Indian Perspective Research Articles

Systematic review with expert consensus on use of extracorporeal hemoadsorption in septic shock: An Indian perspective.

Septic shock is a severe form of sepsis characterised by deterioration in circulatory and cellular-metabolic parameters. Despite standard therapy, the outcomes are poor. Newer adjuvant therapy, such as CytoSorb® extracorporeal haemoadsorption device, has been investigated and shown promising outcome. However, there is a lack of some guidance to make clinical decisions on the use of CytoSorb® haemoadsorption as an adjuvant therapy in septic shock in Indian Setting. Therefore, this expert consensus was formulated. To formulate/establish specific consensus statements on the use of CytoSorb® haemoadsorption treatment based on the best available evidence and contextualised to the Indian scenario. We performed a comprehensive literature on CytoSorb® haemoadsorption in sepsis, septic shock in PubMed selecting papers published between January 2011 and March 2023 2021 in English language. The statements for a consensus document were developed based on the summarised literature analysis and identification of knowledge gaps. Using a modified Delphi approach combining evidence appraisal and expert opinion, the following topics related to CytoSorb® in septic shock were addressed: need for adjuvant therapy, initiation timeline, need for Interleukin -6 levels, duration of therapy, change of adsorbers, safety, prerequisite condition, efficacy endpoints and management flowchart. Eleven expert members from critical care, emergency medicine, and the intensive care participated and voted on nine statements and one open-ended question. Eleven expert members from critical care, emergency medicine, and the intensive care participated and voted on nine statements and one open-ended question. All 11 experts in the consensus group (100%) participated in the first, second and third round of voting. After three iterative voting rounds and adapting two statements, consensus was achieved on nine statements out of nine statements. The consensus expert panel also recognised the necessity to form an association or society that can keep a registry regarding the use of CytoSorb® for all indications in the open-ended question (Q10) focusing on "future recommendations for CytoSorb® therapy". This Indian perspective consensus statement supports and provides guidance on the use of CytoSorb® haemoadsorption as an adjuvant treatment in patients with septic shock to achieve optimal outcomes.

Perspective analysis of assistive robots for elderly in India

Purpose Assistive technology for elderly are advancing, and this study aimed to analyse the Indian perspective on utilising assistive robot technology for aiding elderly individuals. Materials and Methods A population-based survey was undertaken to collect data from three perspectives: Relatives of the elderly, Healthcare professionals and Elderly individuals. The survey gathered 389 responses. The responses are statistically analysed, and data is visualised with different plots for better understanding. Results It is observed that the older people rate with less conviction on the use of technology when compared to the relatives and healthcare professionals. Out of the three target groups, the elderly individuals had the most correlating attributes to purchasing the robot. Also, healthcare personnel, relatives, and older people gave 82%, 63% and 55% affirmatives to the question on purchasing the robot, respectively. And the cost of the robot is preferred to be under 6 lakh rupees. Conclusions Though the younger generation has more orientation towards technology, older people are skeptical about handling computer gadgets or robots. However, there are significant expectations and concerns expressed by three target groups such as conversational, navigational, reminder features, security and malfunction concerns.

An Indian surgeon's perspective on management of asymptomatic gallstones.

Cholelithiasis is widely prevalent in India, with a majority of patients being asymptomatic while a small proportion experiencing mild complications. In the laparoscopic era, the rate of cholecystectomies has increased owing to early recovery and fewer complications. In asymptomatic patients, the risk of complications must be balanced against the treatment benefit. Recent guidelines suggest no prophylactic cholecystectomy in asymptomatic patients. We aimed to find out the Indian surgeons' perspective on asymptomatic gallstone management. A cross-sectional e-survey was conducted of practicing surgeons, onco-surgeons and gastrointestinal-surgeons in India. The survey had questions regarding their perspective on laparoscopic cholecystectomy and treatment modalities in asymptomatic gallstones. A total of 196 surgeons responded to the survey. Their mean age was 42.3 years. Overall, 111 (57%) respondents worked in the private sector. Most surgeons (164) agreed that the rate of cholecystectomy has increased since the advent of laparoscopy; 137 (70%) respondents agreed that they would not operate on patients without risk factors. Common bile duct stones, chronic hemolytic diseases, transplant recipients, and diabetes mellitus were the risk factors. Majority of the participants agreed on not performing a cholecystectomy in patients with asymptomatic gallstones. There exists a lack of consensus among Indian surgeons on asymptomatic gallstone management in India. Where the majority of cases are asymptomatic and do not require surgery, certain comorbidities can influence the line of treatment in individual patients. Currently, the treatment guidelines for asymptomatic patients need to be established as cholecystectomies may be overperformed due to the fear of development of complications.

