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The technology-supported education systems seamlessly integrated throughout the globe in response to the demands of post COVID-19 pandemic. The swift developments of the digital tools with Artificial Intelligence (AI) support are also readily diffused among the educational communities. This research paper investigates the synergistic impact of digital literacy, the incorporation of AI tools, and Peer Supported Collaborative Learning (PSCL) on the learning perceptions of university students. The research aims to discern the implications of these technological and social facets on students' attitudes towards AI assisted learning process. Structured questionnaire-based survey among the University students were done for this descriptive research. 409 responses collected were analysed with SPSS, Excel and Process Macro. It is found that the students' Digital Literacy, Use of AI tools and PSCL on AI assisted learning were positively correlated. The partial mediatory path through the PSCL and AI tool usage has a significant positive influence on students learning process. The insights gathered from this study can inform educators, policymakers, and institutions on optimizing the amalgamation of digital literacy, AI tools and PSCL to enhance the contemporary learning environment. As universities navigate the digital age, this research provides a nuanced understanding of the dynamics shaping students' perceptions, offering valuable insights into the multifaceted aspects of AI influencing the educational landscape.

In this article, we report the development and psychometric validation of the Teachers' Receptivity to Change Scale (TRCS). The sample included secondary school teachers of Kerala, India. In India, the teachers' receptivity to change becomes important in the context of the newly drafted National Education Policy, (2020) which places teachers' at the center of the reforms. The present study proceeded through five phases namely item analysis, exploratory factor analysis, confirmatory factor analysis, validation of the scale, and test-retest reliability. The development of the tool started with the generation of a pool of items followed by item analysis. The exploratory factor analysis extracted four factors and the confirmatory factor analysis confirmed the four-factors namely individual, organizational, educational, and bridging factors. The structural equation modelling established the four-correlated factor construct of teachers' receptivity to change and an additive model indexing teachers' receptivity to change as the sum of the four factors. Both the model fit indices indicated an excellent fit. The validity of the TRCS established by correlating the teachers' receptivity to change and its factors with multidimensional work motivation scale and engaged teachers' scale indicated a moderate correlation. The final 28 item TRCS showed adequate internal consistency (Cronbach's alpha = 0.897) and discriminant validity. The test re-test reliability analysis (Cronbach's alpha = 0.884) confirmed the temporal stability of the scale. The findings recommend a psychometric reliable and valid scale for assessing teachers' receptivity to change with implications for teachers, researchers, and policy makers.

Intercultural Perspectives on Information Literacy and Metaliteracy (IPILM) is a discourseoriented learning environment that engages students from diverse cultural backgrounds to participate in collaborative knowledge construction. The objective is to evolve a thematic approach to course design that includes elements of open pedagogy, information literacy, and metaliteracy. IPILM invites participation from educators and learners from around the world and has witnessed an increase in participating countries. This paper describes the concept of IPILM and demonstrates the implementation of this approach in practice. The initiative was well received by students and is both feasible and sustainable as an intercultural learning endeavor. IPILM is an ongoing project and a work in progress that is an adaptable model which may be transferred to disparate fields of teaching and learning or adopted by international communities of instructors.

Purpose: The objective of the study was to explore the factors influencing the career decisions of students doing the students' undergraduate (UG) and postgraduate (PG) programmes from urban private universities/colleges in the Indian context. Design/methodology/approach: Career decision-making is determined by different factors and is contextual. The present study explores and identifies the prominent factors influencing career decision-making. A pool of 33 questions was developed, and these questions were initially administered to a sample of 233 students. Principal component analysis with Varimax Rotation identified salient factors. In the second study, confirmatory analysis was performed based on the opinion of 304 students. Findings: The study shows that the student's career deciding factors include: (1) career clarity, (2) career exploration, (3) career reward and recognition and (4) career initiative for professional and personal growth. Originality/value: The study focussed on career-deciding factors for UG and PG students from urban universities/colleges in the Indian context and the findings can be used for planning career counselling interventions.

Digital technology systems are adopted rapidly throughout the globe for the virtual learning process especially with the outbreak of the COVID-19 pandemic. Digital screen-based gadgets are integrated to provide a seamless interactive medium of learning even before the initiation of formal education. Studies on the technology use of younger children are critical as uncontrolled gadget use affects their developmental stages yet these studies are still in the infancy stage. This study analyses the impact of extended use of digital gadgets and mobile dependency on early childhood manifested through their cognition, socialization and behaviour. This descriptive study is based on the random responses of 511 parents about their young children of 3-6 years distributed at five civil districts of Kerala State. From the analysis, it is found that the extended use of digital gadgets influenced young children's mobile dependency, socialization process, cognition and behaviour patterns. The young children exhibited alienation tendencies and behavioural deviations which are correlated to their screen time. Both male and female reported similar results. Significant differences were observed by the parents with respect to the age of the children and their parental characteristics. Their mobile dependency mediated their extended digital Screen Time to the Behaviour. Significant relation was predicted by extended Screen Time on Behaviour of the students with a partial sequential path through mobile Dependency, Cognition and Socialization. The study sheds light on the urgency of parental care and implementation of a balanced gadget usage system to reduce the detrimental impacts of gadget usage.

This paper narrates the concept of Sustainable Peace Leadership and examines how three prominent Peace Activists from South and Southeast Asia measure up to the concept. The article will consider the works and ideas of Mohandas K. Gandhi (Mahatma Gandhi), Lhamo Thondup (The 14th Dalai Lama), and Nguyen Xuan Bao (Thich Nhat Hanh). Mahatma Gandhi was instrumental in achieving Indian independence from the British Empire. The Dalai Lama is the spiritual leader of the Tibetan people and has managed a difficult relationship with the Chinese government following the occupation of Tibet. Thich Nhat Hanh was a Vietnamese Buddhist monk, peace activist and is known as the 'father of mindfulness'. The paper identified several characteristics of Peace Leaders. These include being a charismatic leader who motivates their followers to achieve their goals in a non-violent and inclusive manner. Peace leaders meditate and spend time developing inner peace which then leads to outer peace. The paper also asserts that peace leaders are capable of recognizing the humanity in their opponents and seek a mutually beneficial solution. The three chosen individuals are all recognised as being charismatic leaders who were prominent peace leaders. All were deeply spiritual and practiced meditation and other inner work on a regular basis. They stressed the humanity in their opponents, based on their religious beliefs and the concepts of non-duality and interdependence.

