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In an era where arthroscopic rotator cuff repair is dominant in the United States (77.9 % preference) compared to open surgery (53.33 %), a shift towards minimally invasive All-Arthroscopic (AA) techniques over classical Mini-Open (MO) repair is emerging. This study explores current trends in shoulder procedures in India and compares functional outcomes and radiological repair integrity between AA and MO techniques, which are understudied in the Indian context. In this prospective study, 60 patients (30 in the AA group and 30 in the MO group) with rotator cuff tears underwent assessment. Pre/post-operative clinical evaluations and 12-month follow-ups using UCLA and Oxford Shoulder Score, along with preoperative MRI and postoperative USG, were conducted. At one-year follow-up, the AA group showed better functional outcomes (53.3 % excellent/good vs. 30.0 % in MO). No significant radiological differences (Sugaya grading) were found. Tear size was comparable with no association with functional/radiological outcomes. The AA group demonstrated favourable functional outcomes, matched to MO group findings, which is in accordance with global studies. Despite higher costs, the increasing popularity of AA in India is justified by enhanced results and reduced postoperative discomfort. [ABSTRACT FROM AUTHOR]

Objectives: Kerala was the first state to implement a community-based, sustainable primary palliative care (PC) home care (HC) model. Beneficiary satisfaction, an important indicator to assess the quality of service provision with the HC program, has not been assessed since the programme was launched 14 years ago. This study tried to assess the satisfaction of beneficiaries receiving primary PC services through the Kerala State PC programme and the factors associated with the same. Materials and Methods: The cross-sectional survey was conducted among 450 patients registered under the Kerala State Primary PC Programme. Data were collected using a semi-structured questionnaire from October 2022 to January 2023. We summarised the data as proportions and performed Chi-square tests to make comparisons wherever applicable. Results: Most of the beneficiaries (69.1%) were satisfied with HC services. The mean age of the beneficiaries was 65.51 ± 17 years. More than 80% of the participants (88.4%) were married, and the primary caregivers were wives (31.8%) and daughters/daughters-in-law (35.3%). The primary diagnosis of the beneficiaries was a cerebrovascular accident (27.4%), cancer (18.8%), and spinal cord injury (13.2%). The study examined the needs of beneficiaries and found that the top three requirements reported by the patients were the inclusion of doctor visits in HC (71.8%), medicine distribution at home (67.4%), and physical rehabilitation services at home with a minimum of three sessions per month (52.3%). The study found a statistically significant association (P < 0.05) between the Beneficiary's satisfaction and behaviour of PC nurses and certain services, including physiotherapy, procedural care specifically catheterisation and wound dressing, and health check-ups received through the HC program. Satisfaction was reported more in Thiruvananthapuram district, followed by Malappuram. Conclusion: The overall satisfaction with the Kerala State Primary PC Programme was found to be high at about 69%. Despite the fact that the study identified significant relationships between nurses' behaviour, services provided (physical therapy, procedures, and health checks), and satisfaction, the findings suggested expanding the scope of the HC programme by including doctor visits and medicine delivery at patient's home. [ABSTRACT FROM AUTHOR]

Purpose: To explore the oral health beliefs and behaviour among Tibetan immigrants of Bylakkupe village.Materials and Methods: A stratified random sampling technique involving 366 Tibetan monks in Bylakkupe monasteries was used in this study. The oral health beliefs were measured using a pre-tested questionnaire.Results: The results showed that seriousness was higher compared to other domains in the health belief model. Further, as the duration of the stay increased, the perceived importance was also higher among the population studied.Conclusion: The results show that in general, although the seriousness of oral health was high among the participants, the perceived benefit of dental treatment was relatively low. [ABSTRACT FROM AUTHOR]

