Search

Aims and background: Acute poisoning is one of the most common emergencies in India and around the world. Understanding the factors associated with mortality can aid us in devising appropriate preventive strategies to curtail deaths due to poisoning. Purpose of this study is to find various factors that determine the mortality among acute poisoning cases admitted in a tertiary care center. Materials and methods: A retrospective hospital records-based study was conducted at Chengalpattu Medical College Hospital. The study included 2,123 cases of various poisoning cases admitted for a year from January to December 2022. Cases of bites, stings, drowning, and hanging were excluded. Information on sociodemographic profile, type of poison, time since ingestion and admission, and treatment outcome were collected using a structured pro forma. Results: The mean age of the study population was 29.90 ± 14.98 years. Poisoning was found to be predominantly among males (56.42%) and residents of rural areas (58%). Insecticide consumption (27.0%) was the most common modality, followed by oleander poisoning (20%), corrosive poison (17%), rat poison (15%), tablet poison (13%), and other poisons. The overall case fatality rate (CFR) was 5.2%, with the highest CFR of 12.25% with insecticide poisoning. In multivariate analysis, Glasgow coma scale (GCS) score at admission is the only parameter showing a statistically significant association with mortality (adjusted odds-ratio 0.271(0.2-0.38, p-value < 0.01). Conclusion: Acute poisoning primarily affects the young and economically productive population. In the south Indian population, pesticides are still the major contributor though corrosives are a major contributor among children. Mortality is still significant, and GCS status admission is the only predictor of mortality. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of this study was to evaluate and estimate the knowledge, attitude, and practices of Indian fresh medical graduates with respect to ophthalmic emergencies. MATERIALS AND METHODS: This cross-sectional study was conducted on 1300 participants who had completed compulsory rotatory residential internship with the help of a questionnaire distributed through social platforms. The Chi-square and Pearson's coefficient relation tests were used. Statistical analysis was done using IBM SPSS. P <0.05 was taken as the level of statistical significance. RESULTS: Good knowledge proportionately corresponded to a good attitude with statistical significance (P = 0.000). Participants with good practice also had a good attitude with significance (P = 0.001). Good knowledge participants who managed ophthalmic emergencies were statistically significant than that of participants with poor knowledge and managed ophthalmic emergencies, 15.72%. (Χ2 = 16.653, P = 0.000). Attitude toward confidence in the management of ophthalmic emergencies and their willingness in undergoing training was significant (Χ2 = 43.8, P = 0.000). CONCLUSION: Educating and training fresh medical graduates can help in the management and mitigation of ophthalmic emergencies to reduce ocular morbidity and prevent blindness to a greater degree. [ABSTRACT FROM AUTHOR]

Background: There is underutilization of long-acting injectable (LAI) antipsychotics for first-episode schizophrenia (FES) despite having convenient dosing and treatment retention. LAIs are predominantly used for patients with poor compliance, chronic course, and multiple relapses. Materials and Methods: Seventy-two treatment naïve patients with the first episode of Schizophrenia (DSM-5) were assessed for baseline severity of psychopathology using the positive and negative syndrome scale (PANSS) and quality of life (QOL) using the WHOQOL-BREF scale. Patients were randomized to receive either oral haloperidol or LAI haloperidol for a period of 12 weeks. Results: Both the groups had a significant reduction in PANSS scores and improvement in QoL over 12 weeks period (P = 0.0001). The LAI group showed greater adherence and significantly better quality of life than the oral group (P = 0.023). The mean numbers of side effects were less in the LAI group at week 2 as compared to the oral group. Conclusion: LAI haloperidol is similar to oral haloperidol in patients with FES with respect to treatment response and offers benefits in form of a lesser number of side effects during early treatment, overall better adherence rates, and better QOL. [ABSTRACT FROM AUTHOR]

Background: Oral squamous cell carcinoma (OSCC) prevalence is high in India and contributes to about 90% of all oral neoplasms. The 5 year survival rate has not improved even with advances in treatment options. It could be due to delay in patient reporting and lack of proper histopathological examination. Immunohistochemistry helps to confirm the diagnosis in suspicious cases promptly. Aim and Objectives: Aim of the present study is to identify variations in the immunohistochemical expression of CK 8/18 in normal mucosae, oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC). Materials and Methods: A total of 70 samples (Formalin Fixed Paraffin embedded blocks) including 10 normal oral mucosa, 30 OPMD and 30 OSCC histologically diagnosed cases were included in the study. Immunohistochemical staining of CK8 and CK18 was performed. The color grading and assessment of IHC staining of the slides was done by two oral pathologists. The data were tabulated and analyzed with SPSS v 22.0 (SPSS Inc, Chicago, IL) using Mean ± SD, ANOVA, Chi Square test Tukey HSD Post-hoc Test. A probability of p<0.05 was considered as significant. Results: The mean score in the control group was 0.9 with standard deviation 1.1. The mean score in the OPMD group was 1.13 with standard deviation 0.8. The mean score observed in the OSCC group was 1.45 with standard deviation 0.86. We performed the Tukey HSD post-hoc test and evaluated that Difference between control and OPMD group was 0.2300, and p value is 0.7606, which did not achieve statistical significance. Difference between Control and OSCC was 0.5500. p value 0.2169, which was not significant. Differences between OPMD and OSCC group was 0.3200 with p value was 0.3520 which also not significant. Conclusion: Strong expression was noted in OPMD and OSCC in our study. There was a progressive increase in its expression from the normal mucosa to OPMD to OSCC but our values did not reach statistical significance. Further investigations will be necessary to explore the mechanisms of CK8/18 expression as well as their exact functions in such cancerous lesions to improve our understanding on tumor biology and its behavior. [ABSTRACT FROM AUTHOR]