In classification learning of artificial stimuli, participants learn the perfectly diagnostic dimension better than the partially diagnostic dimensions. Also, there is a strong preference for a unidimensional categorization based on the perfectly diagnostic dimension. In a different experimental procedure, called array-based classification task, participants do not exhibit a preference for a unidimensional categorization. In Experiment 1, we replicate the above results. In Experiment 2, we show that when participants learn the partially diagnostic features through repeated testing, there is a decrease in unidimensional categorization. We use Bayesian modeling to show that only those participants who learned the diagnosticity of a dimension with a high level of accuracy ([greather than or equal to]75%) used the dimension for categorization. Our results show that whenever accurate knowledge about feature diagnosticities is available, there is a lesser preference for unidimensional categorization. Our results provide a possible explanation for the preference of unidimensional categorization in classification and observation learning.

Understanding the current and preferred organizational culture among school teachers in India is a primary requirement, particularly when the National Educational Policy (NEP) is being implemented. Measuring the competing values using the Organizational Culture Assessment Instrument (OCAI) provides information about the dominant characteristics of the organizational culture and the school teachers' preferences. We surveyed school teachers and received 273 responses. Research revealed that clan culture is the overall current and preferred organizational culture type. Many of the results are not a surprise. However, we found that organizational leadership is currently in the hierarchy culture and strategic emphasis is on adhocracy, whereas teachers prefer a clan culture on these dimensions. Teachers expect school leaders to be the ones who facilitate the path to achieve, provide mentoring, and are instrumental in team building. They prefer a culture that provides for the development of human capital, promotes high trust and transparency among teachers, and offers an opportunity to participate in decision-making. This study is unique as it measures schools' organizational culture that has not been done earlier in the Indian context. The results suggest implications on the leadership practices and the strategic emphasis that need to change, in order to facilitate the implementation of the National Education Policy (NEP).

Rapid technology advancements resulted a fundamental shift in the education sector which redefined the teaching-learning process and teacher engagement. Based on numerous studies on work engagement models and technology readiness, this study explores, how the teachers' readiness to embrace educational technologies, impact on teacher engagement. With stratified cluster sampling model, data were collected from principals, managers, students and 122 teaching staff from the Higher Secondary Schools of Kerala participated in this quantitative study using standardized tools. The study affirmed that age has negative relation with technology readiness and teacher engagement shows an organic technology adoption trend than a disruptive style. Teachers were highly engaged with students-colleagues and varied across experience/age groups. Technology readiness factors positively impacted on social engagements with students-colleagues. As education technology usage is exponential, more future research is needed.

The study was conducted to assess social-emotional competencies among Indian and Ethiopian undergraduates. A total of 400 (200 each) participants, with an equal number of 100 male and female were selected through a multi-stage sampling procedure from Punjabi University (India), and Wollega University and Ambo University (Ethiopia). The participants were tested with the Social Skills Inventory (SSI: Riggio & Carney, 2003), which consists of two super-dimensions, i.e. emotional competence and social competence each having three sub-dimensions: emotional expressivity, emotional sensitivity, emotional control, and social expressivity, social sensitivity and social control respectively. Obtained data were subjected to t-statistics. Significant mean differences in social-emotional competence were observed between the Indian and Ethiopian young adults; male and female samples of the two countries. The Indian sample was greater in Social-emotional competence than the Ethiopian sample. Similarly, male and female participants from the Indian sample were greater in social-emotional skills than that of the Ethiopian sample, except for emotional sensitivity with the female participants, where the mean difference was non-significant. Further explorations are recommended to consolidate or refute the result of the present study.

While all higher education was affected by the COVID-19 pandemic, study abroad programs were uniquely challenged by the associated restrictions and limitations. This case study integrates a Collaborative Online International Learning (COIL) pedagogy approach and virtual reality (VR) technologies into the curriculum redesign process to transform a business study abroad course into an online format. Using VR technology, U.S. students and their international partners in Germany, Brazil, and India created and shared cultural exchange virtual tours. The redesigned online study abroad course engaged students in active learning activities and cultivated students' intercultural competence development.

The forced changes and disruptions in educational systems and learning experiences due to the pandemic has impacted students' mental health and well-being. The present study aims to understand the effects of the determinants of well-being on students in India during the second wave (April to August 2021) of the COVID-19 pandemic. The determinants of well-being in this study are academic grit, intolerance to uncertainty and students' engagement in an online learning environment. In this study, well-being is characterized as students' confidence and satisfaction in an online learning and pandemic environment. The data collected from 1174 students (12-19 years) from various states, using standardized tools, were analyzed to find out about the mediating effect of students' engagement on the relationship between academic grit and well-being, and between intolerance to uncertainty and well-being. Further, the model fit analysis of the determinants of well-being is explored. The paper reports that students' classroom engagement does mediate in the path of academic grit and well-being, and in the path of intolerance to uncertainty and well-being. It also evidence the model fit of the influence of the determinants of well-being on that of school students during the second wave of the COVID-19 pandemic. The study also draws implications and suggestions for educators using the current model of students' well-being.

Identifying the determinants of positive coping is a critical step in empowering the parents of children with intellectual disability. In this context, this study aims to develop a scale to assess the determinants of positive coping. Accordingly, culturally relevant items were pooled, got validated by experts and refined. The scale was administered to 150 parents of children with intellectual disability. Factor analysis done through polychoric correlation helped reduce the items. Cronbach's alpha coefficients were established for reliability testing. The validity of the new scale was examined with the subjective wellbeing on a visual analogue scale and Family Interview for Stress and Coping in Mental Retardation. The new scale has a Cronbach's alpha of 0.71 and an intraclass correlation of 0.64. After factor analysis, 12 items were retained in the final version. This study also identified specific factors associated with positive coping. The new scale can be used with parents of children with intellectual disabilities to identify the determinants of positive coping.

This article investigates entrepreneurial marketing (EM) and use of business recovery frameworks within experiential learning cycles (ELC)s to investigate post-COVID learning techniques during the learning process. Three distinct post-graduate learner cohorts took part in the study consisting of part-time MBA entrepreneurs from the United Kingdom, part-time upGrad MBA students from India (managers and marketers in large firms) and full-time MCom (Masters in Commerce) marketing students in New Zealand. This inductive study uses coursework artifacts, student feedback with thematic coding, and analysis from live business projects. Use of the post-disaster business recovery framework led to deeper learning, increased understanding, and generation of insights and new knowledge. Both student learner and entrepreneurial marketer skills and competencies are evidenced as essential for business resilience and growth in post-pandemic environments, while the framework aided co-creation of learning between the student and the focal business. Implications for marketing educators are offered together with future opportunities for education research in the EM education, entrepreneurship education and marketing fields. The study will allow educators to understand the three student typologies, leading to effective and impactful pedagogy in EM education.

