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Background: Psychosexual health is an important aspect of mental and physical wellbeing. Though Indian culture has a rich history of sexuality, over the years, our population has been reticent in talking about the same. With the advent of technology and new legislations protecting the rights of LGBTQIA population, awareness is also on the rise. Methods: This review focuses on research published by Indian authors over the past 15 years, with search of databases like PubMed, Scopus, Google Scholar, and Litmaps to include original articles and case reports. Results: Most studies focus on male sexual dysfunctions. Some emerging research showed promise in female sexual dysfunctions, the elderly, and the LGBTQIA population. The majority of research in sexual health continues to concentrate on dysfunctions, primarily prevalence, associations, or risk factors. Several studies investigated various medical/psychiatric comorbidities associated with sexual dysfunctions. A few studies have explored management strategies as well. Conclusion: This review highlights the need for a more holistic approach to management to sexual health issues. It further underscores the importance of grassroots-level initiatives working on improving the training of all medical practitioners and postgraduate students, increasing the availability of services for sexual disorders, promoting sexual health research in areas with gaps, and raising awareness in the general population. [ABSTRACT FROM AUTHOR]

Background: Premenstrual dysphoric disorder is a mood disorder that has been recognized in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) as a subcategory of depressive disorders. The disorder has a high prevalence rate, and yet no uniform measure is standardized on the Indian population. Aim: This study aimed to develop a scale to assess premenstrual dysphoric disorder that can be used for screening and for clinical use and that is standardized on the Indian population. Methods: This study used cross-sectional research design and collected data through social media platforms from a sample of 300 females, out of which 38 were excluded for pregnancy, mental health conditions, substance use, and oral contraceptive use. Results: The scale was analyzed using SPSS 21.0 for descriptive statistics, internal consistency, and convergent, content (factor analysis), and divergent validity. Results showed a high reliability of 0.90 and a concurrent validity of 0.76 and 0.64 against PSTT and BDI. Factor analysis revealed four factors, namely, affective and cognitive functioning, daily life and occupational functioning, somatic symptoms, and interpersonal anger. The sensitivity and specificity of the scale were found to be 86 (86%) and 66 (66%), respectively. Conclusion: The scale developed in this study was found reliable and valid for use on the Indian population. It has high sensitivity and can be used as a screening measure for premenstrual dysphoric disorder. [ABSTRACT FROM AUTHOR]

Water available for human consumption is very limited, as major percentage of water is in oceans which cover around 70% of the earth’s surface and merely 3% of this precious resource is considered fresh water. Major share of fresh water is locked in the polar icecaps leaving humanity with approximately 0.4 percent of the earth’s water which is usable and needs to be shared among the 7 billion population (Worldatlas.com). In recent decades, there has been a growing fear over the possibility of Fluoride (F−) in groundwater and the potential adverse health effects related to F− exposure. So, this study assessed the amount and trend of groundwater F- distribution at the level of the region. The present study was taken up to ascertain the water quality Gurazala division of Palnadu District in Andhra Pradesh with reference to its domestic usage criteria by doing the Fluoride (F−) ion are presented. And the Sampling was carried out during Pre-monsoon season at 10 mandals of 60 locations in Gurazala division and in addition to discover the relative treatment methods to make groundwater for usage. [ABSTRACT FROM AUTHOR]

Background: Renal Anomalies are relatively common. Problems with congenital anomalies of kidney are important as they may cause renal failure. Failure in Ascent of kidney can result in a pelvic kidney alternatively, the kidneys may fuse together at their caudal poles produces Horseshoe kidney. Objectives: The present study is to evaluate renal developmental anomalies Radiologically. Material and Methods: The present study was a Cross Sectional study in Tertiary Care Hospital who were referred to radiology department for CT abdomens. 3500 abdominal CT scans were observed for a period of 6 months. Among those male CT abdominal scans are 2060 and female CT abdominal scans are 1440, from Tertiary care hospital in Andhra Pradesh and observed for renal malformations. Results: 3500 abdominal C. T scans were studied for a period of 6 months. Out of the 3500 ct's males are 2060 and females are 1440. Conclusion: Renal Anomalies all though asymptomatic and accidental finding in most of the cases thorough evaluation of the patient is utmost important to rule out serious pathological conditions prior to the arrival of symptoms. [ABSTRACT FROM AUTHOR]

In this article, we study the long run equity performance of Indian firms which issued Seasoned Equity Offering (SEO) during the period January 2010–December 2022. With a sample of 177 such SEO issuing firms, we show that the long run equity performance of these SEO issuing Indian firms have been significantly inferior compared to firms from the same industry which are similar w.r.t other parameters like size, age and price-book ratio. Investing in an SEO at the close of the first trading day and holding it for 5 years, on an average, gave 17% (3% on an annualised basis) fewer returns than comparable firms. This pattern is more or less independent of the market conditions (bull or bear) except for a brief period during the global financial crisis. The study’s findings suggest that Indian firms that issue SEOs may be underperforming their industry peers over the long term. This could be due to a number of factors, such as the companies raising capital for dilutive purposes, using the proceeds to invest in underperforming projects, or facing challenges in integrating new equity into their existing business operations. Additionally, the study’s findings highlight the importance of careful consideration of longterm performance when evaluating investment opportunities in SEOs. To further explore the factors contributing to the underperformance of SEO-issuing firms, future research could investigate the specific reasons for their lower returns, analyze the impact of different types of SEOs (e.g., rights issues vs. follow-on public offerings) on long-term performance, and examine the role of market timing and investor sentiment in influencing the performance of SEOs. [ABSTRACT FROM AUTHOR]

Background: Long-term diabetic complications have a great negative impact on the healthrelated quality of life of patients with type 2 diabetes mellitus. The study aimed to describe the influence of diabetic complications on HRQoL in patients with type 2 diabetes mellitus. Materials and Methods: A hospital-based cross-sectional study was conducted at a tertiary teaching hospital in India. The study included all patients with type 2 diabetes mellitus above 18 years of age and currently on medication. The study was conducted upon approval from the Institutional Ethics Committee (IEC) and informed consent was taken from all the participants before including them in this study. The European Quality of Life questionnaire (EQ-5D-5L) is used in this study to assess the patient's health-related quality of life. Results: A total of 200 patients participated in this study. Majority of the study participants, 40.5% were adherent to the medication prescribed by the physician and 59.5% were nonadherentto the medication. Hypertension is found to be the most common diabetic comorbidity and complication and CAD, Stroke, and Nephropathy are less frequent diabetic complications but are found to have a greater impact on HRQoL reduction. The mean EQ VAS score was 78.25 ± 14.60 and the mean EQ Index score was 0.8574 ± 0.1432. Mean EQ VAS scores for males and females were 80.3365 ± 14.0779 and 75.9896 ±14.8965 respectively. The mean EQ Index scores for males and females were 0.8657 ± 0.1458 and 0.8483 ± 0.1405 respectively. The mean scores of the HRQoL (both EQ Index and EQ VAS) were found to decrease with the increase in number of diabetic complications. Conclusion: Our study found that patients with type 2 diabetes mellitus have poor health-related quality of life. Non-adherence to medication and the presence of diabetic complications further deteriorate the quality of life of the patients. [ABSTRACT FROM AUTHOR]

