Indian Set Research Articles

Towards the Preparations for Death and Post-Death: the Role of Initiatives

It is a very well-known fact that death is as natural as to that of birth and whoever is born must die ultimately putting an end to the life lead between birth and death. Many people go scary of death and live in a delusion that it can be conquered in the much technologically advanced medical scenario. But when death occurs, they cannot cope with the grief. So many philosophers and spiritual practitioners strive to educate the people to face the death as it is inevitable and one must be ready to accept it, irrespective of age. The fear of death causes lots of tension and a kind of trauma in the aged people as well as people suffering from severe ailments. A sense of insecurity pervades in the aged people mainly because of their thoughts about the death. Being very sentimental, many people do not even try to utter the word “death”, even by mistake, as they believe that gods will grant it if listened to it. What makes the people to go scary about death? How to overcome the fear of the death? What are the preparations to face it? Against this backdrop this paper intends to make an enquiry into the role of certain organizations in the Indian set up to prepare people to talk about death and to face it.

Real World Outcome of High-Risk Multiple Myeloma: An Indian Tertiary Care Centre Experience

IntroductionHigh risk myeloma is heterogeneous with significant variation in risk stratifications. Real world outcomes differ from controlled clinical trials and affected by socioeconomical determinants. Material and methodsThis retrospective study was performed in a North Indian teriarty care cancer hospital. Out of 384,76(19.7%) high risk myeloma patients (median age 58 years) were analyzed. Result and conclusionMost common HRCA was 1 q gain 36(47.4%) followed by del17p 32(42.1%). 61/76(80.2%) received bortezomib based triplets and 15(19.74%) daratumumab based quadruplets induction, 31(40.79%) received ASCT. Median duration of follow up was 19.5 months. The 2 year OS and PFS was 73.8%, 52.6% respectively. Estimated 3 year OS was 74.7% in ASCT cohort versus 52.9% (P = .0067) without. Estimated 3-year PFS in the ASCT cohort was 72.1% versus 30.3% (P = .0026) without. Estimated 3-year OS for single hit and multi hit ultra HRMM was 67.7% and 61.9% (P = .642) whereas PFS was 58.2% and 35.2% (P = .486) respectively. In multivariate analysis ASCT correlated with better OS (HR 0.3, P = .041) and PFS (HR 0.35, P = .012). Absence of baseline renal impairment correlated with better OS (HR 4.12, P = .004) only. Early aggressive therapy with prompt ASCT translates to a better survival in high risk myeloma. Emphasis on real world clinical outcome is the need of the hour for addressing practical issues and improving global myeloma outcome.

DOP30 Cross-ethnic microbiome analyses identify shared and specific signals for Northern Indian IBD patients

