Indian Institute Research Articles

Comparison of Clinical Outcomes of Implantation of Foldable Hydrophobic Acrylic Intraocular Lens With and Without Heparin Surface Modification in Indian Diabetic Patients.

Background This study aimed to compare the clinical outcomes of a heparin surface-modified (HSM) hydrophobic acrylic foldable intraocular lens (IOL) (CT LUCIA 601PY) and non-heparin-modified hydrophobic acrylic foldable IOL (AcrySof IQ SN60WF) in diabetic patients undergoingphacoemulsification. Methodology Thisrandomized, single-surgeon, double-masked controlled trial was conducted at Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi. In this randomized controlled trial, 100 eyes of 100 diabetic patients with or without mild-to-moderate diabetic retinopathy were enrolled (HSM IOL, n = 50; non-HSM IOL, n = 50). Outcome measures were aqueous flare, visual acuity, and anterior chamber depth (ACD). These were measured preoperatively as well as one day, one week, one month, three months, six months, and one year postoperatively. Results The HSM IOL group had significantly lower anterior chamber aqueous flare values (photon count/ms) than the non-HSM IOL group on postoperative day one (9.97 ± 5.2 vs. 17.56 ± 11.3, p < 0.001), postoperative week one (11.47 ± 7.78 vs. 17.06 ± 9.4, p = 0.02), and postoperative month three (7.7 ± 4.1 vs. 12.5 ± 5.6, p = 0.004) of phacoemulsification. The corrected distance visual acuity (CDVA) was significantly better in the HSM IOL group on postoperative day one (uncorrected distance visual acuity: p = 0.022; CDVA; p = 0.005), but there was no significant difference at any other follow-ups. ACD was significantly longer in the HSM IOL group at all follow-ups. Conclusions Theimplantation of HSM IOL resulted in significantly lower inflammatory reactions in the early postoperative period in diabetics.

Impact of Cyber-Attacks on Banking Institutions in India: A Study of Safety Mechanisms and Preventive Measures

This study intends to investigate the disastrous effects of cybercrime on financial institutions, as well as the creation of a strong cybersecurity mechanism and attempts to mitigate its effects. Banks are its direct target as of late. Many banks in India are frequently the target of widespread malware attacks, which not only expose private and sensitive data but also result in significant financial losses. This study’s goals are to determine which company sectors are more vulnerable to cyberattacks and to guarantee that cyber security protocols are developed and customized. The report includes case study examination of numerous cyberthreats and crimes that have previously resulted in significant financial loss, as well as secondary data analysis from a variety of online resources, including government websites, journals, and research papers. This essay will offer cyber regime insights that will be advantageous to financial institutions, banks, and society at general.

From Allston to Ahmedabad: American hegemony in management education reexamined

Purpose This paper aims to study the origin story of Harvard Business School’s involvement with the Indian Institute of Management Ahmedabad to study the reasons for the spread of American management education. It introduces both the explicit influence of Cold War politics and Indian development imaginaries to the export of American management thought in the early 1960s. Design/methodology/approach This paper relies on archival research for its primary source material, drawing upon rich archives of documents found at the Baker Library of Harvard Business School. Findings Harvard’s role in Ahmedabad was explicitly influenced by the Cold War anti-communist foreign policy of the USA, but did so opportunistically and contrary to the Ford Foundation’s (FF) original plans. Vikram Sarabhai, who was a key player in the Indian national imaginary of development, invited Harvard on his own initiative and forced the foundation to follow his interests rather than being a mere “subaltern.” Research limitations/implications This paper could additionally add to the historical debate about the scope and periodization of the Cold War and the role of non-state actors. Originality/value This paper covers new ground in exploring the early connection between the Indian development imaginary and business education. It concludes that the export of hegemonic US management education was not successful during Cold War, and the FF was not as dominant as it was made out to be.

