South India Research Articles

Excess dietary salt is associated with an altered bone strain index, degraded bone microarchitecture, vertebral fractures, and increased prevalence of osteoporosis in postmenopausal women-A study from a teaching hospital in southern India.

Excess dietary salt causes increased urinary calcium and this may lead to bone loss. We proposed to study the association between dietary salt intake and bone health in postmenopausal women from southern India. An observational study in which community-dwelling postmenopausal women were recruited. Daily salt intake and urine calcium/creatinine ratio were assessed. Bone biochemistry and densitometric parameters such as bone mineral density (BMD), trabecular bone score (TBS) vertebral fractures, and bone strain index (BSI) were assessed using Dual Energy X-Ray Absorptiometry (DXA). A total of 383 postmenopausal women with a mean ± SD age of 59.8 ± 7.2 years and BMI of 25.2 ± 4.6 kg/m2 were recruited. Among the participants, 165/383(43.1%) had osteoporosis at any site and 21% had moderate-severe vertebral fractures. The BMD at lumbar spine and femoral neck, TBS and BSI were significantly (p < 0.001) lower and the CTx was significantly (p = 0.008) higher among women with high salt intake (7.2 g/day) as compared to those with salt intake of <7.2 g/day. The prevalence of osteoporosis, low TBS, high BSI, and moderate-severe vertebral fractures significantly increased across low to high salt-intake categories. An ROC analysis showed that excess dietary salt was significantly associated with osteoporosis at any site with an AUC of 0.870 (95% CI: 0.832-0.907). On a multivariate analysis, excess salt intake conferred the highest odds of osteoporosis (OR: 2.296; 95% CI: 1.909-2.761). Excess dietary salt is associated with high urinary calcium and compromised bone health among postmenopausal women from southern India. This may be a modifiable risk factor in osteoporosis and warrants further research.

Geochemistry of shales of middle Permian Barren Measures Formation, West Bokaro Basin, India: implications on provenance, paleodepositional and paleoclimatic conditions

Geochemical analyses of fine-grained clastic sedimentary rocks, such as shales, are significant since they portray the nature of the control factors from source to sink in a sedimentary basin, and help characterizing the heterogeneity in potential source and/or reservoir rocks. Bulk rock geochemistry (including major element oxides, trace elements and rare earth elements) of 20 shale samples from the Permian Barren Measures Formation, West Bokaro Basin, Peninsular India, is presented to decipher the provenance, paleo-weathering, paleotectonic, paleo-depositional and paleoredox conditions of the basin within the Lower Gondwana paleogeographic framework. X-ray diffraction (XRD) peaks and scanning electron microscopy (SEM) reveals an abundance of quartz, muscovite and clay minerals, viz., illite, kaolinite, etc., with less abundant feldspar and glauconite. The concentrations of the major element oxides, the trace elements and rare earth elements (REEs) of the shale samples are compared with predefined standards such as PAAS and UCC. The CIA (chemical index of alteration) and the A–CN–K values, based on the ratios of the major element oxides, signify intense chemical weathering. The ratios of Sr/Cu versus Rb/Sr and K2O/Al2O3 versus Ga/Rb, and high ΣREE values indicate a temperate paleoclimate. Ratios of the major element oxides (e.g., K2O/Na2O versus SiO2) suggest a passive tectonic setting. The Eu/Eu∗ and (Gd/Yb)n values depict predominantly post-Archean granitic and gneissic source rocks. The ratios of trace elements, viz., Th/Sc, Th/Co, Th/Cr, La/Sc and Eu/Eu∗, and the distribution pattern of the REEs (higher LREE in comparison to HREE) attest to a felsic-intermediate source from a nearby provenance. The redox sensitive trace elements, such as V and Ni, indicate a dysoxic condition that prevailed during deposition. The ratios of Fe2O3 versus MgO and Log (MgO/Al2O3) versus Log (K2O/Al2O3), and the ternary plots of Fe2O3–MgO–SiO2/Al2O3 suggest a non-marine to deltaic transitional environment. Such evidence of marine influences during the sedimentation of the Permian Barren Measures Formation confirms the fluvio-marine transgressive paleogeography inferred from sedimentological and paleontological inputs from the Gondwana Basins in Peninsular India, and opens up a scope for regional correlations of paleogeographic changes during the Middle Permian (Guadalupian) across the Gondwanaland.

