Healthy Indian Population Research Articles

Biological Reference Ranges for Healthy Indian Blood Donors: Experience of a Tertiary Care Center Vis-à-Vis International Literature.

Complete blood count is the most common, basic test requisitioned in hematology. The normal reference ranges of hematological parameters are required owing to variable socioeconomic, environmental, and genetic factors in populations. The current study determines the reference ranges of the healthy Indian donor population of a high socioeconomic group. The study was conducted in the Department of Transfusion Medicine at a tertiary care hospital in India and included 4098 individuals, aged 18-65 years coming for voluntary blood donation from July 2021 to October 2022. Blood samples were collected in K2EDTA, analyzed on the Sysmex XN-31 hematology analyzer, and using statistical tools, the normal reference ranges were calculated. The reference ranges for hemoglobin (HB) (137-185 g/L), WBC (5.1-1.7 × 109/L), platelet count (115.6-370.0 × 109/L) were noted. No statistically significant changes were observed in different age groups. There were gender-wise differences noted in nearly all parameters. The HB and hematocrit (HCT) range was slightly higher in other Indian and other Asian populations with comparable values with the Chinese, Korean populations, and Western populations; RBC parameters were overall comparable with minor differences; the WBC count was higher than the other Indian and Asian populations particularly the upper limit of lymphocyte and monocyte; and the range of platelet counts had a comparable upper limit with all populations and had the lowest lower value in males in our study, which was comparable to only the Chinese population. It is concluded that reference ranges of common parameters were calculated with minor changes noted in all hematological parameters on comparing with other Indian, Asian population, and Western data.

Seasonal variation and Vitamin-D status in ostensibly healthy Indian population: An experience from a tertiary care institute

Background25-hydroxy vitamin-D (25(OH)D) deficiency is prevalent worldwide including India. Earlier some cross-sectional studies have discussed 25(OH)D deficiency and its prevalence. The correlation of 25(OH)D with seasonal variation has been reported rarely in India. To determine the 25(OH)D levels and seasonal changes of 25(OH)D status at a tertiary care hospital in North-western India. Materials and methods25(OH)D assessments performed in laboratories between 2018 and 2020 was acquired using hospital records. A total of 11,428 assays of serum 25(OH)D were analyzed in the study. Subjects were divided into three groups based on the International Endocrine Society's recommendation for serum 25(OH)D level. The 25(OH)D deficiency <20 ng/ml, insufficiency 20–29 ng/mL and sufficiency ≥30 ng/mL was defined. The months have been separated into the following seasons to analyze seasonal trends: Summer/monsoon (April–September), and winter/spring (October–March). ResultsThe median 25(OH)D was 17.2 ng/mL. We observed the prevalence of 60 %, 24.1 % & 15.9 % of 25(OH)D deficiency, 25(OH)D insufficiency, and sufficiency respectively in the total number of individuals tested. 56 % male and 63 % females were 25(OH)D deficient. Notably, the lowest median 25(OH)D value was found in the 21–30 age group (14.8 ng/mL). A significant difference in 25(OH)D levels between the summer (18.7 ng/mL) and winter (15.8 ng/mL) seasons has been noticed. DiscussionCurrent study revealing that 25(OH)D deficiency is common in all age groups and genders, according to our findings. Surprisingly, the lowest levels were reported in young adults. Seasonal variation has an impact on 25(OH)D status, however in all seasons 25(OH)D levels are lower than reference intervals. These findings suggest that the criteria for determining the state of 25(OH)D insufficiency and deficiency in the Indian population should be reconsidered.

Measurement of dynamic pupillometry parameters in adult Indian population.

