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Background: Obesity has emerged as an epidemic and is known to be associated with multiple co-morbidities, contributing to increased morbidity and mortality. Body-mass index (BMI) has been traditionally used to assess obesity in an individual but abdominal obesity markers are being claimed to have a stronger association with adverse cardiovascular outcome as compared to BMI. However, there are only a few studies that have evaluated these indices in Asian Indians. Aims and Objectives: The study was conducted to compare BMI and waist measurement based indices among hypertensive adults and their association with adverse cardiovascular outcomes. The secondary objectives were to determine any gender-based differences among anthropometric indices and improved predictability on adding waist-based indices to BMI. Materials and Methods: An observational study was conducted to analyse association of anthropometric indices such as BMI, A body shape index (ABSI), Waist–hip ratio (WHR), Waist-to-height ratio (WHtR), Lean body mass-to-weight ratio, and Waist circumference (WC), with risk of cerebrovascular accidents (CVA) and coronary artery disease (CAD) in Indian hypertensive adults. Results: In total, 400 participants were included and female subjects were noted to have higher prevalence of obesity in our study population. Only 33.25% patients had BMI in recommended range and the numbers were even lower for WHtR and WHR. BMI and ABSI were found to have a weak association with development of co-morbidities while measures of abdominal obesity such as WHR, WC, and WHtR were found to have consistently strong association with CVA and CAD with high sensitivity and negative predictive values. Conclusion: More accurate markers of abdominal obesity can help in better assessment of cardiovascular risk among high-risk population to improve the overall outcome. Easy to use, outpatient-based markers such as WC, WHR, and WHtR appear to be better than BMI in risk assessment.

Introduction Radiography is the most often accessible and affordable imaging modality. Accurate assessments of wrist X-rays can aid in the diagnosis and prognostic evaluation of various wrist problems. This study aims to identify normal radiographic anthropometry reference values and variations of carpal bones and joints by gender and age in sample Indian population, with the potential to be clinically applicable.

Introduction Wrist parameters measured on direct radiography are essential in diagnosing scaphoid-related pathologies and treatment. Although computed tomography has been used to establish normative for scaphoid measurement, no research has focused on Indian norms. This study aimed to determine the distribution and normal limits of parameters measured in our population's posteroanterior (PA) and direct lateral radiographs of the wrist.

Background Glenoid version refers to the angle subtended by the glenoid with the scapula. On average, it is 0 ± 10 degrees with a slight propensity toward retroversion. Numerous factors such the dominance(handedness), gender, ethnicity, and pathology are known to affect version. Version has important consequences on the biomechanics of the shoulder joint and is altered in those with arthritis and shoulder joint instability.

The text is an introduction to a series of seven studies and essays dealing with the use of the term indián/Indián (Indian) in the Czech language as well as in the Anglo-Saxon and Latin American contexts. The editorial first briefly introduces the main problems of the use of the term indián/Indián and related terms both in the domestic and in the Anglo-Saxon and Latin American contexts. It then presents the problems of the grammatical use of the word indián/Indián in the Czech language. It also sums up the discussion related to the use of the term indio in the Anglo-Saxon and Ibero-American environment. Furthermore, it discusses the meaning and genesis of the term indio in the Spanish language and the environment of the former Spanish overseas colonies. The issue of the use of the term indio/indígena in contemporary discourse, academic in particular, is also examined.

The paper explores the use of ethnicity as a strategic tool in the politicization of the Mexican diaspora in the United States of America in the late 1960s and early 1970s. Referring to the example of the 1969 founding manifesto entitled “The Spiritual Plan of Aztlán” (El Plan Espiritual de Aztlán), it pays attention to the ways in which a section of the Mexican diaspora in the United States — Chicanos — came to identify themselves with the indigenous peoples of the United States and Mexico in the construction of their new collective identity. The text further examines the symbols of the Aztlán and the Bronze Race, the meanings attributed to them, and the question of authorship. In doing so, it draws on the interpretive frameworks of S. Hall, B. Anderson, R. Barthes and M. Castells. It concludes that the manifesto represents a highly selective, strategic narrative which mirrors both the Chicano movement’s claims for recognition in the US and the ways the Mexican diaspora interpreted its past to serve its current and future goals between the 1960s and early 1970s.

Abstract Objective ESPRITE (Study 508; NCT03836924) evaluated the real‐world safety, tolerability, and efficacy of adjunctive perampanel in patients aged ≥12 years with focal‐onset seizures (FOS), with or without focal to bilateral tonic–clonic seizures (FBTCS), in India. Methods ESPRITE was a prospective, multicenter, single‐arm, observational, Phase IV study with a 6‐month Treatment Period. Patients were aged ≥12 years and had been prescribed perampanel for adjunctive treatment of FOS, with or without FBTCS. Assessments included incidence of treatment‐emergent adverse events (TEAEs; primary endpoint), median percent reduction in seizure frequency per 28 days from baseline, 50% responder rates, and seizure‐freedom rates. Results Overall, 200 patients were enrolled (199 patients in the Safety Analysis Set and 174 patients who completed all visits in the main efficacy analyses). TEAEs (all mild or moderate in severity) were reported in 18.1% (n = 36/199) of patients (the most common were dizziness [3.0%] and irritability [2.0%]). TEAEs leading to discontinuation of perampanel were reported in 2.0% of patients; no deaths or serious TEAEs occurred. At 6 months, median percent reduction in seizure frequency was 100.0%, 50% responder rate was 83.3%, and seizure‐freedom rate was 49.4%. Significance Adjunctive perampanel (at a mean daily dose of 4 mg/day) was shown to be well tolerated and effective in patients aged ≥12 years with FOS, with or without FBTCS, from India. Plain Language Summary Many patients do not receive adequate treatment for epilepsy and need effective seizure control medications. In this 6‐month clinical study, 199 patients from India, aged 12 years or older, added perampanel to the anti‐seizure medications they were already taking. At 6 months, 49% of patients experienced no seizures since starting perampanel and seizure frequency was reduced by half in 83% of patients. Side effects occurred in 18% of patients (most commonly dizziness and irritability) and caused 2% to stop perampanel; no deaths were reported. Perampanel was an effective and generally safe added medication for patients with epilepsy from India.

Introduction: Recent evidence reveals that type 1 diabetes mellitus (T1DM) impairs muscle function (MF) in adolescents. However, despite its importance in physical well-being, data on dynamic MF in Indian children and adolescents (C and Y) with T1DM are scarce. We assessed MF using Jumping Mechanography (JM, a measurement method for motion analysis and assessment of muscle power and force). (1) To assess dynamic MF by JM in C and Y with T1DM as compared to healthy controls (2) To determine predictors of MF in children with T1DM. Methods: A cross-sectional observational study on 266 children (133 – T1DM duration >1 year with no known comorbidities + 133 age and gender-matched healthy controls) aged 6–19 years. Anthropometry, body composition, and MF (maximum relative power Pmax/mass, maximum relative force Fmax/BW by JM) were recorded. The lean mass index (LMI) was calculated as lean mass (kg)/height (m2). HbA1c was assessed in T1DM. Independent sample t-test and linear regression were performed. Results: MF parameters (Pmax/mass 33.5 ± 7.2 vs 38.0 ± 8.6 W/kg and Fmax/BW 10.5 ± 2.9 vs 11.4 ± 4.1 N/kg, P < 0.05) were significantly lower in T1DM group vs controls. Positive association of body mass index and LMI with both MF parameters and negative association of insulin requirement and HbA1c with Fmax was observed in T1DM. Predictors of MF identified were MMI (Pmax/mass:b = 1.6,95%CI = 0.6–2.6; Fmax/BW:b =2.0,95%CI = 1.6–2.4) and HbA1c (Pmax/mass:b = −2.1,95%CI = −4.5–−0.5; Fmax/BW:b = −1.1,95%CI = −2.0–−0.2) (P < 0.05). Conclusion: C and Y with T1DM exhibits compromised muscle function. Poor glycaemic control increases the risk of having decreased MF, irrespective of diabetes duration and may contribute to sarcopenia in adulthood.

In the rapidly globalizing digital communication sphere, the imperative for advanced multilingual text recognition and identification is increasingly evident. Contrasting the previous works, which were predominantly constrained to 2-3 languages, this paper explores the rich linguistic diversity of India, addressing challenges in automated language processing for 12 languages. BharatBhasaNet, our comprehensive Language Identification (LID) framework, integrates an extensive dataset covering these 12 Indian languages in both native-script and romanized forms, derived from INDICCORP, Bhasha-Abhijnaanam, and Aksharantar datasets by AI4Bharat. The framework accommodates two models, Roberta-native and Roberta-Romanized, based on attention mechanism and transformer architecture. With its exceptional accuracy of 99.54% in native script and 60.90% in Romanized text, BharatBhasaNet significantly advances language identification, providing broader language coverage than existing LIDs. It excels in interpreting code-mixed sentences, unveiling crucial accuracy patterns related to sentence length, word span, and complexity in multilingual contexts. The framework underwent rigorous testing using a real-time dataset from the National Informatics Center (NIC), achieving an accuracy rate of 92.67%. Overcoming challenges like limited training data and distinguishing similar languages, BharatBhasaNet marks a significant leap in Romanized text identification within diverse linguistic landscapes.

