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Groundwater availability has become a global challenge due to climatic droughts and human interventions. North India has emerged as one of the most groundwater-depleted regions. Our study delves into the linkage between groundwater variability, climatic and anthropogenic factors for the last two decades using the Gravity Recovery and Climate Experiment (GRACE) and GRACE-Follow On (GRACE-FO) observations, groundwater levels, climatic and socioeconomic datasets. Our novel spatiotemporal analysis of groundwater storage (GWS) anomaly reveals five episodes of notable changes in north India affected by rainfall variability and groundwater abstraction. The standardized precipitation index (SPI) reveals that the prolonged drought and groundwater pumping during 2015 to 2017 significantly affected GWS. Our results suggest that sufficient rainfall contributed to the replenishment of GWS in some zones during 2018 to 2023, likely due to government recharge programmes. Our findings elucidate the current scenario and underscore a pressing necessity to accelerate groundwater management strategies, ensuring its resilience in future periods of intense drought. [ABSTRACT FROM AUTHOR]

Background: This paper aimed to explore the palliative care (PC) needs and barriers to access among cancer patients in a rural region of North India with a high cancer burden. Methods: A Participatory action research (PAR) approach was employed. Situational assessment, community sensitization workshops (CSWs) and door-to-door surveys were planned, conducted and developed over three PAR cycles. A parallel convergent mixed-methods approach was adopted wherein the quantitative data from door-to-door surveys and qualitative data from CSWs and investigator field notes were collected and analyzed to provide a comprehensive understanding of PC needs and barriers to access. Descriptive statistics and thematic analysis were used. Results: A total of 27 CSWs involving 526 stakeholders were conducted. A total of 256 cancer patients were assessed for PC needs and symptom burden using the Supportive and Palliative Care Indicators (SPICT-4ALL) and the Edmonton Symptom Assessment System (ESAS) tool, respectively. Based on the SPICT assessment, all patients (n = 256) satisfied general and/or cancer-specific indicators for PC. The majority (56.6%) had ≥ one moderate-severe symptom, with the most common symptoms being tiredness, pain and loss of appetite. Analysis of qualitative findings generated three themes: unmet needs, burden of caregiving, and barriers and challenges. Cancer affected all domains of patients' and their families' lives, contributing to biopsychosocial suffering. Social stigma, discrimination, sympathizing attitudes and lack of emotional and material support contributed to psychosocial suffering among cancer patients and their caregivers. Lack of awareness, nearby healthcare facilities, transportation, essential medicines, trained manpower and education in PC, collusion, fear of social discrimination, faulty perceptions and misconceptions about cancer made access to PC difficult. Conclusions: The study emphasize the need for and provide a roadmap for developing context-specific and culturally appropriate CBPC services to address the identified challenges and needs. The findings point towards education of CHWs in PC; improving community awareness about cancer, PC, government support schemes; ensuring an uninterrupted supply of essential medicines; and developing active linkages within the community and with NGOs to address the financial, transportation, educational, vocational and other social needs as some of the strategies to ensure holistic CBPC services. Trial registration: Clinical Trial Registry of India (CTRI/2023/04/051357). [ABSTRACT FROM AUTHOR]

Background: Congenital cardiac malformations are a significant subset of developmental abnormalities, affecting approximately 6-8 per 1,000 live births and 2% of stillbirths. These malformations account for nearly one-quarter of all developmental anomalies, yet the etiology remains unknown in over 90% of cases. Hereditary factors and environmental conditions, such as high altitude and seasonal variations, have been implicated. The prevalence and types of congenital cardiac malformations in North India are not well-documented, prompting this study to investigate these aspects in adult and fetal cadavers at Bhagalpur. Materials and Methods: The study was conducted in the Department of Anatomy at Jawaharlal Nehru Medical College, Bhagalpur, using 25 adult and 45 fetal cadaver hearts, preserved in 10% formaldehyde solution. The hearts were dissected using a standardized method, examining and classifying malformations according to abnormalities in position, developmental progress, and visceral arches. Morphological features were assessed with tools including a dissection kit, magnifying lens, torch, probe, and measuring tape. Results: Out of 70 cases studied, 14 (20%) displayed congenital cardiac malformations, with a higher incidence in adults (24%) than in fetuses (17.78%). A total of 25 anomalies were identified among the 14 cases, with 10 types of anomalies observed. The most common malformation was atrial septal defect, followed by anomalous positions of the great arteries and cor biloculare. Coexistent external anomalies were found in 3 of the 14 cases (21.43%), affecting the face and multiple systems. Conclusion: The incidence of congenital cardiac malformations in Bhagalpur is consistent with findings from other regions of India and internationally. Atrial septal defect is the most prevalent malformation in this population, aligning with patterns observed in other Indian studies but differing from international reports. [ABSTRACT FROM AUTHOR]

Coronary artery disease (CAD) is the leading cause of death in India. Many genetic polymorphisms play a role in regulating oxidative stress, blood pressure and lipid metabolism, contributing to the pathophysiology of CAD. This study examined the association between ten polymorphisms and CAD in the Jat Sikh population from Northern India, also considering polygenic risk scores. This study included 177 CAD cases and 175 healthy controls. The genetic information of GSTM1 (rs366631), GSTT1 (rs17856199), ACE (rs4646994), AGT M235T (rs699), AGT T174M (rs4762), AGTR1 A1166C (rs5186), APOA5 (rs3135506), APOC3 (rs5128), APOE (rs7412) and APOE (rs429358) and clinical information was collated. Statistical analyses were performed using SPSS version 27.0 and SNPstats. Significant independent associations were found for GST*M1, GST*T1, ACE, AGT M235T, AGT T174M, AGTR1 A1166C and APOA5 polymorphisms and CAD risk (all p < 0.05). The AGT CT haplotype was significantly associated with a higher CAD risk, even after controlling for covariates (adjusted OR = 3.93, 95% CI [2.39–6.48], p < 0.0001). The APOA5/C3 CC haplotype was also significantly associated with CAD (adjusted OR = 1.86, 95% CI [1.14–3.03], p < 0.05). A higher polygenic risk score was associated with increased CAD risk (adjusted OR = 1.98, 95% CI [1.68–2.34], p < 0.001). Seven polymorphisms were independently associated with an increase in the risk of CAD in this North Indian population. A considerable risk association of AGT, APOA5/C3 haplotypes and higher genetic risk scores is documented, which may have implications for clinical and public health applications. [ABSTRACT FROM AUTHOR]

