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ABSTRACT Purpose: To create a nomogram to predict the absence of clinically significant prostate cancer (CSPCa) in males with non-suspicion multiparametric magnetic resonance imaging (mpMRI) undergoing prostate biopsy (PBx). Materials and Methods: We identified consecutive patients who underwent 3T mpMRI followed by PBx for suspicion of PCa or surveillance follow-up. All patients had Prostate Imaging Reporting and Data System score 1-2 (negative mpMRI). CSPCa was defined as Grade Group ≥2. Multivariate logistic regression analysis was performed via backward elimination. Discrimination was evaluated with area under the receiver operating characteristic (AUROC). Internal validation with 1,000x bootstrapping for estimating the optimism corrected AUROC. Results: Total 327 patients met inclusion criteria. The median (IQR) age and PSA density (PSAD) were 64 years (58-70) and 0.10 ng/mL2 (0.07-0.15), respectively. Biopsy history was as follows: 117 (36%) males were PBx-naive, 130 (40%) had previous negative PBx and 80 (24%) had previous positive PBx. The majority were White (65%); 6% of males self-reported Black. Overall, 44 (13%) patients were diagnosed with CSPCa on PBx. Black race, history of previous negative PBx and PSAD ≥0.15ng/mL2 were independent predictors for CSPCa on PBx and were included in the nomogram. The AUROC of the nomogram was 0.78 and the optimism corrected AUROC was 0.75. Conclusions: Our nomogram facilitates evaluating individual probability of CSPCa on PBx in males with PIRADS 1-2 mpMRI and may be used to identify those in whom PBx may be safely avoided. Black males have increased risk of CSPCa on PBx, even in the setting of PIRADS 1-2 mpMRI
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Background: Robotic-assisted surgery has attained widespread acceptance within clinical practice, emerging as the definitive standard for various medical indications. Within the realm of Gynae surgery, there has been a notable upsurge in the utilization of robotic and laparoscopic techniques. The Versius robotic system, developed by CMR Surgical, has demonstrated its efficacy on a global scale since its introduction in 2018, marking a significant stride in the landscape of robotic-assisted surgery. This review article was dedicated to providing an impartial assessment of robotic technology, elucidating our insights gleaned from 53 gynaecological surgeries conducted with the Versius robotic system.Methods: A meticulous examination of 53 cases was undertaken, wherein average operative time, estimated blood loss, postoperative hospital stay, Intraoperative and postoperative complications, and conversion rates were subjected to retrospective scrutiny.Results: The study conducted at a Tertiary care hospital involved the analysis of 53 gynecological cases using the Versius system. Results indicate the feasibility, efficiency, and patient-friendly nature of the Versius system, with notable advantages such as reduced hospital stay and smoother manipulation of tissues.Conclusions: We acknowledge the ongoing evolutionary trajectory of robotic surgery and it is evident that its merit has already been substantiated by the endorsement of numerous medical practitioners and patients worldwide. The Versius robotic system stands as a revolutionary force within the healthcare paradigm, distinguished not only by its favorability among medical professionals but also by its patient-friendly attributes. In the realm of minimally invasive gynecologic surgery, robot-assisted surgery emerges as a compelling alternative.
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Objective@#To compile epidemiological characteristics of traumatic spinal cord injury (TSCI) in the Northern Indian Himalayan regions and Sub-Himalayan planes. @*Methods@#The present study is a retrospective, cross-sectional descriptive analysis based on hospital data conducted at the Department of Physical Medicine and Rehabilitation and Spine Unit of Trauma Centre in a tertiary care hospital in Uttarakhand, India. People hospitalized at the tertiary care center between August 2018 and November 2021 are included in the study sample. A prestructured proforma was employed for the evaluation, including demographic and epidemiological characteristics. @*Results@#TSCI was found in 167 out of 3,120 trauma patients. The mean age of people with TSCI was 33.5±13.3, with a male-to-female ratio of 2.4:1. Eighty-three participants (49.7%) were from the plains, while the hilly region accounts for 50.3%. People from the plains had a 2.9:1 rural-to-urban ratio, whereas the hilly region had a 6:1 ratio. The overall most prevalent cause was Falls (59.3%), followed by road traffic accidents (RTAs) (35.9%). RTAs (57.2%) were the most common cause of TSCI in the plains’ urban regions, while Falls (58.1%) were more common in rural plains. In both urban (66.6%) and rural (65.3%) parts of the hilly region, falls were the most common cause. @*Conclusion@#TSCI is more common in young males, especially in rural hilly areas. Falls rather than RTAs are the major cause.
