. This calls for improvement of pediatric care units and implementation of operational guidelines for improving management of diarrhea and pneumonia. [ABSTRACT FROM AUTHOR]

Objective: To study special newborn care units (SNCUs) in terms of family participatory care (FPC) quality initiative as per Government of India guidelines in select public health facilities, and to document the perspectives of the doctors and mothers. Design: Cross-sectional. Settings: SNCUs with functional FPC units in the states of Odisha, Madhya Pradesh and Rajasthan. Participants: 38 SNCUs; doctors and nurses in-charge of the unit; and two eligible mothers per unit, one inside the step-down unit and second outside the step-down unit whose newborns were admitted to special new-born care unit, having a stable baby weighing above 1500 g. Intervention: The states implemented FPC as per Government of India guidelines using National Health Mission funds across special newborn care units. This assessment involved onsite observation and interviews of key providers. Outcome: Proportion of facilities providing regular counselling sessions, enabling support to mothers, recording FPC information; perspectives of health providers on improvement of breastfeeding and kangaroo mother care; proportion of eligible mothers practicing FPC, exclusively breastfeeding, and providing kangaroo mother care services. Results: Out of 38 SNCUs, we found that FPC sessions for mothers were happening in 36 (95%) facilities. SNCUs provided enabling support to mothers on FPC (74.2%), held regular sessions for the families (70.6%), nurses assisted mothers and family members for breastfeeding and kangaroo mother care (76.4%) and FPC information were recorded (70.6%). Conclusions: The assessment of facilities where FPC was implemented showed that SNCUs were equipped to implement FPC in public health settings. [ABSTRACT FROM AUTHOR]

Background: To study the health‐related quality of life (HRQoL) in pediatric onset Type 1 diabetes mellitus (TIDM) in the state of Kerala in India. Methods: Diabetes specific HRQoL was determined in 107 subjects with onset of T1DM less than 21 years using the Pediatric Quality of Life Inventory (PedsQL) 3.2 questionnaire of which 69 also completed the PedsQL 4.0 generic questionnaire. The parents of these patients completed the proxy scoring questionnaire. The generic HRQoL of T1DM was compared with control population without diabetes. Results: Mean age of onset of T1DM was 8.2 ± 4.6 years and mean duration was 8.2 ± 5.6 years. The median HbA1c was 8.7% (72 mmol/mol). Microvascular complications were present in 14.9% of the patients. The generic HRQoL was lower in patients with T1DM compared to peers without diabetes (77.43 vs. 87.45; p < 0.001). Parents reported lower scores in diabetes management, treatment barriers, physical functioning and generic scales compared to patients. Parents reported greater worry about the disease with lesser age of onset of diabetes and with presence of complications. Those using insulin vials and on splitmix regimen had lower HRQoL compared to those using insulin pens. The patients belonging to lower socioeconomic status (SES) reported lower diabetes scores (73.7 vs. 58.7; p = 0.015). Conclusions: The generic HRQoL was lower in children with T1DM compared to peers without diabetes. Parents and children had different perception about HRQoL in many aspects. The diabetes specific scores were lower in those belonging to lower SES. [ABSTRACT FROM AUTHOR]

Monogenic forms of diabetes in children are frequently misclassified as either type 1 diabetes or young‐onset type 2 diabetes. There is a paucity of literature regarding pediatric monogenic diabetes in the Indian population. A retrospective analysis of case records of 37 children with monogenic diabetes who were diagnosed between 2008 and 2019 in a South Indian tertiary care center was performed. The write‐up describes the clinical, biochemical, and genetic characterization of these patients with the diagnoses of neonatal diabetes mellitus (15 patients), MODY (five patients), and various forms of syndromic diabetes (13 with Wolfram syndrome, two with H syndrome, one with mitochondrial diabetes, and one with thiamine responsive megaloblastic anemia). [ABSTRACT FROM AUTHOR]

Corona virus disease 2019 (COVID-19) is an infectious disease with Acute Intense Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), and the World Health Organization (WHO) has proclaimed Covid-19 as a pandemic. The virus can spread quickly through close contact and via respiratory droplets induced when people cough or sneeze. The respective officials have promoted social Distancing, and governing bodies as a precautionary measure to prevent this novel disease as social contacts between people have a solid assortative structure in age. A mathematical model is used to predict the transmission of the disease, including age and social contact structure. In the research paper, a SIR Model of the spread of the corona virus that considers both the age and social contact structure has been explored. The bangs of Covid-19 on different age groups were highlighted for special attention to prevent the transmission of the disease. [ABSTRACT FROM AUTHOR]