PURPOSE: Start-ups are widely acknowledged as crucial catalysts for innovation and drivers of economic progress. However, their vulnerability to failure continues to pose a persistent and significant obstacle. In light of this, the study intends to ascertain the various elements responsible for the elevated incidence of start-up failures and examine their contextual associations. It further aims to establish the hierarchical structure and identify the crucial factors of start-up failure. METHODOLOGY: The paper uses the Interpretive Structural Modeling (ISM) approach to determine the structural hierarchy and interconnections among the causes of start-up failures identified through the comprehensive analysis of existing literature and experts’ opinions. MICMAC (Cross-Impact Matrix Multiplication Applied to Classification) analysis is also being utilized to categorize these identified failure causes into autonomous, independent, dependent, and linking factors by their driving and dependency powers. FINDINGS: A structural framework depicting the interrelationships among the factors has been derived, showing the failure factor, ‘poor market positioning’ factor at the highest level, and the ‘lack of entrepreneurial efficiency’ at the lowest level of the model. The results also revealed that lack of entrepreneurial efficiency, poor management, and external environmental issues are the most significant independent factors upon which all other failure factors rely. It also categorizes ‘poor market positioning’ as the dependent factor, signifying its passive role in the failure of start-ups. IMPLICATIONS: As previous literature has discussed the various factors responsible for the failure of start-ups in isolation, the current study fills out the gap in the literature by establishing linkages among those factors. The study’s insights emphasize the value of effective management teams and entrepreneurial skills in averting start-up failures. It highlights the importance of skill development and mentorship to enhance the capabilities of entrepreneurs and their teams. Furthermore, the research indicates that policymakers and support groups can create focus initiatives addressing issues like market validation, team dynamics, and financial management to enhance the start-up environment. These initiatives may encompass entrepreneurship training, financial assistance, and mentorship through the ‘Start-up India’ Program, Bharat Fund platform, etc. ORIGINALITY AND VALUE: Previous studies on entrepreneurial failure are based on AHP (Analytical Hierarchical Process), content analysis, and quality management methodologies. This is potentially the first study using the ISM-MICMAC approach that explores the complex world of start-up failures in India and illustrates the relative influence and interdependence of various failure factors of start-ups through a hierarchical model.

Mohsin Khan,1,&ast; Syed Khalid Perwez,2,&ast; Rahul Paul Gaddam,2 Rabuni Aiswarya,2 Mohammed Abrar Basha,3 Abhradeep Malas,4 Shafiul Haque,5– 7 Faraz Ahmad4 1Department of Commerce, School of Social Science and Languages, Vellore Institute of Technology, Vellore, India; 2VIT Business School, Vellore Institute of Technology, Vellore, India; 3School of Life Sciences, B.S Abdur Rahman Crescent Institute of Science & Technology, Chennai, India; 4Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, India; 5Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia; 6Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon; 7Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates&ast;These authors contributed equally to this workCorrespondence: Faraz Ahmad, Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, 632014, India, Tel +91 8969 66 8060, Email faraz.ahmad@vit.ac.inPurpose: While previous studies have suggested close association of psychological variables of students withtheir higher-order cognitive abilities, such studies have largely been lacking for third world countries like India, with their unique socio-economic-cultural set of challenges. We aimed to investigate the relationship between psychological variables (depression, anxiety and stress) and cognitive functions among Indian students, and to predict cognitive performance as a function of these variables.Patients and Methods: Four hundred and thirteen university students were systematically selected using purposive sampling. Widely used and validated offline questionnaires were used to assess their psychological and cognitive statuses. Correlational analyses were conducted to examine the associations between these variables. An Artificial Neural Network (ANN) model was applied to predict cognitive levels based on the scores of psychological variables.Results: Correlational analyses revealed negative correlations between emotional distress and cognitive functioning. Principal Component Analysis (PCA) reduced the dimensionality of the input data, effectively capturing the variance with fewer features. The feature weight analysis indicated a balanced contribution of each mental health symptom, with particular emphasis on one of the symptoms. The ANN model demonstrated moderate predictive performance, explaining a portion of the variance in cognitive levels based on the psychological variables.Conclusion: The study confirms significant associations between emotional statuses of university students with their cognitive abilities. Specifically, we provide evidence for the first time that in Indian students, self-reported higher levels of stress, anxiety, and depression are linked to lower performance in cognitive tests. The application of PCA and feature weight analysis provided deeper insights into the structure of the predictive model. Notably, use of the ANN model provided insights into predicting these cognitive domains as a function of the emotional attributes. Our results emphasize the importance of addressing mental health concerns and implementing interventions for the enhancement of cognitive functions in university students.Keywords: depression anxiety stress score, DASS, Montreal Cognitive Assessment, MoCA, college students, artificial neural network, predictive performance, Indian, developing economies, feature reduction, feature weights

Purpose: Hip fractures in elderly have a high mortality. However, there is limited literature on the excess mortality seen in hip fractures compared to the normal population. The purpose of this study was to compare the mortality of hip fractures with that of age and gender matched Indian population. Methods: There are 283 patients with hip fractures aged above 50 years admitted at single centre prospectively enrolled in this study. Patients were followed up for 1 year and the follow-up record was available for 279 patients. Mortality was assessed during the follow-up from chart review and/or by telephonic interview. One-year mortality of Indian population was obtained from public databases. Standardized mortality ratio (SMR) (observed mortality divided by expected mortality) was calculated. Kaplan-Meir analysis was used. Results: The overall 1-year mortality was 19.0% (53/279). Mortality increased with age (p

South Africa is one of the few countries in Africa that no longer criminalises same-sex sexual activity, and the only one to recognise same-sex marriage under the legal system. Yet, at the same time, several groups in the country practice a conservatism that discourages people from being themselves, be it in professing their gender or their sexuality. This article explores the trials and tribulations of making a documentary film with a minority population within one such minority population – Queer and Indian – in Durban, the site of the largest number of Indians outside India. Written in a reflective style that frames the positioning of the authors, a key question posed is: what are the daily issues that queer South African people deal with? Battling with conservatism while trying to find one’s queer voice is just one of them. The film engages with a few people who were generous to allow us to use their experiences with the state, the society, and healthcare. How does one reconcile the Rainbow Nation, the promise of constitutional equality with the insularity that people face on a regular basis? This article aims to be the start of a much larger conversation that needs to be had.

Background: Post-COVID residual dysfunction has been observed in a majority of people, with reduction in cardiopulmonary endurance emerging as a primary symptom. The Six-Minute Walk Test is a simple, reliable, and valid test that is used routinely on people with chronic respiratory dysfunction. In the current COVID-19 pandemic situation, reference values and a predictive equation developed from a large sample across a large age group, from 6 to 75 years, will enable one to establish goals of treatment for post-COVID rehabilitation. Methods: Following institutional ethical clearance, we recruited 1369 participants for the study (685 females and 684 males). Participants were classified according to biological age into group 1 (6–12 years), group 2 (13–17 years), group 3 (18–40 years), group 4 (41–65 years), and group 5 (>65 years). Informed consent was sought and participants were screened using a health history questionnaire. Demographic features, namely, age, height, weight, and body mass index (BMI) were noted. The Six-Minute Walk Test was administered as per ATS guidelines. Clinical parameters, namely, pulse rate, respiratory rate, systolic blood pressure, diastolic blood pressure, and rate of perceived exertion were recorded. Results: The Six-Minute Walk Test (6MWT) was significantly influenced by age and gender (r = 0.257, P = 0.00 and r = 0.501, P = 0.00, respectively). Walking distance was longest in 13–17-year-old males, whereas females demonstrated a linear decline after 12 years. In each age group, males walked a greater distance than females. Stepwise linear regression analysis was used to derive the following predictive equation: 6MWT = 491.93 − (2.148 × age) + (107.07 × gender) (females = 0, males = 1). Conclusion: The study confirmed variability of the Six-Minute Walk Test, with age and gender being predominant predictors. Reference values, equations, and percentile charts generated from the study can be utilised to guide clinical decision-making while exercise prescription for patients with post COVID dysfunction.

