ABSTRACT
Abdominoscrotal hydrocele (ASH) is very rare in adults and difficult to suspect on clinical examination. ASH is a very unusual presentation of scrotal hydrocele with extension intra-abdominally through the inguinal canal either communicating to the peritoneal cavity or non-communicating. An ASH is a congenital pathology involving a scrotal hydrocele expanding through the inguinal canal and reaching the abdominal cavity. Here, we present the case of a 25-year-old man admitted with a complaint of pain and lump in the left lower abdomen for 2 months and swelling in the left groin for 2 years. Ultrasound and computed tomography suggest left ASH with left-sided hydroureteronephrosis. A left DJ stent was placed and on exploration, a large cystic mass was seen intraperitoneally extending into the scrotum through the inguinal canal. Excision of the abdominal part and partial excision of the scrotal part were done with eversion of the remaining tunica vaginalis sac. Although ASH is a rare entity, it should always be kept on the list of differential diagnoses during the complaint of large abdominal mass in adults.
ABSTRACT
Introduction: The AYUSH system of medicine is effective in the case management of non-communicable diseases (NCDs). The Ministry of Health and Family Welfare launched a pilot program in 2016 integrating AYUSH with the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke for community-based screening and management of NCDs. This study was done to assess the effectiveness of AYUSH treatment with Yoga practices in project districts in terms of the adoption of a healthy lifestyle besides relief from NCDs. Material and Methods: The study was conducted in six districts from six states, namely Bhilwara (Rajasthan), Surendranagar (Gujarat), Gaya (Bihar), Darjeeling (West Bengal), Krishna (Andhra Pradesh), and Lakhimpur-Kheri (Uttar Pradesh) with a total sample of 56 lifestyle disease Clinics and 1790 beneficiaries. Results: The results show that 75% of patients were currently doing yoga and 60%–80% of patients experienced various benefits of yoga. These benefits were relief from pain (82%), improvement in appetite (72%), reduction in weakness (72%), and sickness (71%). The study also found that after taking AYUSH treatment, overall 73% of patients reduced dosage of allopathic medicines, 52% had reduced side effects of allopathic medicines, 24% stopped allopathic medicine, and 50% got faster recovery. Conclusion: Low cost and fewer side effects are considered merits of AYUSH medicine that drive its acceptance in the community and could be prioritized under preventive care. The dual form of medicine is the new form emerging option to the existing modern medicine.
ABSTRACT
Background: Tobacco is a major risk factor associaetd with developing oral factor. Recent studies have shown that the age of onset, especially in Asia, is reducing. This study was to determine if tobacco exposure correlated with prognosis in oral squamous cell carcinoms (OSCC) based on age at diagnosis. Methods: Six hundred and forty three patients of OSCC treated in our institution were divided into four groups, younger patients (?45 years) with or without tobacco exposure and older patients (>45 years) with or without tobacco exposure, and compared with respect to prognostically relevant variables, disease?free survival (DFS) and overall survival (OS). Survival analysis was performed. Results: The percentage of those with tobacco exposure was comparable in both age groups. Tobacco correlated with known pathological determinants in OSCC; however, perineural invasion, lymphovascular invasion, and extranodal extension were significantly more common in the young. On survival analysis, tobacco exposure impacted OS (P = 0.04) and DFS (P = 0.03) in patients ?45 years, and not in older patients >45 years. On multivariate analysis, tobacco exposure in the young was significantly associated with recurrence (P = 0.03, hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.07�94) but not survival. Conclusion: Younger patients with a history of tobacco use have a significantly higher risk of recurrence and mortality due to OSCC, but this difference could not be attributed to any of the known prognostic determinants in OSCC. Younger patients also had more adverse pathological features. Whether this occurs because of altered disease biology or pathways of carcinogenesis in the young wi
ABSTRACT
