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Purpose This study aims to investigate the role of consumption coping in managing collective tragedy stress and stress outcomes using the COVID-19 pandemic context. Design/methodology/approach A mixed-method study with a sample size of 931 was conducted to develop the questionnaire, followed by a quantitative study with 1,215 respondents to test the hypotheses. Findings The results of this study empirically validated the use of consumption coping and found it effective in managing collective tragedy stress and its outcomes (subjective well-being and continuance intention). Research limitations/implications This study advances the literature on stress coping in a collective tragedy context, with a specific focus on consumption coping. Practical implications The COVID-19 pandemic has affected all elements of the marketing mix. Understanding pandemic-induced stress and the role of consumption coping can help managers to proactively formulate strategic responses suitable for changing consumer habits. Social implications The COVID-19 pandemic has affected all elements of the marketing mix. Understanding pandemic-induced stress and the role of consumption coping can help managers to proactively formulate strategic responses suitable for changing consumer habits. This should lead to better social outcomes. Originality/value This study developed a scale for pandemic-induced stress that integrates various well-established theories to identify the role of consumption coping in managing collective tragedy stress and the psychological mechanism behind the shift in consumer behavior after a collective tragedy.

Background: Adherence to National Airborne Infection Control Guidelines (NAIC) by health-care facilities is an effective way of reducing the spread of air-borne infections such as H1N1, drug-resistant tuberculosis, and COVID-19 disease. Aims and Objectives: This study aims to assess the gaps in knowledge, attitude, implementation, and satisfaction regarding resources availability of NAIC among postgraduate resident doctors. Materials and Methods: Across-sectional study was conducted from December 2019 to February 2021 at a medical college in central India. Total 301 interns, postgraduates, and senior residents in surgery and medicine allied clinical departments were included by convenient sampling method. A pre-designed, self-administered questionnaire was used to assess knowledge, attitude, and practice (KAP) and their satisfaction with available resources regarding NAIC. The data collected were tabulated and were analyzed using descriptive test and comparison of means by Analysis of variance test. Results: Almost 95%, 77%, and 74% of study participants were having adequate KAP on NAIC, respectively. Sixty-one percent participants were satisfied with the resources availability in their work area. Statistically significant association was observed between participants age, designation with their KAP score (P

Objectives SLE is associated with significant mortality, and data from South Asia is limited. Thus, we analysed the causes and predictors of mortality and hierarchical cluster-based survival in the Indian SLE Inception cohort for Research (INSPIRE). Methods Data for patients with SLE was extracted from the INSPIRE database. Univariate analyses of associations between mortality and a number of disease variables were conducted. Agglomerative unsupervised hierarchical cluster analysis was undertaken using 25 variables defining the SLE phenotype. Survival rates across clusters were assessed using non-adjusted and adjusted Cox proportional-hazards models. Results Among 2072 patients (with a median follow-up of 18 months), there were 170 deaths (49.2 deaths per 1000 patient-years) of which cause could be determined in 155 patients. 47.1% occurred in the first 6 months. Most of the mortality (n = 87) were due to SLE disease activity followed by coexisting disease activity and infection (n = 24), infections (n = 23), and 21 to other causes. Among the deaths in which infection played a role, 24 had pneumonia. Clustering identified four clusters, and the mean survival estimates were 39.26, 39.78, 37.69 and 35.86 months in clusters 1, 2, 3 and 4, respectively (P Conclusion SLE in India has high early mortality, and the majority of deaths occur outside the health-care setting. Clustering using the clinically relevant variables at baseline may help identify individuals at high risk of mortality in SLE, even after adjusting for high disease activity.

