Netarsudil monotherapy as the initial treatment for open-angle glaucoma and ocular hypertension in Indian patients: A real-world evaluation of efficacy and safety

Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40–80. The best way to manage primary open?angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods: An open?label, real?world, multicentric, observation?based 3?month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first?line therapy. Diurnal IOP measurements, best?corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day?1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results: Four hundred and sixty?nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once?daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion: We found that netarsudil 0.02% w/v solution monotherapy when used as the first?line treatment in primary open?angle glaucoma and ocular hypertension was both safe and effective.

Invitro Comparative Analysis of the Flexural Strength of 4 Different Commercially Available Provisional Materials Used in Fixed Partial Dentures – An Original Research

Background: Provisional Prosthesis in fixed partial dentures are subjected to Flexure under stress. Selection of appropriate material for fabrication of Provisional is of utmost importance as the Provisional prosthesis has to remain in function till definitive prosthesis is delivered. Material & Methods: Bar type specimens of four different commercially available brands for provisional restorations fabricated according to ADA specification No. 27 and immersed in artificial saliva. The specimens were fractured under 3-point loading test. Results: The flexural strength ranged between 60 to 110 Mpa. BisGMA Auto polymerizing composite resin from Dentsply Caulk shows the highest flexural strength. Conclusion: Within the limitations of this study, the flexural strengths were material specific rather than category one. The BisGMA composite based resin shows significantly higher flexural strength over other materials

Stability of Denture Base Acrylic Resin to Tea, Coffe and Turmeric Solutions: An in Vitro Study

Background: The color stability of commercially available denture base acrylic resins (Lucitone-199, DPI and Travelon-HI) was studied in vitro. Material & Methods: The specimens were exposed to tea, coffee and turmeric solutions at 37 ± 1 °C. Colour measurement of the specimens from each brand of denture base acrylic resin recorded by spectrophotometer. The specimens were washed under distilled water and dried before measuring the colour on 0, 10, 20 and 30 days of immersion and color differences were calculated. Results: Statistically the colour change was significant between and within the groups of different heat cure denture base acrylic resins. Conclusion: Where as Lucitone-199 heat cure showed the highest colour variation in tea and coffee followed by DPI and Travelon-HI.

Zoster sine herpete después de infección leve por SARS-CoV-2 / Zoster sine herpete after mild SARS-CoV-2 infection

El SARS-CoV-2 es un virus de afectación sistémica que impacta con gran intensidad en el sistema inmunológico; esto permite que virus de naturaleza latente, como el virus de Varicela Zoster (VVZ), tengan oportunidad de reactivarse y agravar el cuadro respiratorio con afectaciones cutáneas, mucosas y neurológicas. Se presenta un caso de Zoster sine herpete, durante la convalecencia del SARS-CoV-2, en un paciente masculino de 43 años, que acudió a consulta por dolor precordial de gran intensidad, sensación de escozor en tórax posterior y dificultad respiratoria; 10 días después de prueba de hisopado nasofaríngeo positiva para antígeno de SARS-CoV-2. Es importante no olvidar la probabilidad de presentaciones atípicas de virus latentes con el fin de realizar un diagnóstico y tratamiento oportuno a los pacientes.

SARS-CoV-2 is a systemic virus that has a strong impact on the immune system; this allows latent viruses, such as varicella-zoster virus (VZV), to reactivate and aggravate the respiratory symptoms with cutaneous, mucosal and neurological involvement. We present a case of Zoster sine herpete, during convalescence from SARS-CoV-2, in a 43-year-old male patient who presented with severe precordial pain, stinging sensation in the posterior thorax and respiratory distress; 10 days after a positive nasopharyngeal swab test for SARS-CoV-2 antigen. It is important not to forget the probability of atypical presentations of latent viruses to make a timely diagnosis and treatment of patients.

