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Background: Chickpea is an important nutrient rich food legume cultivated mainly as rainfed crop in arid and semiarid regions of India. Due to changed climatic conditions incidence of frequent drought stress events are causing significant yield losses. Methods: In order to identify superior and locally adaptable genotypes under rainfed conditions multi-environment chickpea evaluation trial was conducted in five environments with 50 genotypes during Rabi, 2021-2022 stability analysis for grain yield was performed by deploying the AMMI (Additive Main Effects and Multiplicative Interaction) model and GGE (Genotype and Genotype by Environment) biplot method with an aim to identify the high yielding stable chickpea genotypes. Result: The AMMI analysis of variance for grain yield (kg ha-1) of 50 chickpea genotypes revealed significant genotype, environment and G x E interaction indicating the presence of variability among the genotypes and environments. The mean grain yield of 50 genotypes over environments ranged from 1296 kg/ha (G39) to 2222 kg/ha (G8). The genotype G24 exhibited high grain yield than mean yield with specific adaptability for the environment E2 (Palem). The results indicated that, environment E5 (Warangal) was identified as the best suited for potential expression of grain yield. Results of stability analysis revealed that genotype G17 exhibited high grain yield along with high stability across the locations with desirable mean performance. [ABSTRACT FROM AUTHOR]

In India's economy, agriculture has been the most significant contributor. Despite the fact that agriculture's contribution is decreasing as the world's population grows, it continues to be the most important source of employment with a little margin of difference. As a result, there is a pressing need to pick up the pace in order to achieve competitive, productive, diverse, and long-term agriculture. Plant disease misinterpretations can result in the incorrect application of pesticides, causing crop harm. As a result, early detection of infections is critical as well as cost-effective for farmers. To diagnose the disease at an earlier stage, appropriate segmentation of the diseased component from the leaf in an accurate manner is critical. However, due to the existence of noise in the digitally captured image, as well as variations in backdrop, shape, and brightness in sick photographs, effective recognition has become a difficult task. Leaf smut, Bacterial blight and Brown spot diseases are segmented and classified using diseased Apple (20), Cercospora (60), Rice (100), Grape (140), and wheat (180) leaf photos in the suggested work. In addition, a superior segmentation technique for the ROI from sick leaves with living backdrop is presented here. Textural features of the segmented ROI, such as 1st and 2nd order WPCA Features, are discovered after segmentation. This comprises 1st order textural features like kurtosis, skewness, mean and variance as well as 2nd procedure textural features like smoothness, energy, correlation, homogeneity, contrast, and entropy. Finally, the segmented region of interest's textural features is fed into four different classifiers, with the Enhanced Deep Convolutional Neural Network proving to be the most precise, with a 96.1% accuracy. [ABSTRACT FROM AUTHOR]

The aim of this study is to compare the crop insurance systems implemented by the Indian government since their inception in the year1972. The primary purpose of designing a crop insurance policy was to protect farmers from a variety of natural disasters. It was also determined to investigate farmer's expectations and solve the most basic hazards, as evidenced by data gathered from Agricultural insurance corporation of India from the year 1972. [ABSTRACT FROM AUTHOR]

Abstract: Felsic volcanics constitute a primary source of uranium for forming an economic deposit. All over the world, volcanic rocks have not received due attention they deserve in uranium exploration. The volcanogenic deposits have been grouped with “other deposits”, as they constitute a meager<0.5% of world uranium resources. Exploration inputs in the western world have identified a number of uranium deposits associated with volcanic rocks. The uranium resources contributed by volcanic type deposits all over the world stand at 3, 62,000 te U3O8 (IAEA 2008 Compilation). The significance of acid volcanic rocks as a potential uranium source lies in the readily leachable form of their uranium content. A detailed study carried out in Australia to understand the spatial and temporal relationsh ip between the uranium deposits and the unmineralized, uranium enriched rocks from across the continent clearly indicated the role of the acidic volcanics as a potential provenance. Among the acid volcanics, rhyolites form an ideal source followed by welde d tuffs, ignimbrites, etc. The alkali or topaz rhyolite is ideal for its enrichment in many lithophile elements including uranium, which are amenable to subsequent leaching by meteoric water. In India the uranium exploration activities in the early 50s till the 90s were mainly confined to the Singhbhum Shear Zones, the Himalayas,Meghalaya plateau, parts of Central India and the geological environs of the Dharwar Craton. The granitic rocks, especially the peraluminous biotite – granite was always considered as a potential source for uranium and the geological environs closer to these granites always remained the first order targets. A number of small to medium size uranium deposits have been identified in Singhbhum Shear Zone, parts of Cuddappah, Bhima Basins and in Meghalaya. Now since the significance of the volcanic rocks, especially the felsic volcanics as a potential source of uranium has been clearly understood, it is imperative to reorient our exploration strategy to tap the potential of these volcanic rocks. The Malani Magmatic Province (MMP) in the northwestern part is the largest suite of an -orogenic acid volcanics in India occupying an area of 50000 sqkm. The Proterozoic Basins of India are replete with volcanic activity, mainly acid volcanism. In the southern and Central India, Dharwar and parts of Central Indian Craton also witnessed significant acidic igneous activities. The Cuddapah and the Vindhyan Basins have also recorded extensive acidic volcanic activity in the Papaghni, Chitrvati, Nallamalai Groups and Semri and Kaimur Groups respectively. In view of this the Proterozoic Basins mentioned above and the geological environs adjacent to the MMP deserve a re -look to have a proper assessment of their uranium potential, using integrated exploration inputs. [Copyright &y& Elsevier]

Waste collection and transportation is the contact point between waste generators and waste management systems. A proposal for an innovative model for the collection and transportation of municipal solid waste (MSW) which is a part of a solid waste management system using a spatial geo database, integrated in a geographical information system (GIS) environment is presented. Pallavapuram is a fast-developing municipality of Chennai city in the southern suburbs about 20 km from Chennai, the state capital of Tamil Nadu in India. The disposal of MSW was previously occurring in an indiscriminate and irrational manner in the municipality. Hence in the present study an attempt was made to develop an engineered design of solid waste collection using GIS with a vehicle tracking system and final disposal by composting with investment costs. The GIS was used to analyse existing maps and data, to digitize the existing ward boundaries and to enter data about the wards and disposal sites. The proposed GIS model for solid waste disposal would give information on the planning of bins, vehicles and the optimal route. In the case of disposal, composting would be a successful strategy to accelerate the decomposition and stabilization of the biodegradable components of waste in MSW. [ABSTRACT FROM AUTHOR]

The article presents a study on the effect of the combined oral Ivermectin with oral antibiotic in the treatment of Demodicosis in dogs in India. The study intends to evaluate the efficacy of the tablet form of Ivermectin with ciprofloxacin antibiotic and topical antifungal, and antibacterial shampoo in the treatment of dogs' demodicosis. The dermatological examination, skin scraping , and serum biochemistry were conducted to determine the effectiveness of the treatment.