Bio-drainage is removal of excess soil water through bio-energy of fast-growing tree species having higher transpiration rate. Seven tree species viz. Albizia lebbek, Albizia procera, Acacia nilotica, Dalbergia sissoo, Eucalyptus tereticornis, FRI-4 and FRI-5 clones of Eucalyptus hybrid, Terminalia arjuna and Pongamia pinnata were evaluated for their performance through growth characteristics and biomass studies by planting on waterlogged sites on the bank of Left Bank Canal (LBC) of Bargi command area, Jabalpur district of Madhya Pradesh state (India). Eucalyptus hybrid, followed by Pongamia pinnata exhibited maximum height and biomass accumulation and its allocation to leaves and branches after four years of plantation,attributing the most desirable species for reclaiming waterlogged sites along canal command areas with similar edaphic and climatic conditions.

COVID-19; Registries; Vaccination COVID-19; Registros; Vacunación COVID-19; Registres; Vacunació Vaccine hesitancy is considered a major barrier to achieving herd immunity against COVID-19. While multiple alternative and synergistic approaches including heterologous vaccination, booster doses, and antiviral drugs have been developed, equitable vaccine uptake remains the foremost strategy to manage pandemic. Although none of the currently approved vaccines are live-attenuated, several reports of disease flares, waning protection, and acute-onset syndromes have emerged as short-term adverse events after vaccination. Hence, scientific literature falls short when discussing potential long-term effects in vulnerable cohorts. The COVAD-2 survey follows on from the baseline COVAD-1 survey with the aim to collect patient-reported data on the long-term safety and tolerability of COVID-19 vaccines in immune modulation. The e-survey has been extensively pilot-tested and validated with translations into multiple languages. Anticipated results will help improve vaccination efforts and reduce the imminent risks of COVID-19 infection, especially in understudied vulnerable groups. HC is supported by the National Institution for Health Research Manchester Biomedical Research Centre Funding Scheme. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Objectives The COVID-19 vaccination in autoimmune diseases (COVAD) study aimed to assess short-term COVID-19 vaccination-related adverse events (AEs) in RA patients. Methods An online self-reported questionnaire (March–December 2021) was used to capture data related to COVID-19 vaccination-related AEs in RA, other autoimmune rheumatic diseases (AIRDs) (excluding RA and inflammatory myositis), non-rheumatic autoimmune diseases (nrAIDs) and healthy controls (HCs). Descriptive and multivariable regression analyses were performed. Results Of the 9462 complete respondents, 14.2% (n = 1347) had been diagnosed with RA; they had a mean (s.d.) age of 50.7 (13.7) years, 74.2% were women and 49.3% were Caucasian. In total, 76.9% and 4.2% of patients with RA reported minor and major AEs, respectively. Patients with active and inactive RA had similar AE and hospitalization frequencies. Overall, AEs were reported more frequently by BNT162b2 and mRNA-1273 recipients and less frequently by BBV152 recipients compared with the rest. Major AE and hospitalization frequencies were similar across recipients of different vaccines. Patients receiving methotrexate and hydroxychloroquine reported fewer minor AEs than those patients not on them. Compared with HCs and patients with other AIRDs, patients with RA reported similar total AEs, overall minor AEs, and hospitalizations. Compared with nrAIDs, patients with RA reported lower frequencies of overall AEs, minor AEs (both odds ratio [OR] = 0.7; 95% CI: 0.5, 0.9), and injection site pain (OR = 0.6; 95% CI: 0.5, 0.8) with similar major AE and hospitalization frequencies. Conclusion Despite the differences in AE frequency across different COVID-19 vaccines, all were well tolerated in patients with RA and were comparable to HCs, providing reassurance as to the safety of COVID-19 vaccination.

