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The government of India has done remarkable work on commissioning a government funded prehospital emergency ambulance service in India. This has both public health implications and an economic impact on the nation. With the establishment of these services, there is an acute need for standardization of education and quality assurance regarding prehospital care provided. The International Joint Working Group has been actively involved in designing guidelines and establishing a comprehensive framework for ensuring high-quality education and clinical standards of care for prehospital services in India. This paper provides an independent expert opinion and a proposed framework for general operations and administration of a standardized, national prehospital emergency medical systems program. Program implementation, operational details, and regulations will require close collaboration between key stakeholders, including local, regional, and national governmental agencies of India. [ABSTRACT FROM AUTHOR]

Objective: This study analyses the research output in India in neurosciences during the period 1999-2008 and the analyses included research growth, rank, global publications' share, citation impact, share of international collaborative papers and major collaborative partner countries and patterns of research communication in most productive journals. It also analyses the characteristics of most productive institutions, authors and high-cited papers. The publication output and impact of India is also compared with China, Brazil and South Korea. Materials and Methods: Scopus Citation database was used for retrieving the publications' output of India and other countries in neurosciences during 1999-2008. Results: India's global publications' share in neurosciences during the study period was 0.99% (with 4503 papers) and it ranked 21st among the top 26 countries in neurosciences. The average annual publication growth rate was 11.37%, shared 17.34% of international collaborative papers and the average citation per paper was 4.21. India was far behind China, Brazil and South Korea in terms of publication output, citation quality and share of international collaborative papers in neurosciences. Conclusion: India is far behind in terms of publication output, citation quality and share of international collaborative papers in neurosciences when compared to other countries with an emerging economy. There is an urgent need to substantially increase the research activities in the field of neurosciences in India. [ABSTRACT FROM AUTHOR]

Objective: This study analyzes the research output of India in asthma during the period from 1999 till 2008. It analyzes the growth, rank and global publications share, citation impact, share of international collaborative papers, contribution of major collaborative partner countries and contribution of various subject fields. It also analyzes the characteristics of most productive institutions, authors and high-cited papers. Materials and Methods: SCOPUS database has been used to retrieve the data on publication output in asthma research. Results: India ranks 15th position among the top 23 countries in asthma research, with its global publication share of 1.27% (862 papers), registering an average citation per paper of 3.43 and achieved an h-index of 33 during 1999-2008. Conclusion: Indian research output on asthma is quite low in the global context as reflected from its publication output per thousand population (0.001) and its world publication share (1.27%) during 1999-2008. Also, the impact and quality of Indian research is low compared to select developed and developing countries. [ABSTRACT FROM AUTHOR]

Mass media including television, internet, and newspapers influences public views about various issues by means of how it covers an issue. Newspapers have a wider reach and may affect the impact that a news story has on the reader by factors such as placement of the story within the different pages. We did a pilot study to see how two English newspapers from Mumbai, India were covering psychiatry related news stories. The study was done over a period of 3 months. We found a total of 870 psychiatry related news stories in the two newspapers over 3 months with the majority of them being covered in the main body of the newspapers. Sex‑related crime stories and/or sexual dysfunction stories received the highest coverage among all the news while treatment and/or recovery related stories received very little coverage. It is crucial that the print media takes more efforts in improving reporting of psychiatry‑related stories and help in de‑stigmatizing psychiatry as a discipline. [ABSTRACT FROM AUTHOR]

Purpose: To determine the publication rates of free papers and posters presented at the All India Ophthalmic Conference (AIOC) 2010 in peer-reviewed journals up to December 2015 and compare this with publication rates from AIOC2000 published previously.Methods: A thorough literature search was conducted using PubMed, Google Scholar, and the general Google search engine by two independent investigators. The title of the paper, keywords and author names were used to "match" the AIOC free-paper with the published paper. In addition, the "purpose," "methods," and "outcome measures" between the two were studied to determine the "match."Results: A total of 58 out of 394 free-papers (14.7%) from AIOC2010 were published till December 2015 compared to 16.5% from AIOC2000. Out of these, 52 (90%) were published in PubMed indexed journals. Maximum publications were seen in pediatric ophthalmology (50%) followed by glaucoma (24.4%) and cornea (23.8%). Fifteen out of 272 posters (5.5%) were published; orbit/oculoplastics had the highest poster publications (13%). Excluding papers in nonindexed journals and those by authors with international affiliations, the publication rate was approximately 12%.Conclusion: The publication rate of free papers from AIOC2010 has marginally reduced compared to AIOC2000. Various causes for this such as lack of adequate training, motivation, and lack of incentives for research in the Indian scenario have been explored, and measures to improve this paradigm have been discussed. It will be prudent to repeat this exercise every decade to compare publication rates between periodic AIOC, stimulate young minds for quality research and educate policy makers toward the need for developing dedicated research departments across the country. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine personal and professional factors in determining the research activity and research culture among dental teaching faculty members in Hyderabad City, Telangana. Materials and Method: Two dental schools with ongoing dental undergraduate and postgraduate programmes were included in the study. The Research and Development (R&D) Culture Index Questionnaire comprising 16 items was employed for this study. Also, self‑reported research activity undertaken in the past twelve months was recorded. The association of demographic variables and professionally related variables with the perception of R&D culture and participation in research activities was assessed using the Chi‑square test. A P value was set at 0.05. Results: Of the one‑hundred and fifteen faculty members who participated in the study, seventy‑four (64.4%) worked in the government sector and forty‑one (35.6%) in privately funded dental college. The mean age of the study population was 34.11 + 7.13 years. The majority of them presented a paper or poster at the conference (66.1%; 76) followed by publishing paper in peer‑review journal (42.6%; 49) and grant application for research (6.1%; 7), and authoring of a textbook was undertaken by only 2.6% of the study population. Males (61.1%; P = 0.04) and those employed in private dental college (65.8%; P = 0.02) had significantly high levels of overall perception than their respective counterparts. Conclusion: Our study concludes that this study population has a positive perception (50.32 + 6.95) towards research with the majority of them having done a paper or poster publication (66.1%) in the last one year. [ABSTRACT FROM AUTHOR]

The development of the Diagnostic and Statistical Manual-5 (DSM-5) has been an exhaustive and elaborate exercise involving the review of DSM-IV categories, identifying new evidence and ideas, field testing, and revising issues in order that it is based on the best available evidence. This report of the Task Force of the Indian Psychiatric Society examines the current draft of the DSM-5 and discusses the implications from an Indian perspective. It highlights the issues related to the use of universal categories applied across diverse cultures. It reiterates the evidence for mental disorders commonly seen in India. It emphasizes the need for caution when clinical categories useful to specialists are employed in the contexts of primary care and in community settings. While the DSM-5 is essentially for the membership of the American Psychiatric Association, its impact will be felt far beyond the boundaries of psychiatry and that of the United States of America. However, its atheoretical approach, despite its pretensions, pushes a purely biomedical agenda to the exclusion of other approaches to mental health and illness. Nevertheless, the DSM-5 should serve a gate-keeping function, which intends to set minimum standards. It is work in progress and will continue to evolve with the generation of new evidence. For the DSM-5 to be relevant and useful across the cultures and countries, it needs to be broad-based and consider social and cultural contexts, issues, and phenomena. The convergence and compatibility with International Classification of Diseases-11 is a worthy goal. While the phenomenal effort of the DSM-5 revision is commendable, psychiatry should continue to strive for a more holistic understanding of mental health, illness, and disease. [ABSTRACT FROM AUTHOR]