Introduction: Effective glucose control and better prevention of complications resulting from diabetes could be the crucial task in managing people with diabetes mellitus during the COVID-19 pandemic for reducing the vulnerability of people with diabetes toward the disease and preventing the severe outcomes resulting from COVID-19. Materials and Methods: This is a prospective observational study conducted at a tertiary care hospital in Andhra Pradesh. The present study involved 200 diabetic patients through a convenient sampling method (males: 100 and females: 100) who presented to the tertiary care hospital of Andhra Pradesh between August 2020 and January 2021. Results: The highest age of individuals included in the study was 88 years, whereas the lowest age of participants included was 35 years. The majority of the patients (72%) have their blood glucose levels measuring <200 mg/dl. Discussion: Vitamin C is a well-known antioxidant having significant immune-modulating effects through transformation of T-cells, phagocytic function, and interferon production. Zinc is an element having several physiological functions in the human body as antioxidant and anti-inflammatory effects. Zinc is also a cofactor in the action of around 300 enzymes. Conclusion: Nutrient supplementation with zinc, Vitamin C and D can be a good option as it is a safe, low cost, and readily available measure, helpful to get along with the fear of getting infected during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: As we all know that Stroke is becoming an important cause of disability and premature death in low-income and middle-income countries like India, affecting largely the poorer sections of the society driven by demographic changes and enhanced by the increasing prevalence of the key modifiable risk factors which impoverish their families further. Therefore, our study was planned to evaluate the risk factors and their prognostic value in patients of ischemic stroke in our setup? Research Question: What are the risk factors and their prognostic value in the patients of ischemic stroke? The setting of the study was at department of General Medicine, Government General Hospital, Government Medical College, Machilipatnam, Andhra Pradesh. A one-year observational study was conducted during the period from October 2022 to September 2023 on about 100 Ischemic Stroke cases admitted during the above period in the department of General Medicineby studying their socio-demographic profiles, associated risk factors, assessment of the degree of severity in association with risk factors, clinical course and outcome, etc. Results: Among the total study subjects 61% were male and 39% were female and it was observed that the distribution of the disease was more as age advances and it was also noticed that the severity of the disease was more among males when compared to females. Among all the study subjects 55% had hypertension followed by 45% had diabetes mellitus, 34% had history of smoking, 26% had history of regular alcohol intake, 23% had dyslipidemia, 13% had heart disease, 6% had hypercoagulable states,10% had history of TIA, 6% had history of migraine, 3% had history of OC pills usage and 2% had family history of stroke. Hypertension, Diabetes and smoking were the common risk factors present in the majority of the study subjects. Regarding the outcome of the disease the disability and mortality was more among the study subjects who had hypertension and diabetes when compared to non-hypertensive and non-diabetic study subjects significantly (P<0.001). [ABSTRACT FROM AUTHOR]

Marine plankton are also sensitive to changes in ocean temperature, acidity and nutrient availability, making them important indicators of climate change and changes in ecosystems. Studying these organisms helps scientists understand the broader impact of environmental changes on marine ecosystems and global biogeochemical cycles. Kakinada Coast is part of the Bay of Bengal, known for its biodiversity. The presence and abundance of plankton in the waters off the Kakinada coast can vary seasonally and respond to environmental factors such as water temperature, nutrient availability and the ocean flow. These plankton are not only important to the marine ecosystem but also play a vital role in fisheries and aquaculture in the region, as they form the foundation of the food web that supports species. The present review article focuses on evaluation of physiochemical parameters, diversity and distribution of phytoplankton and zooplankton of Kakinada coast of Andhra Pradesh, India. This can be correlated with the role of the plankton diversity for maintaining the ocean surface ecosystem. [ABSTRACT FROM AUTHOR]

A one-week inservice program on mental retardation was provided to 24 teachers of students with visual impairments in India. Emphasis was on community based rehabilitation and the teaching of children with mental retardation who also have visual impairment. Testing revealed participants had gained knowledge and their evaluations indicated they found the program useful. (DB)

Introduction: The use of Tranexamic Acid (TXA) in primary unilateral Total Hip Arthroplasty (THA) is well documented. However, considering the potential side effects including deep vein thrombosis and pulmonary embolism, the ideal route of administration of TXA to patients undergoing THA is still not known. Aim: To compare the efficacy of single dose intravenous (i.v.) TXA administration versus combined intravenous and local infiltration of TXA in reducing the perioperative blood loss in primary unilateral THA patients. Materials and Methods: This prospective, randomised clinical study, was conducted in the Department of Anaesthesiology and Critical Care at Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India, between October 2020 to May 2021. 60 patients were randomly allocated into two groups: the combined group C (i.v. administration of 10 mg/kg of TXA combined with local infiltration of 600 mg TXA diluted to 60 mL with normal saline) and the single i.v. group S (i.v. administration of 10 mg/kg of TXA). The perioperative blood loss was calculated in terms of three variables-intraoperative blood loss, drainage blood loss and total blood loss. The number of postoperative blood transfusions noted. Student's t-test and Fischer's-exact tests were applied for statistical analysis. Results: A total of 60 patients scheduled to have primary unilateral THA. Both the groups were similar in demographic features, baseline biochemical values and procedural distribution. There was a statistically significant reduction in the (mean±SD) intraoperative blood loss (697.26±221.43 mL), drain blood volume (254.66±81.36 mL) and total blood loss (952.26±263.57 mL) in the combined group C when compared to the single group S. There was no statistically significant difference (p-value=0.671) in the postoperative blood transfusion rate between the two groups. Conclusion: Intravenous combined with local infiltration of TXA significantly reduced the perioperative blood loss in patients undergoing primary unilateral THA when compared to single dose intravenous administration of TXA. [ABSTRACT FROM AUTHOR]

Introduction: Facial skin disorders are a major health problem affecting a high proportion of the population in India. Facial skin disorders can place a heavy emotional and psychological burden on patients that may be far worse than the physical impact. Increased consciousness especially among the youth of their body and beauty further aggravates their anxiety. Many factors determine the pattern and prevalence of Facial skin disorders among the youth such as gender, race, personal hygiene, quality of skin care, environmental milieu and diet. Materials an methods: This is an observational study was conducted in all age group patients attending at Department of DVL, Government General Hospital, Guntur for a Period of one year from Dec. 2021 to Dec. 2022. Total 424 patients with facial dermatoses belonging to age group birth to old age above and both sexes were randomly selected and included in the study after taking their consent. Result: Total 424 consecutive patients with newly diagnosed Facial skin disorders attending outpatient department, Government General Hospital, Guntur are examined and data were recorded. In this study, most common facial dermatoses are pigmentary disorders (29.9%), of which melasma constituted the most common, followed by acne, rosacea, and perioral dermatitis (20.3%). 14.6% are infections and 12.7% are eczemas. There is a wide variation in the age group of the cases. In this study, we observed that maximum number of cases are students connective tissue disorders involve Facial skin disorders Conclusion: This study was undertaken to assess the nature and extent of the involvement of the face in various dermatoses at different age and sex. Though the prevalence of various diseases is well known, very few studies exist which have studied face involvement in these. The patients seen in our study were cross sectioned from all age group, both sexes, different socioeconomic status, as well as various geographical areas. It is thus felt that this study provides an insight into various aspects of facial dermatoses encountered in day to day practice. [ABSTRACT FROM AUTHOR]

To analyze the patterns of failure and factors affecting recurrence and overall survival in mucoepidermoid carcinoma of the salivary gland. The hospital records were retrospectively analyzed from October 2010 to January 2016. Patients diagnosed as mucoepidermoid carcinoma of the salivary gland were eligible for analysis. All patients received surgery as the primary treatment modality with or without post operative radiotherapy. Statistical analysis for factors affecting recurrence was done by cox regression analysis and p value less than 0.05 was considered significant. A total of 116 patients were diagnosed to have malignant salivary gland tumors of which 69 were mucoepidermoid carcinomas (69.5%). The median age was 43 years (8–75 years). Majority of the tumors occurred in major salivary glands gland (77%). 51% patients were females. Most common stage was stage II (36%) followed by stage I (27.5%), stage IV (20.3%) and stage III (16%). High grade carcinomas comprised 34.8%, intermediate grade 30.4% and low grade 34.8%. 36 patients (52.2%) received adjuvant radiotherapy (60 Gy in 30 fractions). At a median follow up of 42 months (8–70 months), 8 (11.6%) patients died (7 cancer related and 1 noncancer related). The locoregional recurrence rate was 4.3% whereas the distant metastasis rate was 11.6%. Most common site of distant metastasis was lung. The mean disease free survival time was 61.4 months and the mean overall survival was 62 months. On univariate analysis, age < 50 years, node positive, presence of PNI, high grade, presence of LVI and local recurrence were significant factors for distant metastasis (p < 0.05). On multivariate analysis, high grade, presence of LVI and local recurrence were significant factors for distant metastasis (p < 0.05). Mucoepidermoid carcinomas of salivary gland have good long term local control and overall survival. Majority of the recurrences are distant metastasis. High grade, LVI and local recurrence are significant risk factors for distant relapse. [ABSTRACT FROM AUTHOR]