Analysis of rainfall distribution and its changing pattern plays a vital role in managing water resources in a region. This work examined the spatio-temporal variability and trend of rainfall on yearly and season-wise scales during 1971–2013 in the Wainganga river basin situated in middle India. The Mann–Kendall (MK) test was implemented for identifying the temporal variation in rainfall trends. The magnitude of this changing trend was estimated by applying Sen's slope (SS) method. A paired sample t-test was also employed to appraise the statistical significance of changes in rainfall data. The results of MK and SS tests show both upward and downward trends. The results show positive and negative trends in the south-eastern and northwestern parts of the study area for annual rainfall. The monsoon rainfall also shows very close proximity with annual rainfall data trends. The t-test states that the observed changes in precipitation are statistically significant. After trend and pattern analysis, state-space models (SSMs) were used to predict rainfall for future scenarios. Four SSMs (single, double, and triple exponential, autoregressive integrated moving average (ARIMA)) were employed for rainfall prediction. The analysis shows that the ARIMA is best for rainfall prediction with architecture of (0,0,0) (2,1,0) and can be used in Wainganga River basin. [ABSTRACT FROM AUTHOR]

Introduction: Breakthrough infections in fully vaccinated persons pose a major challenge to the ongoing vaccine campaign against SARS-CoV-2 globally. Objectives: To investigate the occurrence of breakthrough infections and the association of Covid symptoms with the vaccination status of health care workers (HCWs). Material and Methods: Done in Government Medical College, Patiala among Covid-positive HCWs who have received one or both doses of Covid vaccine, using pretested semi-structured validated Proforma and telephonic interview from April 1, 2021 to June 15, 2021. Results: Among 3388 HCWs, 115 vaccinated HCWs (1st or 2nd dose) became Covid positive. Among vaccinated Covid positive HCWs, 54 received the first dose and 61 both doses. Breakthrough infections (≥14 days post 2nd dose) occurred in 4.6% (47 of 1021) HCWs. The vaccine is significantly protective as shown by an odds ratio of 0.27; thus, vaccinated HCWs are 73% less likely to get Covid infection as compared to non-vaccinated HCWs. There was no statistically significant difference between symptom profiles of cases whether they took one or both doses of vaccine, except headache. Only tiredness and headache were reported significantly higher in the unvaccinated group in comparison to vaccinated HCWs. Conclusion; Research is needed on tracking the immune response and viral genomic sequence of samples of vaccinated Covid-positive HCWs to have constant vigilance on remerging new strains of the SARS-CoV-2. [ABSTRACT FROM AUTHOR]

Background and Objective: Children and adolescents are the most vulnerable groups for road traffic injuries in India (39%). Hourly, forty youngsters die in road traffic crashes. Road safety education aims at reducing this burden. Peer-led education (PLE) is a credible approach influencing students to modify their behavior positively. This study aimed to evaluate the effectiveness of PLE in terms of knowledge and attitude toward road safety among adolescents. Methodology: A single-group pretest–posttest design among 113 adolescents was conducted using a two-stage sampling technique. Ten selected and trained student peers provided PLE on road safety to 103 fellow students using a teaching aid. Effectiveness of PLE on knowledge and attitude was assessed pre- and postintervention. Results: Post PLE, the mean knowledge score of subjects increased from 10.5 to 17.5 with a significant mean difference of −6.9 (P < 0.001). The mean attitude score of subjects had increased from 46.7 to 48.1. A positive statistically significant correlation (P = 0.04) between knowledge and attitude and associations between certain sociodemographic variables were noted. Conclusion: Knowledge and attitude of subjects regarding road safety improved after PLE. Innovative teaching methods can be used to promote healthy behaviors among adolescents. [ABSTRACT FROM AUTHOR]

Background and Objectives: Greying of hair is a regular feature of chronological aging that occurs in all regions and races. Premature canities is defined as minimum of five grey hairs in a person less than 20 years in Whites, 25 years in Asians, and 30 years in Africans. Premature canities is a common yet incompletely understood dermatological entity. This study aims at finding any association between premature hair greying (PHG) and parameters like hemoglobin (Hb), ferritin and calcium levels as well as its clinical profile. Methodology: This was a hospital-based cross-sectional analytical study conducted in the Department of Dermatology and Venereology, Trivandrum over one and half years. The study population consisted of 40 cases and 40 controls. Severity assessment, calculation of body mass index, and estimation of hemoglobin, serum ferritin, calcium, Random blood sugar, Anti Thyroid Peroxidase antibody, T3, T4, and TSH were done. Results: The mean age of the 40 patients was 17.14 years and most patients had onset of greying between 16 and 20 years. The male to female ratio was 1.2:1. A positive family history with a paternal predominance was noted. Vertex was the most common site of onset (42.5%), diffuse pattern was the most common clinical pattern (47.5%) and 60% had involvement of mild grade. Fourteen patients (35%) had abnormal investigations reports, in terms of low ferritin levels in 7 (17.5%), low calcium in 4 (10%) and a low Hb levels in 3 (7.5%) patients. Six (15%) patients had raised Anti TPO values. The association of PHG with low ferritin and raised anti-TPO levels were statistically significant. Conclusion: Low serum ferritin and raised Anti TPO levels may have a role in premature hair greying. [ABSTRACT FROM AUTHOR]

Introduction: Dental specialties are seldom recognized in India. Hence, in the present study, we aim to assess awareness among the rural population about the dental specialty of orthodontics. Materials and Methods: We conducted a questionnaire-based cross-sectional observational study at the rural center attached to the institute. We divided the participants into two groups as adults and teenagers. A questionnaire with 15 questions to assess the knowledge of the orthodontics was given and the response was noted. Data were analyzed for the statistical significance. Results: We observed no significant difference in general information and awareness about the knowledge for the orthodontics. Conclusion: There is still a deficit of the awareness among rural India about the dental specialty of the orthodontics irrespective of the age and gender. Awareness camps have to be arranged at the school levels. [ABSTRACT FROM AUTHOR]