Validation of Glasgow-Blatchford Score in Predicting Management of Upper Gastrointestinal Bleeding

Background : Upper Gastrointestinal Bleeding is a common emergency with varying degrees of severity. Haemorrhage is managed by Therapeutic Endoscopy, Radiological Intervention or Surgery and Blood Transfusion which are available only in Tertiary Care Centre. So, when patient presents in primary healthcare setting, it is important to recognize the patients who need this treatment. Glasgow-Blatchford Score is a score which is used for this purpose. The purpose of this research was to validate its reliability in identifying such high-risk patients. Materials and Methods : This study was prospective and observational, conducted in Medical College and Hospital, from December, 2017 to May, 2019. All adult patients presenting to Emergency Department with sudden onset Upper Gastrointestinal Bleeding were included. Glasgow-Blatchford Score was computed. Patients were followed up till their discharge (or death) from the hospital. The therapeutic management needed and its relationship with the score and treatment modalities were noted. Area under Receiver Operating Characteristic (ROC) Curve was calculated. Results : Total 100 patients were included in study. 85% were male and 15% were female. Glasgow-Blatchford Score was found as a good predictor in discriminating patients. Patients with score 14. Interventional radiology or surgery was never used. The area under ROC Curve was 0.738 suggesting fair reliability. Conclusion : Glasgow-Blatchford Score is good predicting tool in cases of Upper Gastrointestinal bleeding and patients with score >7 should be transferred to speciality centres

Factors affecting the willingness to pay extra for safe food

BACKGROUND/OBJECTIVES@#With the outbreak of infectious diseases, such as coronavirus disease 2019 (COVID-19), public interest in health and safety has increased, and consequently, interests in food safety have been heightened too. The purpose of this study was to compare and analyze the involvement of various categories of consumers in food safety, the subjective evaluation of food safety in Korea, and the willingness of the consumers to pay extra for safe food according to their demographic and socioeconomic characteristics.MATERIALS/METHODS: This study used data from the 2020 Consumer Behavior Survey for Food provided by the Korea Rural Economic Institute (KREI). The subjects were 6,355 adult household members aged 19 to 75 years old. The survey was conducted from June 10th to August 21st, 2020. The data for the study were subjected to statistical analyses, including descriptive statistics, complex sample general linear model, k-means cluster, and multiple regression analyses. @*RESULTS@#The factors affecting the willingness to pay extra for safe food were education level, occupation, monthly household income, presence of a young (teenager) household member, and the subjects’ involvement in food safety. the significant factors affecting the willingness to pay extra for safe food were sex, age, and income level for the group exhibiting a low level of involvement in food safety, while education level and presence of a young household member were the statistically significant factors for the group exhibiting a high level of involvement in food safety. @*CONCLUSION@#This study verified the differences in the factors associated with the willingness to pay extra for safe food according to the demographic and socioeconomic characteristics, involvement in food safety, subjective evaluation of food safety. This study offers practical implications to the industry and government that would help in directing strategies to strengthen safe food management.

Conocimientos, percepciones y prácticas de médicos de atención primaria en Ecuador sobre la infección por Angiostrongylus cantonensis / Knowledge, perceptions and practice of primary healthcare doctors in Ecuador on Angiostrongylus cantonensis infection

Introducción: La angiostrongiliasis humana presenta un amplio espectro clínico: desde una infección asintomática a meningitis eosinofílica, meningoencefalitis eosinofílica y angiostrongiliasis ocular. Objetivo: Determinar los conocimientos, percepciones y prácticas en relación con la infección por Angiostrongylus cantonensis que poseen médicos de atención primaria de la República del Ecuador. Métodos: Se realizó un estudio observacional descriptivo. Se diseñó, validó y aplicó una encuesta sobre conocimientos, percepciones y prácticas a 163 médicos de atención primaria de las provincias Napo y Guayas, entre los meses de noviembre y diciembre de 2017. La información obtenida se almacenó en una base de datos Microsoft Access y se realizó un análisis de frecuencias a las respuestas dadas a cada una de las preguntas. Resultados: Se encontraron conocimientos insuficientes, percepciones inadecuadas y prácticas incorrectas en relación con la angiostrongiliasis. Conclusiones: Estos resultados orientan hacia la implementación de un programa de intervención educativa en médicos de atención primaria con el fin de atenuar las deficiencias encontradas, para incidir de forma positiva en comunidades donde existe la presencia de hospederos intermediarios y definitivos infectados y un riesgo potencial de infección.

