Search

Background: Patients with rheumatoid arthritis (RA) often have sleep dysfunction. This may adversely impact quality of life. Despite being common, sleep dysfunction is uncommonly assessed in the clinic. No data on sleep quality in RA patients is available from India. In this study we examined the sleep quality and factors influencing it in Indian patients with RA. Methods: This cross-sectional study evaluated sleep quality in 110 patients with RA using the Pittsburgh sleep quality index (PSQI) or its validated Hindi version (PSQI-H). The risk of sleep apnea was assessed by the Berlin questionnaire while the assessment of pain and fatigue was done on a visual analogue scale (VAS). Disease activity was assessed by simplified disease activity index, functional disability was assessed by the health assessment questionnaire disability index-Centre for Rheumatic Diseases version, and quality of life was evaluated by World Health Organization quality of life-BREF (WHOQOL-BREF). Socioeconomic status was assessed by modified Kuppuswamy scale. Results: Sixty four percent of our patients with RA demonstrated poor sleep quality. The mean global PSQI score was of 6.41 ± 3.07 (range 1–17). A high risk of sleep apnea was present in 26% of the study population. The use of glucocorticoids, high risk of sleep apnea, high disease activity, pain VAS, fatigue VAS, and functional disability were more common in poor sleepers. Multivariate logistic regression analysis revealed that high risk of sleep apnea, fatigue, and poor physical health domain of WHOQOL-BREF were independent risk factors for poor sleep quality. Conclusions: Patients with RA had a high prevalence of poor sleep quality. High risk of sleep apnea, fatigue and physical health domain of WHOQOL-BREF were identified as independent predictors of poor sleep quality. Clinic evaluation of patients with RA should incorporate the domain of sleep quality.

Using Business Intelligence to strategize the use of technology and reduce the rate of an Indian economic issue of unemployment by developing a Start-up web application using By coordinating with the Indian Sports and Cultural Institutions, and establishing agreements with NGOs/Corporates and other sponsorship providers to raise stipends/employment for underprivileged Indian youth using a novel algorithm with the GBDT algorithm for a suitable and secure recruiter recommendation system using firebase encryption. Since the Indian youth require a vast stage of opportunities and growth in variety of employment, the creatives and the sports industry are primarily focused to display limelight on those nurtured with inborn talents using our recruiter recommendation system using the 3 BI principles namely relevance, query intelligence and personalization. This app will seek to eradicate insufficient assessments, location barriers, inaccessibility of academies due to lack of funds, inadequate cultural categories, loopholes in the database due to weak security, and manual screening and verification of UUP details, this paper aims to give an overview and a studied literature review including proposed concepts and describes the need, significance and goal of developing an algorithm using business intelligence and machine learning to solve a socio-economic crisis. [ABSTRACT FROM AUTHOR]

AICA (5-aminoimidazole-4-carboxamide) ribosiduria is an inborn error in purine biosynthesis caused due to biallelic pathogenic variants in the 5-aminoimidazole-4-carboxamide ribonucleotide-formyltransferase/imp cyclohydrolase (ATIC) gene located on chromosome 2q35. ATIC codes for a bifunctional enzyme, AICAR transformylase and inosine monophosphate (IMP) cyclohydrolase, which catalyse the last two steps of de novo purine synthesis. This disorder has been previously reported in only 4 cases worldwide, and herein, we report the first from India. The proband presented with global developmental delay, developmental hip dysplasia (DDH), acyanotic heart disease and nystagmoid eye movements. Whole exome sequencing (WES) identified compound heterozygous pathogenic variants in the ATIC. A novel splice site variant; c.1321-2A > G and a previously reported missense variant; c.1277A > G (p.Lys426Arg) were identified. Segregation analysis of parents showed the father to be a heterozygous carrier for the splice site variant and the mother, a heterozygous carrier for the missense variant. This case of a rare genetic disorder of purine biosynthesis of ATIC deficiency is the first case reported from India. Early diagnosis lead to early interventional therapy and genetic counselling. [ABSTRACT FROM AUTHOR]

Background.: In the recent day, there has been an exponential growth in the usage of clear aligners for orthodontic treatment. As with any removable appliance, the compliance of patients to remove it during ingestion of food is, at times, poor. Thus, the stability of the clear aligner to be "clear" becomes questionable. This in-vitro study examined how the clear aligners changed colour on exposure to various indigenous food products used in everyday life. Methods.: Aligners from 5 different companies (K Line, Clearbite Aligners, The Aligner Company, iAligners and MaxDent CA Digital) were exposed for 12 hours and 24 hours to various indigenous substances (tea, green tea, coffee, turmeric, saffron and Kashmiri red chili powder) and a control solution (distilled water) in-vitro. The color change was assessed with the help of VITA Easyshade compact colorimeter based on Commission Internationale de I'Eclairage L*a*b* color system. Values were then modified to NBS units for clinical relevance. Results.: The hue of the transparent aligners was noticed to change in a statistically meaningful way when exposed to turmeric, saffron, Kashmiri red chili powder and coffee in decreasing order and mild color change in tea and green tea at both 12 hours and 24 hours intervals. Conclusion.: Aligners are prone to color change when exposed to indigenous foods that contain staining properties. [ABSTRACT FROM AUTHOR]

Background: There have been numerous cone-beam computed tomography (CBCT) studies done over the years to analyze the canal configurations among various racial and ethnic population groups. Several of these studies have highlighted a certain consistency in the incidence of particular features within these population subsets. Aim: The study aimed to analyze the root morphology and canal configurations of the maxillary first premolar (Mx1PM) in the Indian Dravidian subpopulation using CBCT. Setting and Design: This study involved a retrospective analysis of 200 CBCT scans, which included 400 Mx1PM. Methods: The CBCT images were evaluated, and the number of roots and canal configurations was recorded as per the Vertucci’s classification. Statistical Analysis: Variations in the number of roots and canal anatomies were statistically interpreted using the Chi-square test of association with the significance level set at P < 0.05. Results: Among the 400 Mx1PM studied, 116 (29%) teeth displayed single roots and 284 (71%) showed the presence of two roots. The single-rooted premolars revealed a varied canal configuration with a predominance of Vertucci’s Type II configuration in around 53.4% of the Mx1PM. The two-rooted premolars revealed 100% Type I canal configuration. Conclusion: The Mx1PM studied predominantly showed the two-rooted morphology with independent canals in each root. There was no significant difference between the teeth on either side of the same arch. The CBCT is an excellent nondestructive modality that can help us study the internal anatomy of pulp space accurately. [ABSTRACT FROM AUTHOR]