Groundwater quality assessment for drinking and irrigation purposes and its human health risks in the Sevathur mine region, south India

In this research, 35 samples of groundwater were collected and subjected to analysis with the aim of assessing its appropriateness for both drinking and irrigation purposes in Sevathur mine region, south India. Spatial depiction illustrates the widespread dispersal of primary positively charged ions and negatively charged ions formulated through the Inverse Distance Weighting (IDW) technique within a Geographic Information System (GIS). The Piper and Gibbs plots reveal a variety of water compositions in the surveyed region, encompassing combinations of mixed Ca-Mg-Cl, Ca-Mg-Cl-SO4, Na-K-Cl-SO4, and a few instances falling within the category of Ca-Mg-HCO3. The current features of hydrogeochemical facies result from the interplay between geological formations and water, alongside the occurrence of ion exchange, dissolution and weathering of calcium carbonate, calc-silicate minerals, and halite within subterranean aquifers. The water quality index unveiled that 23% of the samples fall into the poor category, while a substantial 11% are categorized as very poor. Additionally, 3% are undesirable, 17% are unfit for drinking, 23% exhibit a good, and 23% are distinguished by excellent categories. SAR values of subsurface water samples belong to the excellent class. Additionally, the RSC value indicates that 94% of the samples are categorized as suitable class, while 6% are classified as marginal for irrigation purposes. Individuals are advised to avoid drinking groundwater with fluoride levels above the WHO limit (>1.5mg/l), as 26% of samples exceeded this threshold. The region's groundwater chemistry is influenced by natural geological processes, such as mineral dissolution, and ion exchange, as well as human activities, including agricultural practices. Advanced water treatment techniques are being considered to improve water quality and ensure safer drinking water for the community.

Clinically Suspicious Cases of Hansen's Disease at a Tertiary Care Hospital in South India: A Clinicopathological Study.

Background and objective Hansen's disease, also known as leprosy, is a chronic granulomatous condition caused by Mycobacterium leprae, primarily affecting the skin and peripheral nerves. The disease has a wide spectrum of clinical and histopathological manifestations, often mimicking other inflammatory and infectious conditions. This variability poses significant challenges in its early diagnosis and management. Aligning clinical suspicion with histopathological evidence is critical for effective treatment and control of transmission. This study was designed to explore the concordance between clinical impressions and histopathological diagnoses and to understand the diagnostic utility of various histopathological techniques. We aimed to establish and correlate the histopathological types of leprosy with clinical presentations. We also sought to determine the extent to which different histopathological techniques, including special stains, can corroborate with clinical types, thereby enhancing diagnostic precision. Materials and methods This was a hospital-based, retrospective study of clinically suspicious cases of leprosy at a tertiary care hospital in South India. A total of 100 cases of various age groups were identified and included in the study. All cases underwent skin biopsy with samples subjected to routine hematoxylin and eosin (H&E) staining and acid-fast bacilli (AFB) staining for the detection oflepra bacilli. Results Among the 100 clinically suspicious cases of leprosy, 50were histopathologically confirmed as leprosy and 50were categorized as non-specific dermatitis. Among the 50 histologically confirmed cases of leprosy, the most common type was lepromatous leprosy (LL) (38%) followed by borderline tuberculoid (BT) (30%) leprosy.Modified AFBstain was positive in 21 cases and was instrumental in confirming the suspected cases of leprosy. The overall correlation between the clinical and histopathological diagnosis was significant, with the highest correlation noted in LL cases. Conclusions Our findings underscorethe complexity of diagnosing leprosy due to its varied clinical and pathological presentations. Despite a high overall concordance rate, the discrepancies between clinical impressions and histopathological findings observed highlight the need for a multidimensional diagnostic approach. Incorporating a combination of clinical assessment, routine histology, and special staining can enhance diagnostic accuracy, leading to better patient management and outcomes.

