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The study concentrates on two different genetic programming approaches for determining passenger car equivalent (PCE) values and observing the impact on capacity estimation at urban unsignalized intersections. Considering heterogeneous traffic conditions, a new PCE value is introduced to encompass sustainable modes of public transit vehicles, specifically slow-moving three-wheelers (SM3W), commonly known as E-Rickshaws. Since PCE value is considered an important parameter for capacity calculations, the present study considered 14 unsignalized intersections located in Ranchi city of India. An automatic plate recognition system is employed to have the count of vehicular traffic. The methodologies include age-layered population structure genetic programming (ALPSGP), and the offspring selection genetic programming (OSGP) approach that incorporates static and dynamic variables. Based on the significance test and ranking of the genetic programming (GP) models, the OSGP model is recommended as the most appropriate model for heterogeneous traffic. Sensitivity analysis reported that lagging headway () is the most contributing factor in PCE estimation. The PCE value of SM3W is found to be 0.81 and that could be incorporated as a new classification of vehicles in Indo-HCM. It is observed that evaluated capacity based on PCE values of OSGP performed admirably in both normal and congested traffic situations. [ABSTRACT FROM AUTHOR]

Air pollution is a growing concern in today's urbanized world, necessitating efficient and accurate methods for air quality monitoring. The proliferation of IoT devices has led to a surge in the generation of time-series data. With its high volume and complexity, this surge in time-series data necessitates cloud-based solutions for handling and analyzing this data effectively. However, existing methods for air quality monitoring face challenges in capturing the complex patterns and dynamics of air pollution, which often exhibit both linear and nonlinear characteristics. Air pollution data often exhibit both linear and nonlinear characteristics. Linearity and nonlinearity refer to the nature of the relationships within the data. Some aspects of air quality, such as pollutant concentrations, may follow linear patterns, while other factors, like the interaction of multiple pollutants and environmental conditions, exhibit nonlinear relationships. This complexity arises from the multifaceted nature of air quality dynamics, which various factors and interactions can influence. To address these challenges, this study introduces a novel hybrid time-series approach that combines the proven strengths of two well-established techniques: traditional time-series autoregressive integrated moving average (ARIMA) and soft computing adaptive neuro-fuzzy inference system (ANFIS). The hybrid model is designed to provide a comprehensive solution that accommodates the diverse characteristics of air quality time-series data. To assess the efficacy of our proposed model, we conducted extensive experiments using real-world air pollution datasets obtained from the Ministry of Environment, Forest and Climate Change of India, covering the period from January 2015 to July 2020. Our evaluation includes a range of performance metrics such as root-mean-square error (RMSE), mean absolute error (MAE), mean absolute percentage error (MAPE), and mean squared logarithmic error (MSLE). Specifically, our model demonstrates exceptional accuracy, with notably low error values for key metrics such as air quality index (AQI) and PM2.5. Furthermore, we subjected our innovative hybrid model to rigorous statistical testing using the Diebold-Mariano test, establishing the significance and superiority of our approach. This research advances our understanding of air quality prediction and offers a valuable solution for mitigating the detrimental effects of air pollution on public health and the environment. [ABSTRACT FROM AUTHOR]

Introduction: Urolithiasis is one of the most common urological problems worldwide. The fastest treatment modality to achieve stone clearance of ureteral stones is Ureteroscopic Lithotripsy (URSL). However, it is negated by both the cost burden and potential risk to the patient. Medical Expulsive Therapy (MET) is a treatment option for upto 10 mm stones but has failure rates of 40-60% in the literature. Aim: To analyse the various indications for surgery, whether MET was used or not, if used-its details, operative findings at ureteroscopy including the reason for the failure of MET. Materials and Methods: A cross-sectional study consisting of 72 patients with ureteric calculi undergoing URSL was analysed from June 2017 to December 2018 at Mazumdar Shaw Medical Centre, Bangalore, Karnataka, India. Indications were assessed at the time of admission. During ureteroscopy, factors like impaction, distal obstruction, and unusual findings were studied, which could have contributed to the failure of MET. The Chi-square test was used as a test of significance for categorical data. The Analysis of Variance (ANOVA) test was used as a test of significance to identify the mean difference between continuous variables. The p-value of <0.05 was considered statistically significant. Results: The mean age in the study was 41.65±13.4 years (range 20-69 years), and the mean stone size was 10.03±3.34 mm. Large stone was the most common indication (41, 56.9%, p=0.004), followed by failed MET (35, 48.6%). Even though MET could have been continued for four weeks in 17 patients (23.6%), they were taken up for surgery. The impaction rate was 70.8% (51), with 48.6% (35) being large impacted stones and 22.2% (16) being small impacted stones. The overall stone clearance rate was 68 out of 72 (94.4%). Conclusion: Large stone size (=10 mm) and failed MET were the main indications for surgery. One reason for the failure of MET was not waiting for a duration of four weeks. During ureteroscopy, impaction of the stone, irrespective of size, was the most common finding and was the reason for the failure of MET. Ureteric stones on MET should not be neglected as there are reasons for the failure of MET, and they will require URSL after four weeks. [ABSTRACT FROM AUTHOR]

Background: The first 1,000 days of a child’s life is a critical window for growth faltering, deficiencies, and common childhood illnesses. Even with optimum breastfeeding, children 6-23 months are at higher risk of being undernourished if they do not receive adequate and appropriate complementary feeding. Therefore, this study was carried out to assess the nutritional status of children 6-23 months and find the association between sociodemographic profile and nutritional status. Materials and Methods: Mothers of 411 children of age 6-23 months in an urban area of Raipur were interviewed using a pretested questionnaire based on the WHO indicators to record their complementary feeding practices. Weight, height, and mid-upper arm circumference (MUAC) was taken to assess the nutritional status. Overall and specific (sex-wise and severity-wise) prevalence rate of stunting, wasting, and underweight were calculated. The distribution of these according to various factors like infant and young child feeding practices, and details of study subject and family were calculated. Chi-square test of significance was applied to find the association between nutritional status and independent variables and their strength of association. Results: The prevalence of wasting was 25%, underweight 30%, and stunting 15%. Statistically significant association of underweight with age of the parents, both mother and father, was observed (P < 0.05). Minimum dietary diversity was achieved by only 4.1% and minimum acceptable diet by 2.4% children. Conclusions: The prevalence of wasting and undernutrition was assessed. Complementary feeding indicators were unsatisfactory among children. Ending all forms of malnutrition is the global goal. The Sustainable Development Goals (SDGs) that directly affect or indirectly influence nutrition have to be recalled at this stage and addressing malnutrition is a key element required to achieving them. [ABSTRACT FROM AUTHOR]

Objectives: Osteoporosis is one of the major public health problems worldwide among postmenopausal osteoporotic women. Lifestyle modification interventions along with pharmacotherapy help to revert bone loss and prevent complications. Methods: A randomised controlled trial was conducted at Kasturba Hospital, Manipal from January 2019 to December 2021 among postmenopausal women with osteoporosis. The postmenopausal women who attended the osteoporosis clinic and were within the age group of 45-65 years, could speak and understand English or Kannada and whose bone mineral density (BMD) score was between -1 and -3 were included in the study. The total sample size of the study was 120 with 60 in each of the experimental and control groups. After obtaining informed consent, a stratified block randomisation method was used to allocate the participants to intervention and control groups. The BMD was monitored by the portable ultrasound densitometer by a technician at the outpatient departments. The baseline information was collected by a structured demographic questionnaire. Intervention group participants received a lifestyle modification intervention program (LMIP) whereas the control group received standard regular care from the physician. Follow-up was done at three and six months. Results: The results revealed that the increase in the BMD median score among the experimental group was from -2.2 (-2.5- -1.8) to -1.5 (-1.8- -0.65) whereas in the control group, it was from -2.3 (-2.6- -1.9) to -2.0 (-2.4- -1.5). The results of the Mann Whitey U test showed a statistical significance between the intervention and control groups in the post-test after six months (U = 505.5; P <0.05). Wilcoxon signed rank test showed a significant change in both the intervention and control groups from pre-test to post-test I (3 months) and post-test II (6 months; P <0.001). Conclusion: The lifestyle modification intervention was found to be effective in improving the bone health status of postmenopausal women. Hence it is very important to integrate it into regular therapy. [ABSTRACT FROM AUTHOR]

Context: Pollution-related health hazards are very common among people living and/or working in industrial areas, particularly near industries and metro cities. These air pollutants contribute to allergens, increase inflammation, and affect lung function. Aim: The present study aimed to examine the effect of yoga training on lung functions and inflammation in terms of soluble interleukin-2 receptor (sIL-2R) in people working and living in a polluted area. Settings and Design: This is a randomized controlled interventional pilot study. Methods and Materials: Forty-eight male volunteers from the industrial area, aged 20--50 years, were randomly assigned to the experimental group and the control group. Each group comprises 24 study participants. Lung function and sIL-2R were studied at the baseline and post-yoga intervention period of 16 weeks. Statistical Analysis Used: Study data were analyzed using descriptive methods, a one-tailed t-test, a paired t-test, and an independent t-test. Result: Study results showed directional and significant improvements in forced vital capacity, forced expiratory volume in the first second, and peak expiratory flow rate compared to the control group participants. The results pertaining to sIL-2R showed a directional and significant decrease in the experimental group compared to the control group. Conclusion: The present study showed that yoga helps to promote better health, improve lung function and reduce inflammation among people residing in polluted environments. [ABSTRACT FROM AUTHOR]

