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Aim: This study was undertaken to evaluate the risk factors and associated pathways for unmet dental prosthetic needs among older adult population in Central India. Methods: A total of 11,145 randomly selected older adults participated in the study; 4613 from urban region and 6532 form rural region. Oral examinations were conducted at individual households for recording dental caries, periodontal disease, prosthetic status and needs. Structural Equation Modelling (SEM) was used to examine relationship between a set of exogenous variables and unmet dental prosthetic needs with variables that remained significant in the adjusted multilevel logistic model. Path coefficients were calculated for all variables with 95% confidence interval. Goodness of fit of the model was assessed by several indices. Results: A total of 8433 (75.7%) participants had never visited a dentist and 9139 (82%) had unmet dental prosthetic needs. Dental caries was observed among 3207 (69.5%) and 4644 (71.1%) study participants from urban and rural regions respectively (p <.05). Low utilization of dental services was associated with high dental prosthetic needs in upper arch and lower arch (PC = −0.05, 0.001) and DMFT was associated with lower utilization of dental services (PC = −0.09, 0.001). DMFT was also associated with age, annual income, level of education, paternal education, type of family, tobacco consumption and CPI score in the hypothesized model. The fit indices used indicated that the model was adequate. Conclusions: Dental prosthetic needs in the proposed pathway model was associated with low utilization of dental services, dental caries, periodontal disease and other socio‐demographic factors. [ABSTRACT FROM AUTHOR]

Background: Thyroid dysfunction evaluation during pregnancy is important for the mother's health, obstetric outcomes, and the child's cognitive development. This study is conducted to know various thyroid disorders that can occur during antenatal and their impact on mother and fetus outcomes. Materials and Methods: This observational research was conducted over two years at a tertiary center in Western Rajasthan, India. Seven hundred and seventy-two low-risk singleton pregnant patients who met the inclusive criteria were recruited. The estimation of T3, T4, and TSH was done along with a routine investigation in antenatal women. Antenatal having abnormal thyroid profiles were then analyzed for mother and fetus problems. Results: The prevalence of thyroid dysfunction in antenatal women is 16.5%. Subclinical hypothyroidism (SCH) was seen in 12.5% of cases, overt hypothyroidism in 3.36%, and subclinical hyperthyroidism in only 0.51% of cases. Anti-TPO was positive in 46 (41.44%) women with hypothyroidism and 1 (25%) with hyperthyroidism. Compared to euthyroid women, women with overt hypothyroid (19.23% vs 3.1%, P = 0.002) and subclinical hypothyroid (9.27% vs 3.1%, P = 0.003) were found to be associated with a higher risk of hypertensive disease. Concerning fetal outcomes. There was a high risk for preterm (12.37% v/s 4.9%, P = 0.004) and fetal growth retardation (FGR) in patients with SCH (7.21% v/s 3.1%, P = 0.04). Conclusion: Considering the significant influence of thyroid disorders on mother and fetus outcomes, the screening for thyroid during pregnancy should be considered universally, particularly in developing countries with high prevalent rates, such as India. [ABSTRACT FROM AUTHOR]

Air pollution in India is a foremost environmental risk factor that affects human health. This study first investigates the geographical distribution of ambient and household air pollution (HAP) and then examines the associated mortality risk. Data on fine particulate matter (PM2.5) concentration has been extracted from the Greenhouse Gas Air Pollution Interactions and Synergies (GAINS) model. HAP, mortality and socio‐demographic data were extracted from the National Family and Health Survey‐5, India, 2019–2021. Regression models were applied to see the difference in age‐group mortality by different pollution parameters. The districts with PM2.5 concentration above the National Ambient Air Quality Standard (NAAQS) level of 40 μg/m3 show a higher risk of neonatal (OR‐1.86, CI 1.418–2.433), postneonatal (OR‐2.04, CI 1.399–2.971), child (OR‐2.19, CI 0.999–4.803) and adult death (OR‐1.13, CI 1.060–1.208). The absence of a separate kitchen shows a higher probability of neonatal (OR: 1.18, CI 1.074–1.306) and adult death (OR‐1.06, CI 1.027–1.088). The interaction between PM2.5 levels above NAAQS and HAP leads to a substantial rise in mortality observed for neonatal (OR 1.19 CI 1.051–1.337), child (OR 1.17 CI 1.054–1.289), and adult (OR 1.13 CI 1.096–1.168) age groups. This study advocates that there is a strong positive association between ambient and HAP and mortality risk. PM2.5 pollution significantly contributes to the mortality risk in all age groups. Children are more vulnerable to HAP than adults. In India, policymakers should focus on reducing the anthropogenic PM2.5 emission at least to reach the NAAQS, which can substantially reduce disease burden and, more precisely, mortality. Plain Language Summary: Air pollution in India poses a significant threat to human health, as explored in this study. Using data from the Greenhouse Gas Air Pollution Interactions and Synergies model and the National Family and Health Survey‐5, the research examines both ambient and household air pollution and their impact on mortality risk. Analyzing fine particulate matter (PM2.5) concentration, the study finds that districts exceeding the National Ambient Air Quality Standard (NAAQS) of 40 μg/m3 face increased mortality risks across all age groups, including neonatal, postneonatal, child, and adult deaths. Additionally, the absence of separate kitchens correlates with higher neonatal and adult mortality rates. The interaction between elevated PM2.5 levels and household air pollution further amplifies mortality risks, particularly among neonates, children, and adults. The study underscores the urgent need for policymakers to mitigate anthropogenic PM2.5 emissions to meet NAAQS standards, which could significantly reduce mortality and disease burden, particularly among vulnerable populations like children. Key Points: Interaction between PM2.5 levels above National Ambient Air Quality Standard and household air pollution, leads to a substantial rise in mortality observed for all age‐groupsDistricts with PM2.5 levels exceeding the National Ambient Air Quality Standard show an approximately two fold increase in the odds of mortality among children [ABSTRACT FROM AUTHOR]

Objective To assess the availability of information on indicators of the World Health Organization and United Nations Children's Fund primary health-care measurement framework in Bangladesh, India, Nepal, Pakistan and Sri Lanka and to outline the opportunities for and challenges to using the framework in these countries. Methods We reviewed global and national data repositories for quantitative indicators of the framework and conducted a desk review of country documents for qualitative indicators in February--April 2023. We assessed data sources and cross-sectional survey tools to suggest possible sources of information on framework indicators that were not currently reported in the countries. We also identified specific indicators outside the framework on which information is collected in the countries and which could be used to measure primary healthcare performance. Findings Data on 54% (32/59) of the quantitative indicators were partially or completely available for the countries, ranging from 41% (24/59) in Pakistan to 64% (38/59) in Nepal. Information on 41% (66/163) of the qualitative subindicators could be acquired through desk reviews of country-specific documents. Information on input indicators was more readily available than on process and output indicators. The feasibility of acquiring information on the unreported indicators was moderate to high through adaptation of data collection instruments. Conclusion The primary health-care measurement framework provides a platform to readily assess and track the performance of primary health care. Countries should improve the completeness, quality and use of existing data for strengthening of primary health care. [ABSTRACT FROM AUTHOR]

The purpose of this study is to understand the impact of community mobilization initiatives on citizens' health-seeking behavior through the lens of COVID-19 vaccination in the state of Madhya Pradesh, India. This study follows a case study approach to understand community mobilization initiatives that led to increased COVID-19 vaccination uptake. The study delineates the process to increase community mobilization to improve the uptake of COVID-19 vaccination. It highlights the key components of community mobilization that were adopted: the involvement of local leadership (at district, block, and village level), support of vaccination/mobilizer team, the role of in-person communication, involvement of influential community heads and social workers, localized strategies and IEC materials, and support from the state administration. Additionally, the key communication themes that played a crucial role in increasing COVID-19 vaccination coverage are identified. The findings of this study will help the policymakers and practitioners in the domains of Health and Medical Humanities, Health Policy and Services, and Social Sciences to clarify the roles of community mobilization activities and initiatives in increasing vaccination coverage. Furthermore, the study provides evidence for the adaptation, integration, and enhancement of these activities based on the four case studies discussed. [ABSTRACT FROM AUTHOR]

Purpose: To study the clinical and tomographic characteristics and associations of keratoconus (KC) patients visiting a tertiary eye care hospital. Methods: This was a cross-sectional, observational study that included 242 newly diagnosed clinical KC patients. Detailed ocular and systemic history, visual complaints, habit of eye rubbing, best spectacle-corrected visual acuity (BSCVA), retinoscopy reflex, detailed slit-lamp examination and tomographic findings, and presence of any ocular and systemic associations were documented for the included patients. Severity of KC was further graded into stages 0, 1, 2, 3, and 4 according to the ABCD grading system. Results: The most common visual complaint was blurred vision (82.64%), followed by itching (48.76%), tearing (43.80%), and photophobia (41.32%). A total of 44.62% of patients had the habit of eye rubbing and 4.54% had a family history of KC. Most common clinical signs were scissor reflex (94.21%), Rizutti's sign (77.27%), corneal protrusion (69.83%), and Fleischer ring (67.35%). A total of 14.05% of patients had stage 0, 42.15% had stage 1, 19.83% had stage 2, 18.60% had stage 3, and 5.37% had stage 4 KC. Of these patients, 70.25% had a BSCVA visual acuity of ≥6/12 or better; 26.45% had a BSCVA of ≥6/60 to <6/12; and 3.30% had a BSCVA of <6/60. Ocular allergies, atopy, and asthma were found in 32.32%, 4.96%, and 2.48% cases, respectively. Conclusion: This study gives an overview of the clinical findings of KC cases in western India. Our results suggest that use of retinoscopy should be promoted in early KC detection in primary eyecare screening programs. [ABSTRACT FROM AUTHOR]

