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Solid process fine waste or tailings of a uranium mill is a potential source of release of radiologically significant gaseous radon (222Rn). A number of variables such as radium (226Ra) content, porosity, moisture content, and tailings density can affect the extent of emanation from the tailings. Further, if a cover material is used for remediation purposes, additional challenges due to changes in the matrix characteristics in predicting the radon flux can be anticipated. The uranium mill tailings impoundment systems at Jaduguda have been in use for the long-term storage of fine process waste (tailings). A pilot-scale remediation exercise of one of the tailings ponds has been undertaken with 30 cm soil as a cover material. For the prediction of the radon flux, a numerical model has been developed to account for the radon exhalation process at the remediated site. The model can effectively be used to accommodate both the continuous and discrete variable inputs. Depth profiling and physicochemical characterization for the remediated site have been done for the required input variables of the proposed numerical model. The predicted flux worked out is well below the reference level of 0.74 Bq m−2 s−1 IAEA (2004). [ABSTRACT FROM AUTHOR]

The focus of sustainable development goals (SDGs) is to promote the use of renewable energy so that countries can achieve better environmental quality. However, the progression is plodding, and still, 80% of energy comes mainly from conventional sources in developing countries. The implementation of procedures depends on the political attitudes, political stability, and quality of institutions. India has a diverse political structure ranging from central government to state government to local governments. In the late '80 s, India witnessed a stiff rise in regional and national political parties, which leads more political competition. This paper tries to explain the possible relationship between political competition and CO2 emission in India. With the application of the time series non-linear ARDL (NARDL) model, this study tries to find the asymmetric relationship between political competition and CO2 emission. In our empirical model, we also include other important elements of environmental quality like innovation and fossil fuel consumption. Empirical results show that political competition is asymmetrically related to CO2 emissions in the long run. Fossil fuel consumption and innovation also have a significant relationship with emissions. Based on the results, a few policy recommendations have been discussed. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Serum erythropoietin (S. EPO) continues to be a minor diagnostic criterion for discriminating polycythemia vera (PV) from other causes of erythrocytosis. However, in the current era of Janus kinase 2 (JAK2) mutation testing, its relevance for establishing the diagnosis of PV is controversial. AIMS AND OBJECTIVES: The study aimed to assess the utility of S. EPO in patients with absolute erythrocytosis and ascertain its sensitivity and specificity for establishing the diagnosis of PV. Further, the clinicopathological features of PV and JAK2-EPOlow erythrocytosis were compared to discriminate the two disease states. MATERIALS AND METHODS: A total of 286 samples had undergone concomitant testing for S. EPO levels and JAK2V617F mutation for various indications over a period of 60 months (January 2017-December 2021). Clinical details and laboratory parameters were retrieved from the electronic medical records. RESULTS: Among 203/286 (70%) patients with erythrocytosis, JAK2 positivity was noted in 49 (24.1%) patients. A subnormal S. EPO level (<3.2 mIU/mL) was noted in only 27/43 (62.7%) cases of de novo PV, while the postphlebotomy PV patients (n = 6) had normal S. EPO levels. The sensitivity and specificity of low S. EPO for establishing the diagnosis of PV were 62.7% and 77.4%, respectively, while the sensitivity and specificity of high Hb levels (>16.5 g/dL) with low S. EPO and for diagnosing PV was 62.7% and 79.0%, respectively, while the sensitivity of high Hb levels with JAK2 positivity was 89.7%. In addition, 14.7% (30/203) of cases of high Hb/hematocrit (median: 18 g/dL and range: 16.3-23.8 g/dL) belonged to the JAK2-EPOlow subgroup. The median age of these patients, red blood cell count, total leukocyte count, and platelet count were, however, significantly lower as compared to the PV (P < 0.05). CONCLUSION: Overall, a low sensitivity and specificity of S. EPO were observed for diagnosing PV as an isolated investigation, thus questioning its diagnostic utility, though high levels had an excellent negative predictive value. However, this simple and inexpensive test remains an important screening tool for evaluating patients with absolute erythrocytosis. [ABSTRACT FROM AUTHOR]