Background: To investigate venous thromboembolism (VTE) in hospitalized patients with severe high altitude pulmonary edema (HAPE), we performed a single center retrospective study to evaluate its clinical characteristics, prognosis, and potential thromboprophylaxis strategies in a large referral and treatment center in plateau regions. Methods: We studied a total of 18 patients with severe HAPE from January 1, 2012 to December 31, 2021. Demographic and clinical data, laboratory data, including ultrasound scans of the lower extremities and cardiac ultrasound, and computed tomographic pulmonary angiography (CTPA) variables were obtained, and comparisons were made between groups with and without VTE. Results: Of the 18 patients hospitalized with severe HAPE (age 43 (range, 34–54) years, 14 [77.8%] men), 7 patients developed VTE (38.9%), including 5 with deep vein thrombosis (DVT) and pulmonary embolism (PE), 2 of whom had DVT only. Eighteen patients are all firstly rapid ascent to high altitudes which the mean altitude was 3700 m (3656–4050 m). Compared with patients who did not have VTE, patients with VTE had a longer time in hospital (13 [11, 19] versus 9 [7, 12]; P = 0.027), respiratory failure (6 [85.7%] versus 2 [18.2%]; P = 0.013), the shortened APTT (21.50 [19.00, 27.50] versus 26.30 [24.80, 30.10]; P = 0.044) and the higher level of D-dimer (7.81 [4.62, 9.60] versus 2.90 [1.75, 3.37]; P = 0.003). The proportion of thromboprophylaxis is too low in our cohort which 2 of 18 (11.1%) patients were given VTE prophylaxis. There was no statistically significant difference between the VTE and non-VTE groups (0 [0.0%] versus 2 [18.2%]; P = 0.497). Conclusions: The prevalence of VTE is high in hospitalized patients with severe high altitude pulmonary edema (HAPE). Prophylaxis for venous thromboembolism may be protective in severe HAPE patients after admission. Our data seem to suggest that VTE is probably an additional prognostic factors in patients with severe HAPE. [ABSTRACT FROM AUTHOR]

The North-Western Indian Himalayan Region (NW-IHR) is the source of some of India's major rivers and hosts a few of the highest mountain peaks in the world. The region is also a major source of water for the population living in the plains. We study the rainfall trends, magnitudes, and seasonal and annual variations in the NW-IHR during the last 120 years (1901–2020). The temporal trends in rainfall are estimated using the Mann-Kendall Test (MKT) and Modified Mann-Kendall Test (MMKT) at 10%, 5%, and 1% significance levels. The ACC at lag-1 was calculated and tested at 5% significance level for the MMKT. The magnitude of the seasonal and annual rainfall was calculated using Sen's Slope (SS), Simple Linear Regression (SLR), Innovative Trend Analysis (ITA), and Spearman's Rho (SR). The variability of seasonal and annual rainfalls was studied using the Coefficient of Variation (CV). The results of our analysis revealed both increasing and decreasing trends at various levels of significance during seasonal and annual rainfalls. The majority of the districts in the northern region showed increasing trends, while the districts in the southern region showed decreasing trends. CV was higher for seasonal rainfalls as compared to annual rainfalls. Our analysis of trends and variability will help the local stakeholders for efficient planning and understand the risk and vulnerability of the region at large. [ABSTRACT FROM AUTHOR]

Banks are the pivot of development. The way the banking organisations function (Payer) will influence the performance of the banks as well as the target group (The Receiver). There will be always a business relationship between the banks and their customers. This relationship will be solidified and continue to exist for a lifetime and beyond (generation customers). When a bank lives longer, it means better performance by establishing a continuous customer relationship. It is in this context, a study on the organisational foundations to its performance is critical and essential. The present study aims at establishing a temporal relationship between organisational foundations - Vision, Mission, Objectives, Goals / Values, and Strategies and needs to be juxtaposed for a concomitant relationship. The study covers four types of banks in India - Public Sector (PSBs), Private Sector(Pvt_SBs), Foreign Banks(FBs), and All Scheduled Commercial Banks (ASCBs). The organisational foundational variables such as Vision, Mission, Objectives, Goals/Values, and Strategies are culled out to test the hypothesis of the significance of organisational foundations as explicitly stated will lead to better performance of the banks by type. The above hypothesis is tested using ANOVA Fixed Effects Model for all performance variables at the aggregate level. The data are culled out from reports of eighty banks which form a major chunk of the banks in India. The sources of data are bank websites, annual reports, RBI websites, EPWRF data sets, and the like. The data have been tabulated by bank type from 1991-92 to 2019-20 - the post-liberalization period in India. The findings of the study are: PSBs although form 56.5% of the total transactions (credit) have mixed levels of performance. Some areas are statistically significant and some are not. The organisational foundational variables have moderate clarity and are in most of the cases, objectives and goals are not specified. The Pvt_SBs have a market share of 35.4% of total transactions that are urban-centric and have been performing well and most of the variables are documented. The FBs which are operating in India are clear about all the organisational variables except strategy. The share of the FBs in Indian urban transactions is 4.19% of the total and all the parameters of performance show the statistically significant result at 1% level. Generally, there will be no autocorrelation effect in the time model tested. This means Foreign Banks make very little or minimum time-oriented errors. The paper suggests that all types of banks in India must emulate the FBs to have stronger organisational foundations which in the long run facilitate better competitive performance. [ABSTRACT FROM AUTHOR]

Introduction: Differentiation between Chronic Hand Eczema (CHE) and Palmoplantar Psoriasis (PP) is a diagnostic challenge. Dermoscopy can helpto distinguish between the two conditions. Aim: To establish and compare the dermoscopic findings of the CHE and PP using DermLite DL4 dermoscope and to confirm the accuracy of the dermoscopic findings with the histopathological findings. Materials and Methods: A cross-sectional study was conducted at Navodaya Medical College, Hospital and Research Centre, Raichur, Karnataka, India, from January 2017 to June 2018. Fifty patients each of CHE (26 male and 24 female subjects) and PP (25 male and 25 female subjects) were included in the study. A detailed clinical history, cutaneous clinical and dermoscopic findings of each case were noted. A 4 mm punch biopsy was taken from 30 patients for histopathological analysis. The data was tabulated, analysed and tested for significance using the Chi-square test. Results: The mean age of the patients was 46±4 years. On dermoscopic examination, diffuse white scales in 45 (90%) patients, over a red background in 49 (98%) patients with regularly arranged dots and globules in 45 (90%) patients was seen in PP. Patchy yellow scales 46 (90%), yellow dots, globules and yellow to brown crusts against a yellow background was seen in all patients (100%) of CHE (p-value <0.001). Histopathological findings are in agreement with dermoscopic findings in 9/16 and 10/14 cases of CHE and PP respectively. Conclusion: Dermoscope is a useful non invasive clinical aid to differentiate between CHE and PP. The presence of diffuse white scales over a red background and regularly arranged vessels indicates PP, whereas the presence of patchily distributed yellow scales, yellow dots and globules; and yellow to brown crusts against a yellow background is more suggestive of CHE. [ABSTRACT FROM AUTHOR]

