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Objective: To identify the trends of the top 100 cited articles on economic evaluation in preventive oral health programs. Methods: Top 100 papers involving economic evaluation or cost analysis of preventive oral health programs were selected by querying Scopus and Web of Science databases. Bibliometric analysis was performed using the Bibliometrix tool in R Studio. Performance analysis and science mapping were performed for these 100 articles. Performance analysis included publication-related metrics, citation-related metrics, and citation-publication-related metrics. Science mapping provided information on citation analysis, co-citation analysis, bibliographic coupling, co-word analysis, and co-authorship details. Results: The total citation number of the top 100 most cited articles ranged from 4 to 98, with publication dates spanning from 1978 to 2023. The majority of articles (33.70 %) originated from the USA, while Community Dentistry and Oral Epidemiology stood out as the journal with the highest number of articles published in the top 100 (16 out of 100). Griffin PM emerged as the most cited author, based on the frequency measurement of the number of papers. Program data economic evaluation was the most commonly reported study design, and fluoridation programs were the most frequent topic. The most reported type of economic analysis performed in the articles was cost-effectiveness analysis. Conclusion: The bibliometric analysis of the top 100 most-cited articles on economic evaluation of preventive oral health programs revealed the lacunae in the research literature on this topic. Therefore, preventive oral health programs should be economically evaluated to eliminate the disparity in resource allocation particularly in upper middle income and low-income countries.

Introduction Schools provide an ideal setting for teaching first-aid skills. A concern is who should train these students when medical doctors and paramedics are busy in hospitals. School teachers can be enabled with instructors’ skills for delivering first-aid training to students under the supervision of one lead instructor. We aimed to evaluate the effectiveness of structured first-aid training by trained teachers on knowledge and practice of first aid among school children of Rishikesh, Uttarakhand. Methods This was a school-based pre- and post-test study. A convenient sample of 109 students (30–40 in each group) were recruited. The first phase was the assessment of needs by focus group discussion with school teachers and students, followed by the development and validation of the module and questionnaire. In the implementation phase, teachers were trained in first aid and facilitation skills, followed by students’ training. Knowledge and skill assessment was carried out. Feedback was noted. Result Need assessment interviews revealed first aid is needed for injuries and bleeding, sprain and fractures, basic life support, choking, nose bleed, animal/insect bites, and lifting/transport of victims. The pretest mean score of students was 6 (2) and increased to 16 (2.1). The relative learning gain was 167%, and absolute was 50%. All students were satisfied with the course and instructors. The facilitation skills score of teachers increased from 39-49 just after training to 67-72 by the end of the second workshop. Conclusion Teachers as facilitators for first-aid training of school students were found to be effective and feasible, and students were highly satisfied with the course and facilitators.

Abstract Background The facilities for intensive care are improving day by day in all departments including pediatrics, and prognostication has always been the duty of a physician. Scoring systems are useful to objectively measure the severity and predict the prognosis of sick children. This study was done to assess the severity of illness and mortality risk using the PRISM score in children aged 1 month–18 years, admitted into the pediatric intensive care unit in a tertiary-level hospital. Ninety children of age group 1 month–18 years admitted to the pediatric intensive care unit, satisfying the inclusion and exclusion criteria, were selected after obtaining consent from the parents. A careful history, physical examination, systemic examination, and relevant blood investigations were performed and documented based on the Pediatric Risk Mortality score (PRISM). The relationship between the total prism score obtained and the outcome in terms of mortality, and severity based on the need for either ventilator support or inotrope support or ICU stay of more than 5 days, was studied using appropriate statistical tools. Results The male to female ratio was 53.3% and 46.7%, with a mortality of 10% and severity of 24%. The average value of the PRISM score was 12 to predict mortality, with 100% sensitivity and 91% specificity. PRISM score of 7 had 100% sensitivity and 95% specificity in predicting severe illness. There was a significant association between a low Glasgow coma scale, pupillary reaction, low systolic blood pressure, acidosis, high blood glucose level, and high serum creatinine with the severity of illness. Conclusions The present study demonstrates that Pediatric Risk Mortality score III (PRISM III) acts as an excellent discriminative tool for predicting both mortality and severity of illness of children admitted to the pediatric intensive care unit. The area under the ROC curves was 99% for both. As the PRISM score increases, both mortality risk increases and the risk of severity of illness also increases.

