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Background: Electronic waste, or e-waste, refers to all items of electrical and electronic equipment (EEE) and its parts that have been discarded by its owner as waste without the intent of re-use. Improper e-waste management can lead to adverse human health effects and environmental pollution. The aim of our study was to assess the knowledge, attitude and practice regarding e-waste management and the factors affecting it. Methods: This cross-sectional study was conducted from December 2023 to February 2024 in three block panchayats of Malappuram district in Kerala with a sample size of 266 selected using multistage sampling. Data was entered in Microsoft Office and was analysed using statistical package for the social sciences (SPSS) software. Factors affecting the outcome variables was assessed using Chi-square test or Fisher exact test depending on the sample distribution. Results: Study results showed that 28.9% of the participants had good awareness, 27.1% had average awareness and 44% of the population had poor awareness and on e-waste management. 89.5% of population had a very good perception towards e waste management. Age, gender, type of family they come from, educational factors, occupational factors and socioeconomic class were the factors affecting e-waste management. Conclusions: Increasing public awareness and educating stakeholders about the hazards of e-waste is crucial. Promotion of campaigns and programs to inform individuals about the proper disposal methods, recycling options, and the importance of reducing e-waste generation through responsible consumption can significantly improve the management of e-waste.
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Abstract Small osteolabral avulsions of the hip can be easily missed, and postreduction stress testing and computed tomography (CT) scans of the hip should be performed to look for these injuries. The usual modality of treatment of these unstable osteolabral avulsions is suture anchors, Herbert screws or spring plates. But when the bony avulsion is small, the use of these implants becomes a tedious job. We present a novel technique to fix small osteochondral avulsion fractures not amenable to fixation using screws or spring plates. We performed a retrospective analysis of 57 cases of patients who underwent open reduction and internal fixation for posterior fracture dislocation of the acetabulum, and we identified 6 cases of small posterior labral osteochondral fragments leading to instability. These injuries were fixed using a novel method. The mean Harris Hip Score at the final follow-up was of 92.5. Fixation of osteochondral avulsions associated with posterior hip fracture dislocation can be a difficult task if the bony fragment is small. Our technique is a simple, cost-effective and reliable way of fixing such avulsions with satisfactory outcomes.
Resumo Pequenas avulsões osteolabrais do quadril podem passar despercebidas, e testes de estresse pós-redução e tomografia computadorizada do quadril devem ser realizados para sua detecção. O tratamento dessas avulsões osteolabrais instáveis geralmente é feito com âncoras de sutura, parafusos de Herbert ou placas-molas. Em avulsões ósseas pequenas, porém, o uso desses implantes é um trabalho tedioso. Apresentamos uma nova técnica de fixação de pequenas fraturas com avulsões osteocondrais não passíveis de fixação com parafusos ou placas-molas. Realizamos uma análise retrospectiva de 57 casos de pacientes submetidos à redução aberta e fixação interna de fratura-luxação posterior do acetábulo, e identificamos 6 casos em que um pequeno fragmento osteocondral labral posterior causava instabilidade. Essas lesões foram corrigidas com um novo método. A pontuação média no Harris Hip Score no último acompanhamento foi de 92,5. A fixação de avulsões osteocondrais associadas a fratura-luxação posterior do quadril pode ser difícil se o fragmento ósseo for pequeno. Nossa técnica é uma maneira simples, econômica e confiável de corrigir tais avulsões com resultados satisfatórios.
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Humanos , Fraturas Ósseas , Fratura-Luxação , Fratura Avulsão , Redução Aberta , Acetábulo/cirurgiaRESUMO
Background: Prescribing medicine is a core skill for dentists, impacting patient safety and requiring knowledge of medications, dosages, and risks. This study evaluates dental students' awareness of these critical aspects in Kerala, India. Methods: This study aimed to assess drug prescription awareness among dental students in Kerala, India, highlighting current knowledge, standard practices, and areas for improvement. Results: Dental pain emerged as the most commonly treated condition (57.7%), with Amoxicillin reigning as the antibiotic of choice (69.2%-76.3%). Textbooks reigned supreme as the primary source of prescription information (66.4%-58.3%), even as most participants (78.1%-72.4%) acknowledged the WHO prescribing guidelines. While interns demonstrably boasted greater confidence in their knowledge, nearly half of all participants grappled with a lack of confidence in drug dosage and frequency. Incorrect dosage stood out as the Achilles' heel of prescription practices (71.9%-77.6%). Strengths included awareness of the correct route of delivery (61.6%-74.4%) and adherence to WHO guidelines. Conclusions: Dental students in Kerala demonstrate fair drug prescription awareness but have gaps in knowledge regarding dosage, frequency, and duration. Textbooks are the primary information source, highlighting the need for more in-depth education and reliance on evidence-based resources. Targeted interventions focused on these areas could enhance prescribing practices and patient safety.