Aim: To study the epidemiological data of paediatric burn patients to determine the role of demographic distribution and epidemiological parameters for assessment of mortality rate and development of burn prevention strategy. Materials and Methods: Epidemiological data of 500 patients admitted to the Burns and Plastic Surgery Unit of B.J. Wadia Hospital, Mumbai over a period of six years (2000-2005) was reviewed from medical records. Age, sex, demographic distribution, seasonal variation, total body surface area (TBSA) involved, type and place of burn injury, parental occupation, family size, first aid and mortality rate were studied. Result: Median age group for patient was 3.44 years (range one month to 14 years). The majority (24%) of burns occurred in children between the one to two years age group. Male to female sex ratio was 1.38:1. Most of the patients were from the defined demographic region served by the hospital. A significant number of patients however were from outside this region. Burn injury occurred predominantly during winter. Most common type of burn was scalds which occurred mainly in domestic circumstances. In the majority of patients, less than 10% TBSA was involved. All patients were managed as per the unit protocol. Mortality rate was 10.4%. Mortality rate was high in patients having more than 40% TBSA involvement. Seventy-three per cent of the total deaths occurred in the patients coming from regions outside the demographic region served by the hospital. Parental occupation, family size and the first aid did not affect the mortality rate. Conclusion: Availability of a burn care unit in the vicinity can decrease the mortality rates in the paediatric burn patients. An intense and focused burn prevention campaign to educate the general population about dangerous aetiological factors will decrease the incidence of paediatric burns. [ABSTRACT FROM AUTHOR]

Objective: The growth pattern of low birth weight (LBW) babies was studied prospectively in our hospital from September 1995 to august 1996.Method: Every baby <1.5 kg birth weight (B.Wt), every 2nd baby between 1.5 to 2 kg, every 6th baby between 2 to 2.5 kg and 120 term appropriate for gestation (AGA) babies ( as controls) were included in the study. Severe birth asphyxia, multiple gestation, major malformations or severe birth trauma formed exclusion criteria. Weight, length and head circumference were measured in all babies at birth and at 2 monthly intervals till 1 year of age. All babies completing 1 year follow-up were included for final analysis. Growth distance curves were constructed separately for each parameter for the six categories based on birth weight (Groups I-VI) and on gestational age (Divisions A-F). Comparison was made between the LBW babies and the controls for growth pattern among the babies who completed 1 year follow up (total of 220 babies).Result: The growth pattern for weight and length showed good catch up growth in babies >1.25 kg B.Wt. and >30 weeks gestation, reaching almost the same level as controls by 1 year of age. Babies with B.Wt <1.25 kg and <30 weeks gestation showed late and poor catch up growth, with considerable lag persisting at 1 year of age. Head circumference increased rapidly in all babies, with maximal growth rate initially followed by a steady decline. All babies showed catch up growth, although those <1.25 kg and <30 weeks gestation still lagged behind even at 1 year.Conclusion: It was seen that the smallest and least mature babies had late and poor catch up growth. Recognition of the factors influencing catch up growth and adequate measures to improve growth (like attention to feeding practices) may improve the overall outcome of these babies. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Risperidone in the Treatment of Acute Mania: Double-Blind, Placebo-Controlled Study," by S. Khanna, E. Vieta, B. Lyons, F. Grossman, M. Kramer and M. Eerdekens in a previous issue of the journal.

India has over a century old tradition of development and production of vaccines. The Government rightly adopted self-sufficiency in vaccine production and self-reliance in vaccine technology as its policy objectives in 1986. However, in the absence of a full-fledged vaccine policy, there have been concerns related to demand and supply, manufacture vs. import, role of public and private sectors, choice of vaccines, new and combination vaccines, universal vs. selective vaccination, routine immunization vs. special drives, cost-benefit aspects, regulatory issues, logistics etc. The need for a comprehensive and evidence based vaccine policy that enables informed decisions on all these aspects from the public health point of view brought together doctors, scientists, policy analysts, lawyers and civil society representatives to formulate this policy paper for the consideration of the Government. This paper evolved out of the first ever ICMR-NISTADS national brainstorming workshop on vaccine policy held during 4-5 June, 2009 in New Delhi, and subsequent discussions over email for several weeks, before being adopted unanimously in the present form. [ABSTRACT FROM AUTHOR]

Introduction: Childhood cancers are a significant global health concern, particularly in low- and middle-income countries (LMICs), where over 80% of childhood cancer patients reside. In India, acute myeloid leukemia (AML) constitutes a significant portion of childhood cancers; however, the data on the cost-effectiveness of childhood AML treatment in India and other LMICs remain limited., Methods: The study focused on children (<15 years of age) diagnosed with AML at a tertiary care cancer center in North India. Data, including treatment outcome, treatment-related morbidity, mortality, and costs were retrospectively collected from the electronic medical record and hospital database. Cost-effectiveness was assessed using disability-adjusted life years (DALY) averted in relation to the country-specific cost-effectiveness threshold., Results: Among 59 AML patients, treatment-related high mortality rates, abandonment, and limited access to bone marrow transplantation were notable challenges. Intensive chemotherapy resulted in substantial sepsis-related complications, with treatment-related mortality reaching 30%. The 3-year event-free survival and overall survival of the 43 patients who received intensive therapy were 24.5% ± 7.6% and 27.9% ± 8.3%, respectively. Despite these challenges, treating childhood AML was still found to be cost-effective. The total cost per newly diagnosed patient treated with curative intent was $4454. Cost per DALY averted accounted for 24% of the gross domestic product (GDP) per capita, rendering the treatment to be cost-effective with a stringent cost-effectiveness threshold utilized., Conclusion: The study underscores the challenges faced while treating childhood AML in LMICs, including treatment-induced high sepsis-related mortality and abandonment. Despite these challenges, it remains cost-effective to treat childhood AML in India. Future efforts should focus on reducing treatment-related morbidity and mortality to further improve outcomes and cost-effectiveness., (© 2024 The Author(s). Pediatric Blood & Cancer published by Wiley Periodicals LLC.)

In the present research, we introduce and validate a single-item measure of identity leadership-the visual identity leadership scale (VILS). The VILS uses Venn diagrams of sets of overlapping circles to denote different degrees of alignment between a leader's characteristics and behaviours and a group's values and goals. Key advantages of the VILS over other existing multi-item scales are that it provides a holistic assessment of identity leadership, is short, and can be adapted to address novel research questions that are impractical to address with existing scales (e.g. in diary studies, assessing multiple comparisons of many leaders or groups). Data from three studies (conducted in India, the United States and Germany) provide evidence of the VILS' construct reliability and validity. Results also showcase the instrument's capacity to be adapted to assess variations of identity leadership-for example, by assessing a leader's convergence with descriptive and ideal notions of collective self (i.e. with 'who we are' and 'who we want to be'). We discuss the value of including the VILS in the toolbox that researchers and practitioners can utilize to expand our understanding of identity processes in leadership and group behaviour., (© 2024 The Authors. British Journal of Social Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Contaminated playground soils can expose players to harmful pollutants, increasing the risk of respiratory, skin, and gastrointestinal issues and potentially impacting long-term health and development. This study investigated the chemical forms and the human health risks associated with potentially toxic elements (PTEs) found in playground soil samples from Khagra, a historic town known for its bell metal industry, located in the Murshidabad district of eastern India. Sequential extraction techniques were employed to analyze the distribution of PTEs such as As, Cd, Co, Cu, Mn, Pb, Ni, Sn, and Zn among different fractions: exchangeable (F1), bound to carbonate phase (F2), bound to iron and manganese oxides (F3), bound to organic matter (F4), and residual (F5). The playground soil showed the highest contamination with Sn, with an I POLL value of 3.14, indicating moderate to heavy contamination, while Cd, Cu, Mn, Pb, and Zn exhibit moderate contamination. The mean concentration of PTEs in all fractions (F1-F5) follows the order: Fe > Zn > Cu > Mn > Pb > Sn > Ni > Co > As > Cd. The maximum affinity of PTEs and their percentages are as follows: Fe (F5, 80.6%), As (F5, 55.31%), Cd (F5, 48.8), Co (F5, 64.9%), Mn (F3, 44%), Ni (F5, 53.2%), Pb (F3, 44.7%), Zn (F3, -43.19%), Sn (F3, 55%), Cu (F5 -42.18). As, Cd, Co, Cu, Fe, and Ni have a high affinity for F5, indicating geogenic source, while Mn, Pb, Sn, and Zn have a high affinity for F3, indicating anthropogenic source. Fe-Mn oxide partition was dominant for nearly all PTEs due to elevated sorption of cations onto Fe-Mn oxides at high pH. The risk assessment code for Cd, Cu, Mn, Ni, Sn, and Zn in playground soil is categorized under moderate risk, below 30%, while other elements showed no risk. Also, mobility factors were calculated for each PTEs, suggesting the degree of mobility that PTEs can easily migrate and be taken up, absorbed, or adsorbed by the human body. The mobility factor in playground soil was higher for Sn (59.89%) followed by Mn (54.24%) > Pb (52.91%) > Zn (52.01%) > Cd (39.49%) > Ni (33.20%) > As (30.39%) > Co (26.56%) > Cu (21.24%) > Fe (11.20%). Risk hazard quotients for children and adults were found to follow the order: Pb (0.263; 0.040), Cu (0.098; 0.015) > As(0.056; 0.008) > Mn (0.045; 0.009) > Zn(0.36; 0.05) > Cd(0.006; 0.001) > Ni (0.004; 0.001) > Co (0.001; 0.0). PTEs detected in the environment result from atmospheric deposition from small-scale metallurgical industries (bell metal and brass), coal and oil combustion, civil works, municipal waste incineration, and fugitive emissions from road dust. The human non-carcinogenic health risk for PTEs from ingestion and dermal contact was higher than that from inhalation. In the context of carcinogenic risk, As shows the highest health risk of 2.51E-05, followed by Cd (1.02E-09) and Co (8.14E-09). This study uniquely assesses the chemical speciation of PTEs in playground soils, revealing their geogenic and anthropogenic sources, and evaluates associated health risks. Policy intervention is vital for monitoring and remediating PTEs in playgrounds to protect children's health., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: The Common Risk Factor Approach (CRFA) is one of the methods to achieve medical-dental integration. CRFA addresses shared risk factors among major Non-communicable Diseases (NCDs). This study aimed to explore the perspectives of dental and medical practitioners concerning CRFA for managing NCDs and periodontal diseases and to create and validate a tool to evaluate the Knowledge, Attitude, and Practice (KAP) of medical and dental practitioners in relation to utilization of CRFA for management of NCDs and Periodontal diseases., Methods: This research employed a concurrent mixed-method model and was carried out from January 2021 to February 2022, focusing on medical and dental practitioners in South India. In the qualitative phase, online interviews were conducted with dental and medical practitioners, recorded, and transcribed. Thematic analysis was applied after achieving data saturation. In the quantitative phase, a KAP questionnaire was developed. The sample size was determined by using the G power statistical power analysis program. A sample size of 220 in each group (dentists and medical practitioners) was estimated. Systematic random sampling was used to recruit the potential participants. The data obtained through the online dissemination of KAP tool was analysed and scores were standardized to categorize the KAP., Results: Qualitative thematic analysis identified four major themes: understanding of common risk factors, risk factor reduction and disease burden, integrating CRFA into clinical practice, and barriers to CRFA. In addition, thematic analysis revealed seventeen subthemes. For the quantitative phase, standardization was applied to a 14-item KAP questionnaire for medical practitioners and a 19-item KAP questionnaire for dental practitioners. The total KAP score for medical practitioners in the study was 21.84 ± 2.87, while dental practitioners scored 22.82 ± 3.21, which indicated a high level of KAP regarding CRFA. Meta integration of qualitative and quantitative data identified eight overarching themes: four were concordant, three were discordant, and one theme provided the explanatory component., Conclusion: The study's structured, validated questionnaire showed that both medical and dental professionals had a high knowledge of CRFA. However, they were not appreciably aware of the risk factors that are shared between NCDs and periodontal disease. Both groups were interested in the idea of using CRFA in integrated medical and dental care., (© 2024. The Author(s).)