To determine normative dynamic pupillometry data in healthy Indian adults and to investigate the effect of age on various pupillary parameters. Pupillometry measurements were obtained on healthy participants using an automatic dynamic pupillometry device, the NPi-200 (NeurOptics Inc., Irvine, CA, USA). Various measurements, including neurologic pupil index (NPi), resting pupil size (Size), minimum pupil diameter (MIN), percentage change in pupil size (CH), constriction velocity (CV), maximum constriction velocity (MCV), latency (LAT), and dilatation velocity (DV), were obtained in routine clinical settings and analyzed statistically for change with age. A total of 470 participants (470 eyes) were analyzed. Mean NPi was 4.31 ± 0.31, Size was 4.38 ± 0.80 mm, MIN was 2.87 ± 0.49 mm, CH was 34.67 ± 4.15%, CV was 2.74 ± 0.68 mm/s, MCV was 4.16 ± 0.98 mm/s, LAT was 0.23 ± 0.02 s, and DV was 1.13 ± 0.25 mm/s. NPi and LAT were positively correlated (P < 0.01), whereas Size, MIN, CH, CV, MCV, and DV were negatively correlated with age (P < 0.01). No statistically significant difference was observed between males and females. The study offers normative data on dynamic pupillometry parameters across various age groups within a healthy Indian population, which would serve as a reference for future studies in diverse clinical scenarios. It also elucidates that age significantly influences values in the NPi algorithm.

Estimation of dietary intake of sodium, potassium, phosphorus and protein in healthy Indian population and patients with chronic kidney disease.

Poor nutritious diet is a major risk element for non-communicable diseases (NCD), which are of considerable public health concern. Given the diverse dietary patterns in India, precise determination of nutrient consumption is crucial for disease management. The present study assessed the dietary intake of sodium, potassium, protein, and phosphorus among North Indians. This cross-sectional study included healthy adults and adults with stage 2 to 4 chronic kidney disease (CKD). We analysed sodium, protein, potassium and phosphorus intakes using one-time 24-h urinary excretion. Dietary intake was also analysed in subgroups based on sex, body mass index, blood pressure and abdominal obesity. We evaluated the performance of various equations available to estimate sodium intake using a spot urine sample with respect to the sodium excretion measured in a 24-h urine sample. Descriptive statistics was used along with t-test for statistical significance. A total of 404 subjects (182 adult healthy subjects and 222 adults with CKD) with a mean age of 47.01 ± 11.46 years were studied. Mean dietary intakes of sodium, salt, potassium, protein and phosphorus were 2.94 ± 1.68 g/day, 7.42 ± 4.24 g/day, 1.43 ± 0.59 g/day, 47.67 ± 14.73 g/day and 0.86 ± 0.39 g/day, respectively. There were no differences in nutrient consumption between adults who were healthy and those with CKD. Consumption of sodium, salt, protein, potassium, and phosphorus among healthy population vs. those with CKD were 2.81 ± 1.60 vs. 3.05 ± 1.73 g/day (p = 0.152), 7.08 ± 4.04 vs. 7.70 ± 4.37 g/day (p = 0.143), 47.16 ± 14.59 vs. 48.08 ± 14.86 g/day (p = 0.532), 1.38 ± 0.59 vs. 1.48 ± 0.58 g/day (p = 0.087) and 0.86 ± 0.41 vs. 0.87 ± 0.37 g/day (p = 0.738), respectively. Men had higher consumption of these nutrients than women. Compared to non-hypertensives, hypertensive subjects had higher consumption of salt (8.23 ± 4.89 vs. 6.84 ± 3.59 g/day, p = 0.002) and potassium (1.51 ± 0.63 vs. 1.38 ± 0.55 g/day, p = 0.024), however, no difference were found in protein and phosphorus intakes. In terms of performance of equations used to estimate 24-h sodium intake from spot urinary sodium concentration against the measured 24-h urinary sodium excretion, INTERSALT 2 equation exhibited the least bias [1.08 (95% CI, -5.50 to 7.66)]. The study shows higher-than-recommended salt and lower-than-recommended potassium intake in the north Indian population compared to those recommended by guidelines. The dietary protein intake is below the recommended dietary allowance. These findings help the development of targeted policies for dietary modification to reduce the risk of the development and progression of CKD.

Evaluation of Pancreatic-Quantitative Sensory Testing (P-QST) tool in healthy Indian population.

Evaluation of Pancreatic-Quantitative Sensory Testing (P-QST) tool in healthy Indian population.

Quality of life after traumatic thoracolumbar spinal cord injury: a North Indian perspective.

