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Background: Chronic insomnia, affecting 15.9% of the population, is characterized by sustained hyperarousal and heightened somatic, cognitive, and cortical activity. Despite its prevalence, the precise impact of chronic insomnia on cognitive domains, particularly attention, working memory, and executive function, remains inadequately understood. Aim: This study aims to systematically investigate the cognitive functioning of adults with chronic insomnia. Methodology: A meticulously matched cohort of 80 participants, comprising 40 with chronic insomnia and 40 controls, participated in this cross-sectional study. The diagnosis followed strict criteria outlined in the International Classification of Sleep Disorders-3. Neuropsychological assessments, including the Digit Span Test, Stroop Test, and Trail Making Test, were employed to scrutinize attention, working memory, and executive function. Robust metrics, such as the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9), supported the investigative approach. Results: Analysis revealed notable deficits in backward digit span, digit symbol substitution test, and Stroop Test (cards B and C) among chronic insomnia subjects compared to non-insomniac counterparts. Trail Making Test B indicated prolonged completion times in the chronic insomnia cohort. Despite comparable levels of anxiety and depressive symptoms, the chronic insomnia group exhibited higher ISI and PSQI scores, indicating the severity of their sleep disturbances. Conclusion: This cross-sectional analysis reveals cognitive deficits associated with chronic insomnia, specifically impacting attention, working memory, and executive function. Even with meticulous demographic controls, chronic insomnia leaves a discernible impact on cognitive functions. The study underscores the need for precise cognitive evaluations to reveal the latent impact of chronic insomnia, offering insights for targeted interventions. [ABSTRACT FROM AUTHOR]

Background and Purpose: Two basic methods for genu valgum correction are osteotomy and internal fixation or external fixator assited correction. External fixators have the advantage of stabilizing fragments before osteotomy allowing better control of fragments and preventing secondary displacements. The purpose of this study was to evaluate the efficacy and complications of fixator assisted correction for genu valgum and internal fixation, using the AO distal femur pediatric osteotomy plate. Materials and Methods: Thirty-six limbs in 26 patients (age 10–16 years) underwent osteotomy in the distal femur at CORA. Open lateral wedge osteotomy was done; the desired position obtained was temporarily stabilized by connecting the pins with the AO external fixator and stabilized with 90 degrees AO distal femur pediatric locking plate and gap grafted with hydroxyapatite bone granules. Results: Translation of distal fragment was required in 17 osteotomies (53.12%). Osteotomies united within 12 weeks; no non-union was observed. The range of motion was full in all patients. The mean tibiofemoral angle was corrected by 12 degrees and the mean mechanical LDFA was corrected to 87 degrees. There was no secondary deformity, either in the rotational or sagittal plane. Conclusion: This method combines the modularity of external fixator and the advantages of internal fixation. [ABSTRACT FROM AUTHOR]

The financial influence of agriculture today is expanding in tandem with the economy of our nation and has become the large industry which plays a vital and crucial role for the uplifting of our nation. Keeping track of plant diseases caused by the assistance of experts could be expensive when it comes to the agricultural area, so there is a need for a system capable of automatically identifying since it could revolutionize the monitoring of vast fields of crops and allow for the plant's treatment of leaves as soon as possible after disease detection. There are numerous illnesses that harm various plants/crops and hamper their growth and agricultural fields. So there is a need to identify the disease and tell how to recover from it. So there is a need to develop such an application which could help in the prediction of plant/crops disease and how to recover from the same. In many nations, including India, agriculture is a substantial industry. Given that a massive portion of the Indian financial system depends on agricultural production, it is crucial to give the issue of food production a careful study. The agricultural industry gave immense importance to the nomenclature and acknowledgment of crop infection on both technical and financial level. While monitoring the plant diseases which are caused in the agricultural fields with the help of experts could be very expensive in the long run so a technique or system that can recognize diseases automatically is required because it could change the way the vast fields of crops are monitored, and a perfect automated system could be built which could easily detect the plant diseases. It has become a necessity to develop an automated system which could easily detect the plant diseases beforehand and could easily help in overcoming them by suggesting the measures and techniques to overcome them. So that agricultural productivity could be increased, and agricultural production could be done properly with vast production of good quality crops which in turn help in growth of our nation. [ABSTRACT FROM AUTHOR]

The Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) of India was enacted by the Government of India with the prime objective of improving the security of the households in rural areas of the country by providing 100 days of wage employment annually to every rural household who wishes to work and ask for unskilled manual work. In this paper we have made an attempt to assess the performance of the scheme particularly in the context of how it has delivered benefits to women in the rural areas during the last fifteen years. The study found that women's socio-economic conditions have improved gradually; however, there are developmental initiatives that can be incorporated into the plan to hasten the rate of this improvement. In this context, multi-agency strategy could potentially be a successful plan for the improvement of the socio-economic situation of the rural people in the country in general and the women in particular. [ABSTRACT FROM AUTHOR]