Background: Nasopharyngeal cancer is a rare tumor with significant diversity. Head and neck cancer are common in male whereas nasopharyngeal cancer still is uncommon. There is very less data available on survival and characteristics of nasopharyngeal cancer in North India. Study design: Retrospective study. Materials and methods: The HBCR data on all nasopharyngeal cancer patients who were treated were retrieved for a period of 5 years from 2017 to 2022. Statistical analysis used: SPSS software version 20. Results: A total of 29 patients were analysed. Total male to female ratio is 1.4:1 i.e. 58.4% male and 41.4% are female. Most common age group affected is between 40 years to 60 years. Most common symptom was nasal blockade followed by neck swelling. Patient common stage of disease presentation was stage IV i.e. 45%, stage III was 34.4% and stage II was 21%. Metastasis was common in bone followed by lung and liver. In our study 59% of the patients were treated with radiation and concomitant chemotherapy. The overall survival by Kaplan meire curve at 2 years in our study population was 64.3% and 5 years survival analysis was 46.93%. Conclusion: Nasopharyngeal Carcinoma (NPC) is an infrequent head and neck malignancy in Northern India, often diagnosed at an advanced stage with a higher likelihood of distant metastasis. Concurrent chemo-radiation therapy, particularly utilizing a weekly cisplatin regimen, has demonstrated favorable outcomes and tolerability. There is a pressing need for additional prospective research to evaluate this treatment schedule further and explore the potential benefits of novel agents in managing this potentially curable malignancy. [ABSTRACT FROM AUTHOR]

Summary: Background: Only limited information exists regarding the epidemiology of Kawasaki disease (KD) in low-income and middle-income countries. The present study provides the incidence of KD during 2015–2019 in Chandigarh, north India. Our centre follows the largest KD cohort in India. Methods: Children with KD at Chandigarh diagnosed during January 2015–December 2019 were enrolled in the study. Annual incidence rates were determined using decadal growth rates of the National Census 2011. We computed the incidence of KD in children aged

Background: Chronic pelvic pain (CPP) following a surgical procedure has been reported to affect a significant number of patients and is associated with a decreased quality of life. Objective: To evaluate CCP laparoscopically in patients who had previously undergone hysterectomy for benign lesions. A multicentric study conducted over a period of 8 years. The study group included 88 females with posthysterectomy CPP of more than 8 months in whom a definitive diagnosis was either not reached or was in doubt despite thorough clinical and radiological investigations. Fifty-four patients agreed to the procedure while 34 patients were treated conservatively. Baseline characteristics, subjective pain relief, and overall patient satisfaction were compared between the two groups. Results: The mean age of the patients, body mass index (BMI), duration of symptoms, preoperative visual analog scale (VAS) for pain, and primary approach for hysterectomy were found to be statistically insignificant between the operative and conservative groups (p > 0.05). The most common indications for previous hysterectomy in both groups were dysfunctional uterine bleeding and leiomyoma. The most frequent findings at diagnostic laparoscopy were adhesions (53.70%), cystic lesions of preserved functional ovary (22.22%), and hydro/pyosalpinx (9.25%). Ten (18.51%) patients did not reveal any obvious positive finding. Adhesiolysis and ovarian cystectomy were the most frequently done procedures. Laparoscopic diagnosis was confirmed by histopathology in most of the patients. Improvement in VAS score was more significant in the operated group than in the conservative group. Conclusion: Diagnostic laparoscopy is an effective and accurate tool to evaluate CPP after gynecological surgery apart from being an excellent approach for therapeutic interventions. [ABSTRACT FROM AUTHOR]

This paper explores the varied narratives surrounding Chaṭhī Māī, which do not find a mention in the normative texts. These narratives showcase the blending of religious beliefs with regional traditions in the imagination of her worshippers. Focusing on Kārtika Chaṭha specifically, the study delves into the narratives that depict the Goddess as a healer, protector, and feminine energy tied to the Sun. Our fieldwork in Varanasi, Patna, Munger, and Sahibganj reveals diverse origin stories, showcasing the cultural mosaic of regions venerating her. The research comprehensively examines the evolutionary trajectory of Chaṭhī Māī's worship, emphasizing the synthesis of mythological elements and local folklore. Three key facets--the manifestation of feminine energy, the significance of the title "Māī," and the complementary relationship between male and female principles--are explored to provide a nuanced understanding of the Goddess's multifaceted identity in North India. The absence of normative texts enhances grassroots adaptability, allowing for localized interpretations in the popular imagination of the Goddess. Associations with the Sun god Surya and the continuity of divine male-female dynamics provide varied entry points for believers, enabling emotional connections and familial devotion. The duality of malevolence and benevolence adds complexity, making worship dynamic and responsive to challenges. Linking Chaṭhī Māī to Bihar's regional identity integrates the tradition into daily life, promoting a sense of belonging. The evolving narratives contribute to the deity's adaptability, relevance, and popularity, with potential for further research exploring folk religions' adaptation to societal changes and the impact of evolving narratives on community dynamics. [ABSTRACT FROM AUTHOR]

Background: The relationship between gastroesophageal reflux disease (GERD) and Helicobacter pylori infection is a complicated topic. This study aimed to evaluate the association between H. pylori infection and GERD and identify the associated risk factors in North India. Methods: All individuals who were referred for an endoscopy because they had dyspepsia were included in a cross-sectional study. Using endoscopic assessment, GERD was diagnosed. As a comparison group, patients with normal esophageal function were chosen. H. pylori was cultured and genotyped to assess the virulent genes such as cagA, vacA, and iceA. The relationship of H. pylori infection with GERD and its associated risk factors were estimated with Chi‑square analysis, odds ratios, and 95% confidence intervals using multiple logistic regression analysis. Results: In total, 420 patients were included in this study, of whom 335 (79.8%) had GERD. The mean age was 44.01 ± 16.52 years. Overall, 143 (34%) patients were positive for H. pylori infection. cagA-negative H. pylori isolates were significantly associated with the GERD group. Variables such as gender, age, alcohol, smoking, body mass index (BMI), smoking, and hiatus hernia in patients had no significant association with H. pylori infection. However, increased age, gender, Frequency Scale for the Symptoms of GERD (FSSG) score, BMI, and presence of hiatus hernia were significantly associated with the GERD group. Conclusion: In our results, there was no association between H. pylori infection and GERD. The risk factors for GERD were age, gender, FSSG score, BMI, and hiatus hernia. Further studies are recommended. [ABSTRACT FROM AUTHOR]

Three mite species belonging to the family Phytoseiidae namely, Amblyseiulellasolanaesp. n., Paraphytoseius punjabensissp. n. and Transeiusuttarbharaticussp. n., are described based on specimens collected from plants amidst the dense green semi-arid trans-Himalayan dryland tracts of Punjab plains of North India. Three phytoseiid mite species: Amblyseiusparaaerialis; Scapulaseius asiaticus and Typhlodromips jhilimiliensis were recorded for the first time from Punjab state. Key to the world species of the genus Paraphytoseius is provided. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial susceptibility among bacterial isolates varies from center to center. Mupirocin is a topical antibacterial antibiotic used to treat wound infections caused by methicillin-resistant Staphylococcus aureus (MRSA). Aim and Objectives: This study was conducted to know the prevalence of high and low levels of mupirocin resistance along with antimicrobial susceptibility in MRSA isolates from skin and soft-tissue infection in patients admitted to a tertiary care hospital in North India. Materials and Methods: A total of 97 non-repetitive isolates of MRSA from various pus samples over a period of 1 year were included in this study. These strains were identified as per standard laboratory protocols given by the Clinical Laboratory Standards Institute. High- and low-level mupirocin resistance of the isolates was tested by using mupirocin discs of 200 μg and 5 μg, respectively. Mupirocin strips of 256 μg and 512 μg were used for the E-test to detect low-level and high-level mupirocin resistance, respectively. The isolates were reported as sensitive to mupirocin, with minimum inhibitory concentrations of