A Narrative Review of Urbanization and Mental Health: An Indian Perspective.

Urbanization is a phenomenon that shows the expansion of urban areas in conjunction with industrial and economic progress. Rapid world urbanization is caused by the swift rise in urban residents as a proportion of the population. Efforts to examine the quality of urban life and urbanization as distinct risk factors for mental illness within specific age groups have been made. However, the issue remains contentious and largely unresolved. Urban mental health issues, such as substance abuse, fear of crime, poverty, and ethnicity, are associated with factors like depression, aggression, fear, sadness, and personality disorders. The entire gamut of the population, particularly adult males and females, is affected by these impacts of urbanization. The size of the population increases the prevalence of the preview study. India is expected to concentrate highly on the whole urban population, but this might inadvertently cause harm to urban residents. This review discusses the impact of urbanization on mental health and well-being. We search via PubMed (Medline), Google Scholar, and databases like WHO. The language of the study is English, and other language articles are excluded. The mental health challenges associated with urbanization impact the entire population, with a notable emphasis on adult males and females. They are raising awareness about various urban programs designed for urban populations. It will function as a coordinator of change in a rapidly modified Indian society to spread awareness about mental illnesses throughout all segments of society.

Addressing barriers to child and adolescent reproductive health: an Indian perspective

Addressing barriers to child and adolescent reproductive health: an Indian perspective

Psychosocial Impact on Primary Caregivers of Patients with Alcohol Related Disorders: A Review Based Indian Perspective

Psychosocial Impact on Primary Caregivers of Patients with Alcohol Related Disorders: A Review Based Indian Perspective

Issue of ‘One Nation, One Election’ in Indian Perspective

This research examines the potential impacts—both positive and negative—of introducing simultaneous elections across India, known as "One Nation, One Election." This proposed change aims to synchronise national, state, and local election timings to reduce frequent election cycles. The analysis shows that synchronised elections could save significant costs for state and central governments by reducing expenses related to election administration, security, and disruptions in governance. Estimated annual savings could exceed ₹45 billion. The effect on state governments varies; while national issues might overshadow local concerns, state administrations could benefit from more governance-focused time rather than electioneering. This might decrease voter fatigue but could limit expressing dissatisfaction with state governments at different times. From an industry standpoint, synchronised elections offer more stable policies and less political uncertainty. Overall, simultaneous elections promote better governance focus and enhance political and economic stability. The paper provides a comprehensive evaluation based on evidence of the expected pros, cons, costs, and benefits.

Neglected Tropical Diseases: A Comprehensive Review.

Neglected tropical diseases (NTDs) are a group of diseases caused by diverse organisms, affecting millions of people in tropical and subtropical conditions. NTDs are more prevalent among people who live in poverty, without access to clean water, adequate sanitation, and quality health care. Most NTDs are chronic conditions and are potentially disablers than killers, leaving behind a trail of social consequences. Controlling NTDs has become complicated due to limited resources and are frequently ignored by global funding agencies. India experiences a significant burden of global NTDs. The paradox is that NTDs are preventable and treatable at an affordable cost. It then makes no sense as to why we co-exist with such diseases. The World Health Organization (WHO) has donned the leadership role of eliminating, eradicating, and controlling global NTDs. The WHO published a roadmap delineating a plan of action, which was being reviewed periodically. This led to substantive progress in tackling the NTDs. However, many challenges still exist to controlling and preventing NTDs. India has achieved significant progress towards NTD control and elimination by implementing the WHO strategies and action plans. This was evident by an increase in research and funding in this direction. The number of new drugs, vaccines, and investigative tools available and those in the pipeline is testimony to their efforts. Focusing singly on India's NTD problem would substantially reduce the burden of poverty-related neglected diseases and could dramatically advance the global health agenda. This review highlights the problem of NTDs in the Indian and global perspective.

