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Purpose. The purpose of the study was to assess the impact of an educational intervention on the level of knowledge and adherence to the treatment regimen among hemodialysis (HD) patients as well as to describe the association between these variables. Methods. In this randomized controlled trial, 160 HD patients at an HD centre of a 2030-bed tertiary teaching hospital in Southern India were randomly assigned into intervention (N = 80, received education and a booklet) and control (N = 80, received standard care) groups. Knowledge and adherence were measured preintervention and postintervention using a validated questionnaire for knowledge and the ESRD-AQ (End-Stage Renal Disease Questionnaire) for the level of adherence. The statistical analysis of the data was performed with the help of the Statistical Program SPSS version 19.0. The statistical significance level was set at 0.05. Results. The increase in knowledge on disease management, fluid adherence, and dietary adherence in the intervention group was significantly higher compared to the control group. There was no significant correlation between knowledge and adherence. Adherence improved for all the domains, i.e., dialysis attendance, episodes of shortening, adherence to medication, fluid restriction, and dietary restriction. Adherence to fluid and dietary restriction was statistically significant. [ABSTRACT FROM AUTHOR]

Background: Undernutrition in under-five children remains a worldwide health issue and is considered one of the leading causes of increased morbidity and mortality. This study aims to assess the impact of home-based nutritional intervention on the nutritional status of preschool children living in rural areas of South India. Methods: A single-blinded cluster randomized controlled trial evaluated the impact of the intervention, with weight gain as the primary outcome. A cluster of 12 villages was randomized to intervention or control arms. A total of 253 underweight preschool children from 12 clusters (villages) were randomized to intervention (n = 127) and control arm (n = 126). The intervention was composed of a health-teaching program and a demonstration of nutritious food preparation in addition to the regular services provided at the Anganwadi centers. The control arm received only standard routine care provided in the Anganwadi centre. The anthropometric assessment was carried out at the baseline and every month for a year. Result: A significant increase in the mean weight kilograms was noted in the intervention group (11.9 ± 0.98 to 13.78 ± 0.89) compared to the control group (11.8 ± 1.03 to 12.96 ± 0.88). In the intervention group, at the baseline, 41.5% were moderately malnourished (> − 2SD—3SD), which decreased to 24% at the end of the year. Similarly, severe malnutrition decreased from 8.69 to 3.16%, while 20.5% of malnourished children achieved normal nutritional status. In the control group, undernourished children demonstrated minimal changes in nutritional status. Analysis of repeated measures of ANOVA results between the intervention and control groups on weight measurements (F (1, 251) = 15.42, p.001) and height measurements (F (2, 1258) = 1.540, p.001) revealed statistical significance. Conclusion: The nutritional status of preschool children is found to be improved by home-based intervention, which includes training mothers or caregivers in planning and preparing healthy nutritious diets, providing timely care, and gaining an understanding and knowledge of the nutritional status along with regular home-based diet preparation. Trial registration: ctri@gov.in CTRI/2017/03/008273 [Registered on: 31/03/2017]. [ABSTRACT FROM AUTHOR]

Introduction: Viruses are common etiological agents of severe acute respiratory illness in under five children. Very few studies are available considering the profile of children with viral pneumonia admitted to paediatric intensive care unit (PICU) in our setting. Hence this study was done to describe the clinico- radiological profile and outcome of children diagnosed with viral pneumonia admitted to PICU. Methods: This was a retrospective descriptive study done in the PICU of a tertiary care hospital in South India. The presenting clinical features, blood parameters, chest radiography findings, course during the hospital stay and outcome of children with viral pneumonia (RT- PCR Positive) admitted to PICU were studied. Results: The aetiological profile of 28 children included - Influenza virus - 14 cases, Respiratory Syncytial Virus - 6 cases, Adeno virus - 4 cases, Human Boca virus - 2 cases, Human Rhino Virus - 1 case and Human metapneumo Virus - 1 case. Majority of children (50%) presented with severe respiratory distress. Predominant radiological picture included bilateral interstitial infiltrates followed by patchy alveolar consolidation. Eight children required mechanical ventilation. Complications included septic shock and MODS (n = 5), pneumothorax (n = 2), myocarditis (n = 2), pleural effusion (n = 1), ventilator associated pneumonia (n = 2) and pulmonary artery hypertension (n = 2). Mortality was observed in seven (25%) children. SpO2 / FiO2 ratio < 300, shock at admission, neutrophil leucocyte ratio > 2 and hypoalbuminemia were found to be significant predictors of mortality. Conclusions: Malnutrition and iron deficiency analmia were the common risk factors. Patchy alveolar consolidation is also a common radiological finding along with interstitial infiltrates. Hypoalbuminemia was a common finding among non-survivors [ABSTRACT FROM AUTHOR]