Mapping of soil nutrient parameters using experimental measurements and geostatistical approaches to assist site-specific fertiliser advisories is anticipated to play a significant role in Smart Agriculture. FarmerZone is a cloud service envisioned by the Department of Biotechnology, Government of India, to provide advisories to assist smallholder farmers in India in enhancing their overall farm production. As a part of the project, we evaluated the soil spatial variability of three potato agroecological zones in India and provided soil health cards along with field-specific fertiliser recommendations for potato cultivation to farmers. Specifically, 705 surface samples were collected from three representative potato-growing districts of Indian states (Meerut, UP; Jalandhar, Punjab and Lahaul and Spiti, HP) and analysed for soil parameters such as organic carbon, macronutrients (NPK), micronutrients (Zn, Fe, Mn, and Cu), pH, and EC. The soil parameters were integrated into a geodatabase and subjected to kriging interpolation to create spatial soil maps of the targeted potato agroecological zones through best-fit experimental semivariograms. The spatial distribution showed a deficiency of soil organic carbon in two studied zones and available nitrogen among all studied zones. The available phosphorus and potassium varied among the agroecological zones. The micronutrient levels were largely sufficient in all the zones except at a few specific sites where nutrient advisories are recommended to replenish. The general management strategies were recommended based on the nutrient status in the studied area. This study clearly supports the significance of site-specific soil analytics and interpolated spatial soil mapping over any targeted agroecological zones as a promising strategy to deliver reliable advisories of fertiliser recommendations for smart farming., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Canine monocytic ehrlichiosis caused by Ehrlichia canis is an important rickettsial pathogen of dogs transmitted by Rhipicephalus sanguineus sensu lato ticks in India. Globally, molecular characterization of E. canis is done using different E. canis gene targets. This study aimed to characterize genetic diversity of uncultured Ehrlichia species from dogs by 16S rRNA and partial gp200 gene (termed as p43 region) sequences data. Phylogeny based on 16S rRNA gene did not reveal any region-specific lineages. The phylogeny based on 5' region of E. canis gp200 gene (termed as p43 region) revealed four major clusters (A, B, C and D) and the Indian isolates fall under clusters A and B. Cluster A is characterized by an insertion of unique 141 bp tandem repeat sequence. Similar tandem repeat sequence was found in one of the E canis isolates from east-Asia, suggesting a possible divergence within this species. The study shows evidence for divergence of a new lineage within E. canis. The location of this insertion at the 'ankyrin repeat domains' containing region is suggestive of its possible role in modulation of host responses., Competing Interests: Declaration of competing interest The authors declare that there are no conflicts of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

In April 2024, in a class action suit for compensation to families of persons suffering injury or death after vaccination with AstraZeneca's (AZ) Covid-19 vaccine [1], the manufacturer admitted in a UK court that the Oxford-AZ Covid-19 vaccine could cause a rare and potentially fatal blood clotting disorder ("thrombosis with thrombocytopenia syndrome" or TTS, which when triggered by a vaccine is called "vaccine induced thrombocytopenia and thrombosis, or VITT) [2]. The AZ Covid-19 vaccine is a chimpanzee adenovirus vectored vaccine encoding the SARS-CoV2 spike protein (ChAdOx1-S) marketed under the names Covishield and Vaxzevria.

This work introduces a novel approach to remotely count and monitor potato plants in high-altitude regions of India using an unmanned aerial vehicle (UAV) and an artificial intelligence (AI)-based deep learning (DL) network. The proposed methodology involves the use of a self-created AI model called PlantSegNet, which is based on VGG-16 and U-Net architectures, to analyze aerial RGB images captured by a UAV. To evaluate the proposed approach, a self-created dataset of aerial images from different planting blocks is used to train and test the PlantSegNet model. The experimental results demonstrate the effectiveness and validity of the proposed method in challenging environmental conditions. The proposed approach achieves pixel accuracy of 98.65%, a loss of 0.004, an Intersection over Union (IoU) of 0.95, and an F1-Score of 0.94. Comparing the proposed model with existing models, such as Mask-RCNN and U-NET, demonstrates that PlantSegNet outperforms both models in terms of performance parameters. The proposed methodology provides a reliable solution for remote crop counting in challenging terrain, which can be beneficial for farmers in the Himalayan regions of India. The methods and results presented in this paper offer a promising foundation for the development of advanced decision support systems for planning planting operations., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objective: To explore the relationship between occupational heat exposure, physiological heat strain indicators and adverse outcomes in pregnant women., Design: Prospective cohort., Setting: Workplaces in Tamil Nadu, India., Sample: A cohort of 800 pregnant women engaged in moderate to heavy physical work in 2017-2019 and 2021-2022., Methods: Participants were recruited at between 8 and 14 weeks of gestation. Occupational heat exposure and heat strain indicators were captured each trimester. 'Heat exposed' was defined as heat stress exceeding the threshold limit value (TLV) for safe manual work (with maximum wet-bulb globe temperatures of 27.5°C for a heavy workload and 28.0°C for a moderate workload). Physiological heat strain indicators (HSIs) such as core body temperature (CBT) and urine specific gravity (USG) were measured before and after each shift. Heat-related health symptoms were captured using the modified HOTHAPS questionnaire., Main Outcome Measures: The main outcome measures included (1) a composite measure of any adverse pregnancy outcome (APO) during pregnancy (including miscarriage, preterm birth, low birthweight, stillbirth, intrauterine growth restriction and birth defects), (2) a composite measure of adverse outcomes at birth (3) and miscarriage., Results: Of the 800 participants, 47.3% had high occupational heat exposure. A rise in CBT was recorded in 17.4% of exposed workers, and 29.6% of workers experienced moderate dehydration (USG ≥ 1.020). Heat-exposed women had a doubled risk of miscarriage (adjusted odds ratio, aOR 2.4; 95% confidence interval, 95% CI 1.0-5.7). High occupational heat exposure was associated with an increased risk of any adverse pregnancy and foetal outcome (aOR 2.3; 95% CI 1.4-3.8) and adverse outcome at birth (aOR 2.0; 95% CI 1.2-3.3)., Conclusions: High occupational heat exposure is associated with HSIs and adverse pregnancy outcomes in India., (© 2023 John Wiley & Sons Ltd.)