Background: Arthritis is an umbrella term that refers to approx 200 rheumatic diseases and conditions that affect various joints of the body, which including lupus and rheumatoid arthritis. Rheumatoid arthritis (RA) is a chronic autoimmune and common systemic inflammatory disease that results in joint deformity and functional disability when not properly managed. The early diagnosis and treatment of RA are imperative for optimal disease management, a greater probability of remission, and prevention of permanent clinical and radiographic damage. Objectives: The present study was conducted to study the value of rheumatoid factor (RF), anticyclic citrullinated peptide autoantibodies (anti-CCP), and anti-RA33 autoantibodies for diagnosis of RA and prediction of outcome in patients with very early arthritis. Methods: This was a prospective study carried out in a tertiary care centre situated at western part of India which included 30 patients aged between 18 - 65 years who presented with multiple joints pain. Inclusion criteria included Population aged between 18 to 65 years with clinically suspected patients of Rheumatoid Arthritis and Duration of signs and symptoms more than 6 weeks. Exclusion criteria included Patients <18 years and >65 years, patients with other chronic diseases such as Carcinoma, Diabetes mellitus, HIV, etc. A p-value of <0.05 was considered statistically significant. Results: Out of 30 patients, 57% of patients were females and rest 43% males. Out of which 66.66% patients were positive for antibodies and 33.33% were negative. Rheumatoid arthritis positivity was seen in 60% cases while other arthropathies were observed in 40% of cases. Specific antibody wise distribution shows 75% positivity with RF - IgM plus ACPA (Anticitrulline protein antibody) and 25% positivity with RA - 33 antibody. Conclusion: LIA based autoantibody testing in early inflammatory joint disease, should be used as a sensitive and effective strategy for distinguishing patients with RA at high risk for poor outcome. Anti - CCP is an extremely helpful diagnostic marker being not only highly specific for RA but also strongly associated with erosive disease. [ABSTRACT FROM AUTHOR]

Diagnosing extrapulmonary tuberculosis (EPTB) is challenging. Immunohistochemistry or immunocytochemistry has been used to diagnose tuberculosis (TB) by detection of MPT64 antigen from various extrapulmonary specimens and has shown good diagnostic performance in our previous studies. The test can distinguish between disease caused by Mycobacterium tuberculosis (Mtb) complex and nontuberculous mycobacteria and can be applied on formalin‐fixed paraffin‐embedded tissue. As the antibodies previously used were in limited supply, a new batch of polyclonal antibodies was developed for scale‐up and evaluated for the first time in this study. Our aim was to assess the diagnostic accuracy of the MPT64 test with reproduced antibodies in the high burden settings of Pakistan and India. Patients were enrolled prospectively. Samples from suspected sites of infection were collected and subjected to histopathologic and/or cytologic evaluation, routine TB diagnostics, GeneXpert MTB/RIF (Xpert), and the MPT64 antigen detection test. Patients were followed until the end of treatment. Based on a composite reference standard (CRS), 556 patients were categorized as TB cases and 175 as non‐TB cases. The MPT64 test performed well on biopsies with a sensitivity and specificity of 94% and 75%, respectively, against a CRS. For cytology samples, the sensitivity was low (36%), whereas the specificity was 81%. Overall, the MPT64 test showed higher sensitivity (73%) than Xpert (38%) and Mtb culture (33%). The test performed equally well in adults and children. We found an additive diagnostic value of the MPT64 test in conjunction with histology and molecular tests, increasing the yield for EPTB. In conclusion, immunochemical staining with MPT64 antibodies improves the diagnosis of EPTB in high burden settings and could be a valuable addition to routine diagnostics. [ABSTRACT FROM AUTHOR]

Passiflora edulis Var. flavicarpa (passion fruit) generates vast waste (60–70%) in the form of peel and seed after the juice extraction. The study aimed to isolate Scirpusin B (SB) from passion fruit (PF) seed waste collected from Northeast India and to analyse its anti-radical, antibacterial, anti-diabetic, and anti-oral cancer activities. Scirpusin B was isolated following hydro-alcoholic extraction, fractionation, and column chromatography. The isolated fraction was further identified through NMR and mass spectroscopy. SB exhibited significant antiradical activity against six standard antioxidant compounds, indicating its commercial application. SB inhibited α-amylase (IC50 Value: 76.38 ± 0.25 µg/mL) and α-glucosidase digestive enzymes (IC50 Value: 2.32 ± 0.04 µg/mL), signifying its antidiabetic properties. In addition, SB showed profound antibacterial activity against eight gram-positive and gram-negative bacteria reported for the first time. Furthermore, SB inhibited SAS and TTN oral cancer cell proliferation up to 95% and 83%, respectively. SB significantly inhibited colonies of SAS and TTn cells in the clonogenic assay, attributing to its anticancer properties. The PI-FACS assay confirmed the ability of SB (75 µM) to kill SAS and TTn cells by 40.26 and 44.3% in 72 h. The mechanism of SB inhibiting oral cancer cell proliferation was understood through western blot analysis, where SB significantly suppressed different cancer hallmark proteins, such as TNF-α, survivin, COX-2, cyclin D1, and VEGF-A. The present study suggests that SB isolated from PF seed can add noteworthy value to the waste biomass for various industrial and medical applications. [ABSTRACT FROM AUTHOR]

Purpose: With changing employment conditions, technological advancement, frequent manpower reduction and global competition, the relevance of the protean and boundaryless career concepts is increasing. With this, the country's culture plays a pivotal role in career choice. The purpose of this paper is to develop and validate protean and boundaryless career scales for college passing out students and in the Indian context. The protean career scale was measured by self-directed and values-driven dimensions, while the boundaryless career scale was measured by boundaryless mindset and organizational mobility preference. Design/methodology/approach: The first step involved defining construct and determining face validity. The data collected via questionnaire from India's final year engineering students were subjected to exploratory factor analysis and confirmatory factor analysis in the second and third steps, respectively. Finally, the nomological validity was tested by establishing the relationship between factors influencing career choice and newly developed protean and boundaryless career. Findings: The result suggested using a two-factor model with a protean career (combining self-directed and values-driven items) and a boundaryless career as a separate construct for college passing out students. Research limitations/implications: The developed scale has nine items that can be used to conduct surveys at the time of campus hiring by academic scholars, HR managers, and practitioners who are working on the identification, development and management of human talent as a part of any human resource management system. Originality/value: To the best of the authors' knowledge, this is the first approach to developing the protean and boundaryless career scale for college passing out students and in the Indian context which can be replicable for South Asian countries. [ABSTRACT FROM AUTHOR]

Background and Aim: In this era of the coronavirus disease (COVID) pandemic, new health issues appear quickly and cause an outbreak in India. Here, we focus on invasive fungal infections (IFA), namely mucormycosis, aspergillosis, and candidiasis. Hence, in this article, we focus on conventional techniques for early diagnosis of fungus to help clinicians start empirical treatment for the patient and take necessary steps thereby. Materials and Methods: This observational study was conducted for 1 month, from May 2021 to June 2021, on 200 patients admitted to our mucormycosis ward. Samples were first examined microscopically using potassium hydroxide (KOH) wet mounts followed by culture on sabouraud dextrose agar and the gross appearance of the growth was observed. Further identification of species was achieved through the use of lactophenol cotton blue mounts and slide culture technique. Results: Out of 200 patients, 65.5% were male and 34.5% female. We divided these patients into three age groups, i.e., 20-30 years (15%), 40-60 years (54%), and 60-80 years (31%). Seventy-four percent of patients presented with a history of diabetes mellitus, 50% had a history of steroids taken in their past, and 48% had a history of oxygen therapy taken at the time of COVID-19 positivity (52%) samples positive for mucormycosis. Forty-one percent were KOH-positive for Mucorales and 35.5% were culture positive. The most commonly isolated fungus was Rhizopus, followed by Mucor, Lichthemia, Aspergillus spp., and Candida spp. Conclusion: To improve test sensitivity and enable early diagnosis, other serum biomarkers such as galactomannan, beta-D-glucan, cryptococcal antigenemia, and blood quantitative polymerase chain reaction for Aspergillus or Mucorales should be implemented. [ABSTRACT FROM AUTHOR]

A survey was conducted in eight secondary schools located in two watersheds in Gujarat and Rajasthan (semi-arid region of India) to assess students' perceptions about groundwater scarcity issues and the impact of the scarcity on their educational opportunities. Survey responses to a detailed questionnaire by a cohort of students in both watersheds; school attendance records of year 8 class students (13-14 years old) and responses gathered via a socio-economic survey involving 500 families in the study area were used in the study. In both watersheds, >90% students identified groundwater scarcity as a major issue. Required to work at home or farm, about 65% students in Gujarat and 60% in Rajasthan missed school for up to 2 days/month; and a smaller proportion (~ 30%) missed schools for 4 or more days/month. School absenteeism was found to be linked with gender; female students missed schools more frequently than their male counterpart. The school attendance records in Rajasthan showed that the frequency of female students missing schools for 5 or more days/month was on an average 2-10 times greater than that for males. The gender difference in absenteeism in all schools was statistically significant (P < 0.018**). The study highlighted that groundwater scarcity in the study area, and consequent demand on their time for household work including fetching drinking water are contributing factors towards limiting their educational and economic opportunities. Groundwater scarcity can be one of the key factors that can limit inclusiveness and empowerment of women and need to be considered in policy-making.

