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The spread of Covid-19 has reduced human intervention in aquatic ecosystems, which has shown a discernible improvement in air and water quality. Ganges River, being a historical, economic and cultural icon of India providing multiple ecosystem services as industrial, provisioning, regulatory and cultural services, constitutes an important habitat for Gangetic Dolphin (Platanista gangetica). The surfacing of dolphins in Ganga river is patchy and unpredictable. The present study unravels 25 different chemical, microbiological, biological and meta-genomics of most abundant bacteria at dolphin surfacing sites in Ganges water during October 2017 February 2018 and January 2021 to elicit the impact of Covid-19 lock down at the Garhmukteshwar (28.7601°N, 78.1437°E) stretch in Hapur district of Uttar Pradesh, India. The most abundant bacteria at dolphin surfacing site was Bacillus subtilis in February 2018 which was replaced by Aeromonas sp. in January 2021. The zooplankton community was dominated by rotifers during pre-Covid period however the dominance pattern recorded a shift towards larger herbivorous crustacean species during Covid -19 lock down. Overall bacterial count decreased whereas Chl a level increased during the lock down. The total zooplankton abundance did not show a significant difference, but relative proportion of larger herbivorous crustacean zooplankton increased in January 2021 samples. The present results convincingly establish effects of shutdown on chemical, metagenomics and biological components of the riparian ecosystem and the information of micro to mesoplanktonic community may be useful for characterizing dolphin surfacing sites, enhancing existing water quality monitoring efforts and also for human epidemiological studies associated with recreational use of Ganga water. [ABSTRACT FROM AUTHOR]

India's road network carries over 90% of passenger traffic and over 65% of its freight movement. Therefore, effective maintenance of road networks is to be accorded the highest importance. Assigning priorities to the roads that require immediate repair or maintenance is another vital task. The present study aims to develop a novel method to prioritise the pavement maintenance sections by deploying the functional characteristics of the pavement alone. In order to do this, the relationship between functional and structural characteristics of the pavements is explored with the aid of the computing system, -Artificial Neural Network (ANN). This technique enables pavement maintainers and managers to considerably reduce the frequency of expensive, time-consuming and traffic disruptive tests for obtaining the structural characteristics of pavements. A vast database, comprising of the properties of fourteen rural roads from seven districts of Tamil Nadu, with different traffic characteristics, subgrade soil characteristics, and climatic conditions, is systematically analyzed to achieve the research objective. The numerical outcomes are a testament to evidence the correlation between the structural and functional characteristics of the pavements. The formulated Maintenance Priority Index (MPI) will be beneficial in ranking the Maintenance and Rehabilitation actions based on the urgency level. [ABSTRACT FROM AUTHOR]

In India, in metropolitan cities, a common problem seen is traffic jams or slowdown on traffic due to potholes. Most of the road accidents are due to potholes. In this paper, the authors have tried to ensure that the road surface quality and the potholes should be monitored continuously and must be repaired as necessary. The best possible distribution of resources could be attained when the real-time data is gathered from the mounted sensory system and displayed and visualized in a way (Google Maps) which is comprehensive and empirical. Different sensors would be mounted onto the public transport vehicles. The method mentioned in this paper uses the ultrasonic sensor and the accelerometer to send the data regarding the intensity of pothole straightaway to the cloud data storage, along with the location coordinates of the potholes and the time stamp. Different databases such as traffic density of the city, rain intensity of different areas is used to train different machine learning models to predict the intensity of potholes at the particular locations and get the best possible accuracy. The best-case accuracy attained was 35.5%. The pothole intensity data is visualized through a heat map application. This system helps in reducing the frequency of traffic jams in any city of India. The method suggested in the paper would help in reducing the number of accidents happening in India due to the potholes. [ABSTRACT FROM AUTHOR]

