Funding opportunities for health research in India - A technical scan.

Health research plays an integral part in scientific and academic innovation in health care. India, a rapidly developing country, showed a tremendous increase in the number of health research projects and publications in recent years. Given the broad spectrum of health research areas and a vast number of funding agencies that fund specific areas, it is difficult to gain knowledge about them from a single source. Hence, we scanned the various funding opportunities which exist in India for healthcare research. Various agencies fund health-care research on their thrust areas of national importance. Choosing the funding agency depending on the area of interest and following the guidelines given by them ensures a successful proposal for funding. This article enlists various funding agencies and gives overall information about the nature of support and fund provided for health research in India.

Is fat-to-lean mass ratio a better predictor of heart variability than body mass index?

BACKGROUND: Body mass index (BMI) may not accurately predict cardiometabolic risk due to confounders like age, gender, relatively high lean mass, and the "thin-fat phenotype" prevalent in south Asian populations. Fat-to-lean mass ratio (FTLM), which assesses the balance between fat and lean body mass, may provide a more complete assessment of cardiometabolic health. MATERIALS AND METHODS: This cross-sectional analytical study investigated the relationship between FTLM ratio, BMI, and heart rate variability (HRV) in apparently healthy male adults. 88 participants recruited through convenience sampling underwent anthropometric assessments, bioimpedance body composition analysis, and HRV testing. Pearson's or Spearman's correlation and linear regression analyses were performed where appropriate to assess the relationship between FTLM ratio, BMI, and HRV. RESULTS: Both BMI and FTLM showed significant positive correlation with normalized LF power and LF-HF ratio and a negative correlation with normalized HF power, RMSSD, and pNN50. However, FTLM ratio showed a stronger association with HRV parameters than BMI and could explain a greater percentage of the variability in LF-HF ratio (32% compared to 18.4%, P < 0.001). CONCLUSION: Assessment of both fat and lean mass, expressed as a ratio, is a better index of quantifying adiposity and predicting the influence of altered body composition on cardiometabolic health.

Comparison of P300 Cognitive-evoked Potentials and Visual and Auditory Reaction Time in Stage 5 Chronic Kidney Disease Patients on Different Treatment Modalities.

Patients with chronic kidney disease (CKD) are at a higher risk of cognitive impairment. Poor quality of life and decreased compliance are frequently observed with cognitive decline among CKD patients. Cognitive impairment among Stage 5 CKD patients varies with different modalities of treatment, and contradicting results have been reported. Fifty-four medically stable Stage 5 CKD patients undergoing different modalities of treatment were recruited: Patients with Stage 5 CKD on maintenance hemodialysis (HD) (n = 18), continuous ambulatory peritoneal dialysis (CAPD) (n = 18), and conservative management (CM) (n = 18). Eighteen apparently healthy participants were recruited as a control group. The cognitive functions assessed were P300 event- related potential, auditory and visual reaction times (VRTs). Kidney function was assessed by serum creatinine and estimated glomerular filtration rate. Creatinine levels were significantly higher in all three treatment groups compared with the control group. Multivariate analysis revealed a significant association between the CKD groups (n = 54) and the parameters of cognitive function. P300 latency was prolonged in all treatment groups compared with the control group and was significantly prolonged in patients on CM compared with HD and CAPD patients. The VRT of CM patients was found to be significantly higher compared with the control group. The auditory reaction time was significantly prolonged in all treatment groups compared with the control group and in the CM group compared with the CAPD group. Cognitive function was more affected in Stage 5 CKD patients on CM compared with patients undergoing HD or CAPD.

Clinical profile and outcomes of pediatric scrub typhus associated with elevated hepatic transaminases.

BACKGROUND: Hepatic transaminase (HT) elevation is frequently seen in children with scrub typhus (ST), but the clinical implication of this common finding is not known. OBJECTIVE: To describe the clinical profile and outcome of pediatric ST with elevated hepatic transaminase. METHODS: In this prospective cohort study, all children < 12 years of age presenting with fever for ≥ 5 days and positive immunoglobulin M (IgM) serology for ST were included. Clinical findings, laboratory features and outcomes of children with elevated HT were compared with those who had normal HT. RESULTS: Of 560 ST positive children included, 257 (45.8%) had associated HT elevation. The common age group affected was 5 to 12 years of age (54.9%). Most of the children came during the second week of fever (68.5%) with mean duration of fever of 9.1 days. The common initial presenting symptoms were cough (77.8%), vomiting (65%) and myalgia (59.1%) and signs were hepatomegaly (64.2%), splenomegaly (57.6%) and generalized lymphadenopathy (54.1%). Eschar was seen in 49.8% of children. Thrombocytopenia (58%) and anemia (49%) were the frequently seen laboratory abnormalities. Severe forms of ST were seen in 45.5% children, of which pneumonia was most common. The fever clearance time (48 ± 19.2 h) and mean duration of hospital stay (6.7 ± 3.3 days) were prolonged in these children. On logistic regression analysis, generalized lymphadenopathy (p = 0.002), ascites (p = 0.037), thrombocytopenia (p < 0.001) and hypoalbuminemia (p = 0.023) were found to be associated with HT elevation in these children. CONCLUSIONS: Hepatic transaminase (HT) levels increase with the duration of untreated fever and is found to be associated with severe forms of scrub typhus. Children with elevated HT have delay in fever defervescence and their duration of hospital stay was prolonged.