Purpose: To determine exophthalmometry values (EV) in the north Indian population and to find its correlation with the age, gender, height, weight, body mass index (BMI), locality, and base value of the population. Methods: A total of 1000 eligible participants with 504 females and 496 males with age >5 years were included in this observational cross-sectional study. Age, gender, and locality of the subjects were noted. Hertel's exophthalmometry was performed on all subjects. The exophthalmometry values and base values were recorded. Height and weight were measured for all participants. BMI was calculated using the parameters. Results: The overall mean exophthalmometry value (mm) was 14.94 ± 2.43 mm with a range between 8 and 22 mm. There was no significant difference in EV between the two eyes. Males recorded a significantly higher mean EV of 15.4 ± 2.51 mm as compared to females with a value of 14.49 ± 2.27 mm. Base value of Hertel's exophthalmometer had a mean value 100.78 ± 5.63 mm and a range of 84–120 mm. Age, height, weight, BMI, and locality of the subjects were found to have a significant effect on the exophthalmometry as well as the base value of the population. A significant correlation was also seen between exophthalmometry values and base values of the population. Conclusion: Our study provided the normal exophthalmometric range for the north Indian population and also demonstrated the relationship of age, gender, height, weight, BMI, locality, and base value with the exophthalmometric values. [ABSTRACT FROM AUTHOR]

There There, Cheyenne and Arapaho writer Tommy Orange’s first novel, has been praised as "an astonishing literary debut" (Margaret Atwood), a "tense, prismatic book" (New York Times), a "breathtaking, haunting and gripping story" (Publishers Weekly), and has received multiple literary awards since its publication in 2018. This article explores Tommy Orange’s way of writing the Indian (back) into presence, in response to a “metaphorical,” as well as very “material” (Arif Dirlik) deletion of the “inconvenient Indian” (Thomas King) along centuries of American history. The discussion focuses on Tommy Orange’s understanding of storytelling as a way of continuing “Indian Wars” (E. Cook-Lynn) with the pen. Storytelling is a revisionist act in that it implicitly denies the stereotype of the vanishing race and re-places the Indigenous American not in a(n impossible) pre-colonial past, but in the land with which the Native has never ceased to remain connected. The characters’ stories, some in an autobiographical tone, others in the third person, narrate the Natives as “a present-tense people” (TT 141), grappling with a traumatic, far-from-romanticized past and present, but all the more alive for that.

Among the many film industries of South Asia, the Indian film industry is the most prolific, specifically Hindi language film, more commonly known as Bollywood, which produces almost four hundred films annually. Bollywood films dominate the national market. These films have also been exported successfully to parts of the Middle East, Africa, and the Asiatic regions of the former Soviet Union, as well as to Canada, Australia, the UK, and the US. The success of these films abroad is largely down to the presence of Indian communities living in these regions; as the conventional melodramatic plot structures, dance numbers and musicals tend to deter Western audiences.

Abstract Shiv Prasad Shrivastava Purpose The incidence of cancer has increased in India with a visible impact on the young population (aged 15–39 years). The present study aims to evaluate psychological distress among Indian adolescents and young adults (AYAs) with solid cancer using the National Comprehensive Cancer Network (NCCN) distress thermometer. Methods The demographic and clinical characteristics of AYAs patients (age 15–39 years) with cancer were recorded. Assessment of psychological distress of patients using the NCCN distress thermometer was performed at three time points over a period of 3 months. Distress thermometer scale and a self-administered questionnaire in English and Hindi languages was handed over to participants at three time points: at treatment commencement (T1), at 1 month, and 3 months (T2 and T3, respectively) into therapy. Results Of the 259 patients, 63% were women and 37% men; the median age was 34 years. In total, 71 (27%) were ≤ 24 years old and 188 (73%) were>24 years old. Bone sarcoma (39%) was common cancer in AYA patients aged ≤ 24 years and breast cancer (21%) in >24 years of age. The distress scores in both the groups were the highest at diagnosis (T1) followed by that measured at 1 (T2) and 3 months (T3) after diagnosis. The distress score in the age ≤ 24 years was the highest (6.7) at T1, followed by those measured at T2 (2.6) and T3 (1.1) and among age>24 years was the highest (6.6) at T1, followed by those measured at T2 (2.6) and T3 (1.2). Among AYA patients>24 years old, worry, nervousness, sadness, transportation, and sleep were the top five identified problems and in ≤ 24 years old, the top identified problems were worry, financial support, sleep, nervousness, and sadness. Conclusion Adolescents and young adults experience some level of distress associated with the cancer diagnosis, effects of the disease, treatment regardless of the stage and various transitions throughout the trajectory of the disease. The distress thermometer is an easy and useful tool for the assessment of psychological distress in AYA cancers. Early identification of distress burden with the distress thermometer leads to effective interventions in patients with cancer which could improve outcomes including survival in AYAs with cancer in India.

