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Introduction: According to NFHS-V revealed that in Gujarat, contraceptive prevalence rate was 65.3%. Female sterilization is the predominant contraception method, favored by 35.9% of individuals. Whereas, total unmet need for family planning is 10.3%. Women with unmet need are those who are fecund and sexually active but are not using any method of contraception, and report not wanting to delay the next child. The concept of unmet need points to the gap between women’s reproductive intentions and their contraceptive behaviour. Aims & Objectives of study is the prevalence of unmet needs of family planning and its determinants among married women (15-49 yrs) attending rural and urban health centre of a teaching hospital of Saurashtra Region of Gujarat. Methodology: Cross-sectional Hospital based study which was conducted at rural & urban health centre under MPGMC, Jamnagar, Gujarat amongst married women (15-49 yrs) during April 2021 to August 2021. Sample size was calculated by using Daniels Formula. Verbal informed consent was taken from every subject. The study was initiated after it was approved by the Research and Ethics Committee of MPSGMC. Results: In this study, conducted with a total of 300 participants (comprising 150 from rural areas and 150 from urban areas), the unmet need for family planning stands at approximately 35.67%. This figure was even higher among younger age groups and among women with smaller family sizes. Of the participants, 51% were currently utilizing contraceptive methods, with only a small percentage reporting contraceptive use by their partners. Government health facilities were the major source of contraceptive service. Conclusion: Unmet needs of family planning were high in this study population, and the knowledge about the contraceptive use and family planning was found to be fairly adequate.

The present study was conducted to assess stress distribution around dental implants based on the all-on-four treatment concept. The finite element analysis (FEA) models comprised cancellous bone covered with cortical bone. Four dental implants were placed in two different designs. In model 1, the four implants were placed parallel to each other, whereas, in model 2, the all-on-four concept was followed. The vertical and lateral loads of various values were applied, and stress was evaluated. In model 2, the least stress was observed in both lateral and vertical loading in the peri-implant region. The all-on-four concept proved to be beneficial in reducing the stress around dental implants, thereby reducing the treatment cost.

Background and Objectives: Asthma is a common, chronic and heterogeneous disease with various phenotypes. The clinical phenotypes has aided in revealing the genetic heterogeneity, provide education, life style advice and novel biological treatments. The few common factors associated with phenotypes are smoking, rhinitis and obesity. The present study was thus planned to analyse and correlate the clinical, physiological, biochemical and serological parameters of asthma and to study the phenotypic characteristics in different asthmatic. Methods: This was a prospective observational study of 120 patients with 30 each in BA-rhinitis, BA, BA-obesity and BA smoker phenotypes. All the enrolled patients were assessed by SGRQ, Mini-AQLQ, GINA with ACE, chest X ray, Spirometry, SPT against common aero-allergens, FENO, hsCRP, vitamin-D, IgE, and Interleukins (IL) including IL-5, IL-6, IL-8, IL-13, IL-17 and IL-33. The mentioned profiles of each phenotype correlated and characterized among different phenotypes. Results: The majority of patients 78(65%) were female with mean BMI of 24.07±4.73kg/m2. Majority of the patient in BA and BA-rhinitis phenotype are in mild severity and young compared to majority in BA-obesity and BA-smoker are moderate to severe severity with older. (p

