An assessment of preclinical removable prosthodontics based on multiple-choice questions: Stakeholders' perceptions.

PURPOSE: Item analysis of multiple-choice questions (MCQs) is an essential tool for identifying items that can be stored, revised, or discarded to build a quality MCQ bank. This study analyzed MCQs based on item analysis to develop a pool of valid and reliable items and investigate stakeholders' perceptions regarding MCQs in a written summative assessment (WSA) based on this item analysis. METHODS: In this descriptive study, 55 questions each from 2016 to 2019 of WSA in preclinical removable prosthodontics for fourth-year undergraduate dentistry students were analyzed for item analysis. Items were categorized according to their difficulty index (DIF I) and discrimination index (DI). Students (2021-2022) were assessed using this question bank. Students' perceptions of and feedback from faculty members concerning this assessment were collected using a questionnaire with a five-point Likert scale. RESULTS: Of 220 items when both indices (DIF I and DI) were combined, 144 (65.5%) were retained in the question bank, 66 (30%) required revision before incorporation into the question bank, and only 10 (4.5%) were discarded. The mean DIF I and DI values were 69% (standard deviation [Std.Dev] = 19) and 0.22 (Std.Dev = 0.16), respectively, for 220 MCQs. The mean scores from the questionnaire for students and feedback from faculty members ranged from 3.50 to 4.04 and from 4 to 5, respectively, indicating that stakeholders tended to agree and strongly agree, respectively, with the proposed statements. CONCLUSION: This study assisted the prosthodontics department in creating a set of prevalidated questions with known difficulty and discrimination capacity.

Phylogenetic affiliation of Pedinomonas noctilucae and green Noctiluca scintillans nutritional dynamics in the Gulf of Mannar, Southeastern Arabian Sea.

The present investigation focused on studying the phylogenetic position of the green Noctiluca endosymbiont, Pedinomonas noctilucae, collected from the Gulf of Mannar, India. In this study, we re-examined the evolutionary position of this endosymbiotic algae using rbcL sequences. The phylogenetic analysis revealed that P. noctilucae is distantly related to the Pedinomonas species, and formed a monophyletic clade with Marsupiomandaceae. Based on the phylogenetic association of endosymbiont with Maruspiomonadales it was concluded that the endosymbiont belongs to an independent genus within the family Marsupiomonadaceae. At the site of the bloom, Noctiluca scintillans was found to exhibit a dense monospecific proliferation, with an average cell density of 27.l88 × 103 cells L-1. The investigation revealed that the green Noctiluca during its senescent phase primarily relied on autotrophic nutrition, which was confirmed by the presence of a high number of trophonts, vegetatively reproducing cells (1.45 × 103 cells L-1) and the absence of food vacuoles.

The Influence of Obesity on Cognitive Functioning Among Healthcare Professionals: A Comprehensive Analysis.

Background Excessive body fat, or obesity, is a worldwide epidemic and a major contributor to the development of dementia. Aim The research aimed to determine how obesity affected healthcare professionals' memory performance. Materials and Method A total of 474 participants (both male and female) were recruited in this study by random sampling method from three different health institutions. Participants were categorized into overweight, normal weight, and obese groups based on their body mass index (BMI) as per the WHO guidelines and for body fat participants. The memory function test was done using the Gilewski MJ scale. General frequency of forgetting, mnemonic usage, retrospective functioning, and seriousness of forgetting were measured and compared across the BMI and %body fat groups. Results The percentage of body fat of males and females was 38.19% and 42.26%. Statistically, a significant difference (p<0.05) was observed among the male and female BMI and percentage of body fat. The results showed that there was a significant difference between memory scale parameters and percentage BMI. Statistically, a significant difference was observed in the level of general frequency of forgetting among participants with different percentages of BMI (p<0.05). Similar, results were also observed in the level of seriousness of forgetting, retrospective functioning, and mnemonics usage with different % BMI (p<0.05). The findings showed a positive correlation between BMI and %body fat on the scale of general frequency of forgetting and seriousness of forgetting whereas, a negative correlation was observed on the scale of retrospective functioning and mnemonics usage. Conclusion Memory loss is one of the disorders that obesity is linked to more frequently. A focus on keeping a healthy weight may help prevent the development of future diseases.