Cytogenetic spectrum and clinical presentation of Klinefelter syndrome: A comprehensive study from South India

BackgroundKlinefelter syndrome (KS) is a common sex chromosome abnormality that mostly presents as testicular failure and a myriad of other clinical features. The phenotypic features and their severity vary between individuals, age groups and cytogenetic subtypes. Karyotyping remains the method of choice for the diagnosis of KS despite advanced molecular testing in this modern era. The objective of this study was to determine the cytogenetic subtypes, clinical presentation and hormonal profile of patients with KS. MethodsRetrospective observational study comprised patients with KS determined by cytogenetic analysis at the tertiary care centre in south India from 2001 to 2019. Clinical details including testicular size, hormone levels and semen analysis were obtained from the medical records. ResultsThere were 147 KS (145 post-natal and 2 pre-natal) patients ranging in age from two days to 51 years, 116 (74.8%) patients being ≥18 years. Classic (cKS), mosaic (mKS) and variant KS (vKS) accounted for 126 (85.7%), 9 (6.1%) and 12 (8.2%) cases and their mean ages were 26.6, 29.6 and 12.8 years, respectively. cKS and mKS had diverse clinical presentations including several co-morbidities of which small testes were most common (94.8%). vKS presented with behavioural problems (58.3%) without any comorbidities. Testosterone (p < 0.05), FSH and LH levels were abnormal in >90% of patients. ConclusionAll three cytogenetic subtypes of KS were seen in our patients. cKS was seen in all ages, mKS was common in adults and vKS was seen predominantly in children. Early diagnosis of KS and timely medical intervention may alter the clinical outcomes and improve the quality of life.

Sustainable management of blister and grey blight diseases of tea using antagonistic and plant growth promoting microbes in Western Ghats of India

The blister and grey blights are the devastating leaf diseases in tea. The severity of blister and grey blight diseases in tea ranged from 22% to 68% and 11.41%–57.02%, respectively in a survey conducted in Southern India during 2022–2023. The morphological and molecular identifications of pathogens revealed that Exobasidium vexans and Neopestalotiopsis clavispora were responsible for causing blister and grey blights on tea in southern India. The conventional management strategy with foliar spray of synthetic fungicides result in fungicidal residue in tea causes environmental pollution and health hazards to human. To overcome this the current study aims to manage the blister and grey blight diseases of tea through the microbial biocontrol agents. The bacterial biocontrol agents viz., Bacillus subtilis (BBV57), Bacillus amyloliquefaciens (TNAU), Pseudomonas fluorescens (Pf1) and the fungal antagonist, Trichoderma asperellum (TV 1) were evaluated for their efficacy against the both blight diseases. All the bio agents have significantly reduced the basidiospore germination and the mycelial growth of E. vexans and N. clavispora, respectively. Among the bio agents, B. amyloliquefaciens registered 88.36% reduction in the germination of E. vexans basidiospore and 85.56% of mycelial growth reduction of N. clavispora in vitro (P < 0.05). Under field conditions the combined soil and foliar application of bacterial antagonists viz., B. subtilis, B. amyloliquefaciens and P. fluorescens each with 1 ˟ 1011 CFU/ml @ 5% concentration at 7 days interval significantly reduced the blister blight incidence with 53.53% & 51.53% reduction over control and 51.53% & 43.65% of reduction over initial during first and second year, respectively. The combined application also reduced the grey blight incidence with 53.53% & 52.00% reduction over control and 56.81% & 47.65% of reduction over initial during first and second year, respectively. This treatments with bioagents were almost comparable with synthetic treatments, such as copper oxy chloride (0.25%) and hexaconazole (0.25%) with 64.63% and 64.76% reduction of blister and grey blight reduction in first year; 59.74%, 51.11% reduction in second year over control (P < 0.05), respectively. Thus, the application of B. subtilis, B. amyloliquefaciens and P. fluorescens can be recommended for the sustainable management of tea blister and grey blight diseases in tea gardens.