The quality of the total column water vapor (TCWV) data retrieved from the Indian national satellite (INSAT) system series (INSAT-3D) and its variation at different temporal scales have been evaluated. The reference TCWV dataset is obtained from four ground-based global navigation satellite system (GNSS) receivers and over the entire Indian subcontinent from a global precipitation measurement (GPM) microwave imager (GMI) that uses global analysis (GANAL) model data. TCWV comparison of INSAT-3D, GPM-GMI with GNSS shows higher correlations for GPM-GMI than INSAT-3D at all temporal scales. Though GMI can reproduce observed TCWV variations better than the INSAT-3D, the large biases of both the datasets indicate errors in the magnitude. Seasonal and monthly comparisons at two locations in the southeast peninsular India region show large correlations and small bias in the northeast and small correlations and large biases in southwest monsoon months. Southeast peninsular India receives a significant amount of rainfall in the northeast monsoon, and large TCWV correlations indicate both the algorithms removing cloud pixels with high accuracy. Therefore, the errors in the TCWV are attributed to the estimated radiances at different spectral channels. The spatiotemporal variations of TCWV correlations and bias of INSAT-3D indicate the need for improving the data quality by validating the estimated radiances at different spectral channels and, in turn, the retrieved TCWV over various regions at different temporal scales. [ABSTRACT FROM AUTHOR]

The relative contributions of cyclonic disturbances (CDs; i.e., low pressure systems, depressions, and cyclonic storms) and non-CDs to annual and seasonal rainfall are studied using 22 years of TRMM and GPM measurements during the passage of 866 CDs in the South Asia region (SAR). The changes in stratiform and convective precipitation within the cyclonic storm and in different CDs are also examined. The rainfall in the wettest regions of the SAR, the west coasts of India and Myanmar, and the slopes of the Himalayas is of non-CD origin, while CD rainfall peaks in the eastern parts of the monsoon trough and the northern Bay of Bengal (BOB). The CD rain fraction (RF) of annual and seasonal rainfall exhibits large spatial variation in the range of 4%–55%. The land–ocean dichotomy exhibited by CD RF is not uniform across India. Large CD RF is confined to the coast in some regions due to topographical barriers, but extends to 800–1000 km inland from the coast in the monsoon trough region. Low pressure systems contribute more to annual rain than depressions and cyclonic storms in the monsoon trough and the northern BOB (∼40%), particularly during the monsoon, mainly due to their frequent occurrence. The stratiform RF and occurrence are higher in CDs than in nonCDs, with the greatest contribution in central India (.80%), whereas the non-CDs are characterized by having higher convective RFs. The stratiform rain occurrence increases with intensification of CDs over both land and ocean, indicating its importance in the intensification of CDs and organizing large-scale systems. [ABSTRACT FROM AUTHOR]

Background: Proteus mirabilis is one of the organisms which is often associated with urinary tract infections of humans as well as animals. As a member of Enterobacteriaceae family, the level of antimicrobial resistance tend to pose a significant public health risk. Hence, the present study was undertaken to study antibiogram profiles, multidrug resistance P. mirabilis isolates and detection of ß-lactamase activity in them. Methods: A total of 175 P. mirabilis isolates from different sources were subjected to antibiotic sensitivity/resistant test by Kirby Bauer disc diffusion method. Detection of ESBL production was done phenotypically by Phenotypic Screening Test and Phenotypic Confirmation Test as recommended by CLSI guidelines and genotypically using multiplex PCR assay to detect different classes of ß-lactamase genes. This study was carried out from March 2017 to August 2018 in and around areas of Krishna District Andhra Pradesh. Result: Out of 175 P. mirabilis isolates screened, antibiogram revealed highest sensitivity towards gentamicin (76.57%), followed by ampicillin (64.57%), kanamycin (61.14%), amikacin (60.57%) and streptomycin (43.42%). Higher resistance was observed for erythromycin (71.42%), nalidixic acid (62.85%), ciprofloxacin (62.85%), tetracycline (60%), polymyxin-B (60%), cefoxitin (49.14%) and amikacin (36%). ß-lactamase genes were detected in a total of 23 isolates (13.14%). Prevalence rates of ß-lactamase genes among different samples was 23.6%, 11.1%, 10.8% and 42.8% from chicken, pork, poultry cloacal swabs and human urine samples, respectively with blaTEM being the predominant gene detected (69.56%) followed by blaOXA (26.08%), blaAmpC gene FOX (13.04%), blaCTX-M group I (4.34%), blaSHV (4.34%) and blaAmpC gene CIT (4.34%) among all the tested P. mirabilis isolates. [ABSTRACT FROM AUTHOR]

The article focuses on forensic and legal aspects of sexuality, sexual offences, sexual dysfunctions, and disorders.

Water is essential for all living organisms in the universe. Chemicals can cause contamination in groundwater near aquacultural activity areas. Keeping in view the hectic aquacultural activity in surrounding locations of Akividu town in West Godavari District of AP, India, it is proposed to assess the chemical and microbial contamination of waters to suggest remedial measures to protect the quality of water for safeguarding the health of the public residing in the nearby habitations who consume these waters for drinking purposes. 16 Groundwater samples were collected and analyzed for assessing the physicochemical parameters viz., pH, Electrical conductivity (EC), Total Dissolved solids (TDS), Total hardness (TH), Total Alkalinity (TA), Na+, K+, Calcium, Magnesium, Chloride, Sulphate, Nitrate and Phosphate, Irrigation parameters like %Na, SAR, KR RSC, and microbial analysis. The study results revealed that the samples were contaminated chemically and also with pathogenic bacteria like Pseudomonas, Citrobacter freundii and Escherichia coli which can cause water-borne diseases. Further, a health survey was carried out to verify the adverse effects to be caused by the chemical and microbial contamination of water on people’s health. The health survey results indicated the sufferings of the people who consume this water for drinking and domestic purposes. The waters are to be treated accordingly to control the chemical and bacterial contamination by using the available treatment methodologies before considering them for drinking purposes. [ABSTRACT FROM AUTHOR]

Sexual health, an essential component of individual's health, is influenced by many complex issues including sexual behavior, attitudes, societal, and cultural factors on the one hand and while on the other hand, biological aspects, genetic predisposition, and associated mental and physical illnesses. Sexual health is a neglected area, even though it influences mortality, morbidity, and disability. Dhat syndrome (DS), the term coined by Dr. N. N. Wig, has been at the forefront of advancements in understanding and misunderstanding. The concept of DS is still evolving being treated as a culture-bound syndrome in the past to a syndrome of depression and treated as "a culturally determined idiom of distress." It is bound with myths, fallacies, prejudices, secrecy, exaggeration, and value-laden judgments. Although it has been reported from many countries, much of the literature has emanated from Asia, that too mainly from India. The research in India has ranged from the study of a few cases in the past to recent national multicentric studies concerning phenomenology and beliefs of patients. The epidemiological studies have ranged from being hospital-based to population-based studies in rural and urban settings. There are studies on the management of individual cases by resolving sexual myths, relaxation exercises, supportive psychotherapy, anxiolytics, and antidepressants to broader and deeper research concerning cognitive behavior therapy. The presentation looks into DS as a model case highlighting the importance of exploring sexual health concerns in the Indian population in general and in particular need to reconsider DS in the light of the newly available literature. It makes a fervent appeal for the inclusion of DS in the mainstream diagnostic categories in the upcoming revisions of the diagnostic manuals which can pave the way for a better understanding and management of DS and sexual problems. [ABSTRACT FROM AUTHOR]