Abstract Background Clinical manifestation of the inflammatory bowel disease (IBD) shows considerable variation across the world. We hypothesized these differences may be influenced by geographical differences in gut microbiome. To test this, we investigated the correlation between gut microbiota and the disease phenotypes of IBD in a cohort form the Northern part of India. Methods Stool samples and clinical metadata were collected from 226 IBD patients (198 ulcerative colitis and 28 Crohn’s disease) and 66 controls from a population cohort from the Northern India. We used metagenomic shotgun sequencing to determine diversity, composition and function of the gut microbiota of the participants. Microbiome was then associated to IBD and its subtypes and clinical metadata (e.g. medication use, drug response, and disease activity). We replicated our results in 436 IBD patients and 903 population controls from the Netherlands analyzed using an identical workflow and used machine learning to assess how well do the Indian IBD signals generalize to Dutch IBD. Results We identified reduction in microbiome diversity and changes in beta diversity in Indian IBD patients (FDR < 0.05, replicated in Dutch population) and identified that 319 taxa and 71 biochemical pathways are altered in Indian patients (FDR < 0.05). Of note, 39% of these signals were replicated in the Dutch cohort (at FDR < 0.05 level). We identified strong dysbiosis shared across Indian and Dutch IBD patients, characterized by expansion of opportunistic pathogens (e.g. Genera Clostridium, Streptococcus and Lactobacilli) and oral bacteria (e.g. Streptococcus oralis and Bifidobacterium dentium) as well as reduction in butyrate producers such as Faecalibacterium prausnitzii, Roseburia hominis and Blautia massiliensis. In addition, we found novel pathobionts specific to the Indian cohort (including oral bacteria from Genus Scardovia and Oribacterium; Actinomyces dentalis and Klebsiella pneumoniae). Machine-learning models trained on the Indian cohort were highly predictive in the Indian test set (Sensitivity 0.84, Specificity 0.95) and generalized to Dutch cohort (Sensitivity 0.77, Specificity 0.69). In addition to IBD-associated dysbiosis, we identified links between medication use and gut microbiota independent of the disease activity: use of Tofacitinib (used by 26 UC patients) was linked to decrease in Lactobacilliales and increase in Clostridia, while Prednisolone and Azathioprine associated to reduction in Roseburia and increase in Streptococcus and Granulicatella. Conclusion The IBD patients from Northern India show gut dysbiosis similar to European patients, but also show enrichment in India-specific pathobionts. The microbiome-based diagnostic models generalize across these populations.

Comparing the performance of a deep learning-based lung gross tumour volume segmentation algorithm before and after transfer learning in a new hospital.

Radiation therapy for lung cancer requires a gross tumour volume (GTV) to be carefully outlined by a skilled radiation oncologist (RO) to accurately pinpoint high radiation dose to a malignant mass while simultaneously minimizing radiation damage to adjacent normal tissues. This is manually intensive and tedious however, it is feasible to train a deep learning (DL) neural network that could assist ROs to delineate the GTV. However, DL trained on large openly accessible data sets might not perform well when applied to a superficially similar task but in a different clinical setting. In this work, we tested the performance of DL automatic lung GTV segmentation model trained on open-access Dutch data when used on Indian patients from a large public tertiary hospital, and hypothesized that generic DL performance could be improved for a specific local clinical context, by means of modest transfer-learning on a small representative local subset. X-ray computed tomography (CT) series in a public data set called "NSCLC-Radiomics" from The Cancer Imaging Archive was first used to train a DL-based lung GTV segmentation model (Model 1). Its performance was assessed using a different open access data set (Interobserver1) of Dutch subjects plus a private Indian data set from a local tertiary hospital (Test Set 2). Another Indian data set (Retrain Set 1) was used to fine-tune the former DL model using a transfer learning method. The Indian data sets were taken from CT of a hybrid scanner based in nuclear medicine, but the GTV was drawn by skilled Indian ROs. The final (after fine-tuning) model (Model 2) was then re-evaluated in "Interobserver1" and "Test Set 2." Dice similarity coefficient (DSC), precision, and recall were used as geometric segmentation performance metrics. Model 1 trained exclusively on Dutch scans showed a significant fall in performance when tested on "Test Set 2." However, the DSC of Model 2 recovered by 14 percentage points when evaluated in the same test set. Precision and recall showed a similar rebound of performance after transfer learning, in spite of using a comparatively small sample size. The performance of both models, before and after the fine-tuning, did not significantly change the segmentation performance in "Interobserver1." A large public open-access data set was used to train a generic DL model for lung GTV segmentation, but this did not perform well initially in the Indian clinical context. Using transfer learning methods, it was feasible to efficiently and easily fine-tune the generic model using only a small number of local examples from the Indian hospital. This led to a recovery of some of the geometric segmentation performance, but the tuning did not appear to affect the performance of the model in another open-access data set. Caution is needed when using models trained on large volumes of international data in a local clinical setting, even when that training data set is of good quality. Minor differences in scan acquisition and clinician delineation preferences may result in an apparent drop in performance. However, DL models have the advantage of being efficiently "adapted" from a generic to a locally specific context, with only a small amount of fine-tuning by means of transfer learning on a small local institutional data set.