Background: Literature suggests that the COVID-19 pandemic has resulted in poor sleep quality, especially among the infected population. However, literature regarding the effect of COVID-19 pandemic and SARS-CoV-2 infection on occurrence of insomnia, restless legs syndrome and dream enactment behavior is either scarce or unavailable. Methods: This study was planned to assess the effect of SARS-CoV-2 infection on the occurrence of insomnia, restless legs syndrome (RLS) and dream enactment behavior (DEB). For this cross-sectional study, a questionnaire comprising of items related to demographic details, past medical history, and information related to SARS-CoV-2 infection was distributed through social media. Insomnia was diagnosed using clinical criteria. RLS, DEB, sleep quality, depression and anxiety were assessed using a validated questionnaire. Information regarding the use of hypnotic medications was also gathered. Results: Of the 1596 respondents, 37.2% reported disturbed sleep while insomnia was reported by 22.6% respondents. 27.3% of respondents reported RLS and 17.4% suffered DEB. The odds of insomnia were greater among males (OR = 1.27; 95% CI: 1.03–1.58; P < 0.02) and among those who had SARS-CoV-2 infection (OR = 1.76; 95% CI = 1.42–2.19; P < 0.001). Similarly, SARS-CoV-2 infection was also associated with increased odds of RLS (OR = 2.48; 95% CI = 1.98–3.11; P < 0.001) and DEB (OR = 1.58; 95%CI = 1.21–2.06; P < 0.001). Insomnia, RLS and DEB were more frequent among respondents who required oxygen therapy, those who experienced loss of taste and/or smell, depression and anxiety. Prevalence of insomnia, DEB and RLS was higher than said prevalence among respondents with no history of SARS-CoV-2 infection, but lower than that of those with positive history of SARS-CoV-2 infection. 5.3% of respondents reported taking hypnotic medications before infection, 7% during infection and 5.3% after infection. Conclusion: SARS-CoV-2-infection-related factors in association with environmental factors have increased the prevalence of insomnia, DEB and RLS among subjects having infection. SARS-CoV-2-associated immunological changes, hypoxia and neurotropism may play a role in occurrence of insomnia, DEB and RLS. [ABSTRACT FROM AUTHOR]

Background: Hip fractures are considered as a major cause of mortality worldwide. Even after being the second most populous country in world and facing huge burden of hip fractures, there is scarcity of data from India. For the first time in Indian context, we analysed the predictors of mortality after hip fracture surgery in patients with age 50 years and above. Materials and Methods: In this prospective cohort study, patients with age ≥ 50 years and having hip fractures presented to our institute from January 2018 through October 2018 were enrolled after meeting including and excluding criteria. Patients were followed-up for minimum 1 year after surgery. Association between 1-year mortality and different affecting variables were analysed. Significant variables were further analysed using logistic regression to find independent predictors. Results: Out of 87 patients followed-up for 1 year, 25 patients died within 1 year of surgery. Age > 75 years, road traffic accident as mode of injury, delay in surgery > 48 h, > 2 co-morbidities, haemoglobin level ≤ 10 at the time of admission and osteoporosis are significantly associated with high mortality. When these significant variables were further analysed using logistic regression, age > 75 years and > 2 co-morbidities were only factors associated independently with high mortality. Conclusion: In patients with age 50 years and above, following hip fracture surgery, age > 75 years and > 2 co-morbidities are the predictors of 1-year mortality when adjusted for other variable. A better designed multi-centric study can be more helpful in understanding the things in Indian context. [ABSTRACT FROM AUTHOR]

The article focuses on the development of the psychiatry curriculum as a major subject at All India Institute of Medical Sciences, Rishikesh (AIIMS-Rishikesh). Topics discussed include the process of expert consultation under the Indian Psychiatric Society (IPS) followed by AIIMS-Rishikesh, number of hours of theoretical teaching and clinical skills posting in psychiatry in the undergraduate curriculum, and importance of the integration of the curriculum with other subjects.

Background: Literature shows that home confinement during coronavirus disease 2019 (COVID-19) pandemic has significantly affected sleep. However, such information regarding subjects having Parkinson's disease (PD) is unavailable.Methods: This cross-sectional study was conducted using a questionnaire, developed and validated by experts. PD subjects from nine centers across India were included. Questionnaire assessed presence as well as change in sleep-related parameters and PD symptoms during home confinement. Restless legs syndrome (RLS) and REM sleep behavior disorder (REMBD) was diagnosed using validated questionnaire. Additionally, changes in physical activity, adoption of new hobbies during home confinement and perceived quality of life were assessed.Results: Of 832 subjects, 35.4% reported sleep disturbances. New-onset/worsening of sleep disturbances (NOWS) was reported by 23.9% subjects. Among those with sleep disturbances (n = 295), insomnia symptoms worsened in half (51.5%) and nearly one-fourth reported worsening of RLS (24.7%) and REMBD (22.7%) each. NOWS was common in subjects lacking adequate family support during home confinement (P = 0.03); home confinement > 60 days (P = 0.05) and duration of PD > 7 years (P = 0.008). Contrarily, physical activity >1 h/day and engagement in new hobbies during home confinement were associated with better sleep. NOWS was associated with worsening of motor as well as non-motor symptoms of PD (P < 0.001) and poorer life quality (P < 0.001).Conclusion: Home confinement during COVID-19 pandemic was significantly associated with NOWS among PD subjects. NOWS was associated with global worsening of PD symptoms and poorer life quality. Physical activity >1 h/day and adoption of new hobbies during home confinement were associated with better sleep. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of psychiatric disorders among the general population is 10.6%. Primary care doctors (PCDs) are often the first contact for patients with common psychiatric disorders, but the majority of them are ill equipped to handle the same leading to symptomatic treatment. Hence, an innovative digitally driven and modular-based 1-year primary care psychiatry program (PCPP) was designed and implemented exclusively for practicing PCDs of Uttarakhand. Aim: The aim of the study was to assess the impact of this digitally driven 1-year PCPP on the general practice of PCDs. Materials and Methods: Ten PCDs were trained in the curriculum module "Clinical Schedule for Primary Care Psychiatry" which is a validated concise guideline for screening, classification, diagnosis, treatment, follow–ups, and referrals. Furthermore, they underwent training in on-site basic module (10 days); three online modules (with nil or minimal disruption in their regular clinical work) – Telepsychiatric On-Consultation Training (Tele-OCT), Collaborative Video Consultations, and weekly virtual classroom; and one public health module. In addition, PCDs underwent 10 criteria-based formative assessment including self-reports of weekly patients' audit (Primary Care Psychiatry Quotient [PCPQ]) and quarterly Tele-OCT evaluation sessions (Translational Quotient [TQ]). Results: PCPQ was 11.09% (2182 psychiatric patients of total 19,670 general outpatients) which means 11.09% of PCDs' total general consultations had psychiatric disorders, which would have been otherwise missed. Average scores obtained in first and second Tele-OCT evaluations (similar to clinical examination but in their real-time consultation) were 70.33% and 76.33%, respectively, suggestive of adequate TQ at 6 and 9 months of the course. Conclusions: One-year PCPP is shown to be effective in acquiring psychiatry knowledge, skills, and retention of skills (TQ) and also translated in providing psychiatric care in general practice with a positive impact on the delivery of primary care psychiatry. [ABSTRACT FROM AUTHOR]