Strengthening research capacity of early-mid career researchers: Implementation and evaluation of the Excellence in Non-COmmunicable disease REsearch (ENCORE) program.

High-quality training and networking are pivotal for enhancing the research capacity of early- to mid-career researchers in the prevention and control of non-communicable diseases. Beyond building research skills, these professionals gain valuable insights from interdisciplinary mentorship, networking opportunities, and exposure to diverse cultures and health systems. Despite the significance of such initiatives, their implementation remains underexplored. Here, we describe the implementation and evaluation of the Excellence in Non-COommunicable disease REsearch (ENCORE) program, a collaborative initiative between Australia and India that was launched in 2016 and spanned a duration of 3 years. Led by a consortium that included the University of Melbourne and leading Indian research and medical institutions, ENCORE involved 15 faculty members and 20 early-mid career researchers. The program comprised various elements, including face-to-face forums, masterclasses, webinars, a health-technology conference, and roundtable events. ENCORE successfully trained the early-career researchers, resulting in over 30 peer-reviewed articles, 36 conference presentations, and the submission of seven grant applications, three of which received funding. Beyond individual achievements, ENCORE fostered robust research collaboration between Australian and Indian institutions, showcasing its broader impact on strengthening research capacities across borders.

Development and validation of teachers’ e-readiness scale: a study on higher education institutions in India

PurposeDue to the growing complexity involved in leveraging the endless possibilities of ICT on all levels, the technical competence of faculties of higher education institutions (HEI) and effective methods for fostering e-readiness has become questionable.Design/methodology/approachThis research has developed and validated an empirically supported e-readiness scale, which can be used by HEIs to assess faculty members’ preparedness toward online teaching. The measurement model and the structural model were developed as the results of exploratory factor analysis and confirmatory factor analysis (n = 245). The previously identified components and their indicators were validated using the structural models and the final scale was developed with five dimensions (“online technological readiness, pedagogical readiness, institutional readiness, learning and delivery readiness and content readiness”).FindingsThe faculties’ e-readiness assessment tool, as a useful tool, could aid institutions in identifying problems that affect the implementation of e-learning or digitalization in the institutions and developing strategies in response.Research limitations/implicationsLike any research this research also has some limitations and can be considered as future research probability like the responses for this research were collected from HEI in India; however, a cross-cultural study can be conducted to understand the parameters across the globe. Although the psychometric qualities of the e-readiness scale are acceptable, additional research in various higher educational environments, both nationally and internationally, is required to further establish the scale’s relevance, validation and generalizability.Originality/valueAlthough many scales have been developed to assess the readiness level in the education sector, a scale, that holistically measures, the readiness level of faculties from an overall perspective was required. This scale can be used to recognize the e-readiness level of teachers in HEIs. This scale can also help the institutions assess the readiness level of their faculty members and address any improvements required in their teaching and learning pedagogy, further acknowledging training needs.

Working of Rural Educational Institutions in India Under Right to Education Act, 2009- A Critique

Education has always been considered as a backbone of any society. India is not an exception to it. In order to strengthen the backbone Indian government has made Right to Education a fundamental right through 86th amendment Act. The new article 21 A has been incorporated in part third of the Constitution and for giving effective implementation to it Right to Education Act, 2009 was also passed. In this research paper the researcher intends to probe into the provisions of the Act of 2009 and to carve out its lacunas with reference to functioning of rural educational institutions. The researcher further has analyzed the challenges in the way of rural education and has suggested certain possible solutions to plug the said problems.

Diagnostic Accuracy of Endotoxin and Endotoxin Binding Protein in Late-Onset Neonatal Sepsis.