Background : The availability of nomograms is crucial for the correct interpretation of pediatric and neonatal echocardiograms. Echocardiographic Z-score applications/websites use Western nomograms as reference, which may not be an appropriate standard for gauging Indian neonates. Currently available Indian pediatric nomograms either have not included neonates or have not been specifically designed for neonates. This gross underrepresentation of neonates renders available nomograms unreliable for use as standards for comparison. Objectives : The objective of this study was to collect normative data for the measurement of various cardiac structures using M-Mode and two-dimensional (2D) echo in healthy Indian neonates and to derive Z-scores for each measured parameter. Methods : Echocardiograms were performed on healthy term neonates (within first 5 days of life). Birth weight and length were recorded, and body surface area was calculated using Haycock's formula. Twenty M-mode and 2D-echo parameters were measured (including left ventricular dimensions, atrioventricular valves, and semilunar valves' annuli sizes, pulmonary artery and branches, aortic root, and arch). Results : We studied 142 neonates (73 males) with a mean age of 1.83 ± 1.12 days and mean birth weight of 2.89 ± 0.39 Kg. Regression equations with linear, logarithmic, exponential and square root models were tested to select the best model of fit for the relationship between birth weight and each echocardiographic parameter. Scatter plots and nomogram charts with Z-scores were prepared for each echocardiographic parameter. Conclusions : Our study provides nomograms with Z-scores for term Indian neonates weighing between 2 kg and 4 kg at birth, within first 5 days of life, for a set of echocardiographic parameters that are frequently used in clinical practice. This nomogram has poor predictability for babies at extremes of birth weight. There is a need for further indigenous studies to include neonates at extremes of weight, both term, and preterm.

Introduction: Each population has its own unique genotype. Genotyping data on Indian cardiomyopathy patients is lacking. Methods: We aimed to create and analyse a database of sequence variations in Indian patients with primary cardiomyopathies. This included all data of the cardiomyopathy cohort at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh. In addition, all published papers in Pubmed containing sequence variations in Indian cardiomyopathy patients till December 2020 using specific search terms were included. Affected genes and sequence variations, methodologies and quality of clinical data was analysed. Novel sequence variations were documented. Results: A database of 493 datasets including 417 different sequence variations was created. Of these, the PGIMER database had 137 datasets consisting of 94 different variants. Only 63 publications included genotyping data of Indian cardiomyopathy cohort from 2000 to 2020 reporting 335 sequence variations. Five (7.9%) studies were from institutions abroad. Of published variations, 35.1% were novel. Most studies carried out selective genotyping. Comprehensive genotyping using cardiomyopathy panels or whole exome sequencing was reported in only 9 (14.3%) publications. Conclusion: Database of 417 different sequence variations in Indian cardiomyopathy patients was analysed. Over a third of all reported sequence variations in Indians were novel.

Background. In the recent day, there has been an exponential growth in the usage of clear aligners for orthodontic treatment. As with any removable appliance, the compliance of patients to remove it during ingestion of food is, at times, poor. Thus, the stability of the clear aligner to be "clear" becomes questionable. This in-vitro study examined how the clear aligners changed colour on exposure to various indigenous food products used in everyday life. Methods. Aligners from 5 different companies (K Line, Clearbite Aligners, The Aligner Company, iAligners and MaxDent CA Digital) were exposed for 12 hours and 24 hours to various indigenous substances (tea, green tea, coffee, turmeric, saffron and Kashmiri red chili powder) and a control solution (distilled water) in-vitro. The color change was assessed with the help of VITA Easyshade compact colorimeter based on Commission Internationale de I’Eclairage L*a*b* color system. Values were then modified to NBS units for clinical relevance. Results. The hue of the transparent aligners was noticed to change in a statistically meaningful way when exposed to turmeric, saffron, Kashmiri red chili powder and coffee in decreasing order and mild color change in tea and green tea at both 12 hours and 24 hours intervals. Conclusion. Aligners are prone to color change when exposed to indigenous foods that contain staining properties.

During the COVID-19 pandemic, the mortality rate in densely populated India was reportedly 5 to 8 times lower than in less populous western countries. An international team of scientists from India, Brazil, Jordan, Switzerland, and Saudi Arabia conducted the research suggesting that Indian dietary components suppress cytokine storm and other severity-related pathways of COVID-19 and may play a role in reducing the severity and mortality rates of COVID-19 in India compared to western populations. The findings indicated that the constituents of Indian diets, which ensure high iron and zinc concentrations in blood and ample fibre in foods, played a role in mitigating the severity of COVID-19 caused by carbon dioxide retention and lipopolysaccharide. This narrative review highlights various facets of Indian Traditional Diet which has helped in preventing COVID 19- related mortality.

Background: Longstanding cardiovascular risk factors cause major adverse cardiovascular events (MACE). Major adverse cardiovascular events prediction may improve outcomes. The aim was to evaluate the ten-year predictors of MACE in patients without angina. Methods: Patients referred to Inkosi Albert Luthuli Hospital, Durban, South Africa, without typical angina from 2002 to 2008 were collected and followed up for MACE from 2009 to 2019. Survival time was calculated in months. Independent variables were tested with Cox proportional hazard models to predict MACE morbidity and MACE mortality. Results: There were 525 patients; 401 (76.0%) were Indian, 167 (31.8%) had diabetes at baseline. At 10-year follow up 157/525 (29.9%) experienced MACE morbidity, of whom, 82/525 (15.6%) had MACE mortality. There were 368/525 (70.1%) patients censored, of whom 195/525 (37.1%) were lost to follow up. For MACE morbidity, mean and longest observation times were 102.2 and 201 months, respectively. Predictors for MACE morbidity were age (hazard ratio [HR] = 1.025), diabetes (HR = 1.436), Duke Risk category (HR = 1.562) and Ischaemic burden category (HR = 1.531). For MACE mortality, mean and longest observation times were 107.9 and 204 months, respectively. Predictors for MACE mortality were age (HR = 1.044), Duke Risk category (HR = 1.983), echocardiography risk category (HR = 2.537) and Ischaemic burden category (HR = 1.780). Conclusion: Among patients without typical angina, early ischaemia on noninvasive tests indicated microvascular disease and hyperglycaemia, predicting long-term MACE morbidity and MACE mortality. Contribution: Diabetes was a predictor for MACE morbidity but not for MACE mortality; patients lost to follow-up were possibly diabetic patients with MACE mortality at district hospitals. Early screening for ischaemia and hyperglycaemia control may improve outcomes.

The article surveys the life and output of Eric Schroeder (1904-71), who served from 1938 as (mainly honorary) Keeper of Persian Art at the Fogg Museum of Art, Harvard University, mounting choice exhibitions and greatly expanding the collection of paintings. After assessing his two major books – Persian Miniatures in the Fogg Museum of Art (1942) and Muhammad’s People. An Anthology (1955) – the focus shifts to his chapters and articles on Persian architecture and book painting. His remarkable range, profound erudition, flood of original insights and peerless prose explains why his best work, as relevant today as ever, should be required reading for students of Islamic art.

Introduction: Ascending and descending coli normally are located anterolateral to kidneys. Retrorenal position of the colon has a reported prevalence of 10%–20% in the general population. Its occurrence is of significant while performing percutaneous nephrolithotomy (PNL) which is a routine management procedure for patients showing clinical disease associated with renal calculus. PNL in patients with retrorenal colon can lead to colonic perforation which is associated with significant morbidity and mortality related to septicemia, peritonitis, formation of abscess, and nephro-colic and/or colo-cutaneous fistulae. Hence, the preoperative information about the presence of retrorenal colon is essential for the prevention of surgical complications. Materials and Methods: Our retrospective study included patients who underwent computed tomography (CT)/magnetic resonance (MR) abdomen in our department of radiodiagnosis. All the scans were evaluated for the presence of retrorenal colon. The persistence of retrorenal colon was also observed with change in posture among those with prone scans. Results: The retrorenal colon was present in 130 out of 669 patients included in the study, with an occurrence rate of nearly 20%. Alteration in the position of retrorenal colon was noted with prone position in approximately 79%. Conclusion: The occurrence of retrorenal colon is high in the Indian population being approximately 20% without change with prone position in one-fifth. Thus, to reduce the risk of complication related to colonic perforation during PNL, all patients must be subjected to CT/MR abdomen to detect retrorenal colon followed by scan in the prone position, if retrorenal colon is present, to evaluate the alterations in colonic position with prone posture.