Background: Global health care is moving toward function, quality of life, and occupation. Occupational therapy (OT) has been the only profession using "occupation" as core intervention since inception. With advancements in intervention techniques, occupational therapists (OTs) need to ensure the continued use of "occupation" as core intervention type. Previous surveys were conducted to analyze the use of specific intervention types: occupation-based interventions (OBIs), creative activities, acute-hospital-based rehabilitation, and different interventions used in pediatric OT practice. However, information on OT practices and types of interventions used by Indian OTs versus global OTs is unavailable. Objectives: The objective of this study was to analyze differences, if any, in the OT practices and types of interventions frequently used in daily practice by Indian versus global OTs. Study Design: This was an online, survey-based, cross-sectional study. Methods: The Google Forms questionnaire link was sent to OTs on E-mail with electronic written informed consent from May 2020 to March 2021 using convenient sampling. The questionnaire included participant's demographics, 17 clinical practice areas, and 9 intervention types and factors influencing OT practice. Total 201 (84 Indian OTs and 117 global OTs) fulfilled the selection criteria: OTs with at least bachelor's degree and minimum 3 years of work experience. Results: Indian OT workforce showed significantly more male OTs than global OTs (31 [36.9%] vs. 11 [9.4%]; 95% confidence interval [CI]: [0.0236-0.2964]; P = 0.0001) and OTs with master's degree (56 [66.7%] vs. 41 [35.04%]; 95% CI: [0.1852-0.4480]; P = 0.0001). Global OTs have more OTs with additional qualifications in non-OT fields (58 [49.57%] vs. 27 [32.10%]; 95% CI: [-0.3088--0.0406]; P = 0.013) and more OTDs (13 [11.11%] vs. 1 [1.23%]; 95% CI: [-0.1641--0.0335]; P = 0.006) than Indian OTs. Indian OTs practiced significantly more in the private sector: clinic and hospital (52 [61.90%] vs. 40 [35.80%]; 95% CI: [0.1273-0.3947]; P = 0.0001), whereas global OTs practiced significantly more in the government sector (46 [39.31%] vs. 19 [22.61%]; 95% CI: [-0.2930--0.0410); P = 0.0124). Among the organizational roles, Indian OTs work significantly more as consultants (50 [50.95%] vs. 35 [29.91%]; 95% CI: [0.0751-0.3457]; P = 0.0001) while global OTs work significantly more as managers (36 [30.76%] vs. 12 [14.28%]; 95% CI: [-0.2770--0.0526]; P = 0.0069). Among patient population treated, Indian OTs majorly (54.76%) treat children (up to 15 years) but significantly more in "all age groups" (35 [41.67%] vs. 18 [15.38%]; 95% CI: [0.1388-0.3870]; P = 0.0001) while global OTs treat significantly more adults (21-65 years) (61 [52.13%] vs. 25 [29.76%]; 95% CI: [-0.3569--0.0905]; P = 0.0015) and geriatric (>65 years) (50 [42.73%] vs. 17 [20.23%]; 95% CI: [-0.3492-0.1008]; P = 0.0008). Indian OTs practice significantly more in developmental disability rehabilitation (78 [92.85%] vs. 68 [58.11%]; 95% CI: [0.2424-0.4524]; P = 0.0001), ante- and postnatal women's care (15 [17.85%] vs. 3 [2.56%]; 95% CI: [0.0662-0.2396]; P = 0.00018), and hemophiliac rehabilitation (14 [16.67%] vs. 2 [1.70%]; 95% CI: [0.0666-0.2328]; P = 0.00012) areas of practice than global OTs. Indian OTs practice significantly more in clinic outpatient department (OPD) (62 [73.80%] vs. 55 [47%]; 95% CI: [0.1375-03985]; P = 0.0001), hospital OPD (40 [47.61%] vs. 27 [23.07%]; 95% CI: [0.1141-0.3767]; P = 0.0002), and inpatient (37 [44.04%] vs. 30 [25.64%]; 95% CI: [0.0516-0.3164]; P = 0.0006) while global OTs practice significantly more in natural environment settings (53 [45.29%] vs. 24 [28.57%]; 95% CI: [-0.2994--0.0350]; P = 0.016). Most preferred types of interventions among both groups are relatively the same: client education, counseling, and consultation and interview; therapeutic relationships; and therapeutic use of self. Besides these, Indian OTs prefer performance skills training and adaptive interventions, while global OTs prefer activities as therapeutic media and OBIs over other types. Preventive interventions and advocacy were the least preferred types of intervention among each group. Despite these relative preferences, significant differences were found between groups with regard to number of OTs practicing these 5 types of interventions: client education, counseling, and consultation (46 [54.76%] vs. 47 [40.17%]; 95% CI: [0.0073-0.2845]; P = 0.04]; performance skills training (41 [48.80%] vs. 34 [29.05%]; 95% CI: [0.0626-0.3324]; P = 0.004); preventive intervention and health promotion (29 [34.5%] vs. 24 [20.51%]; 95% CI: [0.0148-0.308]; P = 0.026]; adaptive interventions (39 [46.42%] vs. 23 [19.65%]; 95% CI: [0.1390-0.3964]; P = 0.001]; and preparatory interventions: (35 [41.67%] vs. 28 [23.93%]; 95% CI: [0.0467-0.3081]; P = 0.0075). Conclusion: The study provides the current stand for preferences and practices of therapeutic interventions by OTs in India versus globally, thus aiding in repositioning of OT practice, focusing on core OT domains as well as providing a baseline for monitoring practice trends over time. [ABSTRACT FROM AUTHOR]

Introduction: Sleep is integral to the process of maintenance and restoration of physical as well as mental health encompassing intelligence, memory as well as emotions. Face recognition memory is a special form of memory that gives the ability to remember people meaningfully and is instrumental in any individual's meaningful coexistence in the society. Aim: To determine if different habitual sleep durations may be associated with difference in unfamiliar face recognition memory and if there are any gender differences in the same, among young healthy individuals. Materials and Methods: This was an observational analytic cross-sectional study conducted over a month in B.J. Medical College, Ahmedabad, Gujarat, India, including 98 healthy young volunteers (39 females and 59 males) among 1st year students of different professional courses. The participants were subjected to a questionnaire-based interview followed by a face recognition test based on Parkin's recognition memory test (1995). Mean values and Standard Deviations (SD) were calculated for age, sleep duration, correct and wrong responses in the test and statistical significance was tested by applying t-test with a significance level of p<0.05. Results: The participants were grouped as average-duration (6.6±0.5 hours/day) and long-duration (8.4±1.0 hours/day) sleepers, 53 and 45 in number, respectively, and there was a significant difference in the sleep duration of the two groups (p=8.6×10-17). No significant difference was seen in the number of correct (p=0.08795) and incorrect (p=0.42205) responses of average-duration sleepers and the long-duration sleepers. Gender differences in correct and incorrect responses of average-duration and long-duration sleepers were also not significant. But there was a significant difference in the number of correct responses by females and males, in general. Conclusion: Habitual duration of sleep may not affect face recognition memory in the young ages. [ABSTRACT FROM AUTHOR]

The paper aims to analyze the information needs of Indian Members of Parliament (MPs) related to the rural and urban development in their constituency or region. Rural Connectivity is a key component of the rural development, thus the current study explores the level of awareness of Indian MPs about the status of rural connectivity with the Urban areas and rural accessibility via various means of Transport available for the people in their region/constituency for Intercity and Interstate Travel. The implementation of various Government schemes for the development of rural India by the Indian MPs has also been studied. The data is collected through survey methodology with the help of a predefined structured questionnaire including interview method to get the exact insight about the rural and urban development information needs of Indian MPs. The survey results were tabulated and analyzed with the help of descriptive statistical methods and hypothesis testing is done with Pearson's Chi Square testing technique. The findings reveals that the majority of people use Auto Rickshaw (98.7%) and Taxi (98.7%) followed by Rickshaw (93.6%) for local travelling in their area or region. The major modes of transportation available in the constituencies are Bus (100%) & Rail (97.4%) respectively. The majority of MPs have implemented 'Pradhan Mantri Gram Sadak Yojana' (i.e. 94.9%) and 'Pradhan Mantri Aawaas Yojna' (i.e. 89.5%) in the villages/rural areas of their constituencies. The majority of MPs have responded that HDFC Bank is the Top loan provider agency in both Rural (23) and Urban (24) areas respectively. Lastly, the study concludes that highest number of beneficiaries of Pradhan Mantri Aawaas Yojna (PMAY) are from North region (i.e., 4,01,100) of India followed by 2,78,920 beneficiaries from Central region and 2,45,600 beneficiaries respectively from South region. [ABSTRACT FROM AUTHOR]

Background: Thanks to the liberalisation, privatisation and globalisation measures initiated by Government of India under its new economic policy regime, India is witnessing a boom in the global market. This scenario has enhanced the need for understanding the product adoption behaviour that would enable the marketers to arrive at strategies corresponding to the target markets socio, economic, political, cultural and competitive setting at the macro level and adopter-centred approach at the micro level. Adoption is the decision of prospective buyer to become a regular user of the product. Aims: Indian consumers too have access to many new channels to interact with their bank. Banks race against each other in bringing the latest technology for the benefit of their customers and themselves. But not many studies have been conduced to evaluate if "Digital Banking" channel is utilised properly by the customers in India. Reasons for customer apathy towards Digital banking channel, if that exist, have also not been analysed in an Indian context earlier. Methodology: An exploratory and descriptive both research designs were used in this research paper which included a field survey where the researcher went to the population of interest for them to describe and interrupt problem that are typical of normal conditions, attitudes, beliefs, practices and targets/aims about internet banking usage to establish the status of the problem under investigation. Results/Findings: Multiple regression model will test the assumptions required to ensure validity of its significance test. This will help us check a statistically significant relationship. Other statistical techniques used for analysing the data collected will also be discussed. In the context the findings of the study, data analyses will be reported. Conclusions: Most consumers form expectations of the service product, Banking Service provider, service, and quality of the product that they patronise before engaging in banking activities. These expectations influence their attitudes and intentions to get facilitated banking services through a certain bank and consequently their decision-making processes, purchasing behaviour and loyalty as well. [ABSTRACT FROM AUTHOR]