(Ar) صناديق حفظ العمامة في العصر المغولي الهندية كمؤشرات ثقافية دراسة حضارية فنية تعبر التحف التطبيقية في عصر أباطرة مغول الهند عن حضارة المغول وإبداعتهم، وتعتبر صناديق حفظ العمامات مثالا رائعا لتلك التحف التي تعبر عن حضارة المغول، وتهدف الورقة البحثية لدراسة فنية لهذه الصناديق وكذلك ومسمي جعبة دستار وعلاقة المسمى بأداء الوظيفة التي من أجلها صنعت هذه الصناديق، ولقد كان لفلسة المغول بالهند سواء الأباطرة والأمراء في الاهتمام بالعمامة ومكانتها لديهم دور كبير في ظهور صناديق مخصصة للعمامة، وكانت العمامات تزين بالأحجار الكريمة والجواهر الغالية الامر الذي أدي أيضا إلى ظهور هذه الصناديق، وتعدد طرز صناديق حفظ العمامات في العصر المغولي الهندي فمنها المغطى بغطاء علي هيئة قباب بصلية وأنصاف كروية ومنها ذات الأشكال المضلعة، وظهرت التأثيرات البيئية بشكل كبير على زخارف هذه الصناديق وكان الزخارف مرتبطة بشكل كبير بثقافة الأقاليم الهندية التي أنتجت هذه الصناديق سواء مناظر معبودات أو مناظر كائنات حية وخرافية وزخارف نباتية وهندسية، وتهدف الورقة البحثية ايضا إلى دراسة المواد المستخدمة في صناعة هذه صناديق حفظ العمامات، فأستعمل الأخشاب والأوراق المعجنة papier-mâché كمواد أساسية في صناعة صناديق حفظ العمامات بعد أن تتم معالجتها لتصبح صالحة لأداء وظيفة الصندوق دون الحاق الضرر بمحتويات الصندوق من مواد غالية القيمة، ولقد تأثرت صناديق حفظ العمامات في تصميمها العام بشكل كبير بالمنشآت المعمارية كتأثير من العمارة المغولية الهندية المعاصرة. (En) Applied arts, e.g. turban boxes, in the era of Mughal Indian emperors express the Mughal's civilization and creativity. This paper is an artistic study of these boxes, as well as the name and its relation to fulfilling the function of the boxes. Mughals in India whether emperors or princes, paid considerable attention to turbans, as shown in having turban boxes. These turbans were decorated with gemstones and precious jewelry. Moreover, there were various patterns of turban boxes at the time. Some boxes had an onion-dome cover, semicircular covers, or polygons. The environment affected the decorations of these boxes considerably because they were largely related to the culture of the Indian regions that produced them, including deities, animals, mysterious creatures, as well as floral and geometric motifs. The present research paper aims to examine the materials used in manufacturing such turban boxes, as wood and papier-mâché that were processed to fit the function of the boxes and not to harm the precious contents. It showed that the general design of the turban boxes was affected largely by architectural constructions, e.g., the impact of contemporary Mughal Indian architecture.

Background: The current standard treatment for neovascular age-related macular degeneration (nAMD) involves intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents. The aim of the present study was to compare the effectiveness and safety of two anti-VEGF drugs: brolucizumab and aflibercept, in treatment-naïve nAMD Indian patients over a period of 48 weeks. Methods: A prospective, randomized, single-centre, single-blinded, two-arm comparative study was conducted between March 2021 and February 2022. Of the 114 patients, 56 received intravitreal injections of brolucizumab (6 mg/50 µL) while 58 received aflibercept (2 mg/50 µL). The patients received 03 initial loading doses at 4-week intervals of both the agents and then respective therapies were given as individualized pro re nata (PRN) regimen based on the signs of active macular neovascularization. The functional and anatomical outcomes measured were mean change in best-corrected visual acuity (BCVA, logMAR), central macular thickness (CMT, µm), presence of intraretinal fluid, subretinal fluid or subretinal hyper-reflective material. Furthermore, the average number of additional injections required after the loading doses, the injection-free interval and safety of both the drugs were also assessed. Results: Brolucizumab was found to be non-inferior to aflibercept in terms of mean change in BCVA (−0.13 ± 0.21 logMAR vs. −0.10 ± 0.15 logMAR) and reduction in CMT (−112.59 ± 81.23 µm vs. −86.38 ± 71.82 µm). The percentage of eyes with IRF and SHRM was comparable between both the groups while fewer eyes treated with brolucizumab indicated SRF presence than aflibercept after the loading doses. These beneficial effects of brolucizumab were observed with significant (p < 0.0001) lesser number of injections (1.8 ± 1.1 vs. 3.8 ± 1.5) from week 12 to week 48. Moreover, the probability of no injections after the loading doses was significantly higher with brolucizumab compared to aflibercept indicating prolonged injection-free intervals. The average ocular side effects were comparable in the two groups. One adverse event of severe vitritis requiring treatment with oral steroids occurred in Brolucizumab group, while no such event occurred in Aflibercept group. Conclusion: The results of the present study suggest non-inferiority of brolucizumab PRN regimen to aflibercept PRN regimen in treatment naïve nAMD Indian patients while achieving longer inter-injection intervals. Trial registration Clinical Trial Registration of India (CTRI/2021/06/034415). Registered 03 March, 2021, http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=54328&EncHid=&userName = [ABSTRACT FROM AUTHOR]

Objectives: This study was done to obtain the reference data for the sural SNAP amplitude and latency at distances of 14, 12, and 10 cm from the active recording electrode in Indian healthy subjects for different age groups.Material and Methods: Two hundred forty-four healthy subjects (18-80 years) were included in this cross-sectional study. Subjects were divided into six groups according to age. Sural SNAP was recorded antidromically stimulating at three sites (14, 12, and 10 cm from the recording electrode). The quantitative variables were expressed as Mean ± SD/Median (IQR) and compared using t test/ANOVA. Transformed data for amplitude were analyzed with the use of paired t test. P < 0.05 was considered statistically significant. SPSS version 20.0 software was used for statistical analysis.Results: Mean age of included subjects was 43.28 years. Maximum leg girth was at 14 cm. Analysis showed a significant difference in the leg girth at all three sites (P < 0.001). Sural SNAP latency at each stimulating site was compared in different age groups, no significant difference was found between groups (P = 0.19). Maximum amplitude was in the 18-30-years age group and amplitude was minimum in the 71-80-years age group (4.34 and 2.79, respectively). The difference in the amplitude recorded in the different age groups was found to be statistically different (P < 0.001). The difference in the amplitude recorded at each site was found to be statistically different (P < 0.001).Conclusion: This is the first study with a large sample size (244 subjects) to provide age-stratified reference data for SNAP in the Indian population by using three sites of stimulation at distances of 14, 12, and 10 cm from the recording electrode. This study shows that sural SNAP amplitude varies with the age of the subject and distance from stimulation. [ABSTRACT FROM AUTHOR]