Abstract Background The current standard treatment for neovascular age-related macular degeneration (nAMD) involves intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents. The aim of the present study was to compare the effectiveness and safety of two anti-VEGF drugs: brolucizumab and aflibercept, in treatment-naïve nAMD Indian patients over a period of 48 weeks. Methods A prospective, randomized, single-centre, single-blinded, two-arm comparative study was conducted between March 2021 and February 2022. Of the 114 patients, 56 received intravitreal injections of brolucizumab (6 mg/50 µL) while 58 received aflibercept (2 mg/50 µL). The patients received 03 initial loading doses at 4-week intervals of both the agents and then respective therapies were given as individualized pro re nata (PRN) regimen based on the signs of active macular neovascularization. The functional and anatomical outcomes measured were mean change in best-corrected visual acuity (BCVA, logMAR), central macular thickness (CMT, µm), presence of intraretinal fluid, subretinal fluid or subretinal hyper-reflective material. Furthermore, the average number of additional injections required after the loading doses, the injection-free interval and safety of both the drugs were also assessed. Results Brolucizumab was found to be non-inferior to aflibercept in terms of mean change in BCVA (−0.13 ± 0.21 logMAR vs. −0.10 ± 0.15 logMAR) and reduction in CMT (−112.59 ± 81.23 µm vs. −86.38 ± 71.82 µm). The percentage of eyes with IRF and SHRM was comparable between both the groups while fewer eyes treated with brolucizumab indicated SRF presence than aflibercept after the loading doses. These beneficial effects of brolucizumab were observed with significant (p

Background: Severe acute respiratory syndrome corona virus-2 [SARS CoV2], the virus that cause the COVID-19 pandemic remained a persistent challenge worldwide. India emerged as the second most affected nation after the United States. Many previous studies confirmed the association of comorbidities like diabetes, hypertension, etc. as associated with adverse outcomes in COVID-19.Aim of the work: The current study aimed to ascertain the association of comorbidities like diabetes, hypertension, and CAD with adverse disease outcomes in COVID-19 pneumonia.Patients and Methods: A retrospective observational study was conducted with the data retrieved from medical records of patients admitted with a reverse transcription-polymerase chain reaction [RT-PCR] positive COVID-19 in the intensive care unit [ICU] of a tertiary medical college. We analyzed 467 RT-PCR confirmed COVID19 cases with respect to the association with adverse and critical disease states. Criticality was defined as any one of: a] use of ventilation, b] death or c] Radiographic assessment of lung edema [RALE] Score >24.Results: Of the total cases among critical cases, 52% [95% CI 46%-59%] has comorbidity and non-critical cases 41% had comorbidity [95% CI 34%-48%]. The prevalence of diabetes among critical cases was 43% [95% CI 37%-49%] while in non-critical cases it was 28% [95%CI 21%-34%]. Hypertension was prevalent in 30% [95% CI 24%-37%] in non-critical cases while it was prevalent in 33 % [95% CI 27%-38%] in critical cases. We also examined the association of comorbidities in the ICU admitted cohort and found that there is a significant association of diabetes [p-

Introduction: The knowledge of morphometric parameters of laminae of cervical vertebrae is indispensable in surgical procedures and developing instrumentation for surgical processes. Literature reports ethnic and geographical variations reported in these dimensions. Materials and Methods: This cross-sectional study included analysis of laminae of 212 cervical vertebrae (C3–C6). The length of superior border of lamina and inferior border of lamina was measured on the right and left sides using vernier caliper. Descriptive and inferential statistical analysis was done with the help of Microsoft Excel version 2021. Results: The length of the superior border of lamina on both sides increases from C3 to C5. The length of the inferior border of the lamina on both sides decreases from C3 to C4, then on the right side, it increases from C4 to C5 and then decreases from C5 to C6, and on the left side, it increases from C4 to C6. At C4, the length of superior border of lamina on the right side differed statistically from the length of superior border of lamina on the left side (P = 0.042). A significant difference between lengths of the inferior border of laminae on the right and left sides was also found at the C5 vertebra (P = 0.001) and C6 vertebra (P = 0.012). No significant difference in thickness and height of lamina was observed between right and left sides. Conclusion: The present study indicates morphometric parameters of laminae of typical cervical vertebrae in the North West Indian population differ from the same parameters in Brazilian as well as South Indian populations. The length of superior border as well as inferior border of lamina has significant differences between right and left sides. However, there is no significant difference in height and thickness of laminae between right and left sides.

Purpose: To determine exophthalmometry values (EV) in the north Indian population and to find its correlation with the age, gender, height, weight, body mass index (BMI), locality, and base value of the population. Methods: A total of 1000 eligible participants with 504 females and 496 males with age >5 years were included in this observational cross-sectional study. Age, gender, and locality of the subjects were noted. Hertel's exophthalmometry was performed on all subjects. The exophthalmometry values and base values were recorded. Height and weight were measured for all participants. BMI was calculated using the parameters. Results: The overall mean exophthalmometry value (mm) was 14.94 ± 2.43 mm with a range between 8 and 22 mm. There was no significant difference in EV between the two eyes. Males recorded a significantly higher mean EV of 15.4 ± 2.51 mm as compared to females with a value of 14.49 ± 2.27 mm. Base value of Hertel's exophthalmometer had a mean value 100.78 ± 5.63 mm and a range of 84–120 mm. Age, height, weight, BMI, and locality of the subjects were found to have a significant effect on the exophthalmometry as well as the base value of the population. A significant correlation was also seen between exophthalmometry values and base values of the population. Conclusion: Our study provided the normal exophthalmometric range for the north Indian population and also demonstrated the relationship of age, gender, height, weight, BMI, locality, and base value with the exophthalmometric values.

Background: Patients with rheumatoid arthritis (RA) often have sleep dysfunction. This may adversely impact quality of life. Despite being common, sleep dysfunction is uncommonly assessed in the clinic. No data on sleep quality in RA patients is available from India. In this study we examined the sleep quality and factors influencing it in Indian patients with RA. Methods: This cross-sectional study evaluated sleep quality in 110 patients with RA using the Pittsburgh sleep quality index (PSQI) or its validated Hindi version (PSQI-H). The risk of sleep apnea was assessed by the Berlin questionnaire while the assessment of pain and fatigue was done on a visual analogue scale (VAS). Disease activity was assessed by simplified disease activity index, functional disability was assessed by the health assessment questionnaire disability index-Centre for Rheumatic Diseases version, and quality of life was evaluated by World Health Organization quality of life-BREF (WHOQOL-BREF). Socioeconomic status was assessed by modified Kuppuswamy scale. Results: Sixty four percent of our patients with RA demonstrated poor sleep quality. The mean global PSQI score was of 6.41 ± 3.07 (range 1–17). A high risk of sleep apnea was present in 26% of the study population. The use of glucocorticoids, high risk of sleep apnea, high disease activity, pain VAS, fatigue VAS, and functional disability were more common in poor sleepers. Multivariate logistic regression analysis revealed that high risk of sleep apnea, fatigue, and poor physical health domain of WHOQOL-BREF were independent risk factors for poor sleep quality. Conclusions: Patients with RA had a high prevalence of poor sleep quality. High risk of sleep apnea, fatigue and physical health domain of WHOQOL-BREF were identified as independent predictors of poor sleep quality. Clinic evaluation of patients with RA should incorporate the domain of sleep quality.

Abstract Shiv Prasad Shrivastava Purpose The incidence of cancer has increased in India with a visible impact on the young population (aged 15–39 years). The present study aims to evaluate psychological distress among Indian adolescents and young adults (AYAs) with solid cancer using the National Comprehensive Cancer Network (NCCN) distress thermometer. Methods The demographic and clinical characteristics of AYAs patients (age 15–39 years) with cancer were recorded. Assessment of psychological distress of patients using the NCCN distress thermometer was performed at three time points over a period of 3 months. Distress thermometer scale and a self-administered questionnaire in English and Hindi languages was handed over to participants at three time points: at treatment commencement (T1), at 1 month, and 3 months (T2 and T3, respectively) into therapy. Results Of the 259 patients, 63% were women and 37% men; the median age was 34 years. In total, 71 (27%) were ≤ 24 years old and 188 (73%) were>24 years old. Bone sarcoma (39%) was common cancer in AYA patients aged ≤ 24 years and breast cancer (21%) in >24 years of age. The distress scores in both the groups were the highest at diagnosis (T1) followed by that measured at 1 (T2) and 3 months (T3) after diagnosis. The distress score in the age ≤ 24 years was the highest (6.7) at T1, followed by those measured at T2 (2.6) and T3 (1.1) and among age>24 years was the highest (6.6) at T1, followed by those measured at T2 (2.6) and T3 (1.2). Among AYA patients>24 years old, worry, nervousness, sadness, transportation, and sleep were the top five identified problems and in ≤ 24 years old, the top identified problems were worry, financial support, sleep, nervousness, and sadness. Conclusion Adolescents and young adults experience some level of distress associated with the cancer diagnosis, effects of the disease, treatment regardless of the stage and various transitions throughout the trajectory of the disease. The distress thermometer is an easy and useful tool for the assessment of psychological distress in AYA cancers. Early identification of distress burden with the distress thermometer leads to effective interventions in patients with cancer which could improve outcomes including survival in AYAs with cancer in India.