Introduction: Human angiostrongyliasis presents a broad clinical spectrum, which ranges from asymptomatic infection to eosinophilic meningitis, eosinophilic meningoencephalitis, and ocular angiostrongyliasis. Objective: To determine the knowledge, perceptions, and practice of primary healthcare doctors in the Republic of Ecuador regarding Angiostrongylus cantonensis infection. Methods: It was conducted a descriptive observational study. A survey on knowledge, perceptions, and practice was designed, validated, and applied to 163 primary healthcare doctors from Napo and Guayas provinces between November and December 2017. The information obtained was stored in a Microsoft Access 2016 database, and a frequency analysis was performed to the answers provided to every question. Results: Insufficient knowledge, inadequate perceptions, and incorrect practice regarding angiostrongyliasis were found. Conclusions: The results evidenced the need to implement an educational intervention program to primary healthcare doctors aimed at reducing the deficiencies found to have a positive impact on the communities where the intermediate and definitive hosts and a potential infection risk exist.

Knowledge Regarding Causes and Ill Effects of Household Air Pollution Among Residents of a Selected Community in Kozhikode (Kerala)

The present study was conducted to assess the knowledge regarding causes and ill effects of household air pollution among residents of selected community in Kozhikode (Kerala). The research design adopted was non-experimental descriptive survey type. The sample was selected using non-probability convenience sampling technique. The data were collected using semi structured questionnaire to assess the knowledge regarding causes and ill effects of household air pollution among residents. The data was tabulated and analysed by descriptive and inferential statistics. The study revealed that majority of the samples (50%) had average knowledge regarding causes and ill effects of household air pollution and 31.7 percent had good knowledge, spiratory illness due to household air pollution.

Chronic musculoskeletal pain in older people

Musculoskeletal pain is a common and debilitating symptom in older adults. However, its importance is often underestimated. In this review article, we discuss its proper evaluation and management. Pain evaluation includes detailed history taking, physical examination, imaging, and laboratory investigations. Management of musculoskeletal pain requires a multidomain approach including nonpharmacological, pharmacological, and surgical modalities. A step-wise approach recommended by the World Health Organization can be used for pain management. Common musculoskeletal conditions causing pain are osteoarthritis, low?back pain, gout, pseudogout, rheumatoid arthritis, polymyalgia rheumatica, and fibromyalgia.

Consensus guidelines on management of oral potentially malignant disorders

Oral cancer is usually preceded by oral potentially malignant disorders (OPMDs) and early detection can downstage the disease. The majority of OPMDs are asymptomatic in early stages and can be detected on routine oral examination. Though only a proportion of OPMDs may transform to oral squamous cell carcinoma (OSCC), they may serve as a surrogate clinical lesion to identify individuals at risk of developing OSCC. Currently, there is a scarcity of scientific evidence on specific interventions and management of OPMDs and there is no consensus regarding their management. A consensus meeting with a panel of experts was convened to frame guidelines for clinical practices and recommendations for management strategies for OPMDs. A review of literature from medical databases was conducted to provide the best possible evidence and provide recommendations in management of OPMDs

Cryptosporidium spp. en muestras de lavado broncoalveolar de pacientes VIH/sida en un hospital de Guayaquil, Ecuador / Cryptosporidium spp. in bronchoalveolar lavage samples of HIV/AIDS patients in a hospital in Guayaquil, Ecuador

Introducción: Cryptosporidium spp. son parásitos que causan infecciones respiratorias principalmente en pacientes inmunocomprometidos. Objetivo: Detectar Cryptosporidium spp. en el lavado broncoalveolar (BAL) de pacientes VIH positivos y con síndrome respiratorio. Métodos: Se seleccionaron 60 muestras de BAL y se analizaron mediante microscopía óptica con tinción de Ziehl-Neelsen y PCR de punto final; esta última es una técnica eficiente para el diagnóstico de patógenos oportunistas. Se recolectaron datos clínicos y epidemiológicos de cada paciente. Resultados: La prevalencia hallada en este estudio mediante PCR de punto final fue del 5 %. Los signos y síntomas que se presentaron con mayor frecuencia, sobre todo en el grupo etario de 31 a 40 años, fueron fiebre, tos y disnea; sin embargo, no se obtuvieron asociaciones estadísticamente significativas a ninguna de las variables y no se pudo visualizar parásitos mediante la tinción de Ziehl-Neelsen. Conclusión: Cryptosporidium spp. puede causar infecciones pulmonares de difícil reconocimiento clínico, pues se confunde con otras infecciones oportunistas. En el presente estudio no puede establecerse si la detección del ADN parasitario correspondió a una verdadera infección o solamente a colonización, lo que es importante para implementar técnicas con mayor sensibilidad para el diagnóstico. Se debe considerar relevante la prevalencia encontrada en Ecuador, al ser inusualmente alta en comparación con países cercanos como Brasil(AU)