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Numerous neoplastic lesions can arise in the orofacial region in the pediatric populations. Odontogenic tumors typically affect the mandible more than the maxilla. Airway management can be challenging in pediatric oral tumors because of the distorted anatomy and physiological variations. Conventional awake fiberoptic intubation is not always possible owing to limited cooperation from the pediatric populations. Herein, we report the case of a 1-year-old child with odontogenic myxoma of the mandible and an anticipated difficult airway. Given the expected difficulties in the airway, video laryngoscope-assisted orotracheal intubation under general anesthesia with maintenance of spontaneous breathing was scheduled. Proper planning and thorough examinations are vital for successful airway management in pediatric patients.
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ABSTRACT Purpose: To compare transperineal (TP) vs transrectal (TR) magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS) fusion-guided prostate biopsy (PBx) in a large, ethnically diverse and multiracial cohort. Materials and Methods: Consecutive patients who underwent multiparametric (mp) MRI followed by TP or TR TRUS-fusion guided PBx, were identified from a prospective database (IRB #HS-13-00663). All patients underwent mpMRI followed by 12-14 core systematic PBx. A minimum of two additional target-biopsy cores were taken per PIRADS≥3 lesion. The endpoint was the detection of clinically significant prostate cancer (CSPCa; Grade Group, GG≥2). Statistical significance was defined as p<0.05. Results: A total of 1491 patients met inclusion criteria, with 480 undergoing TP and 1011 TR PBx. Overall, 11% of patients were Asians, 5% African Americans, 14% Hispanic, 14% Others, and 56% White, similar between TP and TR (p=0.4). For PIRADS 3-5, the TP PBx CSPCa detection was significantly higher (61% vs 54%, p=0.03) than TR PBx, but not for PIRADS 1-2 (13% vs 13%, p=1.0). After adjusting for confounders on multivariable analysis, Black race, but not the PBx approach (TP vs TR), was an independent predictor of CSPCa detection. The median maximum cancer core length (11 vs 8mm; p<0.001) and percent (80% vs 60%; p<0.001) were greater for TP PBx even after adjusting for confounders. Conclusions: In a large and diverse cohort, Black race, but not the biopsy approach, was an independent predictor for CSPCa detection. TP and TR PBx yielded similar CSPCa detection rates; however the TP PBx was histologically more informative.
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The research was conducted at University of Agricultural Sciences Raichur during 2021-22. In this research Caenorhabditis elegans is utilized by the researchers to know the effects of various extracts, drugs, nano particles, xenobiotics, magnetic effects on behaviour, neuronal effects, feeding pathways, apoptosis, ageing related pathways. Experiments were performed to evaluate the traditional herbs (Cinnamon, Almond, Beetroot Carrot, Ashwagandha and Tulsi) consumption for their health beneficial effects by monitoring the movement as an end point. Movement of an organism is considered as the health and age influencing factor. As the movement is well maintained in organism means health is also well maintained. Hence consistent movement is the factor for the healthy life. In the present study the organism movement has been monitored from L4 onwards every day for 30 minute till 21st day of the survival by automated system. The worm movement during this period has been categorised based on activity in three categories from L4 to 4days the activity ranged from 28.0 units to 10 IR units, 5th to 15th day 27.82 to 14.67 and from 16th to 21st day ranged from 17.87 to 14.44 IR units in non exposed N2 wild type worms. There is a gradual increase in the activity has been recorded on the exposure to health beneficial extracts in a single dose of supplementation. Hence, the study concludes that the health supplements can impact on the move ability of worms and maintains consistent movement till 21 days. Further studies are required to establish comprehensive health beneficial effects of these extracts at organism level.