Purpose: This prospective, randomized, double-blind, placebo-controlled, parallel-group study aimed to determine the efficacy and safety of a multistrain (Bacillus coagulans [SNZ 1969], Bacillus clausii [SNZ 1971], and Bacillus subtilis [SNZ 1972]) probiotic blend (SNZ TriBac) in managing symptoms of gastrointestinal (GI) discomfort in the absence of specific pathologies. Methods: Sixty adults with symptoms of GI discomfort were enrolled (mean age, 34.89 ± 9.95 years) and randomized to receive either SNZ TriBac or placebo. Changes from baseline in Severity of Dyspepsia Assessment (SODA), Gastrointestinal Symptom Rating Scale (GSRS), and Quality of Life (QoL) scales over the course of product use were determined at baseline and on days 30 and 37 as study outcomes. Results: On day 30, significant improvement with SNZ TriBac was noted in SODA burping/belching (P = 0.025), bloating (P = 0.048), sour taste (P = 0.025), and total (P = 0.007) scores as well as pain (P = 0.003), non-pain (P = 0.04), and satisfaction (P = 0.03) subscores. Significant improvement with SNZ TriBac was also observed in SODA burping/belching (P = 0.011), sour taste (P = 0.011), and total SODA scores (P < 0.001), and in SODA pain (P = 0.005), non-pain (P = 0.06), and satisfaction (P = 0.004) subscores on day 37. No adverse events were reported. Conclusion: Significant improvement in final SODA scores and subscores with SNZ TriBac versus placebo indicates improvement in several symptoms of gastrointestinal discomfort. This multistrain probiotic blend was well tolerated and could be an effective option for treatment of GI discomfort. Trial registration: Clinical Trials Registry of India (CTRI/2018/05/014071) [ABSTRACT FROM AUTHOR]

Hexavalent vaccines containing diphtheria, tetanus, pertussis, Haemophilus influenzae type b, poliomyelitis, and hepatitis B virus antigens have the potential to be used for the primary series in India (6, 10, 14 weeks of age) and the toddler booster dose. Three hexavalent vaccines are available in India: DTwP-Hib/HepB-IPV (wP-hexa), DTaP-IPV-HB-PRP~T(2aP-hexa), and DTaP-HBV-IPV/Hib (3aP-hexa). In the three published phase-3 Indian studies, pertussis 'vaccine response' rates 1 month after a 6-10-14-week primary series were 68.4-75.7% for wP-hexa, 93.8-99.3% for 2aP-hexa, and 97.0-100% for 3aP-hexa; seroprotection rates for the other five antigens were 88.2-100%, 49.6-100%, and 98.6-100%, respectively. Studies outside India show: good immunogenicity/safety after boosting dosing; immune persistence to age 4.5 years (2aP-hexa), 7–9 years (3aP-hexa) (all antigens), and 9–10 and 14–15 years, respectively (hepatitis B); and successful co-administration with other vaccines. Hexavalent vaccines could reduce the number of injections, simplify vaccination schedules, and improve compliance. [ABSTRACT FROM AUTHOR]

Background: The determinants of the outcome in adult convulsive status epilepticus (CSE), also the implication of the value of mean arterial blood pressure (MAP), and random blood sugar at admission on the outcome are not clear. Objectives: The objective of this study is to look for the determinants of unfavorable outcome in CSE. Materials and Methods: Ambispectively gathered data from 55 patients, treated consecutively with identical protocol during January 2010-December 2016, were analyzed. The demographic and clinical variables were identified and correlated with outcome in each individual. Results: There were 65.45% males and 34.55% females. Favorable outcome (conscious and discharged) was seen in 63.6%, unfavorable (death 14.5%, absent cortical functions 10.9%, and inability to wean-off anesthetic agents 10.9%). The parameters associated with unfavorable outcome were female gender (odds ratio [OR]: 1.45), MAP ≤80 mmHg (OR: 2.57), time to first medical attention >5 h (OR: 127.8), and time to control clinical seizures >3.5 h (OR: 7.87). Almost 44.2% of patients with SE severity score >2 had unfavorable outcome (sensitivity 75% and specificity 45.7%). New scoring system, the CSE outcome score (CSEOS, developed by combining the predictors associated with higher odds of poor outcome), predicted the poor outcome with the sensitivity and specificity of 90% and 54.29%, respectively. Discussion and Conclusion: Low MAP and delay of >3.5 h in treatment initiation or seizure control are the key determinants of poor outcome in CSE. With the incorporation of CSEOS, we believe that our findings can be helpful in the process of clinical decision-making and prognostication of patients with CSE. [ABSTRACT FROM AUTHOR]

Background: 10 meters Shuttle run test is a field test which measures the agility and speed of athletes. this is a test of speed, body control and the ability to change direction. Objective: The objective of this study was to find Common value of shuttle run test in athletes of Belagavi and to set concrete data which will prove as a base line for any other studies / training which will involve designing rehabilitation and /or fitness protocol for Belagavi athletic population Methodology: 162 athletes (n=162) were taken for the study.10 meter shuttle run test was performed by the athletes. The time taken to complete the test was recorded. Result: Total mean best time for males was found to be 10.99 and for females it was found to be 10.78. Conclusion: The overall speed range for 10 meter shuttle run test in Belagavi athletes is between 9.0012.70 Seconds. The speed range for male athletes is between 9.00-12.70 Seconds, and for female athletes it ranges between 9.00-12.50 Seconds. Mean best time for males was 10.69 Seconds [ABSTRACT FROM AUTHOR]