Among the many film industries of South Asia, the Indian film industry is the most prolific, specifically Hindi language film, more commonly known as Bollywood, which produces almost four hundred films annually. Bollywood films dominate the national market. These films have also been exported successfully to parts of the Middle East, Africa, and the Asiatic regions of the former Soviet Union, as well as to Canada, Australia, the UK, and the US. The success of these films abroad is largely down to the presence of Indian communities living in these regions; as the conventional melodramatic plot structures, dance numbers and musicals tend to deter Western audiences.

There There, Cheyenne and Arapaho writer Tommy Orange’s first novel, has been praised as "an astonishing literary debut" (Margaret Atwood), a "tense, prismatic book" (New York Times), a "breathtaking, haunting and gripping story" (Publishers Weekly), and has received multiple literary awards since its publication in 2018. This article explores Tommy Orange’s way of writing the Indian (back) into presence, in response to a “metaphorical,” as well as very “material” (Arif Dirlik) deletion of the “inconvenient Indian” (Thomas King) along centuries of American history. The discussion focuses on Tommy Orange’s understanding of storytelling as a way of continuing “Indian Wars” (E. Cook-Lynn) with the pen. Storytelling is a revisionist act in that it implicitly denies the stereotype of the vanishing race and re-places the Indigenous American not in a(n impossible) pre-colonial past, but in the land with which the Native has never ceased to remain connected. The characters’ stories, some in an autobiographical tone, others in the third person, narrate the Natives as “a present-tense people” (TT 141), grappling with a traumatic, far-from-romanticized past and present, but all the more alive for that.

(Ar) صناديق حفظ العمامة في العصر المغولي الهندية كمؤشرات ثقافية دراسة حضارية فنية تعبر التحف التطبيقية في عصر أباطرة مغول الهند عن حضارة المغول وإبداعتهم، وتعتبر صناديق حفظ العمامات مثالا رائعا لتلك التحف التي تعبر عن حضارة المغول، وتهدف الورقة البحثية لدراسة فنية لهذه الصناديق وكذلك ومسمي جعبة دستار وعلاقة المسمى بأداء الوظيفة التي من أجلها صنعت هذه الصناديق، ولقد كان لفلسة المغول بالهند سواء الأباطرة والأمراء في الاهتمام بالعمامة ومكانتها لديهم دور كبير في ظهور صناديق مخصصة للعمامة، وكانت العمامات تزين بالأحجار الكريمة والجواهر الغالية الامر الذي أدي أيضا إلى ظهور هذه الصناديق، وتعدد طرز صناديق حفظ العمامات في العصر المغولي الهندي فمنها المغطى بغطاء علي هيئة قباب بصلية وأنصاف كروية ومنها ذات الأشكال المضلعة، وظهرت التأثيرات البيئية بشكل كبير على زخارف هذه الصناديق وكان الزخارف مرتبطة بشكل كبير بثقافة الأقاليم الهندية التي أنتجت هذه الصناديق سواء مناظر معبودات أو مناظر كائنات حية وخرافية وزخارف نباتية وهندسية، وتهدف الورقة البحثية ايضا إلى دراسة المواد المستخدمة في صناعة هذه صناديق حفظ العمامات، فأستعمل الأخشاب والأوراق المعجنة papier-mâché كمواد أساسية في صناعة صناديق حفظ العمامات بعد أن تتم معالجتها لتصبح صالحة لأداء وظيفة الصندوق دون الحاق الضرر بمحتويات الصندوق من مواد غالية القيمة، ولقد تأثرت صناديق حفظ العمامات في تصميمها العام بشكل كبير بالمنشآت المعمارية كتأثير من العمارة المغولية الهندية المعاصرة. (En) Applied arts, e.g. turban boxes, in the era of Mughal Indian emperors express the Mughal's civilization and creativity. This paper is an artistic study of these boxes, as well as the name and its relation to fulfilling the function of the boxes. Mughals in India whether emperors or princes, paid considerable attention to turbans, as shown in having turban boxes. These turbans were decorated with gemstones and precious jewelry. Moreover, there were various patterns of turban boxes at the time. Some boxes had an onion-dome cover, semicircular covers, or polygons. The environment affected the decorations of these boxes considerably because they were largely related to the culture of the Indian regions that produced them, including deities, animals, mysterious creatures, as well as floral and geometric motifs. The present research paper aims to examine the materials used in manufacturing such turban boxes, as wood and papier-mâché that were processed to fit the function of the boxes and not to harm the precious contents. It showed that the general design of the turban boxes was affected largely by architectural constructions, e.g., the impact of contemporary Mughal Indian architecture.

Abstract Management strategies for chronic wasting disease (CWD) across tribal lands have varied in response to changing dynamics of CWD risk. As CWD continues to spread across the United States, concerns associated with the disease are increasing. We interviewed 19 natural resource managers representing Anishinaabe and Dakota tribes in Minnesota, Michigan, and Wisconsin with goals of understanding needs and opportunities for CWD engagement, surveillance, and outreach on tribal lands; the implementation of natural resources policy and management across tribal nations; and opportunities for tribal partnership‐development to control CWD. Qualitative data analyses of interview responses revealed substantial variation in the number of tribal hunters, hunter regulation, and huntable tribal lands across our study area. Proximity of tribal lands in relation to CWD detections impacted tribal agency management strategies for CWD. Our results indicate a desire for CWD outreach and surveillance, mutually beneficial collaborations, and a need for incorporating cultural knowledge into CWD management strategies. We conclude that tribal CWD management and surveillance plans will be enhanced through strategic and thoughtful CWD outreach methods. Moreover, partnerships must recognize tribal sovereignty and respectfully integrate tribal values, knowledge, and worldview.

Introduction:Malnutrition among adolescents is a persistent problem with a profound impact on different dimensions of health. The objective of this analysis is to assess the burden of malnutrition (Stunting, Thinness, Overweight, and Obesity) and their associated socio-demographic factors among Indian adolescents (10–19 years) from the Comprehensive National Nutritional Survey (CNNS 2016-18) data.MethodsWe used Individual-level data of 35,831 adolescents from the CNNS conducted in 2016–18 for this analysis. CNNS collected data on the nutritional status of adolescents along with socio-demographic variables from all states of India. Burden of stunting (Height for age Z score, HAZ < −2 SD), thinness (BMI for age Z score, BAZ < −2 SD), overweight (BAZ > 1 SD) and obesity (BAZ > 2 SD) were estimated for the entire country and individual states. A multivariable logistic regression analysis was used to assess the socio-demographic factors associated with stunting, thinness, and overweight.ResultsCNNS collected data from 35,831 adolescents, of which 31,941 with BAZ scores, and 32,045 with HAZ scores were included in the final analysis. The burden of stunting and thinness among Indian adolescents was 27.4% (95% CI 26.4, 28.4%) and 24.4% (23.5, 25.4%), respectively. The burden of overweight and obesity was 4.8% (4.5, 5.1%) and 1.1% (0.9, 1.3%), respectively. Adolescents in the age group of 15–19 years (AOR 1.23, 95% CI 1.11, 1.36) compared to 10–14 years, females (AOR 1.20; 1.08, 1.33) compared to males, were at increased odds of getting stunted. Adolescents from lowest wealth index families (AOR 1.66; 1.33, 2.07) were at increased odds of thinness compared to peers of higher wealth index families. Adolescents of 10–14 years (AOR 1.26, 95% CI 1.06, 1.49) compared to 15–19 years, urban residents (AOR 1.43, 95% CI 1.19, 1.71) compared to rural residents, were at increased odds of overweight.ConclusionIndian adolescents face the double burden of malnutrition that is undernutrition (stunting and thinness) alongside overnutrition (overweight and obesity) that are linked with socio-demographic factors. The National Nutritional Programs (POSHAN Abhiyan) should prioritize high-risk groups specifically older age group (15–19 years), females, and low wealth Index quintile families identified in this analysis.

