South India Research Articles

Exploring the clinical utility of exome sequencing/mono, duo, trio in prenatal testing: a retrospective study in a tertiary care centre in south India.

With the availability of Next Generation Sequencing (NGS) diagnosis of genetic disorders has improved significantly. Its use is also applicable to ascertain diagnosis and management in a perinatal setting. The study aims to detect the genetic aetiology of various congenital structural and functional defects using NGS technology in the reproductive cohort at a tertiary centre. The secondary objective is to address challenges in the interpretation of variants. This was a retrospective study of couples who underwent exome sequencing (Mono-testing proband only or Duo-testing parents only or Trio-testing proband and parents) for suspected single gene disorders between years 2020-2022 at a tertiary care perinatal center in the South India. American College of Medical Genetics (ACMG) guidelines were followed to classify the pathogenicity of the variants identified by exome sequencing. The overall diagnostic yield as defined by pathogenic/likely pathogenic variants obtained was (23/43) 53.4 %. The individual subsets have the following diagnostic yield viz., Mono 5/6 (83 %); Carrier 16/32 (50 %); Trio 2/5 (40 %). Diagnostic yield was significantly higher in consanguineous couples. However, miscarriage history, and organ system involvement did not have a significant effect on the diagnostic yield. Prenatal diagnosis was offered for seven patients based on the exome result. One fetus was confirmed with a compound heterozygous pathogenic variant. Diagnostic yield of exome sequencing in our cohort was 53 %. The detection of pathogenic variants was maximum in those cases undergoing mono exome sequencing. In places where there is a high prevalence of consanguinity and endogamy, NGS may be offered as first line test in the context of prenatal diagnosis.

Clinical Profile of Pediatric Oncology Patients Treated by Radiotherapy: A Retrospective Audit from a Tertiary Cancer Care Center in South India

Clinical Profile of Pediatric Oncology Patients Treated by Radiotherapy: A Retrospective Audit from a Tertiary Cancer Care Center in South India

Understanding the social identity of adolescents in the Indigenous Kodava Community of India.

The social identity development of adolescents in marginalized communities across the globe holds paramount significance in determining the overall well-being of its future population. Focusing on one such community, the Kodavas, an Indigenous community in South India, this study aims to understand the shifting configurations of social identity based on the changing sociocultural structure and its implications on identity perception among the adolescents belonging to the Kodava community in Kodagu district in Karnataka, India. This study used a qualitative research design to develop an analytical framework of social identity formation and its transitions in the context of the Kodavas. Data were collected from 188 adolescents (47% boys, 53% girls) between 13 and 17 years (M age = 15 years), in the form of essay writing. The findings based on thematic analysis highlight the core traditional elements of Kodava identity, factors influencing the transition in identity, and its reflection in the contemporary period.

Detecting ‘green shoots’ of agri-food systems transformation: a framework and insights from the spread of non-pesticide approaches in South India

ABSTRACT System innovation is a signature feature of agri-food system transformation. Such system innovation often occurs in niches. However, how the "green shoots" of transformation can be detected and appraised through time remains ambiguous. This paper proposes, applies and tests a framework that could be used as a ‘transformation assessment tool’ to evaluate the level of system innovation in a domain of change. The framework is tested against a case study of a Non-Pesticide Management initiative in South India. The framework helps to reveal how, over 20 years, the initiative triggered a number of system innovations that opened a new development pathway, more aligned to environmental sustainability, equity and social inclusion. A critical enabling factor identified for the expansionand "blossoming" of this green shoot was its capacity to flexibly respond and adapt to emergent and largely unknowable agri-food systems dynamics. In its conclusions, the paper sheds light on the ongoing tensions around the defining benchmarks or thresholds for assessing the ‘transformativeness’ of initiatives and change processes. Finding a way of combining qualitative assessments of system changes with quantitative measures of social, economic, and environmental impact could be a valuable vein of research to enhance our understanding of transformative processes and how to enable them.