A SHIFT TOWARDS E-MOBILITY IN INDIA: CHALLENGES AND INNOVATIONS

The shift towards electric mobility in India is motivated by the need to reduce the considerable environmental effect on the road sector induced by rapid urbanization and commuter traffic. Which accounts for 80% of total emissions including 60% of greenhouse gas emissions from vehicles. To address this problem the Indian government set up a target for electric vehicle fleets in the country by 2030. The goal is very ambitious but difficult to achieve due to the lack of resources, technology, and infrastructure required for EVs. Hence, different policies, battery technology, charging infrastructure, consumer perception, incentive programs, and local manufacturing for affordability and availability will have to be provided to create an ecosystem for electric vehicles in India. The paper gives an overview of current e-mobility trends, practices, and innovations, and the policy imperatives required to encourage the growth of sustainable e-mobility in India.

Assessment of Health-Related Quality of Life Using EQ-5D-5L Tool With Indian Tariffs Among Reproductive Age Group Women Living With HIV in India

ObjectiveIndia is witnessing declining HIV prevalence because of dedicated efforts by the government. The highly active antiretroviral therapy has improved life span of people living with HIV but bearing many side effects. Women living with HIV (WLHIV) in reproductive age group have additional burden of pregnancy-related issues. This study aimed to estimate the health utility score among WLHIV in India, particularly in context of their contraceptive use, during pregnancy and postpartum period. MethodsA primary cross-sectional study was conducted among 195 WLHIV availing antiretroviral treatment services at public health facilities of Mumbai. The EQ-5D-5L interview-based questionnaire in local language and Indian value set was used to estimate health-related quality of life (QOL) reported as mean (± SD) utility and visual analog scale (VAS) scores. The relationship between utility values and VAS scores was assessed. ResultsThe WLHIV with mean age of 31.6 (6.4) years were on antiretroviral medication for nearly 7 years, and 63% had CD4+ cell count > 500 cells/mm3. Response of “11111,” that is, in full health state, was reported by 66.7%. The mean utility and VAS scores were 0.976 (± 0.0519) and 82.21 (± 15.77). Reduced health-related QOL scores were associated with pain and discomfort dimension. Utility scores among contraceptive users (0.986 [± 0.029]) was higher than nonusers (0.976 [± 0.028]). Currently pregnant WLHIV had least utility score (0.959 [± 0.088]). ConclusionsWLHIV had better QOL while using contraceptives more so when they were sterilized. Pregnancy reduces the QOL. This emphasizes the need to promote effective contraceptive methods among WLHIV and prevent unintended pregnancies.

Assessment of Qol among COVID-19 Patients in South India: A Tertiary Care Center Study: An Original Research.

The COVID-19 epidemic has brought about an unparalleled health disaster and fundamentally altered people's livelihoods. We intended to examine risk variables for "Health-Related Quality Of Life (HRQoL)" amid COVID-19 hospital discharged patients. For this cross-sectional study, 1000 discharged patients who tested positive at the tertiary care center before January 2022 were included. The HRQoL was measured using a 5-level EuroQoL survey. The complete health state was evaluated using an Indian value set. The correlation of HRQoL and the clinical, sociodemographic parameters were investigated using appropriate statistical tools. Finally, regression model was utilized to identify all factors that predict the HRQoL dimensions. It was found that 55% of patients said they had moderate or serious health issues. Forty percent of respondents said they had felt moderate-to-severe pain or discomfort, compared to 41% who said they had anxiety or sadness. The outcome of the logistic regression demonstrated the substantial influencers were "age, gender, occupation, location of care, heart conditions, and diabetes" on several HRQoL aspects. The COVID-19 dramatically worsens the patients' physical and mental health conditions. Therefore, the government and policymakers must develop comprehensive ways to lessen the patients' mental and physical health problems.