Purpose: The demand-side view of creditor rights posits a negative association between creditor rights and corporate borrowings. The purpose of this paper is as follows: first, the author examines whether the demand-side effect is more pronounced amongst firms with excess promoter shareholding. Subsequently, the authors analyze the impact of high promoter holdings on investment decisions owing to bankruptcy reforms. Design/methodology/approach: To answer the above questions, the authors exploit the passage of the Insolvency and Bankruptcy Code (IBC) (2016) that strengthens the creditor rights of lenders, which impacts the borrowings and financing activities of Indian corporates. Using a panel of listed Indian firms over the period of 2012–2019, the authors analyze how the IBC affects firms' borrowings and financing decisions with excess promoter holdings. Findings: The authors find that bankruptcy reforms led to a statistically significant decline in the use of borrowed funds (primarily secured and long-term debt) by firms with high concentrated holdings. The analysis also indicates that firms with excess promoter ownership face an increased cost of debt due to bankruptcy reforms. As a result, firms with excess promoter holdings curtail their investments. Overall, the results indicate that India's bankruptcy reforms significantly affect the firms' financing and investment decisions with highly concentrated ownership. Originality/value: While past research has explored the relationship between bankruptcy reforms and demand for/supply of debt, the authors provide novel empirical evidence on the role of promoter holdings that affects the relationship between bankruptcy law and financing and investment decisions. To the best of the author's knowledge, this study is the first to investigate the role of ownership structure in the context of bankruptcy reforms by using a quasi-natural experiment. [ABSTRACT FROM AUTHOR]

Candida organisms colonize the gastrointestinal tract but causation for various diseases needs to be proved. Uncontrolled diabetes is a risk factor for acquiring typical as well as atypical infections. COVID-19 pandemic started in China in 2019 and swept across the world rapidly becoming a pandemic. Various cases of invasive rhino cerebral mucormycosis were reported in India during the second wave of covid. Here we report a case of recently detected diabetes mellitus admitted for rhinological Mucor mycosis who died of gastric perforation. UGIE and biopsy showed yeast and pseudo hyphae which were consistent with candidiasis. [ABSTRACT FROM AUTHOR]

Purpose: To assess the correlation between self-perceived dental appearance and dental malocclusion among 18- to 20-year-old college students in Virajpet, Karnataka.Materials and Methods: A stratified random sample consisting of 280 18- to 20-year-old college students in Virajpet were recruited for the study. A pretested Oral Aesthetic Subjective Impact Scale (OASIS) and Visual Analogue Scale (VAS) were used to assess the subjects' perception of dental aesthetics. Malocclusion was clinically assessed using the Dental Aesthetic Index (DAI). The data were tabulated and analysed using SPSS version 16. The Spearman rankorder correlation coefficient was employed to determine the correlation between self-perceived dental appearance and dental malocclusion.Results: Of the 280 students, 41.8% were females and 58.2% were males. The mean OASIS score was 23.93 (±3.72), the VAS score was 69.61 (±15.78) and DAI 24.80 (±6.29).Conclusion: There was a negative correlation between perception of personal dental appearance and the DAI scores in this group. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence of molar incisor hypomineralization among school children aged 9 to 12 years in virajpet, Karnataka. Method: This cross-sectional descriptive study consisted of 1600 school children aged 9-12 years selected by stratified cluster sampling procedure. The European Academy of Pediatric Dentistry criteria were followed for MIH diagnosis. Chi-square test was used toanalyze the categorical data. P ≤ 0.05 was considered for statistical significance. Results: The prevalence of MIH is 13.12 % with no gender predilection. 10 year old children showed the highest prevalence (15%) among all the age group.Majority of children with MIH (70.2%) have lesions in both molars and incisors with demarcated opacities and atypical restorations being the most frequent defect type. Conclusion: Prevalence of MIH was 13.12% in the 9-12 year child population in Virajpet. There is a need for a properplanned preventive and restorative program with regard to the increasing prevalence of MIH. [ABSTRACT FROM AUTHOR]