Context: The aim was to identify the current training standard of laparoscopy skills among the urology residents. Aims: This paper presents the residents' subjective perception of their laparoscopy skills and evidence of an objective assessment of their actual skills. Settings and Design: An online survey was mailed, and completed by urology residents in training. The residents' perception of laparoscopy training received, exposure to laparoscopy procedures, and training facilities were queried. The assessment was done on the skill levels of the residents presenting at an annual training program. Subjects and Methods: 103 residents responded to the online survey and 115 residents were assessed at the training program. Statistical Analysis Used: Discrete data were compared using the t-test to test for significance of the means; P < 0.05 was considered significant. Pearson's correlation coefficient was used to obtain the relationship between variables. Results: An overwhelming 91% rated their laparoscopy skill as just "satisfactory" or worse, and 60% did not have any training facilities in their department. 66% continue to be "assistants only" in conventional laparoscopy surgeries. Assessment of basic laparoscopy skills in the dry lab revealed 92% of residents having poor laparoscopy skills; similar to the subjective opinion in the survey. Only 6% (n = 5) of the residents showed a good or better skill score in the dry lab; similar to the survey. Conclusions: Based on the survey, a large number of residents have a poor opinion of their own laparoscopy skills, and the training facilities available to them. The data objectively prove the self-assessment of the residents on their laparoscopy skill level. [ABSTRACT FROM AUTHOR]

Aims: To study the impact of vestibular suppressant drugs (VSD) on provocative positional tests (PPT) in patients with benign paroxysmal positional vertigo (BPPV). Settings and Design: A prospective case-control observational study. Materials and Methods: Patients with a history suggestive of BPPV were tested for PPT. Patients with vertiginous symptoms and with nystagmus on PPT were classified as objective BPPV (O-BPPV, control group), while those without nystagmus with no alternate diagnosis were classified as subjective BPPV (S-BPPV, case group). Details of VSD treatment were noted in all the patients. In both groups, patients were instructed to discontinue VSD and were further assigned as the VSD and non-VSD subgroups. Patients were followed for 2 months with PPT every week. PPT positive patients were treated by vestibular rehabilitation maneuvers. Statistics: Student t-test with two-tailed, unpaired, was used for continuous scale and Chi-square test for categorical differences between the two groups. Results: 295 consecutive BPPV patients were enrolled in the study, 55 in the S-BPPV group and 240 in the O-BPPV group. Significantly higher proportion of patients in the S-BPPV group were on VSD at presentation, 80.00% vs. 53.75% (OR 2.52; 95% CI: 1.30-4.86), P = 0.006. In an unadjusted analysis of the S-BPPV group following discontinuation of VSD, PPT became positive in 79.54% of patients as compared to 18.19% in the non-VSD group (OR 35.0; 95% CI: 6.2-197.3), P < 0.001. Conclusion: A higher proportion of S-BPPV patients were receiving VSD in comparison to O-BPPV at the initial visit. The PPT converted positive four times higher after ceasing the VSD in S-BPPV patients. Study Design: Prospective case-control observational study. [ABSTRACT FROM AUTHOR]

Context: Anemia is a serious public health concern especially in women of reproductive age (WRA) as it causes a high burden of morbidity and mortality and persists through intergenerational cycle. As most of the risk factors are preventable, a thorough understanding of its risk factors is necessary to design better interventions. Aims: Current study aimed to estimate the burden of anemia as well as explore determinants of various grades of anemia among WRA in a rural area. Settings and Design: A community-based cross-sectional study was conducted among non-pregnant, non-lactating women of reproductive age in rural field practice area of All India Institute of Hygiene and Public Health. Methods and Materials: House to house visit was conducted for interviewing with pre-designed pre-tested questionnaire along with blood hemoglobin and anthropometric measurement. Statistical Analysis Used: Descriptive statistics and test of significance like multinomial logistic regression and Kruskal-Wallis test (with post-hoc) were used. Results: Majority (70.8%) of participants were anemic. Proportion of mild, moderate, and severe anemia were 24.16%, 37.5%, and 9.16%, respectively. Different levels of anemia were significantly associated with higher age, lower education, poor iron-rich food intake, lack of dietary diversity, and adiposity. Significantly low hemoglobin level in both underweight and obesity was noticed suggesting U shaped relationship between BMI and anemia. Conclusion: Periodic screening for anemia among WRA especially in both extremes of malnutrition, i.e., undernutrition and obesity should be considered at the policy level. Year-round behaviour change communication campaigns must be carried out for the promotion of necessary food groups in diet. [ABSTRACT FROM AUTHOR]

Context: World'spopulation is ageing and increase in geriatric population demands improved oral health care. Previous epidemiologic studies in general population of India and particularly in Kerala (state with maximum proportion of elderly) provided very little information about oral mucosal lesions in elderly. Aims: To find out the prevalence, pattern and distribution of oral mucosal lesions in geriatric patients and to explore their association with different study variables. Settings and Design: A descriptive, hospital-based, cross sectional study was conducted for a period of 9 months in the out-patient clinic, Department of Oral Medicine and Radiology, Government Dental College, Kozhikode (tertiary healthcare centre in Kerala, India). Methods and Materials: Participants aged 60 and above were selected by consecutive sampling. Data were collected through clinical examination and by using a structured proforma.Statistical Analysis Used: Descriptive statistics with tests of significance of associations were done. Results: The geriatric population (N=750, 66.89 ± 6.07, M: F=1.4:1), was recruited by screening 43,180, and 447 (67.29 ± 6.15, M: F=2:1) were identified having oral mucosal lesions withprevalence of 59.6% (95% CI=56.05–63.05). Most common lesion group was red and white (73.2%), followed by pigmented (15.5%). Oral mucosal lesions were significantly associated with age over 65, male gender, presence of habit and denture usage (P < 0.05). Conclusions: The prevalence of oral mucosal lesions in geriatric people is high. Hence setting up of geriatric dental clinics, with appropriate preventive and palliative intervention strategies is mandatory. [ABSTRACT FROM AUTHOR]

Introduction: Early detection and drug susceptibility analysis of Mycobacterium tuberculosis (MTB) in the shortest possible time has been the driving force for research that aims to bridge the gap between detection and treatment. In this regard Line Probe Assays (LPA) were commissioned in 2008 by World Health Organisation (WHO) as an addition in the long list of diagnostic tools for MTB. Aim: To assess the utility of LPA for the detection of Multi Drug Resistant Tuberculosis (MDR-TB) and to find out the most common mutations associated with it. Materials and Methods: Two hundred and fifty two smear positive sputum samples and 100 randomly selected smear negative samples were subjected to LPA and cultured on Loweinstein Jensen (LJ) medium. MTB was confirmed taking into account colony morphology on LJ medium, Ziehl-Neelson (ZN) staining and Nitrate reductase assay. LPA was performed as per the directions of the manufacturer. McNemar χ² test was used for statistical hypothesis testing and data was analysed using OpenEpi version 3. Results: Of the 252 smear positive sputum samples, growth on LJ was seen in 238 (94.4%) samples whereas LPA was positive for 241 (95.6%) samples. Of the 100 smear negative samples growth of MTB was seen in seven samples whereas five were positive by LPA. Sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) for smear positive and negative samples was 100%, 78.6%, 98.9%, 100% and 71.4%, 100%, 100%, 97.9%, respectively. Diagnostic accuracy of the test was 98.6%. One sample showed low level Isoniazid (INH) mono-resistance whereas two samples were hetero-resistant to INH that corresponded to C15T mutation. One sample was resistant to Rifampicin (RIF) that represents a mutation in 531 codon of rpoB gene. Average detection time of MTB on LJ medium was 31.5 days whereas for LPA it was 3.8 days. Conclusion: LPA due to its rapid turnaround time and high sensitivity and specificity for the detection and susceptibility testing of MTB directly from smear-positive sputum samples can significantly aid in the diagnosis, treatment, and management of MDR-TB. However, LPA cannot completely replace phenotypic culture methods, as the performance of this test is still low for sputum smear negative cases. [ABSTRACT FROM AUTHOR]

Context: Parkinson's disease (PD) is a neurodegenerative disease characterized by traditional motor features. Non-motor symptoms (NMS) are also seen in PD, which inevitably emerge through the disease progression and are often under-recognized and untargeted. Aims: We studied the prevalence of NMS in PD and their impact on health-related quality of life (HRQoL). Materials and Methods: A cross-sectional observational study from January 2017 to July 2017 of PD patients (n = 100) was done. NMS and HRQoL are measured using NMS scoring scale; PD questionnaire-39 and Hoehn and Yahr scale, respectively. Motor symptoms were assessed using scales for outcome in Parkinson's disease (SCoPA) - motor scoring scale. Statistical Analysis: Descriptive statistics calculated for NMS' prevalence. Continuous variables were assessed by two-tailed t-test and discrete and categorical variables by chi-square test. Multiple linear regression analysis was done among scoring scales to identify the influence on 39-item Parkinson's disease questionnaire (PDQ-39) scoring scale. All statistical data collected are analyzed with SSPS software version- 20 for windows. Results: In 100 study population, 66 were males and 34 females. The mean age was 68.35 years and median onset of duration of PD was 3.49 with 64.6% on treatment. Fatigue, pain, and lightheadedness were more prevalent NMS with 78%, 75%, and 69%, respectively. With regression analysis, strongest predictor was NMSS score (P = 0.000), with each unit increase, it is associated with nearly 0.65 increase in PDQ-39 score. Conclusion: Though motor symptoms define the disease, NMS have a larger impact on HRQoL in PD and on caregiver's life. Understanding the pattern and effect of NMS is needed for targeted treatment strategies. [ABSTRACT FROM AUTHOR]

