Search

This is a school-based intervention study to promote food label understanding among early adolescents. The researcher assessed the existing nutrition knowledge, attitude, and understanding of food labels. Based on Bandura's social cognitive theory, an educational program was developed. The change was accessed from pre- and post-test intervention scores, using questionnaire technique. The sample comprised of 490 children. The developed program was implemented on an experimental group of 250 students. The control group consisted of 240 students. The test scores increased for nutrition knowledge from 2.62 to 8.24, attitude towards information from 20.41 to 29.92, practice of using information from 20.63 to 28.24, and understanding from 1.24 to 3.75, whereas no improvement in scores was observed in control group.

The aim of this study was to investigate the academic dishonesty among university students. For this the researcher has formulated two types of objectives i.e., 1. To study the predictive power of gender and streams of education in relation to academic dishonesty of university students, 2. To study the direct effect of gender, streams of education, and interaction effect of both on academic dishonesty of university students. In this regard, descriptive survey method was used, and 120 university students were selected by using stratified purposive sampling. For data collection, academic dishonesty scale was adopted which was developed by Bashir and Bala in 2018. Finally, the results of this study shown that gender and stream of education are significant predictors of academic dishonesty and there is significant direct effect of gender, streams of education and interaction of both on academic dishonesty of university students.

Background: Child development assessment tests serve many purposes, including educational placement, identifying cognitive weaknesses, and initiating early interventions. Much of the research associated with developmental testing has been conducted in high-income countries, offering limited guidance on adapting these tests to other settings. Objectives: As part of the first phase of a study exploring the impact of childhood vaccines on cognition and school attainment, we aimed to assess the feasibility of enrolling children from the community, documenting immunization, and conducting child development assessments for children between 18 months and 8 years of age in a rural setting in Haryana, India. Methods: To ensure assessments are optimally tailored to the context, child development assessment tests require valid translation and cultural adaptation. This report describes the rigorous seven-step adaptation process we designed for the contextually appropriate adaptation of the following three child development assessment tests: the Bayley Scales of Infant Development-IV, the Stanford Binet Intelligence Scale Fifth Ed. for Early Childhood, and the Wechsler Intelligence Scale for Children IV. Results: This process involved translating tests into the local language, back-translating them for accuracy, adapting them to the rural context via several iterations, and field-testing to refine and validate adaptation quality. Conclusions: This adaptation process may be beneficial for other researchers involved in adapting child development assessment tests to other settings. Further, this adaptation process may inform other researchers involved in adapting tests for diverse settings. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to suggest a methodology for evaluating the effectiveness of the flipped classroom (FC) model over traditional lecture-based teaching. It also proposed a tool to measure students' perception toward the flipped approach in context of Indian management education. Design/methodology/approach: This study employs an experimental research design to assess the effectiveness of the FC pedagogy over traditional teaching methods. Both qualitative and quantitative research methods are used in order to judge student engagement, content understanding, students' perception and student academic performance. Experimental research design, along with survey research, is implemented in order to judge the students' perception toward FCs. Findings: The study proposes a six-dimensional tool to measure learning in an FC setting. These dimensions are as follows: students' in-class involvement, comprehensive content understanding, students' academic performance, students' cognitive capabilities, collaborative learning environment and students' inclination toward teaching and learning process. Results of this research are promising and encouraging toward the adoption of the FC model. Research limitations/implications: The present research work is limited to assess the effectiveness of FC teaching for a management subject. Future studies may be carried out in other management subjects and other streams. Practical implications: The present study provides several valuable insights for future researchers, academicians and management institutions. Although implementation of flipped approach leads to a collaborative learning environment and prepares students for self-learning, it also offers educationalists to remodel their teaching pedagogy as per students' learning and understanding needs. Originality/value: The research demonstrates the successful implementation of qualitative and quantitative research techniques to evaluate the effectiveness of FC model in context of management education in India.

Objectives: The severity of pulmonary artery hypertension affects the outcomes of patients undergoing mitral valve replacement (MVR). Speckle-tracking derived strain is a new modality for the assessment of the right ventricular (RV) function as well as the longitudinal contractile pattern. Our main objective of this study was to evaluate the right ventricular (RV) function in patients undergoing MVR with pulmonary artery systolic pressure (PASP) of more than 50 mmHg at 1 and 4 weeks postoperatively. Material and Methods: This prospective cohort study included 40 patients with rheumatic heart disease (RHD) (mitral stenosis [MS] and mitral regurgitation [MR]) scheduled to undergo MVR between January 2022 and December 2023 in AIIMS, New Delhi. Serial 2D echocardiography, tissue Doppler imaging, as well as RV speckle-tracking echocardiography were performed, and serum brain natriuretic peptide (BNP) levels were measured during the pre-operative period, 1st week and 4th weeks postoperatively to evaluate RV function. Results: Tricuspid annular plane systolic excursion (TAPSE) and left ventricular ejection fractions (LVEFs) were significantly lower at 1 week after surgery, compared to pre-operative levels, and reached the pre-operative values at 4 weeks after surgery. The RV fractional area change (RVFAC) at 4 weeks postoperatively significantly increased compared to 1st week and baseline values. The tricuspid valve (TV) tissue velocity in systole (S′), TV velocity in diastole (E′), RV global strain (RVGLS), and RV free wall strain (RVFWLS) at post-operative 4 weeks were lower than pre-operative values, and this difference was statistically significant. Conclusion: Four weeks after MVR, in adult patients with RHD (MS and MR) having PASP >50 mmHg, it was observed that deformational indices or speckle-tracking echocardiography such as RVGLS and RVFWLS predict better RV dysfunction than linear indices like TAPSE. The BNP, PASP (delta TR), right atrial volume, left atrial volume, LV internal diameter in systole, and LV internal diameter in diastole decreased significantly in these patients. RVFAC increased significantly to compensate for the loss of longitudinal function. [ABSTRACT FROM AUTHOR]

Introduction: Lung transplant (LTx) is a potential treatment option for all patients with chronic, end‑stage respiratory disease, who are refractory to optimal medical therapy or where no medical therapy exists. In India, LTx is still in its evolving stages and published literature is sparse. The current study was carried out to study the selection criteria for lung transplant and to evaluate the clinical and socio‑economic profile of patients referred for the same at a tertiary health care facility. Methods: The study was a descriptive, prospective, observational study. All adults referred for lung transplant were evaluated for clinical and laboratory profiles. All enrolled patients were assessed for presence of referral criteria, listing criteria, contraindications, and willingness for lung transplant. These patients were followed up for 2 years for transplant‑free survival, and the Cox proportional hazards model was used to determine independent predictors of all‑cause mortality. Results: A total of 103 were included in study. The most common diagnosis was interstitial lung disease (57.2%), followed by bronchiectasis (17.5%) and COPD (13.6%). Most patients were referred for LTx at an advanced stage as 90% met listing criteria. Fifty‑four (52.4%) patients had an absolute or relative contraindication to transplant; however, the majority of those contraindications were modifiable. Patients with a lower socio‑economic status were less likely to be willing for LTx. The median survival was 757 days. A 6‑minute walk distance (6MWD) lesser than 250 m was found to be an independent predictor of mortality. Conclusion: Making patients aware about lung transplant early in their treatment may give them sufficient time to come to terms with their disease and understand the risk and benefits associated. Efforts should be focused on screening and early treatment of reversible contraindications for the eligible patients. Patients with 6MWD < 250 m are at increased risk of mortality. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to assess the efficiency of managing working capital in 1,388 Indian manufacturing firms from 2008 to 2019 and investigate the effects of firm-specific and macro-level determinants on working capital management (WCM) efficiency. Design/methodology/approach: The current study accommodates a slack-based measure (SBM) in data envelopment analysis (DEA) for computing WCM efficiency. Further, we implement a panel data fixed-effects model that controls for heterogeneity across firms in determining the relationships of selected variables with WCM efficiency. Findings: The results highlight that manufacturing firms operate at around 50 percent efficiency, which is constant throughout the study period. Furthermore, among the selected variables, yield, earnings, age, size, ability to create internal resources, interest rate and gross domestic product (GDP) significantly affect WCM efficiency. Originality/value: Instead of the traditional models used for assessing efficiency, the SBM-DEA model is unit-invariant and monotone for slacks, implying that it can handle zero and negative data, which overcomes the incapability of prior DEA models. Hence, this provides accurate efficiency scores for robust analysis. Additionally, this paper provides a holistic working capital model recognizing firm-specific and macro-level determinants for a more explicit estimation of the relationship between WCM efficiency and the selected determinants. [ABSTRACT FROM AUTHOR]

