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Background: Breast cancer (BC) is the leading cancer in India among women accounting for 13.5% of all cancer cases. One of the leading causes of high breast cancer deaths is poor awareness about risk factors, symptoms and screening leading to the late presentation at an advanced stage. Objectives: 1. To understand the knowledge of breast cancer symptoms and risk factors, perceptions and practises of breast cancer screening. 2. To do a need assessment of the people in the community regarding screening of breast cancer. Methodology: A community-based mixed method study was conducted at Chengalpattu, Tamil Nadu and primary data was collected from 401 women aged 18-60 years. Structured questionnaire was used to collect quantitative data to assess the knowledge of breast cancer. The need assessment on screening was done by Focus group discussions (FGD). Mean, median, proportions and chi-square test were used to analyse quantitative data and thematic content analysis for qualitative data. Results: The study found that 71.3% of the women were aware of breast cancer. The women who were aware of breast cancer considered lump in breast (78.3%), pain in one breast (66%) as the common symptoms. Women who were aware of breast cancer reported early menarche (16.8%), late menopause (15.4%), nulliparity (20%) and family history of cancer (49%) as the risk factors of breast cancer. 65% of the women were aware of at least one of the methods of breast cancer screening. More awareness programs, organising screening camps in the village, reducing the cost of screening tests were some of the needs addressed during the FGD. Conclusion: Knowledge of symptoms, risk factors and screening practises of breast cancer were low which necessitates the enhancement of knowledge on breast cancer to reduce the burden in the community.

The Internet of Things (IoT) is a collection of interconnected intelligent devices that exists within the larger network known as the Internet. With the increasing popularity of IoT devices, massive data is generated day by day. The collected data need to be continuously uploaded to the cloud server. Besides, the transmission of data in the cloud environment is performed via the internet, which faces numerous threats. However, the security issue always lacks an effective big data communication. Therefore, a novel technique called Orthogonal Regressed Steepest Descent Deep Structured Perceptive Neural Learning based Secured Data Communication (ORSDDSPNL-SDC) is introduced with higher accuracy and lesser time consumption. The ORSDDSPNL-SDC technique comprises three phases, namely registration, user authentication, and secure data communication. In the ORSDDSPNL-SDC technique, the registration phase is carried out for creating the new ID, and password for each user in the cloud. The IoT device's data is then sent to a cloud server by the cloud user for storage. After that, the orthogonal regressed steepest descent multilayer deep perceptive neural learning is applied to examine the user_ ID with already registered ID based on Szymkiewicz–Simpson coefficient. Then the Maxout activation function is to classify the user as authorized or unauthorized. Finally, the steepest descent function is applied for minimizing the classification error and increasing the classification accuracy. In this way, the authorized or unauthorized user is identified. Then the secured communication is performed with the authorized cloud users. Experimental evaluation is carried out on the factors such as classification accuracy, classification time and error rate, and space complexity with respect to a number of users. The qualitative results and discussion indicate that the proposed ORSDDSPNL-SDC offers elevated performance with regard to achieving higher classification accuracy and minimum error as well as computation time when compared to the existing methods. [JJCIT 2023; 9(1.000): 63-75]

Background: Football players can sustain repeated muscular effort that requires adequate muscular strength and power and adequately conditioned cardiovascular and respiratory systems. Resistance training improves muscular strength and endurance. Concurrent training involves cardiovascular endurance and resistance training within the same session or closely together within the same day. Concurrent training was promoted as a way promoted to save time while multiple training goals. The study's objective is to compare the effectiveness of resistance exercise and concurrent exercise training on the power and strength of lower limbs in football players. Methods: This was an experimental study design with a convenient sampling method. This was conducted on subjects from the Faculty of physiotherapy, Dr.M.G.R. Educational, and Research Institute and took nearly one month to analyze the study. Based on the inclusion and exclusion criteria, 30 samples were selected and divided into Group A and Group B by convenient sampling method. Group A received Resistance training exercise, and Group B received Concurrent training for two sets of 15 repetitions/twice a week for four weeks. Pre and post-test were measured before and after the study for 1 month, using a vertical jump test. The data were compared and analyzed within and between groups. Result: Comparing the Pre and Post-test scores between Groups (A & B) on maximum Isometric Voluntary Contraction (MIVC) &Vertical Jump Test shows a significant difference in Mean values with P ≤ 0.001. Conclusion: Concurrent exercise training is more effective than resistance exercise on the power and strength of lower limbs.

Diabetes is affecting the social and economic developments in developing countries like Sri Lanka. Siddha Medicine (Tamil Medicine) is mostly practiced in the Eastern and Northern Provinces of Sri Lanka. Our recent review of Sri Lankan Siddha historical documents identified 171 plant species used to prepare anti-diabetic preparations. On the other hand, there is no study of plants currently used to treat diabetes in Sri Lankan Siddha Medicine. Hence, the aim of this study is to identify and document the plant species currently used in anti-diabetic preparations in Eastern Province, also enabling a comparative analysis with historical uses. Further, assessing the level of scientific evidence (in vitro, in vivo, and clinical studies) available for recorded species. A systematically prepared questionnaire was used to conduct an ethnobotanical survey with 27 Siddha healers residing in Eastern Province to identify the currently used anti-diabetic plants. Furthermore, Web of Science electronic database was used to assess the level of scientific evidence available excluding widespread and very well studied species. On average 325 diabetic patients were seen by 27 healers per week. Interestingly, inorganic substances, and animal parts used as ingredients in historical anti-diabetic preparations are currently not used in Eastern Province. A total of 88 plant species from 46 families were reported in this study. Syzygium cumini (L.) Skeels was the most frequently recorded species and the largest number of taxa are from Fabaceae. Remarkably, one third of reported species were not stated in Sri Lankan Siddha historical documents. The highest number of plant species (59%) have been studied up to an in vivo level followed by no scientific evidence for anti-diabetic activity found (27%), clinical evidence (10%), and in vitro (2%). This is the first ethnobotanical study of plants used to treat diabetes by Siddha healers in the Eastern Province in Sri Lanka. Moreover, awareness should be created to the diabetics about the side effects of herb-drug interactions and complications caused by taking both herbal preparations and biomedical drugs.

The current debate on decentralisation offers a polarised view on the dynamic power relations involved in water resources management. Drawing New Institutionalism as applied in the social and ecological sciences, the paper argues that decentralisation represents a complex adaptive process that involves a combination of natural and a political endeavour by actors and agents to draw on existing structures to negotiate and renegotiate the existing unequal power relations to (mis)manage water. Examining a Village in the Indian Himalayas as a case study, the paper demonstrates the significance of New Institutionalism for a comprehensive understanding of the decentralisation as a process, with an intention to identify the opportunities and barriers presented by institutional factors on water resources management. The paper reveals the contemporary top-down decentralised reforms though has helped actors to voice their concern and empowered the agents to remain adaptive, these have not ensured resource use efficiency, addressed poverty and promoted greater participation of the actors. Facilitating these will require a strengthening the role of statutory public organisations to regulate water distribution, build capacity of actors and offer diverse forums to facilitate informed water-related decisions for a sustainable future.

Aim: To compare the photographic screening for retinopathy of prematurity (ROP) using RetCam 120 with binocular indirect ophthalmoscope (BIO), which is the current gold standard. Setting and Design: Prospective, comparative study. Materials and Methods: A total of 87 RetCam examinations were performed on 27 premature babies. They were stored in a separate file after deleting the identifying information. At the same visit using the BIO with scleral depression, an experienced vitreoretinal surgeon evaluated the fundus in detail. A masked examiner then evaluated the RetCam photographs for presence or absence of ROP, the stage and zone of the disease, and the presence or absence of plus disease. These data were then compared with the BIO findings to determine the sensitivity, specificity, and the positive and negative predictive values of the method. Results: ROP was detected in 63 of 87 examinations by BIO and in 56 of 87 RetCam examinations. Nine RetCam examinations were false-negative and two were false-positive. Sensitivity of RetCam was 85.71% (54/63) and specificity was 91.66% (22/24). The positive and negative predictive values were 96.43% and 70.97% respectively. Conclusion: Nine cases having ROP were missed by the RetCam. All these cases were either in zone 3 or the outer part of zone 2, which later regressed. These were missed mostly because of the restricted mobility of the camera head caused by its size and the barrier caused by the lid speculum arms. No case of threshold ROP was missed. RetCam may replace BIO for screening of ROP.

Purpose: To analyse the clinical characteristics and treatment outcome of zone 1 Fulminate type of Retinopathy of Prematurity (ROP) and compare it to Conventional ROP. Methods: Preterm infants from two neonatal intensive care units (NICU) born between July 2002 and November 2003 were screened for ROP. Cases with Conventional ROP were classified according to the International Classification of Retinopathy of Prematurity (ICROP) while that of Fulminate ROP according to Shapiro′s classification. Threshold disease was kept the cut off for treatment for Conventional ROP and stage 3A for Fulminate ROP. Results: Of the 54 cases that had treatable ROP, 36 (66.67%) had Fulminate type. The mean gestational age and birth weight was higher in Fulminate ROP compared to Conventional disease (31.75 weeks and 1554 gms vs 31 weeks 1387 gms) whereas the mean postnatal age at laser was lower (4.62 weeks vs 6.3 weeks). The average number of laser spots given was 3036.6 for Fulminate disease. Conclusion: Fulminate ROP had an atypical morphology which was difficult to classify according to ICROP classification and we would like to lay stress upon the importance of screening of premature infants from the age of 4 weeks and to start treatment immediately once Fulminate ROP has been diagnosed.

Intracameral injection of bevacizumab (Avastin) helped in the successful regression of an anterior chamber neovascular membrane in a painful blind eye. The effect was persistent even after six months of follow-up. This is the first report on intracameral administration of bevacizumab with six months of follow-up.

Routine ophthalmoscopic screening for retinopathy of prematurity (ROP) from the age of 2 weeks is necessary to detect and treat fulminate ROP.

PURPOSE: To analyse the intraocular pressure rise after intravitreal dexamethasone implant (Ozurdex) amongst different geographic populations. METHODS: The medical charts of 294 dexamethasone implants between February 2011 and 2017 were reviewed retrospectively. South Asian (India), White (Europe, US and Israel) Latino (Argentina and Brazil) patient data was included in the study. Ocular hypertension (OHT) was defined as intraocular pressure of >25 mmHg or an increase of at least 10 mmHg from baseline. The main indications for treatment were diabetic macular edema (ME) (65.6%), retinal vein occlusion (26.5%), uveitis (7.8%). RESULTS: Amongst 294 intravitreal implants, ocular hypertension (>25 mmHg) was recorded in 0, 8 and 9.5% in White, Latino, and South Asian groups, respectively. However, IOP > 20 mmHg was recorded in 14%, 28% and 27% in White, Latino, and South Asian groups, respectively. Incidence of very high IOP (>35 mmHg) was lower in all geographical groups. It was 3% in Latino followed by 2% in South Asian group. CONCLUSION: Latino and South Asian groups have higher IOP rise compared to White population. Most patients with elevated IOP fluctuate between 20-25 mmHg.