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Background: Road safety continues to be a major developmental issue, a public health concern and a leading cause of death and injury affecting not only the victims and their family but also the economy as a whole in terms of untimely deaths, disabilities and loss of potential income. India ranks 2nd in the number of road accidents and 1st in mortality due to RTA in the world. Road accidents are multi-causal due to interplay of various factors. These can be broadly categorized into those relating to (a) Human error (b) Road condition/ environment (c) Vehicle condition. Human errors for RTA include non-compliance to traffic rules and not using helmets and seatbelts, resulting in mortalities which can be mitigated by proper education, adherence and implementation of traffic rules. Objective: To analyze the mortality trends due to RTA by human errors in Chhattisgarh and India 2016-2022 Methodology: The RTA mortality statistics were retrieved from the Road accidents in India report published annually by the Ministry of Road Transport and Highways. A literature search was done in electronic databases like-PubMed, Google Scholar, other platforms using keywords- RTA mortality, Distracted driving Results: From 2016 to 2022, both Chhattisgarh and India experienced a steady rise in fatalities, peaking in 2022 due to overspeeding and helmet non-compliance. In 2019, India saw its peak in fatalities from alcohol-related driving, mobile use, and signal jumping, followed by a decline. Chhattisgarh experienced the highest signal jumping fatalities in 2017 and alcohol-relatedriving deaths in 2018 compared to other years Conclusion: The study reveals a decrease in road traffic accident fatalities caused by certain human errors post-2019, credited to the adoption of the Motor Vehicle Amendment Act 2019. Boosting public awareness and establishing robust surveillance measures are imperative in curbing fatalities caused by road traffic accidents (RTAs)

RationalMaternal overweight/obesity and gestational diabetes mellitus (GDM) are associated with an increased risk of their offspring developing overweight/obesity or type 2 diabetes later in life. However, the impacts of maternal overweight/obesity and dysglycemia on human milk (HM) macronutrient composition are not well understood.ObjectiveThrough a double-blind randomised controlled trial, we investigated the effects of maternal supplementation from preconception throughout pregnancy until birth on HM macronutrient concentrations, in association with maternal and infant factors including maternal pre-pregnancy body mass index (BMI) and GDM status. In addition, we aimed to characterise longitudinal changes in HM macronutrients.MethodsThe control supplement contained calcium, iodine, iron, β-carotene, and folic acid. The intervention supplement additionally contained zinc, vitamins B2, B6, B12, and D3, probiotics, and myo-inositol. HM samples were collected across seven time points from 1 week to 12 months from Singapore and/or New Zealand. HM macronutrient concentrations were measured using a MIRIS Human Milk Analyser. Potential differences in HM macronutrient concentrations were assessed using linear mixed models with a repeated measures design.ResultsOverall, HM macronutrient concentrations were similar between control and intervention groups. Among the control group, overweight/obesity and GDM were associated with higher HM fat and energy concentrations over the first 3 months. Such associations were not observed among the intervention group. Of note, mothers with GDM in the intervention group had lower HM fat by 10% (p = 0.049) and energy by 6% (p = 0.029) than mothers with GDM in the control group. Longitudinal changes in HM macronutrient concentrations over 12 months of lactation in New Zealand showed that HM fat and energy decreased in the first 6 months then increased until 12 months. HM lactose gradually decreased from 1 week to 12 months while crude protein decreased from 1 week to 6 months then remained relatively constant until 12 months of lactation.ConclusionMaternal overweight/obesity or GDM were associated with increased HM fat and energy levels. We speculate the intervention taken during preconception and pregnancy altered the impact of maternal BMI or GDM status on HM macronutrient composition. Further studies are required to identify the mechanisms underlying altered HM macronutrient concentration in the intervention group and to determine any long-term effects on offspring health.Clinical trial registrationClinicalTrials.gov, NCT02509988, Universal Trial Number U1111-1171-8056. Registered on 16 July 2015. This is an academic-led study by the EpiGen Global Research Consortium.

Background Intention-to-treat analyses of the Omega‐3 to Reduce the Incidence of Prematurity (ORIP) trial found that omega-3 (n-3) fatty acid supplementation reduces the risk of prematurity in the subgroup of women with a singleton pregnancy and low n-3 status early in pregnancy, but not overall. However, results may have been influenced by less-than-optimal compliance.Objectives To identify predictors of compliance with n-3 supplementation and determine treatment effects among compliers.Design Exploratory analyses of a multicentre-blinded randomised trial.Setting 6 tertiary care centres in Australia.Participants 5328 singleton pregnancies.Interventions Daily capsules containing 900 mg n-3 long-chain polyunsaturated fatty acids or vegetable oil, consumed from before 20 weeks gestation until 34 weeks gestation.Outcome measures Early preterm (

Aim: Planning the surgical operation, choosing the type of implant, and the effectiveness of the implant all heavily rely on the quantity and quality of the accessible bone. This study's goal was to determine how promptly inserted dental implants affected postoperative changes in bone density and crestal bone level by Cone bean computed tomography (CBCT) gray-scale value during a follow-up of three to six months. Method: A prospective clinical-radiographic investigation was conducted. Twenty participants with a partly edentulous arch who were also systemically healthy were chosen from the OPD of the Department of Periodontics and Oral Implantology. Each patient's oral hygiene status was noted, and a preoperative CBCT was performed to assess bone density. The following clinical parameters were noted before surgical procedures: plaque index (PI) (Silness and Loe, 1964), gingival index (GI) (Loe and Sillness, 1964), probing pocket depth (PPD), and primary stability. Result: A weak connection between Hounsfield unit (HU) in three months and six months was found. Moreover, a slender positive connection between baseline primary stability and three months was found. PI was shown to have a statistically significant difference between the means at several follow-ups (P value of 0.0001). PI and probing depth were not statistically different between baseline and six months (P values = 0.0001) or between three months and six months (P values = 0.050), respectively. Conclusion: The main outcome of this study shows that insertion torque is directly proportional to bone density and crestal bone level.