Esophageal squamous cell carcinoma (ESCC) is the most common histological subtype of esophageal cancer in India. Cigarette smoking and chewing tobacco are known risk factors associated with ESCC. However, genomic alterations associated with ESCC in India are not well-characterized. In this study, we carried out exome sequencing to characterize the mutational landscape of ESCC tumors from subjects with a varied history of tobacco usage. Whole exome sequence analysis of ESCC from an Indian cohort revealed several genes that were mutated or had copy number changes. ESCC from tobacco chewers had a higher frequency of C:G > A:T transversions and 2-fold enrichment for mutation signature 4 compared to smokers and non-users of tobacco. Genes, such as TP53, CSMD3, SYNE1, PIK3CA , and NOTCH1 were found to be frequently mutated in Indian cohort. Mutually exclusive mutation patterns were observed in PIK3CA – NOTCH1, DNAH5 – ZFHX4, MUC16 – FAT1 , and ZFHX4 – NOTCH1 gene pairs. Recurrent amplifications were observed in 3q22-3q29, 11q13.3-q13.4, 7q22.1-q31.1, and 8q24 regions. Approximately 53% of tumors had genomic alterations in PIK3CA making this pathway a promising candidate for targeted therapy. In conclusion, we observe enrichment of mutation signature 4 in ESCC tumors from patients with a history of tobacco chewing. This is likely due to direct exposure of esophagus to tobacco carcinogens when it is chewed and swallowed. Genomic alterations were frequently observed in PIK3CA-AKT pathway members independent of the history of tobacco usage. PIK3CA pathway can be potentially targeted in ESCC which currently has no effective targeted therapeutic options. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has led to a complete shut-down of the entire world and almost all the countries are presently in a "lockdown" mode. While the lockdown strategy is an essential step to curb the exponential rise of COVID-19 cases, the impact of the same on mental health is not well known. Aim: This study aimed to evaluate the psychological impact of lockdown due to COVID-19 pandemic on the general public with an objective to assess the prevalence of depression, anxiety, perceived stress, well-being, and other psychological issues. Materials and Methods: It was an online survey conducted under the aegis of the Indian Psychiatry Society. Using the Survey Monkey platform, a survey link was circulated using the Whatsapp. The survey questionnaire included perceived stress scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Warwick-Edinburgh Mental Well-being Scale to assess perceived stress, anxiety, depression, and mental well-being, respectively. The survey link was circulated starting from April 6, 2020 and was closed on April 24, 2020. Results: During the survey, a total of 1871 responses were collected, of which 1685 (90.05%) responses were analyzed. About two-fifth (38.2%) had anxiety and 10.5% of the participants had depression. Overall, 40.5% of the participants had either anxiety or depression. Moderate level of stress was reported by about three-fourth (74.1%) of the participants and 71.7% reported poor well-being. Conclusions: The present survey suggests that more than two-fifths of the people are experiencing common mental disorders, due to lockdown and the prevailing COVID-19 pandemic. This finding suggests that there is a need for expanding mental health services to everyone in the society during this pandemic situation. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has created an unprecedented challenge for medical professionals throughout the world to tackle the rapidly changing scenario. The objective of this survey was to analyze the change in neurosurgical practice in India following the COVID-19 outbreak and assess its impact on practising neurosurgeons.Materials and Methods: Between May 7th and 23rd, 2020, a validated questionnaire was circulated amongst practising neurosurgeons across the country by social media and e-mails, regarding changes in the patterns of patients seen, adaptations made in their practice, effect on surgeries performed, financial burden, and impact on their personal lives. The responses were kept anonymous and were analyzed for correlations between the changes observed and independent factors such as hospital affiliations, teaching professions, and neurosurgical experience.Results: Our survey showed a drastic fall in the number of neurosurgical patients seen in the outpatient department (OPD) as well as the number of surgeries performed. A drop of 76.25% was seen in OPD patients (P = 0.000) and that of 70.59% in surgeries performed (P = 0.000). There was no uniformity among the neurosurgeons in the number of COVID-19 tests being done before elective/emergency surgery and in the use of protective gear while examining patients. Private practitioners were more affected financially as compared to those in the government sector. The pandemic has affected the research work of 53.23% of all respondents, with those in the teaching profession (70.96%) more affected than those in the non-teaching profession (24.67%).Conclusions: Evidence-based policies, screening COVID-19 tests with better sensitivity, and better-quality personal protective equipment kits in adequate numbers are required to protect our medical professionals from COVID-19. Mental health issues among neurosurgeons may also be an issue, this being a high risk speciality and should be closely watched for. [ABSTRACT FROM AUTHOR]

