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Abstract Functionalized nanomaterials (FN) have gained significant global attention due to their unique nanoscale properties and promising applications in clean energy storage, especially in supercapacitors (SCs). SCs, known for their rapid charging, high power density, and long cycle life, store energy through electrical double layer capacitance (EDLC) and pseudocapacitance mechanisms. FN enhance SC performance by combining various constituents, leveraging effects such as improved electronic, optical, and mechanical properties. Techniques like non-covalent coupling, pore tuning, doping, and compositing are employed to enhance electrochemical properties by creating abundant active surfaces and minimizing ion transport pathways. To address energy density limitations, hybrid capacitors, also called asymmetric SCs, combine battery-type materials (e.g., metal oxides, conducting polymers) with carbon-based electrode materials to utilize redox processes and electrical double layers. These innovations aim to overcome the lower energy density seen in traditional secondary batteries, such as lithium-ion batteries. This review highlights advancements from the past decade in the application of functionalized nanomaterials, including carbon, conducting polymers, and metal oxides, in three main types of SCs: EDLCs, pseudocapacitors, and hybrid capacitors. It covers their composition, structure, device fabrication, properties, and electrochemical performance, emphasizing their potential to revolutionize energy storage technologies.

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With the discovery of low-density lipoprotein (LDL) receptor in 1980s much of the therapeutic developments have had a robust influence in LDL-c reduction and guidelines globally have documented targets for LDL-c and other lipoproteins. Despite the advances, the risk for atherosclerotic cardiovascular disease (ASCVD) remains high globally and the prevalence of ASCVD has increased since 1990 from 271 million to 523 million in 2019. With time it has become evident that at any level of LDL-c, ASCVD events rate are a 2-3 fold risk higher, when lipoprotein little a Lp(a) level is elevated. Furthermore, the ASCVD risk from elevated Lp(a) has been demonstrated to be similar in magnitude to each of the established major risk factors (hypercholesterolemia, smoking, hypertension, diabetes, etc.). It means unlike other established risk factors, but like homozygous familial hypercholesterolemia, Lp(a) levels influence atherogenicity from birth. Since 24% of the world's population (1.891 billion) is in South Asia (India, Pakistan, Afghanistan, Nepal, Bangladesh, and Sri Lanka) and Indians do tend to elicit ASCVD 5-10 years earlier than other populations; clinicians in this geography may be prudent to consider intervention without waiting given the early incidence of disease and the high burden of illness in this geography. There are no approved medications for lowering Lp(a), but medications have been demonstrated to modulate Lp(a). Except for statins most currently available hypolipidemic agents demonstrate mixed and perhaps ambiguous effects on Lp(a). Emerging nucleic acid-based therapies allow for selective gene silencing, thus preventing the production of proteins that may cause or enhance ASCVD. This review summarise available scientific knowledge and progress made in understanding Lp(a) and the current research that is in works of planned with newer therapeutics.

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With an extensive range of distinctive features at nano meter-scale thicknesses, two-dimensional (2D) materials drawn the attention of the scientific community. Despite tremendous advancements in exploratory research on 2D materials, knowledge of 2D electrical transport and carrier dynamics still in its infancy. Thus, here we highlighted the electrical characteristics of 2D materials with electronic band structure, electronic transport, dielectric constant, carriers mobility. The atomic thinness of 2D materials makes substantially scaled field-effect transistors (FETs) with reduced short-channel effects conceivable, even though strong carrier mobility required for high performance, low-voltage device operations. We also discussed here about factors affecting 2D materials which easily enhanced the activity of those materials for various applications. Presently, Those 2D materials used in state-of-the-art electrical and optoelectronic devices because of the extensive nature of their electronic band structure. 2D materials offer unprecedented freedom for the design of novel p-n junction device topologies in contrast to conventional bulk semiconductors. We also, describe the numerous 2D p-n junctions, such as homo junction and hetero junction including mixed dimensional junctions. Finally, we talked about the problems and potential for the future.