This article summarizes the responses of the sample of Indian school-based counselors who contributed data to the international factor analysis that identified five dimensions of practice. Forty-five complete surveys (i.e., the International Survey of School Counselor's Activities) were obtained from Indian school-based counselors most of whom had a Master's degree in counseling psychology. Counseling Services, Advocacy and Systemic Improvement, Preventive Programs, and Educational and Career Planning were all considered important components of role. Activities related to the Administrative Role were considered as inappropriate. Compared to the other countries, the scores from India suggest that the school-based counselors gave relatively high importance to Counseling Services, Advocacy and Systemic Improvement, Preventive Programs, and Administrative Role. These results are interpreted with respect to important contextual factors operating in India which influence the work of counselors in school.

This report presents the compilation of interaction analysis of a month long online discussion that supplemented regular FAIMER fellowship programme for health professional teachers. Online discussion forums are considered as an effective means and if conducted using appropriate protocols and activities will help learners to share and gain knowledge from each other. Research on interaction analysis stresses the need for proper protocols to evaluate online discussion for meaningful learning. For preparing this report Henri's (1992) model for interaction analysis of computer-mediated communication was used for the qualitative analysis of electronic discourse that held as part of FAIMER programme among the 2015 and 2016 FAIMER fellows. The key domains examined for reporting are electronic interaction, social cues, cognitive skills and depth of information processing and metacognitive skills and knowledge. Transcript of interaction analysis of 454 mails posted for the entire month revealed most of the interactions were linear and some are of branching type. The social cues used during this computer mediated communication gave recognition to the moderators. Around 60% of participants' information were at the surface level, 25% were at an in-depth level of information processing, and nearly 15% were of both surface and deep information processing. The metacognitive activities identified by Henri, such as planning, self-awareness, and evaluation were also witnessed in this online discussion making the discussion forum learner-centered. The outcomes of this maiden attempt on the interaction analysis supports the assumption of online discussion forums as an important component of online courses, and the need for usable protocols for analyzing the effectiveness of online discussions as a form of computer-mediated communication. Thus, the FAIMER online discussion forum that was created for collaborative learning on the topic "Giving Feedback" fulfils the criteria proposed in Henri's protocol for evaluating meaningful collaborative learning through online discussions. Online discussions if conducted following appropriate protocols will have greatest potential on the impact of learning and can serve as easy and effective means of capacity building of health professional educators.

Purpose: In this study, we explore students' views and experiences in relation to education about, through, and for human rights, peace, and sustainability in the global north and south. We investigate what students after nine years of schooling see as central issues and productive actions linked to key elements of global citizenship education (GCE) to better understand the complexity of GCE in theory and practice. Design: We use a survey designed in line with theories of global citizenship education. Using a mixed methods approach, we analyse responses from 672 upper secondary school students, aged 16-19, in England, India, New Zealand, South Africa, and Sweden. Findings: We find that students in different contexts may experience global citizenship education very differently, even if they are all part of a global community with guidelines from UNESCO. Dimensions of human rights education, peace education, and education for sustainable development are evident in both the global north and south; yet, students in European contexts, namely in Sweden and England, for instance, appear to be taking away very different learnings. Overall, while students across the national samples have knowledge about human rights, peace, and sustainability, they seem to struggle to identify activities for human rights, peace, and sustainability. We find a vernacularisation of GCE, highlighting a diversity of methods and cultural contexts linked to students' experiences from education. Research limitations: This study is limited to a few schools in selected countries; thus, our findings may not be generalisable on a national or global level. Practical implications: Students across our diverse sample highlight the importance of education to promote global goals. Findings indicate that more focus on education for global citizenship is necessary if schooling is to work in line with international recommendations. Similarities and differences in students' knowledge and understanding about peace, human rights, and sustainability call for differentiated and localised approaches in attempts to reach common and shared goals.

Though several studies have been undertaken to explore the correlates of academic achievement, there is a dearth of studies relating to the cognitive profiles of children who show marked discrepancies between their cognitive potential and actual academic achievement. The present study was undertaken in this context. The study was conducted on a sample of 308 students in the age range of 12-16 years, drawn from different schools in Kerala, India. The participants belonged to four groups, that is, Underachievers, Normal achievers, Overachievers, and those with Specific Learning Disorders (SLD). WISC-IV India and Rey Auditory Verbal Learning Test (RAVLT) were used for assessing cognitive functions. Results indicated that the SLD group could be discriminated from the other three groups in terms of Digit span, Letter-Number sequencing, Working Memory Index, and Processing Speed Index. Further, a retention score obtained from RAVLT could discriminate between the SLD and UA groups. Discriminant analysis of the variables resulted in the extraction of two significant functions composed of three variables of WISC and two variables of RAVLT. The results indicated that the different groups of scholastically backward children, though similar in their overall IQ, had distinct and characteristic cognitive profiles.

Changes within the structure of a dynamic market and competition influences purchasing preferences and behavior of customers. The consumption fact of today differs from traditional consumption perceptions. This difference is caused by the fact that the act of consumption is not only based on utilitarian but also hedonic instincts. The shopping experience can range from pleasing to terrible, that would be based on a variety of factors including how the customer is treated, convenience, the type of goods being purchased and mood of the customers. In hedonic oriented consumers derive satisfaction from the shopping activity itself on the other hand the task oriented consumer engages in shopping out of necessity. consumers choose the products with the help of media because media give the full detail about the products, offers and about discount etc. The present study attempts to examine the role of media on college going girls towards hedonic shopping. The study has been based on the primary data from 51 degree students from Alphonsa College, Pala. The data are collected using Purposive Random Sampling Technique.

The sudden COVID-19 outbreak has obstructed the conventional method of teaching causing a mandated shift to virtual platforms. A developing country like India which predominantly depended on conventional methods of teaching and learning in the pre-COVID era is gradually gaining success in effectively transitioning into virtual classrooms with the aid of digital programs and online platforms to resume theoretical education. However, chemistry education, in particular, which involves the physical approach to experimentation in conventional laboratories, requires a practical and effective alternative in the virtual arena. Though the country's digital progress has provided virtual experiments that can be helpful in laboratory learning, only very few instructors/teachers are aware of such opportunities. The adaptability and accessibility to virtual laboratories in the Indian context also remain unclear due to various factors that influence the transition from conventional laboratories to virtual laboratories. Therefore, we attempted to evaluate the learning prospects of students by taking up the Royal Society of Chemistry (RSC) screen experiments for virtual titration as an example. This article aims to reflect information from the feedback of students on their first virtual laboratory experience and after completing an academic year to record learning outcomes in comparison to their prior experience on conventionally carrying out titration experiments and to highlight the features of the virtual laboratories that were preferred by students. Among the various components of the virtual laboratory, students state that the quiz is a component that is engaging and ensures knowledge progression. Conclusively, the students perceive that virtual laboratory experiments should be an integrated part of the laboratory curriculum for enhanced learning. In summary, our work throws light on the need for virtual laboratories in chemistry education in India and its prospect in the postpandemic period.