Dimensions of Thyroid Cartilage Window for Medialisation Thyroplasty in Indian Population.

To derive optimal thyroid cartilage window for medialisation thyroplasty in Indian population and comparision of the same with standard parameters including Isshiki's thyroplasty type I. Along with comparision it is also attempted to bring out difference if any, to provide a better guidelines of medialisation thyroplasty in Indian population. A total No of 52 (35 male and 17 female) cadaveric laryngeal samples (formalin fixed) taken into study. Cartilage window over thyroid lamina is created and increased gradually. Endoscopic examination of medialisation by appropriate silastic block of true vocal cord noted at each level. Relevant thyroid anatomy at window corners also taken into consideration. In Indian set up, dimensions of window required for medialisation thyroplasty are slightly lesser than the average size quoted by premier study of Isshiki when compared in male population. The window size of males which produced ideal medialisation was 12-14mm in length and 5mm in height. In females it was 10-11mm in length and 4mm in height.

Optimization of Extraction Conditions using Response Surface Methodology and HPTLC Fingerprinting Analysis of Indian Propolis

The potential of Indian propolis as a suitable therapeutic agent is still to be explored to the fullest. As variation in the chemical composition across different geographical regions has been a major concern, it is, therefore, worthwhile to systematically investigate, and assess the quality of Indian propolis and set nationalized standards. The propolis collected from three different regions were authenticated for the major plant source, followed by the evaluation of physicochemical properties. Different extraction methods were compared, with their influence on balsam content, polyphenol, and flavonoid content. The sample coded HAR using ultrasonication gave the highest extraction yield of 71.87%. Further, the process variables in the ultrasonication method (i.e. Amplitude, extraction time, the concentration of ethanol) at three levels were optimized using the Box-Behnken response design. The model was found significant with the concentration of ethanol having a maximum influence on the responses. The model was successfully verified by setting the amplitude at 48%, extraction time to 5.6 mins, and ethanol concentration to 87% v/v. The extraction efficiency of 83.86±1.17% was achieved with a substantial diminution of extraction time. The total phenolic, total flavonol, and total flavanone content of the optimized batch were 28.74±0.13 mgGAE/g, 4.66±0.78 mgQE/g, and 3.16±0.14 mgPE/g of propolis respectively. Further HPTLC fingerprint image of the optimized extract revealed the presence of quercetin, p-coumaric acid, kaempferol, chrysin, pinocembrin, and galangin.

Recognizing the Indian Cautionary Traffic Signs usingGAN, Improved MaskR‐CNN, and Grab Cut

SummaryThe detection and classification of traffic signs is a major challenge for self‐driving vehicles. The task can be narrowed down to detecting and classifying Indian Cautionary Traffic Signs (ICTS). In this proposed work, the difficulty of detecting and identifying Indian Cautionary Traffic Signs is addressed, and sincere attempts have been made to attain a possible solution using a Generative Adversarial Network (GAN), Improved Mask R‐CNN, and GrabCut algorithms. Data augmentation is done using Cascade Pyramid Generative Adversarial Network (CP‐GAN) to upsize the data set. The Mask R‐CNN with certain adoptions termed Improved mask RCNN is used in conjunction with the Grab‐Cut method to handle ICTS detection and identification through automatic end‐to‐end learning. Initially, Improved Mask R‐CNN generates a pixel‐by‐pixel segmentation mask for each item in the input sample. Masks developed using Improved Mask R‐CNN are not always clean, that is, some background pixels are often seen in the foreground segmentation. Hence, the generated masks are refined using the Grab Cut algorithm to enhance image segmentation. This combined approach works well in isolating the traffic signs from the ground truth images. Improved Mask R‐CNN attained better performance in the overall performance of traffic sign detection in the Indian data‐set. This method recognizes 40 different types of cautionary traffic signs from the unique Indian data set. The results are provided for complicated traffic sign categories that have not been addressed before. The proposed technique is trained and evaluated on ICTS, GTSDB, STSD, LISA, and DITS data sets, and it is also compared against cutting‐edge object recognition methods like Mask RCNN, Faster RCNN, SSD, and YOLOv3.