Context: Medullary thyroid carcinoma (MTC), being an aggressive disease, requires meticulous follow-up and multidisciplinary management. The clinical presentation, management, outcome of MTC varies among different populations. Aims: An audit was conducted to evaluate the demography, clinical presentation, management, and outcome of MTC in a tertiary care center in South India. Settings and Design: A retrospective analysis was conducted of data from hospital records of patients with MTC treated at our center from 2004 to 2019. Statistical Analysis: All analyses were performed with SPSS software (version 16). Results: Among the 82 patients (M 42, F 40), mean age was 42.07 years (SD 14.5), 46 were operated at our center and 36, outside. Follow-up data were not available for all patients. Median duration of the disease was 36 months and median follow-up was 28 months. Lymphnode dissection was more common (37/46) in patients operated at our center than outside operated patients (17/36) (P < 0.01). At presentation, more than half of the patients had stage IV disease and 8 had distant metastases. Bone, lung, and liver were the common sites of metastases. Persistent hypercalcitoninemia >50 pg/mL was seen in 49.9%. Salvage surgeries of the neck were necessary in 29 patients (38.2%). Mean survival was 66 months and 10-year survival was 35%. Male gender (P = 0.008) and Stage IV disease at presentation (P = 0.038) were associated with poorer survival. Conclusion: MTC, in our population, presented at an advanced stage. Male gender and stage IV at presentation had poor survival. Early diagnosis, aggressive initial neck clearance, close follow-up with tumor markers, appropriate imaging, along with prompt surgical intervention will help to improve outcome. [ABSTRACT FROM AUTHOR]

Bovine herpesvirus 1 (BoHV1) and 5 (BoHV5) are genetically and antigenically related alphaherpesviruses. Infection with one virus induces protective immunity against the other. However, disease associated with BoHV1 and BoHV5 varies significantly; whereas BoHV1 infection is usually associated with rhinotracheitis and abortion, BoHV5 causes encephalitis in cattle. BoHV5 outbreaks are sporadic and mainly restricted to the South American countries. We report BoHV5 infection for the first time from aborted cattle in India. Based on the characteristic cytopathic effects in MDBK cells, amplification of the viral genome by PCR, differential PCR for BoHV1/BoHV5, nucleotide sequencing and restriction endonuclease patterns, identity of the virus was confirmed as BoHV5 subtype A. Serum samples from the aborted cattle strongly neutralized both BoHV1 and BoHV5 suggesting an active viral infection in the herd. Upon UL27, UL44 and UL54 gene-based sequence and phylogenetic analysis, the isolated virus clustered with BoHV5 strains and showed highest similarity with the Brazilian BoHV5 strains. [ABSTRACT FROM AUTHOR]

Background and Aims: Liver transplantation has become an effective therapy for patients with end-stage liver disease. The risk of new-onset diabetes after transplantation (NODAT) and posttransplant metabolic syndrome (PTMS) is high among patients after liver transplantation. These are thought to be associated with increased risks of graft rejection, infection, cardiovascular disease, and death. Our study aimed to document the incidence of NODAT and PTMS and analyze pre and posttransplant predictive factors for their development in patients undergoing a liver transplant. Methods: This was a prospective comparative study on 51 patients who underwent live donor liver transplantation. They were evaluated at baseline, 3 and 6 months after transplantation with fasting glucose, lipids, serum insulin levels, C-peptide, and HbA1C. They were followed up at 5 years to document any cardiovascular events or rejection. Results: The incidence of preoperative diabetes mellitus (DM) in the study group was 25/51 (49%). The incidence of NODAT was 38.5% (10/26 patients) and PTMS 29% (10/35), respectively. Age (47.7 ± 5.4 vs 41.5 ± 12.7 years), HOMA2 -IR (2.3 ± 1.8 vs 2.1 ± 1.6), serum insulin (16.1 ± 12.0 vs 17.9 ± 14.5), and C-peptide (4.6 ± 0.5 vs 4.8 ± 0.7) were similar at baseline in the NODAT group compared to those who did not develop it. Mean tacrolimus levels were higher in PTMS group (6.8 ± 2.9 vs 5.0. ± 2.0 P value = 0.042). By the end of 5 years, 7 patients expired; 6 due to rejection and one due to cardiovascular disease. Moreover, 2 of these patients had preexisting DM and 2 had NODAT. Conclusions: None of the baseline metabolic factors in patients undergoing liver transplant were predictive of the development of NODAT or PTMS. Mean tacrolimus levels were significantly higher in the PTMS group. A 5-year follow-up showed no excess risk of cardiovascular events or rejection in those with preexisting DM or in those who developed NODAT. [ABSTRACT FROM AUTHOR]