As millions of people worldwide recover from COVID-19, a substantial proportion continue to have persistent symptoms, pulmonary function abnormalities, and radiological findings suggestive of post-COVID interstitial lung disease (ILD). To date, there is limited scientific evidence on the management of post-COVID ILD, necessitating a consensus-based approach.A panel of experts in pulmonology and thoracic radiology was constituted. Key questions regarding the management of post-COVID ILD were identified. A search was performed on PubMed and EMBASE and updated till 1 March 2022. The relevant literature regarding the epidemiology, pathophysiology, diagnosis and treatment of post-COVID ILD was summarized. Subsequently, suggestions regarding the management of these patients were framed, and a consensus was obtained using the Delphi approach. Those suggestions which were approved by over 80% of the panelists were accepted. The final document was approved by all panel members.Dedicated facilities should be established for the care of patients with post-COVID ILD. Symptom screening, pulmonary function testing, and thoracic imaging have a role in the diagnosis. The pharmacologic and non-pharmacologic options for the management of post-COVID ILD are discussed. Further research into the pathophysiology and management of post-COVID ILD will improve our understanding of this condition.

There is paucity of data on tuberculosis in Indian patients with systemic lupus erythematosus (SLE). We retrospectively studied clinical features and outcome of tuberculosis in SLE. Medical records of patients who developed tuberculosis simultaneous or after the diagnosis of SLE were retrospectively reviewed. All patients fulfilled 1997 ACR and/or SLICC 2012 classification criteria for SLE. A diagnosis of tuberculosis required bacteriological, histopathological or CT/MRI suggestive of tuberculosis and initiation of four drug antituberculous therapy. Baseline parameters were compared with the rest of cohort to identify predictors of tuberculosis. In our cohort of 1335 SLE patients, 48 (3.6%) developed tuberculosis. Incidence of tuberculosis was calculated to be 733 per 100,000 patient years and occurred after a mean disease duration of 3.0 ± 4.1 years. Extrapulmonary tuberculosis (n = 37) was commoner than pulmonary tuberculosis (n =11). Most common radiological pattern in pulmonary tuberculosis was miliary and musculoskeletal TB was most common extrapulmonary TB. A microbiological diagnosis was obtained in 52.1% patients. Male gender was associated with higher risk of tuberculosis [OR 3.30 (1.55-7.05)]. Mortality was 14.5% and all patients who died had either disseminated (n = 5) or central nervous system (CNS) tuberculosis (n = 2). Incidence of tuberculosis in SLE is higher than general population and is associated with different phenotype and higher mortality. Male gender was associated with increased risk of tuberculosis in SLE.

Introduction: Respiratory physiotherapy is one of the therapeutic methods in various respiratoryviral infections. Breathing exercises with other interventions, could enhance the total lung capacityand symptom alleviation in patients with virus-related acute respiratory distress syndrome (ARDS).Aim: To study the clinical evaluation of the role of physiotherapy in hospitalised patients of covid-19diseases. Method: This was an Observational (prospective, cross-sectional) study. 187 patientswere recruited and diagnosed as COVID-19 as per RTPCR at NSCB Medical College, Jabalpur (MP).Patients were randomised into the physiotherapy group and controlled group. Patients in thephysiotherapy group were undergone positional changes, prone ventilation, Breathing exercise,Resistive training, Passive joint motion, Muscle stretching, Bedside standing training, enduranceexercise by a specialized physiotherapist. Mean cough severity index, MMRC grade, respiration rateand peripheral blood saturation were recorded before and after intervention and compared with thecontrolled group. Result: There was significant improvement found in MMRC grade and respirationrate after physical therapy in the physiotherapy group (p-value < 0.05). Exertional dyspnoea andcough severity index significant deceased in physiotherapy group. The positive change was found inperipheral blood saturation. There was decreased in hospitalization stay in the physiotherapy groupas compared to the controlled group. Conclusion: Our study revealed the positive effect ofphysiotherapy on covid-19 disease in terms of symptoms and hospitalization duration among thephysiotherapy group. Physiotherapy exerts a beneficial role in the management of the covid-19disease.