Cross-sectional study. To determine the Quality of Life (QOL) in individuals with traumatic Spinal Cord Injury (SCI) of thoracolumbar region in Indian population, the factors affecting QOL and to compare this to other SCI populations. Tertiary level hospital in low-middle income country. 93 individuals with SCI of minimum 1 year duration since injury were included in the study. Baseline demographics, socioeconomic parameters, and incidence of complications were ascertained. World Health Organisation Quality of Life-BREF (WHOQOL-BREF) score was used for measurement of QOL and was then compared to healthy Indian population and other SCI studies. Subgroup analysis was done to find out impact of variables on different domains of WHOQOL-BREF. The median (IQR)age of the study participants was 35 (25, 45) with a male predominance. The median (IQR) duration since injury in the study population was 50 (26, 70) months. Lowest mean(SD)score was observed in the psychological domain -50.3 (12.1) and comparison to healthy Indian and high-income SCI populations revealed drastically decreased scoresacross all domains (p < 0.01). Employed individuals and housewives had significantly higher scores across all domains than unemployed individuals (p < 0.05). American Spinal Injury Association Impairment Scale (AIS) grade, socioeconomic status, pain and presence of complications all had significant impact on domain scores (p < 0.05). Multiple regression analysis revealed that mobilisation status and pain had the greatest effect on QOL. Individuals with SCI have low QOL scores as compared to general Indian population as well as SCI individuals from a high resource setting. Pain and dependent mobilisation were found to be most significant predictors of poor WHOQOL-BREF domain scores. Housewives were found to have domain scores comparable to employed individuals. Presence of complications negatively impacts QOL.

Optical Coherence Tomography Angiography Parameters of the Retina in SARS-CoV-2 Recovered Subjects.

This study aims to evaluate retinochoroidal optical coherence tomography angiography (OCTA) parameters in patients recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This studywas an observational study that included 80 subjects being discharged after having negative reports on the reverse transcription-polymerase chain reaction (RT-PCR) test for SARS-CoV-2 to evaluate OCTA parameters of the retina. The subjects underwent an ophthalmic evaluation that included best-corrected visual acuity (BCVA), intraocular pressure (IOP), color vision (CV), contrast sensitivity (CS), and optical coherence tomography (OCT) parameters. OCTA was done for all patients and was evaluated for foveal avascular zone (FAZ) area, perimeter, and circularity index, and vessel density (VD) in superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina (OR), outer retina chorio-capillaries (ORCC), chorio-capillaries (CC), and choroid (C) using 3 x 3 mm scans. The OCTA parameters were compared with normative data of the Indian population for various parameters in question. The subjects included 54/80 (67.5%) males and 26/80 (32.5%) females having a mean age of 52.40 ± 15.71 (18-60) years. The systemic evaluation revealed 38.75% of subjects had hypertension, 30% had diabetes, 20% had kidney disease, 5% had tuberculosis, and 3.75% had coronary artery disease.The mean distance BCVA was logarithm of the minimum angle of resolution (LogMAR) (1.17 ± 0.22), mean IOP was 17.0 ± 4.0 mmHg, mean CS was 2.13 ± 0.36, 50.62% of subjects had normal CV on Farnsworth test while 47% had tritanopia, and none of the subjects had red-green CV defect on Ishihara plates. The OCT scan was normal in 90% of eyes while the posterior vitreous detachment was seen in 4% of eyes, broad vitreomacular adhesion in 2.5% of eyes, and the globally adherent epiretinal membrane was seen in 2.5% of eyes. The mean central macular thickness (CMT) measured 245.14 ± 28.41 micrometers. The mean FAZ area measured 0.37 ± 0.15 mm2, the perimeter was 3.28 ± 1.08 mm, and the circularity index measured 0.41 ± 0.10. The average VD in SCP measured 16.06 ± 12.29, in DCPmeasured 9.11 ± 8.75, in ORmeasured 6.38 ± 7.37, in ORCC measured 42.53 ± 12.46, in CCmeasured 25.83 ± 16.31, and in C measured 25.52 ± 17.49. The VD in coronavirus disease 2019 (COVID-19) subjects was significantly lesser than that in the healthy Indian population in all layers except ORCC. The SARS-CoV-2 recovered subjects have a reduced VD in retinochoroidal layersfrom COVID-19, an underlying systemic disease, or both. The CS values fall within normal limits. Several subjects show tritanopia on the Farnsworth test but no red-green CV defect on Ishihara plates.