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The present investigation was conducted to study the genetic variability, correlation and path coefficient analysis for eight yield and yield attributing traits in 47 (40 improved parental lines + 7 checks) lines of rice. Analysis of variance revealed significant differences among all the treatments under study. High values of PCV and GCV were recorded for traits like number of filled grains per panicle and single plant yield while moderate PCV and GCV recorded for plant height, number of productive tillers per plant, spikelet fertility and 1000 grain weight. High heritability coupled with high genetic advance as percent of mean was observed for the traits namely number of filled grains per panicle, plant height and single plant yield. The traits viz., productive tillers per plant, panicle length, number of filled grains per panicle, spikelet fertility % and 1000-grain weight exhibited significant and positive association with single plant yield. Number of filled grains per panicle, 1000-grain weight, number of productive tillers per plant, plant height and panicle length exhibited positive direct effect on single plant yield indicating that direct selection for these traits would lead to improvement in single plant yield.
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Aims: The auto sector in India contributes 7.1% of the country's GDP and is predicted to earn USD 810.3 billion by 2026. However, India has a greater death rate and poorer job safety than the United States, where industrial accidents happen 20 times more frequently. Musculoskeletal disorders are a significant cause of disability and accidents at work. The goal of the study was to evaluate the existing working conditions in the automobile industry, where mechanics play a crucial role in precision.Study Design: The present study was carried out in Uttarakhand at Udham Singh Nagar district, block Rudrapur; Nainital district, block Haldwani; and Almora district, block Dwarahat. Purposive and random sampling techniques were used to select the study area and samples. The total 75 respondents and 14 garages were selected.Methodology: A checklist was developed to get information about the health status of garage workers, awareness of occupational hazards, use of personal protective equipment, risk assessment, and workplace analysis.Results: The study reveals that Udham Singh Nagar garages provide cent per cent PPE to their workers, while Nainital and Almora districts lack proper facilities. Nearly half of workers lack worksite cleaning facilities, slip-resistant floors, spray booths, dip tanks, and clean toilets. Additionally, a quarter of garages require adjustments to work height, foot platforms, item holders, work-rotation systems, hanging toolboxes, and hazardous chemical container labeling.Conclusion: 7.1% of India's GDP is contributed by the auto industry, which is projected to generate $810.3 billion by 2026. In contrast to the US, the nation has a greater fatality rate and a worse level of workplace safety, and industrial accidents happen there 20 times more frequently. According to a survey conducted in Uttarakhand, whereas Nainital and Almora districts lack adequate amenities, Udham Singh Nagar garages offer cent per cent PPE to employees. There aren't enough clean restrooms, or there aren't enough slip-resistant floors for the majority of employees.
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The existence of genetic variability within a population is a fundamental requirement for promoting the effectiveness of any breeding operation. The study was carried out at Dr. RPCAU's research farm located in Pusa Samastipur, Bihar, during the kharif season of 2019-20. The objective was to assess the genetic variability among 23 cowpea genotypes (22 genotypes from various locations in the country and 1 check genotype). The study employed a randomised block design, consisting of three replications and a total of fifteen characters were recorded during the study. The analysis of variance (ANOVA) revealed statistically significant mean sum of squares (MSS) values attributed to genotype for all recorded variables, suggesting the existence of a substantial amount of diversity across the cowpea genotypes utilised in the study. In general, the recorded values for the Phenotypic Coefficient of Variation were found to be higher than those for the Genotypic Coefficient of Variation. The study observed high heritability estimates and high genetic advance for various traits, including plant height, number of leaves per plant, stem thickness, leaf-to-stem ratio, dry matter percentage, leaf fresh weight per plant, dry weight of stem per plant, seed yield per plant, and dry matter yield per plant. These findings suggest that the influence of the environment on these phenotypes is minimal. One of the key conclusions drawn from the study is that the direct selection of these traits can be employed to enhance fodder characteristics in cowpea.