Multisystem Inflammatory Syndrome (MIS) is a newer, rarer and dangerous childhood disease that require early attention and is associated with Coronavirus Disease-2019 (COVID-19) infection. This article reports four clinically ill children of age 6-15 years admitted to Aster CMI hospital, Bengaluru, Karnataka, India, during October and November 2020. The diagnosis was based on elevated laboratory values (D-Dimer, C-reactive Protein (CRP), and Ferritin) and positive COVID-19 antibody test. No infectious aetiologies were identified. All patients presented at Emergency Room (ER) with hypotensive shock and were treated with inotropic support, Intravenous Immunoglobulin (IV-Ig), and steroids. Children responded well to treatment and were discharged within a period of 8-11 days. Clinical characteristics are necessary for understanding more about newly identified paediatric illness. [ABSTRACT FROM AUTHOR]

Context: Insulin autoantibody syndrome (IAAS) is considered to be a rare cause of hyperinsulinaemic hypoglycaemia. Lack of familiarity with the varied clinical manifestations leads to underdiagnosis. Localization techniques aimed at insulin-secreting neoplasms and nesidioblastosis, which are expensive often are ordered when the correct diagnosis is not made. Aims: We describe the myriad of clinical manifestations associated with IAAS based on single centre experience. Settings and Design: Retrospective analysis of patients who got admitted with symptoms suggestive of hypoglycaemia and underwent mixed meal test and prolonged hypoglycaemic test from 2016 to 2019. Subjects and Methods: Retrospective data of 12 patients with IAAS who were diagnosed in the threeyear time period between 2016 and 2019 are included in this analysis. Clinical details, biochemical parameters and imaging modalities were analysed. Statistical Analysis: All analyses were performed with SPSS software (version 17). Results: Total of twelve patients 12 (5 male and 7 females) were identified as IAAS. Median age of presentation was 57 years. Median insulin levels and median C-peptide levels were 300 miu/ml and 18.5 ng/ml respectively. Only 3 (25%) patients had spontaneous resolution. Steroid induced remission occurred by 3 months in the remaining patients. Intermittent hyperglycaemia was seen in 9 (75%) patients. Implicatable drug use preceding the occurrence of the clinical symptoms was observed in five patients. Conclusion: IAAS is not uncommon in India. The diagnosis should be pursued in patients with hyperinsulinaemic hypoglycaemia especially when insulin levels are very high or when there is intermittent hyperglycaemia. [ABSTRACT FROM AUTHOR]

Background: To improve coverage of key child health community practices, Home Based Infant Care (HBNC+) was implemented with support of Norway India Partnership Initiative (NIPI) in 4 States of Rajasthan, Madhya Pradesh, Bihar and Odisha. The innovation aimed at improving coverage of key child health interventions through home visits by community health worker, Accredited Social Health Activist (ASHA). Aims & Objective: This paper elucidates the results from the assessment of implementation in intervention versus control districts of Rajasthan. Material & Methods: A cross-sectional intervention-control design with a sample size of 3211 mothers of children in age group 0 to 23 months was adopted. Results: 85 percent of the children (aged 3-23 months) received at least one infant care home visit in the intervention districts in comparison to 32 percent in control. Significant improvements were found in terms of exclusive breastfeeding, weighing and Iron Folic Acid (IFA) consumption and availability of ORS and Iron Syrup in intervention districts. 15 percent additional children had weight plotted in growth charts and 24 percent more consumed IFA syrup bi-weekly in intervention districts. Conclusion: Home visits in infancy is a scalable model and can lead to improvement of community child health practices. [ABSTRACT FROM AUTHOR]