Acquisition of Higher-Order Cognitive Skills (HOCS) Using the Flipped Classroom Model: A Quasi-Experimental Study.

Introduction Flipped classroom refers to a teaching model where the lecture and homework elements of the class are reversed. Students develop knowledge and understanding during the pre-class session, and use the in-class time for active learning such as small group discussions, wherein they are expected to develop the skills of problem-solving (application) and critical thinking (analysis). An educational psychologist, Benjamin Bloom, proposed Bloom's Taxonomy for the cognitive domain. According to this taxonomy, knowledge, and understanding have been considered to be lower-order cognitive skills (LOCS), while application (problem-solving), analysis (critical thinking), synthesis, and evaluation have been considered higher-order cognitive skills (HOCS). Only one study has reported that flipped classroom approach helps in the acquisition of HOCS such as application, analysis, synthesis, and evaluation. The present study aims to compare the flipped classroom model with the traditional lecture model and focuses particularly on the acquisition of HOCS such as application and analysis, by assessing the students using multiple-choice questions based on clinical vignettes. Methods The study was conducted in the Department of Physiology at Government Medical College, Bhavnagar. A total of 102 students in two groups, Group A (n=52) and Group B (n=50), participated in all the phases of the study. In the flipped classroom group, students watched the pre-recorded videos and studied standard textbooks, followed by a group discussion in the class. The traditional Lecture group attended the didactic lecture only. Topic I was taught to Group A using the flipped classroom model and to Group B using the traditional didactic lecture approach. Topic II was taught to Group B by using the flipped classroom method and to Group A using the traditional didactic lecture. Both groups of students were assessed after a gap of one week with multiple-choice questions based on clinical vignettes for checking the HOCS. These questions were designed based on Blooming Biology Tool (BBT). The feedback collected responses regarding the learning experience, perceived value of the flipped classroom, the course materials, the teaching process, and the evaluation system. Results The students, who participated in the flipped classrooms, performed statistically better than those in the traditional lecture model (5.36 ± 1.69 vs. 4.94 ± 1.34) (p<0.05). The students strongly agreed that the flipped classroom method was an enjoyable way of learning: it enhanced their problem solving and analytical ability as well as developed their ability to work as team members and plan their own work. Students in both the flipped classrooms gave a similar perception indicated by the small effect size (r <0.3). Conclusion The pre-class time of the flipped classroom model helps students remember the facts and understand the concepts (both lower-order cognitive skills), and uses the valuable in-class time to master the application of the concepts and critically analyze them (application and analysis being higher-order cognitive skills).

Prevalence and correlates of vibration perception threshold based diabetic peripheral neuropathy in Gujarati urban population: A cross sectional study.

Background: Diabetic peripheral neuropathy (DPN) is common microvascular complication with lack of data from many regions. Vibration perception threshold (VPT) is an objective tool to screen vibration-based neuropathy both quantitatively and qualitatively. We studied prevalence that correlates VPT in diabetic sample population. Methods: A cross-sectional study was performed in 100 under treatment urban type 2 diabetics. Using bioesthesiometer, we tested VPT from sole of lower limbs of each participant. VPT >25 was considered as DPN. VPT was further correlated to determinants using t test, chi square, and multiple linear regressions. P < 0.05 was taken as statistically significant. Results: Mean age was 57, mean duration was 9.42 years, 40% were good glycemic, 28% were symptomatic for neuropathy, half subjects had co-existing hypertension and positive family history. VPT >25 was prevalent in 38% participants and mild, moderate, severe grades of DPN were present in 10%, 20%, 38%, respectively. VPT was associated with all three measures of glycemic control both quantitatively and qualitatively imposing significant odds risk (3.45, 2.63, 3.63 for HbA1C, FPG, 2hPG, respectively). Presence of symptoms, duration, and family history were significant predictors of VPT, whereas age, gender, hypertension, hyperlipidemia, and glycemic control were not. Conclusion: In chronic type 2 diabetics from a city Gujarat, we report 38% prevalence of DPN, related to symptoms, duration, family history, and all measures of glycemic triad. Unrelated to age and gender, VPT is superior to symptoms to detect DPN and it should be used optimally to insinuate timely preventive measures.