Background: Vitamin D deficiency is high in athletes and has an impact on athletes' performance. Introduction: Assessment of serum Vitamin D levels in healthy North Indian sportspersons and its correlation with serum parathyroid hormone (PTH) levels and bone mineral density (BMD). Materials and Methods: Three-hundred and sixty-nine healthy athletes' aged 1845 years were enrolled. Depending upon Vitamin D levels athletes were categorized into three groups: deficient (<20 ng/ml), insufficient (20-30 ng/ml), and sufficient (>30 ng/ml). BMD and serum PTH levels were assessed in all athletes and correlation was seen with Vitamin D levels. Results: Two-hundred and fifty-eight (69.9%) athletes were Vitamin D deficient, 51/369 (13.8%) were Vitamin D insufficient, and 60/369 (16.3%) athletes were Vitamin D sufficient. There was a direct correlation between low serum Vitamin D levels and low BMD (r = 0.473; P < 0.05). Overall, 114/369 (30%) athletes had low BMD and out of these 114 athletes, 108 (95%) were Vitamin D deficient. Serum PTH levels were found to have inverse relations with both Vitamin D (r= 0.629) and BMD (r=-0.267). Conclusions: Vitamin D deficiency is highly prevalent among the North Indian athletes and the presence of low Vitamin D (<20 ng/ml) levels is associated with low BMD and high PTH levels. [ABSTRACT FROM AUTHOR]

Indigenous cattle of India belong to the species, Bos indicus and they possess various adaptability and production traits. However, little is known about the genetic diversity and origin of these breeds. To investigate the status, we sequenced and analyzed the whole mitochondrial DNA (mtDNA) of seven Indian cattle breeds. In total, 49 single-nucleotide variants (SNVs) were identified among the seven breeds analyzed. We observed a common synonymous SNV in the COII gene (m.7583G > A) of all the breeds studied. The phylogenetic analysis and genetic distance estimation showed the close genetic relationship among the Indian cattle breeds, whereas distinct genetic differences were observed between Bos indicus and Bos taurus cattle. Our results indicate a common ancestor for European Zwergzebu breed and South Indian cattle. The estimated divergence time demonstrated that the Bos indicus and Bos taurus cattle lineages diverged 0.92 million years ago. Our study also demonstrates that ancestors of present zebu breeds originated in South and North India separately ∼30,000 to 20,000 years ago. In conclusion, the identified genetic variants and results of the phylogenetic analysis may provide baseline information to develop appropriate strategies for management and conservation of Indian cattle breeds. [ABSTRACT FROM AUTHOR]

Purpleputtu (Oryza sativa ssp. indica cv. Purpleputtu) is a unique rice landrace from southern India that exhibits predominantly purple color. This study reports the underlying genetic complexity of the trait, associated domestication and de-domestication processes during its coevolution with present day cultivars. Along-with genome level allelic variations in the entire gene repertoire associated with the purple, red coloration of grain and other plant parts. Comparative genomic analysis using 'a panel of 108 rice lines' revealed a total of 3,200,951 variants including 67,774 unique variations in Purpleputtu (PP) genome. Multiple sequence alignment uncovered a 14 bp deletion in Rc (Red colored , a transcription factor of bHLH class) locus of PP, a key regulatory gene of anthocyanin biosynthetic pathway. Interestingly, this deletion in Rc gene is a characteristic feature of the present-day white pericarped rice cultivars. Phylogenetic analysis of Rc locus revealed a distinct clade showing proximity to the progenitor species Oryza rufipogon and O. nivara. In addition, PP genome exhibits a well conserved 4.5 Mbp region on chromosome 5 that harbors several loci associated with domestication of rice. Further, PP showed 1,387 unique when SNPs compared to 3,023 lines of rice (SNP-Seek database). The results indicate that PP genome is rich in allelic diversity and can serve as an excellent resource for rice breeding for a variety of agronomically important traits such as disease resistance, enhanced nutritional values, stress tolerance, and protection from harmful UV-B rays. [ABSTRACT FROM AUTHOR]

In the middle of COVID-19 crisis in India and the psychological impact on millions of peoples, is it time to reconsider psychiatry training for Indian medical graduate under the new competency-based curriculum? India has one of the highest numbers of medical colleges in the world and also has over a million doctors, including MBBS graduates working at the primary health-care centers who are important pillars for health-care delivery. In a major drawback that also plagued the earlier curriculum, the new competency-based curriculum has not incorporated a single mandatory skill in psychiatry which a medical trainee has to demonstrate to become doctor. Mental health and the COVID-19 pandemic are interlinked in a complex manner. Hence, millions are likely to have mental health consequences. With no skill required in psychiatry as a must for a medical trainee to become an MBBS doctor, the mental health services during or aftermath of a disaster are severely compromised and need urgent reconsideration under the new curriculum. [ABSTRACT FROM AUTHOR]

Background: Neuropsychiatric disorders are quite prevalent in the community and are on the rise due to changing lifestyles and lack of social support. Most of the published data is from hospital, which calls for more community-based studies to measure the actual burden of this menace. Aim & Objective: To estimate the prevalence of neuropsychiatric disorders in district Dehradun and to find out association of socio-demographic correlates with neuropsychiatric disorders Settings and Design: This community based cross-sectional survey was conducted in selected rural and urban areas of district Dehradun. Methods and Material: Study areas and households were selected by multistage stratified and systematic random samplings respectively. Participants were chosen from the selected households by Kish method. Respondents were screened for neuropsychiatric disorders by using MINI-6. Statistical analysis used: data was entered in SPSS 20.0 version and analysed by using percentages, chis-quare test and logistic regression. Results: About one fifth of the respondents had a lifetime diagnosis of at least one neuropsychiatric disorder. Age, male gender, higher education, joint family and upper socio-economic status were found to be significantly associated with neuropsychiatric disorders. Conclusions: Factors determining psychological wellbeing are deeply rooted in socio-demographic environment and individual characteristics. Many of the respondents had one or more lifetime neuropsychiatric disorder and most of them were not diagnosed. More community-based research is required to determine the exact magnitude and responsible factors of neuropsychiatric disorders, so that a focused strategy may be developed to address its preventable aspect [ABSTRACT FROM AUTHOR]