Objective: Snake bite is an emergency in tropical and subtropical countries. It is a neglected disease and is most commonly seen in rural setups, where people are ignorant about the venomous snake bites. It results in increased mortality and morbidity because precious time is wasted, either in consulting traditional healers or waiting for the development of signs and symptoms of envenomation. Then only the patient is shifted to a health center. Here we studied the clinical profile, management, and outcome of snake bite patients. Materials and methods: This study was done by retrieving the records of patients with snake bites admitted to the Department of Medicine, Indira Gandhi Medical College & Hospital, Shimla, from 1st January 2017 through December 2019. The recorded data was entered in a precoded performa, and analysis was done with respect to various variables. Result: We evaluated the records of 190 patients. The incidence of the bite was higher among females, 62.1% (n = 118). The commonest age group involved was 21–50 years, 70.1% (n = 34). In 55.8% (n = 106), the site of the bite was the upper limb. The daytime bite was present in 54.7% (n = 106). The maximum incidence of snake bites was found during the rainy season, 81.5% (n = 155). 28.4% (n = 54) of patients presented within 6 hours of the bite. Coagulopathy [whole blood clotting test (WBCT) of >20 minutes] and neurotoxicity were seen in 77.9 and 7.9% of patients, respectively. Anti-snake venom (ASV) was given to 87.8% (n = 167) of patients. In 80% (n = 152) of the cases, hospital stay was up to 3 days. Mortality was seen in only two (1.05%) cases. Conclusion: There is a need to create awareness among the community, particularly in rural areas, about snake bite envenomation and early transportation of victims to the nearest health center. Training of health professionals is also needed to manage cases of snake bites efficiently and judiciously, thereby reducing morbidity and morbidity.
ABSTRACT
Purpose: Extraction of tear protein from Schirmer’s strip is a prerequisite for the proper identification and screening of biomarkers in dry eye disease. The study compares different methods of extraction of tear proteins from the Schirmer’s strip. Methods: Reflex tear was collected from healthy controls (HC; n = 12), Stevens–Johnson syndrome (SJS; n = 3) and dry eye disease (DED; n = 3) patients using capillary tube. This tear was used to measure the volume absorbed by Schirmer’s strip per microliter. Different buffers (6) were used to compare the protein yield from the Schirmer’s strip in four different conditions. The tear proteins extracted using the highest protein yield buffer were analyzed by mass spectrometry. Results: A linear relationship between the tear volume and wetting length was observed (r = 0.0.997, n = 6). The highest yield was observed after incubation of the Schirmer’s strip in 100 mM ammonium bicarbonate (ABC) with 0.25% Nonidet P?40(NP?40) at 4°C for an hour (P < 0.00005). The in?solution digestion of tear eluted in the above condition 100 Mm ABC + 0.25% NP?40 with one?hour incubation yielded a total of 2119 proteins in HC, SJS, and DED. The unique protein observed in SJS and DED was 0.6% and 17.9%, respectively. The significantly expressed proteins are associated with innate immune response, proteolysis, wound healing, and defense response. Conclusion: A method for extraction of protein from Schirmer’s strip was optimized for increase in protein yield from the tear sample. SJS and DED tear samples have unique protein signature. The study will aid in better design of tear protein?based experimental study.
ABSTRACT
Purpose: This study was conducted to report on the pattern of spectacles use and compliance among the elderly (aged ?60 years) in homes for the aged in Hyderabad region in Telangana State, India. Methods: Participants were recruited from 41 homes for the aged centres for comprehensive eye health assessments. A questionnaire was used to collect information on current and past use of spectacles, type of spectacles, spectacles provider and amount paid for the spectacles. For those that reported using spectacles in the past, information was collected on the reasons for their discontinuation. Compliance with spectacles use was assessed after eight months of provision of the spectacles. Results: A total of 1182/1513 participants were examined from 41 homes for the aged in Hyderabad, India. The mean age of the participants examined was 75 years (standard deviation (SD): 8.8 years; range: 60–108 years); 764 (64.6%) of them were women and 240 participants (20.3%) had no formal education. The prevalence of spectacles use was 69.9% (95% confidence interval [CI]: 67.1–72.4; n = 825). Bifocals were the most commonly used type of spectacles (86.7%) followed by single vision glasses for distance vision (7.4%). Private eye clinics were the largest service provider (85.5%) followed by local optical outlets (6.9%) and other service providers (7.7%). The prevalence of spectacles compliance was 81.5% (211/259). Conclusion: Use of spectacles and compliance are high among the elderly living in residential care homes in the Hyderabad region. Spectacles use can be further improved by periodic eye assessments along the lines similar to school eye programs, which can immensely benefit this vulnerable, aged population