Although the River Tern (Sterna aurantia) has been widely distributed across south and southeast Asia, its population is declining and was classified as Vulnerable in the 2020 IUCN Red List of Threatened Species. Insufficient information is available on its breeding ecology. This study reports the breeding ecology and factors affecting breeding of the River Tern over three years (2017-2019) along the Mahanadi River in Odisha, eastern India. Breeding was observed between February and May, with peak activity in April. The mean clutch size was 2.4 ± 0.06 SE and incubation period was 22.1 ± 0.06 days. Out of 163 nests, 68 nests succeeded in hatching at least one egg and apparent nesting success rate varied between 2.6% (2018) and 62.3% (2017). Factors affecting nesting success (95 nests) were predation (37.9%), flooding (32.6%), a cyclone (28.4%) and nest desertion (1.1%). Overall, of 124 chicks hatched, 58 were estimated to have fledged. Factors affecting chick survival were a cyclone (43.9%), predation (39.4%), and unknown causes (16.7%). A cyclone in May 2019 wiped out all eggs and chicks. Development and implementation of an evidence-based multi-species conservation action plan to protect River Tern and other globally threatened riverine ground nesters is urgently required. [ABSTRACT FROM AUTHOR]

Background: Both intrinsic and environmental factors play a role in premature ageing of the skin. Natural extracts have been extensively used to reduce the signs of ageing in recent years. Pterostilbene is a natural analog of resveratrol with therapeutic properties against numerous diseases mainly due to its ability to reduce reactive oxygen species. Methods: We studied the anti-aging and skin brightening effect of a 0.4% formulation of natural pterostilbene in healthy volunteers (N=38) in an open-label, single-arm, monocentric study for 8 weeks. The melanogenesis inhibitory, anti-tyrosinase and anti-collagenase and anti-elastase properties of pterostilbene were evaluated in vitro. Results: Natural pterostilbene showed significant inhibition of melanogenesis in vitro. Pterostilbene cream (0.4%) was highly effective in reducing markers of aging and induces even skin tone. The product was effective in reducing wrinkles and fine lines, improved skin hydration elasticity and showed no adverse effects. Conclusion: Our results suggest that natural pterostilbene is a safe and effective ingredient for use in cosmetic preparation to reduce the markers of skin ageing and brighten the skin tone. Trial Registration: Clinical Trial Registration India Identifier CTRI/2019/01/017160 [Registered on 18/01/2019]. [ABSTRACT FROM AUTHOR]

Background: Childhood injuries represent an important global health problem. Most unintentional injuries to children under 5 years occur in and around the home as this is where they spend the majority of their time. Methodology: A study will be conducted among the caregivers' of children between 2 years to 5 years who are the residents in the selected 30 villages of Udupi taluk. Study consists of two phases: Phase I :A cross sectional prevalence survey (N= 2040), has already been done to find the prevalence of childhood injury among children between 2 to 5 years. The overall prevalence of injury among children was 98.6% 95%CI [97.6, 99.5]. Phase II A randomized controlled trial (RCT): A sample size of 150 (10 households/ village) from 30 villages will be included in the study, which was calculated statistically. Randomization of participants and villages for intervention and control was done by a person not involved in the study. A home safety supervisory program will be provided for the intervention group, the control group will receive a sham normal child care education. A baseline assessment and repeated follow ups in one month, three month and six month will be done in both the groups. The study outcomes will be assessed at each time. [ABSTRACT FROM AUTHOR]

Melioidosis is an infectious disease caused by a gramnegative bacillus, Burkholderia pseudomallei. It is known to be endemic in Southeast Asia and Northern Australia. There is a recent surge in cases from coastal India. We hereby report four episodes of Melioidosis in 3 children with one child having a recurrent episode. One child was male and two were female, with all the children aged more than ten years (range 10-14years). Fever was the most common symptom followed by abdominal and bone pain in 50% of episodes. Immunocompromised state (post-splenectomy status and steroid therapy) as a predisposing factor was present in 2 children. One child presented with septicemia and succumbed within 72 hours of admission. Ceftazidime/Meropenem and cotrimoxazole were used in intensive and eradication phase respectively. A comprehensive knowledge and high index of suspicion are required to diagnose Melioidosis. Prolonged treatment course with appropriate antibiotics would help in minimizing the mortality and morbidity in children. [ABSTRACT FROM AUTHOR]