Aim The aim of the present study was to determine the association between oral health-related quality of life ( OHRQo L) and periodontal status among police personnel in Virajpet, India. Methods Police personnel were randomly selected from the 296 police staff working in Virajpet, India. A self-administered questionnaire was used to collect information on their demographics and dental visit behavior, and to determine their OHRQo L. The community periodontal index ( CPI) and loss of attachment were used to assess periodontal status. Results All 72 invited participants joined this study. The majority ( n = 133) had good OHRQo L. For those with a good OHRQo L, 74 had CPI = 0, 25 had CPI = 1, 20 had CPI = 2, and 14 had CPI ≥ 3. For those who had an average or poor OHRQo L ( n = 37), 19 had CPI = 0, one had CPI = 1, eight had CPI = 2, and nine had CPI ≥ 3. There was a statistically-significant association between OHRQo L and CPI ( P < 0.003). Most participants with good OHRQo L (127/133), but only less than half with an average or poor OHRQo L (22/37), had no loss of periodontal attachment ( P < 0.0001). Conclusion In the present study, there was an association between OHRQo L and periodontal status among police personnel in Virajpet, Coorg. [ABSTRACT FROM AUTHOR]

The article provides a public health perspective on the palliative care and ethical decision-making in Kerala, India. It discusses the concepts of palliative care, hospice, and end-of-life care and the concepts for creating a new framework for ethical-decision making such as respect for life and acceptance of the inevitability of death, human rights, justice, and utilitarianism. It also examines the Neighbourhood Network in Palliative Care (NNPC) as a public health model of palliative care.

Smoking kills 900,000 people every year in India. Many studies have shown that counseling from a health professional is an effective method of helping patients quit. The aim of this study was to evaluate the knowledge and attitudes of dental students in Karnataka, India, towards smoking cessation counseling. A questionnaire study was conducted among a convenience sample of 329 dental students comprised of III year and IV year students and interns in three dental colleges in Karnataka, India. Of the 329 students who completed the questionnaire, twenty-two (7 percent) were current smokers, and fifteen (5 percent) were ex-smokers. Although 94 percent responded they were giving antismoking advice to their patients, only 47 percent said they had been taught antismoking advice suitable for patients. While a majority (95 percent) planned to advise patients about tobacco use in their professional careers, significantly fewer (66 percent) indicated that such counseling would help patients to quit. This study of dental students and interns found that a majority intended to provide smoking cessation counseling in their professional career and agreed it is part of their professional role. [ABSTRACT FROM AUTHOR]

Background: With the emergence of new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, such as the Omicron variant, during the third wave of the coronavirus disease 2019 (COVID-19) pandemic, there was a need to identify useful homeopathic medicines. This study aimed to identify such medicines and their indications using prognostic factor research (PFR)., Methods: This was an open-label, multi-centred observational study conducted in January 2022, on confirmed COVID-19 cases. The data were collected from integrated COVID Care Centres in Delhi, India, where homeopathic medicines were prescribed along with conventional treatment. Only those cases that met a set of selection criteria were considered for analysis. The likelihood ratio (LR) was calculated for the frequently occurring symptoms of the frequently prescribed medicines. An LR of 1.3 or greater was considered meaningful., Results: Out of the 362 COVID-19 cases, 263 cases were selected for analysis after applying selection criteria. Common symptoms included fatigue, cough, sore throat, myalgia and headache. Twenty-one medicines were prescribed, of which nine medicines - Gelsemium sempervirens , Bryonia alba , Hepar sulphuris , Rhus toxicodendron , Pulsatilla nigricans , Arsenicum album , Belladonna , Nux vomica and Phosphorus - were frequently used. By calculating LRs, the study identified meaningful indications for these medicines., Conclusion: Homeopathic medicines have shown promising results in the third wave of COVID-19 as an adjunct therapy. The medicines that were used in the first and second waves were found useful in the third wave also, and their indications were analogous to those found in the earlier waves. Certain new indications of some medicines were elicited in this wave, which warrant further research. However, it is important not to restrict to these medicines only and to continue data collection on COVID-19 in future waves for the improvement of the COVID-19 mini-repertory., Competing Interests: None declared, (Faculty of Homeopathy. This article is published by Thieme.)