Background: Little information is available from India about the psychological impact of COVID-19 on helath-care workers. Aim: The current study aimed to evaluate the psychological issues among the health-care workers (HCW) during the COVID-19 pandemic. Materials and Methods: An online survey using Survey Monkey® platform was carried out to evaluate depression (using Patient Health Questionnaire-9), anxiety (using Generalized Anxiety Disorder Questionnaire-7), and other psychological issues (using a self-designed questionnaire). Results: The study sample comprised 303 participants with a mean age of 4L2 (standard deviation: 11.1) years. A majority of them were male (69%) and married (79.9%). Nearly half (46.2%) of the participants had either anxiety disorder or depression or both and '2.9% of HCW had suicidal behavior. Higher level of anxiety and depression scores were associated with being female, having undergone quarantine, directly involved in the care of COVID-'9 patients, and younger age (<30 years). Higher prevalence of depression and anxiety disorder was seen in younger (<30 years) age group, being a doctor (compared to paramedics). In addition, higher prevalence of depression was seen in those who were directly involved in the care of patients with COVID-'9 infection. Conclusion: About half of the HCWs are suffering from psychiatric morbidity, specifically anxiety, in the wake of the COVID-19 pandemic. There is a need to assess all the HCWs for psychiatric morbidity and provide them with psychological support. [ABSTRACT FROM AUTHOR]

Introduction: Frontline healthcare workers (HCW) have faced significant plight during the ongoing Coronavirus disease 2019 (COVID-19) pandemic. Studies have shown their vulnerabilities to depression, anxiety disorders, post-traumatic stress, and insomnia. In a developing country like India, with a rising caseload, resource limitations, and stigma, the adversities faced by the physicians are more significant. We attempted to hear their "voices" to understand their adversities and conceptualize their resilience framework. Methods: A qualitative approach was used with a constructivist paradigm. After an initial pilot, a socio-demographically heterogeneous population of 172 physicians working in COVID-designated centers were purposively sampled from all over India. Following in-depth virtual interviews using a pre-formed semi-structured guide, the data was transcribed and translated verbatim. The interview was focused on their challenges, needs, and processes of coping and support. Charmaz's grounded theory was used for analysis supplemented by NVivo 10 software. Results: Fear of infection, uncertainty, stigma, guilt, and social isolation emerged as the main challenges. Simultaneously, their "unmet needs" were flexible work policies, administrative measures for better medical protection, the sensitivity of media toward the image of HCW, effective risk communication for their health, and finally, social inclusion. Their resilience "framework" emerged as a process while navigating these adversities and consisted of three facets: forming a "resilient identity," managing the resilience, and working through the socio-occupational distress. The role of mental well-being, social network, peer support, problem negotiation, and self-care emerged as the key coping strategies. Conclusion: The study findings support the global call for better psychosocial health and quality of life of the frontline HCWs. Their "unheard voices" explored in the study can anchor subsequent resilience-enhancing interventions and policies. Guidelines focusing on the psychological wellbeing of frontline HCWs need to be grounded in their unmet needs and lived experiences. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the impact of lockdown on sexual functioning in India. In addition, impact of lockdown on relationship with the partner and mental health was evaluated. Materials and Methods: An online survey was conducted using changes in sexual functioning questionnaire, Patient Health Questionnaire-4, and a self-designed questionnaire. Results: The mean age of the participants was 41.5 (standard deviation: 11.2; range: 22--77; median: 39.5) years, with the majority being males 385 (85.6%). The participants reported that lockdown led to reduction in the frequency of sexual intercourse and also touching the partner (fondling, caressing, touching, or kissing) when not indulging in sexual intercourse. Majority of the participants reported improvement in the overall relationship, communication with the partner, and interpersonal conflicts. About two-fifths of the participants reported engaging in sexual intercourse more than twice a week or more. About one-fifth screened positive for psychiatric morbidity, with 14.2% screened positive for anxiety, 14.8% screened positive for depression and 8.7% screened positive for both. In both genders, presence of depression and anxiety were associated with lower sexual functioning in all the domains. Conclusion: Lockdown led to a reduction in the frequency of sexual intercourse, and reduction in the frequency of intimacy in the form of fondling, caressing, touching, or kissing partner when not doing sexual intercourse. However, lockdown led to the improvement in overall relationship and communication with the partners and a reduction in interpersonal conflicts. [ABSTRACT FROM AUTHOR]

Background: The Coronavirus disease 2019 (COVID-19) has emerged as a global health threat. Certain factors like age, an immunocompromised state, and social impoverishment, etc. can add to health vulnerabilities during this pandemic. One such group is older transgender adults, who often bear a combination of these risks. As the world is aging fast, their numbers have also been increasing. With this in mind, this study explores the lived experiences and psychosocial challenges of older transgender adults during the COVID-19 pandemic in India. Methods: A qualitative approach was used. Ten individuals with "transgender" identity above the age of 60 were recruited with consent through purposive sampling. In-depth interviews were conducted on the telephone using a pre-designed interview schedule. They were recorded, translated, and transcribed verbatim. Hasse's adaptation of Colaizzi's phenomenological method was used for analysis. Independent coding and respondent validation were used to ensure the rigor of data. Results: The super-arching categories (with themes) were marginalization ("second" priority, stigma, social disconnection), the dual burden of "age" and "gender" (ageism, othering, and psychosexual difficulties), and multi-faceted survival threats (physical, emotional, financial) during the pandemic. Social rituals, spirituality, hope, and acceptance of "gender dissonance" emerged as the main coping factors, whereas their unmet needs were social inclusion, awareness related to COVID-19, mental health care, and audience to their distress. Conclusion: The elderly gender minorities are at increased emotional and social risks during the ongoing pandemic, and their voices are mostly unheard. The need for policy implementation and community awareness about their social welfare is vital to improving their health and well-being. [ABSTRACT FROM AUTHOR]