Delay in diagnosis and treatment initiation often lead to poorer outcomes in rheumatoid arthritis (RA). Most of the data on delay in diagnosis and management are from western population with no data from India. Additionally, with improved health care services, whether the delay has changed over years is not known. In this longitudinal observational study, we investigated delay to diagnosis and disease-modifying antirheumatic drugs (DMARDs) initiation over past 9 years.Patients aged ≥ 18 years having RA fulfilling 2010 ACR/EULAR criteria were enrolled from January to June in years 2012, 2017 and 2021. Diagnoses received before presenting to clinic, socioeconomic status, educational level and other demographic variables were recorded.Each year, 323 patients (mean age 49.5-52.01 years) were enrolled. There was a significant reduction in delay in diagnosis from a median (IQR) of 36 (12-84, range 1-288) months in 2012 to 12 (4-36, range 1-180) months in 2017 and 10 (5-24, range 1-120) months) in 2021 (p 0.0001). A significant improvement in time to initiating DMARDs from 2012 [48 (24-96) months] to 2017 [12 (6-36) months] (p 0.0001) and from 2017 to 2021 [12 (5-24) months] (p = 0.03) was seen. Higher education, more patients opting for treatment from rheumatologists, and urbanisation contributed significantly to improvement in delay. There was no impact of age or gender on delay.Delay in diagnosis has improved significantly between 2012 and 2021. However, delay still remains long as most patients miss the 3-month therapeutic window. Future work focussing on reasons for delays in the patient pathway could help improve consultation pathways in India.

Inflammatory response in COVID-19 responsible for acute respiratory distress syndrome (ARDS) and multiorgan failure and play a major role in morbidity and mortality of patients. The present study was undertaken to assess serum level of cytokines and its association with other inflammatory markers and disease severity in COVID-19 and hence their prognostic significance.This was a retrospective observational study of 175 admitted COVID-19 patients. The patient's clinical data, laboratory investigations, inflammatory markers and serum level of cytokines [interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-10 (IL-10) and tumour necrosis factor α (TNFα)] were extracted from their medical records. All patients were divided into three groups viz. group A had asymptomatic patients, group B had mild to moderate ill patients and group C had severe or critical ill patients. Above parameters were analysed and comparative evaluation with severity of disease was done.In present study 55% patients were asymptomatic, 24% patients were mild to moderate illness and remaining 21% patients had severe or critical illness. Fever, cough, dyspnoea and co-morbidities including hypertension and diabetes were more common in group C. Absolute lymphocyte count (ALC), lymphocyte monocyte ratio (LMR) showed decreasing trend whereas absolute neutrophil count (ANC), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and eosinophil-lymphocyte (ELR) showed increasing trend with increase in disease severity. Serum IL-6 was found to be significantly higher in group C (64.98±111.18pg/mL) as compared to group B (15.51±20.66pg/mL) and group A (5.04±56.1pg/mL) (Plt;0.001). Receiver operating characteristic (ROC) curve for IL-6 to differentiate the patients with severe disease from asymptomatic and mild symptomatic disease showed a cut-off of 6.75pg/ml.Elevated IL-6 levels lead to adverse clinical events so IL-6 level might serve as a potential prognostic marker for severity of disease in COVID-19. Inhibition of IL-6 might be helpful to prevent serious adverse events in COVID-19 infection.

Systemic lupus erythematosus (SLE) cohorts across the world have allowed better understanding of SLE, including its bimodal mortality, and the impact of social factors and ethnicity on outcomes. The representation of patients from South Asia has been poor in the existing SLE cohorts across the world. Hence, we planned to initiate an inception cohort to understand the diversity of lupus in India. Indian SLE Inception cohort for REsearch (INSPIRE), planned over 5 years is a multi-centric cohort of adult and childhood lupus patients of Indian origin, fulfilling the SLICC-2012 classification criteria, with an aim to provide cross-sectional information on demography, ethnicity, socio-economic status, standard disease variables, quality of life, and prospective information on new events like hospitalization, infections, pregnancies, changes in disease activity, and damage. One of the other deliverables of this project is the establishment of a biorepository. The instruments to be used for each variable and outcome were finalized, and a web-enabled case report form was prepared to encompass SLEDAI, BILAG, SLICC damage scores, and Lupus quality-of-life index. Ten centers located in different geographic areas of India would enroll patients who are seen for the first time after the start of the study. In the first 8 months, 476 patients (63 children, 36 males) have been enrolled with a median disease duration of 10 (IQR 4–17) months and mucocutaneous features being the most prevalent clinical manifestations. INSPIRE is the first prospective Indian SLE cohort to study the diversity of Indian patients.