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Background: Widespread prevalence of dental caries, particularly in developing countries, poses a major public health challenge. Traditional approaches using fillings and remineralizing agents have limitations. Probiotics offer a potentially self-administered, multifaceted alternative for both preventing and managing caries, with additional health benefits beyond oral health. Methods: A cross-sectional study with a validated questionnaire was conducted among 308 final-year students and 292 interns from dental colleges in Kerala. Data were analyzed using descriptive and inferential statistics. Results: Over 74% of interns and final-year students recognized probiotic benefits. Awareness about prebiotics was limited in both groups (59.7% and 62.3%, respectively). Notably, 65.6% of students and 72.6% of interns demonstrated knowledge about the probiotic potential of streptococcus strains. Almost 43% of students and 55% of interns reported current or past probiotic use and recommendations. A substantial majority in both groups (over 87%) expressed willingness to try recommended probiotic products. Notably, 47.4% of final-year students and 44.5% of interns had not used probiotics therapeutically, with gastrointestinal issues being the primary indication for those who did. Conclusions: High awareness of probiotics with knowledge gaps in certain areas (e.g., prebiotics) was observed. The majority showed a willingness to utilize probiotics in their practice. Educational interventions focused on these areas could equip dental professionals to provide informed advice and recommendations about probiotics to their patients.
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Recurrent tummy (abdominal) pain (RAP) is among the most prevalent symptoms where children experience frequent stomach pain over an extended period. RAP is prevalent in children, affecting 10-20% of school aged children. There is no consensus regarding this widespread issue's genesis, investigation, and management. This review touches on a few concerns about children's recurrent abdominal pain.
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Background@#Nitrous oxide has been an integral part of surgical anesthesia for many years in the developed world and is still used in developing countries such as India. The other main concerns in low-resource countries are the lack of an advanced anesthesia gas-scavenging system and modular surgical theatres. As a greenhouse gas that has been present in the atmosphere for more than 100 years and damages the ozone layer, nitrous oxide is three times worse than sevoflurane. Here, we conducted an observational study to quantify the annual nitrous oxide consumption and its environmental impact in terms of carbon dioxide equivalence in one of busiest tertiary health care and research centers in Northern India. @*Methods@#Data related to nitrous oxide expenditure’ from the operation theatre and manifold complex of our tertiary care hospital and research center from 2018 to 2021 were collected monthly and analyzed. The outcomes were extracted from our observational study, which was approved by our institutional ethics board (INT/IEC/2017/1372 Dated 25.11.2017) and registered prospectively under the Central Registry (CTRI/2018/07/014745 Dated 05.07.2018). @*Results@#The annual nitrous oxide consumption in our tertiary care hospital was 22,081.00, 22,904.00, 17,456.00, and 18,392.00 m 3 (cubic meters) in 2018, 2019, 2020, and 2021, respectively. This indicates that the environmental impact of nitrous oxide (in terms of CO2 equivalents) from our hospital in 2018, 2019, 2020, and 2021 was 13,016.64, 13,287.82, 10,289.94, and 10,841.24 tons, respectively. @*Conclusion@#This huge amount of nitrous oxide splurge is no longer a matter of laughter, and serious efforts should be made at every central and peripheral health center level to reduce it.