Background: The factors associated with the spontaneous remission (SR) of symptoms in carpal tunnel syndrome (CTS) are not well known. Objectives: To look for determinants of SR in medically treated, electrophysiologically proven patients of CTS. Methods: We revisited the medical records and nerve conduction study data of 130 hands with CTS and divided them into two groups as per the absence or persistence of the symptoms when contacted after a median time lapse of 3 years following the diagnosis. Results: SR occurred in 46.1% of the hands. Higher odds of SR were linked with female gender, symptoms restriction to lateral fingers, symptom duration <10 months, mildly delayed median motor and sensory distal latencies, and median sensory amplitude >20 µV. We developed a seven-point scale, on which a score of ≥4 had a strong association (odds ratio 4.31) with SR. Discussion and Conclusion: No single risk factor, standalone, can predict SR in patients with CTS, which could lead to an invasive treatment (Surgery or local injection) to them. We propose that patients scoring ≥4 on our 7 point scale should be treated medically for the initial 10 months after the symptom onset. [ABSTRACT FROM AUTHOR]

Objective. When exploring the scientific basis of reflexology techniques, elucidation of the surface and subsurface features of reflexology areas (RAs) is crucial. In this study, the subcutaneous features of RAs related to the lumbar vertebrae were evaluated by swept source-optical coherence tomography (SS-OCT) in subjects with and without low back pain (LBP). Methods. Volunteers without LBP (n = 6 (male : female = 1:1)) and subjects with LBP (n = 15 (male : female = 2:3)) were clinically examined in terms of skin colour (visual perception), localised tenderness (visual analogue scale) and structural as well as optical attributes as per SS-OCT. From each subject, 6 optical tomograms were recorded from equidistant transverse planes along the longitudinal axis of the RAs, and from each tomogram, 25 different spatial locations were considered for recording SS-OCT image attributes. The images were analysed with respect to the optical intensity distributions and thicknesses of different skin layers by using Axio Vision Rel. 4.8.2 software. The SS-OCT images could be categorised into 4 pathological grades (i.e., 0,1, 2, and 3) according to distinctness in the visible skin layers. Results. Three specific grades for abnormalities in SS-OCT images were identified considering gradual loss of distinctness and increase in luminosity of skin layers. Almost 90.05% subjects were of mixed type having predominance in certain grades. Conclusion. The skin SS-OCT system demonstrated a definite association of the surface features of healthy/unhealthy RAs with cutaneous features and the clinical status of the lumbar vertebrae. [ABSTRACT FROM AUTHOR]

Background: A variety of neurodegenerative disorders produce significant abnormal brain function which can be detected using fluorodeoxyglucose positron emission tomography (FDG PET) scan even when structural changes are not detected on CT or MRI Scan. A study was undertaken at our institute to evaluate the FDG PET/CT findings in Indian population suffering from mild cognitive impairment (MCI), Alzheimer's disease (AD), fronto-temporal dementia (FTD), dementia with lewy body disease (DLBD) and other miscellaneous causes of dementia. Materials and Methods: 117 subjects having neurocognitive deficits and 36 normals were included in our study. All patients underwent a detailed history and clinical examination. This was followed by a mini mental state examination. Subsequently an FDG brain PET scan and an MRI were done. Results: In the patient population included in our study group 36 were normal, 39 had MCI, 40 had AD, 14 had FTD, and 13 had DLBD and 11 dementia due to other miscellaneous causes. MCI patients showed primarily reduced tracer uptake in the mesio-temporal cortex. AD patients showed reduced tracer concentration in temporo-parietal lobes, while patients with advanced diseases showed frontal lobe disease additionally. In subjects of FTD, reduced radiotracer uptake in the fronto-temporal lobes was noted. In addition, FTD patients also showed basal ganglia defects. In contrast the DLBD patients showed globally reduced FDG uptake including severely affecting the occipital cortices. Conclusion: In the current study the F18-FDG PET scans have been shown to be highly useful in the diagnosis of various neurocognitive disorders of the brain. AD was found to be the most common dementia in the Indian population followed by MCI. Diffuse Lewy body disease, FTD and other miscellaneous categories of dementia had a near similar incidence. [ABSTRACT FROM AUTHOR]