Objectives: To report the outcomes of pediatric patients who underwent allogeneic hematopoietic stem cell transplant (HSCT) in single rooms without high-efficiency particulate air (HEPA) filters, laminar air flow or positive pressure at our centre and discuss the adaptations of a high-volume government centre. Methods: Data of the first 20 children who underwent allogeneic HSCT between May 2019 and July 2023 in adaptive settings were reviewed retrospectively. All patients were managed in in single rooms without HEPA filters, positive pressure or laminar air flow. Supportive care in the form of antimicrobial prophylaxis, veno-occlusive disease prophylaxis, anti-epileptics (with busulfan) and irradiated blood products were provided. Trained manpower including multi-specialty consultations were readily available. All complications including infections were managed as per standard guidelines. Results: The median (range) of children included was 6 (1–20) years. For eight patients we used alternate donors. The mean (SD) time to neutrophil and platelet engraftment were 17.0 (8.07) days and 18.8 (10.1) days, respectively. The mean (SD) time to discharge from the hospital was 30.9 (10.04) days. There were no deaths within 30 days. Six children each developed acute and chronic graft-versus-host disease (GVHD). The overall survival at a median follow-up of 292 days was 70% (n = 14). Conclusions: With certain adaptations in the existing infrastructure in resource-limited settings, allogeneic HSCT can be performed with good outcomes, provided experienced, dedicated and adequate personnel, comprehensive supportive care, multidisciplinary consultative support and isolation are provided. [ABSTRACT FROM AUTHOR]

Over the years, survival of children with chronic diseases has significantly improved and a large proportion of them now are entering into adulthood. Transition of Care (ToC) of such patients with having childhood onset of chronic diseases to the adult health care system is well organized in developed countries, although it is an emerging concept in India. In situations where the systems for ToC are not in place, such cases are fraught with unsatisfactory health outcomes. With proper ToC in place, these patients are likely to receive uninterrupted care by the adult care physicians and hence reach their full potential. This document highlights the need, rationale and way forward for ToC of youth with special health care needs (YSHCN) across the country. It also describes the standard operating procedures to develop the ToC at a hospital level for clinicians and administrators. [ABSTRACT FROM AUTHOR]

Many underutilized edible fruit species (UEFS) are found in the Indo-Gangetic Plains (IGP), which support food security (FS) for both indigenous people and other dependent communities. Unfortunately, there is little study and fragmented information available about these naturally edible products. The UEFS of the IGP was the subject of a systematic review utilizing the PRISMA protocol, which produced implications for FS and land degradation neutrality (LDN). This review aims to survey, summarize, and annotate the published information about the angiosperms native and naturalized UEFS of IGP to identify and make use of this species, particularly for the sustainable development of this region. A systematic review confirmed that 371 species of UEFS, of which 62 species were threatened and near threatened (TNT)-UEFS. Among the TNT-UEFS, 41 species were threatened, while 21 species were NT. The threatened species were further categorized as per the International Union for Conservation of Nature (IUCN) Red List in the IGP as vulnerable (21 species), endangered (16 species), and critically endangered (four species). This systematic review suggests integration of the native and naturalized UEFS in afforestation and reforestation programs to aid in various ecosystem services. Calamus inermis, Corypha taliera, Licuala peltata, and Saurauia punduana are examples of multipurpose species that require immediate sustainable conservation and cultivation initiatives to save them from extinction in the near future. Multipurpose species such as Aegle marmelos, Buchanania lanzan, Manilkara hexandra, Syzygium cuminii, Tamarindus indica are immensely constructive and climate-smart by surviving in harsh agroclimatic conditions and have great potential for establishment on marginal and wastelands throughout the IGP region. These resilient fruit species enhance biodiversity, ecosystems, and landscapes in addition to providing food for humans. It progressively advances India’s commitment to LDN, combating climate change, and achieving the UN-SDGs, which call for reducing hunger and raising FS by 2030. As a result, the study will offer baseline data for the next investigations and be helpful to policymakers in creating sustainable and scientific policies for the IGP. [ABSTRACT FROM AUTHOR]

The Indian government reports projected the population increase of senior citizens from 13% in 2011 to 23% in 2036. In such a population expansion, it is a dire need to provide them with dignified, secure, happy, and affordable living. Further, physically, emotionally, and economically, senior citizens have a high dependency on their family members and friends. The primary data has been collected, constituting a sample size of 200 elderly people, who are above 60 years and belong to middle and high-income groups, residing in Delhi NCR. The key requirement that emerged from the study for the growing older population is the locational advantage of community living with full-fledged legal ownership of home along with affordability criteria. [ABSTRACT FROM AUTHOR]

A new species of the genus Awaous (Oxudercidae), Awaous motla sp. nov., is described based on 18 specimens collected from the Mahanadi River near Sonepur, Subarnapur District, and 3 specimens from the same river near Boudh bridge, Boudh District of Odisha, India. This species is distinct from its congeners by having a combination of characteristics: relatively small eyes, diameter of 6.6–8.4 in head length (LH); robust and long snout, 2.0–2.6 in LH; eye diameter 2.7–4.1 in snout length; cephalic sensory pore system interrupted with eight pores; predorsal scales 13–15; longitudinal scale series 55–58; gill rakers 2 + 1 + (6–7) on the first gill arch; teeth small, conical, and in a single row on the upper jaw and multiserial (2–3) on the lower jaw. This species is also differentiated from some of its congeners in the nucleotide composition of the cytochrome c oxidase I gene by 8.3%–13.8% Kimura two‐parameter (K2P) distance and belongs to a separate cluster in the maximum likelihood tree analysis. This finding is also supported by the species delimitation analysis based on Assemble Species by Automatic Partitioning. The new species holds high commercial value in its locality and needs special conservation attention for sustainable utilization. [ABSTRACT FROM AUTHOR]

Introduction: Emicizumab is the initial subcutaneously administered bispecific antibody approved as a prophylactic treatment for patients with haemophilia A (PwHA). Aim: This study assessed the economic evaluation of emicizumab treatment for non‐inhibitor severe haemophilia A (HA) patients in India. Methods: A Markov model evaluated the cost‐effectiveness of emicizumab prophylaxis compared to on‐demand therapy (ODT), low‐dose prophylaxis (LDP; 1565 IU/kg/year), intermediate‐dose prophylaxis (IDP; 3915 IU/kg/year) and high‐dose prophylaxis (HDP; 7125 IU/kg/year) for HA patients without factor VIII inhibitors. Inputs from HAVEN‐1 and HAVEN‐3 trials included transition probabilities of different bleeding types. Costs and benefits were discounted at a 3.5% annual rate. Results: In the base‐case analysis, emicizumab was cost‐effective compared to HDP, with an incremental cost‐effectiveness ratio (ICER) per quality‐adjusted life‐years (QALY) of Indian rupees (INR) 27,869. Compared to IDP, ODT and LDP, emicizumab prophylaxis could be considered a cost‐effective option if the paying threshold is >1 per capita gross domestic product (GDP) with ICER/QALY values of INR 264,592, INR 255,876 and INR 305,398, respectively. One‐way sensitivity analysis (OWSA) highlighted emicizumab cost as the parameter with the greatest impact on ICERs. Probabilistic sensitivity analysis (PSA) indicated that emicizumab had a 94.7% and 49.4% probability of being cost‐effective at willingness‐to‐pay (WTP) thresholds of three and two‐times per capita GDP. Conclusion: Emicizumab prophylaxis is cost‐effective compared to HDP and provides value for money compared to ODT, IDP, and LDP for severe non‐inhibitor PwHA in India. Its long‐term humanistic, clinical and economic benefits outweigh alternative options, making it a valuable choice in resource‐constrained settings. [ABSTRACT FROM AUTHOR]