Introduction: Cryptosporidium spp. are parasites that cause respiratory infections mainly in immunocompromised patients. Objective: To detect Cryptosporidium spp. in bronchoalveolar lavage (BAL) of HIV-positive patients with respiratory syndrome. Methods: Sixty samples of BAL were selected and analyzed by optical microscopy with Ziehl-Neelsen staining and end-point PCR. The latter is an efficient technique for the diagnosis of opportunistic pathogens. Clinical and epidemiological data were collected from every patient. Results: In this study, the prevalence by end-point PCR was 5%. The most frequent signs and symptoms, mainly in the age group 31-40 years old, were fever, cough, and dyspnea. However, no significant statistical associations to any variable were obtained, and no parasites were observed with the Ziehl-Neelsen staining technique. Conclusions: Cryptosporidium spp. can cause pulmonary infections that are difficult to identify clinically, since they are confused with other opportunistic diseases. The current study could not establish whether the detection of parasitic DNA corresponded to a real infection or only to colonization, which is important to implement diagnostic techniques with greater sensitivity. The prevalence found in Ecuador should be considered relevant, as it is unusually high in comparison with nearby countries such as Brazil(AU)

Analytical Profile of Kanchanara Guggulu Tablets Prepared as per References in Sharangadhara Samhita and Bhaishajya Ratnavali

Marketing of Guggulu, an exudate obtained from the plant Commiphora mukul and its preparations is a great concern of different ayurvedic pharmaceutical houses due to its adulteration, substitution and non-availability of genuine samples. Standardization of raw drugs and formulations with modern analytical tools increase their scope, acceptance and scientific validity. In the present study, an attempt was made for the physicochemical analysis of Kanchanara guggulu tablets (having Guggulu as the major ingredient) prepared as per references in Sharangadhara Samhita and Bhaishajya Ratnavali to develop an analytical profile of the formulation. The study was based on the standard analytical parameters proposed by API and PLIM. Six samples of tablets were prepared as per two references (three for each reference) which were available in market following the same manufacturing procedures. The study comprised of three stages- pharmacognosy of raw drugs, pharmaceutical work and analytical study. The analysis was done using the parameters like organoleptic evaluation, weight variation, hardness, friability, disintegration time, ash values, extractive values, loss on drying, pH, HPTLC and microbial contamination and an analytical profile was developed as per both references.

Current estimates of the economic burden of blindness and visual impairment in India: A cost of illness study

Purpose: Currently, there are an estimated 4.95 million blind persons and 70 million vision impaired persons in India, out of which 0.24 million are blind children. Early detection and treatment of the leading causes of blindness such as cataract are important in reducing the prevalence of blindness and vision impairment. There are significant developments in the field of blindness prevention, management, and control since the “Vision 2020: The right to sight” initiative. Very few studies have analyzed the cost of blindness at the population level. This study was undertaken to update the information on the economic burden of blindness and visual impairment in India based on the prevalence of blindness in India. We used secondary and publicly available data and a few assumptions for our estimations. Methods: We used gross national income (GNI), disability weights, and loss of productivity metrics to calculate the economic burden of blindness and vision impairment based on the “cost of illness” methodology. Results: The estimated net loss of GNI due to blindness in India is INR 845 billion (Int$ 38.4 billion), with a per capita loss of GNI per blind person of INR 170,624 (Int$ 7,756). The cumulative loss of GNI due to avoidable blindness in India is INR 11,778.6 billion (Int$ 535 billion). The cumulative loss of GNI due to blindness increased almost three times in the past two decades. The potential loss of productivity due to vision impairment is INR 646 billion (Int$ 29.4 billion). Conclusion: These estimates provide adequate information for budgetary allocation and will help advocate the need for accelerated adoption of all four strategies of integrated people?centered eye care (IPCEC). Early detection and treatment of blindness, especially among children, is very important in reducing the economic burden; thus, there is a need for integrating primary eye care horizontally with all levels of primary healthcare