Evaluating the impact of price regulation (Drug Price Control Order 2013) on antibiotic sales in India: a quasi-experimental analysis, 2008–2018

BackgroundIn India, due to a lack of population-level financial risk protection mechanisms, the expenditure on healthcare is primarily out-of-pocket in nature. Through Drug Price Control Orders (DPCOs), the Indian Government attempts to keep medicine prices under check. The aim of this study was to measure the potential impact of DPCO 2013 on the utilization of antibiotics under price regulation in India using large nationally representative pharmaceutical sales data.MethodsWe used interrupted time series analysis, a quasi-experimental research design to estimate the impact of DPCO 2013 on the utilization of antibiotics in the private sector in India. Indian pharmaceutical sales data set, PharmaTrac from a market research company—All Indian Origin Chemists and Distributors Limited—was used for the study. The data are collected from a panel of around 18,000 stockists across 23 different regions of the country. The primary outcome measure is the percentage change (increase or decrease) in the sales volume of the antibiotics under DPCO 2013, measured in standard units (SUs).ResultsOur estimates suggest that post-intervention (after notification of DPCO 2013) there was an immediate reduction (level change) in the sales of antibiotics under DPCO 2013 by 3.7% (P > 0.05), followed by a sustained decline (trend change) of 0.3% (P > 0.05) as compared to the pre-intervention trend at the molecule level, but both changes were statistically insignificant. However, in terms of ‘average monthly market share,’ the DPCO 2013 notification resulted in a sharp reduction of 579% (P < 0.05) (level change) followed by a sustained increase of 9.5% (P > 0.05) (trend change) in the ‘market share of antibiotics under DPCO’ as compared to pre-intervention trend.ConclusionsThe impact of DPCO 2013 in terms of the overall increase in the utilization of antibiotics under price regulation was limited but there was a switch from non-price controlled antibiotics to price regulated antibiotics (notified under DPCO 2013). We argue that policies on price control need to be complemented with continuous monitoring of market behavior to have a measurable and long-term impact.

Analytical study of psychiatric complains in intensive care unit patients

Introduction: Numerous studies have established a higher incidence of psychiatric disorders among general hospital inpatients. In our local / Indian set ups there is a lack of literature on the prevalence of psychiatric morbidity in patients admitted to the intensive care units. Hence this study was conducted to find psychiatric morbidity among the patients of the intensive care unit (ICU). Methods: The present Observational, Analytical &amp; Cross-Sectional study is carried out on 100 subjects. The SCL-R-90 scale was administered to the participants by the faculty in their respective colloquial language. Each item of the questionnaire is rated by the patient on a five-point Likert scale of distress ranging from 0 (none) to 4 (extreme). Results: Nearly 49% of the participants had no psychiatric morbidity. 36% had mild and 15% had moderate psychiatric morbidity as per the SCL-90-R Scale. There was no participant with severe psychiatric morbidity. Factors such as age, gender, educational level, or duration of stay had no significant influence on the outcome. Among the psychiatric manifestations, interpersonal sensitivity and somatization were found to be the most prevalent symptoms.