The outlook of relapsed ALL in low- and middle-income countries (LMICs) is dismal due to high treatment-related toxicities and inadequate resources. We report our experience of using a locally adapted mitoxantrone-based protocol for non-high risk (HR) relapsed B-ALL (rALL). A retrospective cum prospective study of standard and intermediate risk (SR and IR) rALL patients treated on TMH rALL-18 protocol (adapted from COG/UKALLR3/Int-Re-ALL protocols) between November 2018 and January 2021 was analyzed. The protocol comprising of 7 blocks of multi-agent chemotherapy including mitoxantrone in induction followed by local irradiation and maintenance, underwent serial modifications based on our experience with initial patients. Eighty-two patients (SR rALL, 3; IR rALL, 79) were treated on TMH rALL-18 protocol. Of 321 grade 3/4 reported toxicities, around 43% (138 toxicities) were noted during induction. Induction chemotherapy was outpatient-based; however, 68 patients (82.9%) required supportive care admissions. Twelve out of 19 patients with gram negative bacilli sepsis (included 7 MDRO) died during reinduction. Five remission deaths were seen during block 3 after which cytarabine was dose reduced (3 g to 2 g/m 2 ). Post-reinduction minimal residual disease was negative in 54 (80.6%) out of 67 evaluable patients. At a median follow-up of 24 months (95% CI 22-27), the estimated 2-year event-free and overall survival of the entire cohort was 58% (95% CI 48.1-69.9) and 60.3% (95% CI 50.5-72). Until the time, targeted therapies are freely accessible in LMICs, strengthening supportive care as well as local adaptation of protocols that strike a fine balance between efficacy and tolerability are mandated., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Exposures to volatile organic compounds (VOCs) cause respiratory symptoms among children, a known vulnerable group. Reports on exposures to VOCs and respiratory symptoms among South Indian children living in biomass-using households are not available thus far., Methods: A cross-sectional study was conducted among 313 rural children to assess the influence of emitted VOCs on their respiratory health. Standard analytical procedures for VOCs and Pulmonary Function Test (PFT), allied questionnaires, and all ethical considerations were fulfilled in the study., Results: The increase in VOC concentrations was observed proportional to the amount of burnt biomass fuel in two selected sites in Tamil Nadu (TN) and Andhra Pradesh (AP). Houses cooked for more than 60 min showed a remarkable increase in VOC concentrations and was observed as statistically significant (p < 0.01) in AP households. Among the younger children, the peak expiratory flow rate (PEFR) values were found significantly higher than comparatively older children in both the sites, TN and AP. However, the trend with respect to FEV1 is statistically significant (p < 0.01) among AP children., Conclusions: This study reports reduced lung function for a considerable proportion of the VOC-exposed selected children. Based on PFT, the children who were interpreted to be normal were found to be exposed to lesser indoor TVOC concentrations in comparison with the children of the households having restrictive or obstructive impairments. Diagnostic ratios with Benzene/Toluene (B/T) and Xylene/Ethyl benzene (X/E) confirmed the presence of VOCs-emissions from adjacent cooking fuels only. The observed results of this study recommends cleaner cooking fuel-use for better respiratory health among the citizens across the country, which in turn, in line with the Pradhan Mantri Ujjwala Yojana (PMUY), Government of India., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In vitro oral bioaccessibility assay (simple bioaccessibility extraction test) was used to assess bioaccessible PTEs (As, Cd, Co, Cu, Fe, Mn, Ni, Pb, Sn, and Zn) in 16 playground soils of Khagra, which is a medieval bell metal industrial town at Murshidabad district, West Bengal, India. The aim was also to establish levels of potentially toxic elements (PTEs) in soil, their origin, and human health risk, particularly on children. The average pseudo-total PTEs content in playground soil samples was in the decreasing order of Fe (18,988 mg kg -1 ) > Zn (1229 mg kg -1 ) > Cu (999 mg kg -1 ) > Mn (343 mg kg -1 ) > Pb (181 mg kg -1 ) > Sn (132 mg kg -1 ) > Co (8.63 mg kg -1 ) > As (5.21 mg kg -1 ) > Cd (0.88 mg kg -1 ). The pollution indices indicate significant enrichment of Cd, Cu, Pb, Zn, and Sn in the playground. The bioaccessible percentage of PTEs in the 16 playground soils ranged from 0 to 80.25%, where the range of percentage of bioaccessibility was 13.24-62.50, 0-61.46, 16.82-28.79, 5.05-73.06, 0.96-6.14, 2.28-38, and 0-80 for As, Cd, Co, Cu, Fe, Ni, and Zn, respectively. The order of percentage of bioaccessibility was As > Mn > Zn > Sn > Cu > Co > Pb > Cd > Ni > Fe. PCA extracted two major factors indicating the anthropogenic (Cd, Cu, Ni, Pb, Zn, and Sn) and geogenic (Co, Fe, and Mn) source. Stepwise multiple regression analysis exhibited that the oral bioaccessibility of PTEs did not correlate with physicochemical parameters like pH, EC. In contrast, Sn had a significant correlation with that of organic matter. The health risk for pseudo-total as well as bioavailable fraction in playground soil depicted that children were more vulnerable to ingestion of soil contaminated with PTEs, particularly for Cu and Pb. A risk management plan with the bioaccessible data involving detailed site-specific exposure factors to indicate the importance of the study in terms of child health safety is required., (© 2020. Springer Nature B.V.)

Background: To examine the effectiveness of a computer-assisted device (CAD) for diabetic retinopathy (DR) screening from retinal photographs at a vitreoretinal outpatient department (VR OPD), telecamps, and diabetes outpatient clinic by an ophthalmologist. In particular, the effectiveness of CAD in gradable and ungradable retinal images was examined. Methods: A total of 848 eyes of 485 patients underwent 45° retinal photographs at the VR OPD of a tertiary care hospital in southern India. A total of 939 eyes of 472 patients with diabetes were examined in the telecamps conducted in remote villages in Tamil Nadu, a state in southern India. A total of 2,526 eyes of 1,263 patients were examined in a diabetes clinic using 45° field retinal photographs. The algorithm was validated under physiological dilatation (without pharmacological dilatation) in all three arms. Results: Seventy-one percent of 848 eyes in VR OPD, 13% of 939 eyes in telecamps, and 7% of 2,526 eyes in diabetes clinic were diagnosed to have DR. The algorithm showed 78.3% sensitivity and 55.1% specificity for all images and 78.9% sensitivity and 56.8% specificity for gradable images in the VR OPD; 80.1% sensitivity and 79.2% specificity for all images and 84.8% sensitivity and 80.0% sensitivity for gradable images in telecamps; 63.0% sensitivity and 79.6% specificity for all images and 63.2% sensitivity and 78.1% specificity for gradable images in the diabetes clinic. The algorithm had an overall accuracy of 76.4%. The ungradable rate was variable. Conclusion: The algorithm performs equally well in identifying DR from gradable and ungradable photographs and may be used for DR screening in a rural setting with limited or no access to eye care.