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Background: Proteinuria is a major indicator of hypertensive disorders of pregnancy. Though 24 hr urinary protein is considered to be the gold standard for evaluation of proteinuria in preeclampsia but its collection is time consuming, cumbersome and needs admission of the patient. The role of spot UPCR in random sample proposed as an alternativeMethod: A observational cross-sectional study was conducted from 2020 to 2021 on 78 antenatal women of gestational age >20 weeks meeting the inclusion and exclusion criteria were enrolled into this study. Data was compared by using Pearson correlation coefficient (r). ROC curve was plotted for spot UPCR value for detecting significant proteinuria (>300 mg/24 hr).Result: The quantification of proteinuria by spot UPCR strongly correlated with 24hr urinary protein. The p=0.001. There was a positive correlation of 24hr urine protein (mg/24 hr) with spot UPCR urine sample which was significant statistically (r=0.997, p<0.05) ROC curve analysis of Spot UPCR for proteinuria (>300 mg/24 hr) after the 20 weeks gestation. The spot UPCR showed significant large area under the curve (AUC) on the ROC curve. There is positive correlation between 24 hr urinary protein (>300 mg/24 hr) and spot UPCR in patients of pre-eclampsiaConclusions: From our study we concluded that spot urinary protein creatinine ratio has a significant linear correlation with 24 hr urinary protein in pre-eclampsia.
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Background: Cardiac arrest remains a leading cause of mortality and morbidity worldwide. Though there are many prognostic tools, the importance of predicting prognosis of out of hospital cardiac arrest in the emergency department (ED) using SWAP (Shockable, witnessed, age and pH) score has not been studied extensively. Methods: We conducted a hospital-based prospective observational study in Kerala, India, focusing on patients who arrived at the ED after experiencing out-of-hospital cardiac arrest (OHCA). For patients who met the inclusion criteria, (all patients who came to ED with OHCA with age more than 18 years) we calculated the SWAP score using historical information and venous blood gas sample analysis. Patients who achieved return of spontaneous circulation (ROSC) were closely monitored, and post-cardiac arrest care was initiated. Patients who achieved sustained ROSC were admitted, and at time of discharge, follow-up was conducted using cerebral performance category (CPC) score. Results: The SWAP score was computed for patients who experienced OHCA. The analysis revealed that patients with favorable outcomes (CPC 1 and 2) had an average SWAP score of 1, while patients with unfavorable outcomes (CPC 3, 4, 5) had an average SWAP score of 1.55. Among the total of 116 patients, 7 individuals (6.03%) survived with positive neurological outcomes (CPC 1 and 2), while 109 patients (93.96%) experienced poor neurological outcomes (CPC 3, 4, 5, and mortality). Conclusions: Patients who had a high SWAP score had a reduced likelihood of survival and sustained ROSC. Conversely, patients with a SWAP score below 2 had a higher probability of experiencing a ROSC and surviving.
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Background: The study's objective was to evaluate and compare total serum protein, serum albumin, and thyroid hormones in children with PEM (protein-energy malnutrition) and healthy controls.Methods: In this cross-sectional study, 100 children with PEM served as cases, while an equal number of age and gender-matched healthy children served as controls. 4 ml of venous blood were taken (3 ml in a plain vial and 1 ml in an EDTA vial) and immediately submitted for further investigation. SPSS software (version 25) was used to analyze the data. A p value of ?0.05 was considered statistically significant.Results: PEM children have lower serum total protein, albumin level, total T3 (TT3), and total T4 (TT4) levels compared to healthy controls (p<0.0001). Mean TSH levels in cases and controls were nearly similar. There was no significant difference between serum TSH concentrations in PEM children and the controls. Grade I PEM had the highest mean total protein, serum albumin, T3, and T4 levels, followed by grades II, III, and IV. When mean total protein, serum albumin, T3, and T4 levels of each grade of PEM were compared to controls, mean total protein, serum albumin, T3, and T4 levels were substantially lower in each grade of PEM (p<0.0001).Conclusions: PEM children have low serum total protein and albumin levels. This is probably due to decreased oral intake of proteins and reduced biosynthesis. Serum TT3 and TT4 levels are lower in children with PEM than in healthy controls, which is most likely due to reduction in circulating plasma proteins.