Background: Ensuring high immunisation coverage and its acceptance among the beneficiaries are crucial for a healthy society. Hence, this study aimed to estimate vaccine coverage and barriers of immunisation among children of age 12–23 months in urban areas of Rishikesh, Uttarakhand. Aims: To estimate the immunization coverage rate among children of age 12-23 months in urban area of Rishikesh. Objectives: To identify the barriers towards immunization in children of age 12-23 months in urban area of Rishikesh. Materials and Methods: A community-based cross-sectional study was done in urban areas of Rishikesh for 1 year, including 210 children, using the WHO's 30 × 7 cluster sampling technique to collect data on immunisation status. Results: About 92% of the children were fully immunised. Bacillus Calmette–Guérin has the highest coverage rate (99.5%), whereas the coverage was the lowest for the measles vaccine (93.8%). Full immunisation coverage was found to be statistically significant with the education of the respondent, socio-economic status (SES) of the family and birth order of the child. Additional vaccines uptake showed a significant association between SES of the family and the place of vaccination. Conclusion: There were significant variations in childhood immunisation coverage across socio-economic and demographic factors. These findings emphasize on the need for regular monitoring and evaluation of immunisation coverage to achieve the benefits of vaccination in all strata of society.

Introduction: The interrelationship of diabetes with mental illness has increased in recent years. Diabetes-related distress is the emotional burden, stress, and worries associated with diabetes, which does not reach the threshold for depressive disorder. A diabetes self-management education (DSME) is a structured educational approach to improve glycemic control and diabetes-related distress. This study aimed to assess the effectiveness of DSME in comparison with usual diabetes care in improving glycemic control and diabetes-related distress. Material and Methods: This is a single-center, parallel randomized controlled trial. A total of 106 participants were recruited for both intervention and control groups with 53 participants each. The control group received only routine outpatient department (OPD) care. The intervention group received DSME in addition to routine OPD care. Diabetes-related distress and HbA1C were assessed after 3 months. The data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 25. Per-protocol analysis was done. Results: Of 127 patients screened, 106 met the eligibility criteria and were randomized. At 3-month follow-up, the reduction in mean HbA1C, fasting blood sugar (FBS), postprandial blood sugar (PPBS), and diabetes distress were significant in the intervention group compared with the control group (p 0.001). The mean HbA1C reduction in the intervention group was significant (mean difference: -1.3, SD: 0.4). The mean DDS had decreased significantly in the intervention group from 2 to 1.2 (mean difference: -0.8, SD: 0.1). Conclusion: The DSME was effective in improving the glycemic control, diabetes-related distress, and self-care among type 2 diabetes (T2DM) mellitus patients.

Introduction: An important cause of neonatal morbidity and mortality is the prelabour Preterm Rupture of the Membranes (PPROM) which refers to, the rupture of the membranes before 37 weeks. There are two modes of managing PPROM, active management (immediate delivery) and expectant management (therapy directed toward extending the pregnancy to improve neonatal outcome). Aim: To compare neonatal outcomes following active and expectant (conservative) management in PPROM cases from 34 weeks to 36 weeks six days. Materials and Methods: This retrospective study was conducted in the Department of Obstetrics and Gynaecology at Government Medical College (tertiary care teaching hospital), Thiruvananthapuram Kerala, India, from February 2021 to July 2021. The data collection period was from January 2013 to December 2014. PPROM cases between 34 weeks and 36 weeks and six days were retrospectively studied. A total of 62 patients among the Active Management (AM) group and 62 patients among the Expected Management (EM) group were selected. The neonatal outcomes (respiratory distress syndrome, hypoglycaemia, neonatal sepsis) and maternal outcomes (caesarean section, chorioamnionitis) were compared. The latency period in conservative management and in active management was also compared. The data was analysed using the Chi-square test. Results: In the AM group, 13 (21%) babies had respiratory distress syndrome, whereas, in the EM group it was 4 (6.5%) (p-value=0.019). In the AM group, 13 (21%) babies had hypoglycaemia, whereas, in the EM group, it was 5 (8.1%) (p-value=0.041). In the AM group, 3 (4.8%) women had signs and symptoms of chorioamnionitis, whereas, in the EM group, it was 7 (11.3%) (p-value=0.187). In the AM group, 16 (25.8%) of women had Caesarean section, whereas, in EM it was 9 (14.5%) (p-value=0.117). In AM group, 1 (1.6%) has neonatal sepsis and in EM it was 3 (4.8%) p-value=0.309. The latency period in conservative management was 119.5±31 hours and in active management, it was 51.5±13.2 hours. Conclusion: The present study indicated that expectant management of PROM between 34 weeks to 36 weeks and six days leads to a statistically significant reduction of neonatal respiratory distress syndrome and hypoglycaemia.