Intr oducti on: The diagnosis of Ewing sarcoma family of tumours (ESFT) is challenging, especially in adults and in extra-skeletal or visceral location. Several morphologic mimics with varied treatment options and prognosis confer diagnostic dilemmas. Application of ancillary diagnostic modalities in surgical pathology in clinical routine has enabled accurate diagnosis of ESFT in bone, soft tissues, and viscera. Aim: The study aims to assess the clinicopathological features including molecular test results of ESFT with emphasis on sex, age, and location, especially extra-skeletal soft tissue and visceral location. Materia l and Met hods: Data of clinicopathological, molecular tests (wherever performed), diagnosis rendered in 302 ESFT over a decade from our centre were reviewed. Statistical comparison of skeletal and extra-skeletal tumours with reference to age and sex was done using SPSS package. The P value of <.05 was considered significant. Res ults: The cohort included 302 ESFTs with 49% skeletal and 51% extra-skeletal tumours. Thigh was most common site among skeletal tumours; chest wall, paraspinal location, and retroperitoneum among soft tissues (39.4%); and kidney, ovary, and cervix among visceral tumours (11.3%). Fluorescence in situ hybridisation for EWSR1 gene rearrangement was positive in 54 patients and reverse-transcriptase polymerase chain reaction in 19 patients. Predominance of male sex, younger age and location in extremities among skeletal tumours and lack of gender predilection, higher age and axial location in extra-skeletal tumours were noted, which were statistically significant. Molecular tests were performed more frequently in extra-skeletal tumours, especially in visceral tumours to establish the diagnosis. Conclusi ons: The study showed statistically significant differences in the age, sex, and location between skeletal and extra-skeletal ESFT. The increased percentage of extra-skeletal tumours especially in viscera was attributed to the increased awareness and availability of ancillary techniques. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) has emerged as a global health threat. The South-Asian (SA) countries have witnessed both the initial brunt of the outbreak as well as the ongoing rise of cases. Their unique challenges in relation to mental health during the pandemic are worth exploring. Materials and Methods: A systematic review was conducted for all the original studies on the impact of COVID-19 and lockdown on psychological health/well-being in the SA countries of the World Psychiatric Association Zone 16. PubMed, Google Scholar, PSYCHINFO, EMBASE, and SCOPUS were searched till June 2020. Studies conducted in the age group of 18-60 years with a minimum sample size of 10, and statistically significant results were included. Results: Thirteen studies were included in the review. They showed increase prevalence in nonpsychotic depression, anxiety, somatic concerns, alcohol-related disorders, and insomnia in the general population. Psychological symptoms correlated more with physical complaints of fatigue and pain in older adults and were directly related to social media use, misinformation, xenophobia, and social distancing. Frontline workers reported guilt, stigma, anxiety, and poor sleep quality, which were related to the lack of availability of adequate personal protective equipment, increased workload, and discrimination. One study validated the Coronavirus anxiety scale in the Indian population while another explored gaming as a double-edged sword during the lockdown in adolescents. Another study from Bangladesh explored psychosexual health during lockdown. Most studies were cross-sectional online surveys, used screening tools and had limited accessibility. Conclusion: The ongoing COVID-19 crisis and its impact serve as an important period for adequate mental healthcare, promotion, research, and holistic biopsychosocial management of psychiatric disorders, especially in vulnerable groups. Mental healthcare and research strategies during the pandemic and preparedness for postpandemic aftermath are advocated subsequently. [ABSTRACT FROM AUTHOR]

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

Long term (2005–2016) daily precipitation isotope data (δ18O, δD and d-excess) from Ahmedabad in semi-arid Western India are examined in light of various meteorological parameters and air parcel trajectories to identify prominent patterns in the isotopic character and discern the underlying hydrometeorological processes. One of the most prominent and systematic annual patterns is the isotopic depletion (average δ18O: − 2.5‰ in Jun–Jul; − 5.2‰ in Aug–Sept) in the second half of the Indian Summer Monsoon (ISM), which is observed in the 11 out of the 12 years of this study. Four geographically feasible causal factors have been examined if they contribute to observed late monsoon isotopic depletion. These factors are: (1) increased contribution of terrestrially recycled vapor; (2) intra-seasonal change in sea-surface, surface-air and cloud base temperatures; (3) increased rain-out fraction from marine vapor parcel; and (4) increase in relative proportion of convective rain. It is inferred from the present study that isotopic depletion in the second half of ISM is associated with: (1) increased contribution (45% from 36%) of terrestrially recycled moisture; (2) 1.9° C lower cloud base temperature; (3) increased rainout fraction due to decreased wind velocity (6.9 m/s from 8.8 m/s); and (4) an increase of 22.3% in the proportion of convective rain. Daily rain events with atypical isotopic composition (20‰ < d-excess < 0‰) are ascribed mainly to local weather perturbations causing sudden updraft of moist air facilitating terrestrial recycling of water vapor. [ABSTRACT FROM AUTHOR]

A comprehensive geophysical and petrological study was carried out at Giddalur area in Prakasam district, Andhra Pradesh, which is geologically a highly deformed area and is difficult to delineate the aquifer zone(s). The task was to find out the exact rock type in which aquifer is concealed as well as to delineate the aquifer zone, which can yield sufficient quantity of water. The resistivity models derived from geophysical dataset were interpreted in terms of hydrogeology and the results revealed substantial resistivity contrast of the geological formations within the study area. We have delineated two major groundwater potential zones based on this study. These zones were tapped at different depths in diverse rock types. Drilled hand specimens (rock cuttings) were not adequate, so these specimens were petrographically studied to reveal the exact contact zones of the rock type. On integration of the geophysical and the petrographic results, it was illustrated that two aquifer zones were struck at a depth of 92 and 122 m between shale-phyllite and phyllite-quartzite, respectively. These findings were correlated, which matched with the lithology of the drilled borehole. This integrated approach will be helpful in strategy for groundwater assessment as well as prospecting groundwater resources in different geological terrain. [ABSTRACT FROM AUTHOR]

The prevalence of gastro-intestinal parasites of sheep was studied in Hyderabad Karnataka (H-K) region, Karnataka, India for a period of one year through coprological examination. A total of 1876 sheep were examined, out of which, 1197 (63.80%) sheep were found infected with one or more species of gastro-intestinal parasites. The species identified were Strongyles (27.5%), Trichuris ovis (2.34%) and Strongyloides papillosus (3.3%) in nematodes; amphistomes (1.01%) and Schistosoma spindale (0.11%) in trematodes; Moniezia spp. (1.06%) in cestodes and Eimeria spp. (8.48%) and Buxtonella sulcata (0.21%) in protozoa. Single infection (44.03%) was more common than mixed infection (19.78%). The prevalence of parasitic infection in relation to age, sex and season was also studied. The higher prevalence was recorded in monsoon season (66.90%) compared to that of winter (63.60%) and summer (60.99%) and statistical analysis showed the differences were not significant (P>0.05) between the season. Further, age-wise and gender wise study revealed the prevalence was not significantly (P>0.05) higher in pre-weaning lambs (< 3 months) (66.96%) as compared to post-weaning lambs (> 3 months to 1 year age) (65.56%) and above 1 year (59.56%) sheep. Females showed a higher (P<0.05) infection (65.32%) as compared to males (61.84%). [ABSTRACT FROM AUTHOR]

In the present research we explored the variability of convective available potential energy (CAPE) during wet and dry spells over southeast India. Comparison between India Meteorological Department (IMD) observations and reanalysis products (NCEP, ERA-interim, and MERRA) reconfirms that gridded data sets can be utilized to fill the void of observations. Later, GPS radiosonde measurements made at Gadanki (13.5 N, 79.2 E) Andre analysis output are utilized to address key scientific issues related to CAPE over the southeastern peninsular region. They are: (1) How does CAPE vary between different spells of the Indian summer monsoon (i.e., from wet to dry spell)? (2) Does differences in CAPE and in the vertical structure of buoyancy between spells are localized features over Gadanki or observed all over southeastern peninsular region? (3) What physical/dynamical processes are responsible for the differences in CAPE between spells and how do they affect the convection growth in dry spell? Interestingly, CAPE is higher in wet spell than in dry spell, in contrast to the observations made elsewhere over land and warm oceans. Similar feature (high CAPE in wet spell) is observed at all grid points in the southeastern peninsular India. Furthermore, vertical buoyancy profiles show only one peak in the middle–upper troposphere in wet spell, while two peaks are observed in most of the profiles (66%) in dry spell over the entire study region in all the reanalysis products. Plausible mechanisms are discussed for the observed CAPE differences. They are, among others, timing of sounding with reference to rain occurrence, rapid buildup of surface instabilities, moistening of lower troposphere by evaporation of the surface moisture in wet spell, enhanced low-level moisture convergence, evaporation of rain in relatively warm and dry atmosphere, and reduction of positive buoyancy in dry spell. The omnipresence of stable layers and strong and deep shear in the presence of weak updrafts (buoyancy) limits the growth of convective draft cores in dry spell. [ABSTRACT FROM AUTHOR]