Purpose: To study the effectiveness of part-time occlusion (PTO) in different types of amblyopia in Indian population. Methods: Prospective case series of consecutive cases of amblyopia from a tertiary care center were subjected to PTO of the better eye and monitored periodically for 6 months. Those who failed to improve by 6 months were shifted to full-time occlusion of the better eye and followed for a further 3 months. Results: 175 eyes of 175 patients with amblyopia underwent PTO for 6 months. The mean age of the patients was 10.47 ± 4.69 years (range: 3–26 years). Major subgroups included 94 eyes with strabismic amblyopia and 70 with anisometropic amblyopia. Overall, 168 (96%) children benefited from PTO (improvement being defined as a gain of at least one line of Snellen's visual acuity). The improvement rates for strabismic amblyopes (97.9%) was significantly more than anisometropia (94.3%); P = 0.027. Of the seven patients not responding to PTO, six did not benefit even after full-time patching. Conclusion: PTO is a viable and effective modality of management of amblyopia in Indian patients. Strabismic amblyopia was the commonest and responded best to the occlusion therapy in our cohort.

Polymorphous light eruption (PMLE) is the most common, idiopathic, acquired photodermatosis, characterized by abnormal, recurrent, and delayed reaction to sunlight. Polymorphous light eruption is common worldwide but the morphology, distribution, and pigmentary changes are unique in Indian skin which is discussed in this review. The prevalence of PMLE is around 10–20% in the general population. It commonly occurs in females between 20and 30 years of age. It is the most common photodermatosis in school-going children. Visible light sensitivity is an important phenomenon in PMLE. It typically presents as recurrent and chronic lesions over photoexposed sites. Initially, patchy erythema occurs with pruritus. Most of the Indians belong to type IV to type VI skin and pigmentary changes are commonly seen. The unique feature of PMLE in Indian skin is the pigmentary change which varies from hypopigmented to hyperpigmented lesions. These pigmentary changes may occur alone or in combination with erythematous or skin-colored lesions. The pigmentary lesions are seen in more than 50% of lesions. The histopathology of PMLE is characterized by the presence of hyperkeratosis, spongiosis with or without the presence of liquefactive degeneration in the epidermis. Dermal changes in the upper and mid dermis include the presence of dense perivascular lymphocytic infiltrate. The management of PMLE includes both preventive measures and medical management. Topical sunscreens, topical steroids, hydroxychloroquine and antioxidants play a very important role.

Background: Individuals with cleft lip and palate (CLP) and other craniofacial deformities are often perceived negatively in various social circumstances, resulting in failure to achieve full socio economic potential. Aim of the study: This study aimed to identify social stigmata and their causes associated with CLP and other deformities in an Indian population from a low socio-economic background, ways to reduce such effects and the potential reduction of disability following surgery. Methods: To assess the general awareness of the patients and their families regarding clefts, A GSR Institute: Cleft-Awareness Questionnaire (Reddy SG et al 2018) was used for data collection. 100 consecutive patients treated in GSR Institute for Craniofacial and Facial Plastic Surgery in Hyderabad, Telangana, were invited to join the study Statistical analysis regarding consanguineous marriage, understanding of clefts by parents and members of their community and of their societal conditions and the impact before and after surgery was carried out. Results: Statistical analysis using chi-squared test regarding the frequency of consanguineous marriage revealed no significant difference between the expected and observed frequencies in Telangana whereas there was a significant difference (p

Introduction: There is a dearth of normative data for radiological sagittal parameters of asymptomatic Indians. The present study aimed to address this lacuna. Materials and Methods: Sagittal radiological parameters were studied in asymptomatic volunteers: seven lumbopelvic, i.e., pelvic index (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), cranial LL (crLL), caudal LL (caLL), PI-LL; three thoracic and thoracolumbar, i.e., thoracolumbar alignment (TL), thoracic kyphosis (TK), T1 slope (TS0); five cervical, i.e., cervical sagittal vertical axis (cSVA), cervical lordosis (CL), TS-CL, C2 slope (CS), C2 T1 pelvic angle (CTPA); and lastly, five global parameters: SVA, T9 spinopelvic inclination (T9SPI), T1 spinopelvic inclination (T1SPI), T1 pelvic angle (TPA), C2 pelvic angle (CPA) were studied. Results: Volunteers (n = 125) aged 41.49±12.93 years were included. Mean PI, PT, SS, LL, crLL, caLL, PI-LL, TL, TK, TS, cSVA, CL, TS-CL, CS, CTPA, SVA, T9SPI, T1SPI, TPA, and CPA were 47.23±8.04°, 13.4±6.61°, 33.68±4.59°, −56.19±7.83°, −22.71±9.82°, −45.02±10.07°, −7.83±9.4°, 9.99±11.17°, 22±7.33°, 4.88±7.64°, 34.77±12.2 mm, −6.36±10.99°, −0.5±10.02°, 2.56±9.53°, 3.54±1.04°, −36.49±23.4 mm, −10.89±2.75°, −7.88±2.17°, 5.52±6.82°, and 10.72±6.69°, respectively. As per Roussouly’s classification, the distribution for types I, II, III, and IV was 32 (25.6%), 41 (32.8%), 45 (36%), and 7 (5.6%), respectively. LL correlated significantly with PI, SS, and TK. TS had significant correlation with CL and TS-CL. cSVA significantly correlated with CL. PI-LL significantly correlated with TS-CL. CS significantly correlated with cSVA and TS-CL. TS-CL significantly correlated with cSVA. TPA correlated significantly with PT, SVA, PI, and PI-LL. CTPA correlated significantly with CL, cSVA, TK, and TS-CL. Males had significantly different SVA (−35.3 mm), TK (22.4°), TS (6.2°), TPA (6.35°), cSVA (37.1 mm), and CTPA (3.95°) when compared with females (−58.4 mm, 17.2°, −0.15°, 0.3°, 24.95 mm, and 2.85°, respectively) (P = 0.008, 0.003, 0.002, 0.003, 0.002, and 0.0005, respectively). Conclusion: Normative data for sagittal profile in Indian volunteers, enunciated in this study, can be used to guide decisions in surgery.

Purpose: To study the corneal epithelial thickness with 9-mm scans of optical coherence tomography in normal Indians with appropriate representation of all age groups. Methods: This was a cross-sectional observational study. 263 patients were divided into the age groups 5–20 years, 21–35 years, 36–50 years and more than 51 years were recruited for the study. All patients underwent a detailed ophthalmic examination. Patients found to have any ocular surface or intraocular disease condition (except cataract and refractive error), or who had undergone any ophthalmic surgery in the past, or had corneal topography changes suggestive of corneal ectasias (screened in patients with astigmatism more than 3 diopters) or had been continuously using any topical medication in either eye for a period of 3 months or more with the last instillation being within 1 month of inclusion in the study were excluded. All subjects underwent corneal epithelial thickness measurement with anterior segment optical coherence tomography (AS-OCT) on the Avanti OCT (Model RTVueXR1002, Optovue, USA). The corneal epithelial thickness (CET) data from 25 sectors in each eye were analyzed. Results: 263 right and left eyes of 263 patients were analyzed in the study. Mean CETs in the central 2 mm zone were 54.13 ± 4.51 μm and 54.37 ± 3.75 μm for the right and left eyes, respectively. The superior peripheral sectors and inferior paracentral sectors were the thinnest and the thickest sectors, respectively, in both eyes. Conclusion: CET parameters for Indian eyes are comparable to those reported from racially distinct and geographically distant study subjects.

Context: Autoantibodies have a role in the diagnosis and prognosis in Autoimmune Inflammatory Myositis (AIM). Aims: The aim of this work was to study the prevalence and clinical correlation of myositis specific and associated antibodies (MSA and MAA) in AIM. Setting and Design: This was a cross-sectional observational study. Methods and Materials: Consecutive AIM patents were divided into groups as dermatomyositis (DM), polymyositis (PM), CTD-associated myositis (CTD-M), cancer-associated myositis (CAM) and juvenile myositis (JM). Their data along with serum samples were collected after obtaining informed consent. Sera was analyzed for IgG antibodies against Jo-1, PL-7, PL-12, EJ, SRP, Mi-2, MDA-5, TIF1γ, SAE1, SAE2, NXP2 and SSA/R052kD using the microELISA technique. The institutional ethics committee approved the study. Statistical Analysis: SPSS software (version 24.0) was used. P value < 0.05 was considered statistically significant. Results: There were 48 patients (DM = 19, PM = 19, CTD-M = 5, CAM = 2, JM = 3) included. MSA were positive in 37.5% patients. Antibodies against Mi-2 were present in 6 (12.5%), Jo-1 in 5 (10.4%), 2 (4.1%) each had PL-7 and SRP antibodies. One patient (2%) each had MDA-5, NXP2 and TIf1g antibodies. Jo-1 antibody was associated with mechanic's hands and ILD. There was a significant association of rash in the Mi-2 group with none of the patients having ILD. Malignancy screening was negative in NXP2 and TIF1g antibody-positive patients. Ro52 was the most common MAA (33.3%) and was associated with mechanic's hand. Conclusion: MSA was present in almost 40% of the cohort. Anti Jo-1 antibody was associated with mechanic's hands and ILD. None of the Mi-2 patients had ILD, which may point to a protective role of this antibody for ILD. The association of newer antibodies in Indian patients needs to be further studied in larger cohorts.