Multistage magmatic and post-magmatic evolution of the Neoarchaean Closepet Batholith of Dharwar Craton in southern India - insights from the texture and chemical composition of titanite

Titanite is often used to describe the path of igneous, metamorphic, and hydrothermal processes. Therefore, titanite can unravel the multistage magmatic and post-magmatic evolution of granitoids. In this study, we present a comprehensive study of the ca. 2.57–2.51 Ga Closepet Batholith in the Dharwar Craton of southern India using titanite. This granitoid body provides a unique opportunity as various structural levels of the batholith are continuously outcropping. The textural and geochemical studies of titanite, supported by UPb isotopic dating, allowed us to distinguish five generations of magmatic and hydrothermal titanite. Three types of magmatic titanite demonstrate stage-growth crystallization (type I) and a change from reduced, high-temperature (type II) to oxidised, low-temperature conditions (type III). Hydrothermal titanite is recorded as altered titanite with zoned to patchy textures and secondary fractures and veinlets (type IV) and titanite inclusions within biotite (type V). Hydrothermal titanite (type IV) shows depletion in rare earth elements and high-field strength elements, indicating mobilization of those elements by a fluid. UPb dating by LA-ICP-MS of magmatic titanite type I yielded ages of ca. 2.5 Ga, consistent with the timing of formation of the Closepet Batholith. The relationship between titanite textures and chemistry indicates that titanite serves as a recorder of the multistage magmatic and post-magmatic evolution of the Closepet Batholith. In addition, our study shows that hydrothermal activity affected a large area, with fluids circulating over long distances within the upper structural levels of the Closepet Batholith.

Thyrotoxic periodic paralysis - a retrospective study from Southern India.

Thyrotoxic periodic paralysis is a rare manifestation of thyrotoxicosis. Here, we describe the clinical and biochemical features and treatment outcomes of this disorder. This retrospective study was conducted at a tertiary care centre in southern India. The clinical and biochemical features, treatment received, and therapeutic outcomes of all patients with thyrotoxicosis and acute flaccid paralysis without any other identifiable causes (cases for the study) were compared with an equal number of consecutively selected patients who presented with thyrotoxicosis but without features of paralysis (controls for the study) during the same period. In total, 41 cases and controls were included in this study. The proportion of males was 92.6% and 43.9% in the cases and controls, respectively. The mean age was 32.8 (±7.6) years (cases) and 39.7 (±11.3) years (controls). In the cases, 20% of patients presented without clinical thyrotoxic features. Graves' disease was the most common aetiology of thyrotoxicosis in both groups (92.6% of cases and 87.8% of controls). The prevalence of goitre was significantly higher among controls (90.2%) than among cases (53.7%). The mean serum potassium, free T4, total T4 and total T3 levels were significantly lower in the cases than in the controls. In these cases, two patients had an additional aetiology for persistent hypokalaemia, likely Gitelman's syndrome. This is one of the largest series of thyrotoxic periodic paralysis cases in India. In subjects with thyrotoxicosis, serum potassium, free T4, total T4 and total T3 levels were significantly lower in those with periodic paralysis than in those without.

Efficacy and Safety of Adding 6 Weeks of Doxycycline to the Essential Package of Care to Treat Filarial Lymphedema: A Double-Blind, Randomized, Controlled Trial in Southern India.