Altered baroreflex sensitivity at rest and during Valsalva maneuver in healthy male offspring of hypertensive patients.

INTRODUCTION: A family history of hypertension puts young adults at a higher risk of developing hypertension, that too, at an earlier age than their parents. Recent studies suggest that the baroreflex mechanism, which takes care of the short-term regulation of blood pressure (BP), also plays a role in the long-term regulation of BP. Studies have reported decreased baroreflex sensitivity (BRS) in hypertensives. Reduced BRS is shown to herald the future occurrence of cardiovascular diseases (CVD) and helps in risk stratification AIM: To assess BRS at rest and during the Valsalva maneuver among apparently healthy male offspring (age 18-35 years) of hypertensive patients. METHODS: We recruited 37 participants whose parents (either/both) were hypertensive in the study group and whose parents (both) were not hypertensive in the control group. We measured basic anthropometric parameters (height, weight, waist circumference), cardiovascular parameters (heart rate and BP), short-term heart rate variability, and BRS (at rest and during Valsalva). RESULTS: We found that BRS at rest and BRS during the Valsalva maneuver were reduced among healthy male offspring of hypertensive parents than in healthy male offspring of non-hypertensive parents. Further, HRV indices and Valsalva ratio showed a sympathovagal imbalance in the form of decreased vagal and increased sympathetic activity. CONCLUSION: The reduced BRS and sympathovagal imbalance in male offspring of hypertensive parents reveal the early risk of developing hypertension in the future.

Parental History of Hypertension: A Risk for Autonomic Dysfunction and Metabolic and Vascular Derangement in Normotensive Male Offspring.

BACKGROUND: Children of hypertensive parents have an increased propensity of developing hypertension, at an age very much prior to their parents. Understanding the pathophysiology of hypertension in such young individuals, especially baroreflex sensitivity (BRS), is necessary. Reduced heart rate variability (HRV), insulin resistance (IR), dyslipidemia, and decreased vasodilatory adipokines, namely, apelin and relaxin, in normotensives may predispose to the onset of hypertension. Thus, this study compared autonomic functions, vascular markers, and metabolic profiles between normotensive male offspring with and without parental hypertension. METHODS: This analytical cross-sectional study comprised 40 male normotensive offspring of hypertensive parents, aged 18-35 years, recruited as the study group and 40 age- and body mass index (BMI)-matched normotensive male offspring with non-hypertensive parents enrolled as controls. Cardiovascular autonomic functions, including BRS, HRV, diastolic blood pressure response to isometric handgrip test (ΔDBPIHG), Valsalva ratio, and metabolic and vascular markers, were assessed. RESULTS: The study group exhibited reduced BRS, HRV, and Valsalva ratio and higher ΔDBPIHG compared to controls, indicating impaired autonomic functions. The study group had higher IR and triglyceride levels and reduced apelin and relaxin levels. BRS showed significant correlations with HRV, Valsalva ratio, ΔDBPIHG, and metabolic and vascular markers. CONCLUSIONS: Normotensive male offspring of hypertensive parents exhibit impaired autonomic functions, as evidenced by reduced BRS, HRV, and Valsalva ratio. Additionally, they have higher IR, dyslipidemia, and decreased levels of vasodilatory adipokines, indicating an increased risk for future hypertension development. These findings signify that early identification of hypertensive potential in this high-risk population is warranted, which would enable taking necessary preventive measures.

Comparison of Heart Rate Variability, QTc, and JT Interval Between Diabetic Patients and Healthy Controls: Role of Gender and Phases of Menstrual Cycle.

Background and objectives Type 2 Diabetes mellitus (T2DM) is a heterogeneous group of metabolic disorders with variable degrees of insulin resistance and altered glucose metabolism. Increased attention in studying the role of gonadal hormones in diabetes is not only due to their relation to insulin sensitivity, and glucose tolerance but also to the gender-specific nature of the prevalence of various diabetic complications. The cyclical change in the hormone level in females will make it necessary to consider the menstrual cycle while analyzing the risk factors for diabetes. Hence, the role of gender and menstrual cycle in T2DM are analyzed here using the simple non-invasive cardiovascular risk indices like heart rate variability (HRV), QT interval corrected for heart rate (QTc), and JT interval. Materials and methods In this analytical study, T2DM patients in the age group of 18-45 years with less than five years duration from diagnosis and taking not more than two anti-hyperglycemic drugs were included. Time and frequency domains of HRV analysis, QTc, and JT intervals were compared with age and BMI matched control group. The comparison of these parameters was also made between two genders in the diabetic group and they were analyzed across different phases of the menstrual cycle in female diabetic patients when physiological variation in the gonadal hormones occurred as a natural phenomenon. Results HRV parameters were reduced and the QTc and JT intervals were prolonged in diabetic patients of both genders. Reduction in low-frequency (LF) band power and high-frequency (HF) band power of HRV analysis in diabetic females were statistically significant in the luteal phase of the menstrual cycle in comparison with age and BMI-matched healthy controls. There was no significant difference in the HRV parameters, QTc, and JT interval between the male and female diabetic groups. HF band power is significantly reduced in the menstrual phase and relatively higher in the follicular phase when compared to the luteal phase among female diabetic patients. Conclusion The reduced sympathetic and parasympathetic activity were observed in diabetic patients of both genders and they were significant in the luteal phase of diabetic females compared to the healthy control group. Vagal activity is relatively higher in the follicular phase of the menstrual cycle in female diabetic patients.