Background: Gastritis is one of the most prevalent disorders affecting individuals. Helicobacter pylori infection, along with other factors such as lifestyle, gender, alcohol drinking, and smoking are causes of gastritis. Northeast Indian population is geographically, ethnically, culturally, and linguistically a blend of its surrounding nations, being different from the North Indian population. The objective of the study was to predict the prevalence and risk factors of gastritis in Northeast India and compare it with North India. Methods: A total of 909 dyspeptic patients (Northeast India: 362 and North India: 547) were enrolled and had undergone endoscopy. H. pylori status was identified, determined, and genotyped. They were divided into gastritis and nongastritis samples based on the presence or absence of gastric ulcerations and erosion. The risk factors for gastritis in Northeast and North India were estimated with Chi-square analysis, odds ratios, and 95% confidence intervals using multiple logistic regression analysis. Results: The prevalence of gastritis and H. pylori infection was higher in Northeast India than North India. The risk factors significantly associated with gastritis in Northeast region were H. pylori infection, increased smoking, and alcohol drinking and in North region were smoking and body mass index. Conclusion: Although our study found the risk factors associated with gastritis in Northeast India, the available data do not provide sufficient evidence. Further studies are recommended.

Abstract Background and objectives To enable an accurate assessment of vaccine hesitancy among adults, a validated Hindi vaccine hesitancy questionnaire, encompassing multiple sub-domains of vaccine hesitancy, is a pre-requisite. The following study was conducted to translate and determine the reliability, content, construct, and concurrent validity of the Hindi Adult Vaccine Hesitancy scale (5C) among adults in Northern India. Methods Translation-back translation of the 5C tool (which comprises five domains of vaccine hesitancy: confidence, calculation, complacency, constraint, and collective responsibility) to Hindi, followed by cognitive interviews among the target population, was done. Item-wise (I-CVI) and full-scale Content Validity Index (S-CVI) were determined through a panel of experts. The robust econometric approach of Confirmatory Factor Analysis (CFA) was employed and construct validity were tested among 150 participants. Discriminant and Convergent validity were examined using the Average Variance Extracted (AVE). The reliability of the domains was assessed through Composite Reliability (CR). Results The I-CVI and Kappa statistics of all tool items ranged from 0.8 to 1.0. The S-CVI/AVE was calculated to be 0.97. The composite reliability (CR ≥ 0.70) and convergent validity (AVE ≥ 0.50) coefficients were found to be adequate. AVE of the latent variables was greater than the squared values of the latent variable correlations, indicating adequate discriminant validity. 5C tool in the Indian setting demonstrated a ‘good fit’ established through confirmatory factor analysis. Interpretation and conclusions Hindi version of the 5C scale is a valid tool to assess vaccine hesitancy among the Hindi-speaking population North Indian Population. Willingness to take the recommended vaccines was positively correlated with ‘confidence,’ ‘calculation,’ and ‘collective responsibility’ and negatively correlated with ‘complacency’ and ‘constraint’ domains.

ABSTRACT: Objectives: Drug resistance in leprosy is an emerging concern, leading to treatment failures, recurrences, and potential spread of resistant Mycobacterium leprae in the community. In this study, we aimed to assess drug resistance prevalence and patterns amongst leprosy patients at a tertiary care referral hospital in India. Methods: Mutations in drug resistance determining regions for dapsone, rifampicin, and ofloxacin of the M. leprae genome in DNA extracted from skin biopsies of 136 leprosy patients (treatment-naive = 67, with persistent skin lesions = 35, with recurrence = 34) were analysed by polymerase chain reaction followed by Sanger sequencing. Wild-type strain (Thai-53) was used as a reference strain. Results: Resistance mutations were identified in a total of 23 patients, constituting 16.9% of the cohort. Within this subset of 23 cases, resistance to ofloxacin was observed in 17 individuals (12.5%), while resistance to both dapsone and rifampicin was detected in three patients each (2.2% for both). The occurrence of ofloxacin resistance showed minimal disparity between recurrent and treatment-naive cases, at 17.6% and 16.4%, respectively. Dapsone resistance emerged in two treatment-naive cases and one case with persistent skin lesions. Notably, none of the treatment-naive cases or those with recurrence/relapse exhibited rifampicin resistance. Subsequently, no statistically significant correlation was identified between other clinical variables and the presence of antimicrobial resistance. Conclusions: The occurrence of resistance to the current multidrug therapy regimen (specifically dapsone and rifampicin) and to ofloxacin, a secondary antileprosy medication in M. leprae, represents a concerning scenario. This calls for an expansion towards bactericidal drug options and the establishment of robust surveillance for drug resistance in countries burdened with high leprosy rates. Moreover, the introduction of stringent antimicrobial stewardship initiatives is imperative. As a single centre study, it represents a limited, cross-sectional view of the real situation in the field.

Introduction Intestinal parasitic infections continue to loom in developing countries with low sanitation and socioeconomic conditions. Pandemic times are especially important to study the prevalence of these pathogens since the focus of all healthcare services was coronavirus disease 2019 (COVID-19). This study aimed to evaluate the prevalence and time-trend of intestinal parasitic infections in the capital region of India during the pandemic times.

Our study compares the sensitivity, specificity and cost of visual acuity screening as performed by all class teachers (ACTs), selected teachers (STs) and vision technicians (VTs) in north Indian schools. Prospective cluster randomized control studies are conducted in schools in a rural block and an urban-slum of north India. Consenting schools, with a minimum of 800 students aged 6 to 17 years, within a defined study region in both locations, were randomised into three arms: ACTs, STs or VTs. Teachers were trained to test visual acuity. Reduced vision was defined as unable to read equivalent of 20/30. Optometrists, who were masked to results of initial screening, examined all children. Costs were measured for all three arms. The number of students screened were 3410 in 9 ACT schools, 2999 in 9 ST schools and 3071 in 11 VT schools. Vision deficit was found in 214 (6.3%), 349 (11.6%) and 207 (6.7%), (p <.001) children in the ACT, ST and VT arms, respectively. The positive predictive value of VT screening for vision deficit (81.2%) was significantly higher than that of ACTs (42.5%) and STs (30.1%), (p <.001). VTs had significantly higher sensitivity of 93.3% and specificity of 98.7%, compared to ACTs (36.0% and 96.1%) and STs (44.3% and 91.2%). The cost of screening children with actual visual deficit by ACTs, STs and VTs, was found to be $9.35, $5.79 and $2.82 per child, respectively. Greater accuracy and lower cost favours school visual acuity screening by visual technicians in this setting, when they are available. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial susceptibility among bacterial isolates varies from center to center. Mupirocin is a topical antibacterial antibiotic used to treat wound infections caused by methicillin-resistant Staphylococcus aureus (MRSA). Aim and Objectives: This study was conducted to know the prevalence of high and low levels of mupirocin resistance along with antimicrobial susceptibility in MRSA isolates from skin and soft-tissue infection in patients admitted to a tertiary care hospital in North India. Materials and Methods: A total of 97 nonrepetitive isolates of MRSA from various pus samples over a period of 1 year were included in this study. These strains were identified as per standard laboratory protocols given by the Clinical Laboratory Standards Institute. High- and low-level mupirocin resistance of the isolates was tested by using mupirocin discs of 200 μg and 5 μg, respectively. Mupirocin strips of 256 μg and 512 μg were used for the E-test to detect low-level and high-level mupirocin resistance, respectively. The isolates were reported as sensitive to mupirocin, with minimum inhibitory concentrations of <4 mg/L. Results: Overall, 9.27% of mupirocin resistance was found, of which 2.06% of isolates were high-level resistant to mupirocin, while 7.21% had low-level resistance. All MRSA strains were susceptible to vancomycin, followed by linezolid (94.84%), teicoplanin (91.75%), and fusidic acid (88.65%). Conclusion: Regular monitoring, good infection control practices, and proper awareness about utilizing mupirocin therapeutically and prophylactically may help prevent the emergence of mupirocin resistance in health-care facilities. [ABSTRACT FROM AUTHOR]