Management strategies for chronic wasting disease (CWD) across tribal lands have varied in response to changing dynamics of CWD risk. As CWD continues to spread across the United States, concerns associated with the disease are increasing. We interviewed 19 natural resource managers representing Anishinaabe and Dakota tribes in Minnesota, Michigan, and Wisconsin with goals of understanding needs and opportunities for CWD engagement, surveillance, and outreach on tribal lands; the implementation of natural resources policy and management across tribal nations; and opportunities for tribal partnership‐development to control CWD. Qualitative data analyses of interview responses revealed substantial variation in the number of tribal hunters, hunter regulation, and huntable tribal lands across our study area. Proximity of tribal lands in relation to CWD detections impacted tribal agency management strategies for CWD. Our results indicate a desire for CWD outreach and surveillance, mutually beneficial collaborations, and a need for incorporating cultural knowledge into CWD management strategies. We conclude that tribal CWD management and surveillance plans will be enhanced through strategic and thoughtful CWD outreach methods. Moreover, partnerships must recognize tribal sovereignty and respectfully integrate tribal values, knowledge, and worldview. [ABSTRACT FROM AUTHOR]

Career and technical education courses, funded by a 2018 re-authorization known as the Strengthening Career and Technical Education for the 21st Century Act, provide an ideal opportunity for the advancement of science, technology, engineering, and mathematics (STEM) careers in the United States. The article takes a close look at the conditions and implications of the re-authorized "Perkins V" for the advancement and promotion of career and technical education courses among tribal communities. [ABSTRACT FROM AUTHOR]

Living through menopause is a complex experience. Menopause marks the beginning of an infertile phase from the fertile phase. The experience of menopause influences post-menopausal women's quality of life. This study delves into the understanding of women's menopausal experience and their perception of menopausal experience. Fifteen post-menopausal women were included in the study using purposive sampling through snowball sampling in Kolkata, West Bengal. In-depth semi-structured interviews were used to delve into the understanding of a women's menopausal experience and her perception of menopausal experience. Data were analysed using thematic analysis. To describe the women's experiences and perception of menopause, the themes that emerged were health related changes, perception of menopause, change in relationships, and social support. The current study found that support from husband, and social support largely impacts this experience. According to this study, women turned to their families, and peers, for assistance with their issues. Health care professionals should therefore educate women about menopause in addition to being fully informed of its course. It is important to consider their peers' and families' contributions. It is advised that more research be done on how psychological therapies might be used to address these issues in postmenopausal women. [ABSTRACT FROM AUTHOR]

Introduction:Malnutrition among adolescents is a persistent problem with a profound impact on different dimensions of health. The objective of this analysis is to assess the burden of malnutrition (Stunting, Thinness, Overweight, and Obesity) and their associated socio-demographic factors among Indian adolescents (10–19 years) from the Comprehensive National Nutritional Survey (CNNS 2016-18) data.MethodsWe used Individual-level data of 35,831 adolescents from the CNNS conducted in 2016–18 for this analysis. CNNS collected data on the nutritional status of adolescents along with socio-demographic variables from all states of India. Burden of stunting (Height for age Z score, HAZ < −2 SD), thinness (BMI for age Z score, BAZ < −2 SD), overweight (BAZ > 1 SD) and obesity (BAZ > 2 SD) were estimated for the entire country and individual states. A multivariable logistic regression analysis was used to assess the socio-demographic factors associated with stunting, thinness, and overweight.ResultsCNNS collected data from 35,831 adolescents, of which 31,941 with BAZ scores, and 32,045 with HAZ scores were included in the final analysis. The burden of stunting and thinness among Indian adolescents was 27.4% (95% CI 26.4, 28.4%) and 24.4% (23.5, 25.4%), respectively. The burden of overweight and obesity was 4.8% (4.5, 5.1%) and 1.1% (0.9, 1.3%), respectively. Adolescents in the age group of 15–19 years (AOR 1.23, 95% CI 1.11, 1.36) compared to 10–14 years, females (AOR 1.20; 1.08, 1.33) compared to males, were at increased odds of getting stunted. Adolescents from lowest wealth index families (AOR 1.66; 1.33, 2.07) were at increased odds of thinness compared to peers of higher wealth index families. Adolescents of 10–14 years (AOR 1.26, 95% CI 1.06, 1.49) compared to 15–19 years, urban residents (AOR 1.43, 95% CI 1.19, 1.71) compared to rural residents, were at increased odds of overweight.ConclusionIndian adolescents face the double burden of malnutrition that is undernutrition (stunting and thinness) alongside overnutrition (overweight and obesity) that are linked with socio-demographic factors. The National Nutritional Programs (POSHAN Abhiyan) should prioritize high-risk groups specifically older age group (15–19 years), females, and low wealth Index quintile families identified in this analysis.

Agenesis of the inferior vena cava in H syndrome due to a novel SLC29A3 mutation. Keywords: H syndrome; mutation; SLC29A3; Indian; hyperpigmented plaques EN H syndrome mutation SLC29A3 Indian hyperpigmented plaques e138 e140 3 02/23/23 20230301 NES 230301 Dear Editor, H syndrome is a rare autosomal recessive disorder with a characteristic array of features such as hyperpigmentation, hypertrichosis, short height, hypogonadism, hepatosplenomegaly, hyperglycemia, hearing loss, and heart anomalies. [Extracted from the article]

Background: Individuals with cleft lip and palate (CLP) and other craniofacial deformities are often perceived negatively in various social circumstances, resulting in failure to achieve full socio economic potential. Aim of the study: This study aimed to identify social stigmata and their causes associated with CLP and other deformities in an Indian population from a low socio-economic background, ways to reduce such effects and the potential reduction of disability following surgery. Methods: To assess the general awareness of the patients and their families regarding clefts, A GSR Institute: Cleft-Awareness Questionnaire (Reddy SG et al 2018) was used for data collection. 100 consecutive patients treated in GSR Institute for Craniofacial and Facial Plastic Surgery in Hyderabad, Telangana, were invited to join the study Statistical analysis regarding consanguineous marriage, understanding of clefts by parents and members of their community and of their societal conditions and the impact before and after surgery was carried out. Results: Statistical analysis using chi-squared test regarding the frequency of consanguineous marriage revealed no significant difference between the expected and observed frequencies in Telangana whereas there was a significant difference (p