Studies on thyroid disorders in type 2 diabetes mellitus (DM) are fewer than those in type 1 diabetes, but data from different parts of the world have shown conflicting results. To look at the prevalence of thyroid disorders in type 2 DM and nondiabetic controls separately in a community cohort and a hospital cohort from the same locality in South India. Thyroid function tests and thyroid autoantibodies were done in 986 people in the community (258 diabetics and 634 nondiabetics). In the hospital cohort of 194 people (147 diabetics and 47 nondiabetics), an ultrasonography of the neck was done in addition. Thyroid dysfunction was more common in the community compared to the hospital cohort 15.9 vs 9.6% but there was no difference in the proportion of people with thyroid dysfunction in diabetics and nondiabetics in both the community and the hospital cohorts. (15.6 vs 16.2% in the community and 9.6 vs 6.3% in the hospital in diabetics and nondiabetics respectively). Clinical goiter and sonographically detected goiter were also similar in diabetics and nondiabetics in the community and the hospital cohorts respectively. Females had more prevalence of goiter irrespective of the presence of diabetes. Commonest thyroid dysfunction was hypothyroidism and subclinical hypothyroidism in both cohorts. This unique study conducted in a community and hospital cohort from the same locality showed that the prevalence of thyroid disorders is similar in type 2 diabetic and nondiabetic subjects in our population. [ABSTRACT FROM AUTHOR]

Computer vision technology has led to a robust and reliable e-waste management system by automating and streamlining waste processing. Computer vision technology offers various benefits leading to sustainable improvements in e-waste management practices. It is expected that the adoption of computer vision technology will revolutionize the way processing is carried out in e-waste management by minimizing human intervention, processing time, and cost requirements. India, an emerging economy, faces enormous challenges in efficiently managing and controlling the continuously growing amount of e-waste and its impact on the environment and society. Therefore, it is imperative to adopt computer vision technology to leverage its various benefits. In this study, we identify and analyze the complex interrelationships between the enablers of computer vision technology in e-waste management. From an extensive literature review, fifteen enablers are identified and verified by domain experts before using an integrated "Interpretative Structural Modelling (ISM)" and "Decision-Making Trial and Evaluating Laboratory (DEMATEL)" methodology to visualize the causal relationships. The study findings suggest sustainability as the most important criterion among the identified enablers for computer vision technology implementation in e-waste management. Other significant enablers are adaptability and reliability, cost reduction, quality control and safety management. The study's findings will help waste management practitioners to design appropriate strategies for implementing computer vision in e-waste management and creating effective and automated e-waste processes. [ABSTRACT FROM AUTHOR]

Bacterial blight, caused by Xanthomonas axonpodis pv malvacearum is one of the most important cotton diseases in south western Punjab which leads to heavy losses especially at early crop phonological stages. An experiment was conducted on a cotton genotype (RS 921) at PAU, Regional Research Station, Faridkot to find out relationship between incidence of bacterial blight with weather parameters during Kharif 2014 and 2015. Disease incidence (DI) was recorded weekly. Correlation results revealed that temperatures (maximum, minimum and mean) were negatively correlated with disease whereas, temperature range (maximum temperature - minimum temperature) was highly favorable (r= 0.86* and 0.78** during 2014 and 2015, respectively). Likewise, increase of DI was positively associated with morning relative humidity. Both years, rainfall did not favoured the disease incidence (r = -0.35 and r = -0.07). Similarly, increase in the duration of bright sun shine hours also adversely affected the disease development. The regression model accurately estimated the disease incidence during different standard weeks of Kharif 2014 and 2015 which was validated in Kharif 2016. Results of present study are supposed to provide basis for forecasting of disease development which will help to develop advance warning system for timely management of bacterial blight. [ABSTRACT FROM AUTHOR]

With the rapid development the society the persons are having feelings of sadness, loss, anger, or frustrations which interfere with everyday life for an extended period of time resulting in the appearance of various psychological problems, out of which depression is most common having a prevalance of 15.1% in India. Severe depression causes various physiological abnormalities leading to various co-morbid conditions. But there is very little literature available about moderate depression; hence the present study is designed to study the effect of moderate depression on the autonomic system by galvanic skin response and cold pressor test. We studied 40 male patients (to avoid gender difference) of moderate depression and 40 normal subjects of same age group at rest in supine position (to avoid posture effect). Galvanic skin response was recorded and compared between these two groups. Comparison of these two groups showed that GSR is not significantly different in moderate depression patients than that from the normal subjects. Though the major depression is associated with various co-morbid conditions but moderate depression hardly affects the autonomic system. Hence it is better to diagnose and treat the depression at moderate state. [ABSTRACT FROM AUTHOR]

The article describes the authors' experience with patients who presented with glycemic excursions resulting from insulin autoantibodies from a single university referral teaching center in South India. Eight patients were diagnosed between 2008 and 2014 where insulin autoantibodies could be implicated as the etiological factor responsible for spontaneous hyperinsulinemic hypoglycemia. None of the patients had a recurrence while all severe cases responded to steroid therapy.