Objective  There is no systematic report on pathway to care in autism from tertiary care medical centers of India. The present study was aimed to evaluate the pathways to care among parents of children with autism-seeking treatment at a tertiary care medical center. Methods  Cross-sectional, observational study involving parents of 38 children with autism spectrum disorder diagnosed with INCLEN diagnostic tool. Pathway to care was assessed using World Health Organization Encounter Form. Statistical Analysis   IBM Statistical Package for Social Sciences (SPSS) 20.0 was used for analysis; categorical variables were assessed using Chi-square test keeping statistical significance at 0.05%. Results  A total of 74% parents reported going to a general practitioner and 13% reported going to a child psychiatrist as point of first contact. Among them, 71% parents reported seeking care with a child psychiatrist in a tertiary medical center at the fourth point of contact. Also, 84% parents believed in biomedical explanation of autism. Majority of parents sought for speech therapy and medicines for their child with autism which is in tune with their biomedical explanation. Parents were the first to identify developmental concerns, average age of symptom recognition being 2.2 years. Average age of intervention initiation was 40 months, 8 months prior to diagnosis of autism. Conclusions  Early symptom recognition and initiation of interventions is encouraging. Despite having a biomedical explanation of autism and ability to recognize developmental concerns, there is a lag of 4 years in diagnosis and reaching a specialized child psychiatry setup. This lag is a cause of concern owing to the impact on access to evidence-based interventions. [ABSTRACT FROM AUTHOR]

Background: Old age is often associated with functional decline and physical dependence, thus compromising the ability to carry out basic tasks required for daily living. There are very few community‑based studies on functional disability among elderly, especially in India. This study was done to find out the prevalence of functional disability and associated risk factors among the elderly in urbanized villages of Delhi. Methods: A cross‑sectional study was conducted in two urbanized villages of East Delhi. A semi‑structured interview schedule was used to record the socio‑demographic and relevant personal details of the elderly (>60 years). Functional disability was defined as a disability in activities of daily living (ADL) or blindness or bilateral hearing impairment or a combination of these. Statistical analysis included simple descriptive analysis and tests of significance like Chi‑square test. The multiple logistic regression was used to identify predictors of functional disability. Results: Data were collected from 360 study participants. Around one‑fourth (25.6%) of the study participants were having a functional disability. Older age, presence of chronic disease, and having possible malnutrition were found to be significant predictors of functional disability among the elderly by applying the multiple logistic regression. Conclusions: Functional disability needs to be identified at an early stage using appropriate tools so that proper interventions can be directed to those who need it to ensure healthy aging. [ABSTRACT FROM AUTHOR]

Introduction: Laboratory Request Form (LRF) offers communication triad involving patient, physician and diagnostic service providers. LRFs with complete patient's clinical information along with the diagnostic results may be used as predictor tool for emerging diseases. Overcrowding of wards in developing countries, especially in India, may affect physician's effectiveness causing an appalling lack of clinical symptoms in LRFs or mostly left unattended by form attendees. Solving this problem certainly requires a novel method of data collection with the aim of improving the physician's attention. Aim: The objective of this study was two-fold: (1) to determine the proportion of unattended and partially filled LRFs; and (2) to evaluate the effectiveness of pictograms over text oriented symptoms. Materials and Methods: A total of 645 Pictogram based LRF (PLRF) were provided as an overleaf along with the Text oriented LRFs (TLRF). The percentages of blank form, total symptoms per form, and individual symptoms per form were calculated. Physicians Attention Index (PAI) was also calculated based on the number of LRFs in which physicians filled the duration of one or more symptoms. The difference in frequencies of categorical responses between two dependent groups was calculated by way of the comparison of proportions and chi-square. A two-sided p-value <0.05 was considered as the test of significance for all parameters. Results: A significant proportion of unattended forms decreased upon implementation of PLRFs (23.4% vs. 11.8%; p-value =0.0001). Notably, symptoms such as headache, abdominal pain, rhinorrhea, knee pain showed the most improved proportions of all. During this study period, dengue accounts for >80% of the test request provided with more number of associated symptoms. Interestingly, PAI was 0.125 (21.7%) in PLRFs and this could not be possible in the default TLRF. Conclusion: Revisiting of LRF is need of the hour in order to get maximum attention from form attendees thereby improving adequacy in test requesting information. This will ultimately aid the physician or diagnostic service providers to offer differential diagnosis which in turn improves the quality of patient care. [ABSTRACT FROM AUTHOR]

BACKGROUND: The effects of weather on diarrhea could influence the health impacts of climate change. Children have the highest diarrhea incidence, especially in India, where many lack safe water and sanitation. OBJECTIVES: In a prospective cohort of 1,284 children under 5 y of age from 900 households across 25 villages in rural Tamil Nadu, India, we examined whether high temperature and heavy rainfall was associated with increased all-cause diarrhea and water contamination. METHODS: Seven-day prevalence of diarrhea was assessed monthly for up to 12 visits from January 2008 to April 2009, and hydrogen sulfide (H2S) presence in drinking water, a fecal contamination indicator, was tested in a subset of households. We estimated associations between temperature and rainfall exposures and diarrhea and H2S using binomial regressions, adjusting for potential confounders, random effects for village, and autoregressive-1 error terms for study week. RESULTS: There were 259 cases of diarrhea. The prevalence of diarrhea during the 7 d before visits was 2.95 times higher (95% CI: 1.99, 4.39) when mean temperature in the week before the 7-d recall was in the hottest versus the coolest quartile of weekly mean temperature during 1 December 2007 to 15 April 2009. Diarrhea prevalence was 1.50 times higher when the 3 weeks before the diarrhea recall period included ≥1 d (vs. 0 d) with rainfall of >16:82 mm (95% CI: 1.12, 2.02), and 2.60 times higher (95% CI: 1.55, 4.36) for heavy rain weeks following a 60-d dry period. The H2S prevalence in household water was not associated with heavy rain prior to sample collection. CONCLUSIONS: The results suggest that, in rural Tamil Nadu, heavy rainfall may wash pathogens that accumulate during dry weather into child contact. Higher temperatures were positively associated with diarrhea 1-3 weeks later. Our findings suggest that diarrhea morbidity could worsen under climate change without interventions to reduce enteric pathogen transmission through multiple pathways. [ABSTRACT FROM AUTHOR]

The study has been conducted with a purpose to make an assessment of the usage of a selected set of e-book collections with an objective to work out the similarity or difference in their use across selected states of northern India. An effort has also been made to see whether the users use a single or a combination of e-book collections. Seven sampled universities were surveyed personally by the investigator for collecting data about the questions under investigation. A questionnaire was used as a data collection tool. The investigator also availed of the telephonic and e-mail communication and had a face-to-face interaction with respondents to collect prompt responses, substantiate the responses, and remove ambiguities thereof. Statistical Package for Social Science (SPSS) was analyze the data on an empirical basis. Chi Squared (χ²) Test has been used to derive association between the variables and test the level of significance. It has been found that only one e-book collection, the 'CAB e-Books' is being subscribed and that too by only 42% of the libraries. Thus, the e-book collections has not yet gained popularity among the users of north Indian agricultural libraries, as this e-book collection is found to be used only by 58.33% of users. However, the libraries where the e-books are being subscribed regularly register a comparatively high usage than the ones where it is not as it is found that majority (77.30%) of users therein use e-books on a 'daily' basis. Krishikosh, the recently initiated e-book platform in India is fast gaining its popularity. It is also statistically verified that there is a significant association between 'use of e-book collections' and the 'State' & 'University' as two variables; that is, the usage of the e-book collections under study varies quite significantly from state to state and from university to university (p<0.01). [ABSTRACT FROM AUTHOR]

This paper investigates if better access to secondary education increases enrollment in primary schools among children in the 6–10 age group. Using a household level longitudinal survey in a poor state in India, we find support for our hypothesis. Using recent methods developed to assess the impact of omitted variable bias on the estimated coefficient, we show that correction for a bias emanating from endogenous placement of schools leaves our conclusions unchanged. Moreover, the marginal effect is larger for poorer households and boys (who are more likely to enter the labor force). We also provide some suggestive evidence that this effect may be quite widespread in India. [ABSTRACT FROM AUTHOR]

Context: Lack of literature on psychological aspects of survivors of farmers' suicides is hurdle in devising effective helping strategies for rising number of survivors across the country. Aims and Objectives: To assess the psychological distress and its correlates in survivors of farmers' suicides. Settings and Design: Case--control study design was used in Wardha District of Vidarbha region in the central India. Materials and Methods: A predesigned and pretested semistructured questionnaire was used to assess sociodemographic variables. Self-Reporting Questionnaire-20 was used to evaluate psychological distress in 98 survivors of farmers' suicides and 98 age, sex, and occupation-matched controls. Statistical Analysis: Significance of differences between case and control groups were assessed using Chi-square test or Fisher's two-tailed exact test for class variables. For continuous variables, Student's t-test was used P < 0.05 was considered significant. Results: Significantly higher proportion of survivors had psychological distress than controls. Female survivors, spouse and parents of suicide victims had a high risk of distress. Psychological distress was commonly expressed by depressive and somatic symptoms. Conclusions: Survivors of farmers' suicides are suffering from significant psychological distress. [ABSTRACT FROM AUTHOR]