Objective: Short stature homeobox (SHOX) haploinsufficiency underlies idiopathic short stature (ISS) and Leri-Weill dyschondrosteosis. The worldwide prevalence of SHOX variations in ISS varies from 2.5% to 15.0%. The aim of this study was to assess the implication of SHOX variation in ISS in North Indians and compare this with other cases of SHOX variations from Asian population. Methods: SHOX gene analysis was carried out by multiplex ligation-dependent probe amplification followed by Sanger sequencing in 54 patients with variable phenotypes. Comparison with other reports in a meta-analysis comprising the current study and 11 previous studies (n=979) was performed. Results: SHOX analysis resulted in 12.9% positivity (7.4% deletions and 5.5% duplications). SHOX association was seen significantly related to gender, with predominance in females (p=0.047). Short arms and forearms were the only significantly associated trait seen in 51.9% of children. The overall prevalence of SHOX variation was 15.2% in Asians with ISS. No significant difference was found in geographical region-specific analysis. Conclusion: This study summarises findings from the last decade and provides an updated picture of the prevalence of SHOX variations in Asians, emphasizing their potential as therapeutic targets in ISS patients. Further high quality, large investigations including functional validation is warranted to validate this association. [ABSTRACT FROM AUTHOR]

Purpose: To study the morphology of all the life stages and the life cycle of the parasitic isopod Cymothoa indica Schioedte and Meinert, 1884, and its prevalence in different commercial fishes in the Chilika Lagoon, India. Methods: From April 2021 to December 2022, different life stages of the said parasites were collected from five different fish species from four localities of the Chilika Lagoon. The parasites were carefully removed from the host with a pair of forceps and then identified following standard literature and description. The morphology of all life stages, life cycle, and prevalence of the isopod C. indica were carried out as per the standard protocol. Results: A total of 1252 host fishes were analysed. The total prevalence was 44.5%. The host with the highest prevalence of C. indica was Glossogobius giuris, with 58.79% of the hosts parasitized by at least one parasite individual. Followed by the host Datnoides polota (50.98%), Johnius dussumieri (46.25%), Etroplus suratensis (28.45%) and the least prevalence was in Lates calcarifer (14.70%). The description of the life stages is based on the observation of 523 females, 116 males, 46 Juveniles, and 50 embryonic stages of the said parasites. Conclusion: The description of all the life stages and life cycles certainly helps to identify this species with clarity and ease in understanding the species' biology. In future, this study may be helpful in the effective management towards the improvement of aquaculture productivity. [ABSTRACT FROM AUTHOR]

Limited evidence is available on the vulnerability of Adolescent Girls and Young Women (AGYW) to sexual risk behaviour and STI/HIV. Though there are almost no statistics available on vulnerability, related literature suggests that AGYW have low awareness about sexual risk behaviour/ transmission and the prevalence of STI/HIV, making them vulnerable. We conducted a rapid review of peer-reviewed studies addressing transmission network, prevalence, incidence awareness, common determinants of sexual risk behaviour/STI/HIV, health-seeking behaviour and existing interventions addressing the situation among AGYW (age 15–24) to inform the evidence gap in this crucial area of research. We registered the study in PROSPERO (CRD42023403713). We developed detailed inclusion/exclusion criteria, searched JSTOR, PubMed, Google Scholar, Science Direct and Population Council Knowledge Commons databases and followed the guidance from Cochrane Rapid Review to develop the rapid review. We also searched the bibliography of the included studies. We included the English language peer-reviewed quantitative, qualitative, mixed method studies published from Jan 1 2000 to Mar 31 2023. Six reviewers extracted data, and the seventh reviewer independently assessed the quality. Ninety-six studies met the inclusion criteria. We used descriptive statistics and narrative synthesis methods for data analysis. We also conducted a Risk of Bias Assessment (RoB) to check the quality of the included studies. Inadequate literature was found on the transmission network. Prevalence and awareness of STI/HIV are low among AGYW. However, Female Sex Workers, sex-trafficked women or drug users in this age group suffer more. Age, education, income, relationship dynamics with spouses/partners, multiple partners, and substance use are crucial in determining STI/HIV. Traditional sources of health seeking are more popular than formal sources because of social stigma. Mass media campaigns, community mobilization programs, and life skills training programs increase awareness about HIV, condom use and self-efficacy. The inclusion of only English language studies and not conducting meta-analysis because of high heterogeneity are some of the limitations of the study. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has affected medical education, constraining clinical exposure and posing unprecedented challenges for students and junior doctors. This research explores the potential of artificial intelligence (AI), specifically the ChatGPT-4 language model, to transform medical education and address the deficiencies in clinical exposure during the post-pandemic era. Research Questions/Purpose: What is the potential of AI large language models in delivering safe and coherent medical advice to junior doctors for clinical orthopaedic scenarios? Patients and Methods: A series of diverse orthopaedic questions was presented to ChatGPT-4, from general medicine to highly specialised fields. The questions were based on a variety of common orthopaedic presentations including neck of femur fracture, compartment syndrome, pulmonary embolism, and a motor vehicle accident. A validated questionnaire (Likert Scale) was implemented to evaluate the answers produced by ChatGPT-4. Results: Our results indicate that ChatGPT-4 exhibits exceptional proficiency in delivering accurate and coherent medical advice. Its intuitive interface, accessibility, and sophisticated algorithm render it an ideal supplementary tool for medical students and junior doctors. Despite certain limitations, such as its inability to fully address highly specialised areas, this study highlights the potential of AI and ChatGPT-4 to revolutionise medical education and fill the clinical exposure void generated by the pandemic. Future research should concentrate on the practical application of ChatGPT-4 in real-world medical environments and its integration with other emerging technologies to optimise its influence on the education and training of healthcare professionals. Conclusions: ChatGPT-4's integration into orthopaedic education and practice can mitigate pandemic-related experience gaps, promoting self-directed, personalised learning and decision-making support for interns and residents. Future advancements may address limitations to enhance healthcare professionals' learning and expertise. Level of Evidence: Level III evidence—observational study. [ABSTRACT FROM AUTHOR]

Introduction: Upper Gastrointestinal Endoscopy is considered the best screening tool for varices among patients with chronic liver disease. However, it is an expensive and invasive procedure that is not routinely available in rural India. Abdominal ultrasonography along with colour Doppler study is an inexpensive test commonly ordered for patients with chronic liver disease. Recent literature suggests that ultrasonographic parameters can be used to predict varices. Aim: To determine if ultrasonography of the entire abdomen and spleno-portal Doppler study findings can predict oesophageal varices in patients with chronic liver disease. Materials and Methods: The present hospital-based observational, cross-sectional study was conducted in the indoor ward of the Department of General Medicine at Medical College and Hospital, Kolkata, India, over a duration of one year from February 2021 to February 2022. Total 100 patients with chronic liver disease, admitted to the hospital ward, were included in the study. Child-Turcotte-Pugh (CTP) scores were obtained for all patients. Ultrasonographic and spleno-portal Doppler indices, such as liver size, spleen size, portal vein diameter, splenic vein diameter, peak systolic velocity of the portal vein, and portal vein/splenic vein diameter ratio, were measured alongside upper gastrointestinal endoscopy to detect varices. The data were analysed using Statistical Package for Social Sciences (SPSS) version 28.0. The Chi-square test was used to test for significant differences in proportions (categorical data), and the independent t-test and Analysis of Variance (ANOVA) with Tukey's Post-hoc test were employed to test for significant differences in means (continuous data). Additionally, Receiver Operating Characteristic (ROC) curves were obtained for statistically significant parameters to predict the presence of varices. Results: The study enrolled 100 patients (63% males, 37% females) with a mean age of 49.19±14.965 years, ranging from 14 to 91 years. (median age of 52, range 14-91 years). Of these, 68 patients (68%) had oesophageal varices, while 32 (32%) did not. The study found that a mean spleen size of 13.55 cm, a mean portal vein diameter of 12.5 mm, and a mean splenic vein diameter of ≥9.05 mm were predictive of varices. Additionally, a mean portal vein/splenic vein diameter ratio of 1.6150 was also predictive of varices. However, there was no significant difference in mean liver size and peak systolic velocity between those with and without varices. Conclusion: The present study suggests that a spleen size, portal vein diameter, splenic vein diameter, and portal vein/splenic vein diameter ratio can be reliably used to predict oesophageal varices among patients with chronic liver disease. [ABSTRACT FROM AUTHOR]