Retrospective Study of Clinical Outcomes and Toxicity Profile in Patients Treated with Immune Checkpoint Inhibitors

Abstract Introduction Immune checkpoint inhibitors (ICIs) are rapidly being utilized as treatment option either alone or in combination with chemotherapy in most of the solid tumors. Objectives Our single-center retrospective study aimed to present our experience with the effectiveness and safety of these agents in Indian set of patients with various advanced solid tumors. Material and Methods Twenty-five adult patients with stage IV solid tumors of varying sites treated with ICIs at Aditya Birla Memorial Hospital, Pune, Maharashtra, India, between October 2017 and September 2020 were included in the study. Overall survival (OS), progression-free survival (PFS), overall response rate (ORR), disease control rate (DCR), and toxicity profiles were evaluated. All statistical calculations were performed using IBM SPSS version 25. Results Total of 25 patients (median age 61) was evaluated. Histological evaluation revealed adenocarcinoma (48%), squamous cell carcinoma (40%), and one each (4%) of others. Eastern Cooperative Oncology Group performance status score was I in 16 (64%) and II in 9 (36%) patients. Average of 10 cycles ICIs were received by each patient. Majority were males with 11 (44%) having some comorbidities. Lung (48%) was the most common primary followed by head and neck cancers (32%). Most (76%) were treated with nivolumab, followed by pembrolizumab (20%) while only one patient was given atezolizumab. Median follow-up was 18 months. Median OS was 24 months (95% confidence interval [CI]: 9–NA) and 2-year OS rate in the study was 38.4% (95% CI: 18.8–78.3), while median PFS was 9 months (95% CI: 6–NA) and 1-year PFS rate was 22.3% (95% CI: 9.7–51.2). One patient (4%) had complete response, 6 (24%) had partial response while 12 (48%) had stable disease response at first follow-up. Mean and median time to progression were 5.7 and 9 months, respectively. ORR was 28% (95% CI: 12.07–49.4) while the DCR was 76% (95% CI: 54.87–90.64). PS II patients were associated with significantly poor median OS and PFS. There was no significant difference in survival with respect to age, gender, site, histology, and comorbidities; however, 4/25 patients had undergone biomarker assessment and were associated with a trend toward better median PFS (8 vs. 11 months, hazard ratio 0.53, 95% CI: 0.12–2.34, p = 0.38). Two of 25 patients developed autoimmune conditions namely ophthalmoplegia and hypothyroidism each. Fatigue (36%) and nausea (12%) were the most common toxicities. Conclusion Real-world data from our study depicts our own experience with ICIs to suggest that these agents are well-tolerated and equally effective in Indian set of patients with advanced metastatic solid tumors. ICIs could be safely used even in patients with PS II and biomarker assessment in adjunction needs to be encouraged wherever feasible for better patient selection, prognostication, and clinical outcomes.

No association of the common Asian mitochondrial DNA haplogroups with lung cancer in East Indian population.

Mitochondrial dysfunction has long been associated with the pathogenesis of lung cancer (LC). Mitochondrial DNA (mtDNA) haplogroups have been reported to modify the risk of LC in a few different populations; however, no study has been done among the Indians. Here, we explore the relationship between mtDNA haplogroups and LC in a representative eastern Indian sample set. Different combinations of six mtDNA SNPs, which define the major Asian mtDNA haplogroups M and N, and their sub-haplogroups D, G, M7, R, and F were genotyped via polymerase chain reaction (PCR)- restriction fragment length polymorphism (RFLP)- sequencing approach in 94 smoker LC patients and 100 healthy smoker controls from an eastern Indian cohort. The distribution of 7 mtDNA haplogroups did not show any significant differences between patients and controls (p<0.05). We did not find sub-haplogroup M7 in our study population. Our study is the first to indicate that the major Asian mtDNA haplogroups have no significant (p<0.05) association with LC in East Indian population.

GM Food in India: Are we ready for it?