Background and objectives: To enable an accurate assessment of vaccine hesitancy among adults, a validated Hindi vaccine hesitancy questionnaire, encompassing multiple sub-domains of vaccine hesitancy, is a pre-requisite. The following study was conducted to translate and determine the reliability, content, construct, and concurrent validity of the Hindi Adult Vaccine Hesitancy scale (5C) among adults in Northern India. Methods: Translation-back translation of the 5C tool (which comprises five domains of vaccine hesitancy: confidence, calculation, complacency, constraint, and collective responsibility) to Hindi, followed by cognitive interviews among the target population, was done. Item-wise (I-CVI) and full-scale Content Validity Index (S-CVI) were determined through a panel of experts. The robust econometric approach of Confirmatory Factor Analysis (CFA) was employed and construct validity were tested among 150 participants. Discriminant and Convergent validity were examined using the Average Variance Extracted (AVE). The reliability of the domains was assessed through Composite Reliability (CR). Results: The I-CVI and Kappa statistics of all tool items ranged from 0.8 to 1.0. The S-CVI/AVE was calculated to be 0.97. The composite reliability (CR ≥ 0.70) and convergent validity (AVE ≥ 0.50) coefficients were found to be adequate. AVE of the latent variables was greater than the squared values of the latent variable correlations, indicating adequate discriminant validity. 5C tool in the Indian setting demonstrated a 'good fit' established through confirmatory factor analysis. Interpretation and conclusions: Hindi version of the 5C scale is a valid tool to assess vaccine hesitancy among the Hindi-speaking population North Indian Population. Willingness to take the recommended vaccines was positively correlated with 'confidence,' 'calculation,' and 'collective responsibility' and negatively correlated with 'complacency' and 'constraint' domains. [ABSTRACT FROM AUTHOR]

Background: Poisoning is one of the most common medicolegal problems in India. It is the second most important cause of suicide, followed by hanging in India. Aims and objectives: The current study is designed to determine the sociodemographic profile of the poisoning patients and their outcomes at a tertiary care hospital in Northern India. Materials and methods: All the acute poisoning patients considering inclusion and exclusion criteria, were admitted to the medicine emergency of a tertiary care hospital during the period of June-November 2019 and were enrolled after prior permission from the Institute Ethics Committee. A structured pro forma was filled regarding the patient's demographic information, incidence of poisoning, cause and type of poisoning, clinical presentation of patients, duration of respiratory support, intensive care unit (ICU) stay, hospital stay, and final outcomes. Descriptive statistics were used to analyze the data. Results: Maximum cases were observed in the age group of 21-30 (33.87%). The incidence of poison consumption was marginally higher in females (51.6%). Unemployed (22.6%), housewives (19.4%), and students (17.7%) were the distribution as per occupation. The majority (90.3%) of the patients in all the groups ingested poison with the intent to suicide. Overall, there was 61% pesticide poisoning. The highest mortality (38%) was seen amongst the patients with aluminum phosphide poisoning. Conclusion: Pesticides were the major cause of poisoning in the Northern region. Based on these findings' preventive measures like rationed supply and restricted sale of poisonous agents, improvement of legislature, and provision of license to the sale persons is the need for the hour. [ABSTRACT FROM AUTHOR]

Background: Glaucoma is an optic neuropathy associated with characteristic structural damage to the optic nerve and associated visual dysfunction that may be caused by various pathological processes. A number of pharmacological agents are used to reduce the intraocular pressure (IOP), involving the usage of two or three medications concurrently. Literature is sparse regarding prescription patterns of antiglaucoma drugs, especially regarding variability in public sector vs private sector hospitals. Drug utilization studies can add insight for crafting rational, affordable, and ocular surface friendly prescriptions. Aim: This study assessed the prescription pattern in glaucoma patients of a public sector, tertiary care hospital vs a private sector tertiary care hospital. Materials and methods: In this retrospective study, pertinent data of diagnosed and labeled glaucoma patients were reviewed. Data collected included demographic details, type of glaucoma, number and nature of drugs prescribed, whether innovator or generic drugs were prescribed, if fixed-drug combinations (FDCs) and preservative-free formulations were prescribed. The prescription patterns between the two sectors were compared, as were the prescription patterns between primary open-angle glaucoma (POAG) and primary angle-closure disease (PACD). Results: A total of 336 prescriptions were evaluated (216 from public sector, group I; 120 from private sector, group II). Travoprost 0.004% was the most prescribed antiglaucoma medication in both group I (30.09%) and group II (38.33%). Brimonidine and brinzolamide (14.17%) was the most prescribed combination in group II, while Brimonidine with Timolol (7.87%) in group I. In group I, Timolol and Travoprost were the most prescribed medications for both PACD and POAG. Conclusion: This study showed that both public sector as well as private sector tertiary care centers prescribe antiglaucoma medications in tune with current principles of rational drug use. Preservative-free drugs were preferred in both the groups for better adherence. [ABSTRACT FROM AUTHOR]

The quantity of soil required for embankment construction is enormous. Often the soil is brought to the site in dumpers in multiple rounds. This to and from movement of the wagons leads to the deterioration of the existing flexible pavement. In the absence of good earth nearby, using existing soils to act as a subgrade material upon meeting the desired strength and stability characteristics is the need of the hour. The California Bearing Ratio (CBR) is an indicator of soil's strength, which further depends on the degree of compaction of soil. In this study, an effort has been made to find the required compaction efforts to achieve maximum CBR value finding its applicability for both conventional flexible and perpetual pavements. Three different types of alluvial soils in North India were tested for CBR with varying compaction efforts using the modified Proctor test. The effect of mixing different soils was also considered to find the effectiveness of mechanically mixing soils on the required compaction efforts. It was observed that there is a constant upsurge in the CBR of soils upon an increase in the percentage compactive effort up to a certain limit. In the case of clayey soils, the rate of increase is less as compared to the well-graded sands. This study also highlights the effect of mechanical mixing of such soils with sandy soils in desired proportions giving rise to amplified values of CBR ratio of the soil blend. The regression analysis was also conducted to examine a correlation between the compactive effort and CBR values and it was best represented by exponential function for different types of soils. [ABSTRACT FROM AUTHOR]