In the activity of Research Data Curation, the unpublished datasets generated during research are curated for possible reuse in future research by any researcher. Use of curated data, in several cases, may become helpful in avoiding repetition of efforts involved in generation of datasets. A large number of academic institutions in India are actively involved in research in various knowledge areas. Apart from the doctoral and post-doctoral research in academic institutions, academicians are involved in research projects sponsored by public or private bodies; thereby generating sizeable primary and secondary unpublished datasets worthy of curation in a data repository for possible reuse in some other research. For several reasons, curation efforts for research datasets in academic institutions in the country are negligible when compared to such efforts in research institutions. The present work makes an attempt to identify the cause of negligible research data curation efforts in academic institutions of India by uncovering the associated challenges and discusses the expectations from Research Data Repositories of academic institutions. [ABSTRACT FROM AUTHOR]

Background: The outcome of acute myeloid leukemia (AML) in low-middle-income countries (LMIC) is dismal due to delayed clinical presentation and infection-related complications. We aimed to analyze the outcome of patients with AML and the factors associated with its prognosis. Methods: A retrospective observational study was conducted at a tertiary care university hospital in North India from January 2015 to December 2019. Results: A total of 137 AML patients (median age 32 year (3–66 years) received intensive chemotherapy during study period. The median delay from diagnosis to treatment was 45 days (6–177 days). Among the 352 febrile neutropenia (FN) episodes analyzed, 175 (49.7%) were culture positive; Gram-negative multi-drug resistant organism (MDRO) sepsis during induction being 57.4% with 34.5% infections due to carbapenem-resistant Enterobacteriaceae (CRE) leading to a mortality rate of 14.6%. The median EFS and OS were 12.0 ± 1.57 (95% CI 8.91–15.08) and 15.0 ± 2.44 (95% CI 10.21–19.78) months respectively. Multivariable analysis revealed significant difference in median OS between favorable vs high risk AML groups (20.0 (95% CI: 12.50–27.49) vs 9.0 (95% CI: 2.99–15.01) months; p = 0.002); time from diagnosis to treatment (< 30 days vs ≥ 30 days; not reached vs 9.0 (95% CI: 6.81–11.18) months; p = 0.001), performance status (1 vs 2 vs 3; not reached vs 12.0 (95% CI: 10.32–13.67) vs 4.0 (95% CI:2.77–5.22); p = 0.001), and attainment of complete remission vs induction failure (not reached vs 6.0 (95% CI: 3.78–8.21); p = 0.002). Conclusion: Patient-related factors like delayed treatment initiation and high incidence of MDRO-associated sepsis are critical determinants of AML outcome in LMIC. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the pooled prevalence of dental caries among Indian population through systematic review and meta-analysis. Materials and Methods: A keyword search was conducted in PubMed, Science Direct, Google Scholar, Cochrane, and Scopus databases using relevant key words to extract the data pertaining to dental caries in Indian population. The search criteria included manuscripts published in English language from March 2009 to March 2019 and employed standard Boolean operators. The studies which met the inclusion criteria were independently reviewed by two researchers and their quality was assessed by the Newcastle-Ottawa Scale. The overall prevalence was deduced using the random effects model with prime focus given to the site of anatomical origin. R software version 3.5.2. was used for statistical analysis. Results: Post screening, out of the 253 articles identified, 70 met the inclusion criteria and were used to generate the meta-analysis. Among them, only few studies investigated the prevalence of root caries (n = 1). Overall prevalence of dental caries was 54.16% (CI: 0.4966-0.5866), whereas age-specific prevalence was 62% in patients above 18 years and 52% among 3-18 years of age (P < 0.0001). Maximum overall prevalence was noted in mixed dentition (58%). Region wise prevalence was more in western India (72%). Use of decayed, missed, and filled teeth as diagnostic criteria for early childhood caries was only 29%. Conclusions: Besides an overall prevalence of 54.16%, there exists a remarkable variation in dental caries prevalence rates as per age, diagnostic criteria, dentition, and geographical region. Furthermore, research should be focused on the prevalence of anatomical site specific caries as well. [ABSTRACT FROM AUTHOR]

The global outbreak of COVID‐19 and subsequent lockdowns raises serious economic concern and havoc worldwide. This article tries to provide an economic perspective of COVID‐19 in India using some statistical figure of economic indicators. Analysis is based on the data collected for macro‐economy, travel & tourism, transportation, stock market, human capital and trade. Finding revel that India could experience a health debacle at present and excruciating economic contraction in the near future if the government is unable to execute a proper policy framework. Based on the discussion, a few policy suggestions have been presented to counter both health and economic crisis. [ABSTRACT FROM AUTHOR]