Polymorphous light eruption (PMLE) is the most common, idiopathic, acquired photodermatosis, characterized by abnormal, recurrent, and delayed reaction to sunlight. Polymorphous light eruption is common worldwide but the morphology, distribution, and pigmentary changes are unique in Indian skin which is discussed in this review. The prevalence of PMLE is around 10–20% in the general population. It commonly occurs in females between 20and 30 years of age. It is the most common photodermatosis in school-going children. Visible light sensitivity is an important phenomenon in PMLE. It typically presents as recurrent and chronic lesions over photoexposed sites. Initially, patchy erythema occurs with pruritus. Most of the Indians belong to type IV to type VI skin and pigmentary changes are commonly seen. The unique feature of PMLE in Indian skin is the pigmentary change which varies from hypopigmented to hyperpigmented lesions. These pigmentary changes may occur alone or in combination with erythematous or skin-colored lesions. The pigmentary lesions are seen in more than 50% of lesions. The histopathology of PMLE is characterized by the presence of hyperkeratosis, spongiosis with or without the presence of liquefactive degeneration in the epidermis. Dermal changes in the upper and mid dermis include the presence of dense perivascular lymphocytic infiltrate. The management of PMLE includes both preventive measures and medical management. Topical sunscreens, topical steroids, hydroxychloroquine and antioxidants play a very important role.

Introduction: There is a growing body of evidence against using World Health Organization (WHO) charts for developing nations. Our objectives were: 1) To compare nutritional status of -0.5 (clinically significant), whereas on WHO charts all wealth classes had WHZ

Purpose: To study the corneal epithelial thickness with 9-mm scans of optical coherence tomography in normal Indians with appropriate representation of all age groups. Methods: This was a cross-sectional observational study. 263 patients were divided into the age groups 5–20 years, 21–35 years, 36–50 years and more than 51 years were recruited for the study. All patients underwent a detailed ophthalmic examination. Patients found to have any ocular surface or intraocular disease condition (except cataract and refractive error), or who had undergone any ophthalmic surgery in the past, or had corneal topography changes suggestive of corneal ectasias (screened in patients with astigmatism more than 3 diopters) or had been continuously using any topical medication in either eye for a period of 3 months or more with the last instillation being within 1 month of inclusion in the study were excluded. All subjects underwent corneal epithelial thickness measurement with anterior segment optical coherence tomography (AS-OCT) on the Avanti OCT (Model RTVueXR1002, Optovue, USA). The corneal epithelial thickness (CET) data from 25 sectors in each eye were analyzed. Results: 263 right and left eyes of 263 patients were analyzed in the study. Mean CETs in the central 2 mm zone were 54.13 ± 4.51 μm and 54.37 ± 3.75 μm for the right and left eyes, respectively. The superior peripheral sectors and inferior paracentral sectors were the thinnest and the thickest sectors, respectively, in both eyes. Conclusion: CET parameters for Indian eyes are comparable to those reported from racially distinct and geographically distant study subjects.

Introduction: There is a dearth of normative data for radiological sagittal parameters of asymptomatic Indians. The present study aimed to address this lacuna. Materials and Methods: Sagittal radiological parameters were studied in asymptomatic volunteers: seven lumbopelvic, i.e., pelvic index (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), cranial LL (crLL), caudal LL (caLL), PI-LL; three thoracic and thoracolumbar, i.e., thoracolumbar alignment (TL), thoracic kyphosis (TK), T1 slope (TS0); five cervical, i.e., cervical sagittal vertical axis (cSVA), cervical lordosis (CL), TS-CL, C2 slope (CS), C2 T1 pelvic angle (CTPA); and lastly, five global parameters: SVA, T9 spinopelvic inclination (T9SPI), T1 spinopelvic inclination (T1SPI), T1 pelvic angle (TPA), C2 pelvic angle (CPA) were studied. Results: Volunteers (n = 125) aged 41.49±12.93 years were included. Mean PI, PT, SS, LL, crLL, caLL, PI-LL, TL, TK, TS, cSVA, CL, TS-CL, CS, CTPA, SVA, T9SPI, T1SPI, TPA, and CPA were 47.23±8.04°, 13.4±6.61°, 33.68±4.59°, −56.19±7.83°, −22.71±9.82°, −45.02±10.07°, −7.83±9.4°, 9.99±11.17°, 22±7.33°, 4.88±7.64°, 34.77±12.2 mm, −6.36±10.99°, −0.5±10.02°, 2.56±9.53°, 3.54±1.04°, −36.49±23.4 mm, −10.89±2.75°, −7.88±2.17°, 5.52±6.82°, and 10.72±6.69°, respectively. As per Roussouly’s classification, the distribution for types I, II, III, and IV was 32 (25.6%), 41 (32.8%), 45 (36%), and 7 (5.6%), respectively. LL correlated significantly with PI, SS, and TK. TS had significant correlation with CL and TS-CL. cSVA significantly correlated with CL. PI-LL significantly correlated with TS-CL. CS significantly correlated with cSVA and TS-CL. TS-CL significantly correlated with cSVA. TPA correlated significantly with PT, SVA, PI, and PI-LL. CTPA correlated significantly with CL, cSVA, TK, and TS-CL. Males had significantly different SVA (−35.3 mm), TK (22.4°), TS (6.2°), TPA (6.35°), cSVA (37.1 mm), and CTPA (3.95°) when compared with females (−58.4 mm, 17.2°, −0.15°, 0.3°, 24.95 mm, and 2.85°, respectively) (P = 0.008, 0.003, 0.002, 0.003, 0.002, and 0.0005, respectively). Conclusion: Normative data for sagittal profile in Indian volunteers, enunciated in this study, can be used to guide decisions in surgery.

