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Author(s): Vineet Kashyap [1]; Srikumar Venkataraman (corresponding author) [1]; Bipin Kumar [2]; Gita Handa [1]; Ravindra M. Pandey [3] INTRODUCTION Work-related musculoskeletal disorders (WMSD) are impairments of body structures such [...], Background: There are adverse effects on the health outcomes of workers whose occupation involves prolonged standing, such as lower back pain, leg pain, cardiovascular diseases, fatigue, discomfort, and pregnancy-related health outcomes. The effectiveness of massage therapy as an intervention for managing leg pain associated with prolonged standing needs to be addressed. Aims: This study aimed to evaluate the smart dynamic fabric actuator's effectiveness in treating chronic musculoskeletal leg pain in persons with occupations involving prolonged standing. Setting: Tertiary care hospital. Design: Randomized controlled trial. Methods: Thirty participants with chronic leg pain satisfying the inclusion and exclusion criteria participated in the study. The intervention group used the device for 15 minutes for each leg once a day and stretching exercises twice a day for six weeks. The control group performed stretching exercises twice a day for six weeks. The outcome was assessed at baseline, three weeks, and six weeks with a Numeric Rating Scale for pain and fatigue, short form-McGill Pain Questionnaire for pain, and SF-36 for quality of life. Statistical Analysis: The groups were compared using the two-sample t-test with equal variances, the two-sample Wilcoxon rank-sum test, and the Chi[sup.2] exact test as appropriate. Results: Thirty medical (nursing officers and doctors) and nonmedical professionals (security guards and sales assistants) with a mean age of 32.9 ± 5.6 years (intervention group) and 36.2 ± 5.1 years (control group) participated in the study. At six weeks, a significant improvement in pain (4.80 ± 1.14 to 1.66 ± 1.04 vs 4.66 ± 0.89 to 2.6 ± 0.91, P = 0.014), quality of life (58.77 ± 9.06 to 71.76 ± 8.43 vs 51.39 ± 8.26 to 63.87 ± 7.61, P = 0.012), and reduced fatigue (5 to 2 vs 5 to 3, P = 0.003) was observed in the intervention group when compared with the control group. No adverse events were observed. Conclusion: A smart dynamic fabric actuator can be used as an adjunct to exercises for reducing leg pain and fatigue associated with prolonged standing. Keywords: Chronic pain, exercise therapy, lower extremity, massage, occupational health, quality of life

The study compared the efficacy of 308 nm monochromatic excimer light (MEL) therapy with psoralen ultraviolet A (PUVA) soak therapy for palmoplantar psoriasis (PPP). Results showed that both therapies were comparable in improving PPP symptoms, with PUVA therapy associated with more pruritus. The study, conducted from November 2021 to May 2023, included 31 patients, with 25 completing the 8-week study period. Limitations of the study included an open-label design and a lack of cost-effectiveness comparison. [Extracted from the article]

Author(s): Seema Gulati [sup.1] [sup.2] [sup.3] , Anoop Misra [sup.1] [sup.2] [sup.3] [sup.4] , Rajneesh Tiwari [sup.2] , Meenu Sharma [sup.2] , Ravindra M. Pandey [sup.5] , Ashish Datt Upadhyay [...], Objective The aim of the present study was to evaluate polymorphisms of fat mass and obesity (FTO; rs9939609) and vitamin D receptor (VDR, FokI (rs2228570), BsmI (rs1544410), ApaI (rs7975232), and TaqI (rs731236)] genes on weight loss after lifestyle interventions in Asian Indians. Methods In this 6-month pre-post intervention trial, 110 overweight/obese men and women underwent diet and exercise interventions for 180 days resulting in reduction in body weight, (5.1 kg, p < 0.001), waist circumference, and skinfolds. Results Association of the following genotypes was seen in those with [greater than or equal to]5% weight loss: TT of FTO polymorphism; 35 (81.4%) [OR (95% CI) AT, 2.5 (0.6, 10.9); TT, 6.9 (1.6, 28.2); with reference to AA], tt of VDRTaqI polymorphism, 12 (92.3%) [OR (95% CI); tt, 32.2 (2.4, 436.4); TT, 0.5 (0.08, 3.1); all with reference to Tt], bb of VDRBsmI polymorphism; 27 (65.8%) [OR (95% CI) Bb, 0.2 (0.04, 0.9); bb, 10.6 (0.9, 120.3); all with reference to BB] after adjusting for other genotypes. Further, analysis of combined influence of genotypes conferring maximum weight loss showed that the following had high odds of [greater than or equal to]5% weight loss: (1) TT of FTO gene in combination with BB/Bb of VDRBsmI and TT/Tt of VDRTaqI [OR (95% CI) 5.1 (1.5, 17.4)], (2) bb of BsmI and AA/AT of FTO and tt of TaqI [OR (95% CI) 3.2 (0.3, 31.7)], and (3) bb of BsmI plus TT of FTO and tt of TaqI. Conclusions The above observations suggest a significant and independent role of the genotypes of FTO and VDR in influencing weight loss after lifestyle intervention in Asian Indians.