Background: Depression is a major public health concern among Indian adolescents. Pre- and post-natal depression can often alter fetal development and have negative consequences on the physical and mental health of the mother. This paper aims to draw attention to the prevalence of depression and its correlates among currently married, ever-pregnant adolescents from two Indian States, i.e. Uttar Pradesh and Bihar. Methods: This study utilizes data from a subsample (n = 3116) of the prospective cohort study Understanding the Lives of Adolescents and Young Adults (UDAYA) among 10 to 19 year-old adolescents. Bivariate analysis was performed to assess the prevalence of depression by sociodemographic and behavioral characteristics. To further access the predictors associated with depression a logistic regression model was applied. Results: Around one-tenth (9%) of pregnant adolescents had depression. Regression analysis indicated that substance use, religion, autonomy, considering attempting suicide, premarital relationship, violence, dowry, adverse pregnancy outcome, menstrual problem, and parental pressure for the child immediately after marriage were significantly associated with depression. Conclusions: This study confirms the pre-existing annotation that teen pregnancy is linked with depression. Findings indicate that Adolescent mothers experiencing violence, and a history of adverse pregnancy outcomes are at increased risk of developing depression. These study findings call for an urgent need to address depression among adolescent mothers. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to describe the clinical presentation and demographic distribution of keratoconus (KCN) in India by analyzing the electronic medical records (EMR) of patients presenting at a multitier ophthalmology hospital network. Methods: This cross-sectional hospital-based study included the data of 2,384,523 patients presenting between January 2012 and March 2020. Data were collected from an EMR system. Patients with a clinical diagnosis of KCN in at least one eye were included in this study. Univariate analysis was performed to identify the prevalence of KCN. A multiple logistic regression analysis was performed using R software (version 3.5.1), and the odds ratios are reported. Results: Data were obtained for 14,749 (0.62%) patients with 27,703 eyes diagnosed with KCN and used for the analysis. The median age of the patients was 22 (inter-quartile range (IQR): 17–27). In total, 76.64% of adults (odds ratio = 8.77; P = <0.001) were affected the most. The majority of patients were male (61.25%), and bilateral (87.83%) affliction was the most common presentation. A significant proportion of the patients were students (63.98%). Most eyes had mild or no visual impairment (<20/70; 61.42%). Corneal signs included ectasia (41.35%), Fleischer ring (44.52%), prominent corneal nerves (45.75%), corneal scarring (13.60%), Vogts striae (18.97%), and hydrops (0.71%). Only 7.85% showed an association with allergic conjunctivitis. A contact lens clinic assessment was administered to 47.87% of patients. Overall, 10.23% of the eyes affected with KCN underwent a surgical procedure. the most common surgery was collagen cross-linking (8.05%), followed by deep anterior lamellar keratoplasty (1.13%) and penetrating keratoplasty (0.88%). Conclusion: KCN is usually bilateral and predominantly affects males. It commonly presents in the second and third decade of life, and only a tenth of the affected eyes require surgical treatment. [ABSTRACT FROM AUTHOR]

Background: General hospital psychiatric units (GHPUs) are one of the major service and training providers in the field of mental health in India. However, there has not been any systematic attempt at their contributions toward research. Aim: The present paper reports on contributions of the GHPUs toward the psychiatric research based on analysis of publications in the Indian Journal of Psychiatry (IJP). Materials and Methods: All the issues of IJP of the last 25 years (1989-2013) were manually searched for original research papers, brief reports, and case reports. A semi-structured performa was used to collect information on various parameters. Results: About two-thirds of the papers were contributed by the GHPUs, most being multi-authored and from tertiary care centers. The research covered a variety of psychiatric disorders including schizophrenia, mood disorders, and common mental disorders. Most of the research reported was self-funded. Conclusion: GHPUs have contributed significantly to psychiatric research in India in the last 25 years. [ABSTRACT FROM AUTHOR]

Background: Cancer is often detected much later to its onset, resulting in poor prognosis. This makes cancer the second most common cause of death globally. Looking for cancers much before any symptoms occur is termed "cancer screening" and is a powerful strategy for prevention, early diagnosis, and better management of several cancers. This paper examines the status of cancer screening in India from the National Family Health Survey (NFHS)-5 report for the period of 2019–2021. Methods: Secondary data on participation in screening for cervical, breast, and oral cancer were extracted from the NFHS-5 report. Participation status for all the above cancer types is represented as percentages and compared across 28 states and eight union territories in India. Results: The percentages of women who have ever undergone cervical, breast, and oral cavity screening were 1.9%, 0.9%, and 0.9%, respectively. About 1.2% of men participated in oral cavity screening. The highest percentage of cervical and breast cancer screening participation was reported in Tamil Nadu (9.8% and 5.6%, respectively), followed by Puducherry (7.4% and 4.2%) and Mizoram (6.9% and 2.7%). Andaman and Nicobar Islands reported the highest oral cancer screening among women (10.1%) while Andhra Pradesh (6.3%) reported the highest participation among men. Conclusion: Cancer screening participation in India is extremely inadequate and calls for the immediate attention of national and state governments. Additional efforts are warranted to improve public awareness of cancer screening, and appropriate measures should be implemented to conduct well-organized screening programs across the country to ensure maximum participation. [ABSTRACT FROM AUTHOR]

Background: Qualitative research methods (QRMs) bear a critical role in psychiatry as they explore the phenomenology of psychiatric illness and its sociocultural dimensions. However, there is limited evidence regarding its use in psychiatric research in India. Aim: This study, under the aegis of mapping qualitative health research in India initiative, attempted to landscape the use of QRMs in psychiatry and elicited expert opinion on its potential, perceived quality, and scope for improvement. Materials and Methods: We reviewed studies using qualitative methodology published in the Indian Journal of Psychiatry (IJP) and the abstracts presented at the Annual Conference of the Indian Psychiatric Society (ANCIPS) between 2010 and 2019. Titles and abstracts were screened and shortlisted; full-text articles were checked to identify the relevant ones. In addition, ten experts comprising psychiatry journal reviewers, editors, and conference scientific committee members were interviewed to elicit their views and suggestions. Results: Out of 356 papers published in IJP between 2010 and 2019, only 12 papers used QRMs: five qualitative and seven mixed methods. Out of 2297 abstracts published between 2010 and 2019 in ANCIPS, only 28 had used QRMs, consisting of 20 qualitative and eight mixed methods. The findings reveal that qualitative research is still an understudied domain in Indian psychiatry with a substantial need for rigor and quality. Conclusions: To catalyze the use of qualitative research in Indian psychiatry, continuing medical education programs through workshops or webinar mode need to be imparted. These trainings should aim at building skills on qualitative study design, data collection, analysis, and writing. [ABSTRACT FROM AUTHOR]

Background: Truck drivers in India suffer from many lifestyle-related health problems. Providing primary health care services to truck drivers is essential to improve their overall health and well-being. This paper reports the findings of a community-based mobile medical unit program providing nonemergency and basic primary care services to truck drivers along the major highways of India. Piramal Swasthya Management and Research Institute launched this community-based mobile medical unit program, in partnership with Shriram Transport Finance Corporation Limited (STFCL). Materials and Methods: The paper describes the program model, its coverage, the sociodemographic profile, and common health morbidities of the truck drivers availing the program services. 2-year routine program data (April 2017 to March 2019) were accessed and analyzed. Results: A total of 1,167,210 number of unique truck drivers availed the program services during the reference period, of which 61,331 had complete data. The majority of truck drivers were male (99.1%) and just a few women (0.88%) and transgender (0.003%). The mean age was 45.5 years ± 10.91 and nearly half (49%) were in the productive age group (31-45 years). Noncommunicable and other chronic diseases (34.74%), musculoskeletal problems (24.17%), communicable diseases (14.52%), oral cavity-related problems (1.23%), and other minor ailments (17.77%) were the major consultation categories. Conclusion: Truck drivers in India have significant health morbidities. Providing primary health care services to truck drivers through mobile medical units is a step toward achieving universal health coverage. [ABSTRACT FROM AUTHOR]