Shifting discourses of climate security in India: domestic and international dimensions

The Indian perspectives on climate security are influenced by both domestic and international imperatives. The logic followed by India is not typically the same as that adopted by countries of the Global North. India’s discourses on the interconnections between climate change and security are largely conditioned by developmental priorities (domestic) and geopolitical pressures (international), which are not necessarily mutually exclusive. In this context, the article contextualises India’s climate security narratives at the intersection of domestic and international/foreign-policy realms, involving different actors, including academia and think tanks, the government and its agencies, the military and non-governmental organisations. It argues that there has been a gradual process of integrating climate change into the domestic security policy-making agenda in the country, with the growing recognition of worsening climate vulnerabilities, while demonstrating reluctance to engage with the existing climate security discourses at the international level. It analyses the ways in which the ‘domestic’ and ‘international’ intermingle with each other to shape India’s discourses and practices on climate security by categorising them into two ­dimensions – domestic–international and international–domestic.

Copy Right Act: Developments and Issues in Indian Perspective

Copy Right Act: Developments and Issues in Indian Perspective

Pigmented contact dermatitis: An updated review

Pigmented contact dermatitis (PCD) is a disorder brought on by repeated exposure to low-intensity allergens, usually presenting as blotchy or reticulate slate-gray pigmentation affecting Fitzpatrick skin type IV-VI. The pathogenesis remains unclear; however, type IV hypersensitivity reactions due to allergic sensitization, genetics, ultraviolet exposure, and autoimmunity are to blame. Clinical examination, dermoscopy, patch/photo patch testing, histopathology, and recently, a novel reflectance confocal microscopy and multimodality skin imaging system aid in the diagnosis. Several contact allergens have been linked to PCD, but from an Indian perspective, Kumkum and Paraphenylenediamine are the incriminating agents. Patch testing plays an immense role whenever PCD is diagnosed, primarily due to contact allergens. Devastating psychological impacts can result from PCD-related deformity on social acceptance, mental health, and self-esteem. Avoiding allergens, wearing broad-spectrum sunscreen, and engaging in sun-protective behavior are general measures for treating the condition.

Ensuring global health: a comprehensive review of vaccine regulation with a focus on the Indian perspective

The regulation of vaccines is crucial for ensuring public health and safety. A global perspective on vaccine regulation, with focus on the Indian approach in vaccine regulation, was analysed. The historical evolution of vaccine regulation, highlights significant events that shaped regulatory systems. The role of National Regulatory Authorities (NRAs) in ensuring the safety, efficacy, and quality of vaccines is discussed, along with the pivotal role of the WHO through its prequalification program. The stages of the regulatory review process, including pre-licensure review and post-licensure surveillance, are outlined. The Indian perspective is examined, with a focus on the Central Drugs Standard Control Organization (CDSCO) as the primary regulatory authority. The rigorous vaccine approval process, emergency use authorization, vaccine distribution, and administration, as well as post-marketing surveillance, are discussed. The Indian government's participation in international collaborations and emphasis on indigenous vaccine development are highlighted. This comprehensive review highlights the importance of vaccine regulation and the efforts undertaken by the Indian government to ensure the safety, efficacy, and accessibility of vaccines.

Quality of Life in Locally Advanced Carcinoma Rectum Patients During Various Phases of NACRT: An Indian Perspective.