Introduction: Coronavirus disease 2019(COVID-19) saw an overhaul in the biomedical waste management (BMWM) practices. Waste handlers were at the brunt of these changes. If the challenges pertaining to BMWM at the ground level are better understood, more effective measures to overcome them can be formulated. Objectives: 1. To identify myths and concerns regarding BMWM in the context of COVID-19 pandemic. 2. To explore the challenges faced in BMWM amidst the COVID-19 pandemic. 3.To explore opportunities and future perspectives of BMWM. Method: In-depth interviews were conducted among 17 purposively selected Class IV health care workers during August to November 2021 in a tertiary care institute in Mumbai. Data was reported using thematic analysis. Results: Three major themes - challenges and concerns faced by BMW handlers, enablers/ motivators, opportunities and future practices were generated from the transcripts. Various challenges faced by waste handlers were- difficulties in segregation and transport of BMW, exhaustion from PPE usage and fear of acquiring and spreading COVID-19 from work, stigma faced from public, and handling COVID-19 deaths. Support from family and colleagues, incentives and a positive change in public perception enabled them to work. Forming redressal committees, addressing job security concerns and timely provision of good quality equipment can improve hospital waste management measures in the future. Conclusion: It is of utmost importance to address challenges faced by waste handlers in BMWM. Onus should also be on periodic training in BMWM.

Objectives The risk factors for prematurity are multifactorial and include low omega-3 status. Omega-3 supplementation in pregnancy has been found to reduce prematurity risk, particularly among women with low omega-3 levels. This study aimed to identify maternal characteristics that predict whether women with a singleton pregnancy will benefit from omega-3 supplementation to reduce their risk of prematurity.Design Exploratory analyses of a multicentre, double-blind randomised trial.Setting 6 tertiary care centres in four states in Australia.Participants 5328 singleton pregnancies in 5305 women recruited before 20 weeks of gestation.Interventions Fish oil capsules containing 900 mg omega-3 long-chain polyunsaturated fatty acids per day versus vegetable oil capsules consumed from enrolment until 34 weeks’ gestation.Outcome measures Early preterm birth (EPTB,

Duchenne muscular dystrophy (DMD), a progressive genetic neuromuscular disease, affects all major muscle groups in the body. Academic functioning is affected by the progressive nature of DMD and physical fatigue. To explore the experiential account of schooling and the barriers in schooling among children with DMD in India and to develop recommendations for school accommodation, a descriptive cross-sectional study was conducted with thirty-three male children who were diagnosed with DMD and receiving treatment from a tertiary center. A sociodemographic data sheet and a semi-structured questionnaire were used for data collection. The data were subjected to descriptive statistical and thematic analysis to derive the results. Eighty percent of the children received support from teachers and friends, and 28 percent reported their school as disability friendly. Themes derived from qualitative thematic analysis were physical difficulties, environmental barriers, and emotional difficulties. Based on the study results and review of the existing literature, recommendations for school accommodation will be proposed. Despite the difficulties they face in the school setting, active participation in school is important for children with progressive conditions such as DMD. Families and schools have a responsibility to ensure that children have an inclusive life, the barriers they face are minimized, and their time at school enhances their range of experiences and quality of life.

IntroductionDuring pregnancy and lactation minerals such as zinc are required to support maternal and infant health. Zinc is involved in various cellular processes, with requirements increasing in pregnancy and lactation. In the setting of a randomized trial, we investigated the effects on human milk (HM) zinc concentrations of a micronutrient-containing supplement including zinc in the intervention (but not control) group, started preconception and taken throughout pregnancy until birth. Additionally, we characterized longitudinal changes in HM concentrations of zinc and other minerals (calcium, copper, iodine, iron, magnesium, manganese, phosphorus, potassium, selenium, and sodium).MethodsHM samples were collected across 7 time points from 1 week to 12 months from lactating mothers from Singapore (n = 158) and New Zealand (n = 180). HM minerals were quantified using sector field inductively coupled plasma mass spectrometry. Potential intervention effects on HM mineral concentrations were assessed using linear mixed models with a repeated measures design and time-weighted area-under-the-curve analyses.ResultsOver the first 3 months of lactation, HM zinc concentrations were 11% higher in the intervention group compared to the control group (p = 0.021). Higher HM zinc concentrations were most evident at 6 weeks of lactation. The intervention had no effect on HM concentrations of other minerals, which were not differently supplemented to the control and intervention groups. Temporal changes in HM minerals over 12 months of lactation were studied in the New Zealand mothers; HM zinc and copper concentrations progressively decreased throughout 12 months, while iron, potassium, sodium, and phosphorus decreased until 6 months then plateaued. HM calcium and magnesium initially increased in early lactation and iodine remained relatively constant throughout 12 months. HM manganese and selenium fell over the initial months of lactation, with a nadir at 6 months, and increased thereafter. The contrasting patterns of changes in HM mineral concentrations during lactation may reflect different absorption needs and roles at different stages of infancy.DiscussionOverall, this study indicates that HM zinc concentrations are influenced by maternal supplementation during preconception and pregnancy. Further studies are required to understand the associations between HM zinc and other minerals and both short- and long-term offspring outcomes.Trial registrationClinicalTrials.gov, identifier: NCT02509988, Universal Trial Number U1111-1171-8056. Registered on 16 July 2015. This is an academic-led study by the EpiGen Global Research Consortium.