For a positive integer \(m\) and a finite non-negative Borel measure \(\mu\) on the unit circle, we study the Hadamard multipliers of higher order weighted Dirichlet-type spaces \(\mathcal H_{\mu, m}\). We show that if \(\alpha\gt\frac{1}{2}\), then for any \(f\) in \(\mathcal H_{\mu, m}\) the sequence of generalized Cesàro sums \(\{\sigma_n^{\alpha}[f]\}\) converges to \(f\). We further show that if \(\alpha=\frac{1}{2}\) then for the Dirac delta measure supported at any point on the unit circle, the previous statement breaks down for every positive integer \(m\).

Background: Chronic myeloid leukemia (CML) is the most common leukemia in India. The annual incidence of CML in India was originally reported to be 0.82.2 per 100,000 population. CML is a clonal disorder that is usually easily diagnosed by the Philadelphia chromosome. The approval of tyrosine kinase inhibitors has significantly reduced the mortality rate associated with CML and revolutionized treatment. Materials and Methods: Eighty patients diagnosed with CML were studied. Investigations were done and with European Treatment and Outcome Study (EUTOS) patients were stratified into low- and high-risk group and then treatment with Imatinib was given to all patients and molecular response was evaluated. Results: In the study population, out of 80 patients, 40 were female and 40 were male with M: F is 1:1. Out of total 80 patients', maximum patients (54) were in 31-60 years age group. Our study showed that the most common symptom of presentation is abdominal discomfort followed by fever. Out of total 80 patients, 25 (31.3%) patients had high EUTOS score and 55 (68.8%) patients had low EUTOS score. On 6 months' follow-up, 36.3% patients had complete molecular response, 16.3% patients had major molecular response and 47.5% patients had no molecular response, but on 12 months' follow-up, 71.3% patients had complete molecular response, 16.25% patients had major molecular response, and 12.5% patients had no molecular response. Conclusion: In this observational study, we found a significant correlation between EUTOS score and molecular response at 6 months and 12 months follow-up after Imatinib therapy.

Using first-principles calculations, in this piece of work, authors have investigated the physical properties of Ra2LaNbO6 double perovskite by employing the linearized augmented plane wave (LAPW) method. Structural and electronic properties are determined by using LDA, GGA (WC and PBE), LDA + mBJ, and GGA + mBJ potentials. We have found that Ra2LaNbO6 is an indirect band gap (Eg = 2.4 eV) semiconductor. Its elastic and thermodynamic parameters demonstrate its stability. Its optical study indicates that this material opens the door to its applications in optical devices such as photodetectors, solar cells, superlenses, optical fibers, filters, electromagnetic shielding devices, photovoltaic devices, etc. This material is very good for its practical implementation in thermoelectric devices as both p- and n-type material and extends the interest of experimentalists for further investigations. Thus, Ra2LaNbO6 is found thermodynamically stable and identified as a potential candidate for photovoltaic and thermoelectric devices.

Premature coronary artery disease (CAD) is endemic in India. Global Burden of Diseases study has reported that it led to 286,000 deaths in 2019 in India. Many of these patients have standard risk factors but a third have none. Clinical risk algorithms and imaging provide limited risk information in premature CAD. CAD is multifactorial and studies have now focused on the predictive capability of clusters of genes and single nucleotide polymorphisms (SNPs) using gene risk score (GRS). Older studies combined data from 10 to 12 genes and 100–500 SNPs to calculate GRS, however, following the advent of genome-wide association studies (GWAS), millions of SNPs have been incorporated. Studies have reported that GWAS-based GRS may be more discriminative than conventional tools. Recent studies, especially among South Asians, have reported that GRS improves net reclassification by 15% (12–19%) for younger individuals. Aggressive lifestyle interventions and lipid-lowering therapies can ameliorate risk in high-GRS individuals and potentially prevent premature CAD.

Abstract High-quality reference genome assemblies, representative of global heterotic patterns, offer an ideal platform to accurately characterize and utilize genetic variation in the primary gene pool of hybrid crops. Here we report three platinum grade de-novo, near gap-free, chromosome-level reference genome assemblies from the active breeding germplasm in pearl millet with a high degree of contiguity, completeness, and accuracy. An improved Tift genome (Tift23D2B1-P1-P5) assembly has a contig N50 ~ 7,000-fold (126 Mb) compared to the previous version and better alignment in centromeric regions. Comparative genome analyses of these three lines clearly demonstrate a high level of collinearity and multiple structural variations, including inversions greater than 1 Mb. Differential genes in improved Tift genome are enriched for serine O-acetyltransferase and glycerol-3-phosphate metabolic process which play an important role in improving the nutritional quality of seed protein and disease resistance in plants, respectively. Multiple marker-trait associations are identified for a range of agronomic traits, including grain yield through genome-wide association study. Improved genome assemblies and marker resources developed in this study provide a comprehensive framework/platform for future applications such as marker-assisted selection of mono/oligogenic traits as well as whole-genome prediction and haplotype-based breeding of complex traits.