Background: The present study was conducted to estimate the prevalence and distribution of MSDs in different anatomical regions among Doctors and NO and to determine their ergonomic risk factors and predictors., Methods: This cross-sectional study was conducted in an apex institution in Western India. The socio-demographic information, medical and occupational history, and other personal and work-related attributes were captured using a semi-structured questionnaire, which was developed and finalized by piloting on 32 participants (who were not part of the study). Nordic Musculoskeletal and International Physical Activity Questionnaires were used to assess MSDs and Physical activity. Data were analyzed using SPSS v.23. Prevalence of Musculoskeletal Symptoms (M.S.), Multisite Musculoskeletal Symptoms (MMS), and Widespread Musculoskeletal Symptoms (WMS) were calculated. A comparison was made to estimate the burden and distribution of MSD among Doctors and Nursing officers. Logistic regression was applied to identify the predictors of MSDs and pinpoint the risk factors associated with MSDs., Results: A total of 310 participants, of which 38.7% were doctors, and 61.3% were Nursing Officers (NOs) were included in the study. The mean age of the respondents was 31.63 ± 4.9 years. Almost 73% (95%CI: 67.9-78.1) of participants had MSD in the last 12 months, with approximately 41.6% (95%CI: 36.1-47.3) suffering from MSDs in the previous seven days of the survey. The lower back (49.7%) and the neck (36.5%) were the most affected sites. Working in the same position for a long time (43.5%) and not taking adequate breaks (31.3%) were the highest self-reported risk factors. Females had significantly higher odds of having pain in the upper back [aOR:2.49(1.27-4.85)], neck [aOR:2.15(1.22-3.77)], shoulder [aOR:2.8 (1.54-5.11)], hips [aOR:9.46 (3.95-22.68)] and knee [aOR:3.8(1.99-7.26)]., Conclusions: Females, who are NOs, work for > 48 h per week, and fall in the obese category were significantly at more risk of developing MSDs. Working in an awkward position, treating an excessive number of patients in a day, working in the same position for a long period, performing repeated tasks, and not having enough rest breaks were significant risk factors for MSDs., (© 2023. The Author(s).)

Polycyclic aromatic hydrocarbons (PAHs) are well-known hazardous substances; nevertheless, research on their exposure and health concerns associated with kerosene fuel emissions is limited. In this study, PAH (combined gaseous and particle phase) monitoring was carried out in the kitchen and living room in selected households. Personal exposure and cooking time monitoring were also carried out, simultaneously. The study's findings revealed that BaP, BA, BbF, and Nap were the most prevalent PAHs in both the summer and winter seasons, regardless of urban or rural households. The estimated values of average incremental lifetime cancer risks were found to be greater than the USEPA level, i.e., 1 × 10 -6 , in both urban and rural households, regardless of seasonal fluctuation. In both seasons, the non-carcinogenic risk for developmental and reproductive effects was higher in rural women than in urban women, and in case of developmental risk it showed greater than unity (rural: 1.11 and urban 1.03) in the winter season. On the other hand, Monte Carlo simulation model revealed that concentrations of PAHs (97.1% and 97.5%) and exposure duration (51.7% and 56.7%) were the most sensitive factors contributed for health risk estimations for urban and rural area in both seasons, respectively. Furthermore, the results clearly showed that women who were using kerosene for cooking were at a greater risk of acquiring both carcinogenic and non-carcinogenic health consequences from PAH exposure from kerosene cookstoves. It was recommended that they should utilize clean fuel, either by using LPG under the PMUY scheme or by using electricity/solar power to reduce health risks for better health., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: There is a concurrent increase in anaemia and overweight/obesity among women in the South and South East Asia regions. Despite these, studies on the co-existence of anaemia and overweight/obesity in these countries are abysmally limited. This secondary analysis sought to estimate the burden of the intraindividual double burden of malnutrition (IDBM), i.e., co-existence of anaemia and overweight/obesity among women of reproductive age (15-49 years) in India, Myanmar, and Nepal, and explore the impact of socio-demographic and economic factors on this health outcome., Methods: A secondary analysis of the Demographic and Health Surveys (DHS) of India (2019-2021), Myanmar (2015-2016), and Nepal (2016) was conducted. A descriptive analysis of the health outcomes and the risk factors was done with frequencies and percentages. The association between selected socio-demographic (women's age, education status, number of children and place of residence) and economic (occupation status, and wealth quintile) variables with IDBM was found with binary logistic regression analysis., Results: Around one in ten women of reproductive age group in India and Myanmar had IDBM. In Nepal, it occurs in one in nearly 15 women. Maternal age, education, household wealth, number of children, place of residence, and occupation were found to be significant predictors of IDBM., Conclusion: There is a high prevalence of IDBM in South Asian women and it varies substantially across different socio-demographic and economic predictors. Sufficient evidence from prospective studies is needed to establish causal association and also to implement need-based prevention and curative strategies., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Zoonotic tuberculosis in humans is caused by infection with bacteria of the Mycobacterium tuberculosis complex acquired from animals, most commonly cattle. India has the highest burden of human tuberculosis in the world and any zoonotic risk posed by tuberculosis in bovines needs to be managed at the source of infection as a part of efforts to end human tuberculosis. Zoonotic tuberculosis in humans can be severe and is clinically indistinguishable from non-zoonotic tuberculosis. As a consequence, zoonotic tuberculosis remains under-recognised and the significance of its contribution to human tuberculosis is poorly understood. This study aimed to explore any association between bovine density, bovine ownership, and human tuberculosis reporting in India using self-reported tuberculosis data in households and officially reported tuberculosis cases while controlling for common confounders for human tuberculosis. We find an association between human tuberculosis reporting, bovine density and bovine ownership in India. Buffalo density was significantly associated with an increased risk of self-reported tuberculosis in households (odds ratio (OR) = 1.23 (95% credible interval (CI): 1.10-1.39) at household level; incidence rate ratio (IRR) = 1.17 (95% CI: 1.04-1.33) at district level), while cattle density (OR = 0.80, 95% CI: 0.71-0.89; IRR = 0.78, 95% CI: 0.70-0.87) and ownership of bovines in households (OR = 0.94, 95% CI: 0.9-0.99; IRR = 0.67, 95% CI: 0.57-0.79) had a protective association with tuberculosis reporting. It is unclear whether this relates to differences in tuberculosis transmission dynamics, or perhaps an association between bovines and other unexplored confounders for tuberculosis reporting in humans. Our study highlights a need for structured surveillance to estimate the prevalence of tuberculosis in cattle and buffaloes, characterisation of Mycobacterium tuberculosis complex species present in bovines and transmission analyses at the human-animal interface to better assess the burden and risk pathways of zoonotic tuberculosis in India., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Purpose: To assess the differences in the pattern of presentation of glaucoma emergency conditions during the various phases of pandemic-related travel restrictions: first wave-related lockdown, unlock period, and the second wave-related lockdown., Methods: The number of new emergency glaucoma conditions, the various diagnoses, and the total number of all new glaucoma patients presenting to the glaucoma services at five tertiary eye care centers in south India from 24 th March 2020 to 30 th June 2021 were collected from the electronic medical records and were analyzed. The data were compared with the corresponding time period in the year 2019., Results: In total, 620 patients presented with an emergency glaucoma diagnosis during the first wave-related lockdown as against 1337 during the same period in 2019 (P < 0.0001). During the unlock period, 2659 such patients visited the hospital compared with 2122 in 2019 (P = 0.0145). During the second wave-related lockdown, there were 351 emergency patients compared with 526 patients in 2019 (P < 0.0001). Lens-induced glaucomas (50.4%) and neovascular glaucoma (20.6%) were the most common diagnoses during the first wave-related lockdown. During the unlock period, there was a greater proportion of neovascular glaucoma (P = 0.0123). The second wave-related lockdown had a greater proportion of phacolytic glaucomas (P = 0.005) and acute primary angle closure (P = 0.0397) patients., Conclusion: The study demonstrates that emergency glaucoma care was grossly underutilized by the people during the lockdowns. Trivial conditions like cataracts or retinal vascular diseases if not treated appropriately may progress to become emergencies in the future., Competing Interests: None