Finding additional ways to manage lymphedema due to lymphatic filariasis (LF) is a primary concern for the Global Program to Eliminate Lymphatic Filariasis. The WHO-recommended Essential Package of Care (EPC) consists of skin hygiene, elevation of affected limbs, exercise, protective shoe ware, wound care, and supportive therapy for acute phases. The care program has been successful but often hard to maintain. A double-blind study reexamined previous findings that doxycycline treatment could improve the lymphedematous changes in LF patients. The present study was carried out in a semi-urban location of Kerala, southern India, where Brugia sp. is the predominant parasite, and LF mass drug administration had ceased in many areas. Two hundred individuals (aged 14-65 years; 142 females and 58 males) with lymphedema of stages 1-3 were instructed in the EPC and were randomly administered either 200 mg doxycycline or an identical-appearing placebo daily for 6 weeks. Data were collected at 0, 3, 6, 12, 18, and 24 months and included the state of the lymphedema (size, cleanliness, skin thickness and changes), occurrence of adenolymphangitis (ADL) attacks, and patients' quality of life (QOL). The results demonstrated no difference over time between the two arms of the study; virtually all patients of both groups showed either improvement or "no worsening" in the parameters during the 2-year study period. Importantly, this rigorous trial confirmed that the EPC is of substantial benefit to lymphedema patients by reducing acute ADL and improving their QOL and clinical condition.

Dynamic evolution of meteorological and hydrological droughts under climatic and anthropogenic pressures in water‐scarce regions

AbstractClimate change and anthropogenic influences amplify drought complexity, entangle non‐stationarity (NS) and further challenge drought comprehension. This study aims to understand the dynamic evolution of drought propagation patterns due to climatic and anthropogenic pressures by assessing the non‐stationary linkages between hydrological variables and drought characteristics. It employs four standardized drought indicators to comprehensively examine the spatio‐temporal evolution of meteorological (MD) and hydrological (HD) drought characteristics. Data from 29 semi‐arid catchments from six river basins in Peninsular India, are analyzed to uncover distinct drought propagation patterns. This study utilizes a novel Non‐overlapping Block‐stratified Random Sampling (NBRS) approach to detect NS in drought characteristics and hydrological variables, shedding light on the underlying drivers of this dynamic behavior. The results indicate similarities in drought behavior for the Sabarmati, Mahi and Tapi (SMT) basins compared with the Godavari, Krishna and Pennar (GKP) basins, with shorter (longer) propagation times noted for SMT (GKP) basins. While HD severity decreases over time in SMT basins, it intensifies in GKP basins, which are linked to intensive anthropogenic interventions such as river regulation and reservoir operations, thus resulting in prolonged and intensified droughts. Rainfall primarily exhibits time‐invariance, while significant NS is observed in potential evapotranspiration (particularly in the Krishna and Pennar basins), streamflow and baseflow across all basins. The study also identified three distinct drought propagation patterns in these basins, highlighting cases where MD did not transition to HD, instances of HD occurring without preceding MD and synchronous propagation of MD to HD. The study outcomes provide profound insights into the evolution of drought dynamics under climatic and anthropogenic pressures, which will aid policymakers and stakeholders in formulating strategies for drought preparedness and response.

EP.12A.37 Erlotinib: A Beacon of Hope in EGFR TKI-Progressed Lung Cancer, A Real-World Experience from a Tertiary Care Cancer Centre in South India

EP.12A.37 Erlotinib: A Beacon of Hope in EGFR TKI-Progressed Lung Cancer, A Real-World Experience from a Tertiary Care Cancer Centre in South India

Heat Stress Nephropathy: An Emerging Epidemic of Global Warming.