Dyslipidemias are the most important coronary artery disease (CAD) risk factor. Proper management of dyslipidemia is crucial to control the epidemic of premature CAD in India. Cardiological Society of India strived to develop consensus-based guidelines for better lipid management for CAD prevention and treatment. The executive summary provides a bird's eye-view of the ‘CSI: Clinical Practice Guidelines for Dyslipidemia Management’ published in this issue of the Indian Heart Journal. The summary is focused on the busy clinician and encourages evidence-based management of patients and high-risk individuals. The summary has serialized various aspects of lipid management including epidemiology and categorization of CAD risk. The focus is on management of specific dyslipidemias relevant to India-raised low density lipoprotein (LDL) cholesterol, non-high density lipoprotein cholesterol (non-HDL-C), apolipoproteins, triglycerides and lipoprotein(a). Drug therapies for lipid lowering (statins, non-statin drugs and other pharmaceutical agents) and lifestyle management (dietary interventions, physical activity and yoga) are summarized. Management of dyslipidemias in oft-neglected patient phenotypes-the elderly, young and children, and patients with comorbidities-stroke, peripheral arterial disease, kidney failure, posttransplant, HIV (Human immunodeficiency virus), Covid-19 and familial hypercholesterolemia is also presented. This consensus statement is based on major international guidelines (mainly European) and expert opinion of lipid management leaders from India with focus on the dictum: earlier the better, lower the better, longer the better and together the better. These consensus guidelines cannot replace the individual clinician judgement who remains the sole arbiter in management of the patient.

Dyslipidemias are the most important coronary artery disease (CAD) risk factor. High total cholesterol and its principal subtypes: low-density lipoprotein (LDL) cholesterol and non-high-density lipoprotein (NHDL) cholesterol are the most important. Epidemiological and Mendelian randomization studies have confirmed role of raised triglycerides and lipoprotein(a). INTERHEART study reported a significant association of raised ApoB/ApoA1, total-, LDL-, and NHDL-cholesterol in South Asians. Prospective Urban Rural Epidemiology (PURE) study identified raised NHDL cholesterol as the most important risk factor. Regional and multisite epidemiological studies in India have reported increasing population levels of total-, LDL-, and NHDL cholesterol and triglycerides. India Heart Watch reported higher prevalence of total and LDL cholesterol in northern and western Indian cities. ICMR-INDIAB study reported regional variations in hypercholesterolemia (≥200 mg/dl) from 4.6 % to 50.3 %, with greater prevalence in northern states, Kerala, Goa, and West Bengal. Non-Communicable Disease Risk Factor Collaboration and Global Burden of Diseases Studies have reported increasing LDL- and NHDL-cholesterol in India. Studies among emigrant Indians in UK and USA have reported higher triglycerides in compared to Caucasians. Identification of regional variations and trends in dyslipidemias need more nationwide surveys. Prospective studies are needed to assess quantum of risk with CAD incidence.

Accurate measurement of various lipids- total cholesterol, cholesterol lipoproteins and triglycerides- is important for coronary artery disease (CAD) prevention and management. Over the years many technologies have developed for their accurate measurements and in recent years the assays have been internationally standardised. Most of the guidelines recommend measurement of non fasting levels of total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL cholesterol (non-HDL-C) and triglycerides (TG) for risk estimation and guiding treatment. Measurement of lipid profile in clinics and emergency departments can lead to earlier estimation of CAD risk and rapid initiation of lipid lowering therapy. CAD risk and baseline levels of LDL-C guide intensity of lipid lowering therapies. The LDL-C targets according to CAD risk are detailed in this review. There is an urgent need for standardization of lipid estimation in medical laboratories across the country so that every eligible individual can receive evidence-based lipid lowering interventions.