Purpose: The objective was to study the positivity of the Weil-Felix test (WFT) in epidemic retinitis (ER) during the course of the disease., Methods: This is a retrospective, observational case series of patients diagnosed with ER and presented to a tertiary eye care hospital in south India. Patients with positive WFT at the presentation, and who underwent a follow-up WFT during or after the resolution of ER were studied from September 2019 to March 2022. Patient's demographics, timings of clinical presentation and resolution, and investigation details with a special focus on WFT positivity and its duration were noted., Results: Sixteen patients were studied. Patients presented after 5 weeks of the fever (range: 2-12 weeks, median: 4). After 1-2 months, WFT was still positive in eight patients (50%). Only in one patient titers increased after 1 month, while in others, the titers decreased (n = 11) or remained the same (n = 4). Repeated tests in those patients (n = 6) after 3-4 months turned negative. Resolution of ER was seen at 1.35 months (range: 1-3 months) after the presentation. The mean duration for WFT to turn negative was 2 months from the presentation (range: 1-4 months) or 3.2 months of the fever (range: 1.5-6 months)., Conclusion: In contrast to the reported physician's observation of increasing titers of WFT after rickettsial fever, ophthalmologists may observe decreasing WFT titers in ER. The clinical resolution of ER may precede the normalization of WFT. Follow-up WFT titers should be studied in larger series in confirmed cases of rickettsial-ER to validate the affordable and readily available WFT in India.

Purpose: To study the clinical and demographic profile of patients less than 40 years of age presenting to glaucoma services including the reasons for referral., Methods: Patients in the age group of 5 to 39 years, visiting the glaucoma clinic, who were either suspected to have glaucoma or who had been newly/previously diagnosed with glaucoma were included in the study. After informed written consent, basic demographic details of the participants including age, gender, education, socioeconomic status, and family history were obtained. A comprehensive ophthalmological evaluation was performed by glaucoma specialists., Results: The proportion of glaucoma in the study population (n = 384) was found to be 31.25%, and the incidence of glaucoma among new patients was found to be 11.9%. Among all glaucomas (n = 120), 44.2% of patients had secondary glaucomas, 27.5% had primary glaucomas, and 28.3% had congenital glaucomas. Also, 67.3% of all glaucoma patients were males. Newly diagnosed glaucoma patients presented with a mean intraocular pressure (IOP) of 32.9 mmHg and mild-moderate disc damage with a mean cup-disc ratio of 0.65. Nearly one-third of them had a presenting visual acuity worse than 5/60. The most common reason for referral was raised IOP. Univariate and multivariate analysis revealed that the odds of developing glaucoma were less in females (P = 0.04) and in patients with a higher standard of living index (P < 0.001)., Conclusion: One-third of the patients had glaucoma and another one-third were suspects. Secondary glaucomas are more common than primary/congenital glaucomas. A comprehensive eye evaluation is a must, especially in those with predisposing factors., Competing Interests: None

Background: The role of local self-government (LSG) bodies in planning community-level interventions for noncommunicable diseases (NCD) control is critical. An understanding of how much priority is given to NCD in decentralized health planning is needed., Objective: The objective of this study is to analyze the pattern of budgetary allocation for health sector projects at different levels of LSGs in Thiruvananthapuram, Kerala, with specific reference to NCD control., Materials and Methods: Secondary data analysis was done on economic review reports and reports on health sector projects obtained from LSG department with permission. The pattern of budgetary allocation of health projects in both urban and rural local bodies of Thiruvananthapuram district for 2019-2020 was studied., Results: The proportion of NCD projects in terms of number and budget allocation, respectively, among health sector projects for gram panchayaths (GP) was 47 projects (5.25%) and 63.19 lakhs (1.8%). Figures for block panchayaths (BP) were 13 (9%) and 98.10 lakhs (10.94%), for district panchayath (DP), 1 (0.9%) and 48 lakhs (3%), for municipalities 1 (1.6%) and 4.66 lakhs (1.2%), and for corporation were 1 (1.4%) and 3 lakhs (0.16%). Only 29 (40%) GP and 5 (45%) BP had at least one NCD project. At the GP level, 21% of projects were community-based interventions and 15% of projects were for cancer screening, mental health, and hospital-based NCD clinics each. Among local bodies with lower allocation for NCD projects, the amount allocated for construction and maintenance work in health institutions was higher., Conclusion: Decision-making in decentralized health planning needs an evidence-based realignment of priorities toward NCD., Competing Interests: None

Farming has a plethora of difficult responsibilities, and plant monitoring is one of them. There is also an urgent need to increase the number of alternative techniques for detecting plant diseases, which is now lacking. The agriculture and agricultural support sectors in India provide employment for the great majority of the country's people. In India, the agricultural production of the country is directly connected to the country's economic growth rate. In order to sustain healthy plant development, a variety of processes must be followed, including consideration of environmental factors and water supply management for the optimal production of crops. It is inefficient and uncertain in its outcomes to use the traditional method of watering a lawn. The devastation of more than 18% of the world's agricultural produce is caused by disease attacks on an annual basis. Because it is difficult to execute these activities manually, identifying plant diseases is essential to decreasing losses in the agricultural product business. In addition to diagnosing a wide range of plant ailments, our method also includes the identification of infections as a prophylactic step. Below is a detailed description of a farm-based module that includes numerous cloud data centers and data conversion devices for accurately monitoring and managing farm information and environmental elements. This procedure involves imaging the plant's visually obvious signs in order to identify disease. It is recommended that the therapy be used in conjunction with an application to minimize any harm. Increased productivity as a result of the suggested approach would help both the agricultural and irrigation sectors. The plant area module is fitted with a mobile camera that captures images of all of the plants in the area, and all of the plants' information is saved in a database, which is accessible from any computer with Internet access. It is planned to record information on the plant's name, the type of illness that has been afflicted, and an image of the plant. In a wide range of applications, bots are used to collect images of various plants as well as to prevent disease transmission. To ensure that all information given is retained on the Internet, data is collected and stored in cloud storage as it becomes essential to regulate the condition. According to our findings from our research on wide images of healthy and ill fruit and plant leaves, real-time diagnosis of plant leaf diseases may be done with 98.78% accuracy in a laboratory environment. We utilized 40,000 photographs and then analyzed 10,000 photos to construct a DCDM deep learning model, which was then used to train additional models on the data set. Using a cloud-based image diagnostic and classification service, consumers may receive information about their condition in less than a second on average, with the process requiring only 0.349 s on average., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Aims/hypothesis: South Asians in general, and Asian Indians in particular, have higher risk of type 2 diabetes compared with white Europeans, and a younger age of onset. The reasons for the younger age of onset in relation to obesity, beta cell function and insulin sensitivity are under-explored., Methods: Two cohorts of Asian Indians, the ICMR-INDIAB cohort (Indian Council of Medical Research-India Diabetes Study) and the DMDSC cohort (Dr Mohan's Diabetes Specialties Centre), and one of white Europeans, the ESDC (East Scotland Diabetes Cohort), were used. Using a cross-sectional design, we examined the comparative prevalence of healthy, overweight and obese participants with young-onset diabetes, classified according to their BMI. We explored the role of clinically measured beta cell function in diabetes onset in Asian Indians. Finally, the comparative distribution of a partitioned polygenic score (pPS) for risk of diabetes due to poor beta cell function was examined. Replication of the genetic findings was sought using data from the UK Biobank., Results: The prevalence of young-onset diabetes with normal BMI was 9.3% amongst white Europeans and 24-39% amongst Asian Indians. In Asian Indians with young-onset diabetes, after adjustment for family history of type 2 diabetes, sex, insulin sensitivity and HDL-cholesterol, stimulated C-peptide was 492 pmol/ml (IQR 353-616, p<0.0001) lower in lean compared with obese individuals. Asian Indians in our study, and South Asians from the UK Biobank, had a higher number of risk alleles than white Europeans. After weighting the pPS for beta cell function, Asian Indians have lower genetically determined beta cell function than white Europeans (p<0.0001). The pPS was associated with age of diagnosis in Asian Indians but not in white Europeans. The pPS explained 2% of the variation in clinically measured beta cell function, and 1.2%, 0.97%, and 0.36% of variance in age of diabetes amongst Asian Indians with normal BMI, or classified as overweight and obese BMI, respectively., Conclusions/interpretation: The prevalence of lean BMI in young-onset diabetes is over two times higher in Asian Indians compared with white Europeans. This phenotype of lean, young-onset diabetes appears driven in part by lower beta cell function. We demonstrate that Asian Indians with diabetes also have lower genetically determined beta cell function., (© 2022. The Author(s).)