In low- and middle-income countries (LMICs) including India, cancer patients have a poor prognosis because of late diagnosis and cases already grown to advanced stages, low cancer awareness and skewed cancer care facilities. In India, the incidence of colorectal cancer (CRC) is ranked the 4th most common (6.4%) in males and the 5th most common (3.4%) in females. The improvement in the cure rate of rectal cancer has increased life expectancy, and assessment of the quality of life (QoL) in these patients has become a fundamental requirement. Little is known about how the patients perceive these adverse effects during curatively intended radiotherapy. Although studies have investigated the various adverse effects that can occur with radiotherapy and chemotherapy in carcinoma rectum patients, these have not yet been critically appraised and synopsized to form a comprehensive review of their prevalence and effects on QoL. The study was designed to explore the QoL issues in locally advanced carcinoma rectum patients during various phases of neoadjuvant concurrent chemo-radiotherapy (NACCRT). The study was performed over a period of 2years at a single super speciality cancer hospital in North India. Patients were selected as per the inclusion criteria and followed up with a standard questionnaire incorporating various aspects depicting QoL. The interview technique was used for collecting QoL data at four points, at baseline, midway during treatment, at the end of treatment and 4weeks after completion of NACCRT, using EORTC QLQ C30, for QLQ CR29. Special care was taken to avoid observer bias in cases of language issues, and interpreters' services were utilised, and compared with the baseline pre-treatment scores, patients reported a statistically significant and large clinically meaningful change in the global health status, social functioning, fatigue (FACIT-F), appetite loss, anxiety, sore skin and male and female sexual function at the post-treatment time point. Statistically significant changes with moderate clinically meaningful changes were reported for the functional scales-physical, role and emotional functioning of the QLQ C30 questionnaire and body image and weight of the CR29 questionnaire. Similar moderate clinical changes were found in the symptom scales-fatigue, nausea and vomiting, insomnia, constipation and diarrhoea of QLQ C30 and stool frequency, embarrassment with bowel function, impotence and dyspareunia. These parameters returned to almost the pre-treatment values after 4weeks of completion of NACRT. Since QoL is a relatively subjective variable, differences in human race, culture, education and social environment will have impacts on the results. International cooperation is needed to study the QoL in patients with multiple cultural backgrounds. The existing QoL questionnaire tools have been designed with Western countries in mind, and we did face multiple social issues. We suggest that many similar multicentre studies shall be required to essentially tap the accurate QoL-related issues keeping in mind the diverse social, economic, racial and educational backgrounds. As we deal with the ever-increasing cancer menace and better life expectancy, QoL issues shall be a major determinant of treatment success besides primary treatment. These factors should form an integral part of treatment modality, and adequate counselling must be performed prior to initiation of care.

Echoes Beyond Hearing: Psycho-Social Impacts of OAE Outcomes on Families of Neonates: An Indian Perspective.

The online version contains supplementary material available at 10.1007/s12070-024-04486-1.

An Indian perspective on interdisciplinary storylines and science practices in a socio-cultural context

ABSTRACT Context-based STEM learning has been proven to be useful as interdisciplinary storylines to regulate the flow and sequencing of lessons to obtain expected outcomes. This case study pilot project aims to contextualise scientific learning to local culture. Student groups sampled from two schools in distinct social backgrounds, reflected varied Indian population. Pre-service middle school science and social studies teachers conducted eight lessons as an interdisciplinary storyline with a few natural and social science concepts utilising an artefact representing the cultural history of India for seventh-graders. Data were collected through manually recording of students’ responses and products made during class activities; researchers’ observations and pre-service teachers’ feedback about finding solutions to the difficulties faced. In order to address three research questions about socio-cultural context in science-curriculum design, student adoption of 3D learning, and overcoming teachers’ challenges, a thematic analysis of data through the lens of five science practices and one crosscutting concept was performed. This study supported context-based STEM learning for the twenty-first century and strengthened cultural anchoring from an early stage implying the need for teacher professional development, curricular reform, and school infrastructure improvements to support policy implementation. Such researches may be extended to varied sociocultural contexts and discipline combinations to offer broader perspectives.

Difficult to treat superficial fungal infections: Which factors one should consider in clinical practice – An Indian perspective

Dermatophytosis is a superficial fungal infection caused by filamentous fungi- dermatophytes affecting the skin, hair and/or nails. They have also been termed tinea infections. Dermatophytes, the most common contributing agents, are pretending high importance in developing countries like India. Emerging Pathogen Causing Recalcitrant Dermatophytosis like Trichophyton indotineae, which is terbinafine resistant. Development of Anti-fungal resistance due to irrational usage of antifungals, steroid misuse, availability of topical creams with steroid combination on OTC, improper and inadequate treatment, lack of patient counselling and education are the most important factors which made dermatophyte difficult to treat. Proper diagnosis, correct selection of anti-fungal, with adequate duration of therapy, avoidance of steroid, patient education on lifestyle changes will be probable solutions in resolving current challenges.