Introduction: Lung transplant (LTx) is a potential treatment option for all patients with chronic, end‑stage respiratory disease, who are refractory to optimal medical therapy or where no medical therapy exists. In India, LTx is still in its evolving stages and published literature is sparse. The current study was carried out to study the selection criteria for lung transplant and to evaluate the clinical and socio‑economic profile of patients referred for the same at a tertiary health care facility. Methods: The study was a descriptive, prospective, observational study. All adults referred for lung transplant were evaluated for clinical and laboratory profiles. All enrolled patients were assessed for presence of referral criteria, listing criteria, contraindications, and willingness for lung transplant. These patients were followed up for 2 years for transplant‑free survival, and the Cox proportional hazards model was used to determine independent predictors of all‑cause mortality. Results: A total of 103 were included in study. The most common diagnosis was interstitial lung disease (57.2%), followed by bronchiectasis (17.5%) and COPD (13.6%). Most patients were referred for LTx at an advanced stage as 90% met listing criteria. Fifty‑four (52.4%) patients had an absolute or relative contraindication to transplant; however, the majority of those contraindications were modifiable. Patients with a lower socio‑economic status were less likely to be willing for LTx. The median survival was 757 days. A 6‑minute walk distance (6MWD) lesser than 250 m was found to be an independent predictor of mortality. Conclusion: Making patients aware about lung transplant early in their treatment may give them sufficient time to come to terms with their disease and understand the risk and benefits associated. Efforts should be focused on screening and early treatment of reversible contraindications for the eligible patients. Patients with 6MWD < 250 m are at increased risk of mortality. [ABSTRACT FROM AUTHOR]

Background: The main objective is to detect clinically significant conditions by transcranial ultrasound (TCS) in post-decompressive craniectomy (DC) patients who come to the emergency department. Materials and methods: This was a cross-sectional observational study. We studied 40 post-DC patients. After primary stabilization, TCS was done. Computer tomography of head was done within 2 hours of performing TCS. The correlation between both modalities were assessed by the measurement of lateral ventricle (LV) (Bland-Altman plot), Midline shift and mass lesion. Additionally, normal cerebral anatomy, 3rd and 4th ventricles and external ventricular drainage (EVD) catheter visualization were also done. Results: About 14/40 patients came with non-neurosurgical complaints and 26/40 patients came with neurosurgical complaints. Patients with non-neurosurgical complaints (4/14) had mass lesions and 1/14 had MLS. Patients with neurosurgical complaints (11/26) had mass lesions and about 5 patients had MLS. A good correlation was found between TCS and CT of head in measuring LV right (CT head = 17.4 ± 13.8 mm and TCS = 17.1 ± 14.8 mm. The mean difference (95% CI) = [0.28 (--1.9 to 1.33), ICC 0.93 (0.88--0.96)], Left [CT head = 17.8 ± 14.4 mm and TCS = 17.1 ± 14.2 mm, the mean difference (95% CI) 0.63 (--1.8 to 0.61), ICC 0.96 (0.93--0.98)], MLS [CT head = 6.16 ± 3.59 (n = 7) and TCS = 7.883 ± 4.17 (n = 6)] and mass lesions (kappa 0.84 [0.72--0.89] [95% CI] p-value < 0.001). The agreement between both modalities for detecting mass lesions is 93.75%. Conclusion: Point of care ultrasound (POCUS) is a bedside, easily operable, non-radiation hazard and dynamic imaging tool that can be used for TCS as a supplement to CT head in post-DC patients in emergency as well as in ICU. However, assessment of the ventricular system (pre/post-EVD insertion), monitoring of regression/progression of mass lesion, etc. can be done with TCS. Repeated scans are possible in less time which can decrease the frequency of CT head. [ABSTRACT FROM AUTHOR]