Recovery is a concept that defined a positive and empowering experience for people with Schizophrenia. Recovery is an innately personal phenomenon, but the cultural environment can influence the recovery process. The concept of recovery originated in the West. The Eastern cultures differ in various aspects from the Western cultures. Application of the Western model of recovery in an Eastern culture like India without considering the cultural differences would be misplaced. This paper discusses two cultural factors in Indian life, namely, the family and the doctrines of Karma and Fate, that can impact recovery from Schizophrenia. Understanding the impact of culture on schizophrenia recovery should also consider cultural variations between individuals and over time. Principles and practice of Recovery-oriented mental health care in India should consider the unique local cultural environment. [ABSTRACT FROM AUTHOR]

Tribes are the most vulnerable, particularly in healthcare. Health research in a population helps to understand the trends of various diseases and other social determinants causing them. Our study aims to perform a bibliometric analysis of Tribal research in India from its status quo. Materials and Methods: Research articles on tribal health were retrieved from Scopus and analyzed using MS Office, VOS viewer, and Word Cloud generator from January 2000 to December 2020. The number of research publications published each year, the clustering pattern of contributing authors, the most popular journals, the leading publication, document type, domain research areas, and commonly used keywords were all considered in the study. Results: As a result of the search, 1249 research publications were found. According to our selection criteria, only 395 research papers were included in the analysis. Approximately 43 research publications were published in 2020, but only three articles were published in 2000. Almost 35.7% of articles were published in traditional medicine, and 15.7% and 14.7% of articles were published in nutrition and infectious diseases. Less than 1% of articles were published in Health Policy, and 1.5% were published in Health Systems. Conclusions: The study results showed that the research on tribes has now been improving in the following years. Research into tribal mental health and health care systems should be encouraged. Collaboration and funding may assist academic institutions in raising awareness of health issues in these populations. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has proven to be the worst pandemic in the history of mankind. While the pandemic still continues to perplex scientists globally, attempts are being made to quantify the mortality caused by the pandemic. Official COVID-19 figures in India grossly understate the true scale of the pandemic in the country. Fatality rates help us understand the severity of a disease, identify at risk populations, and evaluate quality of healthcare. Official COVID-19 mortality figures in India grossly understate the true scale of the pandemic in the country. A COVID-19 death is defined for surveillance purposes as a death resulting from a clinically compatible illness in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID-19 disease (e.g., trauma) and excess mortality is defined as the difference in the total number of deaths in a crisis compared to those expected under normal conditions. Materials and Methods: We did a systematic review of multiple papers on PubMed, Medline, Embase, MedRxiV pre print on excess mortality. Differentiation between model based estimated excess mortality and data based excess mortality was studied. Results: All the studies showed that the excess mortality was to the tune of almost three times the official figures. The model based excess mortality assumptions showed higher deaths as compared to the data based one. However, there were a lot of discrepancies in the data provided by various states along with variations observed between the two waves as well. Health survey data suggested higher mortality rate as compared to data compiled from the civil registration system. Additionally, in the second wave, a small but a significant number of deaths occurred due to non availability of oxygen and beds in the hospitals. Conclusions: Official COVID-19 deaths have entirely failed to capture the scale of pandemic excess mortality in India. If most excess deaths were, indeed, from COVID-19 then under ascertainment of COVID-19 deaths has been high, with around 8-10 excess deaths for every recorded COVID-19 death. [ABSTRACT FROM AUTHOR]

Rapidly growing rate of infection among health workers during the current COVID-19 pandemic, is posing a serious challenge to global health systems. Lately, India is also witnessing an intensifying COVID-19 disease burden and its impact on health workers. This paper aims to discuss the challenges to health worker protection in India and the possible ways forward. Given the inadequate and unequally distributed healthcare workforce, it is highly essential for the country to strategize prompt measures for ensuring occupational health and safety of its health workers. Information for this paper were gathered by searching PubMed and Google Scholar databases using "COVID-19", "Infection Control", "Health worker", "India" as search keywords in different combinations. In addition, websites of Government of India, relevant UN agencies and leading news agencies were also searched manually for related reports and publications. India must take timely measures in rapid manufacturing and procurement of essential personal protective equipment (PPE) to ensure adequate stockpiling to meet the rising demands. Comprehensive and repeated training with sharply focussed content including usage of PPE kits as well as active surveillance of adherence to recommended protocol are critical in protecting health workers especially the primary care physicians and frontline health staff from the deadly COVID-19 infection. The provision of psychological and financial support for health workers and their families is absolutely critical in building trust and dedicated work efforts by the health workforce for a continuous fight against the deadly disease. [ABSTRACT FROM AUTHOR]

Background: Primary Care Doctors (PCDs) are the first contact for majority of patients with psychiatric disorders across the world including India. They often provide symptomatic treatment which is naturally inadequate. Absence or inadequate exposure to psychiatric training during undergraduate medical education is one of the prime reasons. Classroom training (CRT), a standard practice to train PCDs is driven by specialist based psychiatric curriculum and inherently lacks clinical translational value. Aim and Context: The 'Department of Psychiatry' of 'National Institute of Mental Health and Neurosciences', Bengaluru, India has recently come up with an innovative digitally driven modules of 'Primary Care Psychiatry Program' (PCPP) for practicing PCDs. Goal of this paper is to provide an overview of all these (five) modules with its various stages of implementation. Methods: Authors briefly discuss the current status of primary care psychiatry in India and also narrate the newly designed five modules of PCPP in this paper. Results and Discussion: An adopted psychiatric curriculum is designed in 'Clinical Schedules for Primary Care Psychiatry' (CSP) which is an integral part of PCPP. This is brief clinical schedules contains culturally appropriate screening questionnaire, transdiagnostic classification of 8 core psychiatric disorders, diagnostic, referral and management guidelines. PCPP contains 5 modules named as orientation module, basic module, advanced module [Tele-psychiatric 'On-Consultation Training' (Tele-OCT)], videoconference based continuing skill development module, and collaborative video consultation modules which covers all essential areas of primary care psychiatry for practicing PCDs. Last three modules are fully designed digital modules in hub and spoke model of Tele Medicine. In this designed program, the CSP and Tele-OCT are two path braking innovations having inbuilt higher clinical translation value. The challenges and opportunities that could be faced during its implementation across India are also discussed. Conclusion and Future Directions: Innovative PCPP is pragmatic in nature and has potential for higher clinical translational value. Once validated thoroughly, PCPP has potential for pan-India expansion. There is a need for artificial intelligence-based modules for next phase of PCPP in India considering her population and lesser number of available psychiatrists. [ABSTRACT FROM AUTHOR]