Justification: Neurodevelopmental disorders, as per DSM-V, are described as a group of conditions with onset in the development period of childhood. There is a need to distinguish the process of habilitation and rehabilitation, especially in a developing country like India, and define the roles of all stakeholders to reduce the burden of neurodevelopmental disorders. Process: Subject experts and members of Indian Academy of Pediatrics (IAP) Chapter of Neurodevelopmental Pediatrics, who reviewed the literature on the topic, developed key questions and prepared the first draft on guidelines. The guidelines were then discussed by the whole group through online meetings, and the contentious issues were discussed until a general consensus was arrived at. Following this, the final guidelines were drafted by the writing group and approved by all contributors. Objectives: These guidelines aim to provide practical clinical guidelines for pediatricians on the prevention, early diagnosis and management of neurodevelopmental disorders (NDDs) in the Indian settings. It also defines the roles of developmental pediatricians and development nurse counselor. Statement: There is a need for nationwide studies with representative sampling on epidemiology of babies with early NDD in the first 1000 days in India. Specific learning disability (SLD) has been documented as the most common NDD after 6 years in India, and special efforts should be made to establish the epidemiology of infants and toddlers at risk for SLD, where ever measures are available. Preconception counseling as part of focusing on first 1000 days; Promoting efforts to organize systematic training programs in Newborn Resuscitation Program (NRP); Lactation management; Developmental follow-up and Early stimulation for SNCU/NICU graduates; Risk stratification of NICU graduates, Newborn Screening; Counseling parents; Screening for developmental delay by trained professionals using simple validated Indian screening tools at 4, 8, 12, 18 and 24 months; Holistic assessment of 10 NDDs at child developmental clinics (CDCs)/district early intervention centre (DEICs) by multidisciplinary team members; Confirmation of diagnosis by developmental pediatrician/developmental neurologist/child psychiatrist using clinical/diagnostic tools; Providing parent guided low intensity multimodal therapies before 3 years age as a center-based or home-based or community-based rehabilitation; Developmental pediatrician to seek guidance of pediatric neurologist, geneticist, child psychiatrist, physiatrist, and other specialists, when necessary; and Need to promote ongoing academic programs in clinical child development for capacity building of community based therapies, are the chief recommendations. [ABSTRACT FROM AUTHOR]

Purpose T2* is the gold standard for iron quantification in liver as well as myocardium. In this study, we evaluated the diagnostic accuracy of myocardial T1 mapping for the assessment of myocardial iron overload (MIO) as compared to the T2* mapping in patients with thalassemia major (TM). Methods Consecutive TM patients attending the thalassemia clinic were prospectively enrolled. Magnetic resonance imaging was performed on a 1.5 T scanner (Siemens Healthineers, Germany) using a gradient echo T2* as well as a T1 mapping (MOLLI) sequence done at a mid-ventricular short-axis single 8 mm slice of the left ventricle. Values were analyzed by manually drawing a region of interest in the mid-septum. T2*less than 20ms was used as the cutoff for significant MIO. Results One-hundred three patients (58 males, mean age: 17 ± 7.8 years, mean ferritin: 2009.5 µg/L) underwent cardiovascular magnetic resonance. Median T2* of myocardium was 33.45ms. Nineteen patients (18.4%) had T2*less than 20ms. T1 value was low (<850ms) in all the patients with T2* less than 20 ms. Receiver operating characteristic curve analysis revealed the best cutoff of native T1 mapping value as 850 ms which had high specificity (95.2%), sensitivity (94.2%) and negative predictive value (98.8%) for T2* less than 20ms. There was excellent agreement between T1 and T2* for diagnosis of MIO (Kappa—0.848, p <0.001). We did not find any patient who had normal T1 mapping values but had MIO on T2*. Conclusion T1 and T2* correlate well and normal T1 values may rule out presence of MIO. T1 mapping can act as additional imaging marker for MIO and may be helpful in centers with nonavailability or limited experience of T2*. [ABSTRACT FROM AUTHOR]

Introduction: Psychosocial aspects of stuttering may affect the quality of life of a person who stutters (PWS). Further, the social stigma and experiences of PWS may vary globally. The WHO-ICF guidelines recommend quality of life as an essential component in the assessment of individuals who stutter. However, the availability of linguistically and culturally appropriate tools is often a challenge. Thus, the current study adapted and validated the OASES-A for Kannada-speaking adults who stutter. Method: The original English version of OASES-A was adapted to Kannada using a standard reverse translation process. The adapted version was administered on 51 Kannada-speaking adults with very mild to very severe stuttering. The data were analyzed for item characteristics, reliability, and validity assessment. Results: The results revealed floor and ceiling effects for six and two items, respectively. The mean overall impact score indicated a moderate impact of stuttering. Further, the impact score for section II was relatively higher when compared to the data from other countries. The reliability and validity analyses showed good internal consistency and test-retest reliability for OASES-A-K. Conclusion: The findings of the current research suggest that OASES-A-K is a sensitive and reliable tool to assess the impact of stuttering in Kannada-speaking PWS. The findings also highlight cross-cultural differences and the need for research in this direction. [ABSTRACT FROM AUTHOR]

Hemophilia A (HA) is an inherited bleeding disorder caused by a deficiency of clotting factor VIII in the blood. In resource-limited settings like India, affordability is a significant challenge in managing patients with severe HA. This study aims to assess the cost-effectiveness of intermediate-dose prophylaxis versus on-demand factor therapy in adult and pediatric populations with moderate-to-severe congenital HA without inhibitors in India. We conducted a prospective cost-effectiveness analysis from a societal perspective, categorizing patients into a base state and a joint disease state (patients with Hemophilia suffering extensive bleeds leading to chronic joint disease). Using targeted literature search and primary market research, we developed a Markov model measuring the total cost of Hemophilia treatment and health outcomes, including life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-utility ratio (ICUR), and incremental cost-effectiveness ratio (ICER). The model extended over a lifetime horizon of 70 years with a one-year cycle length. Sensitivity analyses assessed study robustness. Low-dose prophylactic therapy was cost-effective for adults (>18 years) and pediatric populations (<18 years), yielding better health outcomes (adults: 0.15 LYs and 2.43 QALYs gained; pediatric: 0.40 LYs and 3.12 QALYs gained). Intermediate-dose prophylaxis showed positive net monetary benefits in terms of Quality-Adjusted Life Years (QALYs) for both adult and pediatric populations, with dominant ICER and ICUR values in both cases. Using intermediate-dose prophylactic factor VIII therapy is a cost-effective approach that improves clinical outcomes compared to on-demand therapy in the Indian adult and pediatric HA populations without inhibitors. [ABSTRACT FROM AUTHOR]