Genetic landscape of human neutrophil antigen variants in India from population-scale genomes.

Antibodies against human neutrophil antigens (HNAs) play a significant role in various clinical conditions such as neonatal alloimmune neutropenia, transfusion-related acute lung injury, and other nonhemolytic transfusion reactions. This study aims to identify the genotype and allele frequencies of HNAs in the healthy Indian population. Ten genetic variants in four human genes encoding alleles of HNAs class I-V approved by the International Society of Blood Transfusion-Granulocyte Immunobiology Working Party were used in the analysis. Genetic variants from whole genome sequences of 1029 healthy Indian individuals corresponding to HNA alleles were analyzed. The frequencies of the variants were compared with global population datasets using an in-house computational pipeline. In HNA class I, allele frequencies of FCGR3B*01, FCGR3B*02, and FCGR3B*03 encoding HNA-1a, HNA-1b, and HNA-1c were 0.07, 0.8, and 0.13, respectively. HNA class 3 alleles namely SLC44A2*01 (encoding HNA-3a) and SLC44A2*02 (encoding HNA-3b) were found at allele frequencies of 0.78 and 0.22, respectively. The frequencies of ITGAM*01 encoding HNA-4a and ITGAM*02 encoding HNA-4a were 0.95 and 0.05, respectively. Furthermore, allele frequencies of HNA class 5 alleles were 0.32 for ITGAL*01 (encoding HNA-5a) and 0.68 for ITGAL*02 (encoding HNA-5b). Interestingly, it was also found that rs2230433 variant deciding the HNA class 5 alleles, was highly prevalent (78.2%) in the Indian population compared with other global populations. This study presents the first comprehensive report of HNA allele and genotype frequencies in the Indian population using population genome datasets of 1029 individuals. Significant difference was observed in the prevalence of HNA5a and HNA5b in India in comparison to other global populations.

Normative cutoffs of muscle mass, muscle strength, and frailty for healthy Indian population.

Population-derived cutoffs for low skeletal muscle mass, skeletal muscle strength, and frailty among Indians are lacking. Studies describing sarcopenia and frailty among patients with chronic liver diseases have used cutoffs derived from Caucasian populations giving erroneous results. We aimed to derive gender-specific cutoffs for low skeletal muscle mass and skeletal muscle strength from healthy Indians. Healthy Indian population consisted of two groups. Group 1 (GpI) included 242 healthy liver donors and group 2 (GpII) 272 healthy health care workers. Skeletal muscle index (SMI) was calculated from computed tomography (CT) abdomen performed prior to donor hepatectomy only in GpI. Liver frailty index (LFI) was computed using the online calculator, after recording hand grip strength (HGS), chair stand-up test (CSUT), and balance test in both groups. HGS was measured using the Smedley handgrip dynamometer. CSUT was noted as time to complete 5 chair stand-ups with subjects' arms folded across the chest. Gender-specific cutoffs of SMI and HGS were derived as <5th percentile of the distribution values and as >95th percentile for CSUT and LFI values. The SMI was measured from GpI subjects (n=242; 120 males [mean age 31.13] and 122 females [mean age 36.60]). The HGS, CSUT, and LFI were measured in GpI and GpII subjects (n=514; 272 males [mean age 34.30] and 242 females [mean age 37.52]). The cutoffs for SMI, HGS, CSUT, and LFI were <27.72 cm2/m2, <25.63 kg, >10 s, and >3.49, respectively for healthy males. The corresponding cutoffs for healthy females were <24.4 cm2/m2, <16.7 kg, > 10 s, and >3.68, respectively. We derived gender-specific cutoffs for SMI, HGS, CSUT, and LFI from healthy adult Indian population, which can be used to detect sarcopenia and frailty among patients with liver diseases, as well as other conditions.

