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Background: Proteinuria is a major indicator of hypertensive disorder of pregnancy. The gold standard for diagnosis of significant proteinuria is based on a 24hour urine collection which is cumbersome, time-consuming, and inconvenient to patients. A need, therefore, exists for a rapid, valid, and accurate test to identify significant urinary proteinuria. Methods: We conducted an observational cross-sectional hospital-based study wherein a total of 150 pregnant women who met the criteria of preeclampsia were taken. Spot urine samples for calculating the urine P/C ratio were taken immediately before 24hr urine collection. Correlation between 24hour urine protein and spot PCR was then determined by Pearson’s correlation coefficient(r). Results: The correlation coefficient (r) between 24hr urine protein and spot PCR was found to be 0.734 (n=150) which was highly significant with p

Background - Phantom vibration syndrome (PVS) is the sensation of false belief that mobile phone is vibrating when actually it is not. It is an emerging psychological disorder due to overuse of mobile phones owing to its charismatic features such as portability, accessibility, etc. Mobile phones have become an essential part of day-to-day life. As a society increasingly dependent on mobile phones, PVS easily becomes a phenomenon of worry. Frequent use of Mobile phones on prolonged vibration mode lead towards PVS. Studies suggest that PVS can cause psychological stress, anxiety, depression and if left unmanaged, primary symptoms progress to advanced stages. Aims and Objectives - To estimate the proportion of Phantom Vibration Syndrome among medical students and to assess the Impact of Phantom Vibration Syndrome on Stress, Anxiety and Depression. Materials and Methods - Across sectional online questionnaire-based study was conducted among 280 medical students of Indira Gandhi Government Medical College, Nagpur from January 2022 to February 2022. Data was collected using pre-tested questionnaire which included questionnaire regarding Mobile phone usage and Psychological well- being. Stress, Anxiety and Depression were assessed using Perceived stress scale, Hamilton Anxiety rating scale and Beck's Depression Inventory Scale respectively. Results – Out Of 280 respondents, 135 (48.2%) are Male and 145 (51.8%) are Female. 74% (208) reported having experienced Phantom Vibration Syndrome (PVS) from mobile phones. Whereas only, 18.57% of Study Participants experienced Phantom Ringing Syndrome. Conclusions – Excessive problematic usage of mobile phone has resulted in various disorders like phantom vibration syndrome, Phubbing, Ringxiety and Nomophobia that deals with psychological or socio behavioral changes. By limiting mobile phone use in a productive way, these health-related problems can be avoided.

NCDs are leading cause of premature deaths worldwide. Global trends suggest that these diseases to a large extent are associated with life styles like- unhealthy dietary intake, physical inactivity, tobacco use, high alcohol consumption and are on the rise. CBAC (Community Based Assessment Checklist) is a simple means of early identifying risk of NCDs in the community. There is a paucity of published literature using CBAC as screening tool. Hence this community based study was undertaken among adult population of area adopted by urban and rural health care training centre of IGGMC, Nagpur to assess the risk of NCDs and serve as a tool for early diagnosis and treatment.To assess the risk of Non Communicable Diseases using Community Based Assessment Checklist among adult population of area adopted by urban and rural health training centre, IGGMC, Nagpur. To study the risk of NCDs with place of residence and suggest recommendations based on the study findings. A cross sectional community based study was conducted among 376 adults residing in the field practice area of Urban and Rural Health care Training Centre of IGGMC, Nagpur. Data was collected by conducting face to face interview with structured questionnaire which included socio-demographic variable and CBAC questionnaire. Study was conducted from January to May 2022 by using consecutive sampling till sample size was achieved.Overall risk of NCD was found to be 60.9%. The risk of NCD was 61.2% among rural adults while it was 60.6% among urban adults of adopted field practice area of IGGMC, Nagpur. The risk of NCD was found to be significantly associated with Age (p= 0.000), Gender (p=0.000), tobacco use (p=0.000), alcohol consumption (p= 0.000), Waist circumference (p=0.000) and family history of hypertension, Diabetes mellitus and cardiovascular illnesses (p=0.000). There was no significant association found between risk of NCDs and CBAC variables by place of residence except for waist circumference (p = 0.03) Overall most CBAC variables were found to have significant association with NCDs risk however no significant difference was observed between CBAC variables and place of residence.

The intense heat generation during machining is critical to the workpiece quality. Coolant and lubrication therefore play decisive roles in machining. The conventional cutting fluids employed in machining have certain limitations with regards to their use for ecological and economic reasons. However the need for sustainable manufacturing and better surface quality urged to explore the merits of the lubricants that are eco-friendly such as solid lubricants that are proved to be a feasible alternative to the conventional cutting fluids. Solid lubricants, if employed properly, could control the machining zone temperature effectively by intensive removal of heat from the machining zone. If friction at the tool and workpiece interaction can be minimized by providing the effective lubrication, the heat generated can be reduced to some extent. It will also help reduce wear, thus improving the tool life and the surface finish. These are also used to reduce the force and the energy consumption. So the performance of the solid lubricant needs to be evaluated from tribological point of view. For this, an open tribometer has been envisaged to get the friction coefficient between the coated carbide tool and the austenitic stainless steel AISI 304 workpiece at machining - type situations. Hence this study investigate the effects of the machining parameters and the different machining environments on the machinablity aspects namely surface roughness, tool wear, tool - chip contact length, net cutting specific energy, chip morphology and the chip thickness ratio while machining austenitic stainless steel AISI 304 by TiAlN coated tungsten carbide inserts of the different tool geometry. To show the effectiveness of the solid lubricant, a comparative performance analysis, under the different environments was conducted. Results indicate that there is considerable reduction in the average flank wear (35%–60%), net cutting specific energy (40%–49%); tool-chip contact length (40%–60 %), chip thickness ratio (32%–65%) and the surface roughness (10%–39%) with the solid lubricant assisted machining compared to that of wet and dry machining. This study established that the solid lubricant assisted machining is an eco-friendly sustainable manufacturing process for the industry.

ImportancePreclinical and phase 1/2 studies with esmolol hydrochloride suggest its potential role in treatment of diabetic foot ulcers (DFUs).ObjectiveTo study the efficacy of topical esmolol for healing of uninfected DFUs.Design, Setting, and ParticipantsA randomized, double-blind, multicenter, phase 3 clinical trial was conducted from December 26, 2018, to August 19, 2020, at 27 referral centers across India. Participants included adults with DFUs.InterventionsParticipants were randomized after a run-in phase (1 week) to receive esmolol, 14%, gel with standard of care (SoC), SoC only, or vehicle with SoC (3:3:1 proportion) for 12 weeks (treatment phase) and followed up subsequently until week 24.Main Outcomes and MeasuresThe primary outcome was the proportion of wound closure within the 12-week treatment phase in the esmolol with SoC and SoC only groups. Analysis was conducted using an intention-to-treat safety evaluable population, full analysis set or efficacy-evaluable population, and per-protocol population comparing the esmolol plus SoC and SoC only treatment groups.ResultsIn the study, 176 participants (122 men [69.3%]; mean [SD] age, 56.4 [9.0] years; mean [SD] hemoglobin A1c level, 8.6% [1.6%]) with DFUs classified as University of Texas Diabetic Wound Classification system grade IA and IC (mean [SD] ulcer area, 4.7 [2.9] cm2) were randomized to the 3 groups. A total of 140 participants were analyzed for efficacy. The proportion of participants in the esmolol with SoC group who achieved target ulcer closure within 12 weeks was 41 of 68 (60.3%) compared with 30 of 72 (41.7%) participants in the SoC only group (odds ratio [OR], 2.13; 95% CI, 1.08-4.17; P = .03). A total of 120 participants completed the end of study visit which were analyzed. Target ulcer closure by the end of the study (week 24) was achieved in 44 of 57 (77.2%) participants in the esmolol with SoC group and 35 of 63 (55.6%) participants in the SoC only group (OR, 2.71; 95% CI, 1.22-5.99; P = .01). The median time for ulcer closure was 85 days for the esmolol with SoC group and was not estimable for SoC only group. Significant benefits of Esmolol with SoC were seen in patients with factors that impede the healing of DFU. Treatment-emergent adverse events were noted in 18.8% of the participants, but most (87.3%) of these events were not attributable to the study drug.Conclusions and RelevanceIn this multicenter, randomized, double-blind clinical trial, the addition of esmolol to SoC was shown to significantly improve the healing of DFUs. With these results, topical esmolol may be an appropriate addition to SoC for treating DFUs.Trial RegistrationClinicalTrials.gov Identifier: NCT03998436; Clinical Trial Registry, India CRI Number: CTRI/2018/11/016295

Background: Medicinal herbs remain a vital source of new chemical entities, instead of the attempt of pharmaceutical companies using combinatorial and synthetic chemistry techniques for developing new drugs. Objectives: The primary aim of review is to highlight the different phytochemcial ingredients and their therapeutic potential in Cynara scolymus Methods: Cynara scolymus, commonly known as artichoke is a rich source of polyphenolic compounds, mainly caffeoylquinic acids and flavonoids, isolated in the polar extracts of the plant, together with the polysaccharide inulin. The worldwide scientific databases were comprehensively and systematically reviewed and summarized. Results: The beneficial effects of artichoke in experimental studies include antidiabetic, anti-obesity, anti-inflammatory, anti-hypercholesterolemic, hepatoprotective, nephroprotective, gastrointestinal protectant, reproductive, and anticancer properties. Studies with artichoke conducted in experimental animals reported no mortality or significant toxicity. Increasing attention is being paid to developing herbal medicines as a newly emerging treatment for the welfare of the patients in the last few decades. Conclusion: The present review detailed the versatile therapeutic efficiency and diverse application of C. scolymus. This medicinal herb has been appropriately used in conventional medicine for a long and helps cure various ailments.

Type 2 diabetes mellitus (T2DM) and obstructive sleep apnea (OSA) are closely associated diseases with a significant impact on public health. Both diseases are highly prevalent and the common overlapping risk factors include obesity, old age, and a generally high preponderance in men. A growing body of evidence suggests a bidirectional association between OSA and T2DM; both, in turn, constitute as strong risk factors for cardiovascular diseases, the leading cause of premature deaths and morbidity in India. Several studies have reported a higher prevalence of OSA in Indian patients with T2DM, despite lower levels of obesity. However, OSA remains an underdiagnosed condition in Indian patients with T2DM due to lack of awareness, uncertainty about treatment options, and non-availability of diagnostic facilities. This document embodies evidence-based clinical practice recommendations and outlines an optimized care pathway for patients with T2DM and OSA, based on consensus multidisciplinary observations and clinical experiences. Implementation of screening, diagnosis, and treatment of OSA in patients with T2DM at initial stages could potentially alleviate the risk of cardiovascular disease and substantially improve their quality of life. The recommendations emphasize the need for collaborative efforts from diabetologists, endocrinologists, and sleep medicine specialists towards systematic screening, diagnosis, and treatment of coexisting T2DM and OSA for enhanced patient care.

Background: Several studies have suggested that prevalence of diabetes in India is increasing, a large number of people remain undiagnosed, and overall glycemic control is poor among patients with diabetes. Although there is paucity of data from large population studies. Current study was aimed at analyzing the data collected during the One Nation, One Day, One Million Tests campaign by the Research Society for the Study of Diabetes in India (RSSDI) Methodology: Data collected from the One Nation, One Day, One Million Tests campaign by the Research Society for the Study of Diabetes in India (RSSDI) was retrospectively analyzed. A total data of 225955 adults was included in the analysis out of which 142391 (63%) were males while 83564 (37%) were females. Results: 78694 (34.8%) subjects reported to have preexisting diabetes while 21380 (9.5%) were detected to have diabetes for the first-time during the screening program. Total prevalence of diabetes in the cohort was 100074 (44.3%) . Among people with preexisting diabetes, 68669 (87.3%) reported to be on treatment for diabetes. 17646 of them presented in fasting state and 14834 (21.6%) of them had fasting sugar above 130 mg/dl. Random blood sugar was tested for 423diabetic subjects on treatment, out of which 28335 (41.3%) had random blood sugar more than 180 mg/dl. Overall, 62.9% (43169) of diabetes patients on treatment had their blood sugar values beyond target range. Conclusions: High prevalence of newly detected diabetes in the cohort re-emphasizes the need for aggressive screening for early detection of diabetes in the Indian population. Although the number of people who reported to be on treatment for diabetes was better in this cohort compared to earlier studies, only one third of these subjects had their sugar levels under control. Disclosure R.M.Parikh: None. R.R.Kovil: None. P.M.Chawla: Speaker's Bureau; Biocon, Boehringer Ingelheim International GmbH, Eris Lifesciences Ltd., Novo Nordisk, Sanofi. A.Gupta: Speaker's Bureau; Lupin Pharmaceuticals, Inc., Medtronic, Novartis AG, Novo Nordisk, Sanofi. B.D.Saboo: None. V.K.Ch: None. S.Agarwal: Speaker's Bureau; Novo Nordisk, Roche Diabetes Care, Sanofi, USV Private Limited. B.M.Makkar: None. S.Bhattacharyya: None. S.Chittawar: None. A.Nanditha: None.

Background: Central obesity is a risk factor for cardiovascular and metabolic disorders including diabetes, hypertension and dyslipidemia. Index of central obesity (ICO) , defined as ratio of waist circumference and height, has been earlier proposed as a screening tool for central obesity and metabolic syndrome. We report the prevalence of self-reported central obesity based on ICO in a nationwide community screening program from data collected by the Research Society for the Study of Diabetes in India (RSSDI) as part of the Defeat Diabetes Campaign. Methodology: Data collected from the One Nation, One Day, One Million Tests campaign by RSSDI was retrospectively analyzed. A data of 105481 adults was included in the analysis (69483 were males and 35956 females) . ICO (calculated from self-reported waist size & height) cutoff of 0.5 was used to estimate the prevalence of central obesity in the Indian population. Results: 69.3% (n=73072) of the overall cohort was found to be having central obesity, prevalence being slightly higher among females (75.1%) compared to males (66.3%) . Prevalence of central obesity was higher among diabetic subjects (77.8%) compared to the nondiabetes population (64.6%) . Prevalence of central obesity was higher among females with diabetes (81.5%) compared to males (75.9%) . Prevalence of central obesity was 60.8% and 71.8% in males and females without diabetes respectively. Conclusions: Central obesity is highly prevalent in the Indian population, with prevalence being slightly higher among females compared to males and among people living with diabetes when compared to nondiabetes subjects. As central obesity is a known risk factor for CVD and Metabolic disorders - strategies and interventions directed to address central obesity may be developed and implemented to prevent the future incidence of CVD and Metabolic disorders including diabetes. ICO is a simple screening tool in population dense and resource limited settings. Disclosure B.D.Saboo: None. S.Chittawar: None. A.Nanditha: None. R.M.Parikh: None. A.Gupta: Speaker's Bureau; Lupin Pharmaceuticals, Inc., Medtronic, Novartis AG, Novo Nordisk, Sanofi. V.K.Ch: None. B.M.Makkar: None. S.Agarwal: Speaker's Bureau; Novo Nordisk, Roche Diabetes Care, Sanofi, USV Private Limited. P.M.Chawla: Speaker's Bureau; Biocon, Boehringer Ingelheim International GmbH, Eris Lifesciences Ltd., Novo Nordisk, Sanofi. R.R.Kovil: None. S.Bhattacharyya: None.

Background: The ADA 2022 standard of care recommends routine screening for T2DM beginning from the age of 35 years, while Indian Council of Medical Research recommends to begin screening above the age of 30 years. Current study was aimed at assessing prevalence of diabetes among Indians below 35 and 30 years of age Methodology: Data collected from One Nation, One Day, One Million Tests campaign by RSSDI was retrospectively analyzed. A total data of 225955 adults was included in the analysis. 466 subjects (28026 males & 18561 females) were below the age of 35 years while 27924 (16460 males and 11446 females) were below the age of 30 years. Prevalence of preexisting (self-reported) diabetes and newly detected diabetes was calculated in this subgroup Result: 225955 people screened, 44.3% (100074) were having diabetes. 34.8% (78694) were aware that they have diabetes while 9.4% (21380) were detected with diabetes for the first time during screening. Overall 55.3% (55338) of subjects had family history of diabetes. Subgroup analysis below 35 years of age showed- 12% (5612) had preexisting diabetes while 5.8% (2713) were newly detected with an overall prevalence 17.8% (8325) . Among subjects below 30 years of age 8.7% (2433) had preexisting diabetes while 4.6% (1642) were newly detected with diabetes with an overall prevalence of 13.3% (3713) . Conclusion: The prevalence of T2DM among the young population is on rise. Our study supports the ICMR guidelines for screening of diabetes in the Indian population to begin at the age of 30 years. Higher screening age is likely to miss out a significant number of people. The study has important implications as ADA may also consider screening people of Indian origin at a younger age.Thought should be given to begin screening In Indian population even below the age of 30 years especially in those with a family history of diabetes. Disclosure A.Gupta: Speaker's Bureau; Lupin Pharmaceuticals, Inc., Medtronic, Novartis AG, Novo Nordisk, Sanofi. S.Bhattacharyya: None. S.Chittawar: None. B.D.Saboo: None. R.M.Parikh: None. V.K.Ch: None. S.Agarwal: Speaker's Bureau; Novo Nordisk, Roche Diabetes Care, Sanofi, USV Private Limited. B.M.Makkar: None. R.R.Kovil: None. P.M.Chawla: Speaker's Bureau; Biocon, Boehringer Ingelheim International GmbH, Eris Lifesciences Ltd., Novo Nordisk, Sanofi. A.Nanditha: None.

Hypertension and diabetes mellitus (DM) are two of the leading lifestyle diseases in the Indian and South Asian populations that often co-exist due to overlapping pathophysiological factors. Obesity, insulin resistance, inflammation, and oxidative stress are thought to be some common pathways. Up to 50% of hypertensive cases in India are diagnosed with type 2 diabetes mellitus (T2DM), which defines the need for a comprehensive guideline for managing hypertension in diabetic patients. These RSSDI guidelines have been formulated based on consultation with expert endocrinologists in India and Southeast Asia, acknowledging the needs of the Indian population. Ambulatory blood pressure monitoring and office and home-based blood pressure (BP) monitoring are recommended for the early analysis of risks. Cardiovascular risks, end-organ damage, and renal disorders are the primary complications associated with diabetic hypertension that needs to be managed with the help of non-pharmacological and pharmacological interventions. The non-pharmacological interventions include the nutrition education of the patient to reduce the intake of salt, sodium, and trans fats and increase the consumption of nuts, fresh fruits, vegetables, and potassium-rich foods. It is also recommended to initiate 50 to 60 min of exercise three to four times a week since physical activity has shown to be more beneficial for hypertension control in Indian patients than dietary modulation. For the pharmacological management of hypertension in patients with T2DM, angiotensin II receptor blockers (ARBs) are recommended as the first line of therapy, demonstrating their superiority over other antihypertensive agents such as ACEi. However, most of the global hypertension guidelines recommend initiation with combination therapy to achieve better BP control in most patients and to reduce the risk of adverse events. For combination therapy, calcium channel blockers (CCBs) are recommended to be administered along with ARBs instead of beta-blockers or diuretics to avoid the risk of cardiovascular events and hyperglycaemia. Among the CCBs, novel molecules (e.g. cilnidipine) are recommended in combination with ARBs for better cardiovascular and reno-protection in diabetic hypertensive patients.

The recent advancement towards THz system design and development, THz spectroscopy and Non-Destructive Testing (NDT) fascinates researchers’ attention in development of absorbing coating and composites to counter stealth technologies and shielding from THz radiation. Conductive fillers based THz absorber composites have emerged as a solution as their properties can be tuned with the change in the filler loading. In the current work, several multilayer composites are prepared by wet lay-up process using conducting fillers- chopped carbon fibre (CCF), milled carbon fibre (MCF) and carbon veil (CV) in epoxy matrix with glass fibre as reinforcement. These composite samples were evaluated for absorption in 0.75–2.25 THz frequency domain to explore their use for THz absorber applications. The results show that absorption performance of fabricated composite structures is significantly affected by type of filler, percentage loading of filler and frequency range. The polymer composite with CV filler exhibits maximum 99% absorption (10–20 dB reflection loss) in frequency range 0.5–2.25 THz. Considering the high mechanical strength and broadband absorption of THz radiations, these composites may provide a better substitute for fragile wideband THz absorptive coatings as well as metamaterials based narrowband THz absorbers.

Purpose Type 1 diabetes (T1D) requires a holistic approach and continuous care. The current COVID-19 pandemic has made the health care professionals realise its challenges even more ardently than in the normal times. In a country like India with its huge population burden and a significant number of people having T1D, the risk of COVID-19 in people having T1DM is considerably high. Methods In this article, we are sharing our practical experiences of problems faced by children and adolescents having T1DM during the past 2 months of lockdown. Results We have classified the challenges into 3 broad categories based on diabetes self-management, healthcare system and psychosocial aspects. We have tried to provide precise, comprehensive and region specific solutions to these challenges. Solutions briefly include maintaining the supply chain of essentials like insulin, syringes and glucose meter strips to psychological support, financial aid and support for hospitalization in case of COVID-19 itself or diabetes complications including diabetic ketoacidosis. Conclusions Children and adolescents having T1DM require special care and attention during this period of COVID-19 pandemic because of various challenges as discussed. Our proposed solutions may help them overcome these problems and help them in better diabetes management during such emergency situations.