Human Rights Education (HRE) is critical to human development and societal transformation. In India, although HRE emerged in the 1980s, its incorporation in higher education has not yet reached its full potential. Using the state of Tamil Nadu as our case study, this paper evaluates the integration of courses on human rights in universities and colleges, using a descriptive qualitative approach to analyse the nature and content of such courses, their compliance with India's apex institutional directives, and the challenges faced. The researchers conclude that there is a disconnect between the vision of policy makers and actual implementation of HRE in practice. It is suggested that wider holistic application of HRE in higher education is needed, so that learning becomes a transformative force, empowering the young to develop attitudes of solidarity, tolerance, and respect for social justice.

Duchenne muscular dystrophy (DMD), a progressive genetic neuromuscular disease, affects all major muscle groups in the body. Academic functioning is affected by the progressive nature of DMD and physical fatigue. To explore the experiential account of schooling and the barriers in schooling among children with DMD in India and to develop recommendations for school accommodation, a descriptive cross-sectional study was conducted with thirty-three male children who were diagnosed with DMD and receiving treatment from a tertiary center. A sociodemographic data sheet and a semi-structured questionnaire were used for data collection. The data were subjected to descriptive statistical and thematic analysis to derive the results. Eighty percent of the children received support from teachers and friends, and 28 percent reported their school as disability friendly. Themes derived from qualitative thematic analysis were physical difficulties, environmental barriers, and emotional difficulties. Based on the study results and review of the existing literature, recommendations for school accommodation will be proposed. Despite the difficulties they face in the school setting, active participation in school is important for children with progressive conditions such as DMD. Families and schools have a responsibility to ensure that children have an inclusive life, the barriers they face are minimized, and their time at school enhances their range of experiences and quality of life.

Sericulture is the process of cultivating silkworm cocoons for the production of silks. The quality silk production requires quality seed production which in turn requires accurate classification of male and female pupa in grainage centers. The challenges in the current methods of silkworm cocoon sex classification using manual observation lie in the time-consuming nature of the process, potential human error, and difficulties in accurately discerning subtle morphological differences between male and female cocoons. FC1 and FC2 single hybrid variety breed pupa are commonly used in south India for the production of high yielding double hybrid bivoltine silkworm seeds. In this study, 1579 FC1 and 1669 FC2 variety samples were used for the classification process. To overcome the challenges of present physical observation by expert employees, camera images of FC1 and FC2 cocoons were used in this study for sex classification. The proposed model used Histogram Oriented Gradient (HOG) feature descriptor of cocoon samples. Linear Discriminant Analysis (LDA) was applied on the feature vector to reduce the dimension and this feature matrix was given to the classical machine learning algorithms support vector machine (SVM), k-nearest neighbors (kNN), and gaussian naïve bayes for classification with stratified 10-fold cross validation. The results showed that for FC1 data HOG + LDA + Naïve Bayes performed better with a mean accuracy of 95.3% and for FC2 data HOG + LDA + KNN attained a mean accuracy of 96.2%. Our results suggest that this camera imaging method can be used efficiently in the classification based on the cocoon size and shape of different breeds. [ABSTRACT FROM AUTHOR]

Higher education in both India and the United States has been experiencing a neoliberal turn discernable since the 1990s. At the same time, tensions around who does and does not belong on campuses in the neoliberal moment have also plagued universities in the two nations. Drawing from critical geography, this article employs a 'relational comparison' approach to examine together two much-publicized instances of such tensions, one concerning Black students at Washington DC's American University and the other centered around Dalit students at Hyderabad's University of Hyderabad. I consider how the agendas, routines, and narratives inscribed in and by the institutional cultures of the two universities, both of which are being re-worked by neoliberal logics, cultivate the terrain for moments of race and caste violence. I argue that such moments work dialectically with the project of neoliberalizing the university, serving to reproduce race and caste difference and regulate student political life.

Aim: The human adenovirus (HAdV) is beginning to spread rapidly in children through human, surface and animal vectors. Around 12,000 cases were recognised in 2022 in West Bengal and a shocking number of cases arose throughout India and in other under‐developed areas. This is going to be a big threat to public health since no vaccine, awareness or protocol policies were introduced. Early detection, immediate isolation and proper policy developments are the key factors in overcoming the situation. Therefore, we performed this rapid review and discussed probable mitigation strategies, updated research on vaccine development, and treatment strategies to control the outbreaks of mutated HAdV. Design: This is a narrative review of publicly available information. Methods: Here, we extracted updated information and data using the terms HAdV outbreaks, mutations, species, risks and prevention from Google Scholar and PubMed. We considered relevant articles that have discussed prevention strategies, ongoing research, and antiviral drugs for managing HAdV outbreaks. Results: Early detection from throat swabs, isolation and symptomatic treatments are required to minimise viral infections. A massive test needs to be performed to find the affected people. The cases should be immediately isolated. It is recommended to treat high‐touch surfaces with heat‐ or bleach‐containing cleaners to prevent the spread of infection. Oxygen support and many broad‐spectrum antivirals have been used to treat HAdV. Several studies showed antibody neutralisation and interactions between the natural killer cell receptor KIR3DS1 and HLA‐F in infected cells, indicating possible therapeutic options in the future. HAdV‐4 and HAdV‐7 vaccines have been limitedly approved for administration to military personnel. Conclusion: Isolation, certain safety measures, broad‐spectrum antiviral drugs and further research on new vaccines could be useful to prevent this virus from producing a worldwide pandemic. Also, the authorities should ensure the proper therapeutic interventions and nursing care facilities for the infected children. Patient or Public Contribution: Patient or public contribution was not relevant to our work. [ABSTRACT FROM AUTHOR]