Validating CT characteristics of the thymus in healthy Indian adult population

Validating CT characteristics of the thymus in healthy Indian adult population

Identification of DPYD variants and estimation of uracil and dihydrouracil in ahealthy Indian population.

Aim: This study aimed to identify DPYDvariants and the related but previously unexplored phenotype (plasma uracil, dihydrouracil [DHU], and the DHU-to-uracil ratio) in a healthy adult Indian population. Methods: Healthy adult volunteers (n=100) had their uracil and DHU levels measured and were genotyped for selected variants. Results: Among the nine variants studied, c.1906-14763G>A and c.85T>C were the most prevalent. Participants with any of the variants except for c.85T>C and c.1627A>G had a significantly lower DHU-to-uracil ratio and those with c.1905+1G>A variant had significantly increased uracil concentration compared with wild-type. Conclusion: Participants with five variants were identified as having altered phenotypic measures, and 40% of the intermediate metabolizers had their phenotype in the terminal population percentiles.

Estimating Vitamin D threshold for the Indian population: Delving into the actual disease burden

BackgroundBased on the current guidelines in practice, a vast majority of the healthy Indian population is vitamin D deficient. Since the serum 25 hydroxycholecalciferol (25HCC) levels are affected by race and skin pigmentation, the normal range of vitamin D may differ in the Indians compared to the Western population. This study attempted to determine a population-specific threshold for 25 HCC levels associated with adequate bone health and calcium and phosphate homeostasis in healthy Indians. MethodsSubjects aged 20–50 years were included in the study. The exclusion criteria were obesity, chronic renal disease, liver failure, diabetes mellitus, thyroid disorders, a recent history of fracture, constant joint pain, and postmenopausal status. In addition, participants on prescribed medication such as glucocorticoids, anticonvulsants, or antifungals, as well as vitamin D and calcium supplementation, were also excluded.Blood samples were analyzed for serum calcium, phosphate, alkaline phosphatase, 25HCC, 1,25dihydroxycholecalciferol, parathyroid hormone (PTH), procollagen type-I N propeptide, and C-terminal telopeptide of type 1 collagen.Locally estimated smoothing scatter plot (LOESS) curves and Spearman correlation were utilized to study the correlation of all the biochemical parameters with 25 HCC to achieve thresholds. ResultsThe study consisted of 270 healthy participants, out of which 97.8% were found to have vitamin D levels below 30 ng/ml. In addition, 8.8% had raised PTH, and 1.85% had hypocalcemia. Furthermore, 1.48% had raised serum alkaline phosphatase and hypophosphatemia, respectively. A weak inverse correlation was seen between 25 HCC and PTH (rs = −0.437, p < 0.001), as well as alkaline phosphatase (rs = −0.1475, p = 0.015), while a weak positive correlation was seen with serum phosphate (rs = 0.128, p = 0.047). ConclusionFor a healthy Indian population, the reference range of 25 HCC is much lower, and the lower limit of normal is approximately 13.5 ng/ml. This study indicates that vitamin D insufficiency in this population starts at 25 HCC values of 13.5 ng/ml and deficiency at 7 ng/ml.

1029 genomes of self-declared healthy individuals from India reveal prevalent and clinically relevant cardiac ion channelopathy variants