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This research article discussed about the constraints faced by farmers in the adoption of climate smart agriculture in the Central Plain Zone of Uttar Pradesh. Climate Smart Agriculture (CSA) is basically a management strategy for agriculture in the face of climate change. Farmers face obstacles to adopting diverse Climate Smart Agriculture practices. Farmers face many barriers when it comes to adopting new or unfamiliar practices, such as Climate Smart Agriculture. These include lack of awareness, high cost of machines and input, and insufficient knowledge and guidance. Garrett's ranking technique is used to determine the most important factor influencing the response. The major constraints faced by the farmers in their knowledge and adoption of Climate Smart Agriculture were ‘lack of awareness', 'uncertain returns', 'limited extension activities’ common problems in the study area having the Garrett rank of first (Average Value 114.95), second (Average Value 113.26) and third (Average Value 101.22) respectively, and so forth the other constraints too. The study sought to identify the barriers to Climate Smart Agriculture adoption as well as potential solutions.
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While nitrogen (N) uptake in rice has been extensively studied, the influence of root morphology on this process is not fully elucidated. This study explores the root morphological characteristics and N uptake of five diverse rice genotypes under different N sources, including novel slow-release nanoclay polymer/biopolymer composite (NCPC/NCBPC) fertilizers. A greenhouse experiment was conducted using five diverse rice genotypes (Swarna, Pusa Basmati-1, Pusa-44, MTU1010 and Nagina-22) with five N treatments (T1- control (without N fertilizer), T2- 100% RDF of N through urea, T3- 75% RDF of N through urea loaded NCPC, T4- 75% RDF of N through urea loaded NCBPC-I (NCBPC prepared with wheat flour), T5- 75% RDF of N through urea loaded NCBPC-II (NCBPC prepared with maida)). The results of the study revealed that maximum overall root growth was recorded under Pusa Basmati-1 followed by Swarna, MTU 1010, Nagina-22 and Pusa-44. Among the N treatment, maximum root growth and N uptake was recorded under NCPC treatment followed by NCBPC-II, NCBPC-I, urea and control. Thus, the study reveals significant variations in root traits among genotypes and N treatments, with notable improvements observed under NCPC and NCBPC based N treatments.
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Climate change is viewed as the main problem of agriculture development in India. High dependence on agriculture and allied sectors makes the Indian state of Bihar vulnerable to climate change. Farmers' perceptions of climate change and their preferences for adaptation strategies must be understood in order to improve policies for addressing the issues that climate brings to farmers. Therefore, the main aim of the present study was to understand farmer’s perception of awareness of the climate change and their perception towards coping mechanism for changing climate. A total of 240 respondents were selected using purposive sampling in the % villages of Kishanganj district from March to May 2023. A descriptive research design was used in the study. Data was collected through face to face interview method using a semi structured interview schedule and analyzed using suitable statistical tools and techniques. It was found that the majority of farmers had a medium level of socio-economic characteristics. From the study result it was found that farmers were aware of about the climate change. Farmers agreed that the peak time of seasons has changed and there is a change in the onset of monsoon. Farmers exhibited resilience to changing climate through various local adaptation practices such as Switch to timely weather forecasting information, Climate-resilient practices, etc. The findings will help to refine and enrich the knowledge among the stakeholders to provide an effective framework for decisions and policy making.
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The submergence of rice fields is a significant issue in India's rice production, which is further aggravated by the unpredictable monsoon rain patterns and the impact of climate change. Larger variation in rainfall patterns affected by the timing of nursery raising and transplanting later in the main field therefore, we adopted Climate Resilient Technology (CRT) for rice production, Extended seedbed durations for rice seedlings allow for adequate rainfall during the monsoon season. So that the experiment was conducted at 30 farmer’s fields of NICRA village, Khana Bari, Kishanganj, Bihar, India, in 2022 under the supervision farm science Center, Kishanganj, the experiment was framed in randomized block design with ten replications. All plots received the recommended dose of fertilizers (120:60:40 kg ha-1 N.P.K.) in equal amounts. Urea, di-ammonium phosphate, and muriate of potash were used as the sources of nitrogen, phosphorus, and potassium, respectively. To determine the growth characters i.e., plant height (cm) at harvest stage, number of effective tillers hill-1, LAI, Chlorophyll concentration (SPAD) and days to 50 per cent flowering were recorded at 90 days. Yield attributes viz., After the completion of the harvest, various observations were recorded, such as the number of panicles/m2, the number of grains per panicle, the number of filled and unfilled grains per panicle, the test weight in grams, and the yield. This encompassed grain yield, straw yield, biological yield in quintals per hectare, and harvest index percentage. During the field experiment, both the climate-resilient technology Swarna Sub1 and Sabour Sampans paddy varieties were tested. Swarna Sub1 was found to be significantly superior in terms of plant growth, yield attributes, and yield characteristics. under submergence conditions. The significant maximum grain yield (48 q ha-1), straw yield (84 q ha-1), biological yield (153 q ha-1), and harvest index (45%) were recorded in Swarna Sub-1.