A First Case Report of Talaromyces marneffei Infection in a Person with Immunocompromised Rheumatoid Arthritis and Non-HIV Diabetes in South India

A First Case Report of Talaromyces marneffei Infection in a Person with Immunocompromised Rheumatoid Arthritis and Non-HIV Diabetes in South India

The Moderating Effects of Gender and Age in the Relationship Between 
Job Insecurity and 
Turnover Intention 
During the Global Pandemic

This article explores the effect of perceived job insecurity on employees’ turnover intention during the global pandemic. A conceptual model was developed and tested with data collected from 398 faculty members in higher educational institutions in Southern India. After checking the instrument’s psychometric properties using structural equation modelling, the hypotheses were tested using hierarchical regression. The results indicate that three dimensions of job insecurity—the perceived threat to job features, the perceived threat to total job and the feeling of powerlessness—are positively associated with turnover intentions of faculty members. The results also reveal that age and gender moderated the relationship between (a) perceived threat to total job and turnover intention and (b) feeling of powerlessness and turnover intention. This study recommends that administrators not underestimate the perils of perceived job insecurity in terms of turnover intentions and steps need to be taken to ensure that employees feel safe and continue to work. This study highlights a simple fact: If adequate steps are not taken, crises like the global pandemic may adversely affect organisations.

Meat on and off the Royal Menu: The Medieval Delight of the Mind & the Erasure of Meat from Indian Recipe Collections

ABSTRACT A close study of the twelfth-century Delight of the Mind’s (Mānasollāsa’s) section on cooking called “The Enjoyment of Food” reveals that meat dominated the royal menu in medieval South India. The valuable recipes in this Sanskrit royal encyclopedia’s section of 258 verses on food detail primarily how to prepare wild fish and game, but also meat from tortoise, bandicoot, ram (mutton), other domesticated animals, and an array of delectable foods of the period. Consuming almost all animals that moved in the kingdom formed part of Western Chalukyan emperor Someśvara´s assertion of royal dominion, yet investigation into this recipe collection’s textual history as well as that of other royal recipe collections suggests that the once abundant meat recipes have often been removed from the record, leaving the false impression of more vegetarian dietary practice than really pertained to South Asia’s past. This later “veggie-washing” concerns Hindu ideologies of nonviolence and the disavowal of animal slaughter in ritual sacrifice, both of which originated in Jain and Buddhist ideologies yet have become attached to Hindu ideals of vegetarianism, forming part of a new moral culinary imperative that has advanced over roughly the second millennium of the Common Era. Exploring this topic using the lens of power and politics as they relate to food and dining allows the reader to observe shifts in royal culinary writing as these texts became permeated with religious ideals.

Social capital of families of children with neurodevelopmental disabilities in South India.

To investigate the social capital of families with children with neurodevelopmental disabilities in South India receiving a community-based early intervention (Enabling Inclusion®) program and to explore determinants and associations between social capital and program duration, socio-demographic factors, family empowerment, and caregiver burden. Using purposive sampling in a cross-sectional study design, 217 families (n = 71 received short Enabling Inclusion [<5 months]; n = 146 received long Enabling Inclusion [>9 months]) were recruited and completed the Short Adapted Social Capital Tool (SASCAT: cognitive, structural), measures of family empowerment, and caregiver strain. Descriptive statistics, regression, and correlations were used for analyses. In 52.1% of participants, low cognitive and structural social capital was observed. Higher odds of low structural social capital were observed for mothers with primary versus secondary education (adjusted odds ratio [OR] = 0.35; 95% confidence interval [CI] 0.13-0.90; p = 0.029); and caregivers of children with cerebral palsy versus autism (OR = 4.66; 95% CI 1.02-21.21; p = 0.046). Significant associations were found between structural social capital, the child's age, and support group membership (χ2 = 6.29; 4.70; degrees of freedom [df] = 2; 1; p = 0.04; p = 0.02 respectively), as well as between cognitive social capital and other disability in the family (χ2 = 4.62, df = 1, p = 0.03). While program duration was not found to mediate social capital, mother's education and child's diagnosis emerged as key influential factors, warranting their consideration in interventions supporting families of children with neurodevelopmental disabilities in low- and-middle-income countries and elsewhere.