Background: At high altitude, prevalence of restless legs syndrome has been found to be greater than expected in small population-based studies, which did not use validated tools for identification of RLS. However, it is not known as to whether this increased prevalence is associated with altitude or increased risk factors for RLS in these populations or errors in identification of RLS.Method: This population based, door-to-door study was conducted at low altitude (400 m above sea level) and high altitudes (1900-2000 m and 3200 m above sea level) using random stratified sampling in Himalayan and sub-Himalayan region of India. Subjects between 18 and 84 years were screened for restless-legs-syndrome using the validated Cambridge-Hopkins RLS diagnostic questionnaire. Medical comorbidities were ascertained from their medical records. Their anthropometric measurements were obtained and wake resting oxygen saturation was monitored using finger pulse-oximeter. Physical activity during leisure time was evaluated by using the Goldin leisure time exercise questionnaire.Results: A total of 1689 subjects were included. Average age of the included subjects was 35.2 years; 55.2% were women. RLS was identified in 9.4% subjects with higher prevalence among women (13.6% women vs. 4.1% men; P < 0.001). RLS was significantly more prevalent at higher altitudes (12.2% at 1900-2000 m and 11.8% at 3200 m) compared to low altitude (2.5% at 400 m). The low altitude prevalence matched that reported in prior studies of RLS in India. Subjects with medical disorders sometimes related to RLS (eg, peripheral neuropathy, COPD, varicose veins and anemia) also had higher prevalence of RLS. Binary logistic regression controlling for female gender, number of pregnancies, peripheral neuropathy, varicose veins, anemia showed that high altitude independently significantly increased the likelihood of RLS (OR: 5.4, 95% CI: 2.8, 10.4).Conclusion: RLS is about five times more prevalent at high than low altitudes even when controlling for effects of other medical conditions associated with increased risk of RLS. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to assess the prevalence of sleep disorders among children aging between 4 and 9 years using Hindi version of Pediatric Sleep Questionnaire (PSQ). Methods: This study had two parts first, translation and validation of PSQ into Hindi language, and second, assessment of the prevalence of sleep disorders using PSQ Hindi version. Hindi PSQ was distributed in randomly chosen primary schools in a semi-urban area. The children were requested to get them filled by their parents. When the questionnaires were returned, responses were analyzed. Results: Most of the items of the Hindi version had perfect agreement with original questionnaire in a bilingual population (κ=1). Totally, 435 children were included in the field study having average age of 6.3 years. Obstructive sleep apnea was reported in 7.5% children; symptoms suggestive of restless legs syndrome were reported by 2%-3%; teeth grinding by 13.9% and sleep talking by 22.6% children. Conclusion: PSQ Hindi version is a validated tool to screen for sleep disorders among children. Sleep disorders are fairly prevalent among young children in India. [ABSTRACT FROM AUTHOR]

Background: Professional and paramedical students have a key role in oral health promotion. The aim of this study was to assess oral health-related Knowledge, Attitude, and Practice (KAP) among the nursing students in Rajasthan. Materials and Methods: A cross-sectional, questionnaire-based study was carried out among 409 nursing students from five different institutes who were selected by simple random sampling. A 27-item questionnaire was used to assess KAP. The resulting data were analyzed using frequency distribution. Results: Over 50% of the students used toothbrush and toothpaste twice a day to maintain their oral hygiene. Besides, 41% recognized the importance of dental visit in case of gingival bleeding and knew that poor oral hygiene is responsible for bad breath. Conclusions: Oral health-related behavior among the nursing students needs improvement. More educational and preventive programs should be organized to achieve better results. [ABSTRACT FROM AUTHOR]

Background: Presleep thoughts may vary between patients of insomnia with or without depression. They are important for cognitive behavior therapy for insomnia (CBT‑I), but they have never been systemically examined in Indian population. Materials and Methods: Patients with insomnia (>1 month) who were willing to undergo CBT‑I were included in this study after obtaining informed consent. They were requested to fill a sleep diary and return after 15 days. At the time of intake, diagnosis of depression and anxiety disorders was made according to Diagnostic and Statistical Manual ‑ IV‑Text Revision. They were encouraged to provide information regarding presleep thoughts through open‑ended and then, close‑ended questions. Dysfunctional attitudes and beliefs about sleep were assessed with Hindi version of “dysfunctional beliefs and attitudes scale‑brief version”. Hindi version of “insomnia severity index” was used to assess the severity of insomnia. Subjects were divided into two‑groups ‑ insomnia without depression (I) and insomnia with major depressive disorder (I‑MDD+). Statistical Analysis: It was done with the help of SPSS v 21.0. Descriptive statistics was calculated. Proportions between groups were tested with Chi‑square analysis and categorical variables were compared using independent sample t‑test. Results: This study included a total of 63 subjects, out of which 60% were women. Mean age of the whole group was 41.7 ± 11.8 years. About 40% of all the subjects were diagnosed as having I‑MDD+. Forty‑one percent of the subjects had clinically significant anxiety. Both groups ‑ I and I‑MDD+ had comparable proportion of female subjects (χ2 = 0.002; P = 0.96) and there was no difference regarding precipitating factors for insomnia (χ2 = 0.97; P = 0.61). They were also comparable with regards to sleep‑related measures, themes of presleep thoughts, and dysfunctional beliefs and attitudes about sleep and insomnia severity. Major themes of presleep thoughts included family issues and health issues. Only a small proportion had recurrent thoughts related to insomnia and its consequences. Conclusion: Insomnia is a co‑morbid illness with depression and it needs to be separately addressed during therapy. CBT‑I should include the element of problem‑solving technique, especially when we are dealing with the Indian population. [ABSTRACT FROM AUTHOR]