Forest soils supporting Sal-Shorea robusta (Roxb. ex Gaertn. f.) plantations in the foot hills of Darjeeling and Kurseong Divisions in West Bengal were studied for their physicochemical characteristics and carbon sequestration potential. Soils are acidic, high in organic carbon and clay content but low in soil reaction (pH) and bulk density (BD). Thick deposit of leaf litter and its decomposition products increase the soil organic carbon (SOC). Significant amount of clay content also increases the moisture content which helps in decomposing the organic matter, reducing the bulk density of soil and reduces erosion. Soil organic matter tends to concentrate with roughly more than half of the soil organic carbon in the upper soil horizons (0-30cm) at all the study sites. Among the study sites, Samardanga block registers lowest SOC while Bamanpukuri block shows highest SOC stock.

BackgroundRheumatoid arthritis (RA) is an autoimmune disease with varied articular and extra‐articular manifestations. In developing countries such as India patients with RA often delay seeking medical advice which may impact prognosis and disease burden.AimTo explore perceptions and experiences of patients living in India in seeking medical help for their RA symptoms.MethodsClinician‐diagnosed RA participants from different socioeconomic backgrounds were interviewed using a semi‐structured topic guide. Participants were purposively selected and interviewed following an iterative approach. All interviews were recorded and transcribed by an independent company and analyzed using a thematic framework. Findings were reported in accordance with consolidated criteria for reporting qualitative research guidelines.ResultsTwenty participants (13 male, 7 female) with median age 40 years (35.7‐46.5) were recruited. Three overarching themes demonstrating participants’ experiences and reasons for delay in seeking medical help were identified. (1) “Symptoms perspectives and delay in participants’ journey” narrated participants’ experiences of having RA symptoms, how these were perceived, rationalized and led to delay. (2) “Participants’ experience of the healthcare system” illustrated delay in referral, reaching diagnosis and treatment initiation highlighting their experiences with the health system. (3) “Recommendations for improving care” where participants made recommendations for reducing the delay at local and national levels.ConclusionThis is the first qualitative study which explored perceptions and experiences of RA patients in India resulting in delay. Improved provision of rheumatology care, effective referral system and greater involvement of government at local and national levels are needed to improve the delay in seeking medical help for Indian patients.

BACKGROUND The objective of the study was to assess T-cell subsets in sarcoidosis patients with or without articular involvement. METHODS Treatment-naive patients were divided into Group A (articular) and Group B (non-articular) based on joint involvement. Flow cytometric analysis of T-cell subsets and pro-in˜flammatory cytokines were carried out in the peripheral blood. RESULTS Patients in group A (n = 29, mean age 40 ± 10.1 years) were compared with group B (n = 18, 43 ± 12.2 years). T-cell subsets: the CD4/CD8 ratio was abnormal in two groups but had no significant difference (p = 0.63). Ratios of Th1/Treg, Th2/Treg and Th17/Treg were significantly increased in group A as compared to group B [p < 0.001] indicating polarisation of T-cell subsets. CD8 T-cells in group A had higher granzyme B expression (p = 0.03). B cells were increased in group A [p = 0.04]. Ratio of IFN-γ /IL10, IL-4/IL10, IL-17/IL10 in sera as well as culture supernatant were significantly higher in group A as compared to group B. CONCLUSION

A key issue in the response to the coronavirus disease 2019 (COVID‐19) pandemic is the internationally recognised observation that COVID‐19 disproportionally affects the Black and Minority Ethnic Population (BAME) (1). We focus predominantly on the countries of the UK, USA, and India COVID‐19 rheumatology challenges and examples. This unprecedented public health crisis started in China in Dec 2019, following an infection caused by a novel coronavirus strain, named as SARS‐CoV2 (2). The World Health Organisation in March 2020 declared this public health emergency as a pandemic (2). COVID‐19 pandemic has moved from country to country peaking at different times despite implementation of strict preventive measures, including complete lock down periods with varied success. Case fatality and mortality rates have been highly variable across nations as well as different ethnic groups (3).