Objective The study examined the influence of the COVID-19 pandemic in India on variation in clinical features, management and in-hospital outcomes in patients undergoing percutaneous coronary intervention (PCI).Design Prospective registry-based observational study.Setting A tertiary care hospital in India participant in the American College of Cardiology CathPCI Registry.Participants 7089 successive patients who underwent PCI from April 2018 to March 2023 were enrolled (men 5627, women 1462). Details of risk factors, clinical presentation, coronary angiography, coronary interventions, clinical management and in-hospital outcomes were recorded. Annual data were classified into specific COVID-19 periods according to Government of India guidelines as pre-COVID-19 (April 2018 to March 2019, n=1563; April 2019 to March 2020, n=1594), COVID-19 (April 2020 to March 2020, n=1206; April 2021 to March 2022, n=1223) and post-COVID-19 (April 2022 to March 2023, n=1503).Results Compared with the patients in pre-COVID-19 and post-COVID-19 periods, during the first COVID-19 year, patients had more hypertension, non-ST elevation myocardial infarction (NSTEMI), lower left ventricular ejection fraction (LVEF) and multivessel coronary artery disease (CAD). In the second COVID-19 year, patients had more STEMI, lower LVEF, multivessel CAD, primary PCI, multiple stents and more vasopressor and mechanical support. There were 99 (1.4%) in-hospital deaths which in the successive years were 1.2%, 1.4%, 0.8%, 2.4% and 1.3%, respectively (p=0.019). Compared with the baseline year, deaths were slightly lower in the first COVID-19-year (age-sex adjusted OR 0.68, 95% CI 0.31 to 1.47) but significantly more in the second COVID-19-year (OR 1.97, 95% CI 1.10 to 3.54). This variation attenuated following adjustment for clinical presentation, extent of CAD, in-hospital treatment and duration of hospitalisation.Conclusions In-hospital mortality among patients with CAD undergoing PCI was significantly higher in the second year of the COVID-19 pandemic in India and could be one of the reasons for excess deaths in the country. These patients had more severe CAD, lower LVEF, and more vasopressor and mechanical support and duration of hospitalisation.

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Introduction: Prior bariatric surgery (PBS) status in obese patients is thought to curtail the risk of cardiovascular events, but its role in change of outcomes of patients with obesity developing new acute cardiac events such as cardiac arrests (CA) remains largely unknown. Methods: Hospitalizations among adult patients with obesity and CA were identified retrospectively using the National Inpatient Sample (2015 October-2017 December). Propensity-matched analysis (1:1) was performed for sociodemographic/hospital characteristics to identify two cohorts, with (PBS+) or without (PBS-) status. The primary endpoint was in-hospital mortality, and the secondary endpoint was healthcare resource utilization. Results: Both cohorts (n = 1275 each), had patients with comparable age (mean 58 years), with a higher frequency of white (>70 %), females (>60 %), and Medicare enrollees (>40 %). PBS + cohort had lower rates of diabetes (27.8 % vs 36.1 %), hyperlipidemia (33.7 % vs 48.6 %), renal failure (17.3 % vs 22.0 %), chronic pulmonary disease (11.8 % vs 21.2 %) and higher rates of anemias (18.4 % vs 12.2 %), liver disease (5.1 % vs 2.4 %) and alcohol abuse (6.7 % vs 2.4 %) than PBS- cohort (p

Objective: Registry-based prospective study was conducted to evaluate association of body mass index (BMI) with major adverse coronary events (MACE) following percutaneous coronary intervention (PCI). Methods: Successive patients undergoing PCI were enrolled from April‘19 to March’22 and classified into five BMI categories (