Introduction: Type 2 diabetes is a chronic metabolic disorder characterized by elevated blood sugar levels and impaired insulin function. Achieving optimal glycemic control is crucial in preventing complications associated with diabetes. Antidiabetic medications play a pivotal role in managing diabetes and improving patients' overall health outcomes. Eastern Uttar Pradesh, India, is a region with a high prevalence of diabetes, posing significant challenges for healthcare providers. The study aimed to provide valuable insights into the efficacy and safety profiles of commonly prescribed antidiabetic medications, including metformin, sulfonylureas, DPP-4 inhibitors, and SGLT2 inhibitors, in this population Objective: This prospective open-labeled study aimed to compare the effects of various antidiabetic medications on HbA1c levels, postprandial blood sugar (PPBS), fasting blood sugar (FBS), and vitamin B12 status in patients with diabetes receiving care at a tertiary healthcare setting in Eastern Uttar Pradesh, India. Material and Methods: The present entitled study of antidiabetic medication is an institution based, prospective, randomized, open-label, single center and parallel group study conducted inDepartment of Pharmacology and Department of Medicine OPD at BRD Medical College, Gorakhpur from march 2022 to September 2022. The cases were selected basing on following inclusion and exclusion criteria after informed consent followed by meticulous history taking and clinical examination. Patients diagnosed with type 2 diabetes were enrolled in the study. The patients were divided into four groups based on the prescribed antidiabetic medication: metformin, sulfonylureas, dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors), and sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors). Baseline demographic information, clinical characteristics, and medication details were recorded. HbA1c levels, PPBS, FBS, and serum vitamin B12 levels were measured at baseline and at regular intervals over six month follow-up period. Changes in HbA1c, PPBS, FBS, and vitamin B12 levels were analyzed using paired t-tests, and comparisons between medication groups were made using analysis of variance (ANOVA). Results: A total of 259 patients (mean age59.08±12.17 years; 61% male). The study included four treatment groups: Group A (Metformin monotherapy), Group B (Metformin plus Pioglitazone), Group C (Metformin plus Tenagliptin), and Group D (Metformin plus Glimepiride). After one year of follow-up, all groups showed significant improvements in postprandial blood sugar (PPBS) and fasting blood sugar (FBS) levels (p < 0.001). However, Group A had a higher incidence of vitamin B12 deficiency compared to the other groups. The combination therapies (Groups B, C, and D) did not significantly affect vitamin B12 levels. Conclusion: The combination therapies demonstrated comparable efficacy to metformin monotherapy in improving blood sugar control. However, metformin monotherapy was associated with a higher risk of vitamin B12 deficiency. These findings highlight the importance of monitoring vitamin B12 levels in patients receiving metformin therapy and suggest the need for further research to optimize vitamin B12 status in individuals with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Urban sprawl in context to transportation is a matter of serious concern. It creates unusual environmental challenges for an emerging economy like India, known for geographical spread, population, and use of fossil fuel-based automobiles on road. Indian automotive sector is often held responsible for the emission of greenhouse gasses causing serious environmental deterioration. Government at both central and state levels is dealing with this challenge in two ways-adding more infrastructure for public transport and encouraging electrical vehicles (EVs). Adoption of EVs for public mobility is eco-friendlier and economic. But it is observed that EV penetration in many pockets is not growing and is yet to mature for usage. Regardless of subsidies, it is not picking up as expected and needs to be investigated. Earlier research mainly focused on reporting barriers and did not guide EV penetration enablers. This study bridges the research gap and offers useful insights about EV penetration phenomenon and makes use of both qualitative and quantitative treatments. Accordingly, it models thirteen enablers, guides about tangling interrelationships using an interpretive structural modeling (ISM), and validates it using best worst method (BWM) approach. The study reports six key enablers, which are-developing high-capacity batteries with short recharge time, improving service support, framing promotive government policies, lowering electricity tariffs using sustainable and reliable sources, and reducing dependence on imported raw materials. These enablers need an urgent attention from the industries and researchers for successful EV penetration in Indian context. Authors hope the findings will be useful for other developing countries as well and will influence both researchers and practitioners. [ABSTRACT FROM AUTHOR]

Purpose: To describe the clinical profile and relative prevalence of subtypes of glaucoma presenting to a tertiary care center in India. Methods: This cross-sectional hospital-based study included 6,120 new patients (>16 years) presenting between January 2016 and December 2017. The data were collected using an electronic medical record system. Results: A total of 11,016 eyes of 6,120 new patients were diagnosed with glaucoma. Sixty-one percent were male and 79% had a bilateral affliction. Primary glaucoma was present in 4,352 (71.1%) and secondary glaucoma in 1,063 (17.4%) subjects. Glaucoma was primary open-angle (POAG) in 4,015 (36.4%) eyes and primary angle closure disease (PACD) in 3,806 (34.5%) eyes. Commonest among secondary glaucoma was post-cataract surgery glaucoma (3.1%), neovascular glaucoma (2.4%), pseudoexfoliation glaucoma (PXG) (2.1%), and steroid-induced glaucoma (SIG) (1.4%). Patients with primary glaucoma were older than secondary (56.6 ± 0.2 vs 54.1 ± 0.4; P < 0.0001). Mean IOP was higher in secondary glaucoma compared to primary (26.9 ± 0.3 vs 18.9 ± 0.1; P < 0.0001). Secondary glaucoma had greater mean CDR compared to primary glaucoma (0.77 ± 0.007 vs 0.70 ± 0.003; P < 0.0001). The prevalence of blindness (visual acuity <20/200) was 16.2% of eyes. Mean deviation (MD) 20db or worse was noted in 39.5% of eyes at presentation including 47.8% of PACG, 37.3% of POAG, 51% of JOAG, 58% of PXG, and 45% of SIG, suggesting disease severity. Conclusion: At the presentation to a tertiary care center, 40% of all eyes with glaucoma had advanced disease with MD worse than - 20D. PACG and JOAG had the worse disease among primary; among secondary, PXG and SIG had the worse disease at presentation. [ABSTRACT FROM AUTHOR]

Introduction: Elevated serum prostate-specific antigen (PSA) is the most common trigger for a prostate biopsy. However, the range of normal PSA is poorly defined in many populations. Men with "elevated" PSA may not harbor cancer, and it is unclear if such men with a prior negative prostate biopsy should be biopsied again. We conducted a cohort study to assess the PSA trends and cancer detection rates in such men. Methods: In an Institutional Review Board-approved ambispective study, men who underwent prostate biopsy between January 2016 and December 2021 for PSA > 4 ng/mL were identified. Among them, those whose biopsy was negative for malignancy were contacted either telephonically or reviewed in person, and the most recent PSA and histopathology of any repeat prostate biopsy were determined. These were evaluated to assess the PSA trend, re-biopsy rate, and cancer detection rate. Results: During the study period, prostate biopsies were performed in a total of 1260 men; out of which 444 were negative for malignancy and 241 patients fulfilled the inclusion criteria. Their median prebiopsy PSA was 9.81 ng/mL (interquartile range [IQR]: 7.14--15.6), and the median follow-up PSA was 5.08 (IQR: 3.18--8.4). At a median follow-up of 53 months (range: 6--77 months), PSA had decreased in 177 (73.4%) patients, was static in 48 (19.9%) patients, and increased in only 16 (6.6%) patients. Repeat biopsy was performed on 20 patients; of whom seven had cancer (35%) with an overall positivity rate of 2.9% among the 241 patients. Although the positivity rate was higher in men with increased PSA, it was not statistically different from those with lower or similar PSA. No factors could be identified to predict a positive repeat biopsy. Conclusions: PSA, the sole trigger for a prostate biopsy, declined in nearly three-quarters of men with a negative first biopsy, and <3% of men were detected to have cancer on a repeat biopsy. This information could help appropriately counsel patients and allay anxiety after a negative biopsy. [ABSTRACT FROM AUTHOR]