Climate change has led to global warming since the last century, which has adverse health consequences. Heat stress nephropathy (HSN) is such a disorder that is emerging as an epidemic because of heat exposure, dehydration, and shortage of drinking water. HSN has been suspected to occur in different parts of the world. Many cases of chronic kidney disease of unknown etiology (CKDu) such as Mesoamerican nephropathy and Sri Lankan nephropathy are now being considered as HSN. Influences of agrochemicals (e.g., pesticides), heavy metals (e.g., cadmium, lead, arsenic, and fluoride), and genetic polymorphism were suspected for causation of CKDu in those cases, but results were inconsistent in different studies from different locations. Drinking water with high silica and strontium was also found in a region with high CKDu in South India.1 Malnutrition and infections such as leptospirosis can also cause CKDu. It is not clear whether CKDu in different hot locations studied represents a single disease or a group of different disorders, but the common factors found are heat and related dehydration. However, combined effects may also be possible. Dehydration from heat stress increases toxin exposure of different organs because of higher blood and urine concentration, as chronically dehydrated patients may not excrete toxic substances effectively. Also, the wells and water reservoirs are more concentrated with toxic substances because of hot weather due to evaporation.

Glycemic Control and Its Relationship Between Lipid Profiles and Thyroid Profiles: Insights from a Case? Control Study from Coastal Karnataka, South India

Glycemic Control and Its Relationship Between Lipid Profiles and Thyroid Profiles: Insights from a Case? Control Study from Coastal Karnataka, South India

Impact of post-pulmonary tuberculosis sequelae and its management in a tertiary care facility in South India

BackgroundPost-pulmonary Tuberculosis (PTB) sequelae are chest alterations caused by pulmonary tuberculosis problems, even after treatment and infection elimination. These alterations can cause pulmonary dysfunction, ranging from mild irregularities to acute dyspnea, increasing the risk of respiratory-related deaths. Current research aims to investigate the type, severity, clinical management, and impact on quality of life in affected individuals. Materials and methodsA prospective observational study with 66 patients was carried out in a South Indian tertiary care facility. We gathered sociodemographic and clinical data from the patients. Imaging investigations (chest X-ray, CT scans) and pulmonary function test reports (Spirometry) were used to assess the post-pulmonary TB sequelae. The patient's quality of life was evaluated using the WHOQoL-BREF questionnaire. ResultsOut of 66 patients, 66.7% were men, and the average age was 57.2 years. According to radiological analysis, most patients had airway difficulties (38%), followed by parenchymal problems (36.3%). Obstruction was the most typical abnormality identified (81.9%). Bronchodilators, LABA + ICS, SABA, leukotriene antagonists, antibiotics, and other fixed medications treat post-PTB sequelae. Substantial impairment was observed in quality of life. ConclusionPatients who have had pulmonary TB are prone to post-TB respiratory symptoms and sequelae. The quality of life noticeably declined. This study's findings underscore the importance of robust, evidence-based guidelines and practical implementation techniques for managing post-pulmonary TB.

Retrospective analysis of volumes of manually expressed colostrum among healthy postnatal mothers at a tertiary care referral unit in South India. Not enough milk or not enough patience?

IntroductionThe volumes of colostrum have been quantified as 5 mL and 25 mL per feed on days 1 and 3, respectively, as per the data described about 20 years ago....

Unraveling Sepsis Epidemiology in a Low- and Middle-Income Intensive Care Setting Reveals the Alarming Burden of Tropical Infections and Antimicrobial Resistance: A Prospective Observational Study (MARS-India).

Our study addresses the sepsis research gap in lower middle-income countries, notably India. Here, we investigate community-acquired sepsis comprehensively and explore the impact of tropical microbiology on aetiology and outcomes. MARS-India was a prospective observational study from Dec-2018 to Sep-2022 in a tertiary-care hospital in South India. Adult patients within 24hrs of ICU admission meeting the Sepsis 3.0 definition were enrolled, with 6-months follow-up (http://clinicaltrials.gov number NCT03727243). Over 4000 patients were screened on ICU admission, with 1000 unique patients meeting the inclusion criteria. Median age was 55 years (IQR: 44-65) with a male preponderance (66%). Almost half the cohort resided in villages (46.5%) and 74.6% worked in the primary sector. Mortality in-hospital was 24.1%. Overall, ∼54% had confirmed microbiological diagnosis. Over 18% had a viral cause of sepsis. Surprisingly, we identified leptospirosis (10.6%), scrub typhus (4.1%), dengue (3.7%) and Kyasanur forest disease (1.6%) as notables causes of sepsis. All these infections showed seasonal variation around the monsoon. In community-acquired infections we observed substantial resistance to 3rd generation cephalosporins and carbapenems. In India, sepsis disproportionally affects a younger and lower socio-economic demographic, yielding high mortality. Tropical and viral sepsis carry a significant burden. Analyzing local data, we pinpoint priorities for public health and resources, offering valuable insights for global sepsis research.