In contemporary world, poisonous gases, gas leaks, and greenhouse gas emissions are all often caused by various societal sectors. It might have an impact on the ecosystem, biodiversity, and human lifestyles all around the world. So, importance of gas sensors is increased. Researchers have often concentrated on gases like NH3, NO2, CO2, LPG, H2, etc. in the history. One potential material for this sensor is the conducting polymer, which has shown great promise in ambient gas detection owing to the fact that its conductive properties can alter by exposing to oxidant or reductant gases. Despite the fact that in specific situations, the presence of additional contaminants such as water, poor sensitivity, low selectivity, etc., may cause declining in the sensing response. Semiconductor gas sensors provide more efficient sensing solutions to overcome these constraints. By adding metal oxides, transition metal oxides, and carbon compounds to conducting polymers (CPs) to create composites, semiconductor gas sensors can be created. The future of gas sensors constructed from composites of conducting polymer (CCP) and transition metal oxide (TMO) is the primary focus of this article. Gas sensing features such as sensitivity, reaction time, and recovery time are illustrated in this summary. We highlight the synthesis techniques for conducting polymer composites with reinforcements consisting of TiO2, FexOx, ZnO, and other transition metal oxides, such as V2O5, NiO, and others, when it comes to their sensing properties. This article provides a concise overview of the latest developments in conducting gas sensors made of nanocomposite polymer and transition metal oxide.

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Introduction: Pregnancy and child birth are universally celebrated events. The factors affecting the fetal outcome mainly lie within the premises of the antenatal period. The emergence of mobile telephone technology and its universal reach has improved service delivery, and information transfer. Thus, this study was planned to attempt improvement in the ante-natal care of pregnant women using an interactive voice response system (IVRS) with the ultimate aim of improving the maternal and fetal outcome, mainly in the form of low birth weight (LBW) rates. Methodology: The study was a community-based randomized intervention study. A total of 796 pregnant females of gestational age ≤16 weeks were recruited and followed up till delivery. The target population was from the urban slums of Jaipur. These areas are covered by Integrated Child Development Services (ICDS) scheme for the provision of basic child and maternal service. Results: Out of 796 recruited pregnant females, 722 singleton deliveries were analysed. 98.5% of pregnancy outcomes were in the form of live births and the rest were stillbirths. Among live births, 23.9% were low birth weight (21.4% in the intervention v/s 26.7% in the control area). A difference of 5% was observed in low birth occurrence between the two groups. Institutional deliveries were higher and caesarean sections, abortion, still birth, and congenital malformation among delivered were found to be lower in the intervention group as compared to the control group. The intervention group had a higher number of ANC visits and the difference was statistically significant. The maternal health indicators were slightly better in the intervention group. The number of iron-folic acid (IFA) tablets consumed and the number of pregnant females consuming them was also higher in the intervention group and was statistically significant. Conclusion: Intervention group as a result of intervention by mHealth and IVRS had better indicators of maternal and f

In this paper, Junctionless Twin Gate Trench Channel (JL-TGTC) MOSFET with individual gate control is realized. The device gives full functionality of 2-input digital ‘AND’ and ‘NAND’ logics. The simulation depicts the results in the form of various parameters such as cutoff current, transfer characteristics, and potential profiles. All the simulations regarding device structure and functionality are done on TCAD. This new type of MOS device has improved applicability in low-voltage digital electronics such as sequential circuits etc.

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Hypertension (HTN) is the attributable cause for 57% of stroke and 24% of coronary heart disease deaths in India. High prevalence of hypertension has been reported from various regions of the country. Recent studies have reported that shown that hypertension is present in 25- 30% urban and 10-20% rural subjects in India. This translates into an approximate population burden of 100- 110 million persons with high blood pressure (BP). Approximately half to two-thirds of these are stage I hypertension (systolic BP 140-159 and/or diastolic BP 90- 99 mm Hg) and the rest have stage II -III disease. There is low awareness, treatment and control status of hypertension in India, more among the rural than in urban populations. Determinants of low hypertension treatment and control are rural locations, low socioeconomic and educational status and female gender. Public health strategies are important for creating awareness of hypertension and physician education is required for its better treatment and control. Use of non -physician community health workers and mHealth technology are promising tools for increasing rates of hypertension treatment and promote control and adherence to healthy lifestyles and medicines.

