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Introduction: Several studies show that variations in the length of the menstrual cycle significantly affect lipid and C-Reactive Protein (CRP) parameters. There is an acute paucity of literature comparing lipid profiles and CRP in women with short and prolonged menstrual cycle length in the absence of Polycystic Ovary Syndrome (PCOS) and other gynaecological conditions. Aim: To determine the lipid profile and CRP levels in women with short and prolonged menstrual cycle length and compare them with women with a normal menstrual cycle length to identify women at cardiovascular risk. Materials and Methods: The association of lipid and CRP parameters with menstrual cycle length was evaluated in the present cross-sectional study involving 226 women aged 15-45 years selected from GSMCH, Patiala, Punjab, India, from May 2014 to December 2018. Based on a questionnaire about menstrual bleeding, healthy females were divided into three groups: women with short, normal, and long menstrual cycles. A menstrual cycle length of 24-38 days was considered normal. Lipid profile and CRP were analysed during the menstrual phase of the female monthly cycle in women with short, normal, and prolonged cycles, and the results were statistically analysed using one-way ANOVA. A p-value of <0.05 was considered statistically significant. Results: A total of 111 (49%) of the 226 females had a normal menstrual cycle duration, whereas the remaining 38 (17%) and 77 (34%) had short and lengthy cycles, respectively. Mean levels of Total Cholesterol (TC), Triglycerides (TG), Low-Density Lipoprotein cholesterol (LDL), Very Low-Density Lipoprotein cholesterol (VLDL), lipid ratio, and CRP increased in women with short and long menstrual cycles compared to women with normal menstrual cycles. This increase was significant for TC, TG, VLDL, TC/HDL, and TG/HDL ratios, while HDL was significantly lower (p<0.05). Conclusion: Women with short and long menstrual cycles have a higher risk of developing Cardiovascular Disease (CVD) in the coming years compared to women with a normal menstrual cycle length. [ABSTRACT FROM AUTHOR]

Introduction: Recently, the patient-reported outcome measures (PROMs) have been considered as the most important assessment tool for surgical outcome evaluation in arthroplasty. However, no study from the Indian subcontinent has evaluated the PROM in the total hip (THA) and knee (TKA) arthroplasties. Materials and Methods: This cross-sectional study evaluated the health-related quality of life (HRQoL) of 1244 North Indian patients following primary THA and TKA who had at least one-year follow-up. This study included 617 patients with 664 THA and 627 patients with 1152 TKA. The patients were asked to answer the EQ-5D-5L questionnaires and EQ-VAS in their own languages. The EQ-5D-5L values were used to derive level frequency scores (LFS) with validated Indian norms of EuroQoL. Results: Ninety percent of THA and 82% of TKA patients rated excellent HRQoL using EQ-VAS. The regression analysis revealed age, gender, etiology and brand of prosthesis had a significant impact on EQ-5D-5L following THA. However, gender and simultaneous bilateral surgery were found to be important predictors of outcome in TKA. The mean value of LFS for THA was 0.95 ± 0.12 and TKA was 0.88 + 0.24 (p < 0.001). However, There was no difference in LFS between THA and TKA when only elderly patients (> 60 years) were considered (p = 0.168). Conclusion: THA patients reported better HRQoL than TKA in the Indian subcontinent. One of the factors for a better outcome in hip arthroplasty was the relatively younger age of the patients. Patients above 60 years of age reported similar levels of statisfactior in both THA and TKA. [ABSTRACT FROM AUTHOR]

Background and aim High dependency on nursing care in healthcare delivery systems in recent times has made the quality appraisal of nursing care even more imperative for nursing administrators. This study demonstrates the utility of a two-phase technique to identify the most significant shortcomings pertaining to nursing care delivery in general wards of a tertiary care hospital. The same could be used to set priorities. Methods The first phase involved the use of the Delphi technique facilitating the experts to identify the major problems. The mean rank score was used for grading the problems. The second phase of the study involved getting direct feedback from the ward nurses. The sample size was 147 at a level of significance of 5%. Results Consensus was reached among experts on four problems that should galvanize nursing administration vis-à-vis quality improvement. The responses of ward nurses in the second phase gave a better insight into these problems. Conclusion and implications for nursing management Identifying the existing problems and fostering a team spirit among all stakeholders hold the key in strategizing quality improvement in nursing care. Nursing administrators worldwide, after making suitable situation-specific customizations, may use this approach to realize both these objectives. [ABSTRACT FROM AUTHOR]

Wet direct-seeded rice (Oryza sativa L.) (DSR) is an attractive alternative to transplanted rice, as it saves the drudgery of raising seedlings and transplanting, reducing labor and cost of cultivation. As DSR stays in the field for a longer duration than transplanted rice and water management differs considerably, particularly during early growth stages, need-based fertilizer N management in DSR using chlorophyll meter (SPAD meter) and leaf color chart (LCC) was investigated vis-à-vis fixed-time N application schedules. Applying fertilizer N following sufficiency index approach that ensures maintaining intensity of the color of the uppermost fully opened rice leaves at 90% or more of the intensity of the color of the leaves in the over-fertilizer reference plot, resulted in application of only 70 kg N ha-1. It resulted in grain yield of rice equivalent to that produced by applying 80 or 120 kg N ha-1 in four equal split doses. Since rice farmers may not be able to follow the sufficiency-index approach, two experiments were conducted to find the critical color shade on the LCC to guide need-based fertilizer N application to DSR. Application of 30 kg N ha-1 whenever intensity of the color of the uppermost fully opened leaf of the rice plant was less than LCC shade 3 (LCC3) resulted in higher yields than application of 80 and 120 kg N ha-1 in four equal split doses at fixed times. As higher fertilizer N-use efficiency was recorded with need-based N management using LCC3 rather than LCC4 as critical color shade, this study suggested that to obtain high yields and N-use efficiency, fertilizer N application should be guided by LCC3. [ABSTRACT FROM AUTHOR]

AbstractBackground: Congenital hepatic fibrosis (CHF) is an uncommon cause of portal hypertension in children. So far, there is no report of this from the subcontinent. We have studied the clinical spectrum of CHF in North Indian children. Methods: Fifteen children were diagnosed with CHF on the basis of their liver histology over a period of 6.5 years. Their clinical details were recorded. Oesophagogastroduodenoscopy and abdominal ultrasonography were performed in all cases. All siblings were examined clinically; and ultrasonography, endoscopy and liver biopsy were performed if there was firm hepatomegaly. Children with variceal bleeding were managed by endoscopic sclerotherapy. The median age of these children was 8 years with a male to female ratio of 1.5:1. Results: Only one sibling (of 33) was diagnosed as having CHF. The predominant presentations were variceal bleeding in six, abdominal distension in seven and incidental detection of organomegaly in two. Hepatomegaly was present in all patients and splenomegaly in all but one. Liver function and renal function tests were normal in all children, except for a raised serum alkaline phosphatase in six. Two children had associated renal cysts, two had choledochal cysts, one each had Caroli’s disease and biliary atresia and two children had portal vein thrombosis. Variceal obliteration was achieved in five children after an average 4.8 sclerotherapy sessions and one required a mesocaval shunt. On follow up (median 41 months, range 1–80 months) all are doing well. Conclusions: Congenital hepatic fibrosis is mainly sporadic in India and associated renal lesions are uncommon. Endoscopic sclerotherapy is effective in controlling variceal bleed and the prognosis is universally good in the absence of renal diseases. © 1999 Blackwell Science Asia Pty Ltd. [ABSTRACT FROM AUTHOR]