In India, although incidence of Herpes zoster has not been assessed, regional cases have been reported. We revisited the peer-reviewed literature on clinical cases of HZ to depict the trends in population characteristics, disease presentation, and predisposing factors for the disease in India. Systematically conducted literature search yielded 27 studies, published between January 2011 and May 2020, reporting 3124 HZ clinical cases, with high proportions in older adults (>50 years of age: 15.0-81.3%). Thoracic dermatome was consistently reported as the most frequent site affected by HZ (38.9-71.0%). Post-herpetic neuralgia and secondary bacterial infections were the two most frequent complications (10.2-54.7% and 3.5-21.0%, respectively). Despite the paucity of data and gaps in the reporting of HZ cases, available evidence indicate that the disease causes an important burden to older adults in India, suggesting that preventive strategies, along with recommendations to healthcare practitioners, can help mitigate the burden of HZ.

Introduction: The COVID-19 outbreak and the subsequent declaration of pandemic was an unprecedented event, which created different complex situations for treatment of cancer patients. A critical assessment of the response to this calamity and its impact on healthcare workers (HCWs) and patient care in a dedicated cancer hospital is analyzed., Site of Study: Indrayani Cancer Hospital, Alandi, Pune, India., Materials and Methods: Due to the pandemic, standard operating protocols were decided on for each department. Analysis of the impact on healthcare was done by comparing the number of patients taking treatment in the lockdown period in India with the previous year's data in the same corresponding period in all three departments. The impact of COVID infection on the HCW and its repercussions were analyzed., Results: There was a marked decrease in the total number of patients during the lockdown period. The most affected department was surgical oncology. None of our patients contracted COVID-19, but one HCW was found to be positive., Conclusion: Strict adherence to protocols along with the support of the government authorities can prevent the spread of this virus thus providing optimal patient outcomes. The treatment of patients with cancer should not be delayed, even in times of a pandemic., (© 2020 Wiley Periodicals LLC.)

Despite vast improvements in childhood vaccination coverage in India, adult vaccination coverage is negligible. Our aim was, therefore, to create awareness about the importance of adult immunization. Although the true burden of vaccine-preventable diseases (VPDs) among Indian adults is unknown, adults are particularly vulnerable during outbreaks, due to a lack of immunization, waning immunity, age-related factors (e.g. chronic conditions and immunosenescence), and epidemiological shift. There are no national adult immunization guidelines in India, and although several medical societies have published adult immunization guidelines, these vary, making it unclear who should receive which vaccines (based on age, underlying conditions, etc.). Other barriers to adult immunization include vaccine hesitancy, missed opportunities, and cost. Steps to improve adult vaccination could include: adoption of national guidelines, education of healthcare providers and the public, and promotion of life-course immunization. Improving adult vaccine coverage could help reduce the burden of VPDs, particularly among older adults.

Rotavirus is a leading cause of severe pediatric diarrhea worldwide, with about 199,000 childhood deaths in 2015, of which 90% in low-income countries. India alone accounts for 22% of the global rotavirus gastroenteritis (RVGE)-related deaths among children below 5 years of age. The World Health Organization recommends introducing rotavirus vaccines (RVVs) as a priority in developing countries where high rates of RVGE are observed. To have the desired impact, RVV should be administered the earliest possible, ideally before the first episode of RVGE. In India, four RVVs are available for use in infants ≥6 weeks of age: the single-strain, two-dose, live-attenuated human RVV Rotarix; the five-strain, three-dose, human-bovine reassortant RVV Rotateq; the single-strain, three-dose, naturally reassortant human-bovine RVV Rotavac; and the five-strain, three-dose, human-bovine RVV Rotasiil; all of them proven to be efficacious and well tolerated. Whereas Rotarix and Rotateq have shown high efficacy/effectiveness against severe RVGE in developed countries (≥90%), they have been observed to be lower in developing countries (~40%-70%). Rotavac and Rotasiil have shown similar efficacy in low-income settings, but further studies are needed to assess their effectiveness. Rotarix and Rotateq have not shown increased intussusception (IS) risk in clinical trials. Postmarketing surveillances were able to show a very tiny increased risk of IS after the first dose of vaccine, but the extensive benefits of rotavirus vaccination far outweigh the low-level risk of IS. In India, where the disease is a major problem and occurs in very early months of life, RVVs should have high coverage and vaccination schedule should be completed as early as possible (≥6 weeks of age) to maximize the vaccine impact., Competing Interests: None