Psychological Morbidities and Coping Styles: A Rural Institution-Based Cross-Sectional Comparative Study between Undergraduate Medical Students Undergoing Different Phases of Training

Background?Psychological morbidities are high among undergraduate medical students. They experience the transition between pre-/para-clinical and clinical training as a stressful period, and cope differently. Research studies from India in this regard are lacking. Aims?The aim of this study is to assess and compare the prevalence of psychological morbidities and their respective associated factors and coping styles between pre-/para-clinical and clinical undergraduate medical students. Materials and Methods?This institution-based cross-sectional observational design study was conducted among undergraduate medical students (a total of 382) in pre-/para-clinical and clinical years by using a questionnaire in the period between April and June 2019. A stratified random sampling technique was used to select the study participants. The survey included standard self-administered questionnaires like General Health Questionnaire-28 (GHQ-28) and Lin–Chen's coping inventory to assess psychological morbidities and coping styles, respectively. Associated factors for psychological morbidities and coping styles between two groups were compared using the Chi-square test, independent t-test, and binary logistic regression analysis. Results?Out of the 382 responders, psychological morbidities (GHQ-28 score?>?23) were found in 61% participants. Both groups reported high levels of psychological morbidities; a slightly higher preponderance in clinical (61.5%) than in pre-/para-clinical students (60.6%) with a nonsignificant difference. Compared with the pre-/para-clinical group, the clinical group was found to have more substance consumption behavior (p?<?0.001), dissatisfaction with academic performance (p?<?0.001), sought psychiatric consultation (p?<?0.004), and at that time on psychiatric treatment (p?<?0.04). Active problem coping behavior was more significantly used by the pre-/para-clinical group, while passive problem coping and passive emotional coping behaviors were positively significantly correlated with psychological morbidities in the clinical group. Conclusion?This study suggests a significant correlation between psychological morbidities and passive coping styles in the clinical group. These students need interventions to encourage the use of more active coping styles during training to provide advances in future career. A strong correlation between psychological morbidities and dissatisfied academic performance may be a call for an efficient and more student-friendly curriculum.

Orthostatic hypotension: An overlooked but clinically decisive entity

Orthostatic hypotension (OH) is defined as a drop of >20 mm Hg of systolic or >10 mm Hg of diastolic blood pressure (BP) within 3 min of standing from lying position. It is a common geriatric syndrome caused by impaired orthostatic response of BP. Its clinical manifestation can range from dizziness to syncope. It is a common cause of recurrent falls and fracture in older adults. Its etiology ranges from neurological causes such as Parkinson and diabetes to hypovolemia. Drugs, especially cardiovascular drugs are also frequently identified as the cause of OH. The management of OH is primarily nonpharmacological including medication review, dietary, and lifestyle modifications. However, in partially responsive or resistant cases, medications such as fludrocortisone, midodrine, droxidopa, etc., are also used.

Infecciones múltiples por Alphapapillomavirus, especie 9, en mujeres ecuatorianas con lesiones intraepiteliales y cáncer cervicouterino / Multiple infections by Alphapapillomavirus, specie 9, in Ecuadorian women with intraepithelial lesions and cervical cancer