Healthcare is one of the most important issues in India, but often overlooked and not discussed during election campaigns. Poor medical infrastructure, insufficient public health services, and unmet healthcare needs persist in the country. Though people do want the right, high quality, and cost-effective medical treatment when they fall sick, this is put on the backseat when they are healthy, thereby the demand and struggle for health care in the future remains un-articulated by both the people and the administration. India has a heavy disease burden especially in children under 5 years and women and of lifestyle diseases like stroke, ischemic heart disease, hypertension, diabetes and cancer, now affecting younger adults. Increased dependence on private health care result in high out of pocket expenditure and a huge economic burden. Budgetary allocation for health consistently remains low and has not achieved 2.5% of GDP as recommended under the National Health Policy 2017 and 15th Finance Commission. Improving the public healthcare infrastructure and access, as well as addressing private healthcare costs, is the need of the hour especially during formation of a new democratic order in our country. [ABSTRACT FROM AUTHOR]

Background: Repeated transfusion in sickle cell disease (SCD) and transfusion‑dependent thalassemia (TDT) patients lead to transfusion‑transmitted infections (TTIs). The prevalence, as well as various risk factors for TTIs in these patients, is found to be inconsistent. This study aimed to observe the prevalence, types of infections as well as risk factors for TTIs in a tertiary health care center. Materials and Methods: This observational study was undertaken on both SCD and TDT patients admitted to the hospital for a transfusion. In all patients, the enzyme‑linked immunosorbent assay‑based test kit was used for the diagnosis of hepatitis C virus (HCV), hepatitis B virus (HBV), and human immunodeficiency virus 1 and 2 (HIV 1 and 2). However, a rapid test kit was used for the diagnosis of malaria and syphilis. Detailed information on age of the patients, duration of transfusion, and number of transfusion as risk factors were recorded. The association of factors with various infections was analyzed statistically. Results: A total of 153 patients were recruited including 49 SCD and 104 TDT patients. Of 153 patients, 25 patients were found to have infections including HCV in 22 (14.38%) patients, HBV in 2 (1.31%) patients, and HIV in 2 patients (1 patient was positive for both HCV and HBV). Out of 25 TTIs patients, 7 patients had SCD and 18 patients had TDT. On the association, only an increased number of transfusion per year was found to be significantly associated with TTIs (P = 0.008) in SCD patients. However, all the risk factors were found to be associated with TTIs except gender in TDT patients. Conclusion: The occurrence of TTIs was found to be associated with older patients, increased number of transfusion per year, and large duration of transfusion. The increasing trend in the TTIs in these patients calls for a shift toward preventive and comprehensive care to reduce the health burden. [ABSTRACT FROM AUTHOR]

Background: Cancer is a leading health problem in India with approximately 1.1 million cases occurring each year. Cancer of the Larynx represents about 1% of the total cancer burden and accounts for 0.3% of all cancer deaths. Glottic tumors typically metastasize after they have directly invaded adjacent structures with better drainage. Glottic cancer has a high rate of cure and regardless of the modality used. Radiotherapy is generally the favoured treatment in most centers despite comparable cure rates for selected T1 and T2 glottis tumors. The present study was conducted to compare radiation induced acute and late treatment related toxicities of hypo-fractionated radiotherapy and conventional radiotherapy in early glottic cancer T1-2N0M0". Material and Methods: The study was conducted in Acharya Tulsi Regional Cancer Treatment and Research Institute, Sardar Patel Medical College, Bikaner. It was done on 50 histologically proven new cases of early glottic cancer with age <70 years. Patients were treated by radiotherapy and randomized into either of the two arms Arm A (Study) and Arm B (Control). On ARM A Hypo-fractionated radiotherapy 55Gy/20# in 2.75Gy/# in 4 weeks and on ARM B Conventional radiotherapy 66Gy/33# in 2Gy/#6.5 weeks was given. Voice quality and toxicities were graded at the end of treatment, after 1, 2, 3 and 6 months. Data was analyzed using percentage, mean, chi square test and p-value. Results: Majority of the patients were in their 6th decade of life and all patients were male. Majority of the population had ECOG Performance Score of 1. 46 (92%) of patients presented with hoarseness alone while 4 (8%) of them presented with hoarseness and dysphagia, which were comparable in both the groups. Histologically, patients had Squamous Cell carcinoma (SCC). In study vs control arm where 11 (44%) vs 5 (20%) patients were T1A, 9 (36%) vs 5 (20%) in T1B, 4 (20%) vs 10 (40%) in T2A and 1 (4%) vs 5 (20%) in T2B respectively. In the study arm 25 (100%) patients received 58.4 Gy (2GyEq) whereas in control population 15 (60%) received 66 Gy and the rest 10 (40%) received 64 Gy. All 25 (100%) patients in both arms completed treatment. At the end of treatment, only 3 (12%) patients in study arm and 5 (20%) in control arm had normal voice. At 1st month of follow up, 7 (28%) vs 9 (36%) patients, at 3rd month of follow up, 13 (52%) vs 15 (60%) patients and at 6th month follow up, 21 (84%) vs 22 (88%) patients in study and control arm respectively had normal voice. (X² = 1.026, p value = 0.599). As compared, at the end of the treatment, at 1st, 3rd and 6th months follow up, grades of skin reactions, mucositis and dysphagia reduced from 2 to 1 and later 1 to 0. Conclusions: Hypo-fractionated radiotherapy is a safe modality of treatment with high local control rates, acceptable long term toxicities, favorable voice outcomes and symptomatic relief with added advantage of shorter treatment time which offers better patient compliance. [ABSTRACT FROM AUTHOR]

Odisha has more than twenty tribal languages and imparting education to these children has had several challenges which have resulted in severe school dropouts. The study attempts to find out the possible outcomes of the language policy from the NEP 2020 of India. The researchers surveyed teachers and parents and conducted interviews with a much-acclaimed language expert from Odisha besides classroom observations. The finding summarizes that mother tongue education plays a significant role in the early childhood learning experience and subjects like Math and Science can be better understood in the mother language. The study found real issues and challenges in the implementation of Three Language Formulas, particularly in tribal-populated regions of the state. The problem of teacher inadequacy and lack of proper training may pose serious hindrances in the implementation of the language policy as envisaged by the NEP 2020. The study also found the status of English in the education system in India as the majority of the parents said that they would like their wards to take up English as their third or second language. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to empirically examine the performance of the high-ESG (environment, social and governance) portfolio vis-à-vis the low-ESG portfolio at the Indian stock market before and during the Covid19 pandemic. Design/methodology/approach: The absolute rate of return and several risk-adjusted performance measures, for instance, Sharpe ratio, Modigliani–Modigliani measure, Treynor ratio, Jensen's alpha, information ratio, Fama's decomposition measure and Fama and French's three-factor model, have been used in this study along with the t-test. Findings: All three indices (CARBONEX, GREENEX and BSE 500) had better returns during Covid19 period as compared to the pre-Covid19 period. However, these returns were not statistically significant. During Covid19, the risk of the indices also rose, but they provided better returns for the additional risk taken. Finally, it is concluded that the performance of high-ESG and low-ESG stock portfolios did not differ significantly in both periods. Practical implications: The study is relevant to individual and institutional investors, financial advisors, portfolio managers, corporations, policymakers, market regulators and society at large. Social implications: This study emphasized the need to expand the role of ESG investment in India for the benefit of people, communities and society as a whole. Originality/value: This research is the first of its kind, to the best of the authors' knowledge, that compares the performance of a high-ESG portfolio with a low-ESG portfolio both before and during the Covid19, particularly in the Indian context. [ABSTRACT FROM AUTHOR]

Information and communication technology (ICT) which includes radio, television and newer digital technology such as computers and the internet, are potentially powerful tools for extending educational opportunities, formal and non-formal, to one and all. It provides opportunities to deploy innovative teaching methodologies and interesting material that creates an interest in students. This study is to determine the critical factors that impact the effective use of ICT in management education from students' and teachers' perspective, and to identify the expectations and gaps in its use in management education. A questionnaire-based survey was conducted and the perception of various stakeholders of the importance of these factors was analyzed. The study was conducted at various management institutes across the city of Navi Mumbai. Data analysis revealed that various categories of respondents gave significantly different importance to factors relevant for the effective use of ICT. Notably, there was a significant gap between the respondents' expectations and the actual satisfaction with the current usage of ICT. The findings could be useful to any management institution which is thinking of making effective use of ICT in its curriculum. (Contains 17 tables and 1 figure.)