Introduction: Barometric pressure-induced dental pain is a clinical entity elicited by atmospheric changes in pressure. Barodontalgia among pilots is of marked interest as it can be a potential flight safety hazard and compromise the personnel's operational capability and performance. Due to its overlapping signs and symptoms, it may also remain unnoticed and represent itself during a pressure change which may be during ascend or descend of flight. Aim: To assess presence of barodontalgia and awareness of the phenomenon among commercial pilots based in India. Materials and Methods: This cross-sectional study was conducted from June to August 2020 using self-reported questionnaire submitted via Google forms (Alphabet, Mountain view, CA, USA) among 410 pilots based in India. It consisted of questions inquiring about the occurrence, localisation, intensity and recurrence of in- flight dental pain. Inferential statistics were performed using Chisquare test, One way analysis of variance (ANOVA) and Independent t-test. The level of statistical significance was set at 0.05. results: Three hundred and seventy pilots responded to the questionnaire with a response rate of 90.24%. The incidence was reported among 10.54% (n=39) pilots although 42.7% (n=158) lacked awareness regarding the same. Only a single case of recurrence of pain was reported while none reported any risk to flight safety or accident, secondary to barodontalgia. conclusion: The incidence level of barodontalgia among commercial pilots in India is low. However, the lack of awareness is still an unsettling risk and was not found to be of significant difference when compared on the basis of gender and work experience. [ABSTRACT FROM AUTHOR]

Introduction: This study assessed the process of decision-making among adolescents and the factors affecting it and also explored the styles of decision-making among adolescents. Methodology: A cross-sectional study using purposive sampling was carried out involving 1177 college-going students aged between 17 and 19 years. General Decision-Making Style (GDMS) and semi-structured questionnaire was used to collect data. Data were analyzed with the help of SPSS and AMOS. Exploratory and confirmatory factor analyses were run. Results: Good decision-making process was seen among 76.9% of the students. Kaiser--Meyer--Olkin verified that sampling adequacy was 0.8. Scree plot and Monte Carlo parallel analysis were suggestive of four factors which were logically intuitive, avoidant, dependent, and spontaneous styles of making decisions. Cronbach's alpha was 0.7 for GDMS. Staying arrangement, paternal education, fantasy scale score, perspective-taking score, personal distress score, problem-solving, self-esteem, creative thinking, and coping with stress were found statistically significant with decision-making process. While, on confirmatory factor analysis, a five-factor model was found to be fit with minimum discrepancy/degrees of freedom value of 2.68, root mean square error of approximation: 0.038, Comparative Fit Index (CFI): 0.927, Normed Fit Index (NFI): 0.890, parsimony CFI: 0.66, and parsimony NFI: 0.634. A high correlation was observed between rational and intuitive styles. Conclusion: The process of decision-making was found to be good, but styles of making decisions were overlapping [ABSTRACT FROM AUTHOR]

Background: The pharmacokinetics of primaquine [PQ] have been the subject of studies in both adults and healthy participants. However, there is no study on its pharmacokinetics in a setting of undernourishment. In India, there is evidence to show considerable malnourishment in children that in turn can affect drug pharmacokinetics. Given that the country is moving towards malaria elimination, the present study was planned with the objective of comparing pharmacokinetics of the drug in undernourished children relative to normally nourished children. Materials and Methods: After Institutional Ethics Committee approval, children of either gender between the ages of 5 and 12 years and smear-positive for Plasmodium vivax malaria were included. Nourishment status was determined using the Indian Academy of Pediatrics classification of protein energy malnutrition based on Khadilkar's growth charts. Twelve children each were enrolled in the two groups. PQ was given in the dose of 0.3 mg/kg/d and blood collections were made at 0, 1, 2, 3, 4, 6, 8 and 24 hours post-dosing. Levels were estimated by high-performance liquid chromatography. Chloroquine in the dose of 25 mg/kg was given over three days along with supportive care. Results: Of the 24 children, there were 17 boys and 7 girls. There was a statistically significant difference in the body weight between the undernourished and the normally nourished children [21.5 ± 5.52 vs. 28.8 ± 8.84, P < 0.05]. PQ levels showed wide inter-individual variation in both groups. No significant difference was seen in any pharmacokinetic parameter between the two groups. Discussion: This study adds to the limited body of evidence on the pharmacokinetics of PQ in children with malaria and indicates that the dosing of primaquine could potentially be independent of the nourishment status. [ABSTRACT FROM AUTHOR]

Introduction: We previously showed that patients with chronic kidney disease (CKD) Stage G4-5 have normal bleeding times. This made us question whether hemodialysis (HD) initiation was really necessary solely to improve platelet function. Methods: In this prospective observational study, two 5 ml citrated blood samples and one 2 ml EDTA blood sample were collected from incident HD patients fulfilling inclusion criteria prior to HD initiation (baseline sample) and after three sessions of short duration, low flow, counter-current HD. In each instance, one sample was used to perform Collagen adenosine diphosphate closure time (CADPCT) using the Platelet function analyzer (PFA 200, normal range 68-142 seconds) and the second for light transmission aggregometry (LTA) with ADP as agonist (normal ≥50%). Results: This study included 20 patients between October 2017 and February 2019. Overall, and in the subgroup with normal baseline CADPCT or LTA, there was no statistically significant improvement after HD. However, of the 30% of patients who had an abnormal baseline CADPCT, 50% attained a normal value after three HD sessions, and the overall reduction in CADPCT in this group was statistically significant (P = 0.02). Of those with a baseline normal CADPCT, 21% developed abnormal prolongation post HD. Conclusion: HD for the sole purpose of improving platelet function is only of benefit in the subgroup of patients with an abnormal CADPCT at baseline, with close to 50% normalizing their platelet function after three sessions of low flow, short duration, counter-current HD. [ABSTRACT FROM AUTHOR]