Context: Autoantibodies have a role in the diagnosis and prognosis in Autoimmune Inflammatory Myositis (AIM). Aims: The aim of this work was to study the prevalence and clinical correlation of myositis specific and associated antibodies (MSA and MAA) in AIM. Setting and Design: This was a cross-sectional observational study. Methods and Materials: Consecutive AIM patents were divided into groups as dermatomyositis (DM), polymyositis (PM), CTD-associated myositis (CTD-M), cancer-associated myositis (CAM) and juvenile myositis (JM). Their data along with serum samples were collected after obtaining informed consent. Sera was analyzed for IgG antibodies against Jo-1, PL-7, PL-12, EJ, SRP, Mi-2, MDA-5, TIF1γ, SAE1, SAE2, NXP2 and SSA/R052kD using the microELISA technique. The institutional ethics committee approved the study. Statistical Analysis: SPSS software (version 24.0) was used. P value < 0.05 was considered statistically significant. Results: There were 48 patients (DM = 19, PM = 19, CTD-M = 5, CAM = 2, JM = 3) included. MSA were positive in 37.5% patients. Antibodies against Mi-2 were present in 6 (12.5%), Jo-1 in 5 (10.4%), 2 (4.1%) each had PL-7 and SRP antibodies. One patient (2%) each had MDA-5, NXP2 and TIf1g antibodies. Jo-1 antibody was associated with mechanic's hands and ILD. There was a significant association of rash in the Mi-2 group with none of the patients having ILD. Malignancy screening was negative in NXP2 and TIF1g antibody-positive patients. Ro52 was the most common MAA (33.3%) and was associated with mechanic's hand. Conclusion: MSA was present in almost 40% of the cohort. Anti Jo-1 antibody was associated with mechanic's hands and ILD. None of the Mi-2 patients had ILD, which may point to a protective role of this antibody for ILD. The association of newer antibodies in Indian patients needs to be further studied in larger cohorts.

Purpose: To study the effectiveness of part-time occlusion (PTO) in different types of amblyopia in Indian population. Methods: Prospective case series of consecutive cases of amblyopia from a tertiary care center were subjected to PTO of the better eye and monitored periodically for 6 months. Those who failed to improve by 6 months were shifted to full-time occlusion of the better eye and followed for a further 3 months. Results: 175 eyes of 175 patients with amblyopia underwent PTO for 6 months. The mean age of the patients was 10.47 ± 4.69 years (range: 3–26 years). Major subgroups included 94 eyes with strabismic amblyopia and 70 with anisometropic amblyopia. Overall, 168 (96%) children benefited from PTO (improvement being defined as a gain of at least one line of Snellen's visual acuity). The improvement rates for strabismic amblyopes (97.9%) was significantly more than anisometropia (94.3%); P = 0.027. Of the seven patients not responding to PTO, six did not benefit even after full-time patching. Conclusion: PTO is a viable and effective modality of management of amblyopia in Indian patients. Strabismic amblyopia was the commonest and responded best to the occlusion therapy in our cohort.

Background: Bariatric surgery, besides causing significant weight reduction, leads to improvement in type 2 diabetes mellitus (T2DM). However, there is a scarcity of data on the prediction of diabetes resolution in non-Western population. Objective: To evaluate the impact of bariatric surgery on T2DM and to assess the accuracy of pre-operative scoring systems in predicting remission. Study Setting: A tertiary care academic centre, India. Methodology: We used a retrospective cohort of all diabetic patients (n = 244) who underwent bariatric surgery at our centre in the past 10 years. The cohort was followed up for diabetes remission, and pre-operative scoring systems were analysed against the observed results. Results: Of 244 patients, we were able to contact 156 patients. The median period of follow-up was 38 months. The mean body mass index (BMI) of the study group decreased from 45.4 to 33.4 kg/m2 (%excess BMI loss = 61.2%). The number of patients dependent on oral anti-diabetic pharmacotherapy and on insulin decreased from 133 (85.3%) to 40 (25.6%) and from 31 (19.9%) to 7 (4.5%), respectively. Remission was analysed for 96 patients, who submitted complete biochemical investigations. The median follow-up period for this sub-cohort was 36 months. 38 (39.6%) patients were in complete remission, 15 (15.6%) patients in partial remission and 34 (38.5%) patients showed an improved glycaemic control. The three pre-operative scores, Advanced-DiaRem, DiaRem and ABCD, showed predictive accuracies of 81.1%, 75.6% and 77.8%, respectively. Conclusions: Besides leading to excess BMI loss of 61.2%, bariatric surgery also resulted in diabetes remission in 55.2% of the patients. Amongst various pre-operative scores, Advanced-DiaRem has the highest predictive accuracy for T2DM remission.

Cerebral creatine deficiency syndromes (CCDS) are a group of potentially treatable neurometabolic disorders. The clinical, genetic profile and follow up outcome of Indian CCDS patients is presented. This was a retrospective cohort of CCDS patients seen over six-years. Diagnosis was based either on low creatine peak on proton magnetic resonance spectroscopy (MRS) and/or genetic evaluation. Thirteen patients were eligible [8 creatine transporter deficiency (CTD), 4 guanidinoacetate methyltransferase (GAMT) deficiency and 1 could not be classified]. The mean (±SD) age at diagnosis was 7.2(±5.0) years. Clinical manifestations included intellectual disability (ID) with significant expressive speech delay in all. Most had significant behavior issues (8/13) and/or autism (8/13). All had history of convulsive seizures (11/13 had epilepsy; 2 patients only had febrile seizures) and 2/13 had movement disorder. Constipation was the commonest non-neurological manifestation (5/13 patients). Cranial MRI was normal in all CTD patients but showed globus pallidus hyperintensity in all four with GAMT deficiency. MRS performed in 11/13 patients, revealed abnormally low creatine peak. A causative genetic variant (novel mutation in nine) was identified in 12 patients. Three GAMT deficiency and one CTD patient reported neurodevelopmental improvement and good seizure control after creatine supplementation. Intellectual disability, disproportionate speech delay, autism, and epilepsy, were common in our CCDS patients. A normal structural neuroimaging with easily controlled febrile and/or afebrile seizures differentiated CTD from GAMT deficiency patients who had abnormal neuroimaging and often difficult to control epilepsy and movement disorder. [ABSTRACT FROM AUTHOR]