Cloud-circulation feedback by latent heating (LH) is a major contributor for driving atmospheric circulation. This study examines the potential role of spatial variations of LH in driving a mini-circulation for generating the "pool of inhibited cloudiness", where cloud formation in the lower and middle troposphere is significantly inhibited over the southwest Bay of Bengal (BoB) during the Indian summer monsoon. Spaceborne observations show that LH rates in the deep convective regions of the head BoB are as high as 0.2 K/h, while that over the "pool" are about 5 times smaller. This differential heating results in modulating the mean circulation. 20 years of reanalysis data show good correlation between (a) upper troposphere (300 hPa) convergence and lower tropospheric (1000 hPa) divergence at the "pool" and (b) lower tropospheric divergence at the "pool" and lower tropospheric convergence at the head BoB as well as at the west coast of India. Besides the orographic influence, a portion of the air mass descending at the "pool" arises from deep convective regions in the north BoB and equatorial trough. This subsidence is responsible for the persistent inhibition to cloud formation at the "pool". This case forms a classic example of the cloud-circulation feedback. [ABSTRACT FROM AUTHOR]

Neurosurgery for psychiatric disorders (NPD) has been practiced for >80 years. However, the interests have waxed and waned, from 1000s of surgeries in 1940-1950s to handful of surgery in 60-80s. This changed with the application of deep brain stimulation surgery, a surgery, considered to be "reversible" there has been a resurgence in interest. The Indian society for stereotactic and functional neurosurgery (ISSFN) and the world society for stereotactic and functional neurosurgery took the note of the past experiences and decided to form the guidelines for NPD. In 2011, an international task force was formed to develop the guidelines, which got published in 2013. In 2018, eminent psychiatrists from India, functional neurosurgeon representing The Neuromodulation Society and ISSFN came-together to deliberate on the current status, need, and legal aspects of NPD. In May 2018, Mental Health Act also came in to force in India, which had laid down the requirements to be fulfilled for NPD. In light of this after taking inputs from all stakeholders and review of the literature, the group has proposed the guidelines for NPD that can help to steer these surgery and its progress in India. [ABSTRACT FROM AUTHOR]

The spatial patterns of rainfall and rain systems during El Niño and La Niña episodes are distinctly different due to the longitudinal variations in the Walker circulation ascent/decent branches over India and adjoining Oceans. In order to examine these differences, 16 years (1998-2013) of Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar (PR) data have been utilized. TRMM-PR delineated precipitating systems (convective, stratiform and shallow) show distinctly different spatial structures over India and adjoining Oceans during El Niño and La Niña episodes. During the El Niño episode, the occurrence of deep systems is high over north of 20°N latitude, and shallow systems are plentiful over south of 20°N latitude. On the other hand, during the La Niña episodes, the occurrence of shallow systems is in excess over Pakistan, central India, northwest Arabian Sea, southwest Indian Ocean and northern Bay of Bengal while the deep systems are abundant over west coast of India, Ganges basin, eastern Indian Ocean and Arabian Sea. The excess convective rain pixels observed during El Niño years are from deep and deep and wide convective core systems due to increase in the CAPE, nevertheless the broad stratiform rain systems are prevalent during La Niña years due to the high convergence of moisture flux and mid-tropospheric upward motion. Though the convective occurrence is more, their intensity is weaker during El Niño years than during La Niña years, indicating the intense nature of convective storms during La Niña episodes. [ABSTRACT FROM AUTHOR]

Introduction: Female Sexual dysfunction is an important health concern caused by several factors. This study aimed to compare the sexual function of women who have primary headaches in order to investigate the relationship between sexual dysfunction and the features of headaches. Materials and Methods: 95 consecutive patients aged 18 to 65 years with a history of headache for at least 1 month and sexually active in the last 6 months presenting to Psychiatry OPD of a tertiary care hospital in New Delhi giving informed consent were taken. The diagnosis of headache type was confirmed according to the 2nd edition of International Headache Society (IHS) International Classification of Headache Disorders (ICHD-II) in 2004. The Female Sexual Function Index (FSFI), visual analog scale (VAS) score and Migraine disability assessment scale score (MIDAS) were applied. Results: Those with migraines reported a greater intensity of pain than those with tension headaches. Individuals with tension headaches reported more frequent headaches. The mean MIDAS score in the migraine group was 14.64 (±2.59); 30% of the migraine group fell into the most severe category in MIDAS. Women with headaches had lower scores (indicating impaired sexual functioning) on all FSFI subscales, as well as on the total score when the prescribed cutoffs were applied as compared to controls (66.3% vs. 30% in controls). Conclusion: The present study showed that patients with either type of primary headache experience problems in several aspects of sexuality compared with controls. [ABSTRACT FROM AUTHOR]

Introduction: Acute coronary syndrome (ACS) caused by coronary atherosclerosis include ST-segment elevation myocardial infarction (STEMI), non-STEMI, and unstable angina. The relation between psychiatric disorders and coronary artery disease is a complex one which includes the effect of the psychosocial factors on heart and vice versa. Point prevalence studies have been reported, but there is paucity of follow-up studies from India. Materials and Methods: The study is a follow-up evaluation at discharge of 248 consecutive patients presented with ACS at JSS Hospital, Mysuru, Karnataka, over a period of 6 months to assess the psychiatric comorbidities. The patients were assessed on a structured and validated pro forma before discharge, at 3 months, and at 6 months. Screening of psychiatric disorders was done using Mini International Neuropsychiatric Interview PLUS 5.0.0 and assessment of depression was done using Hamilton Depression Rating Scale. ANOVA, Student's t-test, and SPSS 21 were used for statistical analysis. Results: The most common psychiatric comorbidities include major depressive disorder (44%), it persisted at the end of 3 (P < 0.001) and 6 (P < 0.001) months. A spectrum of anxiety disorders including panic disorder (12.10%), dysthymia (3.60%), agoraphobia (2.40%), social phobia (2%), obsessive-compulsive disorder (1.6%), specific phobia (1.2%), and posttraumatic stress disorder (0.8%) in descending order at the end of 6 months were found. Significant reduction in substance use of nicotine (66.1%) and alcohol (56.0%) was reported on follow-up. Conclusion: Depression, anxiety, and substance use occur in patients with ACS which persist on follow-up. Early recognition at discharge and appropriate counseling on follow-up improve the clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression are common mental health disorders that are responsible for considerable societal burden. There are no data on cost-efficacy and medication compliance related to the treatment of these disorders in rural India. Materials and Methods: All consenting adults (n = 455) diagnosed with generalized anxiety or (unipolar) depressive disorders in Suttur village, Karnataka, were treated with open-label fluoxetine (20-60 mg/day), sertraline (50-150 mg/day), escitalopram (10-20 mg/day), desvenlafaxine (50-150 mg/day), duloxetine (30-90 mg/day), amitriptyline (75-150 mg/day), or clomipramine (75-150 mg/day) in a structured, monotherapy dosing plan. The study was nonrandomized and otherwise naturalistic. Patients were followed up every 4 weeks for 24 weeks. Study discontinuation was defined as medication noncompliance for 3 or more days or withdrawal due to treatment nonresponse. Results: There was substantial discontinuation (34.5%) in the first 4 weeks; 55.4% had discontinued by 12 weeks. Subsequently, only 11.2% discontinued treatment. Only 33.4% of the subjects tolerated the treatment, responded to it, and remained compliant for 24 weeks. Such successful completion was highest for escitalopram and desvenlafaxine (46%-47%) and lowest for clomipramine and amitriptyline (10%-14%). Adverse events were the most common reason for noncompliance with clomipramine and amitriptyline (45%-46%); the experience of sufficient improvement was the most common reason for noncompliance with the remaining drugs (28%-49%). Whereas the average cost of efficacious treatment for a continuous period of 24 weeks was lowest for fluoxetine, an examination of the cost-efficacy tradeoff suggested maximum advantage for escitalopram, sertraline, and desvenlafaxine. The cost-efficacy profile for amitriptyline and clomipramine was poor. Conclusions: Reasons for noncompliance vary by drug class and need to be considered when prescribing antidepressant drugs. Escitalopram, sertraline, and desvenlafaxine perhaps have the most favorable 24-week cost-efficacy profile; tricyclics are poorly tolerated. Rural subjects need to be educated that treatment must be continued even after improvement is established. [ABSTRACT FROM AUTHOR]

The article discusses branded and nominally branded generic versions of prescription writing. Topics discussed include study by Singal et al comparing branded and nominally branded generic versions of the same drug manufactured and formulated by the same company; notification by Medical Council of India (MCI) for doctors in India to prescribe drugs by their generic name and quality control of drugs by the U.S. Food and Drug Administration (FDA).