Proficiency of independent directors: an Indian corporate governance perspective

PurposeIndependent directors (IDs) in India are required to qualify for the online proficiency self-assessment test to acquire or retain their position on the corporate boards. The purpose of this paper was to examine the perceived positive and negative aspects of the new mandate for the overall quality of corporate boards in India.Design/methodology/approachThis study used a qualitative methodology and applied the interpretative phenomenological analysis approach. Data was collected from board members using semi-structured interviews.FindingsThis study revealed the positive and negative perceived aspects of the mandatory policy prescription of proficiency test for IDs. It was found that the participants emphasized training and mentoring programs for the IDs.Practical implicationsDrawing upon the actual board experiences of the participants, this study has the potential to assist policymakers in making regulations that are more effective in enhancing the quality of corporate boards. The example of action taken as well as the criticism or positive aspects pointed out can generate interest in other legislators.Originality/valueThe concept of proficiency test for IDs is unique to India. A review of literature did not reveal the existence of any regulatory provisions for a mandatory uniform test for examining the proficiency of IDs, in any corporate law jurisdiction apart from India.

Rent Seeking Behavior in the Indian Economy

Rent seeking Behaviour, is an economic concept, that occurs when an entity seeks to gain added wealth without any reciprocal contribution of productivity. The concept is devised from Adam Smith’s ideologies. Here, rent refers to wealth derived from potentially unethical sources or means. Such income is low risk and is easier to obtain. Rent-seeking widely impacts our society in multiple ways. The following research paper aims to analyse the impact of Rent Seeking in the economy from an Indian perspective. Keywords: Rent, Wealth, Unemployment, Caste, Game theory, Gender, Entrepreneurship

Navigating the impact of climate change in India: a perspective on climate action (SDG13) and sustainable cities and communities (SDG11)

Climate change is a global concern of the current century. Its rapid escalation and ever-increasing intensity have been felt worldwide, leading to dramatic impacts globally. The aftermath of climate change in India has brought about a profound transformation in India's environmental, socio-economic, and urban landscapes. In 2019, India ranked seventh, among the most affected countries by extreme weather events caused due to changing climate. This impact was evident in terms of both, the human toll with 2,267 lives lost, and the economic damage, which accounted for 66,182 million US$ Purchasing power parities (PPPs). Over the recent years, India has experienced a significant increase in the number and frequency of extreme weather events, causing vulnerable communities. The country experienced severe air pollution problems in several metropolitan cities and was highlighted in the list of the world's most polluted cities. Additionally, India has become the most populous nation globally, boasting a population of 1.4 billion people, equating to ~18% of the global population, and experiencing an increased rate of consumption of natural resources. Owing to the country's current scenario, various climate mitigation strategies, including nature-based solutions, must be implemented to reduce such impacts and support India's target of achieving the Sustainable Development Goals (SDGs). This review tries to have a holistic understanding of the effects of climate change on different sectors to identify India's challenges in achieving SDG 13 and SDG 11. Finally, it also highlighted the future recommendations for climate change-related research from an Indian perspective.

Prioritization of chemicals in personal care products based on persistent, bioaccumulative and toxic (PBT) potential: An Indian perspective

Numerous organic ingredients present in Personal care products (PCPs) are being detected in sewage which has a high potential to impact the environment. These compounds are called as Emerging contaminants (ECs) or Contaminants of emerging concern. However, the information on the source and occurrence of ECs present in PCPs is very minimal. Specifically, information on the persistence (P), bioaccumulation (B) and toxicity (T) is very scarce. The determination of PBT properties is a complex task given the magnitude of chemicals, thus it is necessary to have a tool to quickly screen and prioritize the most important compounds. Estimation Program Interface (EPI) Suite™ is one such tool authorized by United States Environmental Protection Agency (US EPA) for screening purposes. In the present study, several organic compounds present in the PCPs viz. body lotion, sunscreens, moisturizers, hair dyes, and some hair care products were identified and their PBT property was estimated. The results from the study indicate that the order of increasing occurrence of PBT chemicals is sunscreens > moisturizers > body lotion > hair care products > hair dyes. The prioritized compounds were given rank 1 (maximum concern) to rank 4 (minimum concern). From the results, the compounds octocrylene in sunscreens and butylphenyl methylpropional in body lotions were prioritized as Rank 1.