Microbes evolve rapidly by modifying their genomes through mutations or through the horizontal acquisition of mobile genetic elements (MGEs) linked with fitness traits such as antimicrobial resistance (AMR), virulence, and metabolic functions. We conducted a multicentric study in India and collected different clinical samples for decoding the genome sequences of bacterial pathogens associated with sepsis, urinary tract infections, and respiratory infections to understand the functional potency associated with AMR and its dynamics. Genomic analysis identified several acquired AMR genes (ARGs) that have a pathogen-specific signature. We observed that blaCTX-M-15, blaCMY-42, blaNDM-5, and aadA(2) were prevalent in Escherichia coli, and blaTEM-1B, blaOXA-232, blaNDM-1, rmtB, and rmtC were dominant in Klebsiella pneumoniae. In contrast, Pseudomonas aeruginosa and Acinetobacter baumannii harbored blaVEB, blaVIM-2, aph(3'), strA/B, blaOXA-23, aph(3') variants, and amrA, respectively. Regardless of the type of ARG, the MGEs linked with ARGs were also pathogen-specific. The sequence type of these pathogens was identified as high-risk international clones, with only a few lineages being predominant and region-specific. Whole-cell proteome analysis of extensively drug-resistant K. pneumoniae, A. baumannii, E. coli, and P. aeruginosa strains revealed differential abundances of resistance-associated proteins in the presence and absence of different classes of antibiotics. The pathogen-specific resistance signatures and differential abundance of AMR-associated proteins identified in this study should add value to AMR diagnostics and the choice of appropriate drug combinations for successful antimicrobial therapy. [ABSTRACT FROM AUTHOR]

Background: Bipolar hemiarthroplasty is the standard of care for transcervical fracture in the elderly. Stainless steel being cheaper is preferred over titanium in developing nations for implants and prostheses. This study was conducted for assessing the short-term outcomes of uncemented bipolar hemiarthroplasty done using hydroxyapatite-coated stainless steel prosthesis. Methods: Sixty-five patients, >60 year of age operated between 2018 and 2020 at tertiary care centre with stainless steel (316L) completely coated with hydroxyapatite bipolar hemiarthroplasty implants were retrospectively followed up. Radiological outcomes were assessed based on pedestal formation, stem position, radiological limb length discrepancy, sinkage of stem, spot welds and stress shielding. Clinical and functional outcomes were assessed based on mean Harris Hip score. Results: Mean Harris Hip score at baseline, 3-week follow-up, 6-week follow-up, 3-month follow-up and 1-year follow-up was 45.9 (SD 2.5), 63.2 (SD 6.5), 75.1 (SD 9.9), 83.9 (SD 9.8) and 87.1 (SD 9.9), respectively. Excellent, good, fair, poor results were seen in 32.31, 40, 18.46, 9.23 of the patients, respectively. Valgus, central and varus stem position was seen in 49.23, 40, 10.77 percent of the patients, respectively. Pedestal formation, radiological limb length discrepancy, sinkage, spot welds, stress shielding was seen in 6.15, 32.31, 3.07, 53.85, 40 percent of the patients, respectively. Conclusion: Short-term outcomes of this study provides evidence that using a more affordable fully hydroxyapatite-coated stainless steel prosthesis for uncemented bipolar hemiarthroplasty is an appropriate treatment option for the transcervical femur fracture. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis is a chronic, progressive, and degenerative condition with limited therapy options. Recently, biologic therapies have been an evolving option for the management of osteoarthritis. Purpose: To assess whether allogenic mesenchymal stromal cells (MSCs) have the potential to improve functional parameters and induce cartilage regeneration in patients with osteoarthritis. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 146 patients with grade 2 and 3 osteoarthritis were randomized to either an MSC group or placebo group with a ratio of 1:1. There were 73 patients per group who received either a single intra-articular injection of bone marrow–derived MSCs (BMMSCs; 25 million cells) or placebo, followed by 20 mg per 2 mL of hyaluronic acid under ultrasound guidance. The primary endpoint was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score. The secondary endpoints were WOMAC subscores for pain, stiffness, and physical function; the visual analog scale score for pain; and magnetic resonance imaging findings using T2 mapping and cartilage volume. Results: Overall, 65 patients from the BMMSC group and 68 patients from the placebo group completed 12-month follow-up. The BMMSC group showed significant improvements in the WOMAC total score compared with the placebo group at 6 and 12 months (percentage change: −23.64% [95% CI, −32.88 to −14.40] at 6 months and −45.60% [95% CI, −55.97 to −35.23] at 12 months P <.001; percentage change, −44.3%). BMMSCs significantly improved WOMAC pain, stiffness, and physical function subscores as well as visual analog scale scores at 6 and 12 months (P <.001). T2 mapping showed that there was no worsening of deep cartilage in the medial femorotibial compartment of the knee in the BMMSC group at 12-month follow-up, whereas in the placebo group, there was significant and gradual worsening of cartilage (P <.001). Cartilage volume did not change significantly in the BMMSC group. There were 5 adverse events that were possibly/probably related to the study drug and consisted of injection-site swelling and pain, which improved within a few days. Conclusion: In this small randomized trial, BMMSCs proved to be safe and effective for the treatment of grade 2 and 3 osteoarthritis. The intervention was simple and easy to administer, provided sustained relief of pain and stiffness, improved physical function, and prevented worsening of cartilage quality for ≥12 months. Registration: CTRI/2018/09/015785 (National Institutes of Health and Clinical Trials Registry–India). [ABSTRACT FROM AUTHOR]

Introduction: Dermatological manifestations are common manifestations of human immunodeficiency virus (HIV) disease, seen in 80% to 95% of HIV-infected patients. Dermatological manifestations are considered clinical indicators to predict and assess the underlying immune status. Aim: This study aims to document the dermatological manifestations in relation to CD4 count in people living with HIV (PLHIV). Materials and Methods: Cross-sectional study in 250 PLHIV fulfilling inclusion–exclusion criteria was conducted. Variables including sociodemographic profile, recent CD4 count (data from antiretroviral therapy center), and dermatological manifestation (physical examination) were collected. Clinical diagnosis was established, and patients were grouped according to the World Health Organization immunological staging Results: Majority of PLHIV (39.6%) were in the age group of 31–40 years. Males were affected more than females (1.6:1). A total of 364 dermatoses were observed; dermatological manifestation per patient ranged from 1 to 4. 32.80%. PLHIV had CD4 count >500 cells/mm3, 15.60% had CD4 count between 200–349 cells/mm3. Majority of dermatosis had infectious etiology (77.6%), out of which dermatophytosis (27.2%) was the most common infectious condition, whereas pruritic papular eruption was the most common (11.6%) noninfectious condition. A statistically significant association of CD4 count was found with dermatophytosis (P ≤ 0.001) and candidiasis (P = 0.001). Conclusion: The study showed a significant association between the number of dermatological manifestation and CD4 count as majority of study participants (67.2%) had CD4 <500 cells/mm3 at the time of episode of dermatosis. [ABSTRACT FROM AUTHOR]

Due to privatization of higher education in India, there has been an emergence of sub-standard schools throughout the country. The higher education system in teaching institutes lacks incentives to perform; there is no reward for the meritorious and no way to ease out the non-performers. The quality of teaching and research cannot be evaluated because there is no accountability. The reason for these changes, apart from the corruption in the education sector, is also attributable to the degradation of the position of chair. The respectable position of a dean in most private Indian schools has been reduced to that of merely a puppet in the hands of the management. Deans have been given no power to maintain the standard or quality of education. Higher education in India is gasping for breath, at a time when India is aiming to be an important player in the emerging knowledge economy. The maladies and deficiencies in India's higher education system need to be addressed urgently by making the deanship more professional and creative and less bureaucratic and political. The dean of a school plays a key role in the learning process, both in academic and extracurricular capacities. It is an obligatory and moral duty of a dean to maintain academic integrity and promote a strategy for strengthening the quality of graduate and postdoctoral education across the schools. The degradation of the position of the dean must be reversed. People in the position must realize their duties towards the students, the nation and the next generation. The authors contend that the dean will have a crucial role to play if higher education in India is to progress and get out of the present mess.