Introduction: In 2007, Ministry of Women and Child Welfare, supported by United Nations Children's Fund, save the children and Prayas conducted a study to understand the magnitude of child abuse in India, they found that 53.22% children faced one or more forms of sexual abuse; among them, the number of boys abused was 52.94%. Aim: The aim of this study was to explore the barriers for seeking psychiatric help by qualitative analysis of stake holders of male victims of child abuse. Materials and Methods: All the statements made by the stakeholders regarding psychiatric assessment and treatment were recorded in each referral made to the psychiatrist. Semistructured interviews and in-depth interviews were conducted to explore the topic of understanding the need for psychiatric treatment to the victims. Results: Collaborative child response unit, a multidisciplinary team, to tackle child sexual abuse in a general hospital received three referrals of male child abuse among the 27 referrals in 20 months. The main theme of the barrier that was generated by interviewing the stakeholders of male child victims of abuse was the misconception of superiority of a male victim due to gender (patriarchy) an expectation that he will outgrow the experience. In-depth interviews of three cases of homosexual abuse explored the theme. Conclusion: Patriarchy is oppressing male children and acts as a barrier to seek psychiatric help in collaborative child response unit. [ABSTRACT FROM AUTHOR]

Purpose: To determine risk factors for poor visual outcome in postoperative and posttraumatic endophthalmitis in a large referral center in south central India.Methods: In this prospective observational series the authors examined 388 patients of postoperative (n= 206) and posttraumatic (n= 182) endophthalmitis at the L V Prasad Eye Institute in Hyderabad, India between 1991 and 1997. The analysis was confined to 236 patients-128 (62.1%) postoperative and 108 (59.3%) posttraumatic patients who were followed for a minimum period of 3 months. A detailed protocol was followed. Chi-square and logistic regression analysis were used to determine risk factors for visual outcome worse than 6/18 and worse than 6/120.Results: Postoperative endophthalmitis: In univariate analysis the features associated with poor visual acuity (grouped as < 6/18 and < 6/120) included intracapsular cataract surgery, poor presenting visual acuity, presence of vitreous cells, inability to visualise the optic disc on indirect ophthalmoscopy, presence of vitreous membranes on ultrasonography, and a culture-positive vitreous biopsy. In the multivariate analysis, visual acuity of less or equal light perception (LP) at presentation was associated with a 3-month postoperative visual acuity of < 6/18, with an odds ratio of 5.85 [1.25 - 27.42, 95% CI], and vitreous membranes seen on ultrasonography was associated with a final visual acuity of < 6/120, with an odds ratio of 2.47 [1.05 - 5.83, 95% CI]. Posttraumatic endophthalmitis: In univariate analysis the features associated with poor visual acuity (grouped as < 6/18 and < 6/120) included a retained intraocular foreign body (IOFB), trauma by needle (hypodermic or sewing), poor presenting visual acuity, inability to visualise the optic disc on indirect ophthalmoscopy, presence of vitreous membranes on ultrasonography, and a culture-positive vitreous biopsy. In multivariate analysis, IOFB was associated with a 3-month follow-up visual acuity of < 6/18, with an odds ratio of 5.90 [1.85 - 18.78, 95% CI], and trauma by a needle (hypodermic or sewing) and retained IOFB was associated with a final visual acuity of < 6/120, with an odds ratio of 4.47 [1.22 - 16.38, 95%CI] and 3.76 [1.36 - 10.37, 95% CI] respectively.Conclusion: This is the largest, single-centre, prospective study on risk factors for poor visual outcome in postoperative and posttraumatic endophthalmitis. The independent risk factor for 3-month follow-up visual acuity of < 6/18 was the presenting visual acuity of < or =LP in postoperative endophthalmitis and a retained IOFB in posttraumatic endophthalmitis. The independent risk factor for 3-month visual acuity of < 6/120 was the presence of vitreous membranes on ultrasonography in postoperative endophthalmitis, and trauma by a needle (hypodermic/ sewing) and retained IOFB in posttraumatic endophthalmitis. [ABSTRACT FROM AUTHOR]

Introduction: Sexual relationship is a basis for mental health and continuity of the healthy generation. There are very few studies on the female sexual functioning, especially in India. Sterilization being the most common contraceptive method, sexual functioning in women undergoing this surgical intervention has not been adequately explored. Available studies have found conflicting results; some have reported that sterilization has positive effects on sexual functioning since anxiety of getting pregnant is abolished. However, few Indian studies have reported a decline in sexual functioning following the sterilization procedure as women lack interest and perceive sexual function only for the purpose of procreation. The cultural differences and lack of sex education among Indian women are thought to be the reason for such a difference. Materials and Methods: A total of sixty married women above 18 years, who were consulting Family Planning Association, Mysore, for the purpose of undergoing tubal sterilization, and who gave a written consent were interviewed twice; before the sterilization procedure and 6 months post-sterilization. These women were assessed for sexual functioning using female sexual function index and sexual functioning index. Results: The prevalence of sexual dysfunction in the study population was 36.7% before the tubal sterilization. This rate increased to 71.7% after the procedure which was statistically significant. The common disorders were orgasm, arousal, and desire. Pain disorder was least common. This dysfunction exists across all the ages, education level, occupation, and residence. Conclusion: The study shows that whatever may be the attribution, tubal sterilization impairs the sexual functioning among women. A proper education and counseling need to be incorporated to prevent the problems. [ABSTRACT FROM AUTHOR]

Climatological characteristics of precipitation during the active and break spells of the monsoon are studied using 15 years of TRMM measurements. The spatial variation of rain fraction suggests that most of the seasonal rainfall occurs in spells of active monsoon over India, except for the zones along the east coast. The broader reflectivity distribution at higher altitudes and larger average storm height during active spells indicate the high prevalence of deep systems during this spell. The spatial distribution of the occurrence and fraction of different types of rain exhibits large variability from land to ocean and between the spells. The higher occurrence and fraction of stratiform rain during the active spell, particularly over the core monsoon zone, is due to the prevalence of organized mesoscale systems with large stratiform portions. The break spells are characterized by higher occurrence of shallow rain and larger fraction of convective rain. While an evening peak is observed over land during the break spell, the phase of the diurnal cycle exhibits large spatial variability during the active spell. The rainfall peaks from late night to midnight in southeastern India and in the morning near the foothills of the Himalayas during the active spell. The diurnal and semidiurnal components together explain more than 90% of total variance over many of the zones during both spells. The observed differences in precipitation between the spells are discussed in light of the differences in synoptic- and mesoscale mechanisms responsible for the production of precipitation. [ABSTRACT FROM AUTHOR]

The authors reflect on the Mental Health Care (MHC) Bill of 2016 in India. Topics include the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), role of family members during the admission and treatment of mental patients, and significant developments in the new MHC bill. Also mentioned are the challenges and remedies to the new MHC bill.