Immune profiling reveals umbilical cord blood mononuclear cells from South India display an IL-8 dominant, CXCL-10 deficient polyfunctional monocyte response to pathogen-associated molecular patterns (PAMPs) that is distinct from adult blood cells.

Neonate responses to pathogen-associated molecular patterns (PAMPS) differ from adults; such understanding is poor in Indian neonates, despite recognised significant infectious risk. Immune profiling analysis was undertaken of ten secreted mediators contextualised with cellular source induced by six PAMPs in umbilical cord (CB; n=21) and adult-blood (PBMC, n=14) from a tertiary care hospital in South India. Differential cytokine expression analysis (minimum log2-fold difference; adj p-value<0.05) identified bacterial PAMPs induced higher concentrations of IL-1β, IL-10, TNF-α in adults versus IL-8, GM-CSF, IFN-γ and IL-2 in CB. CB responded to poly I:C and SARS-CoV-2 lysate with a dominant IL-8 response, whereas, in PBMC, CXCL-10 dominated poly I:C, but not SARS-CoV-2, responses, highlighting potential IL-8 importance, in absence of Type I Interferons, in antiviral CB immunity. Candida albicans was the only PAMP to uniformly induce higher secretion of effectors in CB. The predominant source of IL-8/IL-6/TNF-α/IL-1β in both CB and PBMC was polyfunctional monocytes and IFN-γ /IL-2/IL-17 from innate lymphocytes. Correlation matrix analyses revealed IL-8 to be the most differentially regulated, correlating positively in CB versus negatively in PBMC with IL-6, GM-CSF, IFN-γ, IL-2, consistent with more negatively regulated cytokine modules in adults, potentially linked to higher anti-inflammatory IL-10. Cord and adult blood from India respond robustly to PAMPs with unique effector combinations. These data provide a strong foundation to monitor, explore, mechanisms that regulate such immunity during the life course, an area of significant global health importance given infection-related infant mortality incidence.

Morphology and morphometry of morphotypes in the population of Artemia franciscana (Kellogg, 1906) from salterns of the southeastern coast of India.

We document the morphology, morphometric variations among the morphotypes of the brine shrimp, Artemia franciscana. From the samples collected at four different locations in South India, Tamil Nadu viz. Kelambakkam, Vedaranyam, Tuticorin and Nagarcoil we identified six morphotypes: M1, M3, M4 in males and F1, F2, F3 in females. The Scanning electron micrographs of male morphotypes show distinct variation in the basal width, shape and number of cuticular cones on the second antennae. Similarly, the female morphotypes show various shape and sizes of the ovisac with or without spines. However, the cyst surface topography is smooth without any specific variation/ornamentation in all three female morphotypes. Multivariate analysis of eighteen morphological traits measured in males and fifteen in females to elucidate the intraspecific variations among morphotypes indicate significant dissimilarity between males and females. Furthermore, relative length measurements showed distinct morphometric variation of traits between the morphotypes encountered at different sampling sites.

A Ten-Year Experience of Musculoskeletal Tuberculosis at a Tertiary Care Hospital in South India

A Ten-Year Experience of Musculoskeletal Tuberculosis at a Tertiary Care Hospital in South India

Impact of scaling up of kangaroo mother care on neonatal mortality among babies born with birth weight

ObjectiveTo assess the impact of scaling up of kangaroo mother care (KMC) on neonatal mortality among babies born with birth weight <2000 g across an entire district in southern India.Design,...

Winter monsoon brings substantial terrestrial aerosols to Bay of Bengal and adjacent Indian Ocean: Insights from carbon and nitrogen isotopes