Introduction: A prototype of good prognosis, t(8;21)‐positive AML, has diverse clinical and genetic features which affect its outcome. This study aimed at evaluating the clinico‐pathological spectrum of t(8;21)‐positive AML and ascertaining prognostic factors influencing its outcome in the Indian subcontinent. Methods: A retrospective analysis of 75 cases of t(8;21)‐positive AML diagnosed over a period of six years (2013‐2018) was carried out. Detailed clinical and laboratory data of the patients were collected from the electronic medical records and reviewed. Results: Median age was 19.5 years (range 5‐75 years) with a M:F of 1.7. Myeloid sarcoma was observed in 9.3% cases. There were 85% FAB AML‐M2, 8% AML‐M1, and 7% AML‐M4 subtypes. Prominent morphological characteristics included dyspoiesis in maturing myeloid cells (83%), long thin tapered Auer rods (58%), cytoplasmic vacuoles (58%), eosinophilia (50%), and mast cells (22%). Auer rods in maturing granulocytes (4% cases) were highly suggestive of the translocation. Additional cytogenetic abnormalities were present in 53% cases. Seventy‐one percent (25/35) achieved CR. The overall survival (OS) was 40%, with a median follow‐up of 27 months (range 4‐57 months). None of the hematological or cytogenetic factors correlated with OS, except for the presence of myeloid sarcoma which had a trend toward poor survival (P =.07). Conclusion: Outcome of t(8;21) AML is not influenced by any of the clinico‐pathological parameters, except for a myeloid sarcoma, which may herald a poor prognosis. Recognition of this distinct subtype of AML would facilitate further molecular screening for risk stratification in resource‐constrained settings. [ABSTRACT FROM AUTHOR]

Objective To understand patients' perspectives on the causative factors and preventive measures of obstetric fistula; and the effect of fistula on the victims' psycho-social, sexual, and economic well being. Methods A questionnaire-based interview of 215 women with obstetric fistula admitted for treatment in 17 hospitals in India was carried out during 2010-2011. Responses of participants from poor, medium, and better performing states were categorized into pre-coded themes and compared. Results The majority of the women were from rural areas (75.3%), multiparous (68.8%), and with less than high school education (82.2%). The majority (70.7%) of the women reported attempt at home delivery by untrained persons. Poor awareness of where and when to seek care when faced with a difficult delivery, and poor quality of care in facilities were perceived as important causative factors. Delivery by trained providers and early referral of women with problems during labor were identified as important preventive factors. Spouses and families were supportive of treatment in spite of economic hardships, but most (79.5%) patients felt socially isolated after developing fistula. Conclusion Poor awareness regarding delivery care among the women indicates a need for increasing birth preparedness in the community. Patients' perceptions of poor quality of care in facilities need to be addressed urgently. Psychological evaluation and counseling should be offered to fistula patients, to help them cope with adverse psycho-social and economic circumstances. The results of this study may provide insights for prevention and management of fistula, and may help to improve patient care and services. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of the study is to find out the incidence of different types of head injury patients and their outcome at the time of discharge. Method: All Traumatic Head Injury patients admitted during the period between 2013 to 2015 under the Medanta Institute of Neurosciences, Medanta the Medicity Hospital were included for the study after getting institutional consent form signed. Comprehensive assessment of the patients was done by the neuro physiotherapist including but not limited to Glasgow Coma Scale, Modified Rankin Scale, and Barthel Functional Index. All patients were provided neuro-rehabilitation as per the hospital protocol which includes maintaining chest hygiene, coma arousal techniques, appropriate positioning, limb exercises, mobilization, etc. Patients functional capacity and disability was assessed using barthel index and modified Rankin scale. Discharge counseling was given to the patients and attendants of the head injury patients at the time of the discharge and they were assessed again by Modified Rankin Scale and Barthel score. Results: The patients were categorized into mild, moderate and severe head injury based on their GCS at the time of admission - 140(40.9%) severe head injury patients, 62 (18.1%) moderate head injury patients, 140 (40.9%) mild head injury patients. Analysis of their outcomes showed that there is significant improvement in patients condition with respect to Modified Rankin Scale and Barthel Score in all 3 categories of head injury - mild, moderate and severe head injury (p<0.001). Inter-group comparison of outcomes revealed that there is significant improvement in Moderate head injury groups compared to other groups. Analysis also revealed that there is high correlation between mRS and Barthel scores at admission, discharge and mean difference between admission and discharge scores (p <0.001). Conclusion: The patients with different severity of injury improved significantly during hospital stay with respect to mRS and Barthel Score. [ABSTRACT FROM AUTHOR]