Background: Stillbirth is a prevalent adverse outcome of pregnancy in India despite efforts to improve care of women during pregnancy. Risk factors for stillbirths include sociodemographic factors, medical complications during pregnancy, intake of harmful drugs, and complications during delivery. The objective of the study was to examine the risk factors for stillbirth with a focus on sex selection drugs (SSDs).Methods: A population-based case-control study was undertaken in Haryana. Cases of stillbirths were identified from the Maternal Infant Death Review System portal of Haryana state for the months of August-September 2014. A consecutive birth from the same geographical area as the case was selected as the control. The sample size was 325 per group. Mothers were interviewed using a validated tool. Bivariate analyses and logistic regression were conducted to examine the association between risk factors and stillbirth. Attributable risk proportions (ARP) and population attributable risk proportions (PARP) were estimated.Results: The sociodemographic profiles of the cases and controls were similar. History of intake of SSDs [adjusted odds ratio (OR) 2.6, 95% confidence interval (CI) 1.5, 4.5] emerged as a risk factor. Other significant factors were preterm <37 weeks (OR 3.5, 95% CI 2.1, 6.0), history of previous stillbirths (OR 4.0, 95% CI 2.1, 7.8), and complications during labour (OR 3.3, 95% CI 2.1, 5.3). Estimates of the ARP and PARP for intake of SSDs were 0.60 (95% CI 0.32, 0.77) and 0.1 (95% CI -0.13, 0.28), respectively.Conclusions: SSDs could be attributed as a risk factor in a fifth of the cases of stillbirths. The number needed to harm for the use of SSDs in causing adverse effect of stillbirths was 5, suggesting thereby that for every five mothers exposed to SSDs, one would have stillbirth. Greater efforts are required to inform people about the harmful effects of SSD consumption during pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: Congenital malformations (CMFs) are a major public health problem in India. Consanguineous marriages, infections during pregnancy, folic acid deficiency during the periconceptional period, exposure to pesticides and a history of intake of drugs during pregnancy have been hypothesized as risk factors. Drugs include oral contraceptive pills, progesterone analogues, medications for ailments and indigenous drugs to bear male offspring. It is important to analyze the risk factors in order to implement preventive measures. The prime objective of this study was to study the risk factors of visible structural CMFs, with a focus on indigenous medicines for sex selection.Methods: A population-based, case-control study was undertaken in Haryana state. Cases included children (0-18 months) with any apparent structural deformity as reported by various Government sources. A consecutive birth from the same area as the case was labelled and included as the control. The sample size calculated was 175 in each group. Mothers of every case and control were interviewed at their respective homes using a structured tool. Descriptive analysis, bivariate analysis, followed by logistic regression was conducted to establish the association between risk factors and CMFs.Results: The sociodemographic profiles of the cases and controls were similar. Among the various risk factors studied, more than two living children (unadjusted odds ratio [OR] 1.6, 95 % CI 1.04-2.4) and intake of sex-selection drugs (unadjusted OR 2.8, 95 % CI 1.6-5.1) were significant risk factors on bivariate and regression analyses. The risk of having a child with CMFs was threefold more among mothers with a history of intake of indigenous medicines for sex selection (adjusted OR 3; 95 % CI 1.7-5.6).Conclusions: The intake of indigenous drugs during pregnancy increased the risk of CMFs almost threefold. This has social as well as economic implications, and hence needs further investigation. [ABSTRACT FROM AUTHOR]

Background: Restless legs syndrome also known as Willis-Ekbom's Disease (RLS/WED) is a common illness. Cambridge-Hopkins diagnostic questionnaire for RLS (CHRLSq) is a good diagnostic tool and can be used in the epidemiological studies. However, its Hindi version is not available. Thus, this study was conducted to translate and validate it in the Hindi speaking population. Materials and Methods: After obtaining the permission from the author of the CHRLSq, it was translated into Hindi language by two independent translators. After a series of forward and back translations, the finalized Hindi version was administered to two groups by one of the authors, who were blinded to the clinical diagnosis. First group consisted of RLS/WED patients, where diagnosis was made upon face to face interview and the other group -- the control group included subjects with somatic symptoms disorders or exertional myalgia or chronic insomnia. Each group had 30 subjects. Diagnosis made on CHRLSq was compared with the clinical diagnosis. Statistical Analysis: Analysis was done using Statistical Package for Social Sciences (SPSS) v21.0. Descriptive statistics was calculated. Proportions were compared using chi-square test; whereas, categorical variables were compared using independent sample t-test. Sensitivity, specificity, and positive predictive value of the translated version of questionnaire were calculated. Results: Average age was comparable between the cases and control group (RLS/WED = 39.1 ± 10.1 years vs 36.2 ± 11.4 years in controls; P = 0.29). Women outnumbered men in the RLS/WED group (87% in RLS/WED group vs 57% among controls; %2 = 6.64; P = 0.01). Both the sensitivity and specificity of the translated version was 83.3%. It had the positive predictive value of 86.6%. Conclusion: Hindi version of CHRLSq has positive predictive value of 87% and it can be used to diagnose RLS in Hindi speaking population. [ABSTRACT FROM AUTHOR]