India’s approval of the first Genetically Modified Food Crop (GMFC), GM Mustard brought about this biotechnological product back in news. Issues pertaining to ecological impact, biosafety, economic benefits and labelling of these crops have been debated continuously at national and global level from past two decades. Yet there is no clarity on their efficacy, benefits or even harmful impacts. This paper is in direction to clear the controversies surrounding GM crops in context with the Indian agricultural set up. The readiness of the country to adopt and use these crops has been studied on 3 indices; Biosafety Readiness Level Regulatory Readiness Level and Social Readiness Level. The in-depth analysis highlighted the preparedness of the agricultural system legislative set up as well as consumer acceptance over these crops. Asymmetrical research database, regulatory lacunae and dubious perception of the society was reported at all the three levels of readiness. Therefore, the study recommends reforms in the agricultural system, in the regulatory policy and science communication policy of GMFCs so that this innovation of biotechnology can be used for the betterment of mankind.

Prevalence of Anxiety, Depression and Stress among Antenatal Women attending a Tertiary Care Centre in Kerala during COVID-19 pandemic

Introduction: Anxiety, depression and stress can cause negative impacts on the foetus and pregnancy. The COVID19 pandemic provides a unique stressor requiring an assessment of its impact in the Indian set up. Objectives:1. To assess prevalence of anxiety and depression among antenatal women attending the antenatal OP at a tertiary care centre during COVID 19 pandemic using Hospital Anxiety and Depression Scale (HADS). 2. To determine stress perceived by antenatal women using the Perceived Stress Scale (PSS). Method: Antenatal women attending the outpatient clinic between November 2020 and January 2021 were consecutively enrolled into the study after obtaining consent and a semi-structured interviewer administered questionnaire was used to collect data. The outcome variables, including sociodemographic details, HADS and PSS scores, were analysed using SPSS software, and results expressed appropriately, with quantitative variables expressed as mean and standard deviation, and qualitative variables as proportions. Results: Prevalence of anxiety among antenatal mothers was estimated to be 39%, of which 87.8 % had income below the poverty line. Prevalence of depression was estimated to be 11.4 %. Stress levels were high in 41.9 % of the women. Anxiety showed a positive correlation with stress (correlation coefficient of 0.711). Conclusion: High prevalence of anxiety and stress among antenatal women, especially from poor income backgrounds, points to an urgent need for reassurance and counselling.

Identifying Traits Associated With Terminal Drought Tolerance in Sesame (Sesamum indicum L.) Genotypes.

Sesame is predominantly cultivated in rainfed and low fertile lands and is frequently exposed to terminal drought. Sesamum species inhabiting dryland ecosystems adaptively diverge from those inhabiting rainfed habitats, and drought-specific traits have a genetic basis. In sesame, traits associated with drought conditions have not been explored to date, yet studies of these traits are needed given that drought is predicted to become more frequent and severe in many parts of the world because of climate change. Here, 76 accessions from the available Indian core set were used to quantify variation in several traits under irrigated (WW) and terminal drought stress (WS) conditions as well as their association with seed yield over two consecutive years. The range of trait variation among the studied genotypes under WW and WS was significant. Furthermore, the traits associated with seed yield under WW and WS differed. The per se performance of the accessions indicated that the expression of most traits was reduced under WS. The correlation analysis revealed that the number of branches, leaf area (LA), leaves dry weight (LDW), number of capsules plant–1, and harvest index (HI) were positively correlated with seed yield under WW and WS, and total dry matter (TDM), plant stem weight, and canopy temperature (CT) were negatively correlated with seed yield under WW and WS, indicating that smaller and cooler canopy genotypes had higher yields. The genotypes IC-131936, IC-204045, IC-204861, IC-205363, IC-205311, and IC-73576 with the highest seed yields were characterized by low canopy temperature, high relative water content, and high harvest index under WS. Phenotypic and molecular diversity analysis was conducted on genotypes along with checks. Phenotypic diversity was assessed using multivariate analysis, whereas molecular diversity was estimated using simple sequence repeat (SSR) loci to facilitate the use of sesame in breeding and genetic mapping. SSRs showed low allelic variation, as indicated by a low average number of alleles (2.31) per locus, gene diversity (0.25), and polymorphism information content (0.22). Cluster analysis (CA) [neighbor-joining (NJ) tree] revealed three major genotypic groups and structure analysis showed 4 populations. The diverse genotypes identified with promising morpho-physiological traits can be used in breeding programs to develop new varieties.