Objective: To compare efficacy, safety and cost-effectiveness of rupatadine and olopatadine in patients of chronic spontaneous urticaria. Materials and Methods: A 6-week, single-centered, randomized, double blind, parallel group comparative clinical study was conducted on patients with chronic spontaneous urticaria. Following inclusion and exclusion criteria, 60 patients were recruited and were randomized to two treatment groups and received the respective drugs for 6 weeks. At follow-up, parameters assessed were mean total symptom score (MTSS) calculated by adding the mean number of wheals (MNW) and the mean pruritus score (MPS), number of wheals, size of wheal, scale for interference of wheals with sleep (SIWS). Results: Both the drugs significantly reduced the MTSS, number of wheals, size of wheal, scale for interference of wheals with sleep, but olopatadine was found to be superior. In olopatadine group, there was significantly higher reduction in MTSS (p = 0.01), Number of wheals (P < 0.05), Size of wheals (p < 0.05), Scale for intensity of erythema (p < 0.05) and change in eosinopils count (p = 0.015) than that of rupatadine. Incidence of adverse effects was found to be less in olopatadine group when compared with rupatadine group. Cost effectiveness ratio was less in olopatadine group as compared to rupatadine group throughout the treatment. Conclusions: Olopatadine is a better choice in chronic spontaneous urticaria in comparison to rupatadine due to its better efficacy, safety and cost effectiveness profile. [ABSTRACT FROM AUTHOR]

Gestational Diabetes Mellitus (GDM) exposes women to a higher risk for development of type 2 diabetes mellitus in later years of life. Newborns of mothers with GDM are at increased risk for acute perinatal complications including hypoglycaemia, jaundice and being large for gestational age. One of the mechanisms underlying glucose metabolism in pregnancy are a group of substances, which includes leptin and adiponectin, produced mainly in the adipose tissue; in this paper we analyze the role of these mediators in women with GDM. This case control study was performed in 90 females (30 GDM patients and 60 control subjects without GDM) referred to a tertiary care hospital. Blood samples were analyzed for fasting blood glucose, leptin and adiponectin. Leptin and Adiponectin were analyzed using ELISA technique. In our study, the levels of fasting blood glucose were statistically significantly higher (p=0.000) in gestational diabetes patients as compared to controls. There was statistically significant positive correlation between blood glucose and leptin (p = 0.000, r = 0.585). There was statistically significant negative correlation between blood glucose and adiponectin(p = 0.000, r = -0.661). An amplification of the low-grade inflammation already existing in normal pregnancy may lead to increase in leptin and decrease in adiponectin. These factors may play a role in development of gestational diabetes mellitus. Further studies are required for establishing them as a marker for gestational diabetes mellitus. [ABSTRACT FROM AUTHOR]

Aims & Objectives: To measure the interest of the subjects in each of the domains of leisure interest and visual function among people with partial and complete (acquired) visual impairment. To find out if a relationship exists between visual function and the domains of leisure interest in people with visual impairment. Methods: 49 visually impaired subjects 18 years and above, were assigned in two groups (group 1 : partial visual impairment, and group 2: complete visual impairment). The degree of leisure interests, and visual function were assessed. Statistical analysis was done. Results: Interest of all the subjects towards each of the domains of leisure interest were observed and compared between group 1 and group 2. A significant difference in the visual function of both the groups was also observed. Pearson correlation (2-tailed) was applied between visual function and domains of leisure interest [Visual function & LIM_D (Artistic domain), r = .351 and visual function & LIM_H (Reading domain), r = -.312]. Conclusion: The results of the study have highlighted the leisure interests of persons with visual impairment and encourages leisure as part of Occupational Therapy intervention for visually impaired people, to manage physical and psycho-social consequences of their visual impairment. [ABSTRACT FROM AUTHOR]

Objectives: Low birth weight (LBW; <2500 g), which is often associated with preterm birth, is a common problem in India. Both are recognized risk factors for neonatal mortality. Kangaroo mother care (KMC) is a non-conventional, low-cost method for newborn care based upon intimate skin-to-skin contact between mother and baby. Our objective was to assess physiological state of LBW babies before and after KMC in a teaching hospital setting. Materials and Methods: Study cohort comprised in-born LBW babies and their mothers - 300 mother-baby pairs were selected through purposive sampling. Initially, KMC was started for 1 hour duration (at a stretch) on first day and then increased by 1 hour each day for next 2 days. Axillary temperature, respiration rate (RR/ min), heart rate (HR/ min), and oxygen saturation (SpO2) were assessed for 3 consecutive days, immediately before and after KMC. Results: Data from 265 mother-baby pairs were analyzed. Improvements occurred in all 4 recorded physiological parameters during the KMC sessions. Mean temperature rose by about 0.4°C, RR by 3 per minute, HR by 5 bpm, and SpO2 by 5% following KMC sessions. Although modest, these changes were statistically significant on all 3 days. Individual abnormalities (e.g. hypothermia, bradycardia, tachycardia, low SpO2) were often corrected during the KMC sessions. Conclusions: Babies receiving KMC showed modest but statistically significant improvement in vital physiological parameters on all 3 days. Thus, without using special equipment, the KMC strategy can offer improved care to LBW babies. These findings support wider implementation of this strategy. [ABSTRACT FROM AUTHOR]

Aims/Introduction Peroxisome proliferator activated receptor gamma ( PPARG) is a nuclear hormone receptor of the ligand-dependent transcription factor involved in adipogenesis, and a molecular target of the insulin sensitizer, thiazolidinediones. The present study aimed to investigate whether the PPARG gene is associated with type 2 diabetes mellitus and its related traits within the population of West Bengal, India. Materials and Methods The study participants (200 type 2 diabetes mellitus and 200 normal individuals) were chosen randomly, and the variants were screened by direct sequencing. Results The results showed that rs1801282 (odds ratio 0.66; 95% confidence interval 0.15-2.96; P = 0.57) and rs3856806 (odds ratio 1.23; 95% confidence interval 0.73-2.06; P = 0.44) variants of the PPARG gene were not associated with type 2 diabetes mellitus. Conclusions The results showed that the PPARG gene was not associated with type 2 diabetes mellitus in our study population. As the lack of association might come from the small sample size, further studies with larger sample size are required to verify the present observation. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of pityriasis rosea (PR) is generally clinical. Previous studies usually recruited relatively small numbers of patients and control subjects, leading to low power of study results. Systematic reviews and meta-analyses cannot be readily performed, as the inclusion and exclusion criteria of these studies were not uniform. We have previously validated a set of diagnostic criteria (DC) in Chinese patients with PR. Aim: Our aim is to evaluate the validity and applicability of the DC of PR in Indian patients with PR. Study Design: Prospective unblinded pair-matched case-control study. Materials and Methods: The setting is a dermatology clinic in India served by one board-certified dermatologist. We recruited all 88 patients seen by us during five years diagnosed to have PR to join our study. For each study subject, we recruited the next patient who consulted us with differential diagnoses of PR as control subjects. We applied the DC of PR on all study and control subjects. Result: The sensitivity, specificity, positive predictive value, and negative predictive value of the DC were all 100%. Two-tailed Fisher’s exact probability test result was 0.036. Φ was 1.00. Conclusion: The set of DC can be validly applied to Indian patients with PR. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis is one of the major extra-pulmonary manifestations of chronic obstructive pulmonary disease (COPD), which limits the physical activity. The present study was undertaken to study the bone mineral density (BMD) and osteoporosis in the elderly COPD patients. Materials and Methods: This was a cross-sectional study carried out among elderly COPD patients. After a detailed clinical history spirometry was done to stage the severity of COPD. DEXA scan of the lumbar spine was performed using bone densitometer to determine osteoporosis. Statistical analysis was based on Chi-square test. Risk factors were identified by univariate and multivariate logistic regression analysis. Results: A total of 70 elderly COPD patients were included. Fourty-six patients (65.7%) had osteoporosis and 13 (18.6%) had osteopenia. Majority of the osteoporosis patients had stage III or stage IV COPD disease (77.2%). As the severity grade of COPD increased, the risk of osteoporosis also increased. Also, with the increasing severity of COPD, BMD decreased. Patients with lower body mass index (BMI) had higher prevalence of osteoporosis (45.7%). Using multivariate regression analysis, stage IV COPD, number of acute exacerbations >3 and steroid cumulative dose >1000 mg were independent risk factors for osteoporosis in elderly COPD patients. Conclusions: The prevalence of osteoporosis was 65.7%, and 18.6% had osteopenia. Stage III and IV patients had significantly lower BMI in elderly COPD patients. High clinical suspicion and early diagnosis and treatment are required in the evaluation of osteoporosis in elderly COPD patients. [ABSTRACT FROM AUTHOR]