Background: The National Mental Health Survey reports a huge treatment gap for all mental disorders. There is an acute shortage of mental health professionals in India. Hence, there is a dire need to support task-shift interventions by nurses in providing non-pharmacological interventions for persons suffering from mental health issues. The traditional psychiatric nursing curriculum emphasizes nurses' knowledge and skills rather than their competency in providing mental health care. We designed an innovative, digitally driven, modular-based primary care psychiatry program for nurses (PCPP-N) to incorporate mental health with physical health and emphasize redesigning nursing practice. In this paper, we discuss the rationale and guiding principles behind designing the curriculum of PCPP-N. Discussion: The PCPP-N program is based on nine guiding principles to provide skill-based, pragmatic, and feasible modules of a higher collaborative care quotient (CCQ) and translational quotient (TQ) that are essential for upskilling primary care nurses. In this program, nurses are trained through telemedicine-based 'on-consultation training' augmented with collaborative video consultations. A tele-psychiatrist/tele-psychiatric nurse will demonstrate how to screen, identify, and plan treatment for patients with psychiatric disorders from patients coming for general medical care using the manual Clinical Schedules of Primary care psychiatry Nursing (CSP-N). The CSP-N manual includes a screener, simplified diagnosing guidelines relevant for nurses and primary care settings, nursing management, pharmacological management, and related side effects, counseling, and follow-up guidelines. This program helps the nurses in identifying the most commonly prevalent adult psychiatric disorders presenting to primary care. Conclusion: This PCPN curriculum contains pragmatic modules with higher CCQ and TQ. This curriculum is dynamic as the learning is interactive. Upskilling primary care nurses in integrating mental health with physical health may reduce the mental health burden. Further, the policymakers and administrators plan to integrate mental health along with physical health in national health programs. [ABSTRACT FROM AUTHOR]

Introduction: Caries in the deciduous dentition of children under six years of age is termed as early childhood caries (ECC). ECC is prevalent among Indian children and identifying modifiable risk factors is important for prevention. This systematic review was undertaken to describe the burden of ECC in India, its prevalence, associated risk factors along with its repercussions on childhood health. Materials and Methods: A search was conducted for published Indian studies on ECC through electronic databases and complemented with hand search. The protocol for the present systematic review was registered at PROSPERO (Ref No.CRD42022306234)Care was taken to include studies which could represent all parts of India-Central, North, South, East and West. Included papers were reviewed for prevalence of ECC and reported risk factors. Results: Overall 37 studies on ECC in India were identified relating to prevalence, 11 reported risk factors and two reported on the association between severe ECC and nutritional health and well-being. The prevalence of ECC in India in these studies varied from16% to 92.2%. This systematic review revealed that ECC is prevalent among Indian children and highlights the need of preventive intervention and early risk assessment by its own caries risk assessment (CRA) tool. Occurrence seems to be firmly connected with age, snacking frequency, feeding and oral hygiene habits and with social determinants of health including parental education level, low socioeconomic status and number of siblings. [ABSTRACT FROM AUTHOR]

Context: Occupational health surveillance in India, focused on notifiable diseases, relies heavily on periodic medical examination, and isolated surveys. The opportunities to identify changes in morbidity patterns utilizing data available in workplace on-site clinics is less explored in India context. Aims: Present paper describes longitudinal assessment of morbidity patterns and trends among employees seeking care in occupation health clinic (OHC). The study also intends to explore associations between work department, clinic visits and morbidity pattern. Materials and Methods: Record-based analysis was undertaken on data available (for the period 2010-2014) from two OHCs in a leading automobile industry in India. The doctor, examining every employee, documented the provisional diagnosis in specific software which in turn provides summary diagnosis based on affected body organ system as per ICD-10 categories. This information was used to assess the morbidity pattern and trend among workers. Chi-square test of significance and Extended Mantel-Haenszel chi square test was used assess the association and its linear trend. Results: Respiratory, musculoskeletal and digestive system related diseases were the top three reasons for employees visit to OHC. The nature of morbidity varied across different departments in the industry. There was a significant increase in proportion of employees visiting OHC during 2010-2014. Conclusion: A clinic visit record, with its own strengths and limitations, provides information on morbidity pattern and its trends among workers. Such information will help plan, implement and evaluate health preventive, promotive, and curative services. [ABSTRACT FROM AUTHOR]

Psychiatric practice in India is marked by an increasing gulf between largely urban-based mental health professionals and a majority rural population. Based on the premise that any engagement is a mutually constructed humane process, an understanding of the culture of psychiatry including social process of local knowledge acquisition by trainee psychiatrists is critical. This paper reviews existing literature on training of psychiatrists in India, the cultural construction of their professional identities and autobiographical reflections. The results reveal a scarcity of research on how identities, knowledge, and values are constructed, contested, resisted, sustained, and operationalized through practice. This paper hypothesizes that psychiatric training and practice in India continues to operate chiefly in an instrumental fashion and bears a circular relationship between cultural, hierarchical training structures and patient--carer concerns. The absence of interpretative social science training generates a professional identity that predominantly focuses on the patient and his/her social world as the site of pathology. Infrequent and often superfluous critical cultural reflexivity gained through routine clinical practice further alienates professionals from patients, caregivers, and their own social landscapes. This results in a peculiar brand of theory and practice that is skewed toward a narrow understanding of what constitutes suffering. The authors argue that such omissions could be addressed through nuanced ethnographies on the professional development of psychiatrists during postgraduate training, including the political economies of their social institutions and local cultural landscapes. Further research will also help enhance culturally sensitive epistemology and shape locally responsive mental health training programs. This is critical for majority rural Indians who place their trust in State biomedical care. [ABSTRACT FROM AUTHOR]

Introduction: Not much is known about impact of 1918 Influenza on patients confined inside mental asylums of that period. Aim and Methods: The study aimed to assess impact of Influenza pandemic on mentally ill patients in asylums, based on data extracted from provincial asylum reports (1915–1923) from British India. Results: The asylum population in most provinces was impacted both in terms of direct mortality (1918) as well as all-cause morbidity and mortality (1918; 1918–1920). Agra and Oudh lost 9.5% of average daily asylum strength directly due to influenza in 1918. All-cause mortality (1918) was highest for mental asylum/s in provinces of Agra and Oudh (16.83%), Punjab (14.83%), and Bombay (14.4%). Isolated outbreaks continued till 1923. Another peculiar finding was markedly reduced sickness and death rates in 1921–1923 compared to 1915–1917, across asylums of all provinces. Conclusion: Findings point to a significant impact of Influenza pandemic in mental asylums across several provinces, and provide historical insights with implications for the current pandemic. [ABSTRACT FROM AUTHOR]

Background: Dermatology is the science of the skin. In India, dermatology came into picture in the twentieth century. Today's dermatology practiced in India is the modern approach developed and established in western countries based on western medical theory, knowledge, experience, and results from study. Growth of dermatology field in India has progressed since two to three decades. This paper assesses the contributions made by India in the dermatology field by analyzing the total number of publications in top dermatological journals. Materials and Methods: SCImago Journal Rank indicator (2019) was used to search for top dermatology journals and publication metrics was recorded from respective journal websites. Simple statistics tools were used to determine the number of publications during this 20-year period. Results: From 1999 to 2019, there were 547 publications from India, in the top dermatologic journals. It was noted that, original research article contributes maximum number of documents (136). Journal of Dermatology had a maximum number of publications with 174 when compared to other journals. Postgraduate Institute of Medical Education and Research, Chandigarh' had a maximum number of publication (150). Conclusion: The last 20 years have seen a massive increase in the field of dermatology. Today, dermatology is a well-developed field in India. From 1999 to 2019, there is an increase in the trend of publications along with the collaborative publications in the top dermatologic journals. This show the encouraging trend in terms of publications from India in past 20 years. [ABSTRACT FROM AUTHOR]