The relationship between physical performance and quality of life and the level of physical activity among the elderly.

BACKGROUND: Loss of physical function during the process of aging might affect the quality of life. Physical function assessment tests predicts outcomes such as falls, institutionalization, and death. Studies assessing the association of physical function with quality of life and physical activity level of elderly population in India is scarce. Hence we aimed to assess the physical function of community dwelling older adults and to determine its association with physical activity levels and quality of life. MATERIALS AND METHODS: This was a cross-sectional analytical study. 89 community dwelling older adults between 60 and 80 years of age were recruited. Physical function was assessed by standing balance, walking speed, and grip strength. Quality of life was assessed by WHO QOL BREF questionnaire and physical activity level was assessed by International Physical activity Questionnaire. RESULTS: Standing balance was reduced in 24% and walking speed was decreased in 33% of the participants. Males had higher walking speed, and grip strength. Quality of life was better among males. Standing balance, walking speed and grip strength was significantly higher in moderate - heavy activity levels. There was positive correlation between physical function and quality of life. There was also positive correlation between physical activity level and quality of life. CONCLUSION: Physical function, quality of life and physical activity level were decreased. Males had better physical function and quality of life. Physically active individuals had better physical function and quality of life. Early detection of decreased physical function and increase in physical activity level could result in better quality of life among elderly.

Cardiovascular Responses and Cardiac Work of Selected Daily Activities in Young Healthy Indian Participants.

BACKGROUND: Studies suggest that habitual daily activities may result in significant cardiovascular responses that might have implications for individuals with coronary artery disease. This study determined the cardiac work for various activities of daily living among healthy young participants. METHODS: We evaluated cardiovascular responses in 42 young adults (21 male, 21 female) to graded activities. Subjects were divided into three groups. In each group, one light, one moderate, and one heavy activity were performed based on published METS. Cardiovascular responses were evaluated using impedance cardiography (BOMED Instruments, USA) and automated blood pressure monitor (Welch Allyn, USA). Cardiac work was computed as the double product (heart rate × systolic blood pressure) and triple product (systolic blood pressure × cardiac output [stroke volume × heart rate]). Perceived exertion was evaluated using Borg's scale. RESULTS: There was high inter-individual variability in cardiovascular responses for each activity. There were, by and large, no gender differences across the activities. Cardiac work was significantly higher with heavy activities than light activities using both indices; however, the triple product showed greater discriminatory ability in evaluating differences in cardiac work across all categories of activities. CONCLUSION: The data suggest a need to develop a compendium of cardiac work related to habitual activities to guide doctors and patients.

Pulmonary function severity in relation to interleukin-23 levels in patients with psoriasis vulgaris.

Background Interleukin-23 (IL-23), a key inflammatory regulator in the pathogenesis of psoriasis, is suspected to play a role in the onset of pulmonary dysfunction (chronic obstructive pulmonary disease) in psoriasis. Despite that, pulmonary function tests are rarely studied in these subjects. This study aims to seek a possible relation between pulmonary function in psoriasis patients serum IL-23. Methods For this analytical cross-sectional study, male psoriasis patients in the age group of 25-45 years were recruited from dermatology out patient department (n = 40). Age and BMI matched apparently healthy individuals were recruited as control group (n = 40). After obtaining demographic and personal details, anthropometric parameters and blood pressure were recorded. The severity of psoriasis was assessed using Psoriasis Area and Severity Index score. Pulmonary function was assessed using computerized spirometry, and serum IL-23 was measured using ELISA. Results Forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow rate, and forced expiratory flow at 25%-75% of the pulmonary volume (FEF25%-75%) were significantly reduced in psoriasis. Based on the percentage of predicted values FEF25%-75% was significantly reduced in psoriasis. Serum IL-23 (pg/mL) was significantly higher in psoriasis. The increase in IL-23 in psoriasis subjects does not correlate with their pulmonary function. Conclusions Psoriasis may be associated with a reduced lung function even when the disease is in the mild stage. Increased IL-23 found in these subjects is suggestive of systemic inflammation, which indirectly lowers lung function.