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Objectives: This study was carried out to assess different counteracting strategies used by patients with idiopathic Willis-Ekbom disease (RLS/WED). Whether these strategies were influenced by gender or disease severity was also assessed. Materials and Methods: A total of 173 patients of idiopathic RLS/WED were included in this study. Their demographic data was recorded. Details regarding the RLS/ WED and strategies that they used to counteract the symptoms were asked. The severity of RLS/WED was measured with the help of the Hindi version of international restless legs syndrome severity rating scale. They were asked to provide the details regarding the relief obtained from all the strategies they used on three-point scale: no relief, some relief, and complete relief. Results: Of the patients, 72% were females. Mean age of the subjects in this study was 39.6 ± 12.6 years, and male subjects were older than females. Four common strategies were reported by the patients to counter the sensations of RLS/WED: moving legs while in bed (85.5%), asking somebody to massage their legs or massaging legs themselves (76.9%), walking (53.2%), and tying a cloth/rope tightly on the legs (39.3%). Of all the patients who moved their legs, 6.7% did not experience any relief, 64.2% reported some relief, and 28.4% reported complete relief. Similarly, of all the patients who used “walking” to counteract symptoms, 50% reported complete relief, 44.5% reported some relief, and the rest did not experience any relief. Many of these patients reported that massage and tying a cloth/rope on legs brought greater relief than any of these strategies. Tying cloth on the leg was more common among females as compared to males (45.9% females vs. 23.5% males; χ2 = 7.54; P = 0.006), while patients with moderately severe to severe RLS/WED reported “moving legs in bed” (79.3% in mild to moderate RLS/WED; 91.8% in severe to very severe RLS; c2 = 5.36; P = 0.02). Conclusion: Patients with RLS/WED use a variety of strategies to counteract symptoms. These strategies may be influenced by gender, disease severity, and cultural practices. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Restless Legs Syndrome is a common problem that is under-diagnosed. This disorder has a significant socio-economic impact as it worsens quality of life. There is either no or little data available in terms of the Indian context. Methods: Patients who presented with insomnia or leg pain were screened for Restless Legs Syndrome (RLS) in the Psychiatry and Neurology departments of a tertiary care teaching institution from June 2011 to October 2011. One hundred consecutive patients diagnosed with RLS were included. Duration of symptoms, previous medical consultation history, and treatment received were scrutinized and recorded. Severity of RLS was assessed using the IRLS Hindi version. For statistical analysis, descriptive analysis and independent sample t-test were used. Results: Out of 653 subjects with insomnia or leg pain, 15.31% of the subjects had RLS. Females outnumbered males by a ratio of 2:1. Ninety-four percent of subjects had a moderate to very severe form of the illness. Only 32% of subjects reported leg symptoms to their physician on each visit. The rest of the patients sought an opinion for other symptoms like insomnia, daytime-fatigue, memory impairment, irritability, etc. Eighty percent of patients visited a general Physician or a primary care Physician. On average, five consultations were made before patients came to see us. None of the patients were diagnosed with RLS by any of their general Physicians or by specialists like neurologists, psychiatrists, etc. Common misdiagnoses (available in just 8% of cases) for legs symptoms were arthritis, calcium deficiency, worms in the stomach, depression, anxiety, stress, and vitamin deficiency. All the patients were prescribed medicines. Benzodiazepines were the most frequently prescribed drugs (97%), followed by injectable vitamin B-Complex (95% cases), calcium tablets (62% cases), selective-serotonin-reuptake-inhibitors (30%), and tri-cyclic antidepressants (25%). Proton pump inhibitors or NSAIDs were prescribed to almost all the patients along with previously mentioned drugs. Conclusion: Diagnosis of RLS was missed not only by general physicians, but also by specialists like neurologists and psychiatrists. Most of the time diagnosis could not be established, yet medicines were prescribed. Many of these medicines were either ineffective or deleterious to RLS. [Copyright &y& Elsevier]

Background: Urinary tract infections (UTIs) are amongst the most common infections described in outpatients setting. Objectives: A study was conducted to evaluate the uropathogenic bacterial flora and its antimicrobial susceptibility profile among patients presenting to the out-patient clinics of a tertiary care hospital at Jaipur, Rajasthan. Materials and Methods: 2012 consecutive urine specimens from symptomatic UTI cases attending to the outpatient clinics were processed in the Microbiology lab. Bacterial isolates obtained were identified using biochemical reactions. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disc diffusion method. Extended spectrum beta lactamase (ESBL) production was determined by the double disk approximation test and the Clinical and Laboratory Standards Institute (formerly NCCLS) confirmatory method. Results: Pathogens were isolated from 346 (17.16%) of the 2012 patients who submitted a urine sample. Escherichia coli was the most frequently isolated community acquired uropathogen accounting for 61.84% of the total isolates. ESBL production was observed in 23.83% of E. coli strains and 8.69% of Klebsiella strains. With the exception of Nitrofurantoin, resistance to agents commonly used as empiric oral treatments for UTI was quite high. Conclusion: The study revealed E. coli as the predominant bacterial pathogen for the community acquired UTIs in Jaipur, Rajasthan. An increasing trend in the production ESBLs among UTI pathogens in the community was noted. Nitrofurantoin should be used as empirical therapy for primary, uncomplicated UTIs. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study is to translate and validate the International Restless Leg Syndrome Study Group rating scale (IRLS) in Hindi language. Materials and Methods: Thirty one consecutive patients diagnosed of Restless Leg Syndrome (RLS) were included in the study. Control group comprised of 31 subjects not having any symptom of RLS. The scale was procured from MAPI research trust; and, permission for the translation was sought. The translation was done according to the guidelines provided by the publisher. After translation, final version of the scale was applied in both the groups to find out the reliability and clinical validity. Results: RLS group had a predominance of females, and they were younger than the male counterparts (Age=36.80 ± 10.46 years vs 45.18 ± 8.34 years; t=2.28; P=0.03). There was no difference in the mean age between groups (RLS=39.77 ± 10.44 years vs Non RLS=38.29 ± 11.29 years; t=-0.53; P=0.59). IRLS scores were significantly different between both groups on all items (P<0.001). Translated version showed high reliability (Cronbach's alpha=0.86). IRLS scores were significantly different between both groups on all items (P<0.001). Conclusion: Hindi version of IRLS is reliable and a clinically valid tool that can be applied in Hindi speaking population. [ABSTRACT FROM AUTHOR]