Anopheles stephensi is the most menacing malaria vector to watch for in newly urbanising parts of the world. Its fitness is reported to be a direct consequence of the vector adapting to laying eggs in over-head water tanks with street-side water puddles polluted by oil and sewage. Large frequent inversions in the genome of malaria vectors are implicated in adaptation. We report the genome assembly of a strain of An. stephensi of the type-form, collected from a construction site from Chennai (IndCh) in 2016. The genome reported here with a L50 of 4, completes the trilogy of high-resolution genomes of strains with respect to a 16.5 Mbp 2Rb genotype in An. stephensi known to be associated with adaptation to environmental heterogeneity. Unlike the reported genomes of two other strains, STE2 (2R+ b /2Rb) and UCI (2Rb/2Rb), IndCh is found to be homozygous for the standard form (2R+ b /2R+ b ). Comparative genome analysis revealed base-level details of the breakpoints and allowed extraction of 22,650 segregating SNPs for typing this inversion in populations. Whole genome sequencing of 82 individual mosquitoes from diverse geographical locations reveal that one third of both wild and laboratory populations maintain the heterozygous genotype of 2Rb. The large number of SNPs can be tailored to 1740 exonic SNPs enabling genotyping directly from transcriptome sequencing. The genome trilogy approach accelerated the study of fine structure and typing of an important inversion in An. stephensi, putting the genome resources for this understudied species on par with the extensively studied malaria vector, Anopheles gambiae. We argue that the IndCh genome is relevant for field translation work compared to those reported earlier by showing that individuals from diverse geographical locations cluster with IndCh, pointing to significant convergence resulting from travel and commerce between cities, perhaps, contributing to the survival of the fittest strain., (© 2022. The Author(s).)

Background: Digitalization of education became a need of the hour when the COVID-19 pandemic affected the traditional modalities of learning, and it was widely implemented in various fields including dentistry., Aims: The aim of this study was to assess the effectiveness of online learning against traditional learning systems among dental students in Chennai., Methods and Materials: A Google Form questionnaire comprising 29 dental learning-based questions was designed and distributed to dental students across colleges in Chennai using online distribution platforms. The study responses were closed after the stipulated period of 1 month. The data were analyzed using SPSS software version 17., Results: The survey was answered by 834 participants comprising 76.9% females and 22.3% males. Of the total study population, 71.1% of them did not have previous online learning experiences. Approximately, 15.5% of the study population were not satisfied with the facilities provided by the online learning platforms. Also, one-third of the study population reported difficulty during the presentation. Three-fourths of the study participants did not prefer online learning over traditional learning and reported that the attention span and communication between the students and teachers were lower in online classes. Overall, 43% of the study participants rated the quality of online video-based learning to be good and 8.5% found it to be poor., Conclusion: Online-based learning systems are evolving and can provide a wide array of knowledge from global experts. However, structured planning and technique may be needed for the dental curriculum.

Identifying risk factors for impaired oral rotavirus vaccine (ORV) efficacy in low-income countries may lead to improvements in vaccine design and delivery. In this prospective cohort study, we measure maternal rotavirus antibodies, environmental enteric dysfunction (EED), and bacterial gut microbiota development among infants receiving two doses of Rotarix in India (n = 307), Malawi (n = 119), and the UK (n = 60), using standardised methods across cohorts. We observe ORV shedding and seroconversion rates to be significantly lower in Malawi and India than the UK. Maternal rotavirus-specific antibodies in serum and breastmilk are negatively correlated with ORV response in India and Malawi, mediated partly by a reduction in ORV shedding. In the UK, ORV shedding is not inhibited despite comparable maternal antibody levels to the other cohorts. In both India and Malawi, increased microbiota diversity is negatively correlated with ORV immunogenicity, suggesting that high early-life microbial exposure may contribute to impaired vaccine efficacy., (© 2021. The Author(s).)

Competing Interests: None

Background: Neonatal rotavirus infections are predominantly caused by distinct genotypes restricted to this age-group and are mostly asymptomatic., Method: Stool samples from neonates admitted for >48 h in neonatal intensive care units (NICUs) in Vellore (2014-2015) and Chennai (2015-2016) in southern India, and from neonates born at hospitals in Vellore but not admitted to NICUs (2015-2016) were tested for rotavirus by ELISA and genotyped by hemi-nested RT-PCR., Results: Of 791 neonates, 150 and 336 were recruited from Vellore and Chennai NICUs, and 305 were born in five hospitals in Vellore. Positivity rates in the three settings were 49.3% (74/150), 29.5% (99/336) and 54% (164/305), respectively. G10P[11] was the commonly identified genotype in 87.8% (65/74), 94.9% (94/99) and 98.2% (161/164) of the neonates in Vellore and Chennai NICUs, and those born at Vellore hospitals, respectively. Neonates delivered by lower segment cesarian section (LSCS) at Vellore hospitals, not admitted to NICUs, had a significantly higher odds of acquiring rotavirus infection compared to those delivered vaginally [p = 0.002, OR = 2.4 (1.4-4.3)]., Conclusions: This report demonstrates the persistence of G10P[11] strain in Vellore and Chennai, indicating widespread neonatal G10P[11] strain in southern India and their persistence over two decades, leading to interesting questions about strain stability., (Copyright © 2021. Published by Elsevier B.V.)

Purpose: To compare the effectiveness of the Optos P200dTx and Zeiss Clarus 500 fundus cameras in detecting diabetic retinopathy (DR) lesions., Methods: A cross-sectional study was conducted among 243 patients with clinically diagnosed diabetes mellitus who were referred for an eye examination from two tertiary eye care centers in Chennai, India. Patients underwent DR screening based on mydriatic fundal images acquired by both fundal cameras. Fundal images from the two separate devices for each eye were compared based on accurately identified pathological retinal lesions with respect to type and location., Results: When studying lesions of the central retina, they were better identified by the Zeiss Clarus compared with the Optos P200dTx, with six out of eight being statistically significant (P < 0.05). However, lesions of the mid-peripheral retina and peripheral retina were better identified by the Optos P200dTx than the Zeiss Clarus, with three out of eight lesions and five out of eight lesions being statistically significant (P < 0.05), respectively. Based on the color and size of lesions, the Optos P200dTx had a higher chance (59.6%) of missing white lesions than did the Zeiss Clarus (17%) (P < 0.0001). Consequently, small- and medium-sized lesions were missed more by the Optos P200dTx (30.72% and 32.63%, respectively) than the Zeiss Clarus (22.3% and 19.30%, respectively)., Conclusions: The capability of detecting or missing a particular DR lesion among diabetics differed between the two cameras based on effective field of view, resolution, and the retinal zone being imaged., Translational Relevance: The choice of which ultra-widefield camera to be used for screening DR can be based on the greater prevalence of central versus peripheral retinal lesions noted in the patient population seen in a clinical practice.