COVID-19 vaccination campaigns have been launched across the globe to mitigate the impact of the COVID-19 disease. However, COVID-19 vaccination campaigns (Vaccination campaigns are the complete process of COVID-19 vaccination campaigns beyond just administrating vaccines.) are a complex multi-stakeholder process, and therefore, it is important to understand the key components and drivers of vaccination campaigns to help devise strategies to increase vaccination coverage for existing and future vaccination efforts. A system dynamics modeling approach was used to trace the vaccination campaign for the Indian state of Madhya Pradesh. The results identified the key stakeholders of the vaccination campaign and their inter-linkages, and the diverse perspectives of stakeholders of vaccination campaigns in Madhya Pradesh were collated in a structured format. Further, system dynamics models were developed to capture all aspects of the vaccination campaign in Madhya Pradesh, including the challenges and innovations. The outcomes of the study can assist academicians, practitioners, and policymakers develop vaccination programs at sub-national, national, and global levels. They will guide decision-makers to take preemptive measures to mitigate possible risks and challenges and provide improved services as part of vaccination campaigns. [ABSTRACT FROM AUTHOR]

The global malaria control and elimination program faces major threats due to the emergence and transmission of the anti-malarial drug-resistant strain of Plasmodium falciparum. Monitoring of artemisinin (ART) resistance marker Kelch-13 in the malaria-endemic region is essential in mitigating the disease's morbidity and mortality. The current study aimed to generate baseline information for further surveillance in the future. The current research was designed and conducted from July 2019 to June 2021 to monitor Pfkelch13 mutation at the molecular level in the eastern region of India. We also conducted an in silico study to understand the drug-protein interactions between ART and the protein crystal of PfKelch13 (KELCH) with PDB id:4ZGC. The kelch-13 gene was amplified by nested polymerase chain reaction (PCR) and sequenced through the Sanger sequencing method. Reference 3D7 clone (PF3D7_1343700) was used to align and probe all the sequences. The sequence analysis showed the absence of validated or associated mutation in the Kelch-13 propeller domain. The absence of natural selection in drug resistance was confirmed by the Tajima test. Further, in silico interaction studies between the drug ART and the Kelch propeller domain of P. falciparum were evaluated by structure predictions, molecular docking, molecular dynamics (MD) simulations, and estimations of binding free energies for the KELCH-ART complex. The results were compared with the apoprotein (KELCH-APO). The study confirmed the favorable binding of ART with the Kelch-13 propeller domain. [ABSTRACT FROM AUTHOR]

The need to enhance the relevance and quality of pre- and in-service teacher education in India has long been recognised in official commentaries. Despite the structural innovation of District Institutes of Education and Training to enhance systemic responsiveness to local contexts, training messages mediated through DIETs are largely not having the expected impact on classroom processes. Using qualitative data generated from six case study sites, this paper examines in-service training in DIETs and how they have responded to teacher development challenges. It finds that formal teacher education continues to have low "ecological validity", and highlights tensions in the recruitment and technical expertise of DIET staff, and in their attitudes towards elementary teachers, that constrain engagement with local contexts. The paper then considers several aspects of elementary teachers' local knowledge which underline the need for a review of the dominant "skills and knowledge" approach to teacher development pursued by DIETs. It argues that training must shift its focus from skills to an engagement with the pressing question of teachers' will to adopt training messages in current contexts. The paper closes with discussions of how teachers' professional agency can be promoted, and further considerations of how teacher education can be strengthened in pursuit of quality in a context of decentralisation.

The article focuses on the medical community's reaction to the recent violent attack on a healthcare professional and the broader issue of systemic corruption impacting the field. Topics include the need for doctors to leverage their extensive training to address root causes of such violence, the challenges faced by the medical community in mobilizing effective responses, and the underlying issues of lack of cohesion and proactive problem-solving within the profession.

Background: The aim of this study is to examine the effects of four different bioclimatic predictors (current, 2050, 2070, and 2090 under Shared Socioeconomic Pathways SSP2-4.5) and non-bioclimatic variables (soil, habitat heterogeneity index, land use, slope, and aspect) on the habitat suitability and niche dimensions of the critically endangered plant species Commiphora wightii in India. We also evaluate how niche modelling affects its extent of occurrence (EOO) and area of occupancy (AOO). Results: The area under the receiver operating curve (AUC) values produced by the maximum entropy (Maxent) under various bioclimatic time frames were more than 0.94, indicating excellent model accuracy. Non-bioclimatic characteristics, with the exception of terrain slope and aspect, decreased the accuracy of our model. Additionally, Maxent accuracy was the lowest across all combinations of bioclimatic and non-bioclimatic variables (AUC = 0.75 to 0.78). With current, 2050, and 2070 bioclimatic projections, our modelling revealed the significance of water availability parameters (BC-12 to BC-19, i.e. annual and seasonal precipitation as well as precipitation of wettest, driest, and coldest months and quarters) on habitat suitability for this species. However, with 2090 projection, energy variables such as mean temperature of wettest quarter (BC-8) and isothermality (BC-3) were identified as governing factors. Excessive salt, rooting conditions, land use type (grassland), characteristics of the plant community, and slope were also noticed to have an impact on this species. Through distribution modelling of this species in both its native (western India) and exotic (North-east, Central Part of India, as well as northern and eastern Ghat) habitats, we were also able to simulate both its fundamental niche and its realized niche. Our EOO and AOO analysis reflects the possibility of many new areas in India where this species can be planted and grown. Conclusion: According to the calculated area under the various suitability classes, we can conclude that C. wightii's potentially suitable bioclimatic distribution under the optimum and moderate classes would increase under all future bioclimatic scenarios (2090 > 2050 ≈ current), with the exception of 2070, demonstrating that there are more suitable habitats available for C. wightii artificial cultivation and will be available for future bioclimatic projections of 2050 and 2090. Predictive sites indicated that this species also favours various types of landforms outside rocky environments, such as sand dunes, sandy plains, young alluvial plains, saline areas, and so on. Our research also revealed crucial information regarding the community dispersion variable, notably the coefficient of variation that, when bioclimatic + non-bioclimatic variables were coupled, disguised the effects of bioclimatic factors across all time frames. [ABSTRACT FROM AUTHOR]

There is a paucity of literature on the association of α+-thalassemia, sickle-cell hemoglobin disorders, and malaria in India. This study aimed to understand the effect of α+-thalassemia on the severity of Plasmodium falciparum malaria in adults with respect to sickle-cell genotypes. The study subjects were categorized into 'severe-malaria' and 'uncomplicated-malaria' and age-gender matched 'control' groups. Sickle-cell and α+-thalassemia were investigated in all the recruited subjects. The effect of α+-thalassemia on the severity of malaria was analyzed in HbAA and sickle-cell genotypes (HbAS and HbSS) separately. The prevalence of α+-thalassemia in various groups ranged from 41.5% to 81.8%. The prevalence of α+-thalassemia was lower (OR = 1.64; p = 0.0013) in severe malaria (41.5%) as compared to healthy controls (53.8%) with HbAA genotype. In contrast, in HbAS genotype, the prevalence of α+-thalassemia was higher (OR = 4.11; p = 0.0002) in severe malaria (81.8%) compared to controls (52.2%). In severe malaria with HbAA genotype, there was a significantly higher hemoglobin level and low MCV and MCH level in patients with α+-thalassemia compared to the normal α-globin genotype. Further, the incidence of cerebral malaria, hepatopathy, and mortality was lower in patients (HbAA) with α+-thalassemia as compared to normal α-globin genotype (HbAA). In severe malaria with either HbAS or HbSS genotype, only a few parameters showed statistical differences with respect to α+-thalassemia. Low prevalence of α+-thalassemia in severe malaria with HbAA genotype compared to healthy controls with HbAA genotype indicates the protective effect of α+-thalassemia against severe malaria. However, the high prevalence of α+-thalassemia in patients with HbAS genotype depicts its interference in the protective effect of sickle-cell against severe malaria. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) is a communicable disease that is a major cause of ill health and one of the leading causes of death worldwide. Monocytes are professional phagocytes that are highly skilled in defence against many pathogens, including MTB.4 They circulate in the blood and can differentiate into monocyte-derived macrophages and monocyte-derived dendritic cells that govern innate and adaptive immune responses and Lymphocytes (L) provide resistance to the spread of infection causing mycobacterial clearance. Aim & Objectives: To assess the monocyte lymphocyte ratio (M/L ratio) as a possible prognostic biomarker to see the outcome of Anti Tuberculous Therapy in terms of sputum status in active TB cases. Material & Methods: The present study was a Prospective observational study. This study was conducted from Feb 2021 and July 2022 at Department of respiratory medicine, Kamla Nehru Chest Hospital, Dr S N Medical College Jodhpur, a tertiary care Centre for respiratory diseases, Rajasthan, India. 130 patients were included in this study. Result: In our study, 7 (5.4%) patients had COPD, 23 (17.7%) patients had HTN and 18 (13.8%) patients had T2DM. The value of z is 9.8029. The value of p is < .00001. The result is significant at p <.05. In our study, 130 (100.0%) patients had Sputum Status at 0 month. In our study, 117 (90.0%) patients had Sputum conversion at 2nd month. The value of z is 12.8996. The value of p is < .00001. The result is significant at p <.05. The mean Monocytes at 0 Month of patients was [5.0769± 1.2519], mean Lymphocytes at 0 Month of patients was [17.7392± 4.3696], mean M/L ratio at 0 Month of patients was [.3057± .1206], mean Monocytes at 2nd Month of patients was [4.4862± 1.1302] and mean M/L ratio at 2nd Month of patients was [.2389± .0821]. Conclusion: Tuberculosis ss associated with Increased M/L Ratio, which Declines and Returns to Normal with Anti-Tuberculous Therapy. [ABSTRACT FROM AUTHOR]