BackgroundThe prevalence and genetic spectrum of cardiac channelopathies exhibit population-specific differences. We aimed to understand the spectrum of cardiac channelopathy-associated variations in India, which is characterised by a genetically diverse population and is largely understudied in the context of these disorders.ResultsWe utilised the IndiGenomes dataset comprising 1029 whole genomes from self-declared healthy individuals as a template to filter variants in 36 genes known to cause cardiac channelopathies. Our analysis revealed 186,782 variants, of which we filtered 470 variants that were identified as possibly pathogenic (440 nonsynonymous, 30 high-confidence predicted loss of function ). About 26% (124 out of 470) of these variants were unique to the Indian population as they were not reported in the global population datasets and published literature. Classification of 470 variants by ACMG/AMP guidelines unveiled 13 pathogenic/likely pathogenic (P/LP) variants mapping to 19 out of the 1029 individuals. Further query of 53 probands in an independent cohort of cardiac channelopathy, using exome sequencing, revealed the presence of 3 out of the 13 P/LP variants. The identification of p.G179Sfs*62, p.R823W and c.420 + 2 T > C variants in KCNQ1, KCNH2 and CASQ2 genes, respectively, validate the significance of the P/LP variants in the context of clinical applicability as well as for large-scale population analysis.ConclusionA compendium of ACMG/AMP classified cardiac channelopathy variants in 1029 self-declared healthy Indian population was created. A conservative genotypic prevalence was estimated to be 0.9–1.8% which poses a huge public health burden for a country with large population size like India. In the majority of cases, these disorders are manageable and the risk of sudden cardiac death can be alleviated by appropriate lifestyle modifications as well as treatment regimens/clinical interventions. Clinical utility of the obtained variants was demonstrated using a cardiac channelopathy patient cohort. Our study emphasises the need for large-scale population screening to identify at-risk individuals and take preventive measures. However, we suggest cautious clinical interpretation to be exercised by taking other cardiac channelopathy risk factors into account.

Evaluating the Quantitative Foveal Avascular Zone and Retino-Choroidal Vessel Density Using Optical Coherence Tomography Angiography in a Healthy Indian Population.

Objective: The foveal avascular zone (FAZ) is the round capillary-free zone within the macula and is supplied only by a single-layered parafoveal capillary arcade. This study aimed to evaluate the quantitative FAZ and retino-choroidal vessel density (VD) using optical coherence tomography angiography (OCTA) in a healthy Indian population.Methods: This was a cross-sectional observational study that was conducted for evaluating the quantitative FAZ and retino-choroidal VD of 200 eyes of 100 healthy Indian subjects, including 62 males and 38 females (age range 17-50 years) having the best-corrected visual acuity (BCVA) of logMAR 0 (20/20; 6/6) and spherical equivalent refractive error of not more than 1 D. The subjects were examined using OCTA automated software on spectral-domain OCT (SD-OCT; Nidek RS 3000 Advance 2; Nidek, Inc., Fremont, CA) on a 3 x 3 mm OCTA macular scan centred on the fovea. The FAZ size, perimeter and circularity index, VD in superficial, deep, and outer retina (OR), outer retinal chorio-capillaries (ORCC), chorio-capillaries (CC) and choroid (C) were analysed in the circular and quadrant-segmented zones. A correlation was found between the FAZ size, perimeter and circularity, and VD in retino-choroidal layers, and between BCVA, age, central foveal thickness (CFT) and sub-foveal choroidal thickness (SFCT), and OCTA parameters.Results: The FAZ and surrounding vascular arcades were intact in all eyes, showing either a vertical or horizontal oval-shaped symmetrical formation without gaps, holes or interruption of the capillary network. The mean value of CFT was 237.5±26.0 microns and SFCT was 269.6±53.0 microns. The mean FAZ area was 0.42±0.23 mm2, FAZ perimeter was 3.3±1.0 mm and FAZ circularity index was 0.46±0.1. The mean VD in superficial capillary plexus (SCP) was 23.87±10.66, in deep capillary plexus (DCP) was 16.03±9.90, in OR was 13.22± 12.27, in ORCC was 39.74±14.32, in CC was 37.02±16.43 and in choroid was 37.43±16.76. The increasing order of VD in different retino-choroidal layers was OR<DCP<SCP<CC<C<ORCC. The FAZ area and perimeter had a statistically significant (SS) negative correlation with the VD in SCP, DCP and OR, while the FAZ perimeter additionally had a SS negative correlation with the VD in the choroid. The FAZ circularity had a SS positive correlation with VD in SCP, DCP and OR. There was no SS correlation between the age of subjects and OCTA parameters. The BCVA had a SS correlation with only one parameter, i.e. ORCC foveal (r=-0.15; p=0.03). There was a SS negative correlation between CFT and FAZ area and perimeter, and a SS positive correlation between the CFT and VD in SCP, DCP and OR. There was a SS positive correlation between the SFCT and VD in different layers including SCP, DCP, ORCC, CC and choroid.Conclusions: VD is the highest in the ORCC and lowest in the OR segment. A better VD in SCP, DCP and OR is associated with a reduced FAZ area/FAZ perimeter and an increased FAZ circularity index. A lower VD in the ORCC is associated with worse BCVA. In a healthy subject, a relatively thicker foveal region is likely to have better vascularity of SCP, DCP and OR and a smaller FAZ area/FAZ perimeter. In the absence of diseases, relatively thicker sub-foveal choroid is expected to have better vascularity of SCP, DCP, ORCC, CC and choroid.