It has been currently recognized that air pollutants (e.g., carbon and nitrogen) from South and Southeast Asia have a significant impact on the coastal waters of the northern Indian Ocean. However, the understanding of the dynamics and fates of these pollutants in aerosols to the remote ocean through long-distance transportation still needs to be improved. To address this issue, stable isotopic compositions (δ13C, δ15N) of total carbon (TC) and nitrogen (TN) and other geochemical indexes in aerosols are investigated over the Bay of Bengal (BOB) and the adjacent Indian Ocean during the winter monsoon period. The concentrations of TN, TC and aerosol nutrients exhibited a decreasing trend from the northern BOB (N-BOB) to the southern BOB (S-BOB) and Indian Ocean, reflecting the weakening trend of polluted continental influence from the N-BOB to the ocean. The high concentrations of TC (4.28-18.21 μg m-3) in the aerosols of the N-BOB are mainly influenced by the emissions of coal combustion (68±21%), while the high concentrations of TN (0.69-7.31 μg m-3) in the N-BOB are mainly from biofuel/biomass burning (52±31%). In the S-BOB, the lower concentrations of TC (1.42-2.98 μg m-3) and TN (0.38-2.03 μg m-3) mainly originated from the formation of secondary aerosols and the changes in aerosol chemical composition during long-distance transportation from the continent. The primary marine source was responsible for the low TC and TN concentrations over the Indian Ocean. This study quantifies the nitrogen and carbon source shifts from continental anthropogenic activities in the N-BOB to dominant marine and photochemical transformation sources in the S-BOB and the adjacent Indian Ocean, quantitatively deepening the understanding of the impact of terrestrial aerosols on the ocean.

Posterior urethral valve in neonates - overview in a tertiary care center

Background: Posterior urethral valves are a unique obstructive pathology occurring in male children. Although known to present during various age groups when diagnosed in the neonatal period itself the outcome is better. Aims and Objectives: To study the incidence, clinical presentation, investigations, and management of neonates with posterior urethral valves and compare with literature. Materials and Methods: Retrospective study of neonates admitted to Government Mohan Kumaramangalam Medical College Hospital in South India for 1 year from August 2022 to July 2023. Results: Of a total of 16 cases studied the age of incidence of posterior urethral valve is 1–28 days with antenatally detected in nine cases. Fulguration was done in all 14 cases with vesicostomy in one case, bilateral ureterostomy in one case, and death in one case. Conclusion: Posterior urethral valve is a rare neonatal disease which is most often diagnosed antenatally. The investigations and modalities of management in our institution are inline with other studies in literature.

Phylogenomic analysis expands the known repertoire of single-stranded DNA viruses in benthic zones of the South Indian Ocean

Phylogenomic analysis expands the known repertoire of single-stranded DNA viruses in benthic zones of the South Indian Ocean

Coronal Plane Alignment Classification of Arthritic Knees in a South Indian Population and Functional Outcome Comparison Post-mechanical Alignment Total Knee Arthroplasty

Coronal Plane Alignment Classification of Arthritic Knees in a South Indian Population and Functional Outcome Comparison Post-mechanical Alignment Total Knee Arthroplasty

Characterizing the stable oxygen isotopic composition of the southeast Indian Ocean

New seawater stable oxygen isotope (δ18O) samples were collected from the southeast Indian Ocean as part of the Coring to Reconstruct Ocean Circulation and Carbon dioxide Across 2 Seas (CROCCA-2S) expedition in November – December of 2018. These data fill a gap in the δ18O sampling coverage of the southern Indian basin, providing new insights into the hydrologic and oceanographic processes influencing the δ18O distribution of the region and its relationship to salinity in the upper ocean. Our surface ocean data (<100 m)—in combination with decades of observations from the broader south Indian Ocean—show distinct δ18O – salinity characteristics on either side of ~85°E. The balance between evaporation and precipitation yields a strong, robust δ18O – salinity relationship west of 85°E (δ18O = 0.50(±0.01) * S – 17.2(±0.22)). However, within the mesoscale eddy field initiated by the Leeuwin Current further east (~85–120°E), our observations fall along a mixing line between the southwest Indian Ocean and data collected from the Australian coastal margin, illustrating for the first time how the unique eastern boundary system of the south Indian Ocean drives regional-scale variability in the δ18O – salinity relationship of the surface ocean. A comparison between our observations in the shallow subsurface (100–1000 m) and those from neighboring surveys reinforces this upper ocean connection across the Indo-Australian basin. Antarctic Intermediate Water from the Indian Ocean can be isotopically distinguished from the more regional Tasman Intermediate Water occupying the South Australian Bight, suggesting exchange between the two regions is most prevalent at surface and mode water depths. In deeper waters (> ~1500 m), we observe a notable 0.87‰ spread in δ18O. This variability may represent interactions between distinct deep water masses in the region, although additional data are needed to confirm. Overall, our data provide a new look at the hydrography and isotopic chemistry of the southeast Indian Ocean, emphasizing the impact of the region's mesoscale eddy field and its interconnectivity with neighboring basins.