Background: The incidence of oral cancer is increasing in south-central Asia. Though it can be detected early, most cases were reported in late stages, resulting in a poor prognosis. Reducing the patient interval will facilitate early diagnosis and better disease survival.  The paucity of research on the patient interval in oral cancer has limited our ability to design and evaluate programs for early diagnosis., Methods: The study was conducted to identify the duration of patient interval and associated factors in oral cancer. Patients with oral cancer reporting at a tertiary cancer center during the study period were interviewed using validated data collection tools. The 'Aarhus statement' guidelines were followed in designing and reporting the study., Results: Among the 261 participants, 54% reported a patient interval of more than 90 days. The median (IQR) patient interval was 92 (38-168) days. In the multivariate binary logistic regression model, those who approached healthcare facilities due to pain (OR, 8.3, 95% CI, 2.9 to 23.4) were more likely to have a patient interval of more than 90 days over those who came due to insistence by family. Smoking status (Current smoker vs. never smoker) at the time of diagnosis (OR, 2.518, 95% CI, 1.3 to 4.7), Stage of cancer (late vs. early) of participants (OR, 2.62, 95% CI, 1.3 to 5.2), and time of travel (>30 minutes vs. ≤ 10 minutes) to health care facility (OR 5.8, 95% CI, 1.6 to 21.7) were the other significant predict8  6766667ors for the patient interval of more than 90 days., Conclusion: Patient interval in oral cancer can be reduced by improving symptom awareness, abstinence from tobacco use, and facilitating access to health care facilities. The double burden of tobacco use in oral cancer, as it increases the risk of disease occurrence and delays symptom presentation, needs serious policy considerations in the context of cancer prevention.

Introduction. Squamous cell carcinoma is a highly aggressive type of oral cancer (OC). It is the most common cancer among men, and accounts for almost 90 % of all oral cancers in India. Consumption of tobacco is a leading factor contributing to maximum oral cancer incidences as per the WHO. Hypothesis/Gap statement. Researchers reported a direct association of microorganisms with dysbiosis in various oral lesions including oral cancer. However, there is a dearth of information related to compositional changes in the oral microbiome in long-term tobacco chewers and the Indian oral cancer population. Aim. The aim of this study was to identify and correlate the bacterial diversity in the oral cavity of tobacco chewers, patients with oral cancer and healthy subjects in the Indian population. Methods. Oral rinse samples were collected for ten subjects in each group followed by DNA extraction. The variable regions of the bacterial 16S rRNA gene (V6-V8) were amplified, sequenced, processed, and analysed using QIIME2 platform to assess alpha and beta diversity between the study groups. Results. This pilot study showed genus Streptococcus dominated the control group (18.54 %), and the abundance decreased in tobacco and OC group (9.63 and 5.45% respectively); whereas genus Prevotella dominated the tobacco and OC group (21.01 and 26.03% respectively). A shift in abundance of microbiome was observed from control population to oral cancer via the tobacco chewing population. Maximum alpha diversity of oral microbiome was found in Indian tobacco chewers. Beta diversity of tobacco chewers was similar to both the healthy population as well as oral cancer patients suggesting transitioning of the oral microbiome from healthy to oral cancer microbiome via the tobacco chewers microbiome. Conclusion. The data provides evidence of oral bacterial dysbiosis due to tobacco chewing habits that can further lead to progression towards cancer.

We investigated the influence of Bacillus Calmette-Guérin (BCG) vaccination on the unstimulated plasma levels of a wide panel of cytokines, chemokines, acute-phase proteins (APPs), matrix metalloproteinases (MMPs), and growth factors in a group of healthy elderly individuals (age, 60 to 80 years) at baseline (before vaccination) and 1 month after vaccination as part of our clinical study to examine the effect of BCG on COVID-19. Our results demonstrated that BCG vaccination resulted in diminished plasma levels of types 1, 2, and 17 and other proinflammatory cytokines and type 1 interferons. BCG vaccination also resulted in decreased plasma levels of CC, CXC chemokines, APPs, MMPs, and growth factors. Plasma levels of the aforementioned parameters were significantly lower in vaccinated individuals when compared to unvaccinated control individuals. Thus, our study demonstrates the immunomodulatory properties of BCG vaccination and suggests its potential utility in nonspecific vaccination of COVID-19 by down-modulating pathogenic inflammatory responses., (Copyright © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution License 4.0 (CC BY).)

Introduction : The Ocular manifestations of coronavirus disease 2019 (COVID-19) reported include conjunctivitis, conjunctival hyperemia, chemosis, epiphora, episcleritis, retinal manifestations included cotton wool spots (CWS), micro-hemorrhages, papillophlebitis and neuro-ophthalmic manifestations. Purpose : To report post COVID-19 ophthalmic manifestations using multimodal imaging. Results : A 66-year-old Asian Indian male presented to us with bilateral blurring of vision, RE>LE, of 3 days following a diagnosis of COVID-19 disease. Corrected distance visual acuity were 20/2666 and 20/25 in the right (RE) and left (LE) eyes respectively. He had bilateral anterior chamber inflammation with a relative afferent pupillary defect in the RE. RE showed central retinal artery occlusion(CRAO) with CWS, few flame-shaped retinal hemorrhages and disc edema and hyperemia. LE had disc edema and hyperemia, few flame-shaped retinal hemorrhages, cystoid changes and CWS. A diagnosis of bilateral panuveitis and papillitis with CRAO in the RE was made. Conclusion : Our patient developed a vascular occlusion with panuveitis, which possibly represents an immune mediated event following COVID-19. Patients should be warned about possible ophthalmic sequelae even after recovery.

South Indians are a heterogeneous population who speak different languages and differ in their life style and physical appearance. Major population movements, social structure and caste endogamy have influenced the genetic structure of Indian populations. The human leukocyte antigen (HLA) system of populations is highly informative because of the high level of polymorphisms. Knowledge of allele and haplotype frequencies of the HLA system is important in the search for unrelated bone marrow donors. We investigated the distribution of HLA A, B, C, DRB1 and DQB1 loci in five linguistic groups from South India. HLA-A*01:01:01~B*57:01:01:01~C*06:02:01~DRB1*07:01:01~DQB1*03:03:02 was the common haplotype with highest frequency in all the five populations studied. A few relevant haplotypes were identified as most common haplotypes in each linguistic group. Comparison of HLA-A, -B and -DRB1 allele distribution in these five linguistic groups with the other Asian population showed that the South Indian populations were closely related to Sri Lankan populations. A large South Indian donor registry might serve as good source of donors for patients from Sri Lanka and vice versa., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: Two-phase II randomised studies have shown a significant benefit of local consolidation therapy in oligometastatic non-small cell lung cancer (NSCLC). This phase III randomised controlled trial (RCT) will evaluate the efficacy of local consolidation radiation therapy (RT) in oligometastases (OM) NSCLC after completion of initial systemic therapy., Methods and Analysis: This is a single-centre phase III RCT of OM NSCLC patients. One hundred and ninety patients will undergo 1:1 randomisation to either standard maintenance therapy (control arm) or local consolidation RT and standard maintenance therapy (experimental arm). Patients will be stratified into the number of OM sites (1-2 vs 3-5), nodal metastases (N0-N1 vs N2-N3) and presence or absence of brain metastases. Stereotactic body radiation therapy to all the oligometastatic sites and definitive RT to primary disease will be given in the experimental arm. The primary endpoint is overall survival and secondary endpoints include progression-free survival, local control of OM sites, new distant metastases free survival, objective response rate, toxicity and quality of life. Translation endpoint include circulating tumour cells and radiomics using texture analysis., Ethics and Dissemination: All patients will be provided with a written informed consent form which needs to be signed before randomisation. The study is approved by the institutional ethics committee-II (project number 3445) and registered with Clinical Trials Registry-India, dated 21 April 2020., Trial Registration Number: CTRI/2020/04/024761; Pre-Results., Competing Interests: Competing interests: VN has received institutional research funding from Amgen, Sanofi India, Dr. Reddy’s Laboratories, Intas Pharmaceuticals and Astra Zeneca Pharma India. All research grants have been paid to the institution. KP has received research funding from Dr. Reddy’s Laboratories, Fresenius Kabi India, Alkem Laboratories, Natco Pharma, BDR Pharmaceuticals Intl. and Roche Holding AG (all research grants paid to the institution and are unrelated to this study project). The rest of the authors declare that they have no competing interest in the proposed study protocol., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)