Introduction: Non-communicable diseases (NCDs) are the new epidemic in India. District specific prevalence of various NCD risk factors is unknown. We used National Family Health Survey-4 (NFHS-4) data to map the syndemics of overweight/obesity, hypertension and hyperglycemia among 15-49 year old women and men in each district of the state. Methodology: Data on location-adjusted prevalence of various NCD risk factors among 15-49 year old women and men were obtained from NFHS-4 fact-sheets. Heat maps were created to determine geographic distribution of obesity (body mass index, BMI >25 kg/m2), hypertension (known and/or BP >140/>90 mmHg) and hyperglycemia (random glucose >140 mg/dl) in all the districts (n=33). We determined correlation of obesity with prevalence of hypertension and hyperglycemia. Descriptive statistics are presented. Results: Significant geographic variation was observed in prevalence of obesity, hypertension and hyperglycemia in men and women. High prevalence of obesity and hypertension (>15%) was observed in central and northwestern districts. Obesity >15% was observed in 9 districts in women and 6 districts in men. Prevalence of hypertension >15% and hyperglycemia >8% was low. There was a significant correlation of obesity with hypertension in women (r= 0.45) and men (r= 0.43) and hyperglycemia in women (r=0.20) (p

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Purpose: This study aimed to ascertain the efficacy and safety of an additional posterior to the ridge laser for treatable zone 2 stage 3 retinopathy of prematurity (ROP). Methods: This study was a retrospective chart review of infants undergoing laser treatment for ROP at a single center from March 2014 to March 2022. The chart review specifically searched for infants treated for zone 2 stage 3 ROP with plus disease, where additional posterior to the ridge laser was performed. Results: Seventy-eight eyes of 45 infants met the inclusion criterion. The mean birth weight and gestational age were 1166.09 ± 329.66 gm and 29 ± 2 weeks, respectively. Group 1 comprised 52 eyes treated for high-risk prethreshold stage 3 ROP, while group 2 comprised 26 eyes treated for threshold ROP. 532-nm frequency-doubled Nd:YAG laser (Nidek, Japan) was used in all eyes. Apart from the standard laser to the avascular retina, an additional three rows of laser were applied posterior to the ridge in all eyes during the primary laser sitting (except in two eyes where it was performed as a rescue treatment 2 weeks after the first sitting). No complications were observed during or immediately after the laser procedure. A favorable outcome was achieved in 98.07% of eyes with prethreshold ROP and 76.92% of eyes with threshold ROP. Overall, a favorable outcome was achieved in 71 (91.02%) of the 78 eyes. Conclusion: Posterior to the ridge laser performed in the primary sitting along with the standard laser for treatable stage 3 ROP in zone 2 is safe and effective. Further prospective studies are needed to study this underutilized approach.

Background and Aims: Persistent hyperglycemia, dyslipidemia, inflammation, and oxidative stress are important in cardiovascular risk in type-2 diabetes mellitus (DM). To evaluate the effect of 24-week yoga intervention on anthropometry and biochemical markers in DM patients, we performed a study. Methods: A hospital-based prospective randomized study in 104 participants with DM divided into control (n = 52) and intervention (n = 52) groups was performed. Patients in the intervention group performed 40 min of multifaceted individualized yoga exercises 5 days/week for 24 weeks. Anthropometric measurements and biochemical analysis were performed at baseline and after 24 weeks in both groups. Descriptive statistics are reported. Results: Baseline characteristics were similar in both groups. At 24 weeks, participants in the intervention versus controls had lower body mass index (25.6 ± 2.9 vs. 28.0 ± 3.2 kg/m2), waist–hip ratio (0.94 ± 0.06 vs. 0.99 ± 0.05), systolic blood pressure (121.2 ± 11.7 vs. 139.3 ± 19.1 mmHg), fasting glucose (142.7 ± 45.3 vs. 175.7 ± 45.4 mg/dL), glycated hemoglobin (7.2 ± 1.8 vs. 9.4 ± 1.9%), low-density lipoprotein cholesterol (167.5 ± 38.1 vs. 192.2 ± 51.4 mg/dL), nonhigh-density lipoprotein cholesterol (136.8 ± 35.3 vs. 158.6 ± 47.2 mg/dL), interleukin-6 (32.0 ± 21.5 vs. 43.5 ± 34.3 pg/mL), and high-sensitivity C-reactive protein (5.1 ± 3.7 vs. 9.5 ± 15.6 mg/L) (P ≤ 0.05). In the intervention group, higher levels of high-density lipoprotein cholesterol (49.2 ± 15.0 vs. 40.4 ± 7.2 mg/dL) and serum total antioxidants (1.9 ± 0.4 vs. 1.4 ± 0.4 mmol/L) were observed (P < 0.001). Conclusion: A short-term yoga intervention led to reduced glycemia, dyslipidemia, and inflammatory markers and increased antioxidant status in patients with type-2 DM.

Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40-80. The best way to manage primary open-angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods: An open-label, real-world, multicentric, observation-based 3-month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first-line therapy. Diurnal IOP measurements, best-corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day-1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results: Four hundred and sixty-nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once-daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion: We found that netarsudil 0.02% w/v solution monotherapy when used as the first-line treatment in primary open-angle glaucoma and ocular hypertension was both safe and effective.

Abstract Waldenström macroglobulinemia (WM) is a rare, incurable low grade lymphoma following a relapsing trajectory. Management strategies have evolved with the introduction of targeted therapy including new classes of Bruton tyrosine kinase inhibitor (BTKi). Treatment may however be limited particularly at relapse by a lack of drug availability and tolerability. We assessed the real‐world efficacy and tolerability of bortezomib‐containing regimens in patients with WM at frontline and relapse including those with prior BTKi resistance. Forty‐one patients were identified with 44 bortezomib‐containing regimens administered (n = 12 frontline, n = 32 relapse). Of patients treated at relapse, the median prior lines of therapy was 3 (range 1–7). 24% (10/41) of the cohort were refractory or intolerant to BTKi prior to bortezomib delivery. The median follow‐up after bortezomib administration was 34 months (range 0‐131). Overall response rate was 88%; 2‐year overall survival and progression‐free survival were 90% (95% confidence interval [CI] 73–96) and 76% (95% CI 55–87), respectively. Median time‐to‐next‐treatment was 66 months. Neuropathy (grade 1–2) occurred in 24% (8/34) and did not result in treatment cessation in any case. Gastrointestinal disturbance occurred in 7% (3/41). Treatment discontinuations were rare (1/44; 2%), suggesting a manageable safety profile. Major response rate was comparable in those with prior BTKi compared with those without (75% [6/8] vs 84% [27/32], p = 0.61). Bortezomib should be considered as a treatment modality particularly in those who are refractory to BTKi.

Objective: To assess the feasibility of measurement of retinal arteriovenous (AV) ratio using a smartphone, we performed a comparative evaluation with fundus camera imaging and coronary SYNTAX score. Method: Successive coronary artery disease (CAD) patients who underwent coronary angiography were recruited for smartphone retinal imaging. Following pupillary dilatation, fundus camera images and smartphone photography were performed. Video images were captured with a smartphone, edited and analysed. Retinal artery and vein size at 0.5 and 1 disc diameter (DD) were measured using DICOM software by two independent observers. Another observer calculated SYNTAX score. Results: Analysable smartphone images were available in 91 (89.2%) of 102 patients. Tobacco use was found in 26%, hypertension in 54%, diabetes in 55%, and high LDL cholesterol in 50%. Median and 25–75 interquartile range (IQR) AV ratio at 0.5 and 1.0 DD, respectively, with smartphone were 0.48 (0.45–0.52) and 0.47 (0.45–0.52) and fundus camera were 0.48 (0.44–0.53) and 0.48 (0.45–0.53) (Spearman's correlation 0.80 and 0.79, p

Secondary prevention in coronary heart disease is the prevention of occurrence of recurrent coronary events after clinical diagnosis. High level of adherence to secondary prevention interventions, especially aggressive lifestyle changes and pharmacotherapy can lead to significant decline in recurrent coronary events. Both international and Indian studies have reported low adherence to such therapies. Evidence-based useful interventions include regular physical activity, yoga, intake of healthy diet, smoking and tobacco use cessation and weight management. Pharmacotherapeutic interventions useful are anti-platelet therapy, target oriented lipid lowering therapy with statins, beta blockers and angiotensin converting enzyme inhibitors in patients with impaired left ventricular function. Hypertension and diabetes management with control to targets is important. Novel strategies include use of anticoagulants, anti-inflammatory drugs, and triglyceride lowering for residual risk. Physician and patient level interventions using multifaceted educational, socioeconomic and technological innovations are important to promote life-long adherence to these strategies.