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Background: Men with early-onset androgenetic alopecia (AGA) often have an abnormal hormonal milieu. Objective: To ascertain the clinico-phenotypic characteristics and the prevalence of hormonal and metabolic changes in men with early-onset AGA. Methods: Consecutive male patients less than 30 years of age with a Norwood-Hamilton grade ?3 AGA were recruited in this comparative cross-sectional study. After endocrine evaluation they were classified into two groups, that is, Group A consisting of subjects with an altered hormonal profile and Group B with normal hormonal profiles. The groups were assessed for differences in disease phenotype and severity (Norwood-Hamilton grade), insulin resistance and parameters of metabolic syndrome (ATP III guidelines). Results: Altered hormonal profiles were seen in 34 of the 100 subjects with AGA, while insulin resistance and metabolic syndrome were noted in 44 and 26 respectively. Altered hormonal profiles were significantly associated with insulin resistance and severe alopecia (grade 4 and above Hamilton-Norwood Scale). Insulin resistant Group A patients had a significantly higher prevalence of severe alopecia (>grade 4) (P = 0.0036). The prevalence of metabolic syndrome was similar in both groups. Limitation: The cross sectional study design was a drawback of this study. Further, a control arm without AGA was not included and the sample size of 100 was selected arbitrarily. Conclusion: An altered hormonal profile and insulin resistance was noted in a third of the males with early-onset AGA. Subjects with altered hormonal profiles had a higher prevalence of insulin resistance and were likely to have severe grades of AGA
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Background: Coronavirus is an RNA virus causing respiratory and gastrointestinal infections. It caused SARS and MERS epidemics. In late 2019, a mutation called SARS-CoV-2 caused COVID-19, a severe respiratory illness. Pregnant women are at risk, but information is limited. The second wave affected pregnant women more. Maternal COVID-19 can lead to preterm births and caesarean sections. Vertical transmission to neonates is possible. Ongoing research is crucial to understand COVID-19's impact on mothers.Methods: A comparative prospective hospital-based study was conducted, including antenatal women with COVID-19 symptoms in the case group. The control group consisted of antenatal women who tested negative for COVID-19. The study analyzed 150 COVID-19-positive antenatal women and 350 COVID-19-negative antenatal women, excluding those who left the study prematurely or tested positive during the study period.Results: In the case group, no abortions were reported (0%), while in the control group, there was 1 abortion (0.29%). PROM occurred in 5.78% of cases and 1.43% of controls, with a significant difference. PPROM occurred in 2.31% of cases and 2.57% of controls, showing no significant difference. Preterm labor was observed in 11.53% of cases and 3.71% of controls, with a significant difference.Conclusions: Pregnant women with COVID-19 experience diverse symptoms, highlighting the importance of vigilant monitoring. Adverse maternal outcomes, including preterm labor and ICU admission, are more common in infected individuals. Managing comorbidities, such as diabetes, is crucial.
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Background: Objective of study was to evaluate the effect of prenatal yoga on maternal gestational weight gain (GWG) and psychological stress in pregnancy (PSS) and to evaluate the effect of prenatal yoga on labour outcomes.Methods: Prospective randomized controlled trial conducted at AIIMS, New Delhi between May 2020-December 2021. Sixty women each were recruited in the yoga and control group. Women in the yoga group attended 60 minutes supervised yoga sessions followed by self-sessions. Women in the control group received routine antenatal care along with 30 minutes per day of walking and dietary counselling. The assessment was done for the weight(WT), dietary intake (D) and perceived stress score (PSS) at the time of recruitment (WT1, D1, PSS1), 28 weeks (WT2, D2, PSS2) and 36 weeks (WT3, D3, PSS3) and the results were then compared.Results: At recruitment all the parameters in both groups were comparable. The difference in mean and difference in percentage in terms of gestational weight gain (GWG) at recruitment and at 36 weeks was statistically significant (p-value=0.027). The per cent weight gain in the Yoga group was significantly low (p value=0.048). The control group experienced more amount of stress both at 28 weeks (p-value = 0.021) and 36 weeks (p-value <0.0001). The difference in mean and difference in percentage in terms of PSS1 and PSS2 (p-value=0.011), PSS2 and PSS3 (p-value=0.0001) PSS1 and PSS 3 (p-value=0.0001). Labour outcomes were comparable between both groups.Conclusions: Yoga helps in controlling excessive GWG and helps prevent many adverse feto-maternal outcomes associated with obesity.