Objective: To assess whether, in those requiring continuing uterine stimulation after cervical ripening with oral misoprostol and membrane rupture, augmentation with low‐dose oral misoprostol is superior to intravenous oxytocin. Design: Open‐label, superiority randomised trial. Setting: Government hospitals in India. Population: Women who were induced for hypertensive disease in pregnancy and had undergone cervical ripening with oral misoprostol, but required continuing stimulation after artificial membrane rupture. Methods: Participants received misoprostol (25 micrograms, orally, 2‐hourly) or titrated oxytocin through an infusion pump. All women had one‐to‐one care; fetal monitoring was conducted using a mixture of intermittent and continuous electronic fetal monitoring. Main outcome measures: Caesarean birth. Results: A total of 520 women were randomised and the baseline characteristics were comparable between the groups. The caesarean section rate was not reduced with the use of misoprostol (misoprostol, 84/260, 32.3%, vs oxytocin, 71/260, 27.3%; aOR 1.23; 95% CI 0.81–1.85; P = 0.33). The interval from randomisation to birth was somewhat longer with misoprostol (225 min, 207–244 min, vs 194 min, 179–210 min; aOR 1.137; 95% CI 1.023–1.264; P = 0.017). There were no cases of hyperstimulation in either arm. The rates of fetal heart rate abnormalities and maternal side effects were similar. Fewer babies in the misoprostol arm were admitted to the special care unit (10 vs 21 in the oxytocin group; aOR 0.463; 95% CI 0.203–1.058; P = 0.068) and there were no neonatal deaths in the misoprostol group, compared with three neonatal deaths in the oxytocin arm. Women's acceptability ratings were high in both study groups. Conclusions: Following cervical preparation with oral misoprostol and membrane rupture, the use of continuing oral misoprostol for augmentation did not significantly reduce caesarean rates, compared with the use of oxytocin. There were no hyperstimulation or significant adverse events in either arm of the trial. [ABSTRACT FROM AUTHOR]

A core component of every blood program is the supply of safe blood and blood products. The elevated risk of transmission through these products is due to parvovirus B19 (B19V) resistance to the virus inactivation procedures. Our study aimed to screen asymptomatic blood donors for B19V at a tertiary care hospital in Chennai, Tamil Nadu, between September 2020 and June 2021. Sera from 106 healthy blood donors who tested negative for Human immunodeficiency virus (HIV), Hepatitis B surface antigen (HBsAg), Hepatitis C virus (HCV), syphilis, and malaria were tested for anti-B19V IgM and IgG using a qualitative indirect enzyme-linked immunosorbent assay (ELISA). In the study population, 23.5% (n = 25) of donors tested IgM positive, 38.6% (n = 41) tested IgG positive, and 7.5% (n = 8) tested positive for both IgM and IgG. A proportion of 61.3% (n = 65) of the blood donors tested IgG negative, suggesting they had no past B19V infection. B19V DNA was not detected in any of the subjects. The high seroprevalence of IgM indicates that blood donors may have been recently exposed to B19V, potentially posing a risk to immunocompromised individuals and those with hematological stress. Further longitudinal studies with a larger sample size are recommended to better understand the risk of B19V transfusion transmission. [ABSTRACT FROM AUTHOR]

China and India are both late comers to industrialization. Both adopted similar economic development strategies after World War II, but the per capita GDP diverged significantly in the last 40 years. While economic growth and development have many components, we explain the difference in economic performance by emphasizing the difference in state capacity in the two economies. A country's state capacity is affected by culture and history. China established a unified language and culture two thousand years ago that enabled it to develop strong state capacity. With a strong state capacity, China made crucial investments in infrastructure and in key heavy industries and developed technological capabilities to help start and sustain growth. India, on the other hand, is a country segmented by religion, caste, and language which has hindered the development of effective state capacity, and thus complementary state investments to spur economic growth. Moreover, India has up to now relied more heavily on expansion of its service sector compared to China, which has hindered its exports, a crucial element that helped China's economy. India's future industrialization crucially depends on national integration and concomitant strengthening of state capacity. [ABSTRACT FROM AUTHOR]

Improving intimate partner violence interventions requires understanding pathways to change among couples participating in these interventions. This article presents qualitative data from 18 males and 16 females who participated in a combined behavioral economics (contingency management) and cognitive behavioral therapy alcohol and violence reduction intervention trial in Bengaluru, India. Results confirmed several theorized pathways of change, as well as identified further mechanisms through which the intervention supported the change. These included the emotional impacts of incentives, perceived and actual accountability via breathalyzers and family involvement, and enhanced support gained through counseling skills. Findings reveal critical insights into intervention design for future implementation. [ABSTRACT FROM AUTHOR]

Background: In order for low and middle income countries (LMIC) to transition to Human Papilloma Virus (HPV) test based cervical cancer screening, a greater understanding of how to implement these evidence based interventions (EBI) among vulnerable populations is needed. This paper documents outcomes of an implementation research on HPV screening among women from tribal, rural, urban slum settings in India. Methods: A mixed-method, pragmatic, quasi-experimental trial design was used. HPV screening on self-collected cervical samples was offered to women aged 30–60 years. Implementation strategies were 1) Assessment of contextual factors using both qualitative and quantitative methods like key informant interviews (KII), focus group discussions (FGDs), pre-post population sample surveys, capacity assessment of participating departments 2) enhancing provider capacity through training workshops, access to HPV testing facility, colposcopy, thermal ablation/cryotherapy at the primary health care centers 3) community engagement, counselling for self-sampling and triage process by frontline health care workers (HCWs). Outcomes were assessed using the RE-AIM (Reach, Effectiveness, adoption, implementation, maintenance) framework. Results: Screening rate in 8 months' of study was 31.0%, 26.7%, 32.9%, prevalence of oncogenic HPV was 12.1%, 3.1%, 5.5%, compliance to triage was 53.6%, 45.5%, 84.6% in tribal, urban slum, rural sites respectively. Pre-cancer among triage compliant HPV positive women was 13.6% in tribal, 4% in rural and 0% among urban slum women. Unique challenges faced in the tribal setting led to programme adaptations like increasing honoraria of community health workers for late-evening work and recalling HPV positive women for colposcopy by nurses, thermal ablation by gynaecologist at the outreach camp site. Conclusions: Self-collection of samples combined with HCW led community engagement activities, flexible triage processes and strengthening of health system showed an acceptable screening rate and better compliance to triage, highlighting the importance of identifying the barriers and developing strategies suitable for the setting. Trial registration: CTRI/2021/09/036130. [ABSTRACT FROM AUTHOR]