Neurocysticercosis (NCC) is one of the most common parasitic diseases affecting the central nervous system. Typically spinal NCC involvement has a concomitant cranial involvement. Spinal involvement by NCC, either intramedullary or extramedullary is very uncommon. The authors report a case of D12-L1 intradural extramedullary lesion in a 38-year-old female patient who presented with complaints of back pain and weakness of lower limbs. She underwent laminectomy and excision of the lesion. Histopathology revealed extramedullary cysticercal abscess. Post-operatively she was treated with albendazole. She had a successful recovery post-operatively and at 8 months follow up had no neurological deficits. This current case presents a very rare case of cysticercal abscess of dorsolumbar spine, without any evidence of cranial involvement. This report is to reemphasize the importance of including NCC as a differential diagnosis in intradural extramedullary lesion at the conus level in endemic areas like India. [ABSTRACT FROM AUTHOR]

In this study, residual concentrations of chlorpyrifos (CPF) were determined in feed (40) and fodder (25) samples collected from various locations of Tarai region of Uttarakhand. For extracting residues, liquid–liquid partition followed by alumina column clean up was used and the detection and quantification of residues was undertaken with the help of high-performance liquid chromatography using C18 column and diode array detector at 220 nm. Of the total 40 feed samples analyzed, 7 (17.5%) samples were found positive for CPF with the mean residual concentration of 0.058 µg g−1; while out of 25 fodder samples, CPF residues were detected in a single (4%) sample with residual concentration of 0.39 µg g−1. However, none of the feed or fodder samples contained CPF residues above the prescribed limit. [ABSTRACT FROM PUBLISHER]

Highlights • Spotted fever group (SFG) and typhus group (TG) rickettsiae are endemic in Gorakhpur, India. • SFG and TG rickettsioses may have roles as potential causes of acute febrile illness and acute encephalitis syndrome outbreaks. • SFG IgM positivity was significantly higher among females, while IgG positivity was significantly higher in individuals ≥45 years of age. • TG IgM and IgG positivity were significantly higher in individuals involved in outdoor activities and among housewives. Abstract Background The aim of this study was to estimate the seroprevalence of spotted fever group (SFG) and typhus group (TG) rickettsiae among individuals with acute febrile illness (AFI) in the scrub typhus endemic district of Gorakhpur in India. This district is one of the worst affected by annual seasonal acute encephalitis syndrome (AES) outbreaks. Methods Antibodies against SFG and TG rickettsiae and the associated risk factors were determined in 294 individuals presenting with an AFI, encountered during a community-based survey conducted during the AES outbreak period October–November 2016. Results Respective IgM and IgG seropositivity was 13.6% and 36.7% for SFG, and 7.1% and 15.3% for TG. SFG IgM positivity was significantly higher among females, while IgG positivity was significantly higher among individuals ≥45 years of age. IgM and IgG seropositivity for TG rickettsiae were significantly higher in individuals involved in outdoor activities and housewives, but did not differ according to age group, sex, or educational status. Conclusion The study results present serological evidence of SFG and TG rickettsiosis, in addition to scrub typhus, among individuals with AFI in Gorakhpur region and indicate the need to explore their roles as potential causes of AES in the region. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM), has been associated with increased fracture risk. However, there are no data pertaining to the prevalence of fractures for patients with DM in India. The aim of this study was to determine the prevalence of fractures in Asian Indians with and without diabetes. The study used the data of Indian Council of Medical Research–India Diabetes (ICMR–INDIAB) study, a community- based cross sectional survey conceived with the aim of obtaining the prevalence rates of diabetes in India as a whole. A community-based sample of 57,117 individuals aged ≥20 years was obtained. Diabetes was diagnosed by oral glucose tolerance test using capillary blood (except in self-reported diabetes). Fractures were self-reported. Fracture data were available in 54,093 subjects. Out of these, 1416 (2.6%) had fractures. Overall prevalence of diabetes and prediabetes was 7.1% and 10.5% respectively. Prevalence of fractures was significantly higher in diabetes group (4%) compared with non-diabetes group (2.5%). In multivariate logistic regression analysis, diabetes was associated with an increased risk (1) of any fracture (OR=1.28, 95% CI: 1.07–1.5) and (2) of low trauma fracture (hip and spine combined) (OR = 1.8, 95% CI:1.1–2.8). After gender stratification, diabetes was a risk factor for fracture only in women. Age (>40 years) in women, high waist circumference (>90 cm) in men, alcohol consumption and urban residence in both men and women were other significant contributors to fracture risk. Increased prevalence of self-reported fractures was seen in individuals with diabetes in this population-based study from India. • Increased prevalence of self-reported fractures was seen in Asian Indians with diabetes. • Diabetes was a significant risk factor for fracture (OR = 1.28). • Old age in women, high waist circumference in men and alcohol intake were other risk factors for fracture. [ABSTRACT FROM AUTHOR]