A retrospective analysis of clinical profile of patients with cancer cervix in a rural medical college in Karnataka

Cancer cervix is most common cause of cancerous deaths in females especially in developing countries. The pre-invasive stage of cervical cancer lasts for a long period and a small proportion progresses to an invasive lesion. In Indian set up, majority of the patients are presenting with an invasive lesion. To describe the clinical profile of patients presented with cervical cancer and to describe various treatments received by those patients.: The present study is a retrospective observational study done on confirmed cases of carcinoma cervix who attended rural medical college in Karnataka. Clinical records of the patients, who presented between November 2019 and November 2020 and were diagnosed with cervical cancer, were retrieved. The data related to demographic and clinical variables like age, socioeconomic status, education, symptoms, clinical staging, treatment and histopathology report were recorded. Data collected were entered in Microsoft Excel Office 2007and data analysed. Data were presented using descriptive statistics. The data was expressed in the form of frequencies and percentagesA total of 30 patients with the median age of 46 years were studied. Most common presentation was post coital bleeding (40%) followed by white discharge per vagina in 33%. Majority were under low socioeconomic status (70%). 60% presented in stage II and 30% in stage I. Chemoradiation was treatment of choice in 60% followed by surgery in 33% and 7% were lost to follow up. On histopathology, majority had squamous cell carcinoma (70%).The appropriate management of Cervical intraepithelial neoplasia(CIN) can prevent invasive cervical cancer. In this study most of them presented in advanced stage which could have been prevented with the regular screening and awareness among women in the reproductive age group. : Detection of pre invasive lesions or in situ cases remains important key to decreasing cervical cancer morbidity and mortality.

Dysphagia intervention in NICU set up: a report of case studies in an Indian public hospital

&lt;p class="abstract"&gt;A retrospective study was conducted in the Neonatal Intensive Care Unit (NICU) of a public hospital in Mumbai, India wherein 13 neonates with varying pathophysiologies were taken up for swallowing intervention. Of these, 7 neonates had history of prematurity, 1 was born of twin birth with prematurity, 3 had clefts of lip/palate and 2 had Pierre Robin Syndrome. For 7 neonates with prematurity, the swallowing regimen consisted of oro motor intervention (OMI) followed with therapeutic oral feeds. With improved tolerance of oral feeds while maintaining airway safety, they were graduated to oral feeds progressively increasing in volume until they reached optimum prescribed oral feeds. 6 out of 7(86%) progressed to breast feeds while1 succumbed to medical complications. 3 babies with CLP graduated to complete oral feeds through bondla, when they were fitted with obturators and had swallowing intervention but were unable to move to breastfeeds while in NICU. 2 babies with PRS could not tolerate oral feeds even after multiple sessions and had to be maintained on orogastric feeds. 1 infant, one of a twin delivery with prematurity although was showing improvement to OMI succumbed to medical complications. Among these neonates, those with prematurity showed the maximum improvement with swallowing intervention followed by infants with CLP. Co-morbidities such as prematurity in twin births worsened the prognosis as did a disorder such as PRS. This preliminary study, done on a small sample, stressed the importance of swallowing intervention in neonates with high risk factors by the SLP in the NICU in an Indian set up. &lt;/p&gt;

Prevalence of Common Mental Disorders at a General Health Clinic in a Corporate Hospital

Western studies show there is a high proportion of somatization of psychiatric disorders among presenters in medical outpatients. Many of these patients go through unnecessary investigations and remain undiagnosed for a significant length of time. These not only add to the suffering of the patients, but also lead to wastage of important resources and manpower. Similar studies have not been replicated in Indian corporate hospital set up using validated questionnaires. In fact, there is dearth of well organized integrated mental health units in corporate hospital setting in India.