Predicting difficult intubation in apparently normal subjects

One of the major problems faced by health care professionals is the prediction of airway difficulties in apparently healthy subjects. Failed endotracheal intubation is a well-known reason for increased morbidity of patients including brain damage or even death. This study is focused on parameters used for prior determination of airway for predicting difficult intubation in healthy Indian populations. This study was done on 500 healthy individuals. Neck parameters were measured including inter-incisal distance, neck circumference, thyro-mental distance and sterno-mental distance. Mallampati classification and mandibular protrusion test were also carried out. Statistical analysis was done using SPSS software (V.25). MC class 3 and 4 percentages were higher in males in comparison to females. Mandibular protrusion test grade A and B percentage was higher in females while class C percentage was higher in males. The comparison of baseline values of the neck parameters (inter-incisal distance, neck circumference, thyro-mental distance and sterno-mental distance) was statistically significant (&lt;0.05) in both genders. The purpose of the study is to find out the baseline values of parameters involved in assessing methods for difficult intubation in healthy Indian population.

Measurement of Posterior Tibial Slope in Healthy Indian Population: A CT-Based Study.

Recreation of near normal posterior tibial slope is required for proper knee biomechanics after unicondylar as well as total knee arthroplasties. It is also required for proper functioning of anterior cruciate ligament after high tibial osteotomies. Researchers have found differences in values of posterior tibial slopes in individuals of different ethnicities. So far there is no study measuring the posterior slopes of medial and lateral tibial plateau separately in knees of healthy Indian population via three dimensional imaging modalities like computed tomography. The aim of our study is to find out the slopes of medial and lateral tibial plateau separately through computed tomography (CT) scans. CT-based measurements of posterior tibial slopes were done in 62 healthy knees. There were 55 males and 7 females. Age groups were in the range of 17-45years. Mean values of Posterior tibial slope of medial and lateral tibial plateau for combined sample were 8.60° ± 3.51° and 7.94° ± 3.91°. Mean values of medial and lateral tibial plateau for males were 8.33° ± 3.51° and 7.71° ± 4.07° respectively; while for females were 10.69° ± 2.86° and 9.77° ± 1.32°, respectively.In our study, there was a large range of slopes, extending from + 0.6° to 15.6° for medial tibial slope, from 0° to 15° for lateral tibial slope. The minimum values of Medial tibial plateau slope are very low as compared to the previous study done in Asian population. Further CT based studies are required to measure values of posterior tibial slope for larger sample from Indian population. The implant design suitable and their implantation guidelines for western population may not be appropriate for Indian population.

Reliability of OHM 3000 Plantar Pressure System for Measurement of Plantar Pressures in Healthy Indian Population

Purpose: The aim of this study is to determine intra and inter-session repeatability and reliability of OHM 3000 for reporting static and dynamic pressures in healthy Indian population. Methods: Using OHM 3000, twenty-eight healthy adults who did not present any gait abnormalities or musculoskeletal conditions were assessed one week apart for static and dynamic pressure. Bipedal stance test was used for assessing static variables- maximum pressure, average pressure, contact area, and weight distribution; whereas dynamic test was used for assessing dynamic variables- maximum pressure, average pressure, and contact area. Each participant performed three trials under supervision of each investigator. Results: Reliability was devised using ICC values and coefficient of variance for static and dynamic variables. ICC values for static and dynamic variables were reported to range between 0.88 to 0.94 and 0.61 to 0.98 respectively. Covariance values were reported to be lower than 13% in static and dynamic pressures recorded by both investigators. Conclusion: The study reports that OHM 3000 is a reliable device for assessing static and dynamic pressure in healthy adults demonstrating moderate to good reliability. KEYWORDS: Gait, Foot, Plantar Pressure.