Emerging pattern of asymptomatic hyperparathyroidism in South India - a six-year retrospective study.

Primary hyperparathyroidism (PHPT) is a common endocrine disease with a variable presentation. There is a recent increase in the number of asymptomatic cases due to the use of multichannel automated analyzers.

Emerging Hypertension in Young Adults: A Detailed Case Report on Takayasu Arteritis in a 29-Year-Old Female from South India

Abstract Introduction: Takayasu arteritis is a rare vasculitic disorder predominantly affecting young women, characterized by inflammation of the aorta and its major branches usually seen in the East Asian population. Due to its varied clinical presentation, early diagnosis remains challenging, necessitating a high index of suspicion. Case Report: A 29-year-old South Indian female presented with exertional dyspnea to the emergency department and was initially diagnosed and treated as middle lobe pneumonia. Further physical and laboratory evaluations done at that time were unremarkable. Following successful treatment, she remained largely asymptomatic and sought evaluation at the local clinic due to elevated blood pressure detected during home monitoring. On work up of hypertension Echocardiography was done which showed unusual wall thickening of the ascending aorta and mild aortic regurgitation .CT aortogram was then done which revealed aortic thickening and left renal artery stenosis. Confirmation of takayasu arteritis was achieved through PET-CT imaging at a higher tertiary care centre, leading to initiation of immunosuppressive therapy and subsequent percutaneous transluminal angioplasty stenting of the left renal artery. Conclusions: A high index of suspicion is crucial in young females with unusual presentations especially in the South Indian population where the disease is not prevalent. Due to financial constraints it is very likely that appropriate imaging is not done in cases where takayasu arteritis is not suspected by the treating physician. Lack of appropriate work up of hypertension can result in missed diagnoses which can lead to potentially disastrous side effects to the disease Keywords: Takayasu arteritis, young female, vasculitis, immunosuppressive therapy, angioplasty.

RV in COPD - The complicated matters of the heart - Correlation of ECHO and biomarker with COPD severity and outcome.

Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of cardiovascular involvement, which is among the leading causes of morbidity and mortality worldwide. Echocardiography (ECHO) could be a reliable, non-invasive tool for predicting the risk of cardiovascular modalities in patients with COPD. Combining the ECHO parameters with highly selective cardiac troponin could predict the severity and outcome of patients with COPD. This prospective observational study was conducted at a tertiary care hospital in South India. All patients who met the criteria were included. Patients with other concomitant chronic lung diseases were excluded. An echocardiographic examination was performed, and blood samples for hs-Tnt were taken on admission for patients admitted with COPD. Categorical variables were analyzed using Pearson's Chi-square test, and the T-test was used to compare the means. One-way analysis of variance (ANOVA) followed by the Bonferroni multiple comparison tests was done to compare different echo parameters concerning COPD severity. The mean tricuspid annulus plane systolic excursion (TAPSE) and right ventricle (RV) fraction area change (FAC) values were lower with the increase in the disease severity (P < 0.001). There was a significant increase in the mean systolic pressures in the right atrium and ventricle in patients with severe COPD (P < 0.001). The mean hs-TnT values were significantly higher in patients with severe COPD (18.86 ± 18.12) and correlated well with the increase in the severity of the disease (P < 0.001). Changes in the echo parameters, such as mean TAPSE and RV FAC values, negatively correlated with COPD severity. There was an increase in systolic pressure in both atria and ventricles with the progression of COPD. Troponin helped predict mortality during hospitalization. Comprehensive echocardiographic parameters, such as TAPSE and RV FAC, help assess the disease's severity, predict mortality, and evaluate whether the proper ventricular function is reliable. Troponin is a valuable adjunct that is an independent and strong predictor of overall mortality in patients with COPD.