Introduction Ivermectin is an antiparasitic drug which has in-vitro efficacy in reducing severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) viral load. Hence, Ivermectin is under investigation as a repurposed agent for treating COVID-19. Methods In this pilot, double blind, randomized controlled trial, hospitalized patients with mild-to-moderate COVID-19 were assigned to a single oral administration of an elixir formulation of Ivermectin at either 24 mg or 12 mg dose, or placebo in a 1:1:1 ratio. The co-primary outcomes were conversion of RT-PCR to negative result and the decline of viral load at day 5 of enrolment. Safety outcomes included total and serious adverse events. The primary outcomes were assessed in patients who had positive RT-PCR at enrolment (modified intention-to-treat population). Safety outcomes were assessed in all patients who received the intervention (intention-to-treat population). Results Among the 157 patients randomized, 125 were included in modified intention-to-treat analysis. 40 patients each were assigned to Ivermectin 24 mg and 12 mg, and 45 patients to placebo. The RT-PCR negativity at day 5 was higher in the two Ivermectin arms but failed to attain statistical significance (Ivermectin 24 mg, 47.5%; 12 mg arm, 35.0%; and placebo arm, 31.1%; p-value = 0.30). The decline of viral load at day 5 was similar in each arm. No serious adverse events occurred. Conclusions In patients with mild and moderate COVID-19, a single oral administration of Ivermectin did not significantly increase either the negativity of RT-PCR or decline in viral load at day 5 of enrolment compared with placebo.

Bronchial thermoplasty (BT) is an interventional bronchoscopic treatment for severe asthma. There is a need to define patient selection criteria to guide clinicians in offering the appropriate treatment options to patients with severe asthma. Methodology: An expert group formed this statement under the aegis of the Indian Chest Society. We performed a systematic search of the MEDLINE and EMBASE databases to extract evidence on patient selection and the technical performance of BT. Results: The experts agreed that the appropriate selection of patients is crucial and proposed identification of the asthma phenotype, a screening algorithm, and inclusion/exclusion criteria for BT. In the presence of atypical clinical or chest radiograph features, there should be a low threshold for obtaining a thoracic computed tomography scan before BT. The patient should not have had an asthma exacerbation in the preceding two weeks from the day of the procedure. A 5-day course of glucocorticoid should be administered, beginning three days before the procedure day, and continued until the day following the procedure. General Anesthesia (total intravenous anesthesia with a neuromuscular blocker) provides ideal conditions for performing BT. A thin bronchoscope with a 2.0 mm working channel is preferable. An attempt should be made to deliver the maximum radiofrequency activations. Middle lobe treatment is not recommended. Following the procedure, overnight observation in the hospital, and a follow-up visit, a week following each treatment session, is desirable. Conclusion: This position statement provides practical guidance regarding patient selection and the technical performance of BT for severe asthma.