Background: Axillary dissection is one of the important components of modified radical mastectomy (MRM). The present study was conducted to compare surgical outcomes by using monopolar electrocautery and ultrasonic dissector for axillary dissection in MRM. Methods: A parallel randomised controlled single blinded study was conducted with a sample size of 70 patients who were randomised into two groups. One group underwent MRM using ultrasonic dissector (Group A) and the other one using electrocautery (Group B). Intra- and post-operative outcomes were compared. Results: Group A had an average operating time of 30.86 min, which was statistically less than that of Group B. The mean mop count and the daily drain output in Group A were less as compared to Group B and the differences were statistically significant. Drain was removed early in Group A as compared to Group B. However, post-operative pain scores and seroma formation were not statistically significant among the two groups. Conclusion: Ultrasonic dissector group had significantly lesser intra-operative bleeding, operating time and post-operative drain output when compared to electrocautery group. However, the two groups had no significant difference in post-operative pain scores and seroma formation. [ABSTRACT FROM AUTHOR]

Background: There is a trend of increase in number of contact dermatitis cases. Studies on the prevalence and epidemiological pattern of allergic skin disorders in Indian scenario are not much available. The present study was designed to assess the epidemiological pattern of contact dermatitis in rural and urban areas in a peripheral district in eastern India. Aims and Objectives: This study was undertaken to find the prevalence of contact dermatitis and to assess the epidemiological pattern of contact dermatitis both in rural and urban community. Materials and Methods: The study was conducted in a medical college located at a semi-urban area in eastern India with written informed consent obtained from each participant. This hospital-based cross-sectional study was done from May 2017 to April 2018. Study population consisted of patients attending the dermatology OPD and having lesions clinically suggestive of contact dermatitis and there were 268 such patients. Patients attending the OPD were divided into urban and rural as per their address. Data analysis was done using suitable, standard, and appropriate statistical methods. Results: The prevalence of contact dermatitis was 4.38% among the dermatology OPD attendees. Urban prevalence was statistically significantly (P < 0.05) higher than rural prevalence. Contact dermatitis was common in the age group of 41–50 years. In urban areas, females were more affected than those in rural areas. Occupationally, the difference between urban and rural patients of contact dermatitis was statistically significant (P < 0.05). Cosmetic history in the urban group was significantly more (P < 0.05). Conclusions: Contact dermatitis prevalence and patient profile in certain factors showed a statistically significant difference between urban and rural patients. [ABSTRACT FROM AUTHOR]

Background: In India, iodine deficiency (ID) still remains a serious concern even after five decades of enormous efforts. ID during the preconception period of adolescent girls may negatively affect future neonates, resulting in neonatal hypothyroidism. Hence, the present study was conducted to assess the prevalence of goiter and associated factors among adolescent girls in a poor socioeconomic district of Rajasthan. Methodology: A cross-sectional study was conducted during January–March 2015 in Tonk district of Rajasthan. A total of 1912 adolescent girls were selected from thirty schools using population proportionate to size sampling. Adolescent girls were clinically examined for thyroid using palpation method. Casual urine (n = 344) and salt samples (n = 370) were collected from a subgroup of girls for the estimation of urinary iodine concentration (UIC) and iodine content in salt, respectively. Results: The overall goiter prevalence was 15.3% (95% confidence interval 13.6%–16.9%) and the median UIC was 266 μg/l (interquartile range: 150–300 μg/l) among 1912 adolescent girls (age, 15.7 ± 1.4 years). Around 16.8% of the families of adolescent girls were consuming salt with inadequate iodine (<15 ppm). Goiter prevalence was statistically significantly different with respect to age groups (P = 0.03). There was no statistically significant difference in goiter prevalence with respect to iodine content of salt (P = 0.98) and UIC (P = 0.41). The median UIC increased with an increase in consumption of iodine content of salt from inadequacy to adequacy (P = 0.15). Conclusion: Adolescent girls, residing in an underdeveloped district, are in the transition phase from mild ID (goiter prevalence 15.3%) to iodine sufficiency (median UIC 266 μg/l). [ABSTRACT FROM AUTHOR]

Introduction: The relationship of tobacco use to dental caries is still unclear. The aim of this study is to assess the relationship between smoking and smokeless tobacco usage and prevalence of dental caries and its pattern in the Varanasi population. Materials and Methods: In this study, 472 elderly dentate and consenting individuals were included. Individuals were examined with the aid of mouth mirror, No. 23 explorer, and cotton rolls. The age of the study group ranged from 16 years to 75 years. Individuals were categorized as smoking tobacco users, smokeless tobacco users, and the combination of these two. Frequency and dosage of tobacco usage was recorded. Dental caries was measured using decayed, missing, and filled teeth (DMFT) index. Oral hygiene practices such as mode, material, and frequency of brushing were also recorded. Data were assessed using SPSS 17.0 using Chi-square, t-test, ANOVA test, and binary regression. Results: Caries rate was similar in both males and females (2.57 and 2.70), and the difference was not statistically significant. Caries was higher in individuals with habits when compared to those who were not having habits. There was no statistically significant association between individuals who were smokers, using smokeless tobacco, frequency, mode, and material of brushing with caries pattern. Among smokers, DMFT increased with frequency and duration of smoking, and it was statistically significant; however, in smokeless tobacco users, this was not the case. There was a positive correlation with DMFT and frequency of smoking. Conclusion: The study has shown that tobacco habit is a risk factor for increased caries activity, and it is higher in smokers as compared to smokeless tobacco chewers. [ABSTRACT FROM AUTHOR]