Genetic Characterization of Methicillin-Resistant Staphylococcus aureus Isolated From Diabetic Foot Ulcers in a Tertiary Care Hospital in Mysuru, South India.

Background Diabetic foot ulcers (DFUs) are common complications in diabetes patients, often leading to sepsis and leg amputation. Methicillin-resistant Staphylococcus aureus (MRSA) infections in DFUs pose challenges due to methicillin resistance with mecA and mecC genes. This study aims to assess the prevalence of MRSA in clinical isolates from DFUs,analyze the antibiogram of MRSA isolates, and detect the presence of the mecA and mecC genes among MRSA isolates. Methodology The isolated S. aureus colonies were identified and antimicrobial susceptibility was performed using the Vitek-2 Compact system. Methicillin resistance was also confirmed through the disc diffusion method. Confirmed methicillin-resistant isolates were subjected to real-time polymerase chain reaction (RT-PCR) to detect mecA and mecC genes. Results A total of 474 purulent samples from DFUs yielded 541 distinct isolates, comprising 201 gram-positive and 340 gram-negative organisms. Among the gram-positive organisms, Staphylococcus species predominated, with 79 S. aureus isolates, 34 of which were methicillin-resistant. All MRSA isolates (100%) were sensitive to tetracycline, linezolid, teicoplanin, and vancomycin, and 94% were sensitive to cotrimoxazole but least susceptible to ciprofloxacin and levofloxacin. RT-PCR confirmed the presence of mecA genes in all 34 isolates and mecC genes in three isolates. Conclusions The presence of mecA in all 34 MRSA isolates underscores consistent methicillin resistance. The co-occurrence of mecA and mecC in three isolates hints at genetic diversity. Two MRSA isolates positive for mecC were isolated from rural patients involved in farming and animal husbandry, suggesting an occupational risk. The third patient was from a non-rural area, indicating potential alternative transmission pathways warranting further investigation.

Knowledge and self-care behavior among heart failure patients in South India

BACKGROUND: Heart failure (HF) is a chronic condition with significant public health concerns. HF necessitates adequate knowledge and adherence to self-care for enhanced quality of life and decreased rehospitalization. This study aimed to explore knowledge and self-care behavior in patients with HF. MATERIAL AND METHODS: The study was conducted in cardiology wards of a tertiary care hospital and the design was a randomized controlled trial. The baseline data (before the intervention) from 160 HF patients enrolled in a randomized controlled trial were analyzed. Knowledge and self-care behavior were measured using the Dutch HF Knowledge Questionnaire (score ranging from 0 to 15) and European HF Self-care Behavior Scale-9 (score ranging from 0 to 100). Higher scores indicated better self-care behavior and knowledge. Descriptive statistics such as frequency, percentage, mean, and standard deviation and inferential statistics such as independent sample t-test and ANOVA were performed. RESULTS: The majority (75.0%) were men with a mean age of 56.1 ± 7.9 years. A significant proportion had hypertension (65%), diabetes (58.7%), or both comorbidities (40.6%). Most exhibited a left ventricular ejection fraction &lt;30% (60.6%) and New York Heart Association class II (43.1%). The mean knowledge and self-care behavior scores were 7.1 ± 2.0 and 45.0 ± 12.4, respectively. Over half of the participants had inadequate self-care behavior (51.2%), and 88.3% lacked sufficient knowledge about HF. Medication adherence was high (87.0%) among the participants, while only 3.1% reported regular weight monitoring and 32.3% exercised regularly. CONCLUSIONS: There was a lack of HF-related knowledge and inadequate self-care behavior for HF management. Effective interventions to improve disease-related knowledge may lead to better self-care behavior and improve clinical outcomes.