A new edaphic green alga, Oedocladium sahyadricum sp. nov was identified from a natural forest in Kerala, India. In the present study, the new species is described and compared with its related species. The primary distinguishing characteristics of O. sahyadricum include its dioecious and terrestrial nature, superior operculum, ellipsoid oogonium, and oospore. The study highlights the presence of Oedocladium in Kerala and emphasize the need for exploration of soil algae to further understand the diversity of this genus. [ABSTRACT FROM AUTHOR]

Background: Molecular subtyping of endometrial carcinomas (EC) has been shown to classify tumors into prognostically relevant groups. Characterizing EC with a limited number of markers viz., POLE mutations, p53 mutations, and MMR status, can provide valuable information. Design: Paraffin sections of a cohort of 48 EC from a tertiary care center were characterized for the above-mentioned molecular markers and analyzed in the context of survival. Methods: Formalin fixed paraffin embedded tissues from 48 EC were characterized for POLE mutations by Sanger sequencing (exons 9–14), for MMR (MLH1, MH2, MSH6) using immunohistochemistry (IHC) and copy number (high/low) using p53 IHC. Mutational status was integrated along with the clinicopathological details and survival analysis performed. Results: Eleven (22.9%) patients were MMR deficient, 3 (6.3%) had POLE mutation, while 2 (4.1%) had both POLE and P53 mutations (regarded as multiple classifiers). Twelve (25%) patients were found to have P53 mutations, while the remaining 20 (41.7%) had no specific molecular profile (NSMP). Median follow-up duration was 43.5 (2–62) months with 8 recurrences and 9 deaths. Tumors with POLE mutation had the most favorable prognosis followed by the NSMP and the MMR mutated group while the P53 and multiple classifier groups had the worst prognosis in terms of OS (Log-rank p: 0.006) and PFS (Log-rank p: 0.001). Conclusion: The integration of molecular-clinicopathologic data for endometrial cancer classification, through cost-effective, clinically applicable assays appears to be a highly objective tool that can be adopted even in resource-limited settings. It has the potential to cause a shift in the paradigm of EC pathology and management practice. [ABSTRACT FROM AUTHOR]

Background: Kennedy disease (KD) is a slowly progressive lower motor neuron degenerative disease. The prevalence of KD is unknown in India. Aim: To describe the phenotypic and laboratory features of an Indian cohort of KD patients. Methods: A retrospective study was done on seven genetically confirmed KD patients based on demographic, clinical and laboratory details. Results: Mean age at onset and presentation was 37 ± 11.9 and 44.6 ± 13.5 years respectively. Progressive asymmetric proximal and distal limb weakness was the commonest symptom (57.1%). All patients had motor symptoms along with non‐specific symptoms such as cramps from the onset. Easy fatigability, decremental response along with ptosis were noted in two patients, which was a novel finding. Gynaecomastia and tongue wasting with fasciculations were universal findings. All five patients with nerve conduction studies showed sensorimotor neuropathy. Magnetic resonance imaging muscle done in two patients showed a prominent moth‐eaten appearance in the thigh and posterior leg compartment in one patient. The mean cytosine‐adenine‐guanine repeats were 44 ± 3.7, and there was no association between age of onset or severity with repeat length. Only one patient required an assistive device for ambulation after 15 years of symptom onset. Conclusions: This study showed phenotypic heterogeneity in the Indian cohort. The age of onset was earlier with a slowly progressive indolent course as compared with other ethnic cohorts. This highlights the importance of considering the KD diagnosis in patients with the indolent course and suspected ALS diagnosis even with ptosis and fatigability in an appropriate clinical context. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the effects of art therapy for 9 children with autism spectrum disorder in India using a pre-post experimental design with a control group. The Childhood Autism Rating Scale was used to measure symptoms before and after 8 individual art therapy sessions, and changes in the children's art development was also examined. Analysis of covariance results showed that art therapy was effective and content analysis of the drawings indicated progress seen in the developmental art stages, based on Lowenfeld theory. The positive changes were notable in the participants' cognitive, social, and motor skills.

Fluopyram, a pyridyl ethyl benzamide broad-spectrum fungicide and nematicide, used for the management of plant parasitic nematodes and soil-borne fungi, is recommended for use in crops like tomato, potato and tobacco. Fluopyram being a pesticide used for drenching soil, there is every possibility of it getting leached down with water, ultimately leading to contamination of waterbodies. An experiment was conducted to study the downward movement of fluopyram in laterite and red loam soils in Kerala, India. Fluopyram and fluopyram benzamide, each at150 µg, were loaded separately on top of the respective soil column and were eluted separately with 20, 40, 80 and 160 mL each of water equivalent to 50, 100, 200 and 400 mm rainfall. It was observed that 76.84% and 74.85% of fluopyram and 73.48% and 64.24% of fluopyram benzamide were confined to the top 0–10 cm soil with application of 20 mL water in laterite and red loam soil, respectively. More than 50% of fluopyram and fluopyram benzamide were detected in the top 0–10 cm layer of soil with the application of 40 and 80 mL water. With the application of 160 mL water, considerable reduction in the concentration of both compounds was observed and the residues moved beyond 30 cm. Leaching of residues was more in laterite soil than in red loam soil, and they are in direct relation to the volume of water applied and the residues moved beyond 30 cm depth with 160 mL water. [ABSTRACT FROM AUTHOR]

The article focuses on the impact of water stress on cropping decisions in the Cauvery Delta Region of India. Topics include the influence of groundwater and surface water availability on crop choice, farmers' responses to market demands and water scarcity, and the broader socio-environmental factors affecting agricultural practices.

Rifampicin-resistant (RR) tuberculosis (TB) in children is a major global health concern but is often neglected in economics research. Accurate cost estimations across the spectrum of paediatric RR-TB treatment regimens are critical inputs for prioritisation and budgeting decisions, and an existing knowledge gap at local and international levels. This normative cost analysis was nested in a Phase I/II pharmacokinetics, safety, tolerability, and acceptability trial of TB medications in children in South Africa, the Philippines and India. It assessed the pharmaceutical costs of 36 childhood RR-TB regimens using combinations from 16 different medicines in 34 oral formulations (adult and child-friendly) in 11 weight bands in children <15 years of age. The analysis used local and Global Drug Facility pricing, and local and international guideline recommendations, including adaptions of BPaL and BPaLM regimens in adults. Costs varied significantly between regimen length, age/weight banding, severity of disease, presence of fluroquinolone resistance, and different country guideline recommendations. WHO recommended regimen costs ranged 12-fold: from US$232 per course (short regimen in non-severe disease) to US$2,761 (long regimen in severe, fluroquinolone-resistant disease). Regimen treating fluoroquinolone-resistant infection cost US$1,090 more than comparable WHO-recommended regimen. Providing child-friendly medicine formulations in <5-year-olds across all WHO-recommended regimens is expected to cost an additional $380 (range $212-$563) per child but is expected to have wider benefits including palatability, acceptability, adherence, tolerability, and dose accuracy. There were substantial differences in regimen affordability between countries when adjusted for purchasing power and domestic spending on health. Appropriate, effective, and affordable treatment options are an important component of the fight against childhood RR-TB. A comprehensive understanding of the cost and affordability dynamics of treatment options will enable national TB programs and global collaborations to make the best use of limited healthcare resources for the care of children with RR-TB. [ABSTRACT FROM AUTHOR]