Introduction: There is a growing body of evidence against using World Health Organization (WHO) charts for developing nations. Our objectives were: 1) To compare nutritional status of -0.5 (clinically significant), whereas on WHO charts all wealth classes had WHZ

Background: Bariatric surgery, besides causing significant weight reduction, leads to improvement in type 2 diabetes mellitus (T2DM). However, there is a scarcity of data on the prediction of diabetes resolution in non-Western population. Objective: To evaluate the impact of bariatric surgery on T2DM and to assess the accuracy of pre-operative scoring systems in predicting remission. Study Setting: A tertiary care academic centre, India. Methodology: We used a retrospective cohort of all diabetic patients (n = 244) who underwent bariatric surgery at our centre in the past 10 years. The cohort was followed up for diabetes remission, and pre-operative scoring systems were analysed against the observed results. Results: Of 244 patients, we were able to contact 156 patients. The median period of follow-up was 38 months. The mean body mass index (BMI) of the study group decreased from 45.4 to 33.4 kg/m2 (%excess BMI loss = 61.2%). The number of patients dependent on oral anti-diabetic pharmacotherapy and on insulin decreased from 133 (85.3%) to 40 (25.6%) and from 31 (19.9%) to 7 (4.5%), respectively. Remission was analysed for 96 patients, who submitted complete biochemical investigations. The median follow-up period for this sub-cohort was 36 months. 38 (39.6%) patients were in complete remission, 15 (15.6%) patients in partial remission and 34 (38.5%) patients showed an improved glycaemic control. The three pre-operative scores, Advanced-DiaRem, DiaRem and ABCD, showed predictive accuracies of 81.1%, 75.6% and 77.8%, respectively. Conclusions: Besides leading to excess BMI loss of 61.2%, bariatric surgery also resulted in diabetes remission in 55.2% of the patients. Amongst various pre-operative scores, Advanced-DiaRem has the highest predictive accuracy for T2DM remission.

Introduction The COVID-19 virus has already caused a pandemic and needs no fresh introduction. Many studies in western literature have described the prevalence of anosmia and ageusia as symptoms of COVID-19. However, to our knowledge, there is no study describing the trend of new onset ageusia amongst covid positive patients in the Indian population. The objective of this study is to analyze the trend of new onset ageusia in COVID-19 affected individuals in the Indian population. Materials and Methods This is a retrospective observational study conducted in a treatment facility set up in Eastern part of India. The data was collected from Sep 2020 to Dec 2020. The study included 422 patients who were laboratory confirmed COVID-19 positive cases. Clinical data was extracted from the medical records of the patients. All the patients were treated as inpatients. The data was collected by Critical care specialist and Physician. All patients were classified as asymptomatic and symptomatic. The presence or absence of new onset ageusia was documented and statistically analyzed. Results Of 422 cases studied, 401 (95.0%) were male and 21 (5.0%) were female with the mean age of 37.9 ± 8.3 years. 147 (34.8%) were symptomatic and 275 (65.2%) were asymptomatic with 18 % (76/422) patients having ageusia in the study population. Conclusion The prevalence of ageusia amongst covid positive patients in Indian population is lesser as compared to reports in the western literature. The cause of this difference in prevalence of ageusia in different ethnicities is unknown. Apparently healthy individuals with new onset ageusia should be considered as asymptomatic covid carriers and should be treated accordingly.

Introduction The COVID-19 virus has already caused a pandemic and needs no fresh introduction. Many studies in western literature have described the prevalence of anosmia and ageusia as symptoms of COVID-19. However, to our knowledge, there is no study describing the trend of new onset ageusia amongst covid positive patients in the Indian population. The objective of this study is to analyze the trend of new onset ageusia in COVID-19 affected individuals in the Indian population. Materials and Methods This is a retrospective observational study conducted in a treatment facility set up in Eastern part of India. The data was collected from Sep 2020 to Dec 2020. The study included 422 patients who were laboratory confirmed COVID-19 positive cases. Clinical data was extracted from the medical records of the patients. All the patients were treated as inpatients. The data was collected by Critical care specialist and Physician. All patients were classified as asymptomatic and symptomatic. The presence or absence of new onset ageusia was documented and statistically analyzed. Results Of 422 cases studied, 401 (95.0%) were male and 21 (5.0%) were female with the mean age of 37.9 ± 8.3 years. 147 (34.8%) were symptomatic and 275 (65.2%) were asymptomatic with 18 % (76/422) patients having ageusia in the study population. Conclusion The prevalence of ageusia amongst covid positive patients in Indian population is lesser as compared to reports in the western literature. The cause of this difference in prevalence of ageusia in different ethnicities is unknown. Apparently healthy individuals with new onset ageusia should be considered as asymptomatic covid carriers and should be treated accordingly.

Objectives: To determine efficacy and safety of sacubitril/valsartan compared with enalapril in Indian patients of PARADIGM-HF trial. Methods: A randomized, double-blind, active-controlled, phase III sub-study (NCT01035255) was conducted between April 2010 and May 2014. Patients with chronic heart failure (HF), aged >18 years with left ventricular ejection fraction ≤40% were randomized (1:1) to receive either sacubitril/valsartan 200 mg twice-daily or enalapril 10 mg twice-daily. The primary endpoint was to compare efficacy of sacubitril/valsartan to enalapril in delaying time-to-first occurrence of the composite endpoint (cardiovascular [CV] death or HF hospitalization). Results: The trial was stopped after a median follow-up of 27 months, because the boundary for benefit with sacubitril/valsartan had crossed. Among 637 Indian patients in PARADIGM-HF (sacubitril/valsartan, n = 322 and enalapril, n = 315), the primary outcome, CV death, and the first hospitalization for HF occurred in 21.81% and 24.76% (HR 0.89; 95% CI, 0.646–1.231), 17.45% and 20.63% (HR 0.87; 95% CI, 0.605–1.236), and 7.48% and 9.52% (HR 0.78; 95% CI, 0.461–1.350) patients in the sacubitril/valsartan and enalapril group, respectively. The all-cause mortality (19.0% vs. 21.9%) and adverse events (78.4% vs. 82.2%) were comparatively lower in the sacubitril/valsartan than enalapril group. No significant difference was seen between the benefits of treatment in Indian and the total PARADIGM-HF cohort (p value for interaction >0.05). Conclusion: Results support the use of sacubitril/valsartan in Indian patients with chronic HF with reduced ejection fraction with treatment benefits similar to global PARADIGM-HF cohort.

İslâm dini, barış, adalet ve sevgiyi tevhid temelinde yükselterek insanlar arasında yerleştirmek üzere gönderilen bir dindir. İslâm, tüm insanlığa hitap eder ve ırk, asalet ve cinsiyete bağlı bir üstünlük ve ayrıcalığa yer vermez. Dolayısıyla kadın ve erkek de insanlık düzleminde denktirler. İslâm’dan önceki toplumlarda ise durum bu şekilde değildir, kadının konumu çoğu zaman erkekten aşağıdadır. Kadına hak ettiği yeri İslâm, yeniden kazandırmıştır. Bu çalışmada öncelikle İslâm’ın kadına bakışı söz konusu edilecek, ardından Eski Yunan, Roma, Yahudilik, Hıristiyanlık ve Hint kültürlerinde kadının konumuna değinilecek ve sonrasında İslâm’ın kadına bakışı daha detaylı ele alınarak kadının İslâm’daki ve mezkûr din ve kültürlerdeki konumu kıyaslanacaktır.