Studies were conducted in SFD controlled pruned tendu bushes dominating forests and CFR controlled non-pruned poles bearing forests in Gondia and Gadchiroli forest divisions of Maharashtra to assess the impact of pruning of tendu bushes on the yield and quality of its leaves. This tree species has attained great economic importance due to its leaves being used as wrappers in the bidi (Indian cigarette) industry and is the good source ofrevenue generation to the states like M.P., Maharashtra, Odisha and U.P. Pruned bushes contributed more than five times healthy leaves (60.33%) than non-pruned poles (11.90%). Gall infested, diseased and defoliated leaves in pruned bushes were recorded less (7.98%, 2.47% and 29.21% respectively), when compared with non-pruned poles (15.37%, 4.97% and 67.76% respectively). The Specific Leaf Area (SLA), which shows the quality of leaves, was found higher (7.46 mm2/mg) in pruned bushes than non-pruned poles (6.39 mm2/mg) exhibiting the better quality of leaves collected from the pruned bushes. Leaf gall in tendu was caused by insect Trioza obsolete, leaf blight disease by Pestalotia diospyri and defoliation by Hypocala rostrata insect. Healthy tendu leaves exhibited maximum carbohydrates and phenols content, while maximum proline was found in diseased leaves and maximum ascorbic acid in insect attacked leaves.

Drought stress is creating dangerous situation worldwide. The impact of stress is not only the deficiency of water but it also leads to the deficiency and losses of everything which are linked to the water resources directly or indirectly. Drought stress disturbs the normal biochemical, molecular and physiological processes, affecting the morphology of plant. As a result the plant is either unable to live on abrupt changes or learn to avoid/tolerate the variation in the environment. The results vary species to species depending on genotype, frequency and time period of drought stress. There is need of screening various tree species for getting information related to their ability and capacity level of susceptibility, tolerance and avoidance behaviour with the further goal of their plantation in the various nurseries in order to rehabilitate the drought prone areas, wastelands and to increase intangible and tangible benefits.

Governments globally are striving to improve citizens’ service delivery by adopting digital technologies, such as online portals and call centres. Although digitization provides an opportunity to improve citizens’ satisfaction, to design citizen centric e-government services, agencies need to proactively understand citizens’ experiences. This study explored the Google Play reviews of UMANG (an aggregated e-government mobile application of the Government of India). We aggregated 4,921 reviews provided from March 2020 to April 2021. We first theoretically (using the S-O-R framework) and empirically (link between sentiment polarity and user rating) examined the validity of user reviews to extract insights into citizens’ experiences. Subsequently, we extracted eight topics related to citizens’ experiences by using latent Dirichlet allocation, an unsupervised machine learning algorithm. The following topics were identified—perceived usefulness, ease of use, product feature experience, delivery turnaround time, technological experience, login experience, customer care experience, and payment experience. We validated identified topics by determining the inter-rater agreement between LDA and human rater output. Finally, we calculated the relative importance of the identified topics and topic-wise sentiment polarity. The findings of this study can help in designing citizen centric e-government services and prioritizing the right dimension of citizens’ experience.

There is paucity of data on tuberculosis in Indian patients with systemic lupus erythematosus (SLE). We retrospectively studied clinical features and outcome of tuberculosis in SLE.Medical records of patients who developed tuberculosis simultaneous or after the diagnosis of SLE were retrospectively reviewed. All patients fulfilled 1997 ACR and/or SLICC 2012 classification criteria for SLE. A diagnosis of tuberculosis required bacteriological, histopathological or CT/MRI suggestive of tuberculosis and initiation of four drug antituberculous therapy. Baseline parameters were compared with the rest of cohort to identify predictors of tuberculosis.In our cohort of 1335 SLE patients, 48 (3.6%) developed tuberculosis. Incidence of tuberculosis was calculated to be 733 per 100,000 patient years and occurred after a mean disease duration of 3.0 ± 4.1 years. Extrapulmonary tuberculosis (n = 37) was commoner than pulmonary tuberculosis (n =11). Most common radiological pattern in pulmonary tuberculosis was miliary and musculoskeletal TB was most common extrapulmonary TB. A microbiological diagnosis was obtained in 52.1% patients. Male gender was associated with higher risk of tuberculosis [OR 3.30 (1.55-7.05)]. Mortality was 14.5% and all patients who died had either disseminated (n = 5) or central nervous system (CNS) tuberculosis (n = 2).Incidence of tuberculosis in SLE is higher than general population and is associated with different phenotype and higher mortality. Male gender was associated with increased risk of tuberculosis in SLE.