ABSTRACT
Introduction : The medical personnel especially have to deal with both the Biological and Psychological consequences originating from the influence of virus. Emergency Care Units equipped with ambulance service always should be at the fore front to face all emerging untoward incidents. Ambulance Drivers often disregard their physical health and mental stress in order to fulfil the duties entrusted on them. Methodology : Cross-sectional questionnaire based on-line survey was conducted. Ambulance drivers were North and South India were taken as study subjects. Knowledge based questions and mental stress were assessed using Perceived Stress level Scale (PSS). The questionnaires were translated toTamil, Kannada, Telugu, Malayalam and Hindi languages. Chi-square test was done to find the association between variables. Results : Among the 101 respondents, 84.2% were having good knowledge about the pandemic. Statistically significant association between number of patients transported per day and the knowledge levels of Ambulance drivers was found (p =0.048)(Chi-square value=15.65). Drivers in Government sector were having more knowledge compared to private sector (p =0.038)(Chi square value=6.53). The perceived mental stress was found to increase with a greater number of patients being transported per day, which was statistically significant (p =0.001)(Chi-square value= 30.42). Conclusion : Knowledge regarding COVID-19 virus was adequate among the Ambulance Drivers. Knowledge was found to be more among drivers who work in Government medical establishments. Mental stress was more among drivers who transported more than 5 patients per day.
ABSTRACT
Background and Objectives@#Severe to profound hearing loss impacts the capacity for verbal communication as well as the social, emotional, and overall quality of life; however, the association between socio-emotional rehabilitation and post-hearing aid use is not widely explored. This study aimed to investigate the socio-emotional change in post-hearing aid fitted individuals with severe to profound hearing loss. @*Materials and Methods@#A total of 60 individuals comprised of 15 females and 45 males with severe to profound hearing loss within the age range of 40-60 years (mean age and standard deviation of 53.4±6.1), participated in this study. Participants were divided into two categories with a 10-year age interval i.e., 40–50 and 51-60 years. These participants were equally divided into hearing aid user (HAU) and non-hearing aid user (NHAU) groups. The hearing handicapped inventory for the adults-short version (HHIA-S) adapted from Weinstein & Ventry (1983) was used in this study. @*Results@#The mean social score of all the participants was significantly higher than the mean emotional score. However, no such advantage was observed between the HAU and NHAU groups. The mean social score of females in the HAU category was significantly higher than males. The mean social and emotional scores were also compared across two age categories in the age range of 40-50 and 51-60 years and revealed no significant difference between mean social and emotional score across the age categories (p=0.026). @*Conclusions@#In individuals with severe to profound hearing loss, social rehabilitation occurs quicker than emotional. In the HAU group, socialization occurred faster in females than males. These findings suggest that a customized counselling should be developed for the social and emotional wellbeing as these two parameters improve distinctly.
ABSTRACT
Transthyretin cardiac amyloidosis (ATTR-CM) is a rare and under-recognized disorder characterized by the aggregation of transthyretin-derived insoluble amyloid fibrils in the myocardium. Heterogeneity of symptoms at presentation, makes its diagnosis often delayed. An expert panel gathered on a virtual platform across India to conduct a meeting for developing a guiding tool for ATTR-CM diagnosis. The panel recommended younger age (40 years) for suspecting ATTR-CM and thick-walled non-dilated hypokinetic ventricle was considered as one of the important red flags. Electrocardiogram (ECG) and echocardiography (ECHO) findings were recommended as primary tests to raise the suspicion while nuclear scintigraphy and hematological tests were recommended to confirm the diagnosis and rule out amyloid light-chain (AL) amyloidosis. Cardiac magnetic resonance (CMR) and biopsy were recommended in case of ambiguity in the presence of red flags. Considering the lack of expert guidelines in the Indian scenario, a standardized diagnostic algorithm was also proposed.