To evaluate the diagnostic utility of endotoxin and endotoxin binding protein (EBP) for the diagnosis of late-onset neonatal sepsis (LOS) and compare it with the diagnostic utility of C-reactive protein (CRP). This diagnostic study of neonates, both term and preterm, with clinical suspicion of LOS was conducted in a tertiary care institute in India between January 2021 and March 2023. Blood samples were collected for evaluating endotoxin and EBP along with culture. Endotoxin and EBP were measured with enzyme linked immunosorbent assay, CRP was measured by nephelometry method, and the results were compared with blood culture done with BACTEC (gold standard). Out of 160 samples, 73 showed culture positivity. Endotoxin was positive in 81 samples and showed sensitivity of 84%, specificity of 78% and diagnostic accuracy of 81% (AUC 0.837, P value <0.001). EBP was positive in 82 samples and showed sensitivity of 80.8%, specificity of 73% and diagnostic accuracy of 76% (AUC 0.824, P value <0.001). CRP was positive in 105 samples and had sensitivity of 86%, specificity of 51% and diagnostic accuracy of 67% (AUC 0.827, P value <0.001). The present study showed endotoxin and EBP have higher specificity for diagnosing neonatal sepsis. As culture takes minimum 48h, endotoxin and EBP can be utilized as biomarkers for diagnosis of sepsis.

Development of Predictive Models Based on Biochemical Parameters to Triage COVID-19 Patients: A Study Conducted in a Tertiary Care Hospital.

Background The COVID-19 disease continues to cause severe mortality and morbidity. Biochemical parameters are being used to predict the severity of the infection. This study aims to predict disease severity and mortality to help reduce mortality through timely intervention in a cost-effective way. Methods A total of 324 COVID-19 casesadmitted at our hospital (All India Institute of Medical Sciences, Patna, BR, India) betweenJune 2020 to December 2020 (phase 1: 190 patients) and April 2021 to May 2021 (phase 2: 134 patients) were recruited for this study. Statistical analysis was done using SPSS Statistics version 23 (IBM Corp., Armonk, NY, USA) and model prediction using Python (The Python Software Foundation, Wilmington, DE, USA). Results There were significant differences in biochemical parameters at the time of admission among COVID-19 patients between phases 1 and 2, ICU and non-ICU admissions, and expired and discharged patients. Thereceiver operating characteristic (ROC)curves predicted mortality solely based on biochemical parameters. Using multiple logistic regression in Python, a total of four models (two each) were developed to predict ICU admission and mortality. A total of 92 out of 96 patients were placed into the correct management category by our model. This model would have allowed us to preserve 17 of the 21 patients we lost. Conclusions We developed predictive models for admission (ICU or non-ICU) and mortality based on biochemical parameters at the time of admission. A predictive model with a significant predictive capability for IL-6 and procalcitonin values using normal biochemical parameters was proposed. Both can be used as machine learning tools to prognosticate the severity of COVID-19 infections. This study is probably the first of its kind to propose triage for admission in the ICU or non-ICU at the medical emergency department during the first presentation for the necessary optimal treatment of COVID-19 based on a predictive model.

Sailing through the COVID-19 challenges on admission rates: An experience-based treatment care model for inpatient psychiatry services from central India

The coronavirus disease 2019 (COVID-19) pandemic hit the healthcare system worldwide and led to the imposing of a lockdown in India from March 24, 2020, except for emergency services. All India Institute of Medical Sciences Raipur started the dedicated COVID service facility, and the workforce and logistics were shifted to the new dedicated service. This has impacted the inpatient services provided, including psychiatry services. Hence, we conducted a retrospective record review of inpatient admission during COVID-19, which was compared with the previous year’s admission rates. We also discussed the challenges faced and steps taken to implement and support an experience-based treatment care model for inpatient psychiatry services during the COVID-19 crisis.

Exploring the Factors Influencing Usage Behavior of the Digital Library Remote Access (DLRA) Facility in a Private Higher Education Institution in India

Digitalization has transformed the world and empowered education across the globe alike. Digital Library Remote Access (DLRA) facilities have empowered students, researchers and academicians to have uninterrupted and complete access to literature and scientific information on finger tips through a single window. In order to understand the factors influencing the digital library usage in a private Higher Education Institution of Eminence in India, the study employs non-probability sampling, convenience sample of 400 researchers and students of the deemed to be university. The results of the investigation substantiates that habit plays a crucial role in ascertaining the behavioral intention and the usage behavior of DLRA technology.