PRéCIS:: Anterior chamber depth, IOP, and thickness confounded the assessment of corneal biomechanical properties with noncontact applanation in glaucoma eyes. Compared with normal eyes, glaucoma eyes, which underwent long-term treatment or filtration surgery, had similar properties., Purpose: The purpose of this study was to evaluate corneal stiffness in primary angle-closure (PACG) and primary open-angle (POAG) glaucoma eyes that were subgrouped on the basis of the type of topical medication and filtration surgery using noncontact applanation., Methods: All eyes were retrospectively reviewed for intraocular pressure (IOP) with Corvis-ST (OCULUS Optikgerate Gmbh, Germany). Nonglaucoma (n=140), PACG (n=102 under medication), and POAG (n=154 under medication) eyes were included. Corneal stiffness was calculated using deformation amplitude and a biomechanical model. Multivariate analyses were performed, which evaluated the effect of systemic conditions (diabetes and hypertension), the effect of medication (prostaglandins or beta blockers or combined), and the effect of filtration surgery (PACG: n=23; POAG: n=26). Age, IOP, central corneal thickness (CCT), refractive error, and anterior chamber depth (ACD) were covariates., Results: Diabetes and hypertension did not alter corneal stiffness of glaucoma eyes compared with nonglaucoma eyes (P>0.05). Corneal stiffness of POAG and nonglaucoma eyes was similar but significantly different from the stiffness of PACG eyes (P=0.002), irrespective of the type of topical medication. This difference was strongly correlated with ACD (P=0.003) in addition to IOP and CCT. In eyes treated with filtration surgery, ACD (P=0.04) again impacted the trends between nonglaucoma and glaucoma eyes., Conclusions: Medication or filtration surgery did not affect the corneal biomechanical parameters differentially from nonglaucoma eyes. However, IOP, CCT, and ACD strongly affected corneal biomechanical parameters in the same glaucoma eyes.

Background: Sputum smear positive pulmonary tuberculosis patients expel infectious viable bacilli for a period following commencement of treatment. Patients on Directly Observed Treatment Shortcourse (DOTS) receive intermittent therapy with multidrug regimen., Aims: To determine the time to sputum smear and culture conversion following initiation of DOTS treatment and study the factors that influence it., Methods: A prospective study was undertaken at a tertiary care teaching hospital in Mumbai over a one year period on a cohort of 71 sputum smear positive patients on Category I DOTS treatment. Patients were followed up weekly for upto 20 weeks or until they underwent smear and culture conversion whichever was earlier. At each follow up, specimens were collected and processed for microscopy and culture using standard protocol., Results: 60/71 [84.55%] patients completed the study. 56/60 [93.3%] patients underwent sputum smear and culture conversion. The median time to smear and culture conversion was end of 5th week [day 35] and 6 1/2 weeks [day 45] respectively. Univariate and stepwise regression analysis showed that patients who had cavitatory disease, high pretreatment smear grade and a past history of tuberculosis were more likely to undergo delayed or nonconversion [P < 0.05]., Conclusion: The time to sputum smear and culture conversion under DOTS is similar to previous antituberculosis regimens. Since viable bacilli continue to be expelled for upto two months, infection control measures should be maintained for such time. Patients with cavitatory disease, high pretreatment smear grade or a past history of tuberculosis need to be monitored more closely.

Background: Patients receiving DOTS undergo periodic follow-up sputum examination, which aids in monitoring response to treatment. Continued or new smear positivity at follow up examination entails extension of intensive phase or change in treatment category and the need for culture and drug susceptibility test., Setting: Tuberculosis microscopy centre at a tertiary care teaching hospital, Mumbai, India., Objective: To determine the incremental yield in sputum smear positivity by examining a second early morning sputum specimen in follow-up patients on DOTS., Design: Retrospective analysis of follow up sputum microscopy results recorded in tuberculosis laboratory register for the period 2002-2008., Results: During the study period, 5015 follow-up patients submitted two early morning sputum specimens, of which 501(9.99%) patients were detected to be smear-positive. Out of smear positive patients under study, 324 patients had both specimens positive, 79 patients had only first specimen positive and 98 patients had only second specimen positive. The incremental yield was 1.95% of total and 19.5% of smear positives., Conclusion: Discordant smears were present in nearly a third of patients detected smear positive during follow-up. More than half of these patients were detected only by examining second specimen. The incremental yield by examining the second early morning specimen was 1.95% of total and 19.5% of smear positive specimens. It is important to detect each possible smear positive follow-up patient as they are likely to benefit from altered treatment. The inclusion of a second early morning sputum specimen examination is essential to maximize their detection.