Impact of diabetic retinopathy on pulse wave analysis-derived arterial stiffness and hemodynamic parameters: A cross-sectional study from Gujarat, India.

PURPOSE: Type 2 diabetes mellitus (T2DM) is known to produce diabetic retinopathy (DR). Pulse wave analysis (PWA) provides arterial stiffness (AS) and central hemodynamic (CH) parameters. We studied the effect of DR on AS and CH parameters in type 2 diabetics (T2D). METHODS: We performed a cross-sectional study on 47 T2Ds attending a private ophthalmology clinic screened for DR by optical coherence tomography angiography and divided into NDR (non-DR), NPDR (non-proliferative DR), and PDR (proliferative DR). Mobil-o-graph (IEM, Germany) based oscillometric PWA yielded AS and CH parameters. They were further compared between groups stratified by DR with P value set at 0.05. RESULTS: Participants had a mean age 62, mean diabetes duration 9 years, high mean BMI, and high prevalence of physical inactivity, hypertension, and poor diseases control. Significant differences were lacking in NPDR, NDR, and PDR in rate pressure product (mean 112.71 vs 116.06 vs 119.57), central pulse pressure (mean 46.50 vs 43.09 vs 42.72), stroke work (mean 153.36 vs 132.36 vs 146.08), augmentation index (mean 29.43 vs 33.14 vs 31.64), and aortic pulse wave velocity (mean 10.06 vs 9.08 vs 9.06). There was no clear pattern of distribution of most parameters among the three subgroups. CONCLUSION: We found a lack of association between DR and cardiovascular ageing studied by AS and hemodynamic parameters. It suggests a possible difference in risk factors for both of these aftermaths of T2DM and calls for further prospective studies with a large sample size.

Effect of Menopause on Arterial Stiffness and Central Hemodynamics: A Pulse Wave Analysis-Based Cross-sectional Study from Gujarat, India.

BACKGROUND: Menopause, a cardiovascular risk in mid-life women, is studied in terms of blood pressure mostly. Arterial stiffness (AS) and central hemodynamics (CH) are direct surrogates measured by pulse wave analysis (PWA) with no study from our region. OBJECTIVE: We studied AS, CH in relation to menopause using PWA. MATERIALS AND METHODS: A cross-sectional study was performed in 134 middle-aged females divided into groups with or without menopause. Oscillometric PWA done by Mobil-o-Graph (IEM, Germany) gave - AS like augmentation pressure, augmentation index at heart rate (HR) 75, aortic pulse wave velocity (aPWV), and total AS pulse pressure amplification; CH like aortic blood pressure, cardiac output and related parameters, peripheral resistance, stroke work, prevalent brachial/central hypertension, and raised central pulse pressure. They were further compared between groups, in relation to body mass index (BMI) and by multiple regressions with P < 0.05 as statistical significance. RESULTS: Postmenopausal women were significantly elder, physically inactive with comparable BMI and showed higher AS (only aPWV was significantly different) and CH. BMI was unrelated to AS or CH in postmenopausal group. Age (except for aPWV), BMI, and HR (except for AIx@75) were insignificant predictors, while systolic blood pressure (SBP) in premenopausal and diastolic blood pressure (DBP) in postmenopausal group was major AS predictors. Age, HR, and BMI were insignificant predictors, while SBP more than DBP was significant predictors of CH. CONCLUSIONS: In obese, predominantly sedentary midlife Gujarati women, menopause negatively affects AS and hemodynamics, central more than peripheral. Menopause accelerates cardiovascular aging, independent of BMI, and age that calls for further studies.