Background: Patients with rheumatoid arthritis (RA) often have sleep dysfunction. This may adversely impact quality of life. Despite being common, sleep dysfunction is uncommonly assessed in the clinic. No data on sleep quality in RA patients is available from India. In this study we examined the sleep quality and factors influencing it in Indian patients with RA. Methods: This cross-sectional study evaluated sleep quality in 110 patients with RA using the Pittsburgh sleep quality index (PSQI) or its validated Hindi version (PSQI-H). The risk of sleep apnea was assessed by the Berlin questionnaire while the assessment of pain and fatigue was done on a visual analogue scale (VAS). Disease activity was assessed by simplified disease activity index, functional disability was assessed by the health assessment questionnaire disability index-Centre for Rheumatic Diseases version, and quality of life was evaluated by World Health Organization quality of life-BREF (WHOQOL-BREF). Socioeconomic status was assessed by modified Kuppuswamy scale. Results: Sixty four percent of our patients with RA demonstrated poor sleep quality. The mean global PSQI score was of 6.41 ± 3.07 (range 1–17). A high risk of sleep apnea was present in 26% of the study population. The use of glucocorticoids, high risk of sleep apnea, high disease activity, pain VAS, fatigue VAS, and functional disability were more common in poor sleepers. Multivariate logistic regression analysis revealed that high risk of sleep apnea, fatigue, and poor physical health domain of WHOQOL-BREF were independent risk factors for poor sleep quality. Conclusions: Patients with RA had a high prevalence of poor sleep quality. High risk of sleep apnea, fatigue and physical health domain of WHOQOL-BREF were identified as independent predictors of poor sleep quality. Clinic evaluation of patients with RA should incorporate the domain of sleep quality. [ABSTRACT FROM AUTHOR]

Inspired by Barthes's analysis of a Paris Match cover image, our paper semiotically explores two oil-on-canvas images by New Zealand-born Indian artist Bephen Bahana. Within our exploration, we use constructs of denotation, connotation, myth and archetype to illuminate those images. Our research aim was to find the meaning behind the two portraits' visual aesthetics. In doing so, we reveal Bahana's The Curry Bunch (2012) images to be a visual shorthand signifying Indian history and the ways in which American media influence impacts notions of identity. Specifically, our insights reveal the ways in which many contemporary Indian people might 'see themselves'. While our work concentrates upon Indian imagery, myth and archetype, those considerations have pan-cultural connections. In these ways, our paper links pop art to popular culture and, in doing so, raises questions about how the canon and hierarchy of art have come to reflect and reinforce wider sociocultural norms. Our paper offers a voice of resistance, in much the same style as Bahana's images. [ABSTRACT FROM AUTHOR]

Objectives: To determine efficacy and safety of sacubitril/valsartan compared with enalapril in Indian patients of PARADIGM-HF trial. Methods: A randomized, double-blind, active-controlled, phase III sub-study (NCT01035255) was conducted between April 2010 and May 2014. Patients with chronic heart failure (HF), aged >18 years with left ventricular ejection fraction ≤40% were randomized (1:1) to receive either sacubitril/valsartan 200 mg twice-daily or enalapril 10 mg twice-daily. The primary endpoint was to compare efficacy of sacubitril/valsartan to enalapril in delaying time-to-first occurrence of the composite endpoint (cardiovascular [CV] death or HF hospitalization). Results: The trial was stopped after a median follow-up of 27 months, because the boundary for benefit with sacubitril/valsartan had crossed. Among 637 Indian patients in PARADIGM-HF (sacubitril/valsartan, n = 322 and enalapril, n = 315), the primary outcome, CV death, and the first hospitalization for HF occurred in 21.81% and 24.76% (HR 0.89; 95% CI, 0.646–1.231), 17.45% and 20.63% (HR 0.87; 95% CI, 0.605–1.236), and 7.48% and 9.52% (HR 0.78; 95% CI, 0.461–1.350) patients in the sacubitril/valsartan and enalapril group, respectively. The all-cause mortality (19.0% vs. 21.9%) and adverse events (78.4% vs. 82.2%) were comparatively lower in the sacubitril/valsartan than enalapril group. No significant difference was seen between the benefits of treatment in Indian and the total PARADIGM-HF cohort (p value for interaction >0.05). Conclusion: Results support the use of sacubitril/valsartan in Indian patients with chronic HF with reduced ejection fraction with treatment benefits similar to global PARADIGM-HF cohort.

İslâm dini, barış, adalet ve sevgiyi tevhid temelinde yükselterek insanlar arasında yerleştirmek üzere gönderilen bir dindir. İslâm, tüm insanlığa hitap eder ve ırk, asalet ve cinsiyete bağlı bir üstünlük ve ayrıcalığa yer vermez. Dolayısıyla kadın ve erkek de insanlık düzleminde denktirler. İslâm’dan önceki toplumlarda ise durum bu şekilde değildir, kadının konumu çoğu zaman erkekten aşağıdadır. Kadına hak ettiği yeri İslâm, yeniden kazandırmıştır. Bu çalışmada öncelikle İslâm’ın kadına bakışı söz konusu edilecek, ardından Eski Yunan, Roma, Yahudilik, Hıristiyanlık ve Hint kültürlerinde kadının konumuna değinilecek ve sonrasında İslâm’ın kadına bakışı daha detaylı ele alınarak kadının İslâm’daki ve mezkûr din ve kültürlerdeki konumu kıyaslanacaktır.

Obesity has emerged as the most potential cardiovascular risk factor and has raised concern among public and their health related issues not only in developed but also in developing countries. The Worldwide obesity occurrence has almost has gone three times since 1975. Research suggests there are about 775 million obese people in the World including adult, children, and adolescents. Nearly 50% of the children who are obese and overweight in Asia in are below 5 years. There is a steep incline of childhood obesity when compared to 1971 which is not only in developed countries but also in developing countries. A considerable amount of weight gain occurs during the transition phase from adolescence to young adulthood. It is also suggested that those adults who were obese in childhood also remained obese in their adulthood with a higher metabolic risk than those who became obese in their adulthood. In India, the urban Indian female in the age group of 30-45 years have emerged as an 〝at risk population” for cardiovascular diseases. To understand how obesity can influence cardiovascular function, it becomes immense important to understand the changes which can take place in adipose tissue due to obesity. There are two proposed concepts explaining the inflammatory status of macrophage. The predominant cause of insulin resistance is obesity. Epidemiological and research studies have indicated that the pathogenesis of obesity-related metabolic dysfunction involves the development of a systemic, low-grade inflammatory state. It is becoming clear that targeting the pro-inflammatory pathway may provide a novel therapeutic approach to prevent insulin resistance, particularly in obesity induced insulin resistance. Some cost effective interventions that are feasible by all and can be implemented even in low-resource settings includes - population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden. The sixth target in the Global NCD action plan is to reduce the prevalence of hypertension by 25%. Reducing the incidence of hypertension by implementing population-wide policies to educe behavioral risk factors. Reducing cigarette smoking, body weight, blood pressure, blood cholesterol, and blood glucose all have a beneficial impact on major biological cardiovascular risk factors. A variety of lifestyle modifications have been shown, in clinical trials, to lower blood pressure, includes weight loss, physical activity, moderation of alcohol intake, increased fresh fruit and vegetables and reduced saturated fat in the diet, reduction of dietary sodium intake, andincreased potassium intake. Also, trials of reduction of saturated fat and its partial replacement by unsaturated fats have improved dyslipidaemia and lowered risk of cardiovascular events. This initiative driven by the Ministry of Health and Family Welfare, State Governments, Indian Council of Medical Research and the World Health Organization are remarkable. The Government of India has adopted a national action plan for the prevention and control of non-communicable diseases (NCDs) with specific targets to be achieved by 2025, including a 25% reduction in overall mortality from cardiovascular diseases, a 25% relative reduction in the prevalence of raised blood pressure and a 30% reduction in salt/sodium intake. In a nutshell increased BMI values can predict the nature of obesity and its aftermaths in terms inflammation and other disease associated with obesity. It’s high time; we must realize it and keep an eye on health status in order to live long and healthy life.