Observations have suggested that during the coronavirus disease 2019 pandemic, because of lockdown students who are in process of doing their thesis related work exhibit responses related to stress due to the fear of spread contagion and because of various limitations in performing thesis work, especially patient-oriented collection of data and clinical work. The present study aimed to determine various problems faced by the students in postgraduate courses for completing their thesis during pandemic. This was a prospective and cross-sectional study based on a questionnaire. This study was comprised of a total sample size of 300 postgraduate students of different disciplines in the health stream. The study was conducted between June 2021 and December 2021. The prepared study questionnaire was sent to postgraduates by use of electronic mail. Of the total selected students, 280 had responded with complete answers to the questionnaire. Collected data were entered into a Microsoft Excel sheet and analyzed for percentage distribution. 50.7% of postgraduates were found in the age range of 26–30 years, 73.1% were female and 35.6% were in their final year of postgraduation. It was seen that 6.5% were unable to procure ethical approval due to the pandemic, and 43.1% were not able to get permission from the board due to the sudden pandemic. 64.9% were unable to collect data for their thesis, and 18% were unable to report to supervisors. 86.9% of postgraduates suffered from anxiety due to the inability to perform thesis work. 78.9% of postgraduate students had a decrease in motivation for a thesis and 89.1% suffered from anxiety. Due to the ongoing pandemic, postgraduate students are facing many problems in completing their thesis work. This resulted in anxiety and stress themselves.

Intestinal amebiasis remains asymptomatic in 90% of cases. Only 4%–10% of individuals monitored for 1 year develop colitis. Amebic colitis evolves to fulminant colitis or rupture in 0.5% of cases. In such scenario, mortality exceeds 50%. We report the case of a 55-year-old male who presented with signs of perforation and was taken up for surgery immediately. On histopathological examination, Entamoeba was diagnosed as the underlying cause of fulminant colitis.

Background/Objectives: The use of hydroxychloroquine (HCQ) for COVID-19 has raised concerns for adverse effects. We aimed to understand the practice, perceptions, and experience of adverse drug reactions (ADRs) with HCQ use for COVID-19 and other indications. Methods: A validated e-survey with 30 questions was circulated among rheumatologists and other specialists using SurveyMonkey. Responses from rheumatologists were compared with other doctors (odds ratio [OR], median, interquartile range), and ADRs encountered based on their indications. Results: Among 410 respondents (71.2% rheumatologists, 27% academicians) with a lifetime experience of 17886 (4884–52074) patients over 12 (7–20) years, and 148 (48–349) prescription of HCQ per month, one-third (135) were managing COVID-19 with 10 (0–60) prescriptions per physician. Electrocardiograms were seldom ordered preprescription (5%), but visual scans were requested by one-thirds, especially by rheumatologists (OR-1.9). Agreement on the safety of HCQ for non-COVID indications was nearly unanimous (99%), but only two-third (64%) perceived it to be safe for COVID-19, with most (72%) being uncomfortable using HCQ with macrolides. ADRs were most often encountered after middle-age with skin pigmentation (554 [123–2063]) being the most frequent, followed by gastrointestinal intolerance (222 [42–980] per million prescriptions). Cardiac toxicity was rarely reported. ADRs other than cutaneous and visual were noted more frequently by nonrheumatologists. Rheumatologists were less likely to consider HCQ unsafe (OR-0.04) and reportedly faced a greater challenge in drug procurance (OR-2.6) during the pandemic. Conclusions: Most ADRs are rare with HCQ use in our respondent population with a large user experience. HCQ use was considered unsafe by one-thirds in the setting of COVID-19 but not outside it, lesser so by rheumatologists.

Introduction: Inflammation is the forerunner to fibrosis and premature aging in various systemic diseases. Hence, we hypothesized that idiopathic inflammatory myopathies (IIM) may exhibit accelerated senescence, and the serum myostatin (MSTN):follistatin system may be a reflection of early senescence events in the muscle. Methods: Patients with IIM (ACR/EULAR criteria) were recruited (2017–2019) for comparison with healthy and disease controls (DCs). Those with active infection, pregnancy, renal dysfunction, or chronic kidney disease were excluded from the study. MSTN and follistatin were estimated in sera using ELISA (R&D systems, USA). Juvenile myositis and young adults (18–40 years) were subsequently analyzed separately. Nonparametric tests were used for paired and unpaired analysis. Results expressed as median and interquartile range. Results: A total of 84 myositis (3 juvenile myositis, 40 DM, 30 PM, 11 overlap) patients (68 females) with median age 38 (27–47.0) years and median disease duration of 0.9 (2.3–5.1) years were included. Serum MSTN was lower in IIM than in healthy control (149.3 vs. 243.6 P < 0.0001) but higher in IIM as compared with DCs (149.3 vs. 85.11, P = 0.0174). MSTN levels were higher in active as compared with inactive myositis in young adults (189.6 vs. 115.8, P = 0.0349). Serum MSTN correlated with height (r = 0.3, P = 0.003) and weight (r = 0.2, P = 0.047) but not MMT8 or muscle enzymes. On follow-up, the serial MSTN estimation paralleled change in disease activity. Conclusion: Elevated serum MSTN levels in active myositis raise the possibility of accelerated senescence in the inflamed muscle tissues which need further investigation.

Background: Biobanking refers to the cryopreservation of the various biologic samples for future research. In the era of omics, biobanking has emerged as a vital process to aid research, more so for rare diseases. Aims and Methods: We describe herein the development of a biobank for idiopathic inflammatory myopathies (IIMs), a rheumatic illness with low prevalence. This study addresses the sample collection, transport, storage, maintenance, retrieval, and disposal of samples with a focus on cost-effectiveness, limitations, ethics, and legal aspects involved. Discussion: Financial constraints are juxtaposed next to a wealth of clinical data in the developing countries with a large population size and consequently high burden of rare diseases. Fine-tuning efforts toward the development of bio-archival facilities can maximize outcomes from research units in these countries. A time and cost-efficient model can be the first step toward such initiatives in the appropriate setting. Unique ethical, executive, and scientific challenges were encountered by the authors while establishing the MyoCite biobank in a resource-poor setting. The various efforts to foreclose these obstacles are discussed. Conclusion: This brief summarizes the unmet need, unique challenges, and potential solutions based on the authors' experiences gathered while setting up the MyoCite biobank for research in IIM. It also outlines the means and directions for national and global collaborations in the times ahead.

An IoT based smart healthcare monitoring system is presented in this study. A local database, sensors, a microcontroller, and a GSM module make up the suggested system. Here, we’re using an Arduino Uno to attach sensors, which then sense the environment and record data that is sent over the internet using the GSM protocol. The health of patients in isolated or rural locations without access to medical services can be tracked using this project. The importance of offering patients who were anticipated to decrease travel and direct contact with others remote patient monitoring services became even more clear when the epidemic struck. When there is an abnormal activity identified, healthcare team will get a message and they would make a call and prescribe the activities which need to be do for emergency and even it doesn’t work ambulance is immediately depart to that particular patient’s location since we have the patient’s personal info about his location and his/her relative emergency mobile number.

Background: Evaluating the fertility and obstetric outcomes in women with rare rheumatic diseases is challenging as it needs to take into account various influencing factors. Aims and Objectives: The aim is to draft a structured case record form (CRF) for collating obstetric outcomes in rheumatic diseases Materials and Methods: Clinical CRFs were designed for inflammatory myositis, ANCA associated vasculitis, Takayasu arteritis and systemic sclerosis with the objectives in mind, taking into account disease characteristics, drugs administered, and the changes related to the pregnant state. The forms underwent four rounds of revision by two rheumatologists with trial runs on three patients each. The form was scrutinized for face validity, ambiguity and were designed to ease filling them in a busy outpatient setup. Results: The CRF forms for obstetric outcomes in patients were labelled as version 10.0, 11.0, 12.0, and 13.0 for myositis, AAV, TA, and SSc. Conclusion: Beginning with a well-designed CRF is the first step in collating proper data for research. This paper details the steps involved in the same for collating obstetric outcomes in tfour rare rheumatic illnesses.

Aim: The aim of the study was to assess the anterior and overall tooth size discrepancies in different malocclusions and evaluate its effect on gender in a sample of South Telangana (Khammam) population and to compare it with Bolton standards. Materials and Methods: The study sample consisted of 311 pretreatment study casts, which were selected from records of orthodontic patients, who were residents of Khammam, South Telangana. The sample was divided into three groups based on Angle Class I, II, and III malocclusions and further subdivided into male and female groups. The mesiodistal diameters of the teeth were measured using digital calipers, and the Bolton's analysis was carried out. Statistical Analysis Used: Intraclass correlation coefficient was assessed using Dahlberg's formula. ANOVA and post hoc least significant difference test were used. Results: The mean anterior and overall ratios were 79.17 ± 2.91 and 92.3 ± 1.88, respectively. A total of 64% and 45% of the study population had tooth size discrepancies in the anterior and overall ratios when assessed for >±1 standard deviation (SD). When the sample was assessed for discrepancies >±2 SD, it was observed that a total of 33.8% and 5.5% patients had anterior and overall tooth size discrepancies. Conclusions: With significant differences being observed between Bolton's and the present study values, the need for population standards gains importance for better results at the end of orthodontic treatment.

Introduction: Brick Industry in India is a small scale industry which employs large number of migrant workers from rural areas. The stress at the work place, long hours of work and poor environmental conditions in and around brick making units have an impact on the workers health. Objective: To assess the morbidity profile of workers in brick kilnsina Gram Panchayatarea in Karnataka. Methods: A pre designed and structured interview schedule was used to collect data with physical examination and pulmonary function testing using Wright Peak Flow Meter (PEFR) was done. Data was analyzed using SPSS Version 16. Results: Most Common morbidities identified were musculoskeletal pain (48%), under weight (31%), respiratory diseases (27%), skin diseases (12%), eye complaints (8%) and work place injuries (5%).Prevalence of tobacco use was 67%.78% of the workers had PEFR less than normal even though there was no statistically significant association between PEFR and respiratory morbidity or duration of work. There was no provision of personal protective equipments (PPE) in any of these factories. Conclusion: An improvement of working environment, residential quarters and enforcement of safety devices are needed in the factories studied. Pre-placement and periodic examination should be done to identify at risk individuals.

Background: Plantation industries in India employ over 1 million people and are among the largest private employers in India. Plantations employ both skilled and un-skilled labour’s. The risks of occupational accidents are higher among this population due to the unfavorable working conditions. Objectives: To study the profile of occupational accidents and to describe the time trend of these occupational accidents. To assess changes if any in the profile of occupational accidents reporting to a rural plantation hospital over the last decade. Methodology: A descriptive hospital record review of all the patients presenting with occupational accident from January 2008 to December 2009. Results: 439 patients were registered with history of accidents; among them 196 were occupational accidents. Majority of the victims of the accident were in the age group of 21 – 40 years and were among males. Most common type and site of injuries were superficial injuries on the upper limbs. There is no significant change in the profile on occupational accidents over the last decade.

In Precision Agriculture, a Decision Support System (DSS) is the ultimate stage that incorporates the basic findings derived from earlier procedures. In many cases, a DSS that is exclusively focused on data-driven methodologies might be highly influenced by data sources if these data resources do not provide any sense of intended conclusion. As a result, on-farm experiment inputs may result in incorrect site-specific crop management in the end. Since data is an essential element of DSS, irregular patterns such as outliers in spatial data that can change the nature of expected outcomes must be avoided during data-driven manipulations. Many of the approaches developed to detect outliers were not designed to deal with masking and swamping effects. With this consideration, the work presented here uses two iterative techniques to locate and remove spatial outliers based on their neighbourhood relationship. As a result of this technique, the masking and swamping effects are reduced. The methods we use are iterative, implying that each iteration discovers and eliminates the expected number of outlying observations. R-Studio is used to demonstrate the use of iterative approaches. The efficacy of both iterative procedures was analysed and compared using one of the current graphical approaches, such as the semivariogram. The research specifically looks at how well these strategies perform on a real-world dataset incorporating spatial observations. The statistical iterative techniques outperformed the graphical approach, according to the findings.