The emergence of various deep learning approaches in diagnostic medical image segmentation has made machines capable of accomplishing human-level accuracy. However, the generalizability of these architectures across patients from different countries, Magnetic Resonance Imaging (MRI) scans from distinct vendors, and varying imaging conditions remains questionable. In this work, we propose a translatable deep learning framework for diagnostic segmentation of cine MRI scans. This study aims to render the available SOTA (state-of-the-art) architectures domain-shift invariant by utilizing the heterogeneity of multi-sequence cardiac MRI. To develop and test our approach, we curated a diverse group of public datasets and a dataset obtained from private source. We evaluated 3 SOTA CNN (Convolution neural network) architectures i.e., U-Net, Attention-U-Net, and Attention-Res-U-Net. These architectures were first trained on a combination of three different cardiac MRI sequences. Next, we examined the M&M (multi-center & mutli-vendor) challenge dataset to investigate the effect of different training sets on translatability. The U-Net architecture, trained on the multi-sequence dataset, proved to be the most generalizable across multiple datasets during validation on unseen domains. This model attained mean dice scores of 0.81, 0.85, and 0.83 for myocardial wall segmentation after testing on unseen MyoPS (Myocardial Pathology Segmentation) 2020 dataset, AIIMS (All India Institute of Medical Sciences) dataset and M&M dataset, respectively. Our framework achieved Pearson's correlation values of 0.98, 0.99, and 0.95 between the observed and predicted parameters of end diastole volume, end systole volume, and ejection fraction, respectively, on the unseen Indian population dataset. [ABSTRACT FROM AUTHOR]

This prospective observational cohort study aimed to establish and compare baseline rates of Clostridioides difficile infection (CDI) in community and hospitalized patients in Nagpur and rural Melghat Maharashtra, including adults aged ≥18 years with a diagnosis of diarrhoea as defined as 3 or more loose stools in a 24 h period. All diarrhoeal samples were tested for CDI using the C. diff Quik Chek Complete enzyme immunoassay. C. difficile-positive stool samples were characterised by toxigenic culture, antimicrobial susceptibility testing and PCR ribotyping. C. difficile testing was performed on 1683 patients with acute diarrhoea. A total of 54 patients (3.21%; 95% CI: 2.42–4.17) tested positive for both the GDH antigen and free toxin. The risk factors for CDI included the presence of co-morbidities, antibiotic usage, and immunosuppression. The detected PCR ribotypes included 053-16, 017, 313, 001, 107, and 216. Our findings show that toxigenic C. difficile is an important but neglected aetiologic agent of infective diarrhoea in Central India. These results underscore the need to enhance the awareness and testing of patients with diarrhoea in India regarding the presence of toxigenic C. difficile, particularly in high-risk individuals with multiple co-morbidities, immunosuppression, and recent or ongoing antibiotic exposure or hospitalization. [ABSTRACT FROM AUTHOR]

This study reports Uranotaenia lowii (Theobald, 1901) as a new record from India. It was collected from Berhampur University Campus, District Ganjam, Odisha, India. This species is not considered to have medical importance, as it does not bite mammals and feeds upon the blood of reptiles and amphibians. [ABSTRACT FROM AUTHOR]

This paper proposes how to select a methodology to target multidimensionally poor households, and how to update that targeting exercise periodically. We present this methodology in the context of discussions regarding the selection of a targeting methodology in India. In 1992, 1997, and 2002 the Indian government identified households that are below the poverty line (BPL) and in updating the 2002 methodology, alternative methods have been proposed and vigorously debated. A fourth BPL method was published and a corresponding Socio Economic Caste Census (SECC), implemented. Using the third National Family Health Survey (NFHS-3), this paper illustrates how a BPL targeting method using SECC variables might be calibrated to a multidimensional poverty measure. This paper compares the fit between a benchmark measure of multidimensional poverty and several plausible targeting methods to determine which method(s) approximate it--as well as related measures--most closely. We find a ten-item binary scoring method, which uses variables already available in the SECC questionnaire, provides a strong proxy. The emphasis of this paper is to illustrate how a particular targeting method can be justified, rather than to advocate any particular solution.

Child sexual violence is a major public health problem in India and is associated with myriad short- and long-term behavioral health effects. Affected children are at an increased risk of post-traumatic stress disorder, major depression, anxiety disorders, behavioral problems, and substance misuse. Behavioral health professionals are highly likely to encounter patients at risk of or with a recent/remote history of child sexual abuse, sexual exploitation, or sex trafficking. Caregivers of patients may report a history of child sexual violence. Clinicians must possess the knowledge and skills to recognize and appropriately respond to suspected child sexual violence using a culturally responsive, trauma-informed, and rights-based approach. Many behavioral health professionals lack the knowledge of child sexual violence and the confidence of working with affected patients. Child sexual violence is not routinely addressed in medical school curricula, nor is it systematically addressed in postgraduate training programs. Practicing clinicians may feel ill-equipped to recognize and manage patients exposed to child sexual violence and may miss opportunities to offer critical support and assistance to vulnerable children and their families. The behavioral health sector needs an organized, systematic, and trauma-informed response to child sexual violence, and this requires specific training of professionals and development of organizational response protocols tailored to fit the needs of the organization and its patient population. Multiple resources are available in India to assist behavioral health professionals, and organization administrators accomplish these goals. [ABSTRACT FROM AUTHOR]

Background The World Health Organization recommends vaccines for prevention and control of typhoid fever, especially where antimicrobial-resistant typhoid circulates. In 2018, the Navi Mumbai Municipal Corporation (NMMC) implemented a typhoid conjugate vaccine (TCV) campaign. The campaign targeted all children aged 9 months through 14 years within NMMC boundaries (approximately 320 000 children) over 2 vaccination phases. The phase 1 campaign occurred from 14 July 2018 through 25 August 2018 (71% coverage, approximately 113 420 children). We evaluated the phase 1 campaign's programmatic effectiveness in reducing typhoid cases at the community level. Methods We established prospective, blood culture–based surveillance at 6 hospitals in Navi Mumbai and offered blood cultures to children who presented with fever ≥3 days. We used a cluster-randomized (by administrative boundary) test-negative design to estimate the effectiveness of the vaccination campaign on pediatric typhoid cases. We matched test-positive, culture-confirmed typhoid cases with up to 3 test-negative, culture-negative controls by age and date of blood culture and assessed community vaccine campaign phase as an exposure using conditional logistic regression. Results Between 1 September 2018 and 31 March 2021, we identified 81 typhoid cases and matched these with 238 controls. Cases were 0.44 times as likely to live in vaccine campaign communities (programmatic effectiveness, 56%; 95% confidence interval [CI], 25% to 74%; P =.002). Cases aged ≥5 years were 0.37 times as likely (95% CI,.19 to.70; P =.002) and cases during the first year of surveillance were 0.30 times as likely (95% CI,.14 to.64; P =.002) to live in vaccine campaign communities. Conclusions Our findings support the use of TCV mass vaccination campaigns as effective population-based tools to combat typhoid fever. [ABSTRACT FROM AUTHOR]

Simple Summary: Spodoptera litura (Fabr.), an important pest of agricultural crops in India, can be controlled using the 'Inherited or F1 sterility technique'. The multiple mating tendency in female moths, their receptivity to remating after initial mating with radio-sterilized males and the sperm use pattern in sequential matings might influence the level of sterility induced in a radiation-mediated F1 sterility program. In this study, the effect of irradiation was assessed on the quality of the ejaculate of exposed male moths, with a substantial decrease in insemination quality in their F1 male progeny. Females mated to F1 males showed an increased calling efficiency and remating propensity (with normal males) and influenced reproductive performance with a prolonged post (initial)-mating interval compared with the control moths. These findings on factors influencing female receptivity during remating and eventual reproductive sterilization might help optimize the technique. The 'Inherited or F1 sterility technique' (IS), using sub-sterilized male moths, is a widely proposed pest management tool for Lepidoptera pests in general, and the tobacco cutworm Spodoptera litura (Fabr.) in particular. However, the multiple mating tendency of female moths and the ejaculate quality of male moths might influence the efficiency of this technique. Reduced ejaculate quality was observed in irradiated males, as evidenced by radiation's impact on certain bio-parameters, such as the weight of the spermatophores and their protein content, sperm count, the molecular expression of the sex peptide receptor (SPR) and egg fertility, with a greater impact in F1 male progeny. During the remating of females with untreated males, irrespective of the irradiation status of the first male, there was an increase in calling behavior, remating propensity and fertility in females, with a larger time gap between consecutive matings. The ability of F1 male progeny to check remating propensity in females 24 h after the initial mating was lower than that of unirradiated males. Partially sterile (130 Gy) males were as successful as unirradiated males in inducing the level of mating refractoriness in females. Decreased ejaculate quality in F1 male progeny could be associated with increased female receptivity during remating. Understanding the influence of male moth irradiation, insemination quality and post (initial)-mating intervals on the remating behavior of normal female moths and induced sterility might help in simulation modeling and optimizing IS insect programs. [ABSTRACT FROM AUTHOR]