ABSTRACT
Defensive medicine; although a recent concept, is slowly beginning to cement its place in the Indian health system. An interaction of multiple factors has paved way for this form of practice. Need for certainty of the diagnosis, lack of hierarchy in medical care, exponential growth of micro/super specializations and private/corporate health institutions, incentive-based practice, increasing incidences of violence against health personnel, rising trend of defamation suites against doctors, bad publicity by media, and interference by elected representatives have jeopardized the situation. This has led to decline in practice of clinical medicine, increased burden of investigations, especially in already compromised public facilities, and high out-of-pocket health expenditure. As much as ethical medical practice, standard patient management protocols, strict protection of interest of medical practitioners by law, responsible role of media and elected representatives are the need of the hour; we need to find ways to accept and incorporate defensive medicine into the modern medicine. Different stakeholders are required to come together and take substantial steps to understand the phenomenon and preserve the art and science of practicing medicine in its true form.
ABSTRACT
India is home to the largest population of indigenous tribes in the world. Despite initiative of the National Rural Health Mission, now National Health Mission (NHM) and various tribal development programmes since India’s Independence, disparity in healthcare for Scheduled Tribes (STs) prevails. The constitution of Village Health Sanitation and Nutrition Committees (VHSNCs) in 2007 by the NHM is a step towards decentralized planning and community engagement to improve health, nutrition and sanitation services. VHSNCs are now present in almost all States of the country. However, several reports including the 12th Common Review Mission report have highlighted that these committees are not uniformly following guidelines and lack clarity about their mandates, with no clear visibility of their functioning in tribal areas. Therefore, this review was conducted to assess the participation of the VHSNCs in tribal dominated States in order to know in detail about their functioning and gaps if any that require intervention. Several deviations from the existing guidelines of NHM were identified and we concluded that in order to sustain and perform well, VHSNCs not only require, mobilization and strict monitoring but also motivation and willingness of its members to bring in a radical change at the grassroot level. With continuous supervision and support from both the Government and various non- governmental organizations, handholding, strategic deployment of workforce, community participation and sustained financial support, VHSNCs would be able to facilitate delivery of better healthcare to the indigenous population
ABSTRACT
Background & objectives: Sickle cell disease (SCD) constitutes frequently inherited haemoglobin disorders and poses a significant health burden in India. Hydroxyurea (HU), the most commonly used drug, has shown promising results in the clinical management of SCD. The present systematic review was undertaken to assess the efficacy and toxicity of HU in Indian sickle cell patients. Methods: A systematic review of studies on HU therapy was conducted to identify the application of HU and its outcome(s) across India. PubMed, Scopus and Cochrane Library was used as data sources for various studies on the efficacy and toxicity of HU therapy for treatment for SCD in India published between January 2001 and October 2021. Two authors independently extracted the data on study design, patient characteristics and therapeutic outcomes of HU in order to determine the study quality of the present review. Results: Overall, 14 studies were included for a systematic analysis. Of these 11 were prospective, two cross-sectional and one double-blind randomized controlled trial. Low-dose HU (10 mg/kg/day) was found to reduce the rates of vaso-occlusive crisis and hospitalization as well as decreased the requirement of blood transfusion in SCD patients. The foetal haemoglobin (HbF) level was recorded in 13 (80%) studies all of whom reported an elevation in the HbF levels, with a mean increase in per cent HbF from 15.8 to 21.4 per cent across studies. The common adverse events were reversible, mild-to-moderate cytopenia and anaemia. Interpretation & conclusions: The findings of the present review suggest that there is still insufficient information presently to determine the long-term or major adverse effects on organ damage, fertility as well as pregnancy on the use of HU therapy for SCD. Long-term multi-centric studies are thus required to address these problems.