Background: Gastritis is one of the most prevalent disorders affecting individuals. Helicobacter pylori infection, along with other factors such as lifestyle, gender, alcohol drinking, and smoking are causes of gastritis. Northeast Indian population is geographically, ethnically, culturally, and linguistically a blend of its surrounding nations, being different from the North Indian population. The objective of the study was to predict the prevalence and risk factors of gastritis in Northeast India and compare it with North India. Methods: A total of 909 dyspeptic patients (Northeast India: 362 and North India: 547) were enrolled and had undergone endoscopy. H. pylori status was identified, determined, and genotyped. They were divided into gastritis and nongastritis samples based on the presence or absence of gastric ulcerations and erosion. The risk factors for gastritis in Northeast and North India were estimated with Chi-square analysis, odds ratios, and 95% confidence intervals using multiple logistic regression analysis. Results: The prevalence of gastritis and H. pylori infection was higher in Northeast India than North India. The risk factors significantly associated with gastritis in Northeast region were H. pylori infection, increased smoking, and alcohol drinking and in North region were smoking and body mass index. Conclusion: Although our study found the risk factors associated with gastritis in Northeast India, the available data do not provide sufficient evidence. Further studies are recommended. [ABSTRACT FROM AUTHOR]

The Indian Councils Act, 1909, the Government of India Act, 1919, and the Government of India Act, 1935, defined political space—an arena of political negotiations through electoral representation—along religious lines. The most crucial aspect of these legislative-institutional developments was the definition and delimitation of 'communal-territorial constituencies', and franchisee qualifications. This specific colonial form of representative politics, which was debated, negotiated and translated by the religio-political elite in the arena of local politics, produced a communal notion of space. Thus, each of the localities, wards, cities and regions at large were officially demarcated into Muhammadan, General/Hindu, Sikh and Indian-Christian electoral constituencies. The paper explores the intricacies of this process and the complex question of 'representation' during the period of the national movement. It argues that this official demarcation of social groups and localities into political constituencies produced a complex configuration of identity and space, which had multiple manifestations with extended franchise. It established electoral representation as a mode to make legitimate claims and counterclaims over space. [ABSTRACT FROM AUTHOR]

Introduction Intestinal parasitic infections continue to loom in developing countries with low sanitation and socioeconomic conditions. Pandemic times are especially important to study the prevalence of these pathogens since the focus of all healthcare services was coronavirus disease 2019 (COVID-19). This study aimed to evaluate the prevalence and time-trend of intestinal parasitic infections in the capital region of India during the pandemic times. Methods In this cross-sectional study, a retrospective review based on data from the past 2 years in the post-COVID-19 pandemic was used. Descriptive and time-trend analyses were applied to the data. Time series analysis was analyzed using the best fit autoregressive integrated moving average (ARIMA) model to look for seasonality in trends and forecasting. Results A total of 7267 patients' stool samples over a 2-year pandemic period were included in the study. Intestinal parasites were detected in 11.18% (813/7276) patients. Giardia lamblia (2.28%) and Blastocystis hominis (3.78%) were the predominant ones. Time-trend analysis from 2020 to 2021 using ARIMA model predicted an increasing trend with waning of pandemic. The most prevalent infection was found in the monsoon and autumn months. Conclusion Rates of infection with Giardia lamblia and Blastocystis hominis have increased in comparison to other protozoan infections like Entamoeba histolytica when compared with prepandemic hospital-based studies. With fading of the pandemic, further increasing trends are predicted. [ABSTRACT FROM AUTHOR]

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common X-linked disorder with well-established clinical and allelic heterogeneity and ethnic disparity. With ~390,000 annual births with G6PD deficiency in India, it emerges as the most predictable and preventable inborn metabolic error. Disease prevalence and mutation spectrum have been reasonably reported from central, western and southern parts of India and are mostly retrospective studies. Although prevalence data from north India is available, there is paucity of data on the mutation spectrum and genotype–phenotype correlation (G×P). Thus, we aimed at establishing the clinical and mutation profiles for G6PD, as a part of a large prospective newborn screening study conducted between 2014 and 2016 across hospitals in Delhi, India. G6PD activity levels were measured at 24–48 h of life for ~200,000 neonates using Victor 2D and/or Genomic Screening Processor followed by confirmatory spectrophotometric analysis using RBC lysates of the respective neonates based on clinical symptoms. A subset of 570 enzyme deficient neonates were screened for mutations by polymerase chain reaction-restriction fragment length polymorphism and/or Sanger sequencing. Mediterranean was the most common mutation (n=318; 55.8%) with the lowest enzyme activity and most severe phenotype, followed by G6PD Orissa (n=187;32.8%); Kerala-Kalyan (n=25); Jammu (n=24); Mahidol (n=14); Chattam (n=1) and Nilgiri/Coimbra (n=1). Of the 163 intramural neonates followed up, 68 developed clinical jaundice. However, no correlation was observed between jaundice and enzyme level. Notable outcome of this first ever prospective screening approach for G6PD deficiency in neonates may help in prediction of disease severity and appropriate timely management. [ABSTRACT FROM AUTHOR]

In practice, individuals who are found normal through various adiposity indicators are screened out from the risk of obesity and subsequently from other cardiometabolic syndromes like hypertension. Against this backdrop, this study aims to examine the prevalence of hypertension among individuals having normal-weight obesity (NWO) and normal-weight central obesity (NWCO). In the present study, Cross-sectional data of 214 participants (100 males and 114 females) were collected using purposive sampling. Adiposity indices like body mass index (BMI), percent body fat (PBF), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) were calculated. Individuals were then categorized into NWO and NWCO. Systolic (SBP) and diastolic (DBP) blood pressure were also measured. All the data were analyzed using SPSS software. The prevalence of generalized obesity measured through BMI and PBF were 15% and 69.6% respectively. Central obesity measured through WC, WHR, and WHtR was 33.6%, 60.3%, and 11.2%, respectively. The prevalence of NWO in the total population was 21.9%. On the other hand, the prevalence of NWCO was 3.3%, 21.5%, and 12.1% as per WC, WHR, and WHtR respectively. The mean value of SBP and DBP was higher in individuals with NWO and NWCO. Preventive, interventional, and community-specific studies on NWO, NWCO, and their association with hypertension should be taken up by researchers who will help our policymakers in managing hypertension. [ABSTRACT FROM AUTHOR]

Focusing on the experiences of the marginalised castes in North India, this article examines the use of given names in intercommunity micro interactions and how it shapes the practices of everyday humiliation. With ethnographic data from Dalit activist discourses as well as everyday life in an urbanising village in Rajasthan, this article analyses how the upper castes tend to deform the given names of the members of the Dalit community to produce undignified names, and how the community claims their right to be addressed with appropriate names. I engage with the complexity of the formation and use of undignified names by analysing their function in shaping the local political field to regulate participation in the public sphere and how they are linked to valuable names in the production of social distinctions and their economic benefits. Taking names as an important symbolic object, this article foregrounds the politics of humiliations in everyday intercaste vyavahar to understand the micro dynamics of caste reproduction and how it is negotiated and contested. [ABSTRACT FROM AUTHOR]