The article reflects on the condition of orphan drugs in India and the cost associated in availing them. It mentions that the process in developing orphan drugs is costly and that industries show negligible interest in the process but such drugs are efficient in the treatment of rare diseases. It cites the moves undertaken by the Organization for Rare Diseases India (ORDI) on addressing the problems caused by rare diseases and the opportunities offered by orphan drugs.

The author offers his views on the issue of developmental delay in children. Topics discussed include the several causes of developmental delays, a national programme for Child Health Screening and Early Intervention Services, launched by India's Ministry of Health and Family Welfare in 2013, and a number of screening tools for assessment of developmental delay.

National Physical Laboratory, India has been maintaining the standards of force from 1 N to 3 MN. There are various force machines of capacities ranging from 50 N to 3 MN. A new 1 MN force standard machine has been established to provide better traceability up to 1 MN. In order to establish the validity of metrological capabilities of the existing 50 kN dead weight force machine (BMC 0.003% at k = 2), it has been compared to 1 MN force standard machine having force realization between 1 and 100 kN using dead weights (best measurement capability (BMC) 0.002% at k = 2) and 10 kN–1 MN with 10 kN incremental using lever multiplication (BMC 0.009% at k = 2) through the precision force transducers of relative repeatability 0.005%. The intercomparison has been used to evaluate the normalized error (En value) and it has been found within the permissible limit during the whole range of the 50 kN dead weight force machine. [ABSTRACT FROM AUTHOR]

The present paper is an attempt to study the long term uncertainty of 1 MN hydraulic multiplication system (HMS) force calibration machine (FCM) at the National Physical Laboratory, India (NPLI), which is used for calibration of the force measuring instruments in the range of 100 kN - 1 MN. The 1 MN HMS FCM was installed at NPLI in 1993 and was built on the principle of hydraulic amplifications of dead weights. The best measurement capability (BMC) of the machine is ± 0.025% (k = 2) and it is traceable to national standards by means of precision force transfer standards (FTS). The present study discusses the uncertainty variations of the 1 MN HMS FCM over the years and describes the other parameters in detail, too. The 1 MN HMS FCM was calibrated in the years 2004, 2006, 2007, 2008, 2009 and 2010 and the results have been reported. [ABSTRACT FROM AUTHOR]

Abstract: Since November 2010, NPL India’s force scale has been complemented in the range from 10kN to 1MN by a further force standard machine. This automatically working 1MN force standard machine utilizes a lever amplification of a 100kN mass stack and enables low relative expanded uncertainties of smaller than 9×10−5 on the lever, and 2×10−5 on the deadweight side. In this paper, the constructional design of the machine is described. According to the new EURAMET Calibration Guide, a model for the uncertainties is developed. Supplementary to this, results from comparison measurements of the new NPL India machine with PTB´s force standard machines are presented. [Copyright &y& Elsevier]

There is a realization that managed forests and other natural areas in the landscape matrix can and must make significant contributions to biodiversity conservation. Often, however, there are no consistent baseline vegetation or wildlife data for assessing the status of biodiversity elements across protected and managed areas for conservation planning, nor is there a rapid and efficient means to acquire those data. We used a unified vegetation classification and simple animal sampling design to describe the patterns of abundance of selected mammals as indicator, or characteristic, species in different vegetation types and protected areas vs. managed forest units in the Terai Conservation Area (TCA) in northern Uttar Pradesh state, India. We quantified the relative abundance of 15 mammals of conservation concern from dung counts in vegetation sampling plots within 122 sample patches in 13 vegetation types and 4 management units. Assemblages of species differed both among vegetation types and among management units. Species assemblages in the two protected areas differed strongly from those in two managed forests. Grasslands in protected areas were the most species diverse among vegetation types and had several indicator species. Protected forests were dominated by chital ( Axis axis) and nilgai ( Boselaphus tragocamelus) in a second species group. A third species group in open grasslands and savannas in managed forests was characterized by cattle ( Bos taurus) and Indian hare ( Lepus nigricollis). Protected areas clearly are the core conservation area of the TCA for their relatively high habitat value and species diversity, and their protected status minimizes human disturbance. Impacts of human use are high in managed forests, indicating their compromised value for biodiversity conservation. Our simple assessment methodology gives managers a simple way to assess the status of important mammals across landscape conservation units. [ABSTRACT FROM AUTHOR]