Introducción: El significado biológico de las infecciones múltiples con virus del papiloma humano de alto riesgo oncogénico (VPH-AR), pertenecientes a la familia Alphapapillomavirus, en la carcinogénesis cervical aún es controversial. Objetivo: Proporcionar información sobre la circulación del VPH-AR del género Alphapapillomavirus-especie 9, e infecciones múltiples en mujeres ecuatorianas con lesiones intraepiteliales y cáncer cervicouterino (CaCU). Métodos: Se estudiaron 300 mujeres, residentes en la región Litoral del Ecuador. Se detectó la infección viral en muestras cervicales, mediante PCR anidada con cebadores genéricos MY09/11 y GP5/GP6. Los genotipos virales fueron identificados con el sistema comercial ANYPLEX II VPH28. La razón de prevalencia (RP) fue utilizada como medida de asociación entre las lesiones citológicas y las infecciones simples, múltiples o combinaciones de genotipos. Resultados: Se detectó VPH en el 92,00 % (276/300) de las mujeres, con frecuencias altas de infección por genotipos individuales, principalmente de alto riesgo oncogénico. Los VPH-AR más frecuentes fueron VPH58 (18,17 por ciento), 70 (8,64 por ciento), 53 (8,34 por ciento), 35 (7,45 por ciento), 16 (7,37 por ciento), 33 (6,55 por ciento), 31 (5,58 por ciento) y 18 (4,24 por ciento). En el 91,66 por ciento (253/276) de las muestras se detectaron infecciones múltiples, hasta con 13 tipos en una misma paciente, incluyendo varias especies del género Alphapapillomavirus. La combinación VPH16/VPH58 fue la más frecuente en lesiones de alto grado (RP = 2,9; p = 0,000), y la coinfección triple VPH16/VPH58/VPH70 predominó en las mujeres con CaCU (RP = 3,5; p = 0,007). Conclusión: Los resultados demuestran que la combinación VPH16/VPH58 del género Alphapapillomavirus, especie 9, podría ser un factor clave en la aparición de lesiones premalignas y su progresión hacia el CaCU(AU)

Introduction: It is still controversial the biological connotation of multiple infections with high-risk human papillomaviruses (hrHPV), that belong to the genus Alphapapillomavirus, for the cervical carcinogenesis. Objective: To provide information on the circulation of hrHPV, genus Alphapapillomavirus, specie 9, and the multiple infections in Ecuadorian women with intraepithelial lesions and cervical cancer. Methods: 300 women, from the coastal region of Ecuador, were screened. Viral infection was detected in cervix samples by nested PCR with MY09/11 and GP5/GP6 generic primers. Viral genotypes were identified using the commercial kit ANYPLEX II VPH28. The prevalence ratio (PR) was used to measure the association between cytological lesions and the simple, multiple or combined genotype infections. Results: Ninety-two percent of women (276/300) tested positive for HPV. Frequency of infection for single genotypes was high, mainly those of high oncogenic risk. The most frequent hrHPV genotypes were HPV58 (18.17 percent), 70 (8.64 percent), 53 (8.34 percent), 35 (7.45 percent), 16 (7.37 percent), 33 (6.55 percent), 31 (5.58 percent) and 18 (4.24 percent). In 91.66 percent (253/300) of the samples, multiple infections were detected, with up to 13 types in a single patient, including various species from the genus Alphapapillomavirus. The combination HPV16/HPV58 was the most frequent on high-grade lesions (PR = 2.9; p = 0,000), and HPV16/HPV58/HPV70 triple co-infection prevailed in women with cervical cancer (PR = 3.5; p = 0.007). Conclusions: The results evidence that the combination HPV16/HPV58, genus Alphapapillomavirus, specie 9, could be a key factor in the occurrence of premalignant lesions and their evolution into cervical cancer(AU)

A Forensic Autopsy Study of Dead Foetuses and Newborns

Background: The term abandonment refers to babies or foetuses which are found abandoned at various unwanted places such as gutter, rubbish dumps, railway tracts and bushes. It does not refer to live born babies left in places, such as hospitals where care can be given by someone other than the mother. Aims and Objectives: To find out the distribution of death cases of newborns/feotuses and to trace its probable reason and its relationship with female foeticide.Methods:A retrospective study of all the medico-legal autopsies of foetuses and newborns was conducted in Forensic medicine and Toxicology department, Government Medical College, Amritsar (Punjab) from Jan 1, 2014 to Jul 31, 2021. During this period, 46 cases of fetal and newborn deaths had been studied.Results:The dead bodies of known foetuses/newborns is 43.5% cases while total unknown cases were 56.5% cases. 32.6% cases were non viable foetuses while 10.8% cases died as a result of prematurity. All the unknown cases (56.5%) were found from the abandoned places like street, bushes, canal side, water bodies that mainly includes pond and railway tract.Conclusion:Despite, the problem is present in every corner of the nation, there is dearth of research studies on this issue. Stringent measures and strict checks are required against antenatal sex determination. The motive behind the abandonment of foetuses can be any, but this grave issue needs urgent attention.