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Background: Coronavirus is an RNA virus causing respiratory and gastrointestinal infections. It caused SARS and MERS epidemics. In late 2019, a mutation called SARS-CoV-2 caused COVID-19, a severe respiratory illness. Pregnant women are at risk, but information is limited. The second wave affected pregnant women more. Maternal COVID-19 can lead to preterm births and caesarean sections. Vertical transmission to neonates is possible. Ongoing research is crucial to understand COVID-19's impact on mothers.Methods: A comparative prospective hospital-based study was conducted, including antenatal women with COVID-19 symptoms in the case group. The control group consisted of antenatal women who tested negative for COVID-19. The study analyzed 150 COVID-19-positive antenatal women and 350 COVID-19-negative antenatal women, excluding those who left the study prematurely or tested positive during the study period.Results: In the case group, no abortions were reported (0%), while in the control group, there was 1 abortion (0.29%). PROM occurred in 5.78% of cases and 1.43% of controls, with a significant difference. PPROM occurred in 2.31% of cases and 2.57% of controls, showing no significant difference. Preterm labor was observed in 11.53% of cases and 3.71% of controls, with a significant difference.Conclusions: Pregnant women with COVID-19 experience diverse symptoms, highlighting the importance of vigilant monitoring. Adverse maternal outcomes, including preterm labor and ICU admission, are more common in infected individuals. Managing comorbidities, such as diabetes, is crucial.
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Background: Objective of study was to evaluate the effect of prenatal yoga on maternal gestational weight gain (GWG) and psychological stress in pregnancy (PSS) and to evaluate the effect of prenatal yoga on labour outcomes.Methods: Prospective randomized controlled trial conducted at AIIMS, New Delhi between May 2020-December 2021. Sixty women each were recruited in the yoga and control group. Women in the yoga group attended 60 minutes supervised yoga sessions followed by self-sessions. Women in the control group received routine antenatal care along with 30 minutes per day of walking and dietary counselling. The assessment was done for the weight(WT), dietary intake (D) and perceived stress score (PSS) at the time of recruitment (WT1, D1, PSS1), 28 weeks (WT2, D2, PSS2) and 36 weeks (WT3, D3, PSS3) and the results were then compared.Results: At recruitment all the parameters in both groups were comparable. The difference in mean and difference in percentage in terms of gestational weight gain (GWG) at recruitment and at 36 weeks was statistically significant (p-value=0.027). The per cent weight gain in the Yoga group was significantly low (p value=0.048). The control group experienced more amount of stress both at 28 weeks (p-value = 0.021) and 36 weeks (p-value <0.0001). The difference in mean and difference in percentage in terms of PSS1 and PSS2 (p-value=0.011), PSS2 and PSS3 (p-value=0.0001) PSS1 and PSS 3 (p-value=0.0001). Labour outcomes were comparable between both groups.Conclusions: Yoga helps in controlling excessive GWG and helps prevent many adverse feto-maternal outcomes associated with obesity.
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An experiment was conducted during in Zaid season (March 2022-June 2022) on central research farm of Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj. The experiment was laid out in randomized block design with three levels of Phosphorus and Zinc (0 %, 50 % and 100 %). The treatment combinations were replicated three times and were allocated at random in each replication. The result shows that application of different levels combination of inorganic fertilizers increased growth, yield of green gram. It was recorded from the application of P and Zinc fertilizers in treatment T7 [P @ 100% + Zinc @ 0%] maximum plant height 40.90, 49.12, and 60.16 cm at 30, 60 DAS and at harvest, number of branches plant-1 9.35, 11.62, and 14.24 at 30, 60 DAS and at harvest, number of pods plant-1 25.73, number of seeds pod-1 10.54, test weight of 1000 seeds 54.66 g, grain yield 11.73 q ha-1 with benefit cost ratio 1: 2.33 best from T1 [(control) P @ 0% + Zinc @ 0 %].