Obesity has emerged as the most potential cardiovascular risk factor and has raised concern among public and their health related issues not only in developed but also in developing countries. The Worldwide obesity occurrence has almost has gone three times since 1975. Research suggests there are about 775 million obese people in the World including adult, children, and adolescents. Nearly 50% of the children who are obese and overweight in Asia in are below 5 years. There is a steep incline of childhood obesity when compared to 1971 which is not only in developed countries but also in developing countries. A considerable amount of weight gain occurs during the transition phase from adolescence to young adulthood. It is also suggested that those adults who were obese in childhood also remained obese in their adulthood with a higher metabolic risk than those who became obese in their adulthood. In India, the urban Indian female in the age group of 30-45 years have emerged as an 〝at risk population” for cardiovascular diseases. To understand how obesity can influence cardiovascular function, it becomes immense important to understand the changes which can take place in adipose tissue due to obesity. There are two proposed concepts explaining the inflammatory status of macrophage. The predominant cause of insulin resistance is obesity. Epidemiological and research studies have indicated that the pathogenesis of obesity-related metabolic dysfunction involves the development of a systemic, low-grade inflammatory state. It is becoming clear that targeting the pro-inflammatory pathway may provide a novel therapeutic approach to prevent insulin resistance, particularly in obesity induced insulin resistance. Some cost effective interventions that are feasible by all and can be implemented even in low-resource settings includes - population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden. The sixth target in the Global NCD action plan is to reduce the prevalence of hypertension by 25%. Reducing the incidence of hypertension by implementing population-wide policies to educe behavioral risk factors. Reducing cigarette smoking, body weight, blood pressure, blood cholesterol, and blood glucose all have a beneficial impact on major biological cardiovascular risk factors. A variety of lifestyle modifications have been shown, in clinical trials, to lower blood pressure, includes weight loss, physical activity, moderation of alcohol intake, increased fresh fruit and vegetables and reduced saturated fat in the diet, reduction of dietary sodium intake, andincreased potassium intake. Also, trials of reduction of saturated fat and its partial replacement by unsaturated fats have improved dyslipidaemia and lowered risk of cardiovascular events. This initiative driven by the Ministry of Health and Family Welfare, State Governments, Indian Council of Medical Research and the World Health Organization are remarkable. The Government of India has adopted a national action plan for the prevention and control of non-communicable diseases (NCDs) with specific targets to be achieved by 2025, including a 25% reduction in overall mortality from cardiovascular diseases, a 25% relative reduction in the prevalence of raised blood pressure and a 30% reduction in salt/sodium intake. In a nutshell increased BMI values can predict the nature of obesity and its aftermaths in terms inflammation and other disease associated with obesity. It’s high time; we must realize it and keep an eye on health status in order to live long and healthy life.

Abstract Introduction Patients with androgenetic alopecia treated with alcohol-based minoxidil topical solutions often report local irritation, dryness, and redness of the scalp. We evaluate the in-use tolerance of 5% minoxidil novel formulation topical solution—test product (TP)—compared with 5% minoxidil alcohol-based topical solutions—reference product 1 (RP1) and reference product 2 (RP2)—in Indian men with androgenetic alopecia. Methods In this randomized double-blind study, patients aged ≥ 18 years with androgenetic alopecia were randomized 1:1:1 to apply TP, RP1, and RP2 twice daily for 30 days. The safety endpoints included mean hydration, mean redness, and mean scaling on scalp. Results All screened patients (N = 100) were enrolled and randomized to TP (n = 33), RP1 (n = 33), or RP2 (n = 34). At day 30, the mean (SD) hydration was significantly increased in patients treated with TP [9.74 (4.98)] but significantly reduced in patients treated with RP1 [3.28 (2.67)] or RP2 [3.03 (1.57)] (p-value 0.001). The mean (SD) score for redness was significantly decreased in the TP group [0.01 (0.04)], (p-value, 0.009) at day 30 compared with baseline, while no change was observed in the RP1 [0.08 (0.13)] or RP2 [0.11 (0.17)] group. After 30 days of treatment, no significant difference was observed in the mean score of scaling in any of the three groups. Conclusions Twice daily application of 5% minoxidil novel formulation for 30 days significantly improved hydration and reduced redness of the scalp. Hence, 5% minoxidil novel formulation could be a safer alternative in treating men with androgenetic alopecia who are sensitive to alcoholic formulations. Trial Registration Clinical Trial Registry of India; CTRI/2018/11/016431.

Purpose: To describe visual morbidity in thyroid orbitopathy in Asian Indians and the factors influencing its onset. Methods: A retrospective chart review was performed for patients with thyroid related orbitopathy seen between May 2014 and April 2019. Three hundred and one patients were included in the study. Relevant history, clinical findings, investigations, and treatment were documented. Results: Nineteen percent of patients had at least 1 visual morbidity feature such as compressive optic neuropathy, exposure keratopathy or diplopia, requiring intravenous glucocorticoid. Male gender, older age, and diabetes were the significant risk factors for high visual morbidity (all P < 0.05). Systemic thyroid status, degree of proptosis, and duration of disease were not significant. Average dose of intravenous glucocorticoid needed was 3.8 g; 24 (7.9%) patients required orbital decompression, and 13 (4.3%) needed eyelid surgery. At the last follow-up, 97% of patients had vision 6/12 or better in both eyes. Conclusion: There is significant visual morbidity found in Indian patients with TED, even with moderate proptosis and systemic control of thyroid status. This is the first set of data on the subject.

Objective: The Asian American population in the U.S. comprises various, ethnically diverse subgroups. Traditionally, this population has been studied as a single, aggregated group, potentially masking differences in risk among subgroups. Analyses using disaggregated data can help better characterize the health needs of different Asian subpopulations and inform targeted, effective public health interventions. We assessed the prevalence of cardiovascular disease (CVD) risk factors and atherosclerotic CVD (ASCVD) and their associations with socioeconomic factors among Chinese, Asian Indian, Filipino and Other Asian subjects, compared with non-Hispanic White (NHW) subjects in the U.S. Methods: : Cross-sectional study using data from 298,286 adults from the National Health Interview Survey (NHIS) from 2007 to 2018. We utilized chi-squared tests to compare characteristics across subgroups. Weighted proportions and unadjusted and adjusted logistic regression models were utilized to examine the associations between Asian subgroups, self-reported CVD risk factors and self-reported ASCVD, as well as between socioeconomic factors within each Asian subgroup. Results: : Asian Indian subjects had the highest prevalence of diabetes (12.5%), while Filipino subjects had the highest prevalence of hyperlipidemia (27.7%), hypertension (29.8%) and obesity (19.8%). Despite this, the prevalence of self-reported ASCVD was lower in all Asian groups compared with NHWs. Chinese subjects had the lowest odds of having each of the CVD risk factors assessed. Conclusion: : We found considerable heterogeneity in the distribution of risk factors as well as ASCVD among Asian subgroups in the US. Compared with health system or community-based reports, the prevalence of risk factors and ASCVD may be underestimated in some Asian NHIS subgroups. There is an urgent need for efforts to improve recruitment of Asian participants of heterogeneous socioeconomic backgrounds in national surveys, as well as to perform a thorough assessment of risk factors and disease in this population, not relying solely on self-report.

This research is an annotated translation in which the researcher provides detailed explanation to account for his selection of translation equivalents. The data source in this research is The Soul of the Indian, a book by Charles Alexander Eastman. This study sought to identify problems encountered over the course of translation and offer the solutions thereto. The data for the study were derived from the problems thus identified and classified into categories of annotation. The qualitative method was employed using a comparative analysis translation model. The key findings of this research are twofold. First, out of 27 units of analysis, 8 are names of or designations for a God or Deity, 1 is the name of a ceremony, 1 is a designation for a spiritual figure, 1 is a name of a spiritual practice, 4 are figures of speech, 9 involve specific terms, and 3 are collocations. The translation itself employed 8 different procedures, with combined procedures being predominantly used. Second, the difficulties encountered when dealing with the problems were solved by employing relevant translation theories, methods, and procedures. These findings demonstrate that Indian spiritualism and culture are interrelated so that the annotation data obtained are not only spiritual in nature but also cultural. A translator should be knowledgeable not only about spiritualism, but also culture prevailing in both the source and target language communities.

Sin dalla sua scoperta a Pompei nel 1938, la statuetta in avorio di manifattura indiana non ha smesso di porre interrogativi sul suo soggetto, sulla sua provenienza, sulla sua funzione prima di arrivare nel municipium campano. In questo contributo, dopo una disamina dello status quaestionis sulla statuetta (datazione, possibile iconografia, provenienza, contesto di rinvenimento) ci si chiederà chi potesse essere il suo proprietario e che cosa avrebbe potuto rappresentare per lui un manufatto tanto particolare. Una risposta potrebbe giungere dalle Metamorfosi di Ovidio, in particolare da una sezione del decimo libro dedicata a miti connessi con l’avorio e la prostituzione femminile, e dall’usanza romana di esporre, durante i banchetti, oggetti curiosi per stimolare la conversazione. Since its discovery, which took place in Pompeii in 1938, the ivory statuette of Indian manufacture has not stopped asking questions about its subject, its origin, its function before its arrival in the Roman municipium. In this paper, after an examination of the status quaestionis on the statuette (dating, possible iconography, provenance, context of discovery) I will try to understand who could be its owner and therefore what a Pompeian of the first century could have seen in such a particular artifact. An answer may come from Ovid's Metamorphoses, in particular from a section of the tenth book dedicated to myths associated with ivory and female prostitution, and from the Roman custom to exhibit curious objects to stimulate conversation during banquets.