Introduction: Abnormal levels of heavy metals (HM) and trace elements (TE) affect body metabolism and can induce carcinogenesis. This study aims to evaluate the role of HM and TE in carcinoma urinary bladder (CAUB). Methods: Patients with biopsy-proven CAUB (n = 100) were taken as the study group, while age-and sex-matched healthy volunteers were taken as control (n = 100). Blood and urine samples were compared for Arsenic (As), Copper (Cu), Manganese (Mn), Selenium (Se), Cadmium (Cd), Lead (Pb), and Mercury (Hg) levels. Serum glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and lipid peroxidation (LPO) levels were assessed to know the redox status between the two groups. Results: A significantly higher blood level of As, Mn, and Pb was observed in CAUB cases as compared to controls. Blood Se level was significantly lower in CAUB patients. On comparing urinary levels, CAUB patients had a higher As, Mn, and Pb levels compared to controls. Further, 68% and 59% of patients had their blood and urinary HM and TE levels above the permitted level, respectively. CAUB cases also had a lower GSH-Px (113.5 ± 44.7 vs. 163.9 ± 120.5, P = 0.0002), lower SOD levels (11.35 ± 5.6 vs. 13.75 ± 3.9, P = 0.008), and a higher LPO levels (15.5 ± 14.7 vs. 11.18 ± 11.2, P = 0.02) in the serum. Conclusions: A significantly higher concentration of As, Mn, and Pb was noted in the blood and urine of CAUB patients compared to controls. CAUB cases also had lower serum GSH-Px and SOD levels with a concomitant increased serum LPO assay suggesting underlying oxidative stress. [ABSTRACT FROM AUTHOR]

Young women in India report that avoidant talk within families hinders their ability to communicate about menstruation, further promoting stigma and limiting knowledge. Participants included 287 college-attending women from one of two colleges in different locations in northern India. Participants completed surveys that were guided by the disclosure decision-making model (DD-MM) and asked about menstruation-related topic avoidance with mothers. Results find that the stigma of being dramatic is a consistent predictor across the two locations but that predictors otherwise differ. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Background : Although immunization is one of the most successful public health interventions, vaccine hesitancy and the COVID-19 pandemic have strained health systems, contributing to global reductions in immunization coverage. Existing literature suggests that involving community members in vaccine interventions has been beneficial, but efforts to facilitate community ownership to motivate vaccine acceptance have been limited. Methods: Our research leveraged community-based participatory research to closely involve the community from conception to implementation of an intervention to facilitate vaccine acceptance in Mewat District in Haryana, an area in India with extremely low vaccination coverage. Through the development of a community accountability board, baseline data collection on vaccination barriers and facilitators, and two human-centered design workshops, our team co-created a six-pronged intervention with community leaders and community health workers. This intervention included involving religious leaders in vaccine discussions, creating pamphlets of local vaccine champions for dissemination to parent and child caregivers, creating short videos of local leaders advocating for vaccines, implementing communication training exercises for community health workers, and implementing strategies to strengthen coordination between health workers and supervisors. Results: Post-intervention data suggested parents and child caregivers had improvements in knowledge of the purpose of vaccines and side effects of vaccines. They noted that the involvement of religious leaders was beneficial, they were more willing to travel to vaccinate their children, and they had fewer non-logistical reasons to refuse vaccination services. Interviews with community leaders and community health workers who were involved in the creation of the intervention suggested that they experienced higher levels of ownership, they were better equipped to address community concerns, and that vaccine misinformation decreased in the post-intervention period. Conclusion: Through this unique intervention to strengthen vaccine uptake that incorporated the needs, interests, and expertise of local community members, we developed a community-driven approach to strengthen vaccine acceptance in a population with low uptake. This comprehensive approach is essential to amplify local voices, identify local concerns and advocates, and leverage bottom-up strategies to co-design successful interventions to facilitate long-term change. [ABSTRACT FROM AUTHOR]

Early in 2021, India embarked on the uphill journey of the COVID-19 vaccination of the largest population group in the world in a prioritized manner and in the shortest possible time. Considering the endless variety of geography and diverse socio-economic demographic, religious, and community contexts, there was a high likelihood of certain population subgroups with known vulnerabilities facing inequities, which were anticipated to be further accentuated by a digital divide. This necessitated devising solutions for such communities in a localized manner to aid the local government in breaking the service access and uptake barriers with an inclusive approach. To bridge this vital gap, the Momentum Routine Immunization Transformation and Equity project implemented a three-tiered collaboration, viz., government, non-governmental organizations (NGOs), and a wide range of vulnerable and at-risk communities, utilizing knowledge exchange and use of data. The project implemented localization strategies through the NGOs for community engagement in conjunction with government vaccination teams to universalize COVID-19 vaccination uptake up to the last mile. The collaboration resulted in reaching close to 50 million beneficiaries through messaging and facilitated the administration of more than 14 million vaccine doses, including 6.1 million doses for vulnerable and marginalized communities in 18 States and Union territories in India, along with suggesting implications for public health practice and research. [ABSTRACT FROM AUTHOR]

Background. Cardiovascular diseases, including heart failure (HF), are leading causes of death and disability in India. However, most studies in India only include urban populations or rural regions with improved access and may not represent the poorest patients or regions. We studied the epidemiology of HF patients admitted to a secondary care hospital in rural Chhattisgarh, India. Methods. We did a retrospective chart review of patients hospitalized with HF in 2018 to obtain their demographic data and risk factors for developing HF. We reviewed echocardiograms to assign patients to their most probable HF category. Results. We studied 88 HF patients with a mean age of 42 years including 55 (62.5%) women. The most common categories of HF were cardiomyopathy (36.8%), rheumatic heart disease (RHD; 25.3%) and right heart failure (RHF; 18.4%). Prior tuberculosis was more prevalent in patients with RHF compared with other types of HF (43.8% v. 13.9%). Conclusions. HF patients in this study from rural central India were young and predominantly women. Cardiomyopathy, RHD and RHF due to past tuberculosis were common causes of HF in this population. Further studies are needed to expand upon these single centre findings to better understand the risk factors and outcomes of HF among the rural poor. [ABSTRACT FROM AUTHOR]

Aim: To determine the awareness about and willingness to donate eyes among ambulance drivers in Central India. Design: Prospective, observational, noncomparative, and cross-sectional survey study. Setting: Tertiary eye care center in Central India. Methods: The present study used a structured questionnaire distributed to ambulance drivers during the eye donation fortnight (August 25–September 8, 2022). The questionnaire comprised four domains: awareness, knowledge beliefs, and willingness to donate eyes. The collected data were entered into an Excel sheet and analyzed using SPSS software. Results: Forty-seven ambulance drivers participated in the study. All participants were men. The results showed that 48.9% (n = 23) of the ambulance drivers had completed elementary or middle school education. Furthermore, 27 (57%) participants were aware of eye donation; however, only 14 (29.7%) realized its importance. The source of information was mobile phones (n = 20, 42.6%). The common reason for the nondonation of eyes was lack of awareness (n = 14 29.7%). Thirty-five (74.5%) ambulance drivers were willing to donate their eyes, and the most common reason was the gratification derived from helping blind people. Conclusion: The study revealed the need to improve awareness and knowledge about eye donation among the participants. Arranging short sessions round the year, addressing the myths associated with eye donation, and sharing motivational stories may help create awareness. Display of information and booklets on eye donation in the ambulance is likely to help in obtaining more corneas for transplantation. [ABSTRACT FROM AUTHOR]

From the 1830s the colonial government in India became the agency for the promotion of "Western education", that is, education that sought to disseminate modern, Western, rational knowledge through modern institutions and pedagogic processes. This paper examines a historical episode in which certain key categories of modern Western thought were pressed into service to explain a consequence of the dissemination of Western knowledge in colonial India. The episode in question was that of the alleged "moral crisis" of the educated Indian, who, many argued, had been plunged into confusion and moral disarray following his exposure to Western knowledge in the schools and universities established by his British ruler. In the discourse of moral crisis, the knowledge being disseminated through Western education was simultaneously put to use in explaining an unanticipated effect of this education. How adequate was Western knowledge to explaining its own effects? More generally--for this paper is drawn from a larger study of how modern Western knowledge "travelled" when transplanted to colonial India--what is the status of the knowledge we produce when we "apply" the categories of modern Western thought in order to understand or explain India? (Contains 1 note.)