The cold air outbreaks in the northern parts of India exert significant impacts on human health, energy, agriculture and transportation. In this study, we investigate the synoptic dynamics of cold waves and their linkages to large scale circulations for the winter period from 1982 to2020. Cold waves are classified into normal and intense (NCWs and ICWs) based on intensity and we examine the underlying mechanisms of formation and their atmospheric drivers. Notably, the spatial extent of the ICWs is almost double than that of normal ones thereby having the potential to affect a wider population. The NCWs are often influenced by western disturbances, leading to the inflow of cold air from Siberia (a region of shallow high). In contrast, ICWs are mostly linked to the presence of an omega block over the Ural-Siberian region. The downstream portion of the Ural block favours the inflow of cold northerlies into north India, leading to cold air advection and extreme cold wave conditions. The influence of Arctic warming for ICWs is further confirmed through a prominent Quasi-Resonant Amplification (QRA) fingerprint. Furthermore, La Niña condition seems to play a crucial role in triggering ICWs over north India. During La Niña, the prominent low level cyclonic anomaly helps in advecting the cold air from the higher latitudes into the country. The frequency as well as the duration of cold wave events are also found to be higher in La Niña years compared to El Niño and neutral years. The trend analysis of cold wave events over north India reveals a significant decrease in the frequency, duration and intensity during the analysis period due to a combination of various factors such as rising winter minimum temperatures (due to global warming), decreasing number of synoptic winter weather systems and Arctic amplification.

Introduction Worldwide nearly 70 million populations are affected by glaucoma, a leading cause of irreversible blindness. Awareness and knowledge about glaucoma is the key to early diagnosis and effective management to prevent debilitating blindness. In India, the literature has shown that the level of awareness ranges from 0.32 to 13.5%, much lower than developed countries. Previous studies found higher levels of education and socioeconomic status along with positive family history of ocular diseases were directly related to improved levels of awareness and knowledge about glaucoma. Considering the improvement in literacy standards, socioeconomic status, and better utilization of medical care in the past few years, we aimed to assess the current trends in levels of awareness and knowledge about glaucoma in the North Indian population.

Coronary artery disease (CAD) is the leading cause of death in India. Many genetic polymorphisms play a role in regulating oxidative stress, blood pressure and lipid metabolism, contributing to the pathophysiology of CAD. This study examined the association between ten polymorphisms and CAD in the Jat Sikh population from Northern India, also considering polygenic risk scores. This study included 177 CAD cases and 175 healthy controls. The genetic information of GSTM1 (rs366631), GSTT1 (rs17856199), ACE (rs4646994), AGT M235T (rs699), AGT T174M (rs4762), AGTR1 A1166C (rs5186), APOA5 (rs3135506), APOC3 (rs5128), APOE (rs7412) and APOE (rs429358) and clinical information was collated. Statistical analyses were performed using SPSS version 27.0 and SNPstats. Significant independent associations were found for GST*M1, GST*T1, ACE, AGT M235T, AGT T174M, AGTR1 A1166C and APOA5 polymorphisms and CAD risk (all p < 0.05). The AGT CT haplotype was significantly associated with a higher CAD risk, even after controlling for covariates (adjusted OR = 3.93, 95% CI [2.39–6.48], p < 0.0001). The APOA5/C3 CC haplotype was also significantly associated with CAD (adjusted OR = 1.86, 95% CI [1.14–3.03], p < 0.05). A higher polygenic risk score was associated with increased CAD risk (adjusted OR = 1.98, 95% CI [1.68–2.34], p < 0.001). Seven polymorphisms were independently associated with an increase in the risk of CAD in this North Indian population. A considerable risk association of AGT, APOA5/C3 haplotypes and higher genetic risk scores is documented, which may have implications for clinical and public health applications.

Abstract Background Congenital Heart diseases (CHDs) account for 1/3rd of all congenital birth defects. Etiopathogenesis of CHDs remain elusive despite extensive investigations globally. Phenotypic heterogeneity witnessed in this developmental disorder reiterate gene-environment interactions with periconceptional factors as risk conferring; and genetic analysis of both sporadic and familial forms of CHD suggest its multigenic basis. Significant association of de novo and inherited variants have been observed. Approximately 1/5th of CHDs are documented in the ethnically distinct Indian population but genetic insights have been very limited. This pilot case–control based association study was undertaken to investigate the status of Caucasian SNPs in a north Indian cohort. Method A total of 306 CHD cases sub-classified into n = 198 acyanotic and n = 108 cyanotic types were recruited from a dedicated tertiary paediatric cardiac centre in Palwal, Haryana. 23 SNPs primarily prioritized from Genome-wide association studies (GWAS) on Caucasians were genotyped using Agena MassARRAY Technology and test of association was performed with adequately numbered controls. Results Fifty percent of the studied SNPs were substantially associated in either allelic, genotypic or sub-phenotype categories validating their strong correlation with disease manifestation. Of note, strongest allelic association was observed for rs73118372 in CRELD1 (p

Sampling was conducted on Agra-Delhi national highway NH-2. Samples were collected with the help of Sioutas cascade impactor. During the sampling, PM1.0-0.5 (255.85µg/m³ ) was higher than PM2.5-1.0 (218.96µg/m3 ). The AQI value for the average PM2.5 concentration also exceeded the severe AQ limit (401-500). These results showed that PM2.5 pollution has a significant influence on the site as a result of a variety of anthropogenic activities. During the summer season, for PM1.0- 0.5 and PM2.5-1.0 highest values (µg/m³ ) of metals followed the same trend and it was observed as Mg(6.52)> Ca(5.89)> Al(3.64)> while for PM2.5-1.0 it was as Mg(10.12)> Ca(9.5)> Al(5.95) respectively. At roadside, most of these metals are emitted from the resuspension of dust and vehicle activities which causes serious diseases to the human being. Cd, Cr, Cu, Pb, and Zn were highly enriched at national highway sampling sites, highlighting the crustal source, which has a major impact on metals concentration, followed by anthropogenic sources. The present research was conducted to find out the concentration level of metals in PM2.5-1.0 and PM1.0-0.5 particles in Agra, India to find out the health risk assessment at highway site. From the results, it was observed that all metals bound to larger size PM has high bioavailability. From the health risk assessment, it was found that all the metals bound smaller size particles showed higher HQ except in the case of Ni and Al. Cr, Pb showed carcinogenic risk to children and adults in both size fraction of PM except in the case of Ni. [ABSTRACT FROM AUTHOR]