South Asian Working Action Group on SARCOpenia (SWAG-SARCO) e A consensus document

The South Asian population is rapidly ageing and sarcopenia is likely to become a huge burden in this region if proper action is not taken in time. Several sarcopenia guidelines are available, from the western world and from East Asia. However, these guidelines are not fully relevant for the South Asian healthcare ecosystem. South Asia is ethnically, culturally, and phenotypically unique. Additionally, the region is seeing an increase in non-communicable lifestyle disease and obesity. Both these conditions can lead to sarcopenia. However, secondary sarcopenia and sarcopenic obesity are either not dealt with in detail or are missing in other guidelines. Hence, we present a consensus on the screening, diagnosis and management of sarcopenia, which addresses the gaps in the current guidelines. This South Asian consensus gives equal importance to muscle function, muscle strength, and muscle mass; provides cost-effective clinical and easy to implement solutions; highlights secondary sarcopenia and sarcopenic obesity; lists commonly used biomarkers; reminds us that osteo-arthro-muscular triad should be seen as a single entity to address sarcopenia; stresses on prevention over treatment; and prioritizes nonpharmacological over pharmacological management. As literature is scarce from this region, the authors call for more South Asian research guided interventions.

Foodservice Status and Perception regarding Foodservice Management in Kindergartens attached to Elementary Schools in Seoul / 대한지역사회영양학회지

Objectives@#This study examines the foodservice status of kindergartens attached to elementary schools in Seoul. We further determine the perception of elementary school principals and kindergarten assistant principals on the foodservice management for kindergartens. @*Methods@#This survey was conducted from July 17 to 23, 2019, enrolling 207 kindergartens attached to elementary schools in Seoul. Questionnaires were sent to principals of elementary schools and assistant principals of kindergartens, and the data obtained from 89 kindergartens were included in the analysis. The questionnaire consisted of four parts: general information on subjects, foodservice management status, foodservice management status during elementary school vacations, and the perception of principals of elementary schools and assistant principals of kindergartens on foodservice management. Data are presented as frequency and percentage or mean and standard deviation. Statistical comparison between principals of elementary schools and assistant principals of kindergartens was conducted by paired t-test, chi-square test, and Pearson's correlation analysis. @*Results@#A separate menu (10.1%) or recipe (20.2%) that considers preschooler characteristics was rarely used for foodservice at kindergartens attached to elementary schools. Most kindergartens did not have a separate dining space (3.4%) or a dedicated cook (93.3%). Although most kindergartens (92.1%) had operational foodservice during elementary school vacations, non-professional staff and non-nutrition teacher were mainly in charge of organizing the menu and purchasing ingredients (34.1% and 41.5%, respectively). The rate of using a contract catering company (28.0%, 23.2%) was also high. Both elementary school principals and assistant principals of kindergartens showed a high perception of the necessity for providing responsibility allowances for nutrition teachers and improving the cooking environment for kindergartens during elementary school vacations. @*Conclusions@#There is a need for policies and administrative support measures to improve the quality of foodservices for kindergartens attached to elementary schools.

The Influence of Customer Perception about Food Safety on the Use of Restaurant Food Delivery or Takeout

After the onset of the COVID-19 pandemic, there has been an explosive increase in restaurant meal delivery or takeout. The purpose of this study was to analyze the consumer perception of food safety and its influence on the purchase of delivery or takeout food from restaurants. This study, the 2020 Consumer Behavior Survey for Food (CBSF), was conducted from June 10 to August 21 2020. A total of 6,355 responses were used for the analysis. The results were as follows: First, the differences in consumer perception about food safety were analyzed according to whether they used delivery or takeout. Concern about food safety, satisfaction with dietary habits, and the ability to maintain safe dietary habits were higher in the non-user group. Except for food at home, the perception about food safety at other locations was higher in the user group. Food hazards such as antibiotics were perceived to be safer in the user group. Second, the perception of food safety affecting use of delivery or takeout was analyzed. It was found that the usage of delivery or takeout increased when the perception of the safety of home meal replacement (HMR), delivery or takeout food, and the ability to be informed about the harmful factors of agricultural products increased. The findings of this study may offer the basis for the food and food service industry to consider safety issues seriously and develop strategies to lead to feasible practices. Further, this study also supports the direction of the government toward strengthening the safety of new segments which have shown explosive growth in the COVID-19 era.