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Introduction: Heart failure epidemiology has been very poorly studied in India. There are only limited studies that have evaluated etiologies and outcomes. The aim of this study was to determine etiologies and management of heart failure in hospital and clinic-based patients. Methodology: Successive patients presenting to a tertiary care hospital with acute decompensated heart failure (ADHF, n=102) and stable heart failure (SHF, n=179) were enrolled. Etiology of heart failure was diagnosed using clinical examination and echocardiography. Both the groups were followed for 90 days. Descriptive statistics are presented. Results: Etiologies of heart failure in ADHF vs SHF patients, respectively, was coronary heart disease 50.0 v/s 53.6%, hypertension 27.4 v/s 15.1%, dilated cardiomyopathy 16.7 v/s 7.3%, rheumatic heart disease 4.9 v/s 14.0%, and hypertrophic cardiomyopathy 1.0 v/s 7.3%. Heart failure with normal ejection fraction was in 23 ADHF (22.5%) and 2 SHF (1.1%) patients. In-hospital treatments included diuretics, nitrates, angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), mineralocorticoid receptor antagonists (MRA), digoxin, anticoagulants, vasodilators and vasopressors. In-hospital mortality in ADHF was 10.3% (n=11). At discharge significantly greater numbers of patients with ADHF v/s SHF were on loop-diuretics (95.5 v/s 78.2%), antiplatelets (74.4 v/s 64.2%) and antiarrhythmics/ivabradine (23.3 v/s 6.1%) while lesser were on thiazides (1.5 v/s 9.5%), MRA (33.4 v/s 43.0%), ACEFARB (34.5 v/s 76.0%) and beta-blockers (33.4 v/s 45.8%) (p

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Obstructive sleep apnea is a major health problem in adults and leads to a variety of cardiovascular, respiratory, neurocognitive and metabolic problems. Continuous positive airway pressure is therapy of choice. All treatments have low adherence rates. Given the pathogenic importance of oropharyngeal muscles we hypothesized that conch blowing could be useful for improving its severity. A50-year old gentleman presented to us with daytime somnolence and excessive snoring. Physical examination showed body mass index of 32.0 2 kg/m with normal examination. Polysomnography showed apnea-hypopnea index of 78.0 and oxygen desaturation index of 74.8. He refused positive airways pressure therapy. He was advised conch blowing, 5 times twice daily. At 12 months follow-up his daytime 2 somnolence decreased, body mass index was 30.8 kg/m , apnea-hypopnea index was 50.6, and oxygen desaturation index was 43.7. Mechanistic studies and randomized controlled trials are required to demonstrate benefits of conch blowing in obstructive sleep apnea.

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Novel strategies are needed to provide universal health care to underserved rural and urban slum populations in India. We searched the existing literature regarding community health workers using mHealth strategies in India and other low and lower-middle income countries. The search was performed using the PUBMED database. Inspite of dearth of evidence from India, the use of mHealth tools by ASHA with caution have a potential of 'novelty effect' on chronic disease surveillance in the community settings.

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Introduction: A population-based study to determine association of depression and stress with cardiovascular risk factors was performed. Methodology: We evaluated 5234 urban subjects (men 2891, women 2343) in 11 cities. Prevalence of depression, and perceived stress (work, home, or financial for >12 months) and cardiovascular risk factors was determined. Associations were tested using logistic regression, odds ratio (OR) and 95% confidence intervals (CI) calculated. Results: Age-adjusted percent prevalence (95% CI) in men and women of depression was 23.5 (21.9-25.0) and 24.7 (23.1-26.3), home stress 56.0 (54.2-57.8) and 60.5 (58.5- 62.5), work stress 46.3 (44.5-48.1) and 36.5 (34.5-38.4), financial stress 54.4 (52.6-56.2) and 55.5 (34.5-38.4), all three 30.7 (29.0-32.4) and 23.8 (22.1-25.5) and depression with all three in 11.3 (10.1-12.4) and 7.8 (6.7-8.9). In individuals with depression v/s without, prevalence (%) was significantly greater for physical inactivity (men 46.6 v/s 36.4, women 51.9 v/s 45.5), high waist-hip ratio (men 80.2 v/s 67.2, women 88.5 v/s 83.4), low HDL cholesterol (men 37.7 v/s 32.3, women 58.1 v/s 52.0), and diabetes (men 17.5 v/s 15.5, women 14.5 v/s 12.4) (p