Reflection-based electromagnetic interference shielding materials, though effectively stop the radiation, redirect the interference to nearby electronic devices, creating secondary pollution. In this sense, it is better to use absorption-dominant lightweight and flexible materials with high shielding effectiveness. This paper reports the fabrication of a multilayered polymer nanocomposite for enhancing electromagnetic interference shielding applications through absorption. By using a doctor-blade technique, three individual layers of poly(vinylidene fluoride) based polymer nanocomposite, each with different fillers, were prepared and stacked together to form a 3 mm thick multilayered (four-layer) composite. The fillers were 5% Ag-decorated graphene nanoplatelets, acid-functionalized MWCNT, and barium hexaferrite. Between 8 and 18 GHz, this multilayered composite absorbs a maximum of 90% of incident microwave radiation, resulting in a shielding in the range of 20–45 dB. This structure is very useful for developing flat and lightweight absorbers. For comparison, a homogeneously prepared nanocomposite comprising all these three fillers is found to give a shielding of around 53 dB with a reflection ranging between 78% and 89%. [ABSTRACT FROM AUTHOR]

Introduction: Medical education is one of the most stressful academic curricula worldwide, negatively affecting the health of medical students. Stress in medical students if not tackled in time, can have professional ramifications, as well as personal consequences. Hence, in this background, this study was undertaken to find out the prevalence of stress among medical students, its determinants and its association with academic performance. Material and Methods: This was a cross-sectional study done at a medical college, Wayanad district, between January and June 2019. All the undergraduate medical students of the college were the study subjects. Data were collected using a predesigned and pretested self-administered questionnaire, the first part of which had questions pertaining to basic sociodemographic details, factors affecting stress, and their academic performance, and the second part was the Medical Student Stress Questionnaire. Completed responses were obtained from a total of 605 students. Results: About 29.8%, 53.6%, 16.7% and 0% were found to have no/mild stress, moderate stress, high stress and severe stress respectively. The prevalence of moderate/high stress was more among 25–26 years, males, married, Phase I MBBS, government quota, Muslim, urban origin, and day scholar students. However, only religion and place of origin were found to have a significant association (P =

Introduction: The United Nations has set a target to reduce global maternal deaths to less than 70 per 100,000 live births by 2030. However, despite high rates of institutional deliveries in Karnataka, a state in southern India, maternal mortality remains a significant challenge. This study aims to analyse a 10-year period of pregnancy-related deaths in a healthcare centre in Karnataka to identify the causes and avoidable factors contributing to maternal mortality. Material and Methods: A comprehensive review of records from 2009 to 2018 was conducted, gathering data on socio-demographic features, obstetric and medical history, referral details, duration of hospital stay until death, cause of death, organ dysfunction at admission and avoidable factors contributing to maternal death by inputs from expert committee. The percentages of incidences of causes were determined and analysed using binary logistic regression. Results:One hundred nine maternal deaths were reported during the study period. The majority of these deaths occurred in rural areas, with infections and obstetric haemorrhage being the primary causes. A significant number of deaths occurred within 24 hours of admission, including during the postpartum period, with approximately one-fourth of cases being critically ill and nearly half of the cases had multiorgan dysfunction. Delay in seeking health services (42.8%) and failure to recognize early features of infection (36.3%) emerged as a common contributing factor tomaternal deathss. The presence of any delay in receiving obstetric care (odds ratio [OD]= 3.31), referral status (OD= 3.20), and rural residence (OD=3.06) were significant factors contributing to instability at the time of admission. Conclusions: This study underscores the urgent need to address preventable factors contributing to maternal deaths in Karnataka. Strategies should focus on reducing delays in seeking care, improving recognition and management of infection during pregnancy and enhancing access to emergency obstetric services, particularly for women in rural areas. [ABSTRACT FROM AUTHOR]

Socio-economic status is the key parameter for understanding the affordability of the community of health services and their purchasing capacity. Kuppuswamy's socio-economic scale based on educational, occupational status of head of the family and overall aggregate income of the whole family measures the socio-economic status of urban areas. The scale changes with the updated values of consumer-price index and base year.