Type 1 diabetes (T1D) is the most common form of diabetes in children in Western countries. There have been no large studies of childhood diabetes from India. We undertook the MEDI study ( ulticenter Survey of arly Onset iabetes in ndia) to assess the proportion of various subtypes of diabetes among the young subjects presenting to the endocrinology divisions of seven large teaching hospitals in different regions of India. In addition, we compared the clinical features of T1D and type 2 diabetes (T2D) in Indian subjects. Patients with onset of disease at younger than 20 years of age were included in this study. Six hundred and three subjects (603) were studied of whom 535 subjects (89%) had T1D, 36 (6%) had T2D, 18 (3%) had diabetes related to tropical pancreatitis or other forms of chronic pancreatitis, while other subtypes accounted for the rest. Compared to those with T2D, subjects with T1D were younger, had a lower C-peptide level, higher prevalence of ketosis, lower prevalence of acanthosis nigricans, and lower LDL and triglyceride levels. When compared with that of T2D, a higher proportion of patients with T1D were positive for GAD-65 and IA-2 antibodies, and this difference was statistically significant for GAD-65 antibodies. Overall, this large multicenter study showed that T1D is the commonest form of diabetes in childhood. T2D is the next most common kind, while chronic pancreatitis-related diabetes is uncommon. [ABSTRACT FROM AUTHOR]

Summary: Objective: Aim of the study was to determine the prevalence of Acanthosis Nigricans (AN) in a central Kerala south Indian population and to evaluate its correlations with diabetes, obesity, insulin levels and other factors. Methods: A cross-sectional community survey including physical examination and biochemical evaluation was conducted among adults above the age of 18 years in central Kerala In the first phase of the study 3069 participants were surveyed using questionnaires regarding socioeconomic status and medical details. Among them 986 subjects were evaluated in the second phase of the study which included anthropometric measurements, examination for blood pressure and Acanthosis Nigricans, blood tests such as blood glucose, fasting lipids. Fasting serum insulin level was measured for all non-diabetic subjects. Statistical analysis was done using SPSS 11.0 version software. Results: Results of the study showed that 16.1% of population had AN and it was significantly higher among females (19.6%) than males (11.4%). Prevalence of AN was highest in 30–40 year age group and it decreased with the age. Prevalence of AN correlated positively with female gender, obesity, high triglyceride levels and presence of diabetes. Presence of AN was significantly associated with higher fasting insulin levels. Males with AN had significantly higher insulin values than females with AN. Conclusion: AN has stronger clinical relevance among males than females and it can be used as a marker of insulin resistance in south Indian population especially if obesity and family history of diabetes are also present. [Copyright &y& Elsevier]

The fruit borer Helicoverpa armigera (Hu¨bner) (Lepidoptera: Noctuidae) is a serious pest of several crops in India. Among these, tomato, cotton, pigeon pea, and chickpea consistently suffer extensive damage by the insect in different parts of the country. The pesticides no longer control the insect. Among the alternative tactics for its control, transgenic plants expressing toxic proteins of Bacillus thuringiensis offer a sustainable and effective method to prevent the crop losses because of H. armigera attack. The transgenic Bt tomato plants expressing a Cry1Ab protein of B. thuringiensis suffered significantly lower damage by H. armigera than the non-transgenic control plants in the laboratory, greenhouse and field. The Bt plants caused 100% mortality of the larvae and did not support any growth and development by the latter. The only damage caused by the invading neonate larvae was to the terminal parts of tomato shoots, which underwent wilting though larvae died thereafter. In view of this, a complete control of the H. armigera by Bt plants in the field will have to be supported by the other tactics of pest management such as bio-control agents or limited use of pesticides. [Copyright &y& Elsevier]

The article focuses on the first photographic record of the four-horned Antelope Tetracerus quadricornis or chousingha from the Pilibhit Forest Division in Uttar Pradesh, India. It states that the image was captured by a camera trap during the population estimation exercises of tiger Panthera tigris from May 22 and June 30, 2010. Furthermore, it mentions that the chousingha was differentiated in terms of size and height from other species which include nilgai, muntjac and hog deer.