Background: By encouraging treatment adherence and lowering mortality, dietary supplements can serve as adjuvant therapy for the success of medical interventions. We determined the effect of locally accessible food supplements on treatment outcomes, and health-related quality of life in patients with pulmonary tuberculosis initiating anti-tuberculosis treatment (ATT) in Odisha, India. Method: Between September 2017 and December 2018, implementation research in patients with newly diagnosed sputum smear-positive pulmonary tuberculosis initiating ATT in five districts of the tribal belt of Odisha, offered food supplements along with ATT in a phased manner. Clinical symptoms, anthropometry, sputum for M. tuberculosis (M. tb), health-related quality of life and return to normal function were assessed periodically, and favourable treatment outcome (cure or treatment completed) was measured at the end of treatment. The effect of the food supplement on unfavorable outcomes (treatment failure, death, or lost-to-follow-up) was modelled using mixed-effects Poisson regression to determine the risk factors. Results: Among the 761 participants enrolled, 614 participants received the food supplement and 147 did not receive the food supplement. Among the 614 participants in the supplement group, 537 (87%) had a favorable outcome and among the 147 participants in the no-supplement group, 113 (77%) had a favorable outcome (p = 0.0017). Higher age (>55 years) [aRR = 2.1(95% CI: 1.1–3.8)], male gender [aRR = 1.7(95% CI: 1.2–2.9)], and smear grading ≥2+ [aRR = 1.5 (95% CI: 1.1–2.2)] were associated with unfavorable treatment outcomes. Nutritional status, quality of life and lung health showed significant improvement from baseline in the supplement group. Conclusion: Improvement in the nutritional status of the patient can be considered a predictor of treatment success rates. Early food supplementation has a positive impact on the nutritional status. [ABSTRACT FROM AUTHOR]

The administration of intravenous thrombolysis (IVT) for patients with acute ischemic stroke who have recently ingested direct oral anticoagulants (DOACs) presents a clinical challenge due to the perceived increased risk of intracranial hemorrhage (ICH). Traditional guidelines from the US and European authorities advise against IVT within 48 h of last DOAC ingestion, unless specific coagulation tests indicate safety. However, emerging observational studies suggest that IVT might be safe in selected patients. A US stroke registry study and a global multicenter cohort study both reported no significant increase in symptomatic ICH among patients on DOACs compared to those not on anticoagulants. A systematic review of all published observational studies further supported these findings, showing comparable bleeding rates and functional outcomes in DOAC-treated patients. Reversal agents like idarucizumab for dabigatran have demonstrated potential in facilitating safer IVT administration, though logistical and cost-related barriers limit their widespread use. The variability in global guidelines reflects differing approaches to risk assessment and resource availability, highlighting the need for individualized treatment decisions. In India, the increasing prevalence of atrial fibrillation and stroke as well as prescription of DOACs necessitate adapted guidelines that consider local health-care infrastructure. Despite the promising observational data, the lack of randomized controlled trials underscores the need for further research to establish robust evidence for IVT use in this context. Collaborative international efforts and inclusion of diverse patient populations in future studies will be crucial to refine treatment protocols and improve outcomes for stroke patients on DOACs. [ABSTRACT FROM AUTHOR]

Objectives: Neurodegenerative disorders necessitate comprehensive palliative care due to their progressive and irreversible nature. Limited studies have explored the comprehensive assessment needs of this population. This present study is designed to develop a checklist for evaluating the palliative care needs of individuals with motor neuron disease (MND) and Parkinson's disease (PD). Materials and Methods: The checklist was created through an extensive literature review and discussions with stakeholders in neuropalliative. Feedback from six field experts led to the finalisation of the checklist, which comprised 53 items addressing the unique biopsychosocial needs of MND and PD. Sixty patient-caregiver dyads receiving treatment in a tertiary referral care centre for neurology in south India completed the checklist. Results: People with MND had more identified needs with speech, swallowing, and communication, while people with PD reported needs in managing tremors, reduced movements, and subjective feelings of stiffness. People denying the severity of the illness was found to be a major psychosocial issue. The checklist addresses the dearth of specific tools for assessing palliative care needs in neurodegenerative disorders, particularly MND and PD. By incorporating disease-specific and generic items, the checklist offers a broad assessment of patients' multidimensional needs. Conclusion: This study contributes to the area of neuropalliative care by developing the neuropalliative care needs checklist (NPCNC) as a valuable tool for assessing the needs of individuals with neurodegenerative diseases. Future research should focus on refining and validating the NPCNC with larger and more diverse groups, applicability in different contexts, and investigating its sensitivity to changes over time. [ABSTRACT FROM AUTHOR]

Background People with HIV (PWH) who are coinfected with hepatitis B virus (HBV) have a higher risk of mortality compared with PWH alone. Populations such as people who inject drugs (PWID) and men who have sex with men (MSM) are particularly at high risk for HBV acquisition; yet, limited epidemiological data from these populations exist on HBV prevalence from low- and middle-income country settings (LMICs). Methods We characterized the prevalence and correlates of HBV serological markers in a sample of PWID and MSM with HIV recruited across 15 Indian cities using hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), and hepatitis B surface antibody (anti-HBs). Testing of stored specimens for the presence of these markers was performed on the Abbott ARCHITECT i1000 as per the manufacturer's instructions. Correlates of ever being infected with HBV (reactive for anti-HBc and/or HBsAg) and chronic HBV (reactive for HBsAg) among those ever infected were assessed using univariable and multivariable multilevel logistic regression models accounting for site-level clustering. Results A total of 2198 (95%) of the 2314 participants recruited for the trial were screened for HBV markers. The median age among the PWID and MSM participants was 30 and 32 years, respectively. The prevalence of ever being infected with HBV was 75.6% vs 46.9% in PWID vs MSM, respectively (P <.01); prevalence of chronic infection was also higher in PWID vs MSM (14.1% vs 9.5%; P <.01). Correlates of ever being infected with HBV among PWID included unstable housing (adjusted odds ratio [aOR], 5.02) and sharing injection paraphernalia (aOR, 2.70), and among MSM, correlates included history of injection drug use (aOR, 4.87) and gender identity. The prevalence of isolated core (anti-HBc in the absence of anti-HBs) was 34.7% vs 29.4% in PWID vs MSM (P <.05). Vaccination serostatus was <10% in both populations. Conclusions In this large sample of PWID and MSM with HIV, we observed a high prevalence of serology consistent with HBV infection and low vaccination, highlighting the need for routine screening and catch-up vaccination. The high prevalence of isolated anti-HBc reactivity highlights the need to understand the risk of reactivation with this serological pattern. [ABSTRACT FROM AUTHOR]