The inter-annual variations in wave spectrum are examined based on the wave data measured at 9 m water depth off the central west coast of India from 2009 to 2012 using a wave rider buoy. The temporal variation of the spectral energy density over a calendar year indicates similar variation in all the four years studied. The inter-annual variations in wave spectrum are observed in all months with larger variations during January to February, May and October to November due to the changes in wind-sea. The seasonal average wave spectrum during the monsoon (June–September) is single-peaked and the swell component is high in 2011 compared to other years. The annual averaged wave spectrum had higher peak energy during 2011 due to the higher spectral energy present during the monsoon period. During the non-monsoon period, two peaks are predominantly observed in the wave spectra; with the average peak at 0.07 Hz corresponding to the swells from the Indian Ocean and another at 0.17 Hz due to the local wind field.

Objectives: The present study was conducted to evaluate the anxiolytic potential of ethanolic leaf extract of Tinospora cordifolia Linn. Tinospora cordifolia, the versatile herbal drug is the distinctive source of constituents which is having antidiabetic, immunomodulatory, antioxidant, antimicrobial, antitoxic and anticancer activity. Methods: Leaves of Tinospora cordifolia was collected, dried and powdered used for 7 days cold maceration process. Ethanolic extract was subjected to the preliminary phytochemical screening to analyse the presence of active constituents. At a dose of 100mg/kg, 200mg/kg, 400mg/kg body weight of animal was evaluated for antianxiety activity in mice using 3 experimental designs; elevated plus maze, open filed, light/dark transition model. Test group animals were compared with group of animal treated with diazepam (1mg/kg) as standard drug. Ethanolic extract at 100, 200, and 400mg/kg showed activity in dose dependent manner and at a dose of 400mg/kg showed significant increase; in elevated plus maze, number of entries in open arm and time spent in open arm; number of entries into light chamber and time spent in light chamber in light and dark transition model and in open field; number of square crossed, number of rearing and time spent in central square. Results: The results supported traditional use of Tinospora cordifolia in nervous disorders. Conclusion: Study concluded that ethanolic extract of leaves of Tinospora cordifolia at a dose of 400mg/kg has significant antianxiety activity. [ABSTRACT FROM AUTHOR]

The Bombay Electric Lighting Large-scale Experiment (BELLE) lighting efficiency program was started in Bombay, India as a response to consumer, utilities and manufacturing constraints. The plan involved a consortium of a local utility, a research institution and a manufacturer of compact fluorescent lamps. Failure of the BELLE project points to a need for an integrated analytical framework which includes an assessment of institutional behavior.

Michael L. Tushman and Philip Anderson, eds. New York: Oxford University Press, 1996. 672 pp. $69.95, cloth; $41.95, paper. Innovation, Tushman and Anderson argue, is the linchpin of economic growth [...]

Mahatma Gandhi, the father of India, knitted the Indian community into a strong political force to liberate India from British bondage. Grounded in India's rich culture and heritage, Gandhi's philosophies delineated the social, political, economic, moral and spiritual aspects of personal and social transformation. His mission was to reconstruct India through truth, love, tolerance, non-violence, freedom and peace. Even after 72 years of Indian independence, Gandhian thoughts remain essentially significant in the contemporary social milieu where the whole world strives hard to deal with phenomena of unequal growth and economic processes, modernisation and its consequences, structural and economic inequalities, social injustice, corruption, marginalisation, exclusion racial discrimination and enormous social problems. Gandhi's development and empowerment strategies were far ahead of his time. The constructive programme, an example of such kind, was based on a philosophical and moral approach put into a pragmatic framework spanning across different target populations. The constructive programme was an integrative public work to make India attain Poorna Swaraj (complete independence), self-reliance, self-sufficiency, equality and sustainability. Through his 18 constructive works, he unravelled the psychology of non-violence achieved through self-discipline and selfdetermination. The paper is a critique of Gandhi's constructive programme and the interpretation of authors' views on personal and social transformation. The paper links these thoughts to the present day context to re-examine the social transformation witnessed by India over the years. [ABSTRACT FROM AUTHOR]