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The contribution of the livestock sector to the Indian Economy is 4.11% of its total GDP and it is nearly 25.6% for total agricultural GDP. Small and marginal farmers are mainly attached to the mixed farming of field crops and dairy animals. Farmers get regular income from their dairy unit and also use dairy animals as economic security. Though India comes under the highest livestock populated countries, the production of milk is lower than expected because of improper feeding quality. Through the last two decades, the demand and price of milk both increase gradually, and farmers are not getting that much profit because of their dependency on ready cattle food. The gross profit after the selling of milk is nearly equal to the feeding expenditure. For the use of paddy straw as dry fodder, the quality and quantity of milk production are decreased. So, green fodder is the best option for livestock as it contains adequate nutrients as well as crude fibre. Among the fodder and forage crops, berseem is the second maximum cultivated fodder crop which possesses a 2 million ha area of fodder crops in India. There are several advantages of berseem as a fodder crop such as a short-duration crop, multi-cut nature, the capability of higher biomass production, the presence of a good amount of crude protein, cellulose, total digestible nutrients and succulent nature. Though Phosphorus and zinc play an antagonistic effect on each other, both are required for the growth and development of berseem crops. From cellular respiration to enzymatic reactions, phosphorus is essential for completing several metabolic activities. Zinc is related to yield and fodder quality by completing plant metabolisms like carbohydrates and auxin production. Adequate management practice is required to maintain the concentration of both nutrients at an optimum level. In Indian soil, zinc is deficient and phosphorus is mostly present in organic form. So, the use of biofertilizers will be effective to convert those complex nutrients form into simple and available for the plant.
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Neonatal diabetes mellitus is considered when there is hyperglycaemia requiring insulin therapy. Phenotypically NDM is classified into three types-transient, permanent and syndromic forms. Permanent NDM-may start in new-born life and is mainly due single gene mutations-KCNJ11 and ABCC8. This mutation is almost 90% manageable with oral sulphonyl ureas. We report a case of Permanent NDM with KCNJ11 mutation who presented in diabetic Ketoacidosis at 4 months of age. Clinical genome sequencing revealed a heterozygous missense variation in exon 1 of the KCNJ11 gene (chr11: g.17387491G>A) that results in the amino acid substitution of cysteine for arginine at codon 201. She was initially treated with insulin for which she had poor glycaemic control. She responded well following the switch over to sulphonylureas with good compliance and has normal development.
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Background: The existing global and national demographic structure is evolving towards a greater number of elderly people. Chronic diseases have negative personal, societal, and financial consequences in all communities and economies. Health seeking behaviour is thought to be the result of a complicated interplay between the patient's disease condition and socioeconomic and demographic variables, as well as the quality, availability, and accessibility of healthcare services. Methods: Community based cross sectional study was carried out among the persons aged 60 years or above who had one or more chronic disease residing in rural area of Malappuram district, Kerala. Data was collected from 240 participants by interview method using a pre-designed questionnaire. Results: Hypertension, dyslipidemia, and diabetes mellitus were the three diseases that affect elderly individuals most frequently. Majority (86.7%) of the study population is seeking medical care for chronic conditions. 82.1% of the population prefer modern medicine and 5.8% prefer AYUSH system of medicine. Age, marital status, education, and occupation were all factors that contributed to their health-seeking behaviour. Conclusions: Immediate attention and action are required from the health care authorities and policymakers to reinforce the geriatric healthcare strategy and enhance the behaviour of people seeking health care for chronic diseases.