This research article scrutinises the connotation among bond prices and electricity prices (EP) across different threshold regions in India using threshold regression analysis. We resolve to investigate whether or not there exists a non-linear association between bond prices and EP and if this relationship differs across different threshold regions. The data covers a period of five years from 2018 to 2022, and the analysis includes three different threshold regions based on different threshold bond prices. The results show that there exists significant non-linear association between bond prices and EP, and this relationship differs across the three threshold regions. We surmise presence of an optimality between bond prices (interest rates) and EP, beyond which the EP increase. We conclude that as interest rates increase, the cost of financing for electricity companies also increases, which may lead to higher EP. However, there may be a certain threshold beyond which the cost of financing becomes too high, leading to a decrease in investment and ultimately a decrease in electricity supply, which in turn could lead to higher EP. [ABSTRACT FROM AUTHOR]

In emerging economies like India, the focus of public health policies is shifting toward the treating non-communicable diseases to preventing communicable diseases. The public welfare demands appropriate targeted healthcare subsidies for non-communicable diseases. In this paper, we investigate whether out-of-pocket expenditure toward mitigating non-communicable diseases for the poorer section of the population is catastrophic by nature. In a representative futuristic scenario for an emerging economy, we have collected the cancer patients' expenditure data from the patients and hospital management in a not-for-profit cancer hospital located in the state of Kerala. We have analyzed the variation of expenditure categorized as government subsidy toward treatment, private expenditure toward medical goods and services, and private expenditure toward non-medical goods and services against different socio-economic variables. The analysis of catastrophic health expenditure data reveals that relatively lower income lower-income households face more risk of catastrophic health expenditure and are in greater need of government subsidy. [ABSTRACT FROM AUTHOR]

The 1859 Carrington event is the most intense geomagnetic storm in recorded history, and the literature provides numerous explanations for what drove the negative H perturbation on the Earth. There is debate on what dominated the event. Our analysis shows a combination of causes of similar orders of magnitude. Previous analyses generally rely upon the observed H perturbation at Colaba, India; historic newspaper reports; and empirical models. We expand the analysis using two Space Weather Modeling Framework simulations to examine what drove the event. We compute contributions from currents and geospace regions to the northward B field on Earth's surface, BN. We examine magnetospheric currents parallel and perpendicular to the local B field, ionospheric currents, and gap region field–aligned currents (FACs). We also evaluate contributions from the magnetosheath, near–Earth, and neutral sheet regions. A combination of currents and geospace regions significantly contribute to BN on the Earth's surface, changing as the storm evolves. At storm onset, magnetospheric currents and gap–region FACs dominate in the equatorial region. At auroral latitudes, gap–region FACs and ionospheric currents are the largest contributors. At storm peak, azimuthal magnetospheric currents and gap–region FACs dominate at equatorial latitudes. Gap–region FACs and ionospheric currents dominate in the auroral zone, down to mid‐latitudes. Both the magnetosheath and FACs contribute at storm peak, but are less significant than that from the near–Earth ring current. During recovery, the near–Earth ring current is the largest contributor at equatorial latitudes. Ionospheric currents and gap–region FACs dominate in the auroral zone. Key Points: Prior Carrington event analyses attributed the ΔH perturbation observed on Earth to various causes, with debate on which dominatedUsing MHD simulations, we compute how currents in various systems and geospace regions contribute to ΔHRather than a dominant contributor, we find that multiple current systems and regions contribute with the same order of magnitude [ABSTRACT FROM AUTHOR]

How do parties in multiethnic societies shape voter attitudes toward female candidates? We address this question, focusing on parties with ideologies that contain ethnonationalist gender norms—patriarchal norms applied to women from an ethnonationalist party's core ethnic constituency. We argue that, while these norms appeal to an ethnonationalist party's base, they also provide informational cues to the party's "non‐core" voters that undermine their support for the party's "core" female candidates. Evidence from an original conjoint survey experiment in the Indian state of Bihar supports our argument; upper‐caste female candidates suffer a support penalty when they are affiliated with the national ruling party, whose ideology prescribes ethnonationalist gender norms targeting its core Hindu upper‐caste constituency. This penalty, we show, is driven by the party's non‐core voters. Our results, which we further bolster using real‐world electoral data, illuminate when and how ethnonationalist gender norms disadvantage elite female candidates. [ABSTRACT FROM AUTHOR]

Introduction: Medullary thyroid carcinoma (MTC) is a rare type of thyroid cancer and the main treatment is surgery. The extent of surgery depends on the spread of tumour and often involves thyroidectomy and neck dissection. Recurrent or metastasis tumour can be detected with raising calcitoninand there are various options of treatment. Methods: This was a retrospective study of MTC over seven years in a tertiary cancer centre which evaluated the treatment outcome and the non-surgical options available in recurrent and metastatic tumours. Results: Among the 601 thyroid cancers, 34 patients (5.3%) were MTC, of which 29 were studied. Majority were women, below 60 years, were diagnosed with fine needle aspiration cytology of thyroid nodule or nodes and had raised calcitonin value (Ctn). The value of Ctn was correlated with tumour burden rather than extent (p=0.7). Recurrence was seen in 35% and all patients with locoregional recurrence had curative surgery whereas metastatic patients were offered palliative treatment. Acceptance of palliative treatment was less due to financial burden. The five year overall survival for nonmetastatic disease was 89.4 % and for patients with metastatic disease at presentation was 54.7 %. Conclusion: The incidence of medullary thyroid carcinoma is low compared to the differentiated thyroid carcinoma. The main treatment is surgery and other treatment options are limited. [ABSTRACT FROM AUTHOR]