A Novel Technique for Hand-Assisted Laparoscopy in Difficult Nephrectomies-Is One Hand Better Than Two? A Single-Centre, Single-Surgeon Series.

Laparoscopic radical nephrectomy is the standard of care for T1 renal tumors and nowadays being used for T2 or higher tumors, resulting in higher the conversion rates. To bridge this gap, the hand-assisted laparoscopy (HAL) method was introduced. Even now, in the robotic era, this HAL approach continues to find importance in urology, especially in the most challenging cases, albeit, with a relatively low usage rate due to the cost involved and availability of hand port devices. Here, we report a case series using a novel modification of the HAL nephrectomy (HALN) technique when open conversion is needed. From a prospective database, we retrospectively analyzed the data of Six patients who underwent HALN at the All India Institute of Medical Sciences between January 2019 and December 2022. Indications for surgery included both malignant and benign renal disease. Four surgeries were performed on the right side while two were performed on the left. Five patients underwent a HALN for renal cell carcinoma (RCC) and 1 for a benign non-functioning kidney. In our series, all the cases with RCC had were T2a or higher. Our case series shows that HALN is technically safe, effective, and a great adjunct to conventional laparoscopy. The ingenious use of a surgical glove as a hand port is an easy-to-make-and- use device in such challenging surgeries.

Evaluation of Risk Factors for Lung Cancer Among Never Smokers and Their Association With Common Driver Mutations.

The majority of lung cancers are caused by tobacco use, which is linked to lung tumors of all major histological types. A considerable fraction of lung cancer cases, the vast majority of which are adenocarcinomas, occur in "never smokers," who are characterized as having smoked fewer than 100 cigarettes in their lives. The primary objective was to assess risk factors for lung cancer in non-smokers. In contrast, secondary objectives included evaluating histological subtype, staging, and performance status and exploring associations between risk factors and common driver mutations. The study was a single-center, observational, case-control study done at All India Institute of Medical Science, Bhubaneswar, Indiathat focused on non-smokers with lung cancer. It included 145 cases and 297 controls, with statistical analyses such as chi-square tests and logistic regression used to assess associations between risk factors and lung cancer, considering factors such as socioeconomic status, body mass index (BMI), occupation, outdoor and indoor air pollution, personal habits, and medical history. The study, comprising 145 lung cancer cases in non-smokers and 297 controls, found that 92.4% (134/145) of cases had adenocarcinoma, 6.9% (10/145) had squamous cell carcinoma, and 0.7% (1/145) had small cell carcinoma. Significant associations were observed for high-risk occupations, indoor biomass use without proper ventilation, low BMI, and family history of lung cancer. Specific pre-existing lung conditions like old pulmonary tuberculosis and asthma were linked to increased and decreased odds of developing lung cancer, respectively. Environmental factors, living near heavy industry, and dietary habits showed significant associations. A significant association was not found between the driver mutations and the risk factors studied. This single-center study sheds light on significant risk factors influencing lung cancer development among non-smokers. The predominant occurrence of adenocarcinoma and associations with high-risk occupations, indoor biomass exposure, low BMI, and family history emphasize the multifaceted nature of non-smoking-related lung cancer. The findings underscore the importance of comprehensive risk assessment and targeted preventive strategies in this population.