Background: The venous stasis of soleal vein during surgery may be an important factor in the development of deep vein thrombosis (DVT). The stimulation of calf muscle during surgery may help in preventing DVT. The present study is conducted to evaluate the role of peroperative calf muscle electrostimulation in prevention of DVT in patients undergoing surgeries around the hip joint. Materials and Methods: The study comprised 200 patients undergoing surgeries around the hip joint. The patients having risk factors (such as previous myocardial infarction, malignancies, paraplegia or lower limb monoplegia, previous history of DVT or varicose veins, etc.) for the development of DVT were excluded. They were randomized into two groups: 100 cases were given peroperative calf muscle electrostimulation for DVT prophylaxis (Group A) and the remaining 100 patients were taken as controls without any prophylaxis (Group B). The color Doppler ultrasound was performed to exclude pre-existing DVT and on 7th day postoperative to find out the incidence of DVT in both the groups. Results: Two patients among Group A and six patients among Group B demonstrated DVT on ultrasonography, but the difference was not found to be statistically significant (P=0.279). None of the patients had any clinical evidence of DVT. Conclusion: The role of peroperative calf muscle electrostimulation for DVT prophylaxis remains controversial. The risk of developing DVT in patients undergoing surgeries around the hip joint is very less in patients analysed in our series. [ABSTRACT FROM AUTHOR]

Background: The present work aimed at to describe hearing threshold based on audiometry data of the mine workers based on their age, work station and years of working of an open cast chromite mine in Odisha, India at high fence. Materials and Methods: A cross-sectional study of hearing threshold of the subjects of the chromite mine was carried out. Audiometric data of 500 subjects were taken from the hospital of the mines of Sukinda Valley, Jajpur, Odisha, India. The latest audiometry data available during the period 2002 to 2008 was used in the statistical analysis. Results: The age group 50-60 years is found to be the most influential age group suffering significant hearing loss on both the ears. Also, the Work Zone area is found to be most significant area affecting hearing loss on both the ears. However, the subjects having experience of 30-35 and 25-30 years have the most significant hearing loss on the left and right ears, respectively. Conclusion: The hearing loss is found to be at 6 kHz, thus the working areas of the subjects working at work zone should be regularly rotated in less noisy areas to reduce the exposure duration. High frequency noise protective device should be advocated among all the subjects in general and HEMMs operators in particulars. Regular audiometry test of all the subjects should be performed to identify the hearing loss of the subjects occurring at 6 kHz. It is essential to perform periodic maintenance of all the HEMMs to keep all the vehicles in good condition those are generating noise at dominating frequency of 4 and 6 kHz. [ABSTRACT FROM AUTHOR]

Background: Topical steroids remain the mainstay of treatment in eczema, an inflammatory skin reaction characterized by pruritus, redness, scaling, and clustered oozing papulovesicles. Halometasone is a new potent corticosteroid approved in the Indian market for topical application in the treatment of dermatitis. Aims: To evaluate the efficacy and safety of halometasone in the treatment of acute or chronic noninfected eczematous dermatosis in Indian population. Materials and Methods: A prospective, open, multicentric, phase 3, noncomparative clinical trial conducted at outpatient departments of seven centres. Two hundred endogenous eczema patients meeting study criteria were enrolled. Halometasone 0.05% cream was applied twice daily for 30 days in chronic and 20 days in acute eczema patients. Calculation of eczema area and severity index, and assessment of investigator's global assessment of severity of eczema and severity of pruritus score were done at each visit and compared with baseline. All adverse events (AE) were captured and documented. Laboratory investigations including haematological tests, urinalysis, renal and liver function tests were performed at baseline and at end of treatment. Results: Of the 200 patients enrolled, 180 were chronic and 20 were acute eczema patients. It was found that there was a significant (P<0.001) improvement in all efficacy parameters compared with baseline. The treatment was shown to be successful in 91% patients. AE were reported in 30 patients and there was no serious AE reported. There was no clinically significant difference in laboratory investigations with treatment. Conclusions: Halometasone was shown to be safe and very effective in Indian patients with acute and chronic eczema and the drug was well tolerated. [ABSTRACT FROM AUTHOR]

Falls are prevalent reasons for spinal cord injury (SCI). Postinjury fear of falling (FOF) can affect rehabilitation potential. We quantified FOF in 15 men with paraplegia (ambulatory with bilateral knee-ankle-foot orthoses [KAFOs] and elbow crutches) in correlation with their postural control at the center for long-term SCI rehabilitation of a tertiary-care teaching hospital. Our outcome measures comprised the American Spinal Injury Association Impairment Scale, the Modified Falls Efficacy Scale (MFES), postural sway measurements in the anteroposterior and mediolateral directions; and walking speed, cadence, and endurance. We assessed FOF with the MFES followed by measuring postural sway with a force platform. We measured gait parameters by asking the participant to ambulate on an indoor pathway. The mean postural sway was 314.13 +/-184.05 mm (mean +/- standard deviation) in the anteroposterior direction and 222.16 +/- 112.34 mm in the mediolateral direction. The MFES score was 41.29 +/- 12.77, which showed a statistically significant negative correlation with postural control. The self-perception of confidence as measured by MFES might not really represent the actual postural stability in individuals with low-level paraplegia. FOF can adversely affect the postural control of individuals with low-level paraplegia. Clinicians should consider FOF as an influential factor in postural control during rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: The present study was undertaken to find out the relationship of Goseki grading system (I-IV) with existing classification of WHO, Lauren and tumour differentiation of gastric carcinoma and its prognostic information in relation to AgNOR & PCNA expression. Materials and methods: To assess the reproducibility and usefulness of Goseki grading system thirty five gastric carcinoma were selected from January 2007 to July 2009 in the department of Pathology, Burdwan Medical College in West Bengal, India and analyzed in relation to existing grading system by chi-squared testing. Mean AgNOR count & mean PCNA leveling index quantities of different tissue sections were assessed according to different classification system of gastric carcinoma and interobserver variations of all data were evaluated from Spearman Rank-order Correlation Coefficient (rs ). Results: Highly significant predictable correlation of Goseki grading system for existing classification of gastric carcinoma was obtained statistically. Increasing values of mean AgNOR count and PCNA leveling index (2.35% & 15.14%, 2.91% & 21.32%, 3.08 %& 24.76% and 3.2% & 25.12 respectively) were observed from Grade I - IV of Goseki grade. Mucin rich (3.05% & 23.22%) and tubule poor (3.14% & 24.76%) tumours higher values than mucin poor (2.71% & 19.95%) and tubule rich (2.63% & 18.23%) tumors. No significant correlations were observed in other grading system. Conclusion: Following Goseki grading system increasing expression of proliferating marker in mucin rich than mucin poor tumours and tubules poor than tubules rich tumors indicate poor prognosis and tumour behavior. Simple system may help to select patients for adjuvant therapy. [ABSTRACT FROM AUTHOR]

Background and Aims: The 2009 pandemic influenza A (H1N1) has taken its toll across most parts of India. We aimed to study its epidemiology, clinical characteristics and outcomes from an Indian multidisciplinary intensive care unit (ICU). Materials and Methods: All patients admitted to our ICU with a flu-like illness and who tested positive for the 2009 H1N1 by reverse -transcriptase polymerase- chain -reaction assay during a 3 month period were prospectively studied. Results: Thirty one patients were admitted to the ICU during the study period. Patients were in the younger age group with a median age of 35 years (IQR: 28.2-42.8). Obesity was the commonest risk factor. Twenty six patients (83.9%) required ventilator support; the median duration of ventilator support was 10 days (IQR: 4-22). Severe hypoxemia was the predominant feature in all patients. Circulatory failure requiring vasopressors occurred in 18 (58.1%) patients and acute kidney injury in 6 (3.2%) patients. Twenty six patients were alive at the end of 28 days; subsequently all except one were discharged. The median duration of hospital stay was 15 (IQR: 8-22.5) days. Increasing APACHE II scores were associated with an increased risk of death (Hazard Ratio: 1.1; CI: 1.08 -1.2; P = 0.04). Mean tidal volumes in non-survivors were significantly lower; this was related to poor lung compliance in this group. Conclusions: 2009 H1N1 infection caused severe disease in relatively young patients without significant co-morbidities, characterized by severe hypoxemia and the requirement for prolonged mechanical ventilation. Extra-pulmonary organ failure included circulatory and renal failure. [ABSTRACT FROM AUTHOR]