Background: Demanding clinical and academic environments have been potential sources of stress among nursing students. Inability to cope effectively often potentiates this stress. If not intervened early, this may have a detrimental effect on health and may eventually affect the future workforce in rendering care. Objectives: The objective of this study was to explore the levels and sources of perceived stress and coping behavior among undergraduate nursing students in West Bengal. Materials and Methods: This descriptive cross-sectional study was conducted in two nursing training institutions in West Bengal, from July to September 2018, using a validated pretested self-administered questionnaire comprising demographics, Perceived Stress Scale (PSS), and coping behavior inventory (CBI). Students having at least 6 months of clinical exposure were invited to participate. Of 256 eligible students, 182 returned completed questionnaires, giving an overall response rate of 71%. Descriptive statistics, Pearson's correlation, and multiple regression analysis were performed using SPSS 16.0 software. Results: "Stress from assignments and workload" and "problem-solving" was the most prominent stressor and coping behavior (Factor rank 1) respectively among students. Statistically significant correlation was observed between overall mean PSS and CBI score (r = 0.306, P < 0.01). Years of education, self-decision to join, increased screen time, staying at hostel significantly predicted stress (R2 = 0.248, F = 9.640, P < 0.01), and coping behavior (R2 = 0.223, F = 10.077, P < 0.01) among students. Conclusions: Stress from academics and clinics were high among nursing students. As they are the future carers, it is apt to intervene early to mitigate their stress and enhance their coping skills during professional training and practice. [ABSTRACT FROM AUTHOR]

Background: The most common cancer among Indian females is breast cancer. Limited access to early detection and treatment is responsible for more than half of the deaths, primarily in rural areas, where organized mammography screening is neither affordable nor feasible. Therefore, imparting awareness on breast health and breast self-examination (BSE) is highly recommended. This study aimed to assess the impact of a health education interventional program on breast health awareness and BSE among rural women of Tamil Nadu. Methodology: A quasi-experimental study was conducted among 266 women. A preinterventional survey was done using a pretested validated questionnaire. A multipronged breast health education intervention was administered and its effectiveness was measured after 3 months using the same tool. Results: There was a statistically significant (P = 0.0001) improvement in the knowledge of breast health, perceived susceptibility, and reasons for practice and proficiency of BSE practice of the interventional group from pre- to post-test. After the interventional program, 71.8% of increase in knowledge about breast health and BSE was observed. In addition, 64.7% of the women practiced BSE compared to 7.14% pretest. Conclusion: This study highlights the awareness needs by the women and application of extensive strategies to increase the acceptance of cancer screening programs. [ABSTRACT FROM AUTHOR]

Background: Maternal health is severely affected by home deliveries because it contributes to maternal mortality, especially if home births are not made safer. Objectives: The present study aimed to assess the determinants of home delivery among mothers in urban and rural Vadodara district, Gujarat. Materials and Methods: This community-based, cross-sectional study was carried out during April 2017–July 2017. The mothers who delivered at home and hospital in urban and rural Vadodara district between April 15 and March 16 were included in the study. A semi-structured questionnaire was used for interviewing all the mothers. Information regarding sociodemographic and obstetrics characteristics of mothers was recorded. The study finding was presented in the form of frequencies and percentages, and the association was found with Chi-square test.P ≤0.05 was considered statistically significant. Results: The present study was carried out among 138 mothers, of them, 71.7% were in the age group of 20–25 years. The mean age of mothers was 24.5 ± 4.4 years. The analysis of sociodemographic and obstetric factors revealed that mothers age more than 25 years, mothers from nuclear family, illiterate mothers, late antenatal care registration by mothers, mothers not registered in Janani Suraksha Yojna/Chiranjeevi Yojana scheme, and prior experience of home delivery by mothers were significantly associated with home delivery (P < 0.05 each). Conclusions: This study highlighted that several sociodemographic and obstetrics determinants related to mother were associated with home delivery in the study setting. Taking these findings into consideration, it is recommended that appropriate maternity services should be designed with a special focus on poor, uneducated, and multiparous women as well as it should ensure early registration of pregnancy for every pregnant woman. Institutional delivery should be encouraged and advocated among mothers having all previous deliveries at home. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of studies on the progression and outcome of Systemic Inflammatory Response Syndrome (SIRS) with its determinants. Aims and Objectives: To determine the predictors of the outcome and progression of pediatric sepsis and septic shock. Materials and Methods: Prospective observational study of children fulfilling criteria of SIRS and their progression to sepsis, severe sepsis, and septic shock (clinically and biochemically) was conducted at a tertiary care center. Results: Totally, 200 children were recruited over a period of 21 months (from February 2016 to October 2017). Most cases (80, 40%) were infants. Of the total, 188 (94%) cases were of an infective etiology (mostly respiratory system). Temperature and heart rate were the two commonest SIRS parameters which were deranged. Blood cultures were positive in only 25 (12.5%) cases. Out of the total 200 children, 108 progressed to sepsis, of which 26 progressed to severe sepsis, of which 22 progressed to septic shock. Abnormal leukocyte count, culture positivity and severe acute malnutrition were significantly associated with progression of SIRS patients to septic shock (P = 0.001, 0.00001 and 0.002, respectively). Factors associated with mortality were positive blood culture, multiorgan dysfunction, late hospital admissions, severe acute malnutrition, and requirement of supportive care (P values-<0.0001, <0.0001, 0.03, <0.0001 and <0.0001, respectively). Conclusions: SIRS can progress to septic shock if not identified early. The predictors of mortality were positive blood cultures, multiorgan dysfunction, late hospital admissions, severe acute malnutrition, and requirement of supportive care. The predictors of progression to septic shock were abnormal leukocyte count, culture positivity, and severe acute malnutrition. [ABSTRACT FROM AUTHOR]