The main purpose of the study was to conduct a comprehensive needs assessment of primary healthcare professionals in order to develop a training program aimed at enhancing competencies in suicide risk assessment and management. A total of 144 primary healthcare professionals (physicians = 46; primary care workers = 98) completed the needs assessment questionnaire. The majority of healthcare professionals rated their level of comfort and competence in assessing, treating, and referring suicidal patients as medium or high. However, their knowledge about suicide, risk factors for suicide, asking about suicidal behaviour, and helping a suicidal patient was rated low or medium. Overall, the scarcity of qualified healthcare professionals and the existing gaps in core competencies for suicide risk assessment and management was identified. Development of innovative and effective competencies-based suicide specific training for primary care providers in India is urgently required. [ABSTRACT FROM AUTHOR]

Introduction: Malaria has been a major public health problem plaguing India for centuries and about 95% of Indian population is residing in malaria endemic regions. The proportion of the Pf% has gradually increased from 39% in 1995 to 65% in 2014. Periodic clinical profiling studies may help us in understanding of the changing pattern of the disease, complication rate and emerging drug resistance patterns, which can help the clinicians in making better and informed clinical decisions. Objective: To analyze the socio demographic and clinical profile of falciparum malaria cases and to study the incidence and profile of complications of falciparum malaria and their impact on hospital in falciparum malaria. Materials and methods: A prospective observational study was conducted in department of General Medicine of tertiary care hospital from November 2011 to November 2013 among patients diagnosed with falciparum malaria by smear. Patients aged above 18 years, both genders were included in the study. Results: Among 50 study participants, 42% belonged to 26 to 40 years of age and 76% of them were males. Fever was the most common clinical symptom reported by all the patients, followed by chills and rigors (90%), headache (74%), nausea and vomiting (46%). A total of 37 (74%) of the patients had complicated malaria, out of the 37, 17 (45.95%) had single complication and remaining 54.05% had multiple complications. Liver involvement manifested by jaundice was the most common complication seen 51.4% of the subjects, followed by cerebral malaria (48.6%) and anemia (45.9%). None of the patients reported mortality. Conclusions: Males in the age group of 26 to 40 years is the most common population group affected by plasmodium falciparum malaria. The proportion of complicated cases is very high (73%) in the study population and the most common complications include liver dysfunction and cerebral malaria. No mortality was reported in the study probably attributed to early diagnosis and effective management. [ABSTRACT FROM AUTHOR]

This paper describes the establishment of a dense rain gauge network and small-scale variability in rain events (both in space and time) over a complex hilly terrain in Southeast India. Three years of high-resolution gauge measurements are used to validate 3-hourly rainfall and subdaily variations of four widely used multi-satellite precipitation estimates (MPEs). The network, established as part of the Megha-Tropiques validation program, consists of 36 rain gauges arranged in a near-square grid area of 50 km50 km with an intergauge distance of 6-12 km. Morphological features of rainfall in two principal rainy seasons (southwest monsoon, SWM, and northeast monsoon, NEM) show marked differences. The NEM rainfall exhibits significant spatial variability and most of the rainfall is associated with large-scale/long-lived systems (during wet spells), whereas the contribution from small-scale/short-lived systems is considerable during the SWM. Rain events with longer duration and copious rainfall are seen mostly in the western quadrants (a quadrant is 1=4 of the study region) in the SWM and northern quadrants in the NEM, indicating complex spatial variability within the study region. The diurnal cycle also exhibits large spatial and seasonal variability with larger diurnal amplitudes at all the gauge locations (except for 1) during the SWM and smaller and insignificant diurnal amplitudes at many gauge locations during the NEM. On average, the diurnal amplitudes are a factor of 2 larger in the SWM than in the NEM. The 24 h harmonic explains about 70% of total variance in the SWM and only ~30% in the NEM. During the SWM, the rainfall peak is observed between 20:00 and 02:00 IST (Indian Standard Time) and is attributed to the propagating systems from the west coast during active monsoon spells. Correlograms with different temporal integrations of rainfall data (1, 3, 12, 24 h) show an increase in the spatial correlation with temporal integration, but the correlation remains nearly the same after 12 h of integration in both monsoon seasons. The 1 h resolution data show the steepest reduction in correlation with intergauge distance and the correlation becomes insignificant after ~30 km in both monsoon seasons. Validation of high-resolution rainfall estimates from various MPEs against the gauge rainfall data indicates that all MPEs underestimate the light and heavy rain. The MPEs exhibit good detection skills of rain at both 3 and 24 h resolutions; however, considerable improvement is observed at 24 h resolution. Among the different MPEs investigated, the Climate Prediction Centre morphing technique (CMORPH) performs better at 3-hourly resolution in both monsoons. The performance of Tropical Rainfall Measuring Mission (TRMM) multi-satellite precipitation analysis (TMPA) is much better at daily resolution than at 3-hourly, as evidenced by better statistical metrics than the other MPEs. All MPEs captured the basic shape of the diurnal cycle and the amplitude quite well, but failed to reproduce the weak/insignificant diurnal cycle in the NEM. [ABSTRACT FROM AUTHOR]

Aim: To assess the phenomenology and associated beliefs in patients with Dhat syndrome. Methods: A total of 780 male patients aged more than 16 years were recruited from 15 centers spread across the country and were assessed on Dhat Syndrome Questionnaire. Results: The most commonly reported reasons for passage of Dhat were excessive masturbation (55.1%), sexual dreams (47.3%), excessive sexual desire (42.8%) and consumption of high energy foods (36.7%). The most common situation in which participants experienced passage of Dhat were as ‘night falls’ (60.1%) and ‘while passing stools’ (59.5%). The most common consequence due to passage of Dhat was weakness in sexual ability (75.6%). In terms of psychological and somatic symptoms, the common symptoms included bodily weakness (78.2%); feeling tired or having low energy (75.9%); feeling down, depressed, or hopeless (67.9%); and little interest or pleasure in doing things (63.7%). In terms of treatment expectations, about half of the patients (49.1%) expected that energizing medications like vitamins/tonics/tablets were required and more than one-third (38.2%) expected that there was a need for taking energizing injections. Conclusion: Present study shows that Dhat syndrome is a distinct clinical entity seen all over India, with its characteristic features. [ABSTRACT FROM AUTHOR]

Introduction: India accounts for the highest estimated number of suicides in the World. In 2012, more than 258,000 of the 804,000 suicide deaths worldwide occurred in India. Early identification and effective management of suicidal ideation and behavior are paramount to saving lives. However, mental health resources are often scarce and limited. Throughout India, there is a severe shortage in mental health professions trained, which results in a treatment gap of about 90%. A comprehensive needs assessment was undertaken to identify the nature of the deficits in suicide prevention training for physicians in three Indian cities: Mumbai, Ahmedabad, and Mysore. Materials and Methods: The study was carried out in several concurrent phases and used a mixed‑method approach of converging quantitative and qualitative methodologies. Data were collected using survey questionnaires, focus groups, consultations, and environmental scans. A total of 46 physicians completed the questionnaire. Focus groups were conducted in Mumbai and Ahmedabad with 40 physicians. Consultations were carried out with psychiatrists and psychiatric residents from hospitals and clinics in Mumbai, Ahmedabad, and Mysore. Results: Training gaps in suicide prevention exist across the health care professions. Existing training lacks in both quality and quantity and result in critical deficits in core competencies needed to detect and treat patients presenting with suicidal ideation and behavior. Only 43% of the surveyed physicians felt they were competent to treat suicidal patients. The majority of surveyed physicians believed they would greatly benefit from additional training to enhance their suicide risk assessment and intervention skills. Conclusions: There is a dire need for medical schools to incorporate suicide prevention training as a core component in their medical curricula and for continuing medical education training programs for physicians to enhance competencies in early detection and management of suicidal behavior. [ABSTRACT FROM AUTHOR]