ABSTRACT
Abstract Introduction: In developing countries like India, it is common for late presentation of Tetralogy of Fallot (TOF) patients to a hospital as compared to that of developed countries. The objective of this study is to analyze the surgical outcome of TOF patients with age > 15 years. Methods: This is a retrospective descriptive study of the surgical outcomes of 45 adult patients undergoing correction for TOF. Epidemiology, symptomology, and preoperative evaluation were performed. Results: Most of the patients were male (33 [73%]). The median age was 21 years. A total of 42 (93.33%) patients had subaortic ventricular septal defect (VSD), while three (6.6%) patients presented with doubly committed VSD. The most common type of right ventricular outflow tract (RVOT) obstruction was combined infundibular and valvular types, accounting for 34 cases (75.5%). Six patients had infundibular RVOT obstruction, while three patients (6.6%) had predominantly valvular pulmonary stenosis. We performed trans-right atrial repair in 33 patients. Right atrium-pulmonary artery approach was used in five patients (11.1%). The most common postoperative complication was right bundle branch block, seen in 14 patients, with a mortality rate of 2% in the early postoperative period. We achieved excellent early and midterm survival results and significant improvement in functions and disease-free quality of life. Conclusion: Intracardiac repair in adult TOF can be performed with low mortality, less residual RVOT obstruction, and need for revision of RVOT far less frequent by using the Jhajhria Infundibular Resection Adequacy Assessment technique (JIRAAT) to assess for adequacy of infundibular resection.
ABSTRACT
Background: Substance abuse is a major but neglected public health problem across the globe. Most of the time it starts during adolescence, which is also considered a critical risk period for the initiation of substance use. Materials and Methods: We conducted a cross-sectional analytical study to estimate the prevalence and determine the association of socio-demographic and other risk factors with substance abuse among adolescents in an urban area of Himachal Pradesh. A multi-stage cluster with probability proportional to size sampling technique was followed and a semi-structured, pretested questionnaire was used as the study tool. Results: We studied a total of 728 participants and 39.6% were females. The mean age was 15.6 ± 1.3 years. Out of these, 12.1% reported any substance abuse earlier in their lifetime. Among ever users, most commonly abused substance was alcohol (8.9%), followed by smoked tobacco (7.1%), bhang (3.7%), hard liquor (2.8%), charas/ganja (1.4%), chewing tobacco (1.4%), inhalants (fluid/eraser) 0.82%, prescription drugs (cough syrup/tablets 0.69% and injecting drugs 0.27%), Chitta (0.27%), opium and heroin with 0.14% each. On multiple logistic regression analysis, male gender (AOR=1.82), among friend’s tobacco smoking (AOR=2.33), alcohol abuse (AOR=4.52), and cannabis abuse (AOR=2.99) were found to be associated with an increased likelihood of substance abuse. High socio-economic status (AOR=0.59) and tobacco chewing among friends (AOR=0.49) had a protective effect on indulgence in substance abuse. Conclusion: The influence of peers played the most significant predictor while the presence of substance abuse in the family was also associated with an increased likelihood of abuse by adolescents.
ABSTRACT
Omicron is currently shaking the world to its core. The disease is mainly transmitted via the respiratory route when people inhale droplets and small airborne particles (that form an aerosol) that infected people exhale as they breathe, talk, cough, sneeze, or sing. “UK becomes first country in Europe to pass 1,50,000 COVID deaths Omicron clouds forecasts for Covid end game.Omicron is a variant of nSARS-CoV-2 that has been identified initially in COVID19 patients in Botswana and South Africa. The chief of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, has said that the combination of Delta and Omicron variants of coronavirus is driving a tsunami of COVID-19 cases. The statement came as record new cases were reported from the United States and countries across Europe. France recorded the highest ever daily numbers in Europe for the second consecutive day, at 208,000 new cases.Vaccines offer strong protection from serious illness.
ABSTRACT
Background:Acute kidney injury (AKI) is a frequent complication in critically sick patients admitted to the intensive care unit (ICU). The objective of this study was to assess the risk factors and clinical outcomes of AKI in patients admitted to a teaching hospital's intensive care unit.Methods:This prospective observational study was conducted in the department of internal medicine, Janaki Medical College, Janakpur, Nepal from June 2018 till May 2019. Adults (aged 18 years or more) diagnosed with AKI using RIFLE criteria and were either admitted in ICU with diagnosis of AKI or developed AKI after admission to ICU. AKI patients were classified as those who satisfied any of the RIFLE categorization criteria.Results:The most common presenting complaint was fever (77%). The most common etiology of AKI was sepsis (71%). Other causes of AKI were post-operative cases (16%) and alcoholic liver disease (13%). When classified as per RIFLE criteria, we classified 38 cases (31.9%) as ‘risk’, 53 (44.54%) as ‘injury’ and28 (23.53%) as ‘failure’. The etiological classification of our patients to be significantly associated with RIFLE classification (p<0.01). However, we found the mortality not to be significantly associated with RIFLE classification (p=0.74). Conclusions:AKI classification should be used as a risk assessment tool towards the AKI's influence on the prognosis of ICU patients. Further study should investigate determining the death rate according to the RIFLE criteria in this region of Nepal.