This study addressed the problem of scheduling walk-in patients in real time. Outpatient clinics encounter uncertainty in patient demand. In addition, the disparate departments are locally (department-centric) organized, leading to prolonged waiting times for patients. The proposed integral patient scheduling model incorporates the status and information of all departments in the outpatient clinic along with all possible pathways to direct patients, on their arrival, to the optimal path. The developed hybrid ant agent algorithm identifies the optimal path to reduce the patient waiting time and cycle time (time from registration to exit). An outpatient clinic in Aravind Eye Hospital, Madurai, has a huge volume of walk-in patients and was selected for this study. The simulation study was performed for diverse scenarios followed by implementation study. The results indicate that integral patient scheduling reduced waiting time significantly. The path optimization in real time makes scheduling effective and efficient as it captures the changes in the outpatient clinic instantly. [ABSTRACT FROM AUTHOR]

Tamil Nadu, an agriculturally important state in India, is recurrently exposed to floods, cyclones, and droughts that have devastating effects on human, agriculture, and economy. This persuades the study to focus on future climate extremities of the state. The future climate extremes are examined using daily temperature and rainfall simulations developed by Hadley Center's Regional Climate Model termed PRECIS (Providing REgional Climates for Impacts Studies) at a horizontal resolution of 25 km. The study uses the simulations that are driven by the lateral boundary condition of HadCM3Q0 (Hadley Centre Coupled Model-Q0) generated by a Perturbed Physical Ensemble of 17 ensembles under A1B scenario for the period of 2005 to 2095. Extreme indices have been acquired from the simulations using RClimDex. The trends of extreme indices are computed and verified for statistical significance using Mann–Kendall and Sen's slope test. The changes in extreme indices with respect to baseline (1970–2000) reveal that almost all temperature indices denote a highly significant trend. The minimum temperature indices have shown prominent increase compared with maximum temperature indices, which is also upheld by the significant decrease in the diurnal temperature range trend. The summer days above 40 °C have indicated a substantial increase with a stronger slope of 0.77. However, the rainfall indices depict the insignificant trend. The changes in extreme wet days (R99p) and very wet days (R95p) exhibit a positive shift, and the increase of maximum 1-day rainfall is projected to be higher than maximum 5-day rainfall. Furthermore, the probability of rainfall indices exemplifies the increase of intense rainfall by the end of the century. The overall results of indices intimate that Tamil Nadu will be shifted to the extreme warmer and wetter condition by 2080s (2065–2095). Such information will act as a baseline to study the future impact assessment on different sectors thereby supporting policymakers and stakeholders to formulate suitable adaptation and mitigation strategies. [ABSTRACT FROM AUTHOR]

Introduction: The Postgraduate (PG) student admission scheme laid down by Medical Counselling Committee (MCC), Directorate General of Health Services, Government of India require the allottees to report to the allotted institute in online or offline mode in view of ongoing Coronavirus Disease (COVID- 19) pandemic. Aim: To identify the problems faced by Medical and Dental PG allottees during admission process. Materials and Methods: This was a cross-sectional, online questionnaire-based survey conducted among newly admitted students of Medical and Dental PG programs. The structured prevalidated questionnaire was filled by the students voluntarily and anonymously after giving consent. The detailed descriptive analysis was done using Statistical Package for the Social Sciences (SPSS) version 23 software. To study statistical significance, variables were tested using Chi-square test. Results: In the present study, 31(67.4%) Medical PG students and 15 (32.6%) Dentistry PG students participated. The students that reported to the allotted institute by both online and offline mode were 35 (76.1%), while only 8 (17.4%) reported by offline mode which was statistically significant (p<0.005). Maximum number of students {30 (65.2%)} found online mode convenient (statistically significant; p<0.005), while 12 (26.1%) said that offline mode was convenient. Conclusion: The online reporting for admission process is time saving. Continuous upgradation of system through feedback from stakeholders is desirable. [ABSTRACT FROM AUTHOR]

Background: High blood pressure (BP) is often an underdiagnosed problem, because of the asymptomatic nature in early phases of onset during adolescence. This increases the chances of developing complications later during adult life. Objective: The objective of this study was to find the relationship of BP with anthropometric measurements among school-going adolescent boys. Materials and Methods: It was a cross-sectional study conducted among 894 adolescent schoolboys aged 13 to 18 years from July 2013 to October 2014 in schools of Burdwan Municipal area, West Bengal. The required number of students from each school was determined by proportional probability sampling. Then, the required number of students from each school was selected by systematic random sampling technique. BP and anthropometric measurements such as weight, height, and waist circumference were done using standard guidelines. Results: The mean systolic and mean diastolic BP in the study participants was significantly higher with an increase in weight, height, waist circumference, and body mass index (BMI) (P < 0.05). BP was found to be positively correlated with different anthropometric measurements such as weight, height, waist circumference, and BMI, which were statistically significant. Conclusion: Early detection of high BP and application of lifestyle modification among adolescents will be helpful in reducing the burden of high BP in adult life. [ABSTRACT FROM AUTHOR]

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

Aims: 1. To evaluate the effectiveness of home based exercise program 2. To involve the patient & his family members in treatment program. 3. To enhance self esteem of patients 4. To restore or reinforce functional capabilities. Hypothesis: Home-based exercise program in colles' fractures is also effective like institutional based occupational therapy. Methodology: Subjects: 30 nos. Procedure: A screening had been done among post colles' fracture patients those are attending outdoor occupational therapy department, NIOH with the help of FAS (Functional Assessment Scale), which is based on pain and functional capacity, and randomly choose 30no patients within the age group of 25 - 45years. Among them 15 are included in the control group and 15 in the experimental group. The subjects in each group were evaluated pre therapeutically by using the following instruments. Instrumentation: • VAS • MMDT • Tracker version 5 software (Goniometer, Dynamometer, Pinch meter) Intervention: After pre therapeutic evaluation, the control group underwent institution based Occupational therapy(IOT) where as the experimental group adhere to home based exercise program(HEP). The followup evaluation was done after 6-weeks for each group to find out the improvement in hand skills. Data analysis: SPSS version-13 was used. Paired t-test for each variables are comparatively measured where p < 0.05. Results: This study significantly shows that self introduced home based exercise program and need based institutional occupational therapy both are equally effective in improving hand skills. Conclusions: Based on the results of the present study, it can be concluded that both HEP and IOT are equally important for reducing pain & stiffness and also for increasing pain free ROM, muscle strength and hand skills in post colles' fractures. [ABSTRACT FROM AUTHOR]