Azo dyes have aromatic rings, sulfonic groups, and azo bonds (-N=N-) making it one of the most often used dye classes in industry and a substantial class of environmental pollutants. The majority of textile dyes are flushed away through drainage systems. Due to their persistent nature and toxicity to both humans and animals, these dyes must be removed from the environment. The current work focuses on the biodegradation of such azo dye, Malachite Green (MG) and Congo Red (CR), by potent dye degrading fungal strain FSS4 isolated from textile water in Dravyavati river, Rajasthan, India. Potato dextrose broth with 100 mg/l MG and CR was used for dye degradation assay. FTIR (PerkinElmer Spectrum TwoTM IR spectrometer) examined the degradation products from 4000-400 cm-1 wavenumber range. Molecular characterization identified this potent fungus as Aspergillus flavus strain GKRS09 (GenBank accession number; OK236565). The strain demonstrated remarkable decolorization and degradation properties after 07 days. FT-IR study showed that A. flavus strain GKRS09 decomposed Malachite Green and Congo Red dyes into non-toxic products. The isolate GKRS09 can treat azo dye-containing industrial effluent economically and sustainably. [ABSTRACT FROM AUTHOR]

Background: Thrombocytopenia develops in 5% to 10% of women during pregnancy or in the immediate postpartum period. A low platelet count is often an incidental feature of pregnancy, but it might also provide a biomarker of a coexisting systemic or gestational disorder and a potential reason for a maternal intervention or treatment that might pose harm to the fetus. Maternal thrombocytopenia is commonly diagnosed during routine prenatal complete blood count. Aims: To determine various etiologies of thrombocytopenia in pregnancy and to study fetal outcome & maternal outcome of thrombocytopenia in pregnancy. Material and Methods: This study was a Prospective Observational Study conducted in the Department of Gynecology & Obstetrics, NRSMC&H & Department of Haematology, NRSMC&H Kolkata, West Bengal, India from April 2019 to March 2020. 100 Pregnant women with thrombocytopenia attending ANC clinic & Haematology OPD were included in the study. A suitable predesigned pretested Proforma for data collection was used. Template was generated in MS excel sheet and analysis was done on SPSS software. Result: In the present study 23(23.0%) patients were ≤20 years old, 75(75.0%) patients were 21-30 years old Pre-term delivery (69%) is significantly higher than subjects with no Pre-term delivery (20%). 31(31.0%) patients had SNCU admission, 7(7.0%) patients had neonatal thrombocytopenia, 13(13.0%) patients had IUD, 28(28.0%) patients had LBW, 11(11.0%) patients had Spontaneous miscarriage, 26(26.0%) patients had FGR. In ITP Group, 9 (25.0%) patients had preterm delivery. In PPH Group, 3(8.1%) patients were had Preclamsia. A significant higher proportion of patients had been given spinal anaesthesia (76.92%) followed by epidural anaesthesia (23.08%). Conclusion: It was found that 7 (7.0%) patients had neonatal thrombocytopenia and 50 (50%) patients had gestational thrombocytopenia. From this study, conclusion can be made that, platelet count may not be included in routine antenatal investigations. [ABSTRACT FROM AUTHOR]

Communication about menstrual health continues to be influenced by institutional and social practices which deem it to be unclean and impure. In a country such as India, several customs and traditions reinforce secrecy and shame about menstruation. As such, scholars advocate the need to generate knowledge that can open opportunities to converse on the topic of menstruation and understand issues related to bodily changes. Using a culture-centered approach, this study examined how college-going adult women from two cities in Northern India made sense of menstrual health. Data collection included 20 focus groups with 180 college-going women and interviews with 16 female family members. Participants discussed communication patterns surrounding menstrual health and how they uphold, challenge, and change social practices. Specifically, participants reflected on how they were communicated to about their menstrual health with underpinnings of secrecy and shame and how the influence of current opportunities for openness encourage them to anticipate positive change. Theoretical and practical implications for studying communication around menstruation in diverse cultural contexts are discussed. [ABSTRACT FROM AUTHOR]

Introduction Colonic self-expanding metal stent (SEMS) placement is the preferred method for palliation of malignant colonic obstruction. We analyzed outcomes of patients who underwent colonic SEMS placement for palliation at a tertiary care oncology center in Western India. Methods Retrospective review of the endoscopy database was done for patients who underwent colonic SEMS placement at our center between January 2013 and September 2021. Demographic details, intent of stent placement, site of obstruction, length of stricture, technical success of stenting, clinical success, and complications (both immediate and long term) were noted. Results Sixty-one patients underwent colonic SEMS placement during the study period (mean age 53.6 years, 50.7% men). Obstruction was due to primary colonic malignancy in 43 (70.5%) patients and extracolonic malignancies in 18 (29.5%) patients. Most common extracolonic malignancy was gallbladder cancer in 8 (44.4%) patients. Most common site of obstruction was sigmoid colon in 18 (29.5%) patients. Proximal colonic obstruction was seen in 17 (27.9%) patients. Peritoneal metastases were seen in 26 (42.6%) patients. Colonoscopy revealed an impassable stenosis in 58 (95.1%) patients. Median length of stricture was 5 cm (range 2–9 cm). Technical success was achieved in 98.3% (60/61). Clinical success was achieved in 51 (86.4%) patients. Perforation during colonic SEMS placement was seen in 2 (3.4%) patients. Stent migration was seen in 3 (5.9%) patients, needing surgery for retrieval in all 3 patients. Over a median follow-up of 9 months (0–21 months), stent block was seen in 7 (13.7%) patients. Stent block developed after a median period of 6 months. Of these patients, three patients underwent SEMS placement within the SEMS and the other four patients underwent surgery. Conclusion Colonic SEMS placement achieves good palliation of malignant colonic obstruction in approximately 87% patients. Long-term complications like obstruction occur in a few patients after a median duration of 6 months. [ABSTRACT FROM AUTHOR]

Worsening heart failure (WHF) is a distinct under-diagnosed and under-treated condition, independent of location of care. Heart failure (HF) progression is punctuated by repeated WHF events, each resulting in reduced cardiac function. One-third of the patients with HF with reduced ejection fraction experience a decompensation event. These decompensation events often result in the emergency department visits and HF hospitalization. Despite its inclusion in recent guidelines, there is no precise definition of WHF or its various forms. It is worth noting that WHF signals a need for treatment optimization as per guideline-directed medical therapy and the addition of novel drugs like a stimulator of soluble guanylate cyclase that benefit this high-risk patient population. This practical document is based on the expert opinion of cardiologists, cardiothoracic surgeons, and physicians that discussed the definition, assessment, pharmacological management, and monitoring of WHF patients in a hospitalized setting. In addition, there is also a need for an expert opinion for the management of WHF in an outpatient setting. [ABSTRACT FROM AUTHOR]