ABSTRACT
Introduction: The global burden of sepsis is overwhelming and novel therapeutic agents is the need of the hour. The present study was designed to understand the role of Malondialdehyde as a marker of the oxidative stress in sepsis, as well as the effect of supplementation of Vitamin C and Thiamine in patients of sepsis. Methods: 80 patients of sepsis were randomly divided into 4 groups of 20 each. Twenty age-sex matched healthy volunteers were chosen as controls. The first group received Vitamin C, the second group received Thiamine, the third group received both and the fourth group received neither. Vitamin C (2g 8 hourly) and Thiamine (200 mg 12 hourly) were given intravenously for five days. The outcome was recorded in terms of mortality in the various groups as well as by the improvement in SOFA scores (?SOFA). The serum levels of Vitamin C, Thiamine and Malondialdehyde were estimated. Results: Among the 80 patients, 17 (21%) were in septic shock. The mortality rate was 10% overall, and 47% among patients of septic shock. No additional mortality benefit was observed in the groups supplemented with Vitamin C and Thiamine. However, the ?SOFA score in patients who received both Vitamin C and Thiamine was significantly higher as compared to the other groups. The mean malondialdehyde level was higher in patients of sepsis (1.81±1.18 ?mol/l) as compared with healthy controls (0.78 ± 0.36 ?mol/l). The Vitamin C level and Thiamine level (estimated indirectly by TPP effect), at presentation were 5.14±4.19 ng/ml and 52.99±28.45 % in patients of sepsis, which was significantly lower than that in healthy controls, in whom the levels were 14.64±5.51 ng/ml and 27.55±13.67% respectively. Conclusion: Vitamin C and Thiamine supplementation is a cost-effective approach with a good safety profile. Additional studies including a larger population is required to study the mortality benefits and reaffirm our findings.
ABSTRACT
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.
ABSTRACT
Background and Objectives@#The influence of music training on different areas of the brain has been extensively researched, but the underlying neurobehavioral mechanisms remain unknown. In the present study, the effects of training for more than three years in Carnatic music (an Indian form of music) on the discrimination ability of different areas of the brain were tested using P300 analysis at three electrode placement sites. @*Subjects and Methods@#A total of 27 individuals, including 13 singers aged 16-30 years (mean±standard deviation, 23±3.2 years) and 14 non-singers aged 16-30 years (mean age, 24±2.9 years), participated in this study. The singers had 3-5 years of formal training experience in Carnatic music. Cortical activities in areas corresponding to attention, discrimination, and memory were tested using P300 analysis, and the tests were performed using the Intelligent Hearing System. @*Results@#The mean P300 amplitude of the singers at the Fz electrode placement site (5.64±1.81) was significantly higher than that of the non-singers (3.85±1.60; t(25)=3.3, p<0.05). The amplitude at the Cz electrode placement site in singers (5.90±2.18) was significantly higher than that in non-singers (3.46±1.40; t(25)=3.3, p<0.05). The amplitude at the Pz electrode placement site in singers (4.94±1.89) was significantly higher than that in non-singers (3.57±1.50; t(25)=3.3, p<0.05). Among singers, the mean P300 amplitude was significantly higher in the Cz site than the other placement sites, and among non-singers, the mean P300 amplitude was significantly higher in the Fz site than the other placement sites, i.e., music training facilitated enhancement of the P300 amplitude at the Cz site. @*Conclusions@#The findings of this study suggest that more than three years of training in Carnatic singing can enhance neural coding to discriminate subtle differences, leading to enhanced discrimination abilities of the brain, mainly in the generation site corresponding to Cz electrode placement.