'We are not aware of notification of tuberculosis': A mixed-methods study among private practitioners from western India.

BACKGROUND: Implementing the Standards for tuberculosis care in India (STCI) guidelines in the private sector is vital. This study attempted to estimate the knowledge and practices regarding STCI guidelines among private practitioners and to explore the reasons and solutions for low tuberculosis (TB) notification rates. METHODS: We conducted a cross-sectional study for assessing the knowledge and practices of the STCI guidelines among 100 full-time allopathic private practitioners in Bhavnagar (in western part of India) from September 2018 to January 2019. Knowledge and practice were categorised as good or poor by assigning scores to the responses to a questionnaire based on the STCI guidelines. It was followed by two focus group discussions to explore the reasons and solutions for low notification rates of TB as perceived by private practitioners. RESULTS: Among the 100 private practitioners, 55% had good knowledge, and 41% had good practice regarding the STCI guidelines; 69% knew about the gazette notification of mandatory notification of TB, and 58% were notifying TB cases to the government. Lack of awareness about the process as well as incentives for notification, time constraints and infrequent visits by health workers were the main reasons perceived by private practitioners for not notifying TB cases to the government. The critical solutions suggested by them were creating awareness regarding the notification process as well as incentives, increasing health worker visits and use of social media for notification. CONCLUSION: Only about half of private practitioners follow the STCI guidelines for TB care, and the notification rates are low in our setting. Regular sensitisation programs need to be arranged for private practitioners to create awareness on TB notification.

Assessment of Arterial Stiffness, Brachial Haemodynamics, and Central Haemodynamics in Diabetic Hypertensives: A Pulse Wave Analysis-Based Case-Control Study from an Urban Area of West India.

INTRODUCTION: Hypertension (HTN) and diabetes frequently coexist, imposing significant cardiovascular risk that is normally studied in terms of brachial blood pressure (bBP). Direct and superior parameters like central haemodynamics and arterial stiffness are studied scarcely. Pulse wave analysis (PWA) offers a non-invasive measurement of the same that we studied in diabetic hypertensives. MATERIALS AND METHODS: We conducted a case-control study on 333 treated diabetic hypertensive cases and 333 euglycaemic normotensive controls. Oscillometric PWA was performed by Mobil-o-Graph (IEM, Aachen, Germany). Parameters were further analysed in relation to gender, physical activity, body mass index (BMI), glycaemic control, blood pressure control, and disease duration (cut-off 5 years). Multiple linear regressions were done to find significant associations. RESULTS: Cases had significantly higher brachial haemodynamics (blood pressure, heart rate (HR), and rate pressure product); arterial stiffness measures (augmentation pressure, augmentation index, pulse wave velocity, total arterial stiffness, and pulse pressure amplification), and central haemodynamics (central blood pressure, cardiac output, stroke work) than controls. In the case group, female gender, BMI ≥23, and uncontrolled blood pressures were significant factors that affected the results while other factors such as glycaemic control, physical activity, and duration did not. HR was significantly associated with study parameters. Brachial pressures were not significantly associated with corresponding aortic pressures. CONCLUSION: Diabetic hypertensives had adverse profile of cardiovascular parameters beyond bBP, related to female gender, and HTN and its control, more than that of diabetes. This baseline work suggests further study on these potential parameters.

210Pb dating of recent sediments from the continental shelf of western India: factors influencing sedimentation rates.

Several cores from the continental shelf of the Arabian Sea along the Indian Coast were investigated for change in sedimentation rates duly constrained for chronology based on 210Pb and 137Cs dating techniques. The emphasis was to look for spatial and temporal variation in the sedimentation rate along the continental shelf of eastern Arabian Sea between Goa to Kochi for water depth ≤ 150 m. This study showed varying sedimentation rates in coastal and distant sediment cores. Both 210Pb and 137Cs dating techniques showed comparable sedimentation rate in most sediment cores. The sedimentation in the continental shelf region of the coastal Arabian Sea is primarily controlled by discharge of sediments from rivers during Indian summer monsoon. Increased sedimentation rate from the north (off Goa) to the south (off Kochi) was triggered by high riverine flux and longshore sediment transport.