Characterization of Oral Bacterial Composition of Adult Smokeless Tobacco Users from Healthy Indians Using 16S rDNA Analysis.

The present investigation is aiming to report the oral bacterial composition of smokeless tobacco (SLT) users and to determine the influence of SLT products on the healthy Indian population. With the aid of the V3 hypervariable region of the 16S rRNA gene, a total of 8,080,889 high-quality reads were clustered into 15 phyla and 180 genera in the oral cavity of the SLT users. Comparative analysis revealed a more diverse microbiome where two phyla and sixteen genera were significantly different among the SLT users as compared to the control group (p-value < 0.05). The prevalence of Fusobacteria-, Porphyromonas-, Desulfobulbus-, Enterococcus-, and Parvimonas-like genera among SLT users indicates altered bacterial communities among SLT users. Besides, the depletion of health-compatible bacteria such as Lactobacillus and Haemophilus also suggests poor oral health. Here, the majority of the altered genera belong to Gram-negative anaerobes that have been reported for assisting biofilm formation that leads in the progression of several oral diseases. The PICRUSt analysis further supports the hypothesis where a significant increase in the count of the genes involved in the metabolism of nitrogen, amino acids, and nicotinate/nicotinamide was observed among tobacco chewers. Moreover, this study has a high significance in Indian prospects where the SLT consumers are prevalent but we are deficient in information on their oral microbiome.

Bone mineral density in healthy adult Indian population: the Chandigarh Urban Bone Epidemiological Study (CUBES).

Osteoporosis is a major public health problem around the globe including India, resulting in significant morbidity, mortality, and health care burden. However, the reference values used for its diagnosis are largely based on data from the western population, which may lead to over- or underdiagnosis of osteoporosis in Indians. Our study aimed to determine the reference range for bone mineral density for the healthy population of India. This is a cross-sectional study of 825 subjects (men 380, women 445) (median age: 41 years, IQR 32-55 years), recruited by a house-to-house survey. The population was stratified into decade-wise groups and biochemical measurements including renal and liver function tests, glycated hemoglobin, serum calcium, 25-hydroxyvitamin D, parathyroid hormone, and bone mineral density were performed in all the subjects. The T-scores for men aged > 50 years and post-menopausal women were calculated based on the data generated from this study in young men and women aged 20-40 years. According to the BMD manufacturer's data, which is based on the western population, 70% of the Indian men (> 50 years) and 48% of the post-menopausal Indian women had osteopenia while 18% of the men and 25% of the women had osteoporosis. However, according to the re-calculated T-scores from the current study, only 56% and 7.2% of men and 33% and 5% of women had osteopenia and osteoporosis, respectively. An age-related decline in bone mineral density, as seen in the western population, was also seen in both Indian men and women. We have established a reference database for BMD in healthy Indian adult population, which may have clinical implications for the diagnosis and intervention strategies for the management of osteoporosis.

Serum Cys C Assessment in Healthy Indian Population and Chronic Kidney Failure Individuals – A Case Control Study

Background Serum Cys C has been acknowledged as a simple and reliable biomarker for assessing renal function in research studies. Evolving evidence show its efficacy in improving the diagnostic approach when included in routine clinical practice. Objectives The study intended to evaluate and compare serum Cys C sCys C levels in healthy individuals with chronic kidney diseases.Materials and Methods A case control observational study was conducted at Padmashree Diagnostic Centre Vijayanagar Bengaluru. The sCys C test was assayed by latex enhanced immunoturbidometric method.Result Serum Cys C levels assessed in normal subjects was in the range of 1.03 plusmn 0.11 mgL comparable to the available reference interval for normal healthy population while sCys C values were between 3.55 and 4.71mgL with mean value of 4.3 mgL SDplusmn0.34 in chronic kidney patients. The results displayed significant increase in the values of serum Cys C in chronic kidney disease patients.Conclusion To conclude sCys C is a convenient diagnostic instrument for calculating the functional ability of the kidneys. Furthermore serum Cys C can be included in routine tests for clinical decision making and in the health care package for renal function.