Background & Objectives: In India, acute encephalitis syndrome (AES) cases are frequently reported from Gorakhpur district in Uttar Pradesh. Scrub typhus is one of the predominant aetiological agents for these cases. In order to delineate the extent of the background of scrub typhus seroprevalence and the associated risk factors at community level, serosurveys during both lean and epidemic periods (phase 1 and phase 2, respectively) of AES outbreaks were conducted in this region., Methods: Two community-based serosurveys were conducted during lean (April-May 2016) and epidemic AES (October-November 2016) periods. A total of 1085 and 906 individuals were enrolled during lean and epidemic AES periods, respectively, from different villages reporting recent AES cases. Scrub typhus-seronegative individuals (n=254) during the lean period were tested again during the epidemic period to estimate the incidence of scrub typhus., Results: The seroprevalence of Orientia tsutsugamushi during AES epidemic period [immunoglobulin (Ig) IgG: 70.8%, IgM: 4.4%] was high as compared to that of lean AES period (IgG: 50.6%, P <0.001; IgM: 3.4%). The factors independently associated with O. tsutsugamushi positivity during lean AES period were female gender, illiteracy, not wearing footwear, not taking bath after work whereas increasing age, close contact with animals, source of drinking water and open-air defecation emerged as additional risk factors during the epidemic AES season. IgM positivity was significantly higher among febrile individuals compared to those without fever (7.7 vs. 3.5%, P=0.006). The seroincidence for O. tsutsugamushi was 19.7 per cent, and the subclinical infection rate was 54 per cent., Interpretation & Conclusions: The community-based surveys identified endemicity of O. tsutsugamushi and the associated risk factors in Gorakhpur region. The findings will be helpful for planning appropriate interventional strategies to control scrub typhus., Competing Interests: None

Objective: To prospectively report and grade the perioperative complications of ureteroscopy (URS) for stone removal using a semirigid ureteroscope with the modified Clavien classification system and to identify the determinants of the complications., Methods: From August 2010 to November 2011, the prospective data from 120 consecutive patients (71 men and 49 women) who had undergone primary unstented URS at a resident training center were analyzed. Patients with renal failure, pyonephrosis, diabetes mellitus, hypertension, and congenital ureteral abnormalities were excluded (n = 29). The data recorded included patient demographics, stone size and location, and complications according to the modified Clavien classification system., Results: Of the 120 patients, 36 (30%) experienced 79 complications. The stone size was ≤ 10 mm in 56 and >10 mm in 64 patients. The stone location was the lower, mid-, and upper ureter in 62, 58, and 3 patients, respectively. The latter 3 were excluded because of the small sample size. Grade 1, 2, 3a, 3b, 4a, and 4b complications were encountered in 46 (38.3%), 18 (15%), 3 (2.5%), 10 (8.3%), 1 (0.8%), and 1 (0.8%) patient, respectively. The incidence of complications was greater for stones >10 mm, a mid- versus distal ureteral location, impacted stones, and surgery performed by a resident. The incidence was not affected by patient sex, stone laterality, or lithotripter type. The patients with complications had a longer operative time (75 vs 46.5 minutes), longer hospitalization (4.8 vs 1.5 days), and lower stone-free rate (64% vs 97%)., Conclusion: Most complications were grade 1-3 (98%), and grade 4 complications were rare (<2%) with URS. The present study is probably the first to prospectively study the complications of URS using the modified Clavien classification system., (Copyright © 2012 Elsevier Inc. All rights reserved.)