Point-of-care ultrasound (PoCUS) has a potentially vital role to play in emergency medicine (EM), whether it be in high-, medium-, or low-resourced settings. However, numerous barriers are present which impede EM PoCUS implementation nationally and globally: (i) lack of a national practice guideline or scope of practice for EM PoCUS, (ii) resistance from non-PoCUS users of ultrasound imaging (USI) and lack of awareness from those who undertake parallel or post-EM patient care, and (iii) heterogeneous pattern of resources available in different institutes and settings. When combined with the Indian Preconception and Prenatal Diagnostic Techniques (PCPNDT) Act, this has led to the majority of India's 1.4 billion citizens being unable to access EM PoCUS. In order to address these barriers (globally as well as with specific application to India), this article outlines the three core principles of EM PoCUS: (i) the remit of the EM PoCUS USI must be well defined a priori, (ii) the standard of EM PoCUS USI must be the same as that of non-PoCUS users of USI, and (iii) the imaging performed should align with subsequent clinical decision-making and resource availability. These principles are contextualized using an integrated PoCUS framework approach which is designed to provide a robust foundation for consolidation and expansion across different PoCUS specialisms and health-care settings. Thus, a range of mechanisms (from optimization of clinical practice through to PoCUS educational reform) are presented to address such barriers. For India, these are combined with specific mechanisms to address the PCPNDT Act, to provide the basis for influencing national legislation and instigating an addendum to the Act. By mapping to the recent Lancet Commission publication on transforming access to diagnostics, this provides a global and cross-discipline perspective for the recommendations. [ABSTRACT FROM AUTHOR]

BACKGROUND: There are over 12,000 chemists registered in the capital city, Delhi to support patient health needs. A study was conducted to improve the tuberculosis (TB) notification rates as conceptualized by the Revised National Tuberculosis Control Program (RNTCP). As part of the end TB mission, the feasibility of capturing data of TB patients coming to buy anti-TB drugs at the licensee level (chemists and drug shop owners) in Central Delhi area was assessed. MATERIALS AND METHODS: The prospective study was conducted from July 2017 to March 2018. TB notification through a paper-based system and self-notification through online mode were the operational modality used for engagement with chemists. A team of paramedical workers was deployed for data collection from those pharmacists who chose to notify through the paper mode. Self-notification through online mode was through the RNTCP's NIKSHAY web-based reporting platform. RESULTS: From the 330 chemists sensitized, 871 TB notifications were received during the study. Younger age groups comprised a majority of these cases with 198 (37.5%) from 21 to 30 years and 122 (23.1%) from 11 to 20 years. By the end of six visits, 28 (46%) of the 61 pharmacies that were eventually successfully sensitized had started returning the Folio cards with filled patient details. A total of 581 (66.6%) prescriptions received by the pharmacists were from government hospitals. The annual TB case notification in Central Delhi showed a significant increase from 271 TB patients/100,000 population to 871 TB patients/100,000 population during the study period when compared with expected trends in the past year (P < 0.05). CONCLUSION: Self-notification of TB engenders successful TB notifications from chemists. This progenitor approach to TB notification in the capital emphasizes the need to categorize pharmacists as an independent private care provider for improving TB notification across high-burden settings. [ABSTRACT FROM AUTHOR]

A resilient health system necessitates strong governance, political commitment, effective administrative entities and inter-organisational collaboration. This paper examines India's current health policy landscape and explores the analytical and operational capacities required to establish a robust post-pandemic health system using the policy capacity framework described by Wu et al. (2015). We emphasised the need for a coordinated policy response to strengthen health information systems, health service management, human resource management and healthcare financing. The role that the planned implementation of Indian public health management cadres would play in the coming era, the importance of a comprehensive health information management system and the need for operational coordination between government and non-governmental organisations has also been emphasised. [ABSTRACT FROM AUTHOR]

Background and Aims: Sexual dysfunction is often associated with substance use disorders. This study aimed to synthesize Indian literature on sexual dysfunction among patients with substance use disorders. Materials and Methods: Electronic search engines were used to identify studies of the last 20 years that reported sexual dysfunction with different substance use disorders. Information was extracted using a predefined template. Quality appraisal of the included studies was carried out using Joanna Briggs Institute checklist. Results: Twenty-seven relevant papers were identified that pertained to 24 distinct studies. Most of them were in patients with alcohol dependence, and fewer were in patients with opioid dependence. The study designs were primarily single-group cross-sectional, though many case--control, cross-sectional studies were also identified. The proportion of participants with sexual dysfunction ranged from 22.2% to 76% for studies related to alcohol dependence and 40% to 90% for studies pertaining to opioid dependence. Varied types of sexual dysfunctions were identified, including poor satisfaction, lack of desire, premature ejaculation, and erectile dysfunction. Efforts to address bias and confounders were not reported in most studies. Conclusion: Sexual dysfunction affects a substantial proportion of patients with substance use disorders. Clinicians can make an effort to ascertain and address sexual dysfunction in their routine clinical practice while dealing with patients with substance use disorders. [ABSTRACT FROM AUTHOR]

Background: The occurrence of workplace hazards, occupational diseases, and deaths contribute significantly to the increase in the global burden of diseases. The Municipal Solid Waste (MSW) workers experience occupational stressors throughout the process of waste management that affects their well-being and results in high rates of occupational health problems. It is vital to understand the workplace practices and occupational morbidities of the MSW workers to ensure their safety and well-being. In this context, the study aimed to explore the occupational health and safety practices at the place of work among the MSW workers in Karimnagar and Hyderabad in Telangana, India. Methodology: A cross-sectional study was conducted in two cities of Telangana. A total of 394 MSW workers were surveyed. The number of MSW workers in Karimnagar and Hyderabad were 152 and 194, respectively. A pre-tested questionnaire was administered to the MSW workers to study the occupational morbidities and workplace safety practices. Focused group discussions were conducted among the MSW workers in both cities. In-depth interviews of sanitary supervisors in Karimnagar were conducted. Semi-structured questionnaires and interview guides were used with questions on sociodemographic characteristics, health status, work environment, protection strategy, and healthcare utilization. MS Excel and NVivo-12 were used for data analysis. Results: Musculoskeletal problem was the major reported morbidity among the MSW workers (76.6%). Injuries were reported more among the MSW workers in Hyderabad (39.7%) along with a fear of being hit by vehicles while working on the main roads. About 88.7% of the MSW workers had less than secondary education. There was a wage difference between the contract and permanent MSW workers. There was a lack of provision of personal protective equipment and poor working conditions, overall. Lack of basic amenities such as the provision of drinking water and toilets apart from inadequate social security and healthcare facilities was reported. Conclusion: This paper highlights the unsatisfactory working environment and high-occupational morbidities among the MSW workers in Telangana. There was a lack of basic amenities at the workplace making it difficult for the MSW workers. A comprehensive approach which focuses on the health and safety with social security for the MSW workers is required. [ABSTRACT FROM AUTHOR]

Loneliness is an abstract construct defined in multiple ways. It is a feeling of disconnectedness, emotional isolation, and subjective feeling of lacking social relationships. Research shows loneliness to be common in older people, which, in turn, is a potent risk factor for various physical and psychosocial health conditions. Chronic loneliness is a predisposing factor for suicide, worsens cognitive outcomes, and impairs quality of living. Conventionally, aging is associated with "loss of vitality" and the "desperate need to retain older abilities." In contrast to these concepts, eastern views center around acceptance, "letting go" and aging with a greater sense of purpose. Traversing loneliness with self-esteem is viewed over a consistent resistance against loneliness. Self-acceptance, wisdom, and understanding the processes of emotional aging can foster hope and resilience which help navigate the inevitable loneliness that may arise in old age due to a multitude of factors. Spirituality has various intersections with mental well-being, however, it is often considered to be an esoteric concept. In this paper, we provide an Indian understanding of accepting and dealing with loneliness through the daily implementation of spiritual practices in life as well as mental health interventions. The four ashramas of Hinduism are discussed with special relevance to Vanaprastha Ashrama (forest-dweller), which signifies renunciation and acceptance associated with aging. The actionable areas with respect to spirituality and its philosophical underpinnings in mitigating loneliness in older people are also highlighted. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic restricted movement, closed businesses, and economic activities which disproportionately affected people globally. This pandemic has resurfaced the existing cracks in the societal set-up and has pushed the vulnerable and marginalized communities like migrant workers, people with disabilities, geriatric population, and commercial sex workers (CSWs) to an edge for their existence. Materials and Methods: Due to the paucity of peer-reviewed research publications on CSWs, formative research was conducted to identify the determinants and attributes of the challenges faced by CSWs during COVID-19 situation in India. Media scanning approach was used to collate literature from newspaper and magazine reporting, and peer-reviewed articles were referred from research-based search engines. Results: In total, 31 articles were included for content analysis and four domains of issues i.e., economic, social, psychological and health related challenged faced by them were identified which are supported with the verbatims of the community members as reported in the data sources considered for this study. It was identified that the CSWs adopted several protective measures and coping strategies to deal with the pandemic situation. Conclusion: This research highlighted that there is a need for further exploration of issues among CSWs by conducting studies among the communities. Furthermore, this paper provides a scope for future implementation research by identifying the key priorities and determinants of the challenges among the personal livelihood of CSWs in the country. [ABSTRACT FROM AUTHOR]