This study estimates the radiative forcing by biomass burning and dust aerosols over the Indian subcontinent, with emphasis on the Indo-Gangetic Plains (IGP) during the period from January 2021 to April 2021, based on multiple satellite and reanalysis datasets. In this respect, we used retrievals from the Moderate Resolution Spectroradiometer (MODIS) and the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) system, as well as reanalysis data from the Goddard Earth Observing System, version 5 (GEOS-5), the Modern-Era Retrospective analysis for Research and Applications, version 2 (MERRA-2), the Copernicus Atmosphere Monitoring Service (CAMS), and ERA-Interim. According to the MERRA-2 and the CAMS, the highest black carbon (BC) concentrations in January 2021 were 7–8 µg m−3, which were significantly lower than measurements performed in main cities along the IGP, such as Patiala, Delhi, and Kanpur. The meteorological data analysis accompanied by the CALIPSO lidar measurements showed that the vertical distribution of total attenuated backscatter (TAB) could reach altitudes of up to ~4–5 km and could be transported over the central Himalayan region. The spatial-averaged daily aerosol radiative forcing (ARF) values over the Indian subcontinent from January 2021 to April 2021 were found to range from −51.40 to −6.08 W m−2 (mean of −22.02 ± 9.19 W m−2), while on a monthly basis, the ARF values varied widely, from −146.24 to −1.63 W m−2 (mean of −45.56 ± 22.85 W m−2) over different parts of the study region. Furthermore, the spatial-averaged daily BC radiative forcing ranged from −2.23 to −0.35 (−1.01 ± 0.40 W m−2), while it varied from −15.29 to −0.31 W m−2 (−2.46 ± 2.32 W m−2) over different regions of southern Asia, indicating a rather small contribution to the total aerosol radiative effect and a large presence of highly scattering aerosols. Our findings highlight the importance of growing biomass burning, in light of recent climate change and the rapid decline in air quality over North India and the Indian Ocean. [ABSTRACT FROM AUTHOR]

Introduction: The significant impact of climate change on temperature is an important topic of discussion as it rises globally. Hence, the present study is designed to investigate the profound influence of climate change on temperature by considering the North Indian States.Methods: In this comprehensive case study, CMIP6 models are used to investigate temperature behaviour in the states of North India under 1.5°C and 2°C warming scenarios. Comparisons are made between observed surface temperature data from the Climatic Research Unit (CRU) and ensemble mean simulations from CMIP6.Results and Discussion: Results indicate that CMIP6 ensemble mean simulations effectively depict observed climatological patterns of surface temperature with negligible discrepancies. Under both the 1.5°C and 2°C warming scenarios, extreme temperatures show an increase compared to the preindustrial and present periods, suggesting an elevated risk of future severe heat events. Temperature changes relative to the preindustrial period are around 1.5°C, 3°C, and 4.5°C for the present, 1.5°C, and 2°C scenarios, respectively. Return period analysis shows a significant temperature rise of approximately 4.5° over a return time of 60 years. These findings highlight the importance of climate models, valuable for impact studies, and emphasize the need to accurately enhance future model iterations’ precision in simulating regional climates. Urgent climate change mitigation strategies are vital to curb temperature rise and mitigate potential adverse impacts on the region.Conclusion: The study provides critical insights into North India’s climate behavior, underscoring the significance of proactive measures to effectively address climate change challenges within the region.

Explore door-to-door eye screening in India as a model to reach school age children in need of eye care, especially during school closures due to the Covid-19 pandemic. Children between 5 and 18 years were screened in an urban-slum of Delhi from September 2020 to March 2021. Screening included capturing ocular complaints, visual acuity and conducting a torchlight examination. Children with any eye-related complaints, gross abnormality or a LogMAR acuity of more than 0.2 in either eye were referred to the nearby vision centre. Data were disaggregated by gender and age group. Reporting after referral and proportion of true positives referrals were used to assess the model. 32,857 children were screened. 55% were boys. Only 917 children (2.8%) had previous eye examinations. 1814 (5.5%) children were referred. Overall compliance rate amongst those referred was 59% (1070 of 1814) and compliance was significantly higher (72%) amongst those referred with poor vision as compared to those with only ocular morbidities (38%). Overall compliance was significantly higher amongst older age group (64% vs 50%) and amongst girls than boys (61% vs 56%). 3.9% children were detected with refractive error (RE) and 2.5% with uncorrected RE which was significantly higher in girls and in older age group. Of 1070 children reporting after referral, 85% had confirmed diagnosis for RE or other ocular pathology. Door-to-door screening had good referral compliance and positive predictive value. We recommend this model as a supplement to school screening especially in regions with low enrolment and high absenteeism in schools. [ABSTRACT FROM AUTHOR]

This article explores the conceptual landscape of open prisons in India. Open prisons are institutions intended to facilitate prisoner rehabilitation by permitting them to live in small dwellings with their families and earn livelihoods outside their boundary walls. The article delves on the tensions between how "openness" is conceived in prison reform documents and the multiple ways in which it is imagined and materialized through everyday practices. It focusses on a specific open prison in north India which is considered exceptional even as far as open prisons are concerned both for its scale and forms of community. It draws attention to its histories and the modes of governance that incrementally shape its socio spatial landscape. This is followed by an interrogation of the elevated status this specific prison enjoys in penal discourse as an idealised community of reformed prisoners while underscoring the open prison's overall potential as a shifting institutional form. By drawing on ethnographic research conducted with activists, open prison advocates, formerly incarcerated persons and open prison residents, this article makes contributions to the study of governance, political and legal institutions and the carceral state. [ABSTRACT FROM AUTHOR]

Background: Congenital Heart diseases (CHDs) account for 1/3rd of all congenital birth defects. Etiopathogenesis of CHDs remain elusive despite extensive investigations globally. Phenotypic heterogeneity witnessed in this developmental disorder reiterate gene-environment interactions with periconceptional factors as risk conferring; and genetic analysis of both sporadic and familial forms of CHD suggest its multigenic basis. Significant association of de novo and inherited variants have been observed. Approximately 1/5th of CHDs are documented in the ethnically distinct Indian population but genetic insights have been very limited. This pilot case–control based association study was undertaken to investigate the status of Caucasian SNPs in a north Indian cohort. Method: A total of 306 CHD cases sub-classified into n = 198 acyanotic and n = 108 cyanotic types were recruited from a dedicated tertiary paediatric cardiac centre in Palwal, Haryana. 23 SNPs primarily prioritized from Genome-wide association studies (GWAS) on Caucasians were genotyped using Agena MassARRAY Technology and test of association was performed with adequately numbered controls. Results: Fifty percent of the studied SNPs were substantially associated in either allelic, genotypic or sub-phenotype categories validating their strong correlation with disease manifestation. Of note, strongest allelic association was observed for rs73118372 in CRELD1 (p < 0.0001) on Chr3, rs28711516 in MYH6 (p = 0.00083) and rs735712 in MYH7 (p = 0.0009) both on Chr 14 and were also significantly associated with acyanotic, and cyanotic categories separately. rs28711516 (p = 0.003) and rs735712 (p = 0.002) also showed genotypic association. Strongest association was observed with rs735712(p = 0.003) in VSD and maximum association was observed for ASD sub-phenotypes. Conclusions: Caucasian findings were partly replicated in the north Indian population. The findings suggest the contribution of genetic, environmental and sociodemographic factors, warranting continued investigations in this study population. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) and depression are major public health problems globally. Evidence of linkage of common mental disorders (CMDs) including depression and anxiety disorders with DM is sparsely reported from community-based settings. Objective: The present study aimed to study the association between CMDs and DM among adult population (>30 years) residing in a rural area of North India. Materials and Methods: A community-based case–control study was conducted in 28 villages of Ballabgarh block of Faridabad district of Haryana. Cases (diabetes) were recruited from the community with at least 1 year of diabetes. Age- and sex-matched two neighborhood controls were selected from the same community. Diabetic status was confirmed using glycated hemoglobin. CMDs such as depression and anxiety disorders were screened using PRIME-MD Hindi version. Conditional logistic regression was used to study the relationship between diabetes and CMDs. Results: Total 211 cases (diabetic) and 273 controls (nondiabetic) were approached for the study, of which 173 cases and 175 controls were analyzed. Cases and controls were comparable with respect to age, sex, and socioeconomic status. CMDs were found more among cases as compared to controls (67.5% vs. 37.5%) (P < 0.001). On conditional logistic regression analysis, CMDs were significantly higher among diabetes cases (adjusted odds ratio – 3.2, 95% confidence interval: 1.9–5.2). Conclusion: Strong evidence of coexistence of CMDs and DM from this population-based study necessitates the need of incorporation of management of CMDs into diabetes control program in India.