Introduction: A pleural effusion is accumulation of excessive fluid in the pleural space due to an imbalance between the production and absorption of pleural fluid by pleurae (visceral as well as parietal). Pleural effusion is a common clinical manifestation and about 3000 per Million people in the world suffers from pleural disease. Aims: To assess usefulness of ratio of serum LDH to Pleural Fluid ADA in differentiating Malignant Pleural Effusion and Tubercular Pleural Effusion. Materials and Methods: The study was a Descriptive Observational Crosssectional study was conducted in Department of Respiratory Medicine, Kamala Nehru Chest Hospital, Dr S N Medical College Jodhpur (Rajasthan), and a tertiary care centre for Respiratory Disease in Rajasthan, India after getting clearance from the Ethical committee. Result: found that most patients with tubercular pleural effusion (n=20) had Pleural Fluid ADA levels >35 and majority of the patients had Biopsy proven Malignant pleural effusion [22 (44.0%)] and it was statistically significant (p< .00001), (z=4.1036). Conclusion: We found that, most number of patients had Tubercular Pleural Effusion. It was statistically significant and majority of the patients had Biopsy proven malignant pleural effusion and it was statistically significant. [ABSTRACT FROM AUTHOR]

Background: Chest X-ray plays a vital role in diagnosis of tuberculosis (TB) in HIV infection. These patients present with variable chest radiographic presentation, making diagnosis and treatment of TB notoriously challenging and increasing the risk of treatment failure, relapse, and even death. Aims: The objective of this study was to identify various radiological patterns of TB in HIV-TB-co-infected patients and to correlate with CD4 count. Setting and Design: This was an analytical cross-sectional study conducted in a tertiary care center in the southern part of Rajasthan, India. Materials and Methods: In our study, 110 consecutive patients with pulmonary TB-HIV co-infection were subjected to chest radiographs and evaluated for the types of lesion/TB; anatomical distribution, and type of radiological shadows. The findings were correlated with CD4 counts and sputum acid-fast bacilli (AFB) status. The main outcome measures were radiological shadows and their correlation with level of immune suppression. The sample size was 110 patients. Results: Patients of Group I (CD4 <200) had significantly more involvement of mid and lower zones than Group II (CD4 >200). Nodular shadow (54.1% vs. 46.9%), consolidation (28.4% vs. 25.0%), hilar lymphadenopathy (23.0% vs. 9.4%), and miliary shadow (9.5% vs. 3.1%) in Group I, while cavitation (25.0% vs. 20.3%) and pleural effusion (18.8% vs. 16.2%) were more frequent in Group II. In Group I, consolidation (44.8% vs. 17.8%, P = 0.012) while in Group II, both consolidation (46.2% vs. 10.5%, P = 0.038) and cavitation (46.2% vs. 10.5%, P = 0.038) were present in significantly higher proportion in AFB-positive cases. Conclusion: A wide spectrum of radiographic shadows in consonance with varying CD4 counts was observed in the study. Along with well-known atypical radiological findings, some features were present throughout spectrum of CD4 counts, indicating that TB should be considered in this group of patients with these radiographic presentations, regardless of CD4 count. The small study population, majority of the patients' already hospitalized indicating serious nature of illness. In addition, no prospective follow-up of the study population to identify over the time changes in radiological pattern. [ABSTRACT FROM AUTHOR]

The rocks of the Aravalli Protocontinent of NW India are enriched in lead–zinc bearing deposits amongst which the Zawar mineralized belt is one of the famous for base metal deposits and was mined since ancient times. In the present study, an attempt has been made to identify and map the extension of the mineralized belt and base metal prognostic zones using the integration of multi-sensor remote sensing, geological and geochemical data. Remote Sensing studies were carried out using ASTER, AVIRIS-NG, and ASAR datasets to understand the extension and associated structural features of host rocks (dolomite in the present case) of lead–zinc mineralization from the Middle Aravalli Group. Relative band depth (B6 + B9/B8) was used to delineate the dolomite of the region using the ASTER imagery. Mineral map was derived using the AVIRIS-NG dataset with the help of the MTMF algorithm. Multifrequency and multipolarization ASAR datasets demarcated the structural features in the complexly deformed rocks of the extended belt. The obtained results from remote sensing were validated with the help of geological and geochemical studies. Geological studies (field surveys and petrographic studies) confirmed the presence of dolomites and associative mafics. Mineralogical, major oxides and trace elements data further substantiated the presence of dolomite, associated sulfides such as galena, sphalerite, pyrite, and chalcopyrite, and lead, zinc and copper in the Zawar–Dungarpur Belt. Presence of chromium and nickel were observed through the trace element studies of dolomite belt. The trace elements interpolated maps were superimposed by traced structural maps using ASAR datasets. The densely populated E-W lineaments are considered the suitable zones for base metal accumulation. These lineaments carried the base metal bearing fluid along with a low concentration of Chromium and Nickel. Under the finding of this study, the northern head of Hati Magra and near Keekawat are the suitable zones for Pb–Zn sulfide mineralization. [ABSTRACT FROM AUTHOR]

The present study focusses on the estimation of ET using Mapping Evapotranspiration at high Resolution with Internalized Calibration (METRIC) model over the Sal (Shorea robusta Gaertn.f) forest in the subtropical Doon Valley, India for the dry periods of 2016–18. Parameterization of METRIC model was done for surface temperature (Ts), momentum roughness length (zom), and surface albedo (α) estimations to make it suitable for Forest ET assessment. Results showed good agreement between the daily ET derived from the METRIC model and observed ET by eddy covariance method at Barkot Flux Tower (BFT) site. Results of parameterized METRIC model showed improvement over non-parameterized model with higher coefficient of determination (0.81), Nash Sutcliffe Efficiency (0.71) and lower Root Mean Square Error (0.48 mm). Average ET for the Sal forest ranged from 1.18-4.78 mm/day. Monthly and seasonal ET was derived using cubic spline interpolation-based time integration of reference ET fraction (ETrF). [ABSTRACT FROM AUTHOR]

Background: Brucellosis is the most common zoonotic disease caused by Gram-negative coccobacillus belonging to genus Brucella. It is a recognized public health problem in developing countries including India. Aims and Objectives: The aims of these study were to determine the seroprevalance of brucellosis in population having occupation dealing with animals and thus are in close contact of animals. Materials and Methods: The study was conducted in semi-urban areas of central India. Blood samples were collected from personnel working in slaughter houses, meat shops, and veterinarians and their close contact and who are willing to participate in study. A total 102 samples collected randomly from butchers (n=20), veterinarians (n=29), and animal handlers (n=53) and were tested for Brucella abortus and Brucella melitensis by a commercial kit which allows the detection of both complete (IgG and IGM) and incomplete antibodies. Results: A total 102 subjects were included in the study and overall prevalence of brucellosis among high-risk group was found to be 2.9%. One veterinarian doctor was also found positive for both B. melitensis and B. abortus. Highest prevalence of brucellosis was found in veterinarians (6.8%) followed by animal handlers (1.8%), and none of the butcher was tested positive for any of the Brucella antibody. Conclusion: The present study screened all possible known high-risk groups for brucellosis and revealed that veterinarians have high chances of getting the infection. Occupation-related disease like brucellosis needs regular surveillance and integration into control and prevention program at a local and national level. [ABSTRACT FROM AUTHOR]

Background: The global expansion of antibiotic-resistant bacteria is a serious concern and is increasing worldwide in both pathogenic and commensal bacteria. The study determined the correlation between individual child-level antibiotic consumption and antibiotic resistance among the commensal Escherichia coli (E.coli) in a cohort of 125 children in rural Ujjain, India. Methods: During a two-year period between August 2014 and September 2016, stool samples were collected at seven-time points from a cohort of 125 children; aged 1– 3. A total of six colonies of E.coli per stool sample were collected for antibiotic susceptibility testing. Antibiotic consumption data was collected during the healthcare-seeking follow–up done during the same period. At each of the seven-time points correlation between antibiotic consumption (Defined Daily Dose-DDD/100 patient-days) and antibiotic resistance (number of resistant isolates) was analyzed independently using the Spearman correlation coefficient. Further, mixed-effects logistic regression models were built to study correlation between child-level consumption of penicillin with the number of E.coli isolates resistant to ampicillin, consumption of cephalosporin with resistance to cefotaxime and ceftazidime, consumption of fluoroquinolones with resistance to nalidixic acid and consumption of cotrimoxazole with resistance to cotrimoxazole. Results: Out of 756 illness episodes reported in 125 children 42% were with antibiotic prescriptions and reported a total antibiotic consumption of 55DDD/100 patient-days. The most common antibiotics used were cefixime (J01DD08;72 DDD/100patient/days) followed by ofloxacin (J01MA01;51DDD/100patient-days), cefpodoxime (J01DD13;38DDD/100patient-days) and amoxicillin (J01CA04;28DDD/100patient-days). The highest percentage of resistance was found to the ampicillin (67%) followed by nalidixic acid (52%) and cefotaxime (44%) and when summarized, more than 90% were resistant to cefotaxime, ceftazidime, and co-trimoxazole in commensal E.coli isolates. The consumption of cephalosporins showed weak positive correlation with the resistance to cefotaxime (Coefficient±SE=0.13 ± 0.09,p< 0.001). Conclusion: Our findings showed no correlation between individual-level antibiotic consumption and resistance development in commensal E.coli in a rural community environment. [ABSTRACT FROM AUTHOR]