The article reports that the competency‑based medical curriculum the psychiatry, training of faculty, and Indian Psychiatric Society (IPS). Topics include the IPS has considered this lacuna as a major setback for mental health services in the Indian scenario, and the IPS shall pursue to appraise the Government of India and the National Medical Commission to psychiatric skill evaluation in mandatory psychiatric training of the budding doctors training.

A considerable portion of the solar radiation falling on transparent north wall/roof inside an east–west-oriented greenhouse is lost due to low-altitude angle of sun during winter months. Replacing the transparent north wall with a reflecting surface can increase solar radiation on the floor of the greenhouse. Effect of vertical and inclined reflecting north wall on distribution of solar radiation on the floor of greenhouse has been studied for five different locations in India. These locations are Chennai (13°N), Kolkotta (22.53°N), Jodhpur (26.30°N), Delhi (28.58°N) and Srinagar (34.08°N). Evenspan greenhouse (6 m×4 m×3 m) has been considered for the present study. The proposed model can also be used to determine the distribution of solar radiation for any other place and shape of the greenhouse. [Copyright &y& Elsevier]

In the present paper, distribution of solar energy inside various greenhouses/solariums has been determined in terms of weighted solar fraction on north partition wall by using Auto-CAD 2000 for five cities of India (New Delhi, Leh, Jodhpur, Kolkota and Bangalore). This enables the prediction of a greenhouse''s performance for passive heating/cooling of a solarium. The shapes of the greenhouse (attached with solarium) included for study are even span, uneven span, modified arch, vinery and modified IARI. Basic dimensions are 6 m×4 m×3 m for each greenhouse. Analysis has been carried out with the help of a 3D model based on Auto-CAD 2000 for a typical day of each month of the year. It has been observed that the weighted solar fraction plays an important role at low altitude for thermal heating of a solarium during winter months. It mainly depends on the shape and size of the greenhouse/solarium and time of the nth day of the year. Based on the analysis it can be concluded that, generally, the even shape is best for different locations. [Copyright &y& Elsevier]

A response by S. Neogi and colleagues to a letter to the editor about their article "Indigenous Medicine Use for Sex Selection During Pregnancy and Risk of Congenital Malformations: A Population-Based Case-Control Study in Haryana, India" in the 2015 issue is presented.

Narcolepsy is a common sleep disorder with a prevalence of about 0.02%. However, it may remain largely unrecognized in the Indian population owing to the perceived low prevalence. To the best of our knowledge there is only one case of narcolepsy reported from India so far. We present a case of narcolepsy with cataplexy with classical clinical and polysomnographic findings of narcolepsy. [ABSTRACT FROM AUTHOR]

Background: Studies evaluating next‐generation sequencing (NGS) for retinal disorders may not reflect clinical practice. We report results of retrospective analysis of patients referred for clinical testing at two institutions (US and India). Methods: This retrospective study of 131 patients who underwent clinically validated targeted NGS or exome sequencing for a wide variety of clinical phenotypes categorized results into a definitive, indeterminate, or negative molecular diagnosis. Results: A definitive molecular diagnosis (52%) was more common in the India cohort (62% vs. 39%, p =.009), while an indeterminate molecular diagnosis occurred only in the US cohort (12%). In the US cohort, a lower diagnostic rate in Hispanic, non‐Caucasians (23%) was seen compared to Caucasians (57%). The India cohort had a high rate of homozygous variants (61%) and different frequency of genes involved compared to the US cohort. Conclusion: Despite inherent limitations in clinical testing, the diagnostic rate across the two cohorts (52%) was similar to the 50%–65% diagnostic rate in the literature. However, the diagnostic rate was lower in the US cohort and appears partly explained by racial background. The high rate of consanguinity in the Indian population is reflected in the high rate of homozygosity for pathogenic mutations and may have implications for population level screening and genetic counseling. Clinical laboratories may note diagnostic rates that differ from the literature, due to factors such as heterogeneity in racial background or consanguinity rates in the populations being tested. This information may be useful for post‐test counseling. [ABSTRACT FROM AUTHOR]

India has 40 distinct zebuine cattle breeds with different adaptability and production traits. In the present study, we report the complete mitochondrial genome sequence of Indian cattle for the first time. The mitogenome contains 13 protein-coding genes, 22 transfer RNA genes, two ribosomal RNA genes and a control region (D-loop region). The phylogenetic analysis showed close genetic relationship among the Indian cattle breeds studied, where as, distinct genetic differences were observed between Bos indicus and Bos taurus cattle. Our results will expand genomic information for further studies on evolution, domestication and conservation of indigenous cattle breeds in India. [ABSTRACT FROM AUTHOR]