Assessment of contaminants in the northwestern Bay of Bengal.

The coastal sediments in the northern Bay of Bengal has undergone contamination due to the heavy metal contribution from rivers. To evaluate the status of contamination in the inner shelf region of the Bay of Bengal, a sediment core chronologically constrained using 210Pb dating technique from the northwest Bay of Bengal was investigated for several trace elements. To assess sediment quality, enrichment factor (EF), geo-accumulation index (Igeo), and Modified Nemerow Pollution Index (MPI) were derived. The influence on ecology by individual contaminants and combined contaminants was evaluated using the potential ecological risk factor (Eri) and modified ecological risk index (MRI). The single-element pollution indices indicated that the sediment has no significant pollution by individual elements. However, the multi-elemental approach shows slight pollution in the sediment core. The ecology is at low risk by contaminants present in the sediment. Comparison of the elemental values of shelf sediment with adjacent riverine and estuarine samples demonstrates the role of estuarine environment and/or high riverine flux of sediments causing either removal or dilution of trace elements during its transport from the river to the sea.

Central hemodynamics and arterial stiffness by oscillometric pulse-wave analysis in treated Gujarati euglycemic hypertensives: A case-control study.

INTRODUCTION: Hypertension is the most prevalent noncommunicable disorder, studied in terms of brachial blood pressure. Direct parameters like central hemodynamics and arterial stiffness, though superior, are not studied much. The same can be studied by pulse-wave analysis (PWA) and we did that in euglycemic treated hypertensives. MATERIALS AND METHODS: A case-control study was conducted in 258 treated euglycemic hypertensives and 258 matched controls. Oscillometric PWA was accomplished by Mobil-O-Graph (IEM, Germany). Parameters were further analyzed for the effect of gender, physical activity, body mass index (BMI) (cutoff 23), blood pressure control, and duration (cutoff 5 years). Multiple linear regressions were used to find significant predictors. P < 0.05 was taken as statistically significant. RESULTS: Cases had significantly higher brachial arterial parameters (blood pressure, heart rate, rate pressure product), arterial stiffness (augmentation pressure, augmentation index, pulse-wave velocity, total arterial stiffness, pulse pressure amplification), and central hemodynamics (central blood pressure, cardiac output, stroke work) compared to age, gender, and BMI-matched controls. In the case group, female gender, BMI ≥ 23, and uncontrolled blood pressure were significant factors affecting results. Heart rate and pulse pressure were major predictors of study parameters. Central pressure parameters were not predicted significantly by corresponding brachial pressure parameters. CONCLUSION: PWA revealed the adverse profile of arterial stiffness and central hemodynamics in treated Gujarati hypertensives, associated with female gender, BMI, and blood pressure control, predicted mainly by heart rate and pulse pressure, independent of brachial blood pressure. It indicates both potential and further study of these parameters.

Central hemodynamics and arterial stiffness in Gujarati diabetics not receiving any antihypertensive: A case-control study based on oscillometric pulse wave analysis.

INTRODUCTION: Diabetes is a modern epidemic imposing significant cardiovascular risk. Immediate and discrete parameters such as arterial stiffness and central hemodynamics are studied scarcely. Pulse wave analysis (PWA) offers noninvasive measurement of the same and we performed that in diabetics. MATERIALS AND METHODS: We performed a case-control study on 148 treated diabetic not on antihypertensive and 148 nondiabetic normotensive controls. Oscillometric PWA was performed by Mobil-O-Graph (IEM). Parameters were further analyzed for effect of gender, physical activity, body mass index (BMI; cut-off 23), glycemic control, and disease duration (cut-off 4 years). Multiple linear regressions were used to find significant predictors. P <0.05 was taken as statistical significance. RESULTS: