Deaths In India Research Articles

A simple and effective method for smartphone-based detection of polyamines in oral cancer

Oral cancer accounts for 50%–70% of all cancer-related deaths in India and ranks sixth among the most frequent cancers globally. Roughly 90% of oral malignancies are histologically arise from squamous cells and are therefore called oral squamous cell carcinoma. Organic polycations known as biogenic polyamines, for example, putrescine (Put), spermidine (Spd), and spermine (Spm), are vital for cell proliferation, including gene expression control, regulation of endonuclease-mediated fragmentation of DNA, and DNA damage inhibition. Higher Spm and Spd levels have been identified as cancer biomarkers for detecting tumour development in various cancers. The current study utilises tannic acid, a polyphenolic compound, as a reducing and capping agent to fabricate AuNPs via a one-step microwave-assisted synthesis. The fabricated TA@AuNPs were utilised as a nanoprobe for colourimetric sensing of polyamines in PBS. When TA@AuNPs are added to the polyamine, the amine groups in polyamines interact with the phenolic groups of TA@AuNPs via hydrogen bonding or electrostatic interactions. These interactions cause the aggregation of TA@AuNPs, resulting in a red shift of the Surface Plasmon Resonance band of TA@AuNPs from 530 nm to 560 nm. The nanoprobe was found to be highly specific for Spm at low concentrations. TA@AuNPs were able to detect Spm successfully in artificial saliva samples. On recording the RGB values of the sensing process using a smartphone app, it was found that as the nanoparticles aggregated due to the presence of Spm, the intensity of the R-value decreased, indicating the aggregation of TA@AuNPs due to interaction with the polyamine.

Phase 2 study of concurrent cisplatin, capecitabine and celecoxib with radiotherapy in patients with carcinoma of the oesophagus.

e16078 Background: Oesophageal cancer is the fourth common cause of cancer-related deaths in India. Definitive Chemoradiotherapy is standard for non-metastatic Squamous cell carcinoma of the oesophagus cancer. Chemoradiotherapy when given as definitive treatment is more effective than radiotherapy or chemotherapy alone. This treatment is usually offered to patients who are unsuitable for surgery. Unsuitability for surgery might be due to the extent of disease precluding the likelihood of a curative resection, or because the patient is physiologically not fit for surgery because of comorbidities or poor performance status. The aim of the present study was to analyse the effect of definitive concurrent chemo-radiotherapy in oesophageal cancer patients and assessment of toxicity profile and response. Methods: In the present Phase II study total 22 patients were recruited who had non-metastatic histologically confirmed carcinoma of the oesophagus selected for definitive chemoradiotherapy were enrolled. Chemotherapy consisted of three-weekly cycles of Inj. Cisplatin 60 mg/m2 given on D1, Tab. Capecitabine 625 mg/m2 given BD on D1-D21, and Tab. Celecoxib 200mg given BD on D1-D21. The planned protocol involved four cycles of concurrent chemotherapy. Radiotherapy in a dose of 50.4 Gy in 28 fractions was initiated on D1 of the second cycle of concurrent chemotherapy, or latest by D1 of the third cycle of concurrent chemotherapy. Results: In this Phase 2 study, 22 patients with a mean age of 55.68 ± 11.23 years, were treated. The tumor length averaged 6 ± 2.25 cm, with most common Stage III (52.17%), followed by Stage II (34.78%), Stage I (8.69%), and Stage IVA (4.34%). Grade 3 dysphagia was predominant (56.52%), followed by Grade 2 (34.78%), Grade 1 (4.35%), and Grade 4 (4.35%). During treatment, notable grade 1-2 toxicities included esophagitis(68%), fatigue(63%), nausea (54%), neutropenia (31%), anemia (22%), mucositis(18%), diarrhoea(13%), dermatitis(9%). There was gradual decline in the severity of dysphagia of all patients. Of the 8 patients evaluated for response with a median follow up of 12 months, the complete response rate was 25%, partial response rate was 25% and 37.5% showed stable disease whereas 12.5% developed progressive disease. The median overall survival is yet to be estimated. Conclusions: A notable clinical response, indicating a substantial treatment effect was observed. While some treatment-related toxicities were present, This approach shows potential in the treatment of oesophageal carcinoma. However, this study is still ongoing and it would be hasty to draw definitive conclusions.

Validating the indicator "maternal death review coverage" to improve maternal mortality data: A retrospective analysis of district, facility, and individual medical record data.

Understanding causes and contributors to maternal mortality is critical from a quality improvement perspective to inform decision making and monitor progress toward ending preventable maternal mortality. The indicator "maternal death review coverage" is defined as the percentage of maternal deaths occurring in a facility that are audited. Both the numerator and denominator of this indicator are subject to misclassification errors, underreporting, and bias. This study assessed the validity of the indicator by examining both its numerator-the number and quality of death reviews-and denominator-the number of facility-based maternal deaths and comparing estimates of the indicator obtained from facility- versus district-level data. We collected data on the number of maternal deaths and content of death reviews from all health facilities serving as birthing sites in 12 districts in three countries: Argentina, Ghana, and India. Additional data were extracted from health management information systems on the number and dates of maternal deaths and maternal death reviews reported from health facilities to the district-level. We tabulated the percentage of facility deaths with evidence of a review, the percentage of reviews that met the World Health Organization defined standard for maternal and perinatal death surveillance and response. Results were stratified by sociodemographic characteristics of women and facility location and type. We compared these estimates to that obtained using district-level data. and looked at evidence of the review at the district/provincial level. Study teams reviewed facility records at 34 facilities in Argentina, 51 facilities in Ghana, and 282 facilities in India. In total, we found 17 deaths in Argentina, 14 deaths in Ghana, and 58 deaths in India evidenced at facilities. Overall, >80% of deaths had evidence of a review at facilities. In India, a much lower percentage of deaths occurring at secondary-level facilities (61.1%) had evidence of a review compared to deaths in tertiary-level facilities (92.1%). In all three countries, only about half of deaths in each country had complete reviews: 58.8% (n = 10) in Argentina, 57.2% (n = 8) in Ghana, and 41.1% (n = 24) in India. Dramatic reductions in indicator value were seen in several subnational geographic areas, including Gonda and Meerut in India and Sunyani in Ghana. For example, in Gonda only three of the 18 reviews conducted at facilities met the definitional standard (16.7%), which caused the value of the indicator to decrease from 81.8% to 13.6%. Stratification by women's sociodemographic factors suggested systematic differences in completeness of reviews by women's age, place of residence, and timing of death. Our study assessed the validity of an important indicator for ending preventable deaths: the coverage of reviews of maternal deaths occurring in facilities in three study settings. We found discrepancies in deaths recorded at facilities and those reported to districts from facilities. Further, few maternal death reviews met global quality standards for completeness. The value of the calculated indicator masked inaccuracies in counts of both deaths and reviews and gave no indication of completeness, thus undermining the ultimate utility of the measure in achieving an accurate measure of coverage.

Analysing the interlinkage between diarrhoea and drinking water faecal contamination in India

ABSTRACT Diarrhoea is one of the major waterborne diseases spread through the faecal–oral route causing over 10 million cases and over 1,000 deaths per year in India. This study critically evaluates the interlinkage between bacteriological water quality, i.e. faecal coliforms and diarrhoea cases for the three pre-pandemic years 2017, 2018 and 2019 based on multiple sources. With around 17% of households tap water connectivity as of August 2019, the majority of the Indian population depends on raw groundwater (GW) and surface water sources. For this, faecal coliform (FC) levels in surface and GW have been mapped at district levels using data from India's National Water Quality Monitoring Programme. Health Management Information System's data on diarrhoea have been used to understand the monthly and district-wise variation of diarrhoea. The trends of FC, diarrhoea inpatient cases, and diarrhoea inpatient rates have been discussed. The analysis showed issues associated with the reliability and usefulness of these datasets with 43% of total India districts with no reported FC values for the study period. This study reveals a clear gap in the interlinkage between diarrhoea and bacteriological water quality with the unavailability of granular water quality data as a major challenge.

"The burden of lifestyle diseases and their impact on health service in India"-A narrative review.

Basically, non-communicable diseases (NCDs) are lifestyle diseases. They cannot be transmitted from one person to another person. Instead, our lifestyle, genetics, and environment influence our susceptibility to various diseases. In India, non-communicable illnesses and injuries are responsible for 52% of fatalities. The burden of non-communicable diseases and the resultant mortality are predicted to increase if the government does not take significant steps to prevent and control NCDs and related risk factors. According to the currently available research, the top causes of illness, disability, and death in India include hypertension, cardiovascular diseases, cancer, diabetes, lung disease, chronic renal disease, trauma, stroke, and chronic obstructive and mental disorders. Since 1980s, the Government of India has assisted the states through several vertical programs to prevent and control NCDs. However, efforts to prevent and control NCDs significantly increased under the 11th plan. New programs were launched on a small scale in a select few districts. The financial burden of NCDs has mostly stayed the same, though based on past experiences, reducing exposure to risk factors requires focusing on health promotion and preventative actions. The public healthcare system must have the tools and talents needed for effective management, early diagnosis, and screening. Effective monitoring systems, integrated management, and public awareness campaigns are required to successfully implement the program and make services available to all national citizens.

Role of prophylactic tranexamic acid in reducing blood loss during cesarean section: A double-blind placebo-controlled randomized controlled trial.

Postpartum hemorrhage (PPH) is defined by the World Health Organization as blood loss of ≥500 mL within 24 h of delivery. Globally, hemorrhage accounts for 27.1% of maternal deaths, making it the leading direct cause of maternal death. PPH has been identified in more than two-thirds of reported hemorrhage-related deaths, causing 38% of maternal deaths in India. Tranexamic acid, an antifibrinolytic, has been used to control bleeding after PPH is identified. Antenatal women admitted for elective cesarean section were randomized into two arms: the case group (received one gram of tranexamic acid 20 min prior to skin incision) and the control group (received a placebo), each group consisting of 36 participants. Clinical Trials Registry - India (CTRI) registration number - CTRI/2021/02/031579. The mean (±standard deviation [SD]) intraoperative blood loss in the case group was 241.25 (±67.83) mL, and in the control group, it was 344.92 (±146.67) mL (P = 0.001), while postoperative blood loss did not differ significantly between the groups (P = 0.1470). In terms of the difference in hemoglobin, there was a significant difference between the two groups (P = 0.001). No significant maternal or neonatal side effects were found. Preoperative tranexamic acid, when given in elective cesarean section, significantly reduces intraoperative blood loss.

Cardiovascular Outcomes Among Patients with Acute Coronary Syndromes and Diabetes: Results from ACS QUIK Trial in India.

Despite cardiovascular disease being the leading cause of death in India, limited data exist regarding the factors associated with outcomes in patients with diabetes who suffer acute myocardial infarction (AMI). We examined 21,374 patients with AMI enrolled in the ACS QUIK trial. We compared in-hospital and 30-day major adverse cardiac events including death, re-infarction, stroke, or major bleeding in those with and without diabetes. The associations between diabetes and cardiac outcomes were adjusted for presentation and in-hospital management using logistic regression. Mean ± SD age was 60.1 ± 12.0 years, 24.3% were females, and 44.4% had diabetes. Those with diabetes were more likely to be older, female, hypertensive, and have higher Killip class but less likely to present with STEMI. Patients with diabetes had longer symptoms onset-to-arrival (median 225 vs 290 min; P < 0.001) and, in case of STEMI, longer door-to-balloon times (median, 75 vs 91 min; P < 0.001). Diabetes was independently associated with higher in-hospital death (adjusted odds ratio [aOR], 1.46; 95% CI, 1.12-1.89), in-hospital reinfarction (aOR, 1.52; 95% CI, 1.15-2.02), 30-day MACE (aOR, 1.33; 95% CI, 1.14-1.55) and 30-day death (aOR, 1.40; 95%CI, 1.16-1.69) but not 30-day stroke or 30-day major bleeding. Among patients presenting with AMI in Kerala, India, a considerable proportion has diabetes and are at increased risk for in-hospital and 30-day adverse cardiovascular outcomes. Increased awareness of the increased cardiovascular risk and attention to the implementation of established cardiovascular therapies are indicated for patients with diabetes in lower-middle-income countries who develop AMI. ClinicalTrials.gov Unique identifier: NCT02256658.

IJCM_278A: Forecasting of Dengue Cases and Deaths in India: An application of Auto Regressive Integrated Moving Average Model

Background: Dengue is a mosquito borne viral disease caused by Dengue virus (DENV). Nearly about half of global population is at risk now with an estimated 100-400 million infections occurring every year. South East Asia (SEA) countries are at more risk for having Dengue infections due to its temperate climate. In India also, the cases are rising every year due to change in environmental and climatic conditions. Objectives: 1. To assess the trend of Dengue in India, 2. To forecast Dengue cases and deaths in India Methodology: For this time series analysis study, data on Dengue were collected from National Health Profile 2005-2022 and NVBCDCP; and a secondary data analysis was done. Gretl software was used to develop the model and to forecast Dengue cases and deaths. Data were checked for stationarity and appropriate ARIMA (Auto Regressive Integrated Moving Average) model for the available data was developed. Using the developed model, the cases and deaths are forecasted for next 3 years (2023-2025). Results: The available data showed an increasing trend of Dengue cases and deaths in India. The three years forecasted data for Dengue cases &amp; deaths also shows an increasing trend. The predicted Dengue cases for 2025 are 278513 (95% CI; 208898-348128) and the Dengue deaths for 2025 are 308 (95% CI; 166-450). Conclusion: From the time series analysis of the data, it is clear that the public health burden of Dengue is on an increasing trend. Hence, it is recommended that the policy makers &amp; health workers need to focus more on planning &amp; implementing effective preventive interventions to reduce the public health burden of Dengue cases &amp; deaths.

IJCM_153A: Assessment of cancer awareness and health-seeking behavior among residents of Arang block, Raipur, Chhattisgarh.

Background: Cancer is one of the major NCDs and is emerging as a major health problem globally with over 10 million new cases and more than 6 million deaths (12% of all deaths) every year. Cancer has become one of the leading causes of death in India. There is need to document public awareness about the early warning signs of cancer, its risk factors and health seeking behavior in Arang block of Raipur district, Chhattisgarh. Objective: To find out the status of cancer awareness and health-seeking behavior among residents of Arang block, Raipur, Chhattisgarh. Methodology: A cross sectional study was conducted among residents of Arang block of Raipur district, Chhattisgarh during August-October 2023. The study sample size was 288. Face-to-face interview was done through a pretested semi-structured questionnaire. Data were entered into the Microsoft excel spread sheet and analysis is being done by using statistical software. Results: This study showed that nearly 114(40%) in the age group of 21-30 years and majority of the participants belong to low SES 198(68%), awareness of warning signs was low, where pain (43%), swelling or lump (41%), and weight loss (37%) were the most recognized symptoms. The most commonly reported barriers were the following: being too scared (65.6%), worrying about the other things (60.76%) and too busy to go for the treatment (55.9%). Conclusion: The study has identified low levels of awareness of cancer warning signs, a wide range of barriers to attendance and a high level of anticipated delay in seeking help for possible cancer symptoms.

Behind Bars: Addressing Custodial Deaths in India’s Criminal Justice System

Torture and violence have been common since ancient times. Torture is the deliberate infliction of cruelty by individuals in positions of power on others who lack power and are vulnerable. Custodial torture is torture that takes place in police stations, prisons, or under the authority of government institutions. These actions are a serious infringement of human rights and go against Article 21 of the Indian Constitution. This paper provides an in-depth examination of the legal framework of custodial violence. While the idea has not been clearly defined, different laws deal with the matters of custodial torture and sexual assault. Therefore, the judiciary has taken on the burden of defining this extensive phrase. This study analyzes the judiciary's approach to combating custodial violence by examining judicial rulings to determine the judiciary's position on these matters. The author concludes the analysis by recommending legislative measures that need to be promptly put into effect to address the deficiencies noted by the judiciary.

Alarming Increase Death in Custodial Death in India: Legal Analysis

Custodial death is not a new concept, especially in India, where it has become a phenomenon since India's rule at the hands of the British. Police brutality and violence has increased exponentially in the last four to five years. This situation shows that there is no law in our country's judicial system to punish officials by "fulfilling their duties" for committing acts of violence and torture. Police violence often results in serious injury to defendants, and police must be informed to use appropriate force to prevent such incidents. The media's perception of the defendants is also a factor in monitoring the violence. The death of George Floyd due to police brutality in the USA sparked a new "Black Lives Matter" movement. The custodial deaths of Jayaraj and Bennix in Tamil Nadu have outraged the public, with calls for adequate measures to prevent police brutality. These incidents highlighted the lack of anti-torture laws in India and called for action to prevent such incidents.

An experimental study to evaluate galactagogue activity of Bidali (Dioscorea pentaphylla Linn.) with special reference to Stanya Janana

More than 8 Lakh infantile deaths in India are attributed to inadequate breastfeeding, which is correlated with a prevalence of 45% to 53.6% cases of oligogalactia. Bidali (Dioscorea pentaphylla Linn.) is one among the two varieties of Vidari as described by Acharya Dalhana, with Stanya Vardhaka Karma. Hence the experimental evaluation of galactagogue activity of Bidali (Dioscorea pentaphylla Linn.) was carried out using milk estimation by the means of pup weight and weight gain along with estimation of serum prolactin and histology of breast tissue. Assessment was done by dam weight, daily milk yield by the means of pup weight and weight gain, serum prolactin estimation and histology of breast issue. The treatment groups have shown positive result in dose dependent manner in the parameters; Weight of Dams, and Weight of Pups. Histology reports re-emphasize the same; the development of Tubulo-alveolar unit and intraluminal secretions were more in group treated with higher dose than that of group treated with lower dose of Bidali (Dioscorea pentaphylla Linn.).

Tomb Stoning of ST Segment in Acute Myocardial Infarction

Cardiovascular disease is a leading cause of death in India. ST Elevation myocardial infarction (STEMI) is associated with high risk of morbidity and mortality. In recent times due to early diagnosis and timely reperfusion, survival after STEMI has considerably increased. We present a case of high-risk STEMI which was managed by timely reperfusion by thrombolysis and subsequent coronary angiogram.

Detection of Antimicrobial Resistance by Phenotypic and Genotypic Methods in E. coli Isolated from Diarrhea of Cattle Calves in Mhow, Indore

Background: Neonatal calf diarrhoea, a complex illness, continues to be the leading cause of neonatal calf deaths. The complex pathophysiology of infectious calf diarrhoea results in severe losses to the dairy sector, either directly via mortality or indirectly through the costs of prophylaxis and slowed growth in infected calves. Neonatal calf diarrhoea during the first month of life causes between 80 to 85 per cent of all deaths in India. Methods: A total 137 cattle calve diarrhea samples were collected from calves that show clinical signs of diarrhea. Swabs of the rectum were taken directly from diarrhoeic calves and collected in sterile test tubes. They were then immediately transported to the laboratory for the isolation of E. coli. Result: A total 64 E. coli isolates were detected and identified from samples via biochemical and molecular assays employing PCR targeting the E. coli specific 16s rRNA gene. The result of antibiotic sensitivity of 64 isolated strains of E. coli to 15 antimicrobial drugs shows highest sensitivity towards antibiotic gentamycin (68.75%) followed by sulfadiazine and co-trimoxazole (39.06), ciprofloxacin (32.81%) and highest resistance against ampicillin (87.5%) followed by ceftriaxone (82.813%), ceftazidime plus clav (81.25%). There is the variation in the expression of the AMR genes in the isolated E. coli strains. The detection rate of AMR gene blaTEM was highest 90% and that of aadA was the lowest (0%). The other AMR genes blaCTX-M, blaSHV, sul1 and tetA showing 50%, 20%, 50% and 30%.

Spectrum of intestinal lesion: A clinicopathological study in a tertiary care centre

Intestine has wide spectrum of diseases comprising neoplastic and non-neoplastic lesions. Inflammatory bowel diseases are showing increasing trend and intestinal neoplasms are the most frequently observed and leading cause of death in India. This study aims to find the occurrence of various intestinal lesions, classify them as neoplastic and non-neoplastic and to correlate the histopathological findings with clinical profile of patient in tertiary care hospital of north India. 1129 biopsies and resection specimens of intestinal lesions were examined over a period of two years. Sections were fixed, paraffin embedded and stained by H&amp;E. Immunohistochemistry was applied wherever required. Nearly two third patients were males in their second decade who presented with abdominal pain as the most common complaint and majority were diagnosed with non-neoplastic diseases. Among non-neoplastic lesions non-specific inflammation was predominant in small intestine (47.04% cases) and appendicitis (55.0%) in large intestine. Adenocarcinoma was predominant in both small and large intestine with 80.77% and79.45% of neoplastic cases respectively. This work gives a panoramic view of different intestinal pathologies and emphasises on the need of planning accurate diagnostic and screening strategies along with effective treatment plans both for neoplastic as well as non-neoplastic diseases.

The impact of Covid-19 in Chhattisgarh, India: A descriptive study.

India is among the most severely affected countries in the ongoing Covid-19 pandemic, second to the USA. Until July 2022, there were 43 million confirmed Covid-19 cases, with 0.53 million Covid-19 deaths in India. Chhattisgarh, the twelfth-highest affected state by Covid-19 disease, has had an enormous mortality toll, with 14,046 deaths by 15th July 2022. This study is a descriptive analysis of the Covid-19 deaths across Chhattisgarh from September 2021 to February 2022 (the third pandemic wave). All Covid-19 deaths that occurred between September 2021 to February 2022 were line-listed, and family members of all who died in the hospital were interviewed. 356 Covid-19 deaths were included in the present study. The top three districts which observed maximum deaths (63.48%) were Raipur (27.53%), Durg (15.45%), and Bilaspur (7.87%). Around 50% of the deceased were of age 65 years or above. The male deaths were twice as compared to the female deaths. The RT-PCR was the most used testing method, followed by RAT. Most of the admissions (58%) were in a government facility. Among the deceased, 60% had one or two associated comorbidities. Hypertension and Diabetes were the most common comorbidity identified. Almost 90% of patients were symptomatic. Breathlessness was the most common symptom. Half of the deceased were not vaccinated. The median expenditure on Covid-19 management was ₹ 50,000 (€ 565.13). The deaths in the study were urban-centric. Higher Covid-19 mortality was observed in unvaccinated older men (≥65 years) with one or more comorbidity.

An Analysis of Custodial Detention, Torture and Deaths in India

An Analysis of Custodial Detention, Torture and Deaths in India

Histopathological Analysis of Lung Lesions in Cases of Sudden Death: An Autopsy-based Study

Introduction: Cardiovascular and respiratory causes account for the major chunks in sudden death cases in various Western studies. Overall, a very limited number of studies have been conducted on respiratory system changes in cases investigated as sudden and unknown death in India. Pathological respiratory findings are said to be common in the autopsy population; however, their nature and prevalence are not well documented. Aim: To document the morphologic changes in lungs (both gross and microscopic) in cases of sudden death. Materials and Methods: The present study was a cross- sectional, prospective, and observational study conducted over a period of 12 months from 1st April 2010 to 31st March 2011. It was conducted on autopsy lung specimens received in the Department of Pathology, RG Kar Medical College and Hospital, Kolkata, West Bengal, India. For the purpose of present study, sudden death was defined as death occurring within 24 hours of the onset of the terminal symptoms. Unidentified subjects who were declared “Brought Dead” at the emergency room were also included in the study. The lungs were fixed in 10% formalin, weighed, and dimensions measured. Grossly, the lungs were examined for colour, volume, consistency, presence of any pathological changes, the status of bronchi and pleura, and findings were recorded. After routine processing and paraffin embedding, histological sections were stained with Haematoxylin and Eosin (H&amp;E) stain and special stains as and when necessary. All the histological sections were examined microscopically, and findings were recorded. The obtained data were subjected to appropriate statistical analysis by entering the data in Microsoft (MS) excel 2010. Results: There were 46 males (88.46%) and 6 females (11.54%). The age range was 26-86 years, with a mean age of 51.02 years. Among the 52 cases, significant pulmonary pathology was found in 26 cases (50%), excluding postmortem changes. Extensive fibrocaseous pulmonary Tuberculosis (TB) 15 (28.85%) was the most common pulmonary lesion found, present in all age groups. The other major pathological lesions encountered were lobar pneumonia 4 (7.69%), emphysema 3 (5.77%), bronchopneumonia 2 (3.85%), etc. Conclusion: A significant number of cases with pathological lesions in the lung were detected during the histopathological examination of sudden death cases. All the lesions may or may not have contributed to death in a direct or indirect way. The undetected lung pathologies emphasise the importance of autopsy in cases of sudden death.

Prediction of road crash attributes using machine learning

Road crashes are a significant global problem, resulting in the loss of over 1.19 million lives and causing around 50 million severe injuries each year. However, despite the efforts made by the Government to improve the situation, no significant results have been observed in respect to decline in number of accidents and deaths in India. Road safety is a complex issue and requires a multifaceted approach including adequate research and development in the field. At present the mostly traditional approach is applied in terms of data collection, statistical analysis and decision making. Over time, the Government may start building advanced data analytics solutions for prediction of various road crash attributes. With this intent this paper aims to depict the application of combination of different algorithms including Support Vector Machine, Random Forest, Decision Tree, Artificial Neural Network, K Nearest Neighbor, Logistic Regression, and Gradient Boosting Algorithm for prediction of road crash attributes.

Prevalence of vitamin D deficiency in the hypertensive south Indian population

Aim. The leading cause of early cardiovascular death worldwide is systemic hypertension (HTN). It is accountable for 57% of stroke and 24% of coronary heart disease deaths in India. Vitamin D indirectly regulates blood pressure through regulating the RAAS across clinical, pathophysiological, and molecular domains. This study examines Vitamin D deficiency in South Indian hypertensives. Materials and Methods. In this cross-sectional observational study, 500 routine health checkup patients at our clinic were assessed and enrolled. Demographics, symptoms, and lifestyle were collected using a standard questionnaire. Patients with chronic and newly diagnosed hypertension were included in the study. Blood was drawn to test Vitamin D (25-OH) levels. The data was evaluated to compare hypertensives who were already on medication and those who were newly diagnosed. Results. The population showed hypovitaminosis D, with an average Vitamin D level of 20.2 ± 10.3 ng/mL. A considerable number of newly diagnosed hypertensives had Vitamin D deficiency, with an average value of 17.7 ± 8.7 ng/mL. The observed value was significantly lower than the chronic hypertensive group (17.7 ± 8.7 ng/mL vs. 21.4 ±10.9, p &lt;0.001). LDL, HDL, cholesterol, creatinine, and HbA1C levels were not signi­ficantly different across groups. Vitamin D levels were similar for outdoor and indoor workers (p = 0.727). Conclusion. Our study demonstrates there is a high prevalence of vitamin D insufficiency in the hypertensive South Indian population. There were substantially lower levels of Vitamin D identified in those who were newly diagnosed hypertensives compared to chronic hypertensives on treatment.