Clinical Profile and Outcome of Covid-19 Intensive Care Patients with Nosocomial Infections: A Single-Centred Experience from India

Background: Incidences of nosocomial infections in COVID-19 patients admitted to the intensive care unit (ICU) have become a common occurrence. Hospital-acquired infections (HAI) present increased mortality, cost-of-care, especially relevant in multidrug resistant (MDR) infections. Our study aimed to assess the clinical implications associated with HAI-infected COVID-19 patients. Patients and Methods: We conducted retrospective single-centred study on ICU-admitted adult COVID-19 patients for a year i.e., 2021-22 at a tertiary Indian institute and collated data of HAI epidemiological, clinical and microbiological reports. Results: Rate of HIA at our centre was estimated to be 10.29% and the mortality rate was 40.4%. 10 different organisms(Bacteria: 8, Fungi: 2) were detected in HAI, of which the incidence of Gram-negative infections (GNI) was highest i.e., 60% and that of Gram-positive infections (GPI)/Fungi (Fungi infected) were 20% each. Mortality was highest among GPI (36.67%), FI (13.46%), followed by and GPI (7.69%). Tocilizumab treatment decreased the risk of survivability with no significant difference in the treatment outcomes. Conclusion: This study provides a comprehensive picture of nosocomial infections characteristics among COVID-19patients and provides insights regarding the impact of treatment on the outcome of these patients with suggestions for strategies. We found that critically ill patients with COVID- 19 are at a high risk of developing HAI, especially MDR mediated CLABSI and CAUTI. Clinicians must therefore be cautious and mindful during implementing protocols for management of infectious complications with COVID-19 patients.

A Methodology for Improving the Quality of the Research Article Publications in Engineering Institutions in India: A Case Study

A Methodology for Improving the Quality of the Research Article Publications in Engineering Institutions in India: A Case Study

MOOCs: Determinants of Enrolment and Completion Rate among Learners of Higher Education Institutions in India

Aims: The advancement and integration of technology in education made a dramatic change in the landscape of the teaching-learning process. Massive Open Online Courses (MOOCs) as one of the emerging trends in education removed the barriers of time, space, and pace throughout the world. Diverse lifelong learners irrespective of social, cultural, economic, age and gender identity are participating in the melting pot of MOOC. This study aimed to explore the present landscape of the participation and completion rate in MOOCs by learners from formal educational institutions in the eastern part of India specifically in West Bengal. The research also aimed to identify the underlying causes of the present landscape.&#x0D; Place and Duration of Study: The study was conducted among the learners who enrolled in different programs in different Higher Education Institutions (HEIs) during the end of 2023.&#x0D; Methodology: A self-administered questionnaire in Google Forms was used to collect data from the learners. A total 298 samples have been collected. Collected data have been analyzed by descriptive statistics, independent samples ‘t’ test, ANOVA using SPSS and MS Excel.&#x0D; Results: The study depicted poor enrolment as well as completion rates in MOOCs among the learners. Lack of awareness and huge pressure on the present curriculum were the main factors behind non-enrolment. SWAYAM was the most popular MOOC platform among the students of West Bengal. Attaining knowledge, enhancing skills, and earning certificates were the main intentions of the students who enrolled in MOOCs. Lack of time, affordability, in-person proctored examination, non-cooperation of facilitators, length of courses, and uninteresting discussion forum were the major constraints to completing the MOOCs for the enrolled learners.&#x0D; Conclusion: Organizing awareness-building programs, institutional policy framing, and incorporating a credit transfer system into enrolled courses may be emphasized as immediate initiatives for re-thinking the present opportunities and challenges in higher education.

Retinal Vasoproliferative Tumours in Uveitis

ABSTRACT Purpose To describe a cohort of patients with retinal vasoproliferative tumours (RVPT) seen in the uveitis clinic of a single tertiary eye care institute in India. Methods Retrospective Chart Review Results In our study of 17 patients with 18 eyes affected by RVPTs, 94.1% showed unilateral involvement, one patient had bilateral RVPTs, and another had two RVPTs in the same eye. The mean age was 36.3 ± 15.1 years (range: 12–63 years), with a male majority (76.4%). The most common location was inferotemporal quadrant (44.4%). The most common associated uveitic condition was intermediate uveitis (50%). Patients were treated with oral corticosteroid (in 94.1%) and immunosuppressive (35.2%) in addition to transconjunctival cryotherapy (in 52.9%) or laser photocoagulation (in 41.1%). Regression of the RVPT was achieved in all cases except one. Visual acuity at time of detection of RVPT ranged from 6/6 to HM. No significant change was noted in the mean best corrected visual acuity pre and post treatment in the study group. Conclusion RVPTs, rare peripheral retinal lesions often associated with intermediate uveitis, require early diagnosis with targeted therapy to prevent vision loss and achieve favorable long-term outcomes with rare recurrences.