Background: General hospital psychiatry units (GHPUs) are the major providers of mental health services in India. Unlike in high-income countries, GHPUs in India are also the main training centers for providing postgraduate training in psychiatry and allied disciplines. Aim: This paper traces the history of the GHPUs in India from beginning to the present. Material and Methods: PubMed, old issues of the Indian Journal of Psychiatry and related sources were searched with key words general hospital and psychiatry both electronically and manually to look for the related literature. Results: The history of the development of GHPUs is discussed under 3 phases: beginning to the preindependence period, independence to the year of the launch of the National Mental Health Programme of India, and afterward. Contributions of the GHPUs towards service development, teaching, research, community awareness and reducing stigma, and their future scope are discussed. Conclusion: GHPUs have been a revolutionary development in India with great contribution in the field of mental heath [ABSTRACT FROM AUTHOR]

School mental health program (SMHP) has been recognized worldwide as key to improve the mental health and wellbeing of school going children. Unfortunately, in India, SMHP is badly neglected. There is no comprehensive SMHP that covers all school children (from rural and urban areas) across the country. A few sporadic activities that occur are praiseworthy; however, they lack a long-term approach. Major reasons for such neglect of SMHP in India could be lack of a steering body, poor intersectoral coordination, and minimal stakeholders' involvement. India, as any other country, needs to implement countrywide SMHP on the model of mental health promotion, prevention, and early intervention (PPEI). This paper outlines the deplorable state of SMHP in India and the needed steps to implement an effective countrywide SMHP on the PPEI model. [ABSTRACT FROM AUTHOR]

The objective of this systematic review was to examine the pooled prevalence of common mental disorder (CMD) and to evaluate the predictability of screening instruments to detect CMD in the children and adolescent population in India. Data sources included the MEDLINE, PubMed, PyschEXTRA, and PyschINFO up to 2020, with additional studies identified from a search of reference lists to examine the diagnostic utility of tools carried out in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, PRISMA within parentheses after the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines (PRISMA). Only studies involving children and adolescents with an independent measure of depression and anxiety in India were included. Random effects meta-analyses were employed to calculate a pooled estimate of depression prevalence. Twenty studies met all inclusion and exclusion criteria for the systematic review. The analysis showed that several tools were used in different regions of the nation to measure CMD such as the beck depression inventory (BDI), Children's Depression Rating Scale-Revised (CDRS-R), and Depression Anxiety Stress Scale. The pooled prevalence of depression was 19% (95% confidence interval (CI) = 12.57–27.12), 15% (95% CI = 4.67–30.90) for anxiety, and 11% (95% CI = 4.37–19.77) for any depressive disorder. In terms of BDI had the highest sensitivity (61%) while CDRS-R had the highest specificity (75%). Given the high heterogeneity of the studies, there is insufficient evidence that any tool accurately screens for CMD and likely to underestimate the true prevalence. [ABSTRACT FROM AUTHOR]

Introduction: Injection drug use (IDU) is intricately linked to preventive aspects for human immunodeficiency virus from a public health perspective. No large-scale data are yet available for injectable drug use among children and adolescents in India, apart from few anecdotal reports. Aims and Methods: The present paper reports on the profile and substance use pattern of 509 child IDU users, among a total sample of over 4000 children using substances across 100 sites from 27 states and 2 UTs in India. It was undertaken in 2012-2013 by the National Commission of Protection for Child Rights in collaboration with the National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi. For inclusion, participants had to be 18 years or less, should have used at least one other substance besides tobacco in the last 1 year, and should be living at home/street, in or out of school. Data were gathered using a 95-item semi-structured questionnaire. Results: A large proportion of ever users of IDU also reported use in the past year (96.5%) and past month (92.7%). Apart from IDU, tobacco, alcohol, cannabis, and pharmaceutical opioids were the most common substances of abuse in order of frequency. There was an interval of about 3 years from the initiation of tobacco to the initiation of IDU. Average age of onset for IDU was a year lesser in males than female users. The street children initiated IDU earlier than out-of-school and schoolgoing children. No quit attempt was made by more than half of the children. More than 40% had frequent familial conflicts, more than half had a familial history of substance use, and three-fourths had drug-using peers. Conclusion: The paper highlights the profile and pattern of children and adolescents using IDU across many parts of India, dispelling the myth that IDU is largely an adult phenomenon in India. There is a clear need to promote different harm reduction and preventive strategies across the "hard-to-reach" younger age groups using injecting drugs. [ABSTRACT FROM AUTHOR]

Introduction: This paper describes a fictitious study of a fictitious drug. A companion paper in this issue of the Indian J Psychiatry critically examines this paper and provides author, reader, reviewer, and researcher perspectives on problems related to the design and conduct of a clinical trial; on issues related to the analysis of data; on how to write a research paper; and on how to critically read or review a journal article. Readers are invited to appraise this paper and then compare their assessment with that presented in the companion paper. Background: This study sought to compare the safety and efficacy of placeboxetine (PB) hydrochloride extended release capsules with sertraline hydrochloride in patients diagnosed with major depressive disorder in 15 general hospitals in south India. Materials and Methods: In a prospective, open-label, 15-center, randomized controlled clinical trial, consecutive outpatients diagnosed with major depressive disorder of at least moderate severity were randomized 1:1 to receive flexible doses of either PB or sertraline once each morning. Patients were evaluated every two weeks, until the study endpoint, using the Hamilton Rating Scale for Depression (HAM-D) and the Montgomery-Asberg Rating Scale (MADRS). Safety was determined through assessments of vital signs, adverse events, study discontinuation rates, hematological parameters, metabolic parameters, electrocardiography, and other measures. Results: Ten patients dropped out of the study from each treatment arm. There was a significant, marked improvement in HAM-D and MADRS scores in each group by the treatment endpoint. There was no significant difference between PB and sertraline groups on either HAM-D or MADRS at any visit. The response rate was 90% with PB and 92% with sertraline. The remission rate was 70% with PB and 75% with sertraline. All laboratory parameters were within normal limits in all patients. There were no serious adverse events. Conclusions: Placeboxetine is as safe and effective as sertraline in Indian patients with major depressive disorder. [ABSTRACT FROM AUTHOR]

Cancer awareness is the key to early detection and better health-seeking behaviour. Cancer is quite common in both developing as well as developed countries, but awareness is yet poor among the general population. Poor awareness may lead to poor uptake of screening modalities and delay in diagnosis. One factor that has been consistently shown to be associated with late diagnosis and treatment is a delay in seeking help for cancer-like symptoms. This paper reviews the literature on cancer awareness among the general population and attitude towards screening modalities. The poor awareness level among the Indian population shows the need for health education and sensitisation regarding cancer and its different aspects. This will be helpful in the successful implementation of health programmes related to cancer. [ABSTRACT FROM AUTHOR]

Glaucoma, a leading cause of irreversible blindness, can be prevented or stabilized the progression if identified early and managed it appropriately. In India, around 12 million people suffer from glaucoma, and 1.5 million are blind due to it, so making the third most common cause of blindness. More than 75% of glaucoma are undiagnosed, which perhaps represent the submerged portion of the iceberg phenomenon of the traditional disease explanations. Though glaucoma per se does not lead to mortality, glaucoma blindness is categorized as a severe form of disability (category VI) out of seven World Health Organization (WHO) classification on the global burden of diseases. Indeed, there is a large gap between the prevailing burden of glaucoma and service being delivered about its prevention compared to other leading causes of blindness in India. Considering the magnitude of the problem as well as the severity of disability, a strong and effective advocacy is an urgent call to deal glaucoma problem in the country. For a resource-limited country, where mass population based-screening programs are not feasible, alternative methods like facility-based opportunistic screening and referring the high-risk groups for early detection and treatment should be aimed. However, glaucoma should not be screened in isolation from other eye problems. In fact, screening of any potential blinding ocular problems, including glaucoma, should be a clear mandate under comprehensive eye program of the WHO to achieve Universal Eye Health Coverages. This paper highlights the strategy inclusive of advocacy to curtail the increasing burden of glaucoma blindness in India. [ABSTRACT FROM AUTHOR]

The healthcare industry worldwide is undergoing a radical transformation. An enthusiastic healthcare system of the Government of India (GOI) continually tries to tackle numerous challenges facing the system. The Rashtriya Swasthya Bima Yojana (RSBY) program has provided secondary level healthcare facilities to more than 36 million families across most states in India. This particular health insurance initiative was taken by the GOI with the purpose to safeguard the pitiable or marginalized Indian population or those households who are facing economic risks due to hospitalization and their everyday expenditures. RSBY provides affordable and accessible healthcare services along with insurance coverage for secondary care. However, it is limited to inpatient treatment or hospitalization. For outpatient coverage many strategies have been applied but low enrolment is still an existing flaw under this streamer. The present paper discusses various features of RSBY, outpatient projects undertook, and various obstacles that can be removed to integrate this insurance scheme with primary healthcare in India. [ABSTRACT FROM AUTHOR]

Background: The immunization coverage in India is far away from satisfactory with full immunization coverage being only 62% at national level. Targeting the intensive efforts to poor performing areas and addressing the determinants of nonimmunization and dropouts offers a quick solution. In this paper, we assess the inter-district variations in Haryana state, and the association of social determinants with partial and no immunization. Methodology: This analysis is based on data collected as part of a large household survey undertaken in the state of Haryana to measure the extent of Universal Health Coverage. A multistage stratified random sampling design was used to select primary sampling units (i.e., subcenters), villages, and households. A total of 11,594 mothers with a child between 12 and 23 months were interviewed on receipt of immunization services. Determinants of nonimmunization and partial immunization were assessed using multiple logistic regression. Results: About 21% of children aged 12-23 months were partially immunized, while 4.3% children aged 12-23 months had received "no immunization." While the coverage of full immunization was 74.7% at the state level, it varied from 95% in best performing district to 38% in poorest performing district. Odds of a partially immunized child were significantly higher in urban area (odds ratio [OR] = 1.23; 95% confidence interval [CI] = 1.1-1.38), among Muslim household (OR = 3.52; 95% CI = 3.03-4.11), children of illiterate parents (OR = 1.58; 95% CI = 1.22-2.05), and poorest quintile (OR = 1.61; 95% CI = 1.36-1.89). Conclusions: Wide interdistrict variations call for a need to consider changes in resource allocation and strengthening of the government initiatives to improve routine immunization in these districts. [ABSTRACT FROM AUTHOR]

The oral health delivery strategies are taking back seat in the universal health coverage scheme in India. This paper highlights the personal experience of a dental professional from India as an educator, motivator, and collaborator to nullify or minimize social policy challenges faced by medical health providers in the administrative cadre to strengthen the oral care delivery model in the health services department in Kerala state. The author has nevertheless persisted with positive educational, motivational, and collaborative approaches with medical health providers in the administrative cadre, general cadre, and specialty cadre in the health services department in Kerala state to change the current climate. [ABSTRACT FROM AUTHOR]

We aimed to review the contributions by Indian researchers to the subspecialty of skeletal dysplasias (SDs). Literature search using specific keywords in PubMed was performed to retrieve all the published literature on SDs as on July 6, 2017. All published literature on SDs wherein at least one author was from an Indian institute was included. Publications were grouped into different categories based on the major emphasis of the research paper. Five hundred and forty publications in English language were retrieved and categorized into five different groups. The publications were categorized as reports based on: (i) phenotypes (n = 437), (ii) mutations (n = 51), (iii) novel genes (n = 9), (iv) therapeutic interventions (n = 31), and (v) reviews (n = 12). Most of the publications were single-patient case reports describing the clinical and radiological features of the patients affected with SDs (n = 352). We enlisted all the significant Indian contributions. We have also highlighted the reports in which Indians have contributed to discovery of new genes and phenotypes. This review highlights the substantial Indian contributions to SD research, which is poised to reach even greater heights given the size and structure of our population, technological advances, and expanding national and international collaborations. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases (CVDs) are the leading causes of death globally (nearly 17.5 million deaths/year). Hypertension and coronary heart disease (CHD) are two of the most important CVDs. There is a dearth of studies at a large scale in India to ascertain the factors as well as social differentials in the prevalence of heart disease associated with hypertension. This paper attempts to bridge the gap in the relevant area. Methodology: Secondary analysis of the data obtained from India Human Development Survey (IHDS), conducted in two rounds in 2004-2005 and 2011-2012, was done (n = 147,201). Bivariate and logistic regression analyses have been used. Results: In India, the prevalence for CHD is 1.1% for 2011-2012. Findings showed that persons with hypertension are 11 times (odds ratio [OR] = 11.58, P < 0.01) more likely to be affected by CHD among adults (15 and above years) as compared to nonhypertensive adults. When the odds are adjusted for socioeconomic and demographic variables, hypertensives are found to be 5 times more likely (OR = 5.096, P < 0.01) to be having CHD as compared to nonhypertensives. Conclusions: The unadjusted odds of suffering from CHD when hypertension is a predictor are much higher than when the odds are adjusted for socioeconomic and demographic variables. Along with hypertension, age, education, and place of residence have also been found to be important determinants of CHD. [ABSTRACT FROM AUTHOR]

In India, under the Revised National Tuberculosis Control Program (RNTCP), the percentage of smear-positive retreatment cases is high. The causes of re-treatment include relapse of the disease after successful completion of treatment, treatment failure, and default in treatment. RNTCP does not follow up the patients for any period of time after successful completion of treatment to determine whether they relapse. Given the high cost of treatment for each patient under RNTCP and the potential for spread of disease from these patients, it is crucial for the success of the program and control of the disease in the country to find out more about the reasons behind this. To conduct a systematic review of literature and determine evidence regarding recurrence of TB after its successful treatment with standard short course chemotherapy under DOTS guidelines. Ten databases were searched including Medline, Cochrane database, Embase and others and reference lists of articles. 255 papers resulted from these searches. Seven studies were finally included in the review after applying the inclusion, exclusion and quality assessment criteria. Relapse rate is high (almost 10%) in India which is higher than international studies. Majority of relapse cases present soon after completion of treatment (first six months). Risk factors for relapse included drug irregularity, initial drug resistance, smoking and alcoholism Sex and weight were not risk factors in India. The outcome of relapse cases put on treatment is positive but less effective than new cases. There are sound arguments and sketchy evidence that DOTS Category 2 treatment may not be adequate for retreatment patients. [ABSTRACT FROM AUTHOR]

Objective: The objective was to conduct a bibliometric analysis of Indian ophthalmic papers published from 2001 to 2006 in the peer-reviewed journals, to assess productivity, trends in journal choice, publication types, research funding, and collaborative research. Materials and Methods: We searched PubMed for articles indicating both vision-related content and author affiliation with an Indian research center. We identified research collaborations and funding from indexing for research support, and classified articles as reporting basic science, clinical science, or clinically descriptive research. Impact factors were determined from Journal Citation Reports for 2006. Results: The total number of published articles that were retrieved for the years 2001 to 2006 was 2163. During the six-year period studied, the annual output of research articles has nearly doubled, from 284 in 2001 to 460 in 2006. Two-thirds of these were published in international journals; 41% in vision-related journals with 2006 impact factors; and 3% in impact factor journals which were not vision-related. Fifty percent of the publications came from nine major eye hospitals. Clinical science articles were most frequently published whereas basic science the least. Publications resulting from international collaborations increased from 3% in 2001 to 8% in 2006. The focus of the journal with the highest number of publications corresponds to the most common cause of bilateral blindness in India, cataract. Conclusion: This bibliometric study of publications of research from India in the field of ophthalmic and vision research shows that research productivity, as measured in both the number of publications in peerreviewed journals and qualitative measures of those journals, has increased during the period of this study. [ABSTRACT FROM AUTHOR]

Introduction: It is essential to maintain optimal nutrition during the early years of life when the growth rate is maximum. Aims and Objectives: Our study investigated the prevalence of various feeding practices. We also explored their association with different sociodemographic, biomedical variables, and childhood morbidity. Methodology: This was a cross-sectional community-based study. Data were collected through a questionnaire-based survey of mothers of school-going children aged 2–6 years in the districts of Anand and Vadodara, Gujarat. Results: A total of 367 mothers participated in the study. About 78% of the mothers did early initiation of breastfeeding within 1 h of birth, and 68% gave colostrum to the newborn. Around 30% of the mothers practiced bottle feeding, and 25% gave prelacteal feeds. Most mothers received good family support for breastfeeding (93.73%). On univariate analysis, we found the following associations of feeding practices—breastfeeding initiation with the gender of the baby (P value—0.006) and type of delivery (P value < 0.001); the duration of exclusive breastfeeding with the time difference between two deliveries (P value—0.027) and maternal age (P value—0.004); prelacteal feeds with the type of delivery (P value—0.034); feeding difficulty with the time difference between two deliveries (P value < 0.001) and breastfeeding at night with maternal education (P value—0.002). The time of the initiation of breastfeeding was associated with cough and cold episodes. No other association was found between breastfeeding variables and health indicators. Conclusion: Maternal age, maternal education, the time difference between two deliveries, the type of delivery, and gender of the baby were significantly associated with different Infant and Young Child Feeding (IYCF) practices. Identifying these factors might help in the development of strategies for optimizing feeding practices. [ABSTRACT FROM AUTHOR]

Yoga tourism is an emerging market in India, with a great economic potential to boost revenue in the wellness travel and hospitality industries. Millions of tourists from foreign countries visit India each year to explore the history, philosophy, practice, and experiences of Yoga as the art originated there. However, little is known in the scientific literature on the Yoga-linked tourism and hospitality subject. Besides, how the enduring COVID-19 pandemic impacts the emerging Yoga tourism and hospitality sector in India is not fully understood. This article highlights the less-known aspects of India's Yoga tourism and hospitality and how the continuing COVID-19 pandemic impacts the business. [ABSTRACT FROM AUTHOR]

The increased detection of thyroid nodules in the human population has led to an increase in the number of thyroid surgeries without an improvement in survival outcomes. Though the choice for surgery is straightforward in malignant thyroid nodules, the decision is far more complex in those nodules that get categorized into indeterminate thyroid nodules (ITN) by fine needle aspiration. Therefore, there is a pressing need to develop a tool that will aid in decision-making among the ITN. In this context, the development of various molecular testing (MT) panels has helped to confirm or rule out malignancy, reducing unnecessary surgeries and potentially guiding the extent of surgery as well. Currently, such tests are widely used among the Western population but these MT panels are not used by the South Asian population because of non-availability of validated panels and the high cost involved. There is a need to develop a suitable panel which is population-specific and validate the same. In this review, we would focus on current trends in the management of ITN among the South Asian population and how to develop a novel MT panel which is cost-effective, with high diagnostic accuracy obviating the need for expensive panels that already exist. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has become a global pandemic, prompting lockdowns in practically every country. To prevent the spread of the disease, India has enforced a rigorous nationwide lockdown that commenced in March 2020. The lockdown imposed amid the pandemic ensured that most commercial activities and vehicle transportation ceased, resulting in a significant reduction in air pollution levels. Material and Methods: The value of air pollutants PM10, PM2.5, NO2, and SO2 from January to May 2020 was obtained from the Indian Central Pollution Control Board. Before lockdown and during lockdown, relative fluctuations in ambient concentrations of four air contaminants were investigated. The Box-Jenkins approach was used to estimate future air pollution data points using time series data analysis. Results: The PM10 level reduced by 61%, 30%, 68%, 37%, and 43% in the selected cities, respectively. Comparison of other pollutant concentrations before and after the lockdown also found a reduction in ambient pollutant concentrations, resulting in improved air quality. Inference of predicted model values to observed values revealed a significant increase in the concentrations of all pollutants. The percentage increases in AQImean from predicted to observed values were 206% in Ghaziabad, 148% in Delhi, 59% in Hyderabad, and 160% in Cochin. Conclusion: The strict lockdown has resulted in a significant drop in air pollutant levels. Upgrading present technologies could help keep pollution to a minimum of 37% under control. The findings would prompt the government to consider how to strictly reduce vehicle and industrial pollution to improve air quality and maintain improved public health. [ABSTRACT FROM AUTHOR]

Background: A staggering 85% of the global population resides in low- and middle-income countries (LAMICs). India stands as an exemplary pioneer in the realm of mental health initiatives among LAMICs, having launched its National Mental Health Program in 1982. It is imperative to effectively evaluate mental health systems periodically to cultivate a dynamic learning model sustained through continuous feedback from mental healthcare structures and processes. Materials and Methods: The National Mental Health Survey (NMHS) embarked on the Mental Health Systems Assessment (MHSA) in 12 representative Indian states, following a pilot program that contextually adapted the World Health Organization's Assessment Instrument for Mental Health Systems. The methodology involved data collection from various sources and interviews with key stakeholders, yielding a set of 15 quantitative, 5 morbidity, and 10 qualitative indicators, which were employed to encapsulate the functional status of mental health systems within the surveyed states by using a scorecard framework. Results: The NMHS MHSA for the year 2015--16 unveiled an array of indices, and the resultant scorecard succinctly encapsulated the outcomes of the systems' evaluation across the 12 surveyed states in India. Significantly, the findings revealed considerable interstate disparities, with some states such as Gujarat and Kerala emerging as frontrunners in the evaluation among the surveyed states. Nevertheless, notable gaps were identified in several domains within the assessed mental health systems. Conclusion: MHSA, as conducted within the framework of NMHS, emerges as a dependable, valid, and holistic mechanism for documenting mental health systems in India. However, this process necessitates periodic iterations to serve as critical indicators guiding the national mental health agenda, including policies, programs, and their impact evaluation. [ABSTRACT FROM AUTHOR]