Background: Narrow‑band ultraviolet B (NB‑UVB) is the standard therapy for vitiligo. Objective: The objective of this study is to compare the safety and clinical efficacy of a handheld NB‑UVB comb device with the standard whole‑body NB‑UVB therapy in localized stable vitiligo. Materials and Methods: Thirty‑one vitiligo patients were allocated to either daily therapy with a home‑based handheld comb device (group A, n = 17) or thrice‑weekly hospital‑based whole‑body NB‑UVB therapy (group B, n = 14) for 4 months, based on their preference. The primary and secondary outcomes were assessed at each follow‑up, and appropriate statistical tools were used for analysis. Results: Of the 31 patients enrolled, 26 patients (study groups A/B: 15/11) completed the study. Primary outcome: Median percentage repigmentation of the representative patch in groups A and B were 51.35% and 63.85%, respectively (P = 0.64). The median size reduction of the representative patch in both groups was statistically significant (P < 0.05). The mean difference between “per protocol analysis” and “intention to treat” showed noninferiority. Secondary outcomes: Both groups were comparable on Lund and Browder score, patient global assessment and investigator global assessment scores, adverse events, color match, and change in the quality of life. The comparison group had a significantly greater number of missed sessions (P = 0.02). The majority of patients had a “good” response in both groups. Conclusion: Handheld NB‑UVB comb device daily with a fixed dose of fluence was found to be noninferior with better compliance to standard whole‑body NB‑UVB therapy [ABSTRACT FROM AUTHOR]

Author(s): Narendra K. Arora 1,*, M. K. C. Nair 2, Sheffali Gulati 3, Vaishali Deshmukh 1, Archisman Mohapatra 1, Devendra Mishra 4, Vikram Patel 5,6, Ravindra M. Pandey 7, Bhagabati [...], Background Neurodevelopmental disorders (NDDs) compromise the development and attainment of full social and economic potential at individual, family, community, and country levels. Paucity of data on NDDs slows down policy and programmatic action in most developing countries despite perceived high burden. Methods and findings We assessed 3,964 children (with almost equal number of boys and girls distributed in 2- Conclusions The study identifies NDDs in children aged 2-9 years as a significant public health burden for India. HI was higher than and ASD prevalence comparable to the published global literature. Most risk factors of NDDs were modifiable and amenable to public health interventions.

Objective Early aggressive therapy using biologicals is increasingly being used in JIA for early disease remission. Pulse steroids are used in induction regimes for rheumatic disorders such as SLE and systemic JIA; however, no controlled studies have demonstrated their use in non-systemic JIA. The objective of the present study was to evaluate the efficacy and safety of pulse dexamethasone therapy in children with treatment-naïve non-systemic JIA as early aggressive therapy in resource-limited settings. Methods Sixty treatment-naïve children with non-systemic JIA with an active joint count of ≥5 and/or involvement of hip or cervical joints were randomized to receive either pulse dexamethasone (3 mg/kg/day, max 100 mg/day) or placebo (normal saline) for three consecutive days during each visit at 0, 6 (±2) and 12 (±2) weeks; along with standard therapy (MTX and NSAIDs). The use of oral bridge steroids was permissible for persistent severe disease as per predefined criteria. The primary outcome was ACR-Pedi 70 response at 16 (±2) weeks after enrolment in the two groups. Results The proportion of children achieving ACR-Pedi 70 in the two groups at last follow-up was 11/30 (36.7%) in pulse dexamethasone arm vs 11/28 (39.3%) in the placebo arm (P -value 0.837, relative risk 0.93, 95% CI 0.48, 1.80). We did not observe any significant difference in the proportion of children requiring bridge steroids. Adverse events were comparable in the two groups. Conclusion The addition of pulse dexamethasone to standard treatment may not add any advantage in improving ACR-Pedi 70 scores at medium-term follow-up. Trial registration Clinical Trial Registry-India; www.ctri.nic.in CTRI/2018/08/015151. [ABSTRACT FROM AUTHOR]