Spatial and temporal variation of cooking-emitted particles in distinct zones using scanning mobility particle sizer and a network of low-cost sensors

Exposure to ambient and household fine-particulate matter is identified as a substantial contributor to premature mortality in India, according to the Global Burden of Disease Studies. This study examines the impacts of typical Indian cooking practices on indoor air quality characteristics by monitoring the evolution of fine and ultrafine particle (UFP) concentration in the dining facility of a residential educational institute in India. The monitoring area was spread across the kitchen (zone 1) and the dining hall (zone 2). A combination of validated low-cost PM sensors (LCS), DustTrak8433, and Scanning Mobility Particle Sizer (SMPS) was utilized for real-time data acquisition while using Liquefied Petroleum Gas (LPG) as the cooking fuel. PM2.5 and UFP concentrations were monitored at 1.3 m and 1.8 m from the floor to assess the vertical variation of pollutants during cooking activities, including breakfast, lunch, and dinner, and processes such as preheating, reheating, stir-frying, and deep-frying. It was found that the prolonged cooking durations involved in high-heat cooking methods like stir-frying and deep-frying resulted in a rise in coarser UFP (300–550 nm) and PM2.5, causing a higher exposure to PM and UFP concentration. PM2.5 levels are higher at upper heights during typical cooking processes because of temperature-driven convection currents and hygroscopic growth of particles due to high humidity levels. Air exchange rates (AER) considerably varied by using chimneys and were low during the controlled (closed doors) compared to mixed ventilation (opened doors) conditions. The maximum AER was obtained during lunch (4.3–9.9 h−1) compared to breakfast (-7.8–6.8 h−1) and dinner (0.55–7.9 h−1). The decrement rate of PM2.5 inside zone 1 was highest during lunch (126 µgm−3 h−1), coinciding with the highest AER during mixed ventilation. It is recommended that improving ventilation and better design of the kitchen can reduce the exposure of PM and UFP in commercial and rural area kitchens.

Governing soils sustainably in India: Establishing policies and implementing strategies through local governance

Years of chemical-intensive agricultural practices following the Green Revolution in the late 1960s have led to extensive soil degradation in India. This has implications for food security, farmers’ incomes, and the country's economy. However, domestic top-down policy mandates in recent times have favoured practices like natural farming with a view to slow down and eventually halt soil degradation. This is in line with the international Sustainable Development Goals (SDGs), one of which is focused on restoring degraded lands (SDG 15.3 aims to strive achieve land degradation neutrality). Taking cue from recent policy mandates on soil and land, this chapter posits the historical significance of the Panchayat — a village-level administrative institution in India — and argues for its involvement in policy implementation for soil rehabilitation at the village level, The article also makes a case for the introduction of an overarching National Soil Policy to encourage natural farming practices and biofertilizer use.

112 Differentiated Thyroid Cancer with Synchronous second Primary Cancer : Retrospective study from a cancer institute in India

112 Differentiated Thyroid Cancer with Synchronous second Primary Cancer : Retrospective study from a cancer institute in India

A Comprehensive Carbon Footprint Assessment Using Integration of GHG Protocol and LCA: A Case Study of an Engineering Institute in India

A Comprehensive Carbon Footprint Assessment Using Integration of GHG Protocol and LCA: A Case Study of an Engineering Institute in India