Relationship between species' home range and their other biological traits remains poorly understood, especially in migratory birds due to the difficulty associated with tracking them. Advances in satellite telemetry and remote sensing techniques have proved instrumental in overcoming such challenges. We studied the space use of migratory ducks through satellite telemetry with an objective of understanding the influence of body mass and feeding habits on their home-range sizes. We marked 26 individuals, representing five species of migratory ducks, with satellite transmitters during two consecutive winters in three Indian states. We used kernel methods to estimate home ranges and core use areas of these waterfowl, and assessed the influence of body mass and feeding habits on home-range size. Feeding habits influenced the home-range size of the migratory ducks. Carnivorous ducks had the largest home ranges, herbivorous ducks the smallest, while omnivorous species had intermediate home-ranges. Body mass did not explain variation in home-range size. To our knowledge, this is the first study of its kind on migratory ducks, and it has important implications for their conservation and management. [ABSTRACT FROM AUTHOR]

The data on completed research and development (R&D) projects in sericulture in India for over 60 years (1994-2006) has been compiled. Information from 56 organisations totaling to 4716 projects, has been documented. Mulberry silkworm has been extensively studied in as many as 2243 projects followed by the work on the food plant mulberry in 1409 projects. Non-mulberry sericulture research was carried out in 400 projects followed by the studies on silk technology (396) and sericulture extension (253). Among the institutes. Central Sericulture Research and Training Institute (CSR & TI). Mysore ranks the top position with 2223 projects followed by Karnataka State Sericulture Research and Development Institute (KSSRDI), Bangalore (361), CSR&TI, Pampore (327), and CSR&TI, Berhampore (306). Universities initiated R & D projects from 1980 onwards and their priorities on sericulture R & D have been low. Scientists who have initiated work on socio-economic issues of sericulture industry during 1980s have discontinued sericulture related projects later. This information has been documented in the form of a 'Directory of Sericulture Projects of India', in two volumes comprising of about 2200 pages. The information is also available in the form of CD and has been hosted in the Institute's website www.kssrdi.org [ABSTRACT FROM AUTHOR]

The author's objective is to correct many of the misconceptions about India and to combat mistaken analysis. He highlights the hundreds of millions who live in poverty, the rampant corruption and the incompetence of the administration. He asserts that comparisons with China are always to the disadvantage of India, except in the field of democracy, and suggests that the Indian Space Programme is symptomatic of a wide-spread misallocation of resources. And to suggest that the traffic problems in Delhi and Mumbai are being caused by more motor vehicles is a misdiagnosis. The real cause is an increase in the number of bullock carts. [ABSTRACT FROM AUTHOR]

E-governance is premised on the notion that information technology can be used to reconfigure relations among various government departments as well as between governments and other stakeholders such as the private sector and civil society. This study uses social construction of technology (SCOT) and institutional theory as the lenses through which to deconstruct the process involved in using information technology to enhance transparency and accountability of an urban local government in India. It highlights how diverse stakeholders, by tapping into existing notions of good governance, articulated the project as resolving the need for timely, accurate, and structured information for decision-making. This problem definition led to the recognition that fundamental to transforming how the urban local government works was a reform in its financial management systems. [ABSTRACT FROM AUTHOR]

Early pregnancy scan and a good antenatal care are the most important entities which most of the rural areas in India lack. Here, we report a case of late tubal pregnancy who was mistakenly diagnosed as abdominal pregnancy. Intraoperative findings showed an unruptured 16 weeks tubal ectopic pregnancy which states that at such an advanced gestation it would be very difficult to diagnose either. This states the importance of an early ultrasound diagnosis of an intra-uterine pregnancy especially in developing countries which is required in each and every antenatal patient to ensure a safe and a healthy pregnancy. [ABSTRACT FROM AUTHOR]

Background: The prevalence of malnutrition among children in developing countries is very high. As a step towards reducing the prevalence of malnutrition, there is a need to identify the important determinants of malnutrition in the specific population so that preventive and control measures can be implemented. The objective of the study is to determine the risk factors for malnutrition among preschool children in Rural Karnataka, South India.Methods: A case-control study was carried out among preschool children, aged between three to six years, attending the Anganwadi centers and their mothers' in Udupi district of Karnataka, India. A total of 570 children (190 cases and 380 controls) were selected by multistage cluster sampling technique. A semi-structured risk factors questionnaire was used to identify the risk factors for malnutrition among children.Results: The majority (45.8 and 45.5%) of the children in the study were in the age group of 3.0 to 4.0 years in case and control groups respectively. There was a slight preponderance of illiterate parents among cases in comparison to the controls. Largely, 87.4% of the children belonged to poor socio-economic status in the case groups compared to 82.4% in the control group. After adjusting for the confounders, underweight was significantly associated with socio-economic status of the parents (aOR: 2.05, 95% CI: 1.06, 3.96), birth weight < 2000 g (aOR: 25, 95% CI: 0.10, 0.59), recurrent diarrhoea (aOR: 2.74, 95% CI: 1.56, 4.83), recurrent cold and cough (aOR: 3.88, 95% CI: 1.96, 7.67), worm infestation (aOR: 2.0, 95% CI: 1.19, 3.38) and prelacteal feed given (aOR: 3.64, 95% CI: 2.27, 5.86).Conclusion: Parental education, childhood illness, short birth interval, open defecation, type of weaning and complimentary food given to children were some of the significant determinants of underweight that were found in the study. Information, Education and Communication (IEC) campaigns alleviating food habits and taboos and promoting birth spacing is the need of the hour for preventing the occurrence of undernutrition among preschool children. [ABSTRACT FROM AUTHOR]