Comparison of Low-dose Diluted Hyperbaric Bupivacaine and Standard Hyperbaric Bupivacaine in Subarachnoid Block for Ambulatory Endovenous Laser Ablation of Varicose Vein: A Randomized Controlled Trial

Abstract Background: Low-dose spinal anesthesia represents a highly coveted anesthetic technique for patients undergoing endovenous laser ablation of varicose veins in a day-care setting, given its prompt onset, reliable anesthesia, brief turnover time, and cost-effectiveness. Given that intense motor block is not required for this procedure, this trial compared the efficacy of low-dose diluted hyperbaric bupivacaine with standard hyperbaric bupivacaine in the subarachnoid block for endovenous laser ablation of varicose veins. Methodology: A prospective, randomized controlled trial at a tertiary care hospital, Tamil Nadu, South India. Sixty individuals with varicose veins requiring endovenous laser ablation surgery were split at random into two groups. Group A (n = 30) got 0.5% hyperbaric bupivacaine 10 mg (2 ml), Group B (n = 30) got diluted hyperbaric bupivacaine 5 mg (1 ml of 0.5% hyperbaric bupivacaine diluted with an equivalent volume of normal saline) intrathecally. This study evaluated the time to surgical readiness, peak sensory block level, motor block grade, sensory block level at the completion of surgery, duration of motor and sensory blocks, and timing of discharge. Results: The median peak sensory block level for Group A was T6 (T8–T6), whereas for Group B it was T8 (T10–T6), with a P = 0.03. At the conclusion of surgery, the median sensory block level was T6 (T6–T8) for Group A and T8 (T7–T10) for Group B. No patients in either group needed a rescue analgesic. The average timing of discharge for Group B was shorter (P = 0.00002). Conclusion: For patients receiving endovenous laser ablation therapy for varicose veins, subarachnoid blockade with low-dose diluted hyperbaric bupivacaine (5 mg) offers an effective anesthesia, the best recovery profile, and early hospital discharge.

A retrospective study to assess adolescent nutritional deficiencies and the association with post-COVID-19 status

ABSTRACT Introduction: Adolescents represent 16% of the world’s population and around 21% of the Indian population. A study was done to assess the double burden of malnutrition, the proportion of inadequate intake of some important macronutrients and micronutrients, and the impact of COVID-19 pandemic on nutrient intakes among adolescents. Methodology: Retrospective data analysis of the adolescents presented at the Adolescent Health Clinic at a teaching hospital (tertiary care level) in Andhra Pradesh, India, between September 2022 and December 2022 was done in the current study. Results: A total of 800 adolescents were studied with the mean age of the participants as 15.8 (±2.38) years of age. Among the participants, the majority (59%) were immunized with Td vaccination at 10 years and/or 16 years, 21% were not immunized, and the rest 20% did not remember the status. Only 17 participants had a history of COVID-19 infection in the past. The majority (62.75%) of the participants belong to normal nutrition status as per BMI for age WHO growth charts. There is a significant difference in the nutrition status between males and females belonging to overweight and obese subgroups. There is no significant difference in the intake with respect to past COVID-19 status. Almost all the participants take inadequate amounts of carbohydrates (calories), pyridoxine, folate, iron, calcium, vitamin D3, and retinol. Protein intake is inadequate in 63% of participants, and the deficient intake rises with the age with respect to both EAR and RDA guidelines. Conclusion: A large proportion of adolescents suffer from the double burden of malnutrition in South India, and almost all the adolescents do not get the recommended intake of most of the macro- and micronutrients in their diet following the lockdown and online schooling due to the COVID-19 pandemic.