Abstract Introduction Patients with androgenetic alopecia treated with alcohol-based minoxidil topical solutions often report local irritation, dryness, and redness of the scalp. We evaluate the in-use tolerance of 5% minoxidil novel formulation topical solution—test product (TP)—compared with 5% minoxidil alcohol-based topical solutions—reference product 1 (RP1) and reference product 2 (RP2)—in Indian men with androgenetic alopecia. Methods In this randomized double-blind study, patients aged ≥ 18 years with androgenetic alopecia were randomized 1:1:1 to apply TP, RP1, and RP2 twice daily for 30 days. The safety endpoints included mean hydration, mean redness, and mean scaling on scalp. Results All screened patients (N = 100) were enrolled and randomized to TP (n = 33), RP1 (n = 33), or RP2 (n = 34). At day 30, the mean (SD) hydration was significantly increased in patients treated with TP [9.74 (4.98)] but significantly reduced in patients treated with RP1 [3.28 (2.67)] or RP2 [3.03 (1.57)] (p-value 0.001). The mean (SD) score for redness was significantly decreased in the TP group [0.01 (0.04)], (p-value, 0.009) at day 30 compared with baseline, while no change was observed in the RP1 [0.08 (0.13)] or RP2 [0.11 (0.17)] group. After 30 days of treatment, no significant difference was observed in the mean score of scaling in any of the three groups. Conclusions Twice daily application of 5% minoxidil novel formulation for 30 days significantly improved hydration and reduced redness of the scalp. Hence, 5% minoxidil novel formulation could be a safer alternative in treating men with androgenetic alopecia who are sensitive to alcoholic formulations. Trial Registration Clinical Trial Registry of India; CTRI/2018/11/016431.

Introduction The COVID-19 virus has already caused a pandemic and needs no fresh introduction. Many studies in western literature have described the prevalence of anosmia and ageusia as symptoms of COVID-19. However, to our knowledge, there is no study describing the trend of new onset ageusia amongst covid positive patients in the Indian population. The objective of this study is to analyze the trend of new onset ageusia in COVID-19 affected individuals in the Indian population. Materials and Methods This is a retrospective observational study conducted in a treatment facility set up in Eastern part of India. The data was collected from Sep 2020 to Dec 2020. The study included 422 patients who were laboratory confirmed COVID-19 positive cases. Clinical data was extracted from the medical records of the patients. All the patients were treated as inpatients. The data was collected by Critical care specialist and Physician. All patients were classified as asymptomatic and symptomatic. The presence or absence of new onset ageusia was documented and statistically analyzed. Results Of 422 cases studied, 401 (95.0%) were male and 21 (5.0%) were female with the mean age of 37.9 ± 8.3 years. 147 (34.8%) were symptomatic and 275 (65.2%) were asymptomatic with 18 % (76/422) patients having ageusia in the study population. Conclusion The prevalence of ageusia amongst covid positive patients in Indian population is lesser as compared to reports in the western literature. The cause of this difference in prevalence of ageusia in different ethnicities is unknown. Apparently healthy individuals with new onset ageusia should be considered as asymptomatic covid carriers and should be treated accordingly.

Background: Androgenetic alopecia (AGA) is the most prevalent cause of hair loss around the world., Objective: The purpose of this study was to evaluate the efficacy of laser stimulation with a 675-nm wavelength for the treatment of AGA in male and female Indian patients., Methods: A total of 20 Indian healthy patients aged 23-57 years who presented a grade of alopecia stage I to stage V underwent one single pass with a 675-nm laser to the scalp area twice a week for a total of 8 sessions, followed by once a week for 4 sessions and once in 2 weeks for 2 sessions. There are 14 laser treatments in total. Macro- and dermatoscopic images have been acquired at T0 (baseline) and T1 (4 months). The vertex, frontal, and parietal areas of the scalp were evaluated. Many parameters were analyzed including hair count and hair density of terminal; mean thickness; vellus follicles; total follicular units; units with 1 hair, 2 hairs, 3 hairs, 4 hairs, and >4 hairs; unit density; and average hair/unit., Results: The macroimages and dermatoscopic evaluations showed good improvement over the entire treated area, with a clear increase in the number of hairs and hair thickness. General parameters such as hair count and hair density showed a percentage increase of around 17%. The hair mean thickness parameters showed a significant (P<.001) percentage increase of 13.91%. Similar results were obtained for terminal and vellus hair: terminal hair count and hair density significantly (P=.04 and P=.01, respectively) increased by 17.45%, vellus hair count increased by 16.67% (P=.06), and the density of vellus hair increased by 16.61% (P=.06)., Conclusions: The study findings demonstrate that the 675-nm laser system improved AGA in Indian patients, facilitating the anagen phase and improving hair density and other positive hair parameters., (©BS Chandrashekar, Oliver Clement Lobo, Irene Fusco, Francesca Madeddu, Tiziano Zingoni. Originally published in JMIR Dermatology (http://derma.jmir.org), 23.09.2024.)