Background. SARS-CoV-2 has emerged as a global threat due to its infectivity and rapid transmission. We evaluated the safety and efficacy of herbal and mineral formulation (ImmuActive) as an adjunct therapy in COVID-19 patients. Methods. A randomized, double-blind, placebo-controlled study was conducted in 100 COVID-19 patients in three centers in Southern India, and 92 subjects completed the study. Subjects were followed up until they were discharged from the hospital or for a maximum of 28 days, whichever was earlier. The primary outcome parameters were the mean change and time required to change the ordinal scale of disease severity by one unit. The secondary outcomes were the time required to turn RT-PCR negative or get discharged from the hospital, change in modified Jackson's Symptom Severity score, and COVID-19 quality of life questionnaire. Results. The ordinal scale at the end of the study was significantly lower in COVID-19 patients supplemented with ImmuActive (0.57) than placebo (1.0), with a p value of 0.0043. The ordinal scale decreased by one unit within 2.35 days in ImmuActive-supplemented patients, while it took 3.36 days in placebo-supplemented patients. Days of hospitalization and time required to turn RT-PCR negative were comparatively lower in the ImmuActive arm than the placebo arm. Change in modified Jackson's Symptom Severity Score and COVID-19 QOL were significant from screening to the end of the study in both ImmuActive and placebo arms. There were no adverse events observed during the study period. Conclusion. The study results suggest that ImmuActive could be a beneficial and safe adjunct treatment for effectively managing COVID-19 infection symptoms. [ABSTRACT FROM AUTHOR]

Background: Urinary tract dilatations (UTD) are frequently diagnosed during Mid-Trimester Anomaly Scan (MTAS), at which time, given their variable progression and heterogeneous classification systems, offering suitable counsel to the couple is challenging., Objective: Based on postnatal data, we aimed to guide parental counseling, and further evaluation of UTD diagnosed at MTAS. Specifically, the utility of multi-disciplinary UTD classification system was tested., Methods: A retrospective observational study of all UTDs included from five years (2015-2020) MTAS register. The multi-disciplinary UTD classification system was used for antenatal/postnatal UTD categorization. Follow-up data were obtained from case records until the current age of children (2-6 years)., Results: Out of 527 fetal abnormalities, 103 had UTD at MTAS. Based on the third-trimester ultrasound, 49 were low-risk UTD A1, and 44 were increased-risk UTD A2-3 (including the nineteen UTD A1 at MTAS worsened to A2-3 by third-trimester). On postnatal follow-up of UTD A1 and A2-3, respectively, neonatal UTD P2/P3 was seen in 2% and 40.9%; complete spontaneous resolution was seen in 79.5% and 43.18%; none and 22.7% underwent surgical intervention; persistent P2/P3 UTD were seen on follow-up in 2% and 4.5% (excluding those who needed surgery); impaired renal function was seen in none and 36.3%, and recurrent UTI in 8.1% and 34.09%. The subgroup with progressive UTD (from A1 to A2-3 by third-trimester ultrasound) formed 43% of the final UTD A2-3 category. Among these 19 cases, surgical intervention was performed in eight (42%); impaired renal function was seen in 7 cases (36.8%), and recurrent UTI was seen in eight (42%)., Discussion: Given the diverse classification systems for UTD, ours is the second Indian data proving the prognostic utility of multi-disciplinary UTD classification system, specifically at third trimester scan, based on postnatal outcome. In contrast to published guidelines, our data suggests follow-up for renal pelvis anteroposterior diameter (APD) of 4-7 mm at MTAS, as some may worsen. Similar progression has been noted in other Indian studies, but the classification systems are different. Contrary to the published literature, we could not suggest a renal APD cut-off as a single criterion to predict surgical intervention. Significant limitations are retrospective observational design and multiple sonographers., Conclusion: Our data helps guide parental counseling and further evaluation for UTD diagnosed at MTAS. The multi-disciplinary Consensus UTD Classification system, was helpful in prognostication., Competing Interests: Conflicts of interest None., (Copyright © 2022 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)