Aim: Pattern of uveitis in a tertiary eye care centre in Hilly area of North India. Materials and Methods: All new cases of uveitis seen in Out Patient Department (OPD) and In Patient Department (IPD) of department of Ophthalmology from June 2017 to May 2019 were consecutively enrolled in the study. After taking a complete history of systemic and ocular diseases, all patients underwent a thorough ophthalmic examination including determination of Snellen visual acuity, slit lamp biomicroscopy, applanation tonometry and dilated posterior segment examination. Patients were classified according to International Uveitis Study Group (IUSG) definitions. Results: A total of 89 patients diagnosed with uveitis with mean age of onset 35 ± 15.16 years. Male patients were 47 (52.80%) with mean age of 32 ± 15.56, and female patients were 42 (47.19%) with mean age of 38 ± 15.05. Follow-up duration varied from 4 months to 18 months. Uveitis was unilateral in 78 patients (87.64%) and bilateral in 11 patients (12.36%). The clinical course acute in 42 patients (47.19%) and chronic in 47 patients (52.81%). The uveitis was granulomatous in 12 patients (13.48%) and non-granulomatous in 77 patients (86.51%) . Anterior uveitis (iritis and iridocyclitis) was most common type of inflammation (41 patients, 46.07%), followed by (Retinitis or Retinochoroiditis) posterior uveitis (23 patients, 25.84%), panuveitis (13 patients, 14.61%) and least common intermediate uveitis (12 patients, 13.48%). HLA-B27 negative was most common type of anterior uveitis (20 patients, 22.47%) . In cases of posterior uveitis, panuveitis and intermediate uveitis (Cyclitis), idiopathic uveitis was most common. Uveitis was infectious in 10 patients (11.24%), non-infectious in 78 patients (87.64%). Hence, non-granulomatous and non-infectious uveitis was most common. In intermediate uveitis, all cases were idiopathic. Uveitis with diagnosis was herpetic (five cases), toxoplasma (two cases), tuberculosis (two cases) and HIV-associated uveitis in one case. Uveitis with specific ocular disease most common was serpiginous choroiditis (four cases), Fuchs' heterochromatic uveitis (FHU) (three cases), VKH (two cases) and sympathetic ophthalmitis (two cases). Uveitis with systemic disease non-specific arthropathy (six cases) is followed by ankylosing spondylitis (two cases), juvenile idiopathic arthritis (one case), inflammatory bowel disease (one case), sarcoidosis (one case) and systemic lupus erythromatosus (SLE one case). Conclusion: The most common uveitis in hilly area of North India is anterior uveitis. The most common aetiology is idiopathic in all types of uveitis.

Background: Clinical data such as menstrual cycle or uterine size often are not reliable parameter for pregnancy dating. Sonographic measurements of the fetus provide information about gestational age, growth and expected date of delivery. Aims: To develop a reference chart to estimate gestational age by ultrasonographic measurement of fetal bi-parietal diameter (BPD) and to find out correlation between two variables. Material and Methods: Cross sectional study was conducted on among 750 pregnant women of gestational age of 14-40 weeks, attending the Obstetrics and Gynaecology out-Patient department during one year period. Each fetus was ultrasonographically measured for BPD, the mean was used in subsequent statistical analysis. Statistical Analysis: It was done by the software SPSS version 21.0. A p-value < 0.05 considered to be significant. The previously published nomograms were compared by using unpaired t-test. Correlation & regression analysis has been done for BPD and GA. Results: Out of total 750 participants, 97.6% females confirmed their pregnancy by urine pregnancy test, 22.9% had dating scan, mean height was 163.004 cm. On ultrasound examination 78% participants had vertex, 7.6% had breech and 14.4% had variable presentation of fetus.Mean BPD increases 3.07 mm per week from 14to30 weeks and 1.93 mm per week from 31 to 40 weeks. For establishing a relationship between two variables GA & BPD, the correlation & regression analysis has been done.Sigmoid regression equation was the best for this study. Conclusions: Data showing that North Indian fetuses are smaller than European fetuses after 22 weeks gestation. [ABSTRACT FROM AUTHOR]

Background and Aim: Several histopathological and gross changes are seen in human brain as age increases, causing enlargement of the lateral ventricles. Morphometric measurement and size of the lateral ventricle of the brain are of great importance to identify certain changes and correlate it with clinical significance. This study was designed to provide a normal data of the cella media index (CMI) measurements of the lateral ventricle of the brain and its association between both the genders and its correlation with different age groups of North Indian Population, which will be helpful for diagnosis of cerebral atrophy. Subjects and Methods: This study was carried out in the Department of Anatomy and Department of Radiodiagnosis, S. N. Medical College, Agra, Uttar Pradesh. In the present prospective study, computed tomography scans of 200 patients between the age of 18 and 75 years (126 males and 74 females) were done, and measurements of the lateral ventricle of the brain were analyzed statistically. Results: In our study, the overall mean CMI was 4.62 ± 0.5 (CMI in male was 4.53 ± 0.41 and mean CMI in female was 4.42 ± 0.28), difference being statistically significant between both genders as P = 0.04 (P ≤ 0.05). In our finding, r = -0.13, indicating a mild positive correlation between age and transverse diameter of CMI of the lateral ventricle in North Indian population. Conclusion: This study concludes that with increase in age, there is a decrease of cella media ratio/Schiersmann's Index, which is helpful in diagnosis of neurological conditions (e.g. schizophrenia, bipolar disorder, and Alzheimer's disease). [ABSTRACT FROM AUTHOR]

Rheumatoid factor (RF), anticyclic citrullinated peptides (Anti-CCP), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) are used as disease markers for rheumatoid arthritis (RA). However, correlation of disease activity score (DAS) 28 with autoantibodies and inflammatory markers has not been studied in detail. Here, we have made an attempt to determine the association of DAS-28 with autoantibodies and inflammatory markers among the North Indian population. Further, we investigated the potential of subsets of autoantibodies in RA diagnosis. Disease activity was calculated by DAS-28-ESR calculator and levels of disease markers were estimated in serum. We noticed positive correlation between DAS-28, CRP (r=0.63, p=0.00) and ESR (r=0.72, p=0.00). Moderate and weak correlation was found with RF (r=0.41, p=0.00) and anti-CCP (r=0.25, p=0.011), respectively. Patients with positive subsets of both autoantibodies (RF+/Anti-CCP+) have shown a positive correlation with DAS-28. In our study, we found that the presence of RF and Anti-CCP in patient sera can increase the early detection rate of disease. But, for the diagnosis of disease in seronegative patients, more studies on biomarkers are required. [ABSTRACT FROM AUTHOR]