Aging is a progressive process, and it may lead to the initiation of neurological diseases. In this study, we investigated the effects of wild Indian Curcuma longa using a Morris water maze paradigm on learning and spatial memory in adult and D-galactose-induced aged mice. In addition, the effects on cell proliferation and neuroblast differentiation were assessed by immunohistochemistry for Ki67 and doublecortin (DCX) respectively. The aging model in mice was induced through the subcutaneous administration of D-galactose (100 mg/kg) for 10 weeks. C. longa (300 mg/kg) or its vehicle (physiological saline) was administered orally to adult and D-galactose-treated mice for the last three weeks before sacrifice. The administration of C. longa significantly shortened the escape latency in both adult and D-galactose-induced aged mice and significantly ameliorated D-galactose-induced reduction of cell proliferation and neuroblast differentiation in the subgranular zone of hippocampal dentate gyrus. In addition, the administration of C. longa significantly increased the levels of phosphorylated CREB and brain-derived neurotrophic factor in the subgranular zone of dentate gyrus. These results indicate that C. longa mitigates D-galactose-induced cognitive impairment, associated with decreased cell proliferation and neuroblast differentiation, by activating CREB signaling in the hippocampal dentate gyrus. [ABSTRACT FROM AUTHOR]

OBJECTIVE OF STUDY: To compare the effect of DSP alone and DSP along with play through feet on infant at risk for developmental delay using DASII. METHODS: Study design: Hospital based, comparative, AB design, experimental, controlled. Sampling method: Simple random alternate allocation. Sample size: 30 RESULTS AND CONCLUSION : The control group who were subjected to DSP showed statistical significance in overall motor development quotient, neck control, manipulation and mental deviation quotient. The experimental group who were exposed to exploration with feet along with DSP had significant change in all the developmental indices i.e. neck control, body control, locomotor skills, manipulatory skills and over all motor and mental development quotient. On comparing the scores of control and experimental, experimental group performed significantly better on development of motor quotient, body control and locomotor skills than the control group. [ABSTRACT FROM AUTHOR]

Objective: Persons with Neuromuscular impairments like Cerebral Palsy. Spinal cord injury, Multiple sclerosis and Coordination problems often suffer from varying degrees of handicap when it comes to use of computers. In today's technology driven world this can have devastating effects both on functioning and also rehabilitation of the patient. Training for use of computer can be a challenging task both for the client and the therapist Methods: This study was done to compare the effects of one month training computer access skills using three different techniques 1. Training using Normal Keyboard 2. Training using on screen key boards 3. Training using Voice recognition system 15 participants (5 for each type of training group) were included in the study. Word per minute (WPM), percentage of errors and a structured computer fluency questionnaire was used to measures the outcome before and at end of training. Paired t test was used to assess the significance of training. Results: Computer fluency was significantly improved in all three groups(p< 0.05). WPM index improved with fewer errors in all three groups. However training with on screen keyboards and voice recognition system showed better results than conventional key board training. Conclusion: Use of innovative techniques of training can lead to faster and effective computer access skills in persons with Neuromuscular Impairments. [ABSTRACT FROM AUTHOR]

Objective: The purpose was to assess the level of learning in caregivers of children with Cerebral Palsy [CP] and the effectiveness of the Occupational Therapy Caregiver Education. Method: 15 caregivers [Mean age=41 years, 3males and 13 females] of children with CP attended a 2 day caregiver training workshop on "Handling of a CP child". They were given a questionnaire [English/ Marathi] comprising of demographic data, 15 questions pertaining to Brain and Development, Abnormal reflexes and their effect on brain development, Occupational Therapy process and hands on training, pre and post and questions relating to the perceived effectiveness of the workshop to caregivers and peers. Results: The score obtained pre-post from 10 participants on 15 questions [pre mean score=10.09 SD=.87, post mean score=12.73, SD=1.79] were statistically computed using paired t-test, t-value=4.47 at p value < 0.00 which indicates very highly significant results. The perceived effectiveness of the workshop was high [mean ~9out of 10] rated by parents and the peer group. Conclusion: Workshop was effective and efficient in inducing learning in caregivers of children with CP. [ABSTRACT FROM AUTHOR]

AbstractHepatocyte growth factor (HGF) plays an important role in hepatocyte proliferation. HGF expression is regulated by various signaling molecules and nuclear receptors. In the present study, LiverCare®(LC), a novel polyherbal formulation (The Himalaya Drug Company, Bangalore, India), was evaluated for its efficacy, using co-cultures of primary rat hepatocytes–non-parenchymal cells (NPCs) and human hepatocellular carcinoma cells (HepG2). The rate of primary hepatocyte co-culture proliferation was significantly and dose-dependently increased by LC as determined by [3H]thymidine incorporation into newly synthesized DNA and cell proliferation assay. LC also increased HGF expression in primary hepatocyte co-culture. Albumin and urea content remained constant during proliferation of hepatocyte co-cultures in the presence of LC with decreased activity of alanine aminotransferase. It is interesting that LC inhibited incorporation of [3H]thymidine into DNA in HepG2 cells. LC enhanced peroxisome proliferator-activated receptor-α expression during hepatocyte proliferation, whereas tumor necrosis factor-α expression remained unaffected. In conclusion, our study clearly showed that LC differentially regulates primary rat hepatocytes and human hepatocarcinoma cell proliferation. LC may be a promising candidate for treating degenerative liver diseases by enhancing liver regeneration. [ABSTRACT FROM AUTHOR]