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An experiment was conducted during in Rabi season (December 2021 – March 2022) on central research farm of Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj. The experiment was laid out in randomized block design with three levels of NPK and Biochar (0, 50 and 100%). The result shows that application of different levels combination of inorganic fertilizers increased growth, yield of field pea and improved soil chemical properties. It was recorded from the application of NPK and Biochar fertilizers in treatment T9 [NPK @ 100% + Biochar @ 100%] maximum bulk density 1.274 Mg m-3 at and 1.279 Mg m-3, particle density 2.518 Mg m-3 and 1.523 Mg m-3, % pore space 47.71% and 44.68%, water holding capacity 39.75% and 36.82%, pH 7.05 at and 7.15 at, EC 0.473 dS m-1 and 0.479 dS m-1, organic carbon 0.497% and 0.495%, available nitrogen 314.56 kg ha-1 and 311.55 kg ha-1, available phosphorus 38.70 kg ha-1 and 36.28 kg ha-1, available potassium 220.42 kg ha-1 and 217.67 kg ha-1 all parameters at 0-15 cm and 15-30 cm best from T1 [ NPK @ 0% + Biochar @ 0 %].
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Myopia is a major public health problem worldwide, including India, with the global prevalence of myopia increasing rapidly over decades. The clinical and socioeconomic impact of myopia is also expected to rise with rising prevalence. Therefore, the focus has now been shifted to prevent the incidence and progression of myopia. However, there is lack of any standardized guidelines for myopia management. This document aims to generate a national-level expert consensus statement on the management of childhood myopia in the Indian scenario. The expert panel of pediatric ophthalmologists consisted of 63 members who met in a hybrid meeting. A list of topics deliberating discussion in the meeting was provided to the experts in advance and they were instructed to provide their opinions on the matter during the meet. The panel of experts then gave their views on each of the items presented, deliberated on different aspects of childhood myopia, and reached a consensus regarding the practice patterns in the Indian scenario. In case of opposing views or lack of a clear consensus, we undertook further discussion and evaluated literature to help arrive at a consensus. A written document is prepared based on recommendations explaining definition of myopia, refraction techniques, components and methods of workup, initiation of anti-myopia treatment, type and timing of interventions, follow-up schedule, and indications for revised or combination treatment. This article formulates evidence-based guidelines for progressing myopes and pre-myopes and also establishes uniformity in the management of childhood myopia in the country.
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Extracorporeal Shock Wave Lithotripsy (ESWL) is one of the treatment options for renal and upper ureteric calculus; however, the outcome depends on multiple factors. Our study aims to evaluate the factors that may inuence ESWL outcomes in Indian patients with upper urinary tract calculi. Between 2018 and 2020, a total of 300 adult patients who underwent ESWL for renal and upper ureteral calculus sizing 5 to 20 mm were included in the study program. Patients with
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Dystonia is a movement disorder characterised by involuntary, extended, patterned, and often repetitive muscle contractions of skeletal muscles, frequently causing twisting movements or abnormal postures. Recent studies have shown that stress and coffee consumption can precipitate dystonic attacks. Many people, due to their diligent life schedules and increased physical inactivity due to less work-life balance, have been identified as the major cause of this neurological movement disorder. The action of caffeine and other CNS stimulants may be related to dystonic episodes in an individual. Cervical dystonia is specifically characterised by involuntary muscle contraction of the trapezius muscle, pain in the cervical region, numbness in one or both arms, and restricted movement. Proper understanding and management of spasmodic torticollis are necessary to avoid discomfort and progress towards a healthy life. The case study aims to highlight the role of physical activity along with proper work-life balance to live a healthy lifestyle and minimise the frequency of muscle spasm attacks caused by spasmodic torticollis. The role of clinicians such as physicians and clinical pharmacists in understanding and managing the disease is critical and crucial for a better quality of life and leading a stress-free life.
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Trauma is a global challenge and India has one of the highest trauma deaths in the world. Despite the United Nations’ target to halve the global number of deaths and injuries from road traffic crashes by 2030, death tolls from road traffic injuries (RTI) are rising in India. In the pediatric age group, falls from height add to the burden of trauma. Uncontrolled bleeding from exsanguination on scene is estimated to account for nearly 40% of RTI trauma related mortality. Stopping the bleeding in the first few minutes is crucial for meaningful survival and hence the role of training lay public who can reach the scene in minutes. Active bleeding control (ABC) pilot research project to simulation train the bystanders to stop the bleed showed promising outcomes in Hyderabad, India. This paper describes the ABC project and discusses the role of pediatricians in training the public to reduce morbidity and mortality from uncontrolled bleeding at the trauma scene.