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Background: Depression is characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities. It is very important to identify the factors predisposing to depression among paramedical students. The main objective of this study was to assess the prevalence of depression and the factors associated with depression among the paramedical students. Methods: A cross-sectional study was done among all the 208 paramedical students studying in MES using a predesigned questionnaire along with Beck’s depression inventory tool to identify depression. Chi-square test and multivariate regression analysis were used to find the association between variables. Results: The prevalence of depression was found to be 24.5%. 11.54 % of the total study participants have borderline depression, while 10.58%, 1.92% and 0.48 % had moderate, severe and extreme form of depression respectively. Chi square test showed type of family, course of study, smoking habits, traumatic events in the past, bad interpersonal relationship, concern regarding the future were found to be statistically associated with depression. In multivariate analysis, bad interpersonal relationship between friends and family members (OR= 3.13), worrying about the future (OR=6.03) and those who never sought any form of help for mental stress (OR=1.5) were the risk factors identified. Conclusions: Course selection, type of family they came from, any traumatic events in the past, lack of interpersonal relationship between friends, worrying about the job opportunities after completing the course, not seeking help for mental stress were the factors contributing towards depression.
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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.
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Background: Subarachnoid block has been used for intracavitary radiotherapy (ICRT) for carcinoma cervix, but the literature on the appropriate dose of local anesthetic required to achieve the desired effect is lacking. We compared two different intrathecal doses of 0.5% hyperbaric bupivacaine (1.2 and 1.5 mL) for providing optimal surgical conditions and readiness to discharge in patients undergoing ICRT for carcinoma cervix. Materials and Methods: This prospective double?blind study was done in 80 patients undergoing ICRT. The patients were randomized into two groups (Groups I and II) to receive 1.2 and 1.5 mL of intrathecal hyperbaric bupivacaine, respectively, for ICRT. The level of sensory achieved, the patient satisfaction score, radiation oncologist score, time to L5 regression, and time to motor recovery (walking unaided) were assessed. Statistical Analysis Used: The data were analyzed using SPSS 20 for Windows (IBM, Chicago, IL, USA). Results: The time taken for the block to regress to L5 (Group I: 134.6 � 32.4 minutes vs. Group II: 143.2 � 43.0 minutes, P = 0.31) were comparable. However, the mean time for walking unaided (Group I: 220.87 � 47.12 minutes versus Group II: 247.00 � 49.83 minutes, P = 0.032) after the subarachnoid block was significantly less in Group I. The patient satisfaction with the procedure and overall satisfaction of the radiation oncologists regarding the operating condition were comparable in both the groups. Conclusions: Hence, a 1.2 mL dose of intrathecal hyperbaric bupivacaine for ICRT provides optimal surgical conditions with hemodynamic stability and ensures the early discharge of the patient.
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Background: The data on clinical characteristics, treatment practices and out comes in patients with Nonischemic Systolic Heart Failure (NISHF) is limited. We report clinical characteristics, treatment and outcomes in patients with NISHF. Methods: 1004 patients with NISHF were prospectively enrolled and their demographics, clinical characteristics, and treatment were recorded systematically. Patients were followed annually for a median of 3 years (1 year to 8 years) for allcause death, major adverse cardiovascular events (MACE); composite of all-cause death, hospitalization of heart failure, and or for stroke. Results: Patients of NISHF were middle-aged (58.8±16.2 years) population with severely depressed left ventricular ejection fraction (29.3±7.02%) and 31.1% had symptoms of advanced Heart failure. Hypertension (43.6%), obesity and or overweight (28.0%), Diabetes (15.0%), and valvular heart disease (11.8%) were the common risk factors. The guideline directed medical treatment was prescribed in more than 80% of the study cohort. Incidence of all cause death and MACE was 7 (6.8, 8.8) per 100 person years and 11(10, 13) per 100 person years respectively. The cumulative incidence of deaths and MACE was 35% (30%, 40%) and 49% (44%, 53%) at 8 years of follow-up. Conclusions: Patients of NISHF were middle-aged population with severely depressed LV systolic function with significant incident morbidity and mortality. Early detection of risk factors and their risk management and enhancing the use of guideline directed treatment may improve the outcomes. Keywords: Non-ischemic systolic heart failure, risk factors, outcomes, guideline directed treatment