Outcome prediction for individual patient groups is of paramount importance in terms of selection of appropriate therapeutic options, risk communication to patients and families, and allocating resource through optimum triage. This has become even more necessary in the context of the current COVID-19 pandemic. Widening the spectrum of predictor variables by including radiological parameters alongside the usually utilized demographic, clinical and biochemical ones can facilitate building a comprehensive prediction model. Automation has the potential to build such models with applications to time-critical environments so that a clinician will be able to utilize the model outcomes in real-time decision making at bedside. We show that amalgamation of computed tomogram (CT) data with clinical parameters (CP) in generating a Machine Learning model from 302 COVID-19 patients presenting to an acute care hospital in India could prognosticate the need for invasive mechanical ventilation. Models developed from CP alone, CP and radiologist derived CT severity score and CP with automated lesion-to-lung ratio had AUC of 0.87 (95% CI 0.85–0.88), 0.89 (95% CI 0.87–0.91), and 0.91 (95% CI 0.89–0.93), respectively. We show that an operating point on the ROC can be chosen to aid clinicians in risk characterization according to the resource availability and ethical considerations. This approach can be deployed in more general settings, with appropriate calibrations, to predict outcomes of severe COVID-19 patients effectively. [ABSTRACT FROM AUTHOR]

In the dryland areas watershed development is one of the major programs of the Government of India. Ever since its initiation (1981), large tracts of degraded lands are treated through this approach. Remote sensing (RS) is a tool that has been successfully applied to capture groundwater potentials in different regions and geological units. In this study RS & GIS tools are applied to correlate groundwater potentials with various geological controls and watershed development activities at Anjeni watershed, Udaipur district, Rajasthan, India. In the study reference periods taken are year 2013 (pre-project) and 2016 (post-project). A hydro-geomorphological approach integrating remote sensing applications, field investigations, geological and hydrological studies were undertaken to delineate and study the groundwater potential along with recharge dynamics before and after intervention situation. Thematic maps were prepared through linking the RS data with morphometric characteristics, topographic analysis, land use/cover assessment and groundwater conditions. Geographical Information System (GIS) was used to integrate all the contributing factors like lithology, geomorphology, LU/LC, lineaments, drainage, and slope with the help of weighted overlay analysis. Merging the characteristics of groundwater potential, hydro-geomorphology, geology, water harvesting structures, morphometric analysis, lineament density studies, and water balance elements provide an effective approach for the delineation of potential sites for groundwater. This integrated approach has successfully captured the changes that occurred in groundwater situation of the Anjeni watershed in form of poor to very high groundwater potential zones. It establishes the importance of application of RS-GIS in flagship development program of the watershed management. [ABSTRACT FROM AUTHOR]

Pollination and pollinators are major keys in the working of almost all terrestrial ecosystems. Bumblebees are the key pollinators belonging to the family Apidae. Their large and fuzzy body makes them more efficient pollinators than any other bee. Because of their thermoregulatory abilities, they can efficiently and effectively work in the cold climate of the Himalayan region. This study is conducted in the Dehradun valley of Uttarakhand, India, which is situated in the foothills of the Shiwalik hills of Himalaya. It is a preliminary study of the foraging behavior of bumblebees in this region, and it is observed that they mainly forage on species of the families Asteraceae, Verbenaceae, Tropaeolaceae, Solanaceae and Bignoneaceae. [ABSTRACT FROM AUTHOR]

Antibiotic resistance is a naturally occurring phenomenon, but the misuse and overuse of antibiotics is accelerating the process. This study aimed to quantify and compare antibiotic use before, during, and after seeking outpatient care for acute febrile illness in Ujjain, India. Data were collected through interviews with patients/patient attendants. The prevalence and choice of antibiotics is described by the WHO AWaRe categories and Anatomical Therapeutic Chemical classes, comparing between age groups. Units of measurement include courses, encounters, and Defined Daily Doses (DDDs). The antibiotic prescription during the outpatient visit was also described in relation to the patients' presumptive diagnosis. Of 1000 included patients, 31.1% (n = 311) received one antibiotic course, 8.1% (n = 81) two, 1.3% (n = 13) three, 0.4% (n = 4) four, 0.1% (n = 1) five, and the remaining 59.0% (n = 590) received no antibiotics. The leading contributors to the total antibiotic volume in the DDDs were macrolides (30.3%), combinations of penicillins, including β-lactamase inhibitors (18.8%), tetracyclines (14.8%), fluoroquinolones (14.6%), and third-generation cephalosporins (13.7%). 'Watch' antibiotics accounted for 72.3%, 52.7%, and 64.0% of encounters before, during, and after the outpatient visit, respectively. Acute viral illness accounted for almost half of the total DDDs at the outpatient visit (642.1/1425.3, 45.1%), for which the macrolide antibiotic azithromycin was the most frequently prescribed antibiotic (261.3/642.1, 40.7%). [ABSTRACT FROM AUTHOR]

The COVID-19 lockdown has led all the citizens (mobile subscribers) of India to stay at home and rather work from home. The people have started consuming more channel utilization (in mobile communication) through a continuous long duration conversations and more internet data through more streaming content as well as logging on to work from home. It was also reflected in how data demand from residential areas rose as compared to commercial areas. Consequently the bandwidth and channel saturation has evolved out to be a severe problem thereby affecting the work performance of all online offices and multi-national companies. This research paper proposes the simulation based experimental study of DITMC technique for mitigating this effect with a special concern in North Western Rajasthan part of India. The simulation results show that significant enhancement of 60.52% in channel utilization and bandwidth optimization is possible with negligible overhead of 0.23%. This technique also enables the telecom operators to ponder research in this field that will promisingly lead to manage augmented number of mobile subscribers (independent of any lockdown period) in limited bandwidth thereby using the spectrum efficiently. [ABSTRACT FROM AUTHOR]

Background: The Government of India launched the Ayushman Bharat (AB) program in 2018 which aims to transform 150,000 existing Sub Health Centres and Primary Health Centres into Ayushman Bharat Health and Wellness Centres (HWCs). In this study, we assessed health system readiness for establishment of HWCs. Methods: The assessment comprised of a cross sectional facility assessment and a knowledge assessment of community health officers (CHOs) and female multipurpose health workers also known as auxiliary nurse midwives (ANMs), in 26 HWCs in one community development block of Punjab state. HWCs were assessed for key input and process parameters such as a human resource, physical infrastructure, supplies, capacity building etc., and processes including health promotion, community participation, digitization of management information system, and service delivery. Results: It was observed that only 7 of the 26 HWCs had all human resources as per guidelines. The median knowledge score of CHOs and ANMs was 54% and 51% respectively. 11 of the 26 HWCs were co-located with Zila Parishad SHCs. Out of the 15 standalone HWCs, while 9 had independent buildings, 5 were located in buildings of other community level institutions. 50 percent of the HWCs were not able to perform diabetes screening due to lack of glucometers or testing supplies. While services for non-communicable diseases were available, a two-way referral tracking system for patients was missing. The mean job satisfaction rated by the newly appointed CHOs was 3.12 on a scale of 1 to 5, where 5 represented very high job satisfaction. Conclusion: The operationalization of HWCs requires State and local level interventions for strengthening of existing physical infrastructure, ensuring a regular supply of medicines and consumables, development of referral mechanisms for patients and enhancing community participation. [ABSTRACT FROM AUTHOR]

Metals including lead (Pb), aluminum (Al), and zinc (Zn) are widely used in factories such as welding, handicrafts, and paint. Occupational exposure to such metals causes a wide range of biological effects, depending upon the metal levels and duration of exposure. Accumulation of these metals may lead to several adverse health effects such as neurodegenerative diseases and cancer. The study aimed to evaluate Pb, Al, and Zn levels in occupationally exposed workers of North-Western India and create awareness about its toxicity and adverse outcomes. The study included 120 factory workers (exposed) and 100 healthy controls (nonexposed); age ranged 18–78 years. Blood Pb and serum Al was estimated by graphite furnace atomic absorption spectrophotometry and serum Zn was estimated by flame atomic absorption spectrophotometry (ICE 3000, Thermo Fisher Scientific). Results indicated significantly higher levels of Pb, Al, and Zn in the exposed than the nonexposed. No significant difference was observed in metal levels, based on age and duration of exposure. Painters showed higher blood Pb, whereas welders were found to have higher serum Al and Zn levels. To conclude, workers showed higher levels of metals and it may cause deleterious effects on the health of workers occupationally exposed to these metals. Appropriate maintenance regarding worker's safety and hygiene is required to protect them from the harmful effects of these toxic metals. [ABSTRACT FROM AUTHOR]