In this response, we seek to analyse and rebut the observations of Karpagam S using an understanding of the Kerala Health system and the general purpose of the Kerala Public Health Act (KPHA). The KPHA was crafted with a greater focus on a one-health and preventive approach. It does not seek to interfere in an individual's preferred choice of treatment, except in the case of public health emergencies. KPHA is not a standalone document, but a supporting tool to the existing Kerala Health Policy and various other health policies and programmes instrumental in improving the health and quality of life of the people of the State. The KPHA is intended to be an enforcement tool for legal provisions to ensure welfare maximisation of the society at large, and thus detailed discussions regarding actions to be taken beyond these legal provisions do not fall within the purview of the Act.

Salinity is among the harshest environmental stress conditions that negatively affects productivity of salt-sensitive rice. Since, germination is the most crucial phase in the life-cycle of plants, the present study was carried out to study the morpho-physiological traits associated with salinity stress. Evaluation of tolerance in four contrasting rice genotypes was assessed on the basis of specific morpho-physiological parameters including radicle emergence, seedling vigour index, germination index, mean germination time, radicle and plumule growth and seedling water uptake. Largely, our findings revealed that mean germination time (MGT) and seedling vigour index (SVI) are fast-screening procedures to test seedling performance in salt stress conditions. Salt sensitive genotypes showed higher MGT and lower SVI, confirming that these indices are good indicators of poor germination response. Salt-tolerant genotypes were shown to be inhibited to a lesser extent in alpha-amylase activity in spite of high concentrations of imposed NaCl stress, that correlated with better regulation of water-uptake and increased accumulation of total soluble sugar content. Exogenous supplementation of soluble sugars improved the germination rate in a salt sensitive genotype, Jyothi, confirming the importance of soluble sugars in signaling under NaCl stress conditions. Increased total phenols and flavonoids were observed to be relative to higher Total Antioxidant Capacity in salt tolerant genotypes underlying the significance of seed phenolic compounds in early germination response in NaCl stress conditions. Kagga, a landrace grown in coastal Karnataka performed comparably with that of salt tolerant rice, Pokkali. In conclusion, the determination of early seedling response may be utilized as a useful strategy to uncover genetic variation in rice germplasm to salinity stress., (© 2023. The Author(s) under exclusive licence to The Botanical Society of Japan.)

Background/objective: Coronavirus disease 2019 (COVID-19) is a new disease; its clinical profile and natural history are evolving. Each well-recorded case in homeopathic practice is important for deciding the future course of action. This study aims at identifying clinically useful homeopathic remedies and their prescribing symptoms using the prognostic factor research model., Methods: This was an open-label, multi-centric, observational study performed from April 2020 to July 2020 at various public health care clinics. The data were collected prospectively from clinical practice at integrated COVID-19 care facilities in India. Good-quality cases were selected using a specific set of criteria. These cases were analyzed for elucidating prognostic factors by calculating the likelihood ratio (LR) of each frequently occurring symptom. The symptoms with high LR values (>1) were considered as prescribing indications of the specific remedy., Results: Out of 327 COVID-19 cases reported, 211 met the selection criteria for analysis. The most common complaints were fatigue, sore throat, dry cough, myalgia, fever, dry mouth and throat, increased thirst, headache, decreased appetite, anxiety, and altered taste. Twenty-seven remedies were prescribed and four of them- Arsenicum album, Bryonia alba, Gelsemium sempervirens , and Pulsatilla nigricans -were the most frequently used. A high LR was obtained for certain symptoms, which enabled differentiation between the remedies for a given patient., Conclusion: Homeopathic medicines were associated with improvement in symptoms of COVID-19 cases. Characteristic symptoms of four frequently indicated remedies have been identified using prognostic factor research, findings that can contribute to accurate homeopathic prescribing during future controlled research in COVID-19., Competing Interests: None declared., (Faculty of Homeopathy. This article is published by Thieme.)