Setting: Under India's Revised National Tuberculosis Control Programme (RNTCP), >15% of previously-treated patients in the reported 2006 patient cohort defaulted from anti-tuberculosis treatment. Objective: To assess the timing, characteristics, and risk factors for default amongst re-treatment TB patients. Methodology: For this case-control study, in 90 randomly-selected programme units treatment records were abstracted from all 2006 defaulters from the RNTCP re-treatment regimen (cases), with one consecutively-selected non-defaulter per case. Patients who interrupted anti-tuberculosis treatment for >2 months were classified as defaulters. Results: 1,141 defaulters and 1,189 non-defaulters were included. The median duration of treatment prior to default was 81 days (25%-75% interquartile range 44-117 days) and documented retrieval efforts after treatment interruption were inadequate. Defaulters were more likely to have been male (adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI] 1.2-1.7), have previously defaulted anti-tuberculosis treatment (aOR 1.3 95%CI 1.1-1.6], have previous treatment from non- RNTCP providers (AOR 1.3, 95%CI 1.0-1.6], or have public health facility-based treatment observation (aOR 1.3, 95%CI 1.1-1.6). Conclusions: Amongst the large number of re-treatment patients in India, default occurs early and often. Improved pretreatment counseling and community-based treatment provision may reduce default rates. Efforts to retrieve treatment interrupters prior to default require strengthening. [ABSTRACT FROM AUTHOR]

Background and purpose: Death anxiety is defined as anxiety caused by conscious and unconscious fear of death that has relations with several variables. The aim for this study is to estimate the prevalence of death anxiety among a hospital staff in Sari. Materials and methods: This is a descriptive study and data was collected through a questionnaire. The number of cases was 576. The questionnaire (Templer's Death Anxiety Scale) includes 15 True-False questions. After data collection processing was done through spss.16 and analyzing performed through T-test and Chi-square test. Results: The age range was 20-53. 42.2% of cases had low death anxiety and 57.8% had high death anxiety. The mean of scores achieved by cases through questionnaire was 7.70 ± 3.133 by women and 6.19 ± 2.552 by men. The degree of death anxiety has had significant correlation with variable of sex while has had no relation with age, marriage condition, having or lack of child, level of graduation and career condition. Conclusion: The results of this study shows that the most cases have had high degrees of death anxiety that can be because of the special condition of working or the combination of cases's sex and age. With caution to results, it is recommended to Mental Health interventions to the same population to improve the mental health Quality additionally perform more comprehensive studies in more generally populations. [ABSTRACT FROM AUTHOR]

Utilizing data from the Census of India, this study compared child sex ratio in rural and urban regions of India and analyzed whether the child sex ratio was associated with mother’s education level. The child sex ratios in the rural and urban regions throughout India were analyzed using the two-sample and paired Student’s t-test. Further, the Chi-square test for trend in binomial proportions was used to assess the association between child sex ratios and mother’s education levels in rural and urban areas. Analysis of the data showed that there was a significant difference between the child sex ratios in rural areas versus urban areas. In addition, the Chi-square test for trend showed that there was a significant association of the child sex ratio and the educational levels of their mothers. This trend occurred in both rural and urban areas. [ABSTRACT FROM AUTHOR]

Background Systematic evidence on the patterns of health deprivation among indigenous peoples remains scant in developing countries. We investigate the inequalities in mortality and substance use between indigenous and non-indigenous, and within indigenous, groups in India, with an aim to establishing the relative contribution of socioeconomic status in generating health inequalities. Methods and Findings Cross-sectional population-based data were obtained from the 1998-1999 Indian National Family Health Survey. Mortality, smoking, chewing tobacco use, and alcohol use were four separate binary outcomes in our analysis. Indigenous status in the context of India was operationalized through the Indian government category of scheduled tribes, or Adivasis, which refers to people living in tribal communities characterized by distinctive social, cultural, historical, and geographical circumstances. Indigenous groups experience excess mortality compared to non-indigenous groups, even after adjusting for economic standard of living (odds ratio 1.22; 95% confidence interval 1.13- 1.30). They are also more likely to smoke and (especially) drink alcohol, but the prevalence of chewing tobacco is not substantially different between indigenous and non-indigenous groups. There are substantial health variations within indigenous groups, such that indigenous peoples in the bottom quintile of the indigenous-peoples-specific standard of living index have an odds ratio for mortality of 1.61 (95% confidence interval 1.33-1.95) compared to indigenous peoples in the top fifth of the wealth distribution. Smoking, drinking alcohol, and chewing tobacco also show graded associations with socioeconomic status within indigenous groups. Conclusions Socioeconomic status differentials substantially account for the health inequalities between indigenous and non-indigenous groups in India. However, a strong socioeconomic gradient in health is also evident within indigenous populations, reiterating the overall importance of socioeconomic status for reducing population-level health disparities, regardless of indigeneity. [ABSTRACT FROM AUTHOR]

Aims and Objectives: It is observed that negative studies published in medical journals are underpowered to detect the actual difference between the groups, but no data are available on the quality of the statistics reported in these studies. Therefore, this study was carried out with aim of evaluating negative studies published in Indian medical journals for adequacy of reporting of descriptive and inferential statistics. Materials and Methods: All the original articles published in 14 Pubmed-indexed Indian medical journals were analyzed to determine whether the study was negative or positive. All the negative studies were analyzed for correctness of the descriptive statistics and inferential statistics. The types of data and statistical methods were also noted down. Descriptive statistics was used and values were expressed as frequency, percentages and confidence interval. Results: Incorrect descriptive statistics was mentioned in 15 (28.8%, 95% CI 18.3-42.2%) studies. Information related to assumptions of statistical tests were mentioned in only two (3.8%, 95% CI 1.0-12.9%) articles. Inappropriate/incorrect statistical tests was used in 22 (42.3%, 95% CI 29.8-55.8%) studies. The most common reason for inappropriate reporting of descriptive statistics was use of mean and SD for description of ordinal data. The most common reason for incorrect statistical test was use of parametric test for ordinal data. The most common statistical test was the t-test. Conclusion: Negative studies published in prominent Indian medical journals are statistically weak, and readers critically analyze these studies before making any opinion based on them. [ABSTRACT FROM AUTHOR]

Background: DNA methylation is an important epigenetic feature of DNA that plays a pivotal role in gene expression regulation during spermatogenesis. The enzyme methylenetetrahydrofolate reductase (MTHFR) catalyses the formation of folate intermediates that are vital for DNA synthesis and methylation reactions. C677T and A1298C variants of MTHFR result in reduced plasma folate and increase the susceptibility to various multifactorial disorders. We have already shown that homozygosity for 677 (C→T) mutation in the MTHFR gene, is a risk factor for idiopathic male infertility in an Indian population. Aim: Recently, we showed that homozygosity for the 677(C→T) mutation in the MTHFR gene is a risk factor for idiopathic male infertility and now we aim to assess whether the A1298C mutation in the same gene is an additional risk factor for idiopathic male infertility in an Indian population. Setting and Designs: In a case-control study 151 idiopathic male infertile patients and 140 healthy fertile control individuals were recruited from the University hospital and infertility clinics in Varanasi city, India. Materials and Methods: Genotyping for A1298C change of the MTHFR gene was done by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Statistical Analysis: Allele frequencies were calculated using Fisher's exact test. Odds ratio was calculated as the measure of the association between the MTHFR genotype and idiopathic male infertility. Results: The homozygous (C/C) A1298C polymorphism of the MTHFR gene was present at a statistically high significance in idiopathic azoospermic infertile men (OR=3.4494, CI: 1.0092 to 11.7899, P<0.05). Conclusion: The MTHFR 1298CC genotype is an additional genetic risk factor for idiopathic male infertility in an Indian population. [ABSTRACT FROM AUTHOR]

Background: Betel quid habits in India is widely prevalent and responsible for increased incidence of head and neck cancer in the country. Head and neck cancer is a major public health problem among Paniya tribes, a marginalized tribal group in Kerala state, India. Previous studies among Paniya tribals in Wayanad have documented a high prevalence of betel quid habit. Oral leukoplakia (OL) and oral submucous fibrosis (OSF) are the most common oral mucosal diseases that have a very high malignant transformation rate. Aim: Aim of this study was to evaluate the risks imposed by betel quid habits in the development of oral leukoplakia and oral submucous fibrosis among Paniya tribes of Wayanad. Methods: A cross-sectional study was carried out in 300 residents between September 01, 2009 and March 31, 2017 using a structured questionnaire containing details of betel quid habits and socio-demographic details. Descriptive statistics and testing of hypothesis were used for the analysis using EPI INFO and SPSS 16 software. Results: In the 300 subjects, the mean age was 32.4 ±SD 11.4 years, gender distribution (57.5% males vs. 42.5% females). 32.5% out of the study population were betel quid chewers (46.5% of males and 14.6% of females). The prevalence of OL and OSF was 12.9% and 13.02%, respectively among betel quid chewers. Conclusion: Awareness of head and neck cancer by betel quid habits varied with socioeconomic status among Paniya tribes of Wayanad. Despite their awareness of tobacco chewing as a risk factor for head and neck cancer, most of them still continue to chew. There is an urgent need to develop and implement culturally appropriate awareness-raising activities to target betel quid habit. [ABSTRACT FROM AUTHOR]

The author highlights some commonly observed statistical errors found in clinical trials published in Indian medical journals. He cites inadequate reporting about sample size as one of the major problems. He also observes inappropriate/wrong statistical tests like the chi-square test as another problem. He adds that failure to report adjustment for multiple endpoints is another significant error in clinical trials published in Indian medical journals.