Background: The existing treatments for Parkinson's disease (PD) were associated with side effects and do not offer a complete cure. Hence, there is a need for an alternative therapy that can prevent or delay the onset of PD with less or no side effects. Our extensive review of literature has shown no studies to be existing so far in India regarding vestibular stimulation as a treatment method for PD. Aims and Objectives: The present study was undertaken to administer electrical vestibular nerve stimulation (VeNs) as an adjunct therapy in the management of motor functions and to improve the quality of life in PD patients. Materials and Methods: The present study was a randomized controlled trial. (ClinicalTrials. gov Identifier: NCT04450550). 30 cases of PD, of both genders, were part of the study by convenient sampling after obtaining written informed consent. Patients were recruited from the out-patient ward of the General Medicine department, R.D. Gardi Medical College. Motor activities were assessed using the Berg balance scale, strength procedures by hand dynamometer and hand-eye coordination by 100 pin dexterity test. Quality of life was assessed by the World Health Organization Quality of Life Brief. Results: The study results support the earlier studies as there was a significant improvement in the motor functions and quality of life of the study participants. Conclusion: The study recommends further detailed studies with higher sample size and involving many centers to recommend the use of electrical VeNs as adjunctive therapy in the management of PD. [ABSTRACT FROM AUTHOR]

Huge quantum of agricultural crop residue from agrarian economies like India is disposed of improperly by open land burning contributing to particulate and gaseous pollutants thereby severely impacting the environment and human health. There is an overwhelming need for sustainable utilization of this misplaced resource as feedstock in biofuel production through anaerobic digestion. Substrate composition influences the digestibility of the substrate and underlying microbial plasticity involved in anaerobic digestion. In this study, anaerobic inoculum was subjected to enrichment in the presence of agricultural residues with different lignin content whose influence on biogas production, and differential modulation/ reorganization of microbial communities was explored. BMP assay emphasized the inverse proportionality between lignin content and biogas yield, with highest biogas yield of 622 mL/g VS added in case of rice straw (lowest lignin, 16.9%), followed by wheat straw—556 mL/g VS (18.12% lignin), sugar cane leaves—451 mL/g VS (21.87% lignin), and lowest biogas yield of 411 mL/g VS added in case of cotton crop waste (highest lignin, 23.97%). Biogas production efficiency was correlated with the selection and shift of microbial communities to key hemicellulolytic (Bacteroides, Clostridium, Prevotella, Thermotoga, Cytophaga) and lignocellulolytic (Bacillus, Geobacter, Flavobacterium, Spirochaeta, Klebsiella, Escherichia, Pseudomonas, Burkholderia) genotypes in comparison to initial anaerobic inoculum. Study highlighted that the variable lignin content resulted in genomic reorganization and created a scenario for high biogas production by selectively enriching different methanogenic pathways such as hydrogenotrophic pathways in rice straw metagenome (lowest lignin) and acetoclastic pathways in cotton crop waste metagenome (highest lignin). [ABSTRACT FROM AUTHOR]

Introduction: Early diagnosis of sepsis and its severity is essential for appropriate treatment to improve patient survival, especially in resource-limited settings. The aim of the present study was to study the role of red blood cell distribution (RDW) as a biomarker for the early detection of severe sepsis defined clinically and also in the prediction of mortality from sepsis. Methods: The cross-sectional study included a total of 175 subjects who met the inclusion criteria for the diagnosis of severe sepsis. After a thorough clinical examination, blood samples were taken from all patients within 3 hours of presenting the disease. The RDW values and other investigations were studied on the day of admission compared to other severity markers with the mortality index of 30 days. Result: The RDW value was significantly higher in patients with severe sepsis and in non-survivor patients than in survivors (P <.0001). There was a strong correlation between the SOFA score and RDW in predicting the disease outcome with the Pearson correlation coefficient of r =.46. The area under the receiver operating characteristic curve was found to be 0.852 at a CI of 95% (0.796-0.909) with RDW 17.15, sensitivity was 88.6% and specificity was 63.5%. There was a positive correlation with Pearson's correlation coefficient of r =.46 between RDW and the SOFA score. Conclusions: RDW can be used as a potential marker for the early detection of severe sepsis and in the prediction of the outcome. Large multicenter prospective studies can confirm the utility of this routinely available marker for patients with sepsis. [ABSTRACT FROM AUTHOR]

Introduction: Chronic low back pain (CLBP) is two and a half times more prevalent in the working population than in nonworking population. The 1-year prevalence of low back pain (LBP) in working population ranges from 23% to 38%. However, the 1-year prevalence in computer professionals was found to be 31%-54%. Studies have demonstrated the vast mental and physiological health advantages associated with yoga. Objective: We planned to investigate the effect of yoga and mindfulness meditation in computer users with CLBP. Methods: Eighty computer users (42.6 ± 8.45 years of age; suffering from CLBP for 5.20 ± 3.01 years; 51 males and 29 females) were recruited from Bengaluru, Karnataka, India. Subjects were randomized into two groups; yoga and mindfulness meditation/YM group (n = 40) and physical exercise/PE group (n = 40). YM group practiced an integrated module comprising yoga practices and mindfulness meditation, while PE group practiced physical exercises designed for LBP (1 h per day, 3 days per week for 16 weeks). Assessments were done at baseline, after 8 weeks, and after 16 weeks. Results: Seventy-seven participants (39 in YM and 38 in PE) completed the study. Oswestry Disability Index (ODI) scores and Numerical Rating Scale (NRS) scores decreased significantly, and the Sit and Reach Test (SRT) scores improved significantly in both groups after intervention (p < 0.001). Between-group analyses demonstrated that there was a significant difference in ODI scores (YM = 7.28 ± 5.68, PE = 15.53 ± 8.13, P < 0.001), NRS scores (YM = 1.00 ± 0.89, PE = 1.82 ± 0.73, P < 0.001), and SRT scores (YM = 26.41 ± 5.03, PE = 22.82 ± 4.96, P = 0.002) between the YM group and PE group at 16 weeks, favoring the YM group. Conclusion: A 16-week yoga & mindfulness meditation program appeared to be effective in reducing pain and functional disability, and in improving spinal flexibility in computer users with CLBP. [ABSTRACT FROM AUTHOR]

In most countries, the efforts to attract and retain health workers have been focused on extrinsic measures of motivation, with very less focus on a better understanding of job satisfaction—an important intrinsic factor and construct. The main aim of this study was to assess job satisfaction, its seven dimensions, and motivation among health service providers (doctors and nurses) employed within the public sector in India. The study was conducted in three districts representing two states in India. The study participants represent the doctors and nurses from public health and service delivery centres. Data were collected from a total of 307 healthcare providers (152 doctors and 157 nurses). 'Measure job satisfaction' tool was adapted that contained 41 items capturing seven dimensions of job satisfaction on a five-point Likert scale with a higher score indicating a higher level of job satisfaction and vice versa. In addition, one single statement was used to assess motivation. Average scores were calculated for each of the seven dimensions of job satisfaction, motivation and for overall job satisfaction. Parametric tests such as t -test and analysis of variance (ANOVA) were used for comparisons of job satisfaction scores according to the place of work, years of work experience, appointment type and health professional categories. The statistical analysis was carried out using SPSS version 22.0. Exploratory factor analysis was carried out to assess the relationship between job satisfaction and motivation and regression analysis of motivation was carried to assess predictors of job satisfaction, demographic and work-related factors' effect on motivation. The average scores for most of the dimensions of job satisfaction were low for both doctors and nurses with the lowest scores reported for the dimensions of 'professional support' and 'personal satisfaction' while the highest score reported for 'satisfaction with pay'. Significant results in the difference of mean scores were found for all seven dimensions of job satisfaction except for 'prospects' at different levels of place of work, 'standard of care' at different levels of length of service and 'training' for different levels of types of appointment. The mean scores of motivation were found to be significantly different for different levels of place of work and also between the doctors and nurses. The regression analysis of motivation on various predictors of job satisfaction suggests that personal satisfaction and satisfaction in prospect were highly significant while other variables such as gender and place of posting were marginally significant. Understanding of job satisfaction can provide useful insights to both extrinsic as well as intrinsic aspects of work motivation, which arguably is the most critical area of health systems research that could potentially feed into streamlined and improved health workforce management policies aimed at addressing the shortage and retention of the health workforce. [ABSTRACT FROM AUTHOR]

The Government of India initiated the Beti Bachao Beti Padhao (B3P) programme in 2015 as a flagship initiative to reduce gender imbalance in sex ratio at birth (SRB) and to ensure social protection of girls. The present study was conducted to evaluate the medium-term impact of B3P implementation in Haryana state, from 2015 to 2019, on SRB. Monthly data on SRB were collected for the entire state of Haryana through a civil registration system. Segmented time series regression analysis was used to estimate the variations in SRB after the B3P programme with the help of Winter's additive interrupted time series model. The SRB in Haryana increased from 876 girls per 1000 boys in 2015 to 923 in 2019. The results of the model demonstrated that before the inception of intervention (pre-slope), there was a significant monthly change in SRB of 0.217 (95% confidence interval: 0.144-0.290). Following the B3P programme, SRB was found to increase by 0.835 per month, which implied that an increase of 0.618 (confidence interval: 0.338, 0.898) every month in SRB can be attributed to the B3P programme. This indicated that SRB for the state of Haryana increased at the rate of 7.42 units per year as a result of the B3P programme. B3P has led to a significant improvement in SRB in Haryana state. The continuity of efforts in the same direction with a sustained focus on behaviour change will further help achieve the goal of gender parity in births and child survival. [ABSTRACT FROM AUTHOR]