Abstract: Time-series decomposition analysis was performed on, (1) Multi Sensor Reanalysis (MSR) Total Ozone Column (TOC) monthly mean time-series data-set [1979–2008], and (2) Total Ozone Mapping Spectrometer (TOMS) Version 8 Overpass monthly mean time-series data-set from Nimbus 7 satellite, (TOMS N7) [1979–1993] to estimate long-term linear trends in the data to assess a scale of surface UV changes over India. Long-term trend estimation, subsequent to the removal of annual cyclic variations, for MSR TOC data-set was done over Indian region covering latitude spread 0° N – 40° N, and Longitude spread 67.5° E to 97.5° E. Trend estimates for TOMS Overpass data-sets, treated on similar lines, was done for fifteen locations over India (1°19′N to 34°04′N). Statistically significant declining trends ranging from (−) 0.8 – (−) 1.5 percent/decade were seen over Indian region above 25° N latitude in MSR TOC data-set (1979–2008). In case of TOMS N7 data-set (1979–1993), statistically significant declining trends were estimated over New Delhi (28°40′N) and Srinagar (34°04′N) with a value of (−) 2.5 and (−) 3.6 percent/decade respectively. Observed TOC decline covered 40% of total geographical area of Indian region, however rest of the Indian region (peninsular) did not show statistically any significant trend. [Copyright &y& Elsevier]

The authors characterized human immunodeficiency virus (HIV) and hepatitis C virus (HCV) incidence and prospective changes in self-reported risk behavior over 2 years among 1,158 injection drug users (IDUs) recruited in Chennai, India, in 2005–2006. At baseline, HIV prevalence was 25.3%, and HCV prevalence was 54.5%. Seropositive persons with prevalent HIV infection were used to estimate baseline HIV incidence by means of the Calypte HIV-1 BED Incidence EIA (Calypte Biomedical Corporation, Portland, Oregon). Longitudinal HIV and HCV incidence were measured among 865 HIV-negative IDUs and 519 HCV antibody-negative IDUs followed semiannually for 2 years. Participants received pre- and posttest risk reduction counseling at each visit. Estimated HIV incidence at baseline was 2.95 per 100 person-years (95% confidence interval (CI): 1.21, 4.69) by BED assay; observed HIV incidence over 1,262 person-years was 0.48 per 100 person-years (95% CI: 0.17, 1.03). HCV incidence over 645 person-years was 1.71 per 100 person-years (95% CI: 0.85, 3.03). Self-reported risk behaviors declined significantly over time, from 100% of participants reporting drug injection at baseline to 11% at 24 months. In this cohort with high HIV and HCV prevalence at enrollment, the authors observed low incidence and declining self-reported risk behavior over time. While no formal intervention was administered, these findings highlight the potential impact of voluntary counseling and testing in a high-risk cohort. [ABSTRACT FROM PUBLISHER]

• Clinical pharmacist's intervention in providing advice on life style modifications and improving the medication adherence among the 150 post-myocardial infarction (MI) patients of south Indian population. • Reduction in blood sugar (FBS, PPBS), blood pressure, and total cholesterol levels was observed and created effective awareness regarding smoking and alcohol cessation among the pharmacist-counseled group compared to usual care group (lifestyle modifications for the secondary prevention of MI). • There was no significant reduction in LDL, HDL, VLDL, and TGL levels among the pharmacist-counseled group compared to usual care group. • Improvement of medication was seen among the pharmacist counseled study population. Myocardial infarction (MI) is associated with significant short-term and long-term mortality and morbidity. Secondary prevention and treatment of post-MI patients through medication and lifestyle modification is becoming an important aspect of patient care regimens. Pharmacists have a crucial role in providing these disease-prevention interventions compared with other health care professionals. The primary objective included evaluation of clinical pharmacist interventions at discharge and post-MI discharge follow-up to improve the secondary lifestyle modifications and medication adherence among post-MI patients. The secondary objective included the prevention of hospital readmission rates for major adverse cardiovascular events and death among post-MI patients. In this prospective interventional study comprising 160 screened patients, 154 patients were randomized according to eligibility criteria of whom 77 were enrolled in Group A (the intervention group: clinical care along with pharmacist education) and 77 in Group B (the control group: clinical care with usual counseling) (November 2017–April 2018). Two patients were lost to follow-up in both study groups. Group A patients received clinical care with pharmacist structured intervention at post-MI discharge and through telephone follow-ups, whereas Group B patients received clinical care with usual counseling at baseline. Patients in both groups were analyzed for secondary lifestyle modifications such as fasting blood sugar level; postprandial blood sugar level; blood pressure; and total cholesterol, LDL-C, HDL-C, VLDL-C, and triglyceride level; hospital readmission rates; and medication adherence at the baseline. At the end of 6 months patients in both study groups underwent follow-up. Medication adherence was analyzed using the Medication Adherence Rating Scale. Statistical analysis was carried out by using SPSS software version 17 (SPSS-IBM Inc, Armonk, NY). The mean (SD) age of the study population was 56.38 (11.68) years in Group A and 53.93 (13.26) years in Group B. Ther were more male patients than female patients in the study population. There was a statistically significant reduction in systolic and diastolic BP in Group A (P ˃ 0.0031 and P ˃ 0.0069, respectively) compared with Group B. Reduction in total cholesterol levels were observed in Group A compared with Group B (P ˃ 0.0001) patients, but there were no significant reductions found in lipid profile values, including LDL-C (P ˃ 0.0669), HDL-C (P ˃ 0.595), triglyceride (P ˃ 0.119), and VLDL-C (P ˃ 0.4215) at follow-up. Group A patients were more adherent to the medications with lower hospital readmission rates compared with Group B. Clinical pharmacist counseling improved the medication adherence and lifestyle modifications in post-MI patients with the reduction in blood glucose levels, blood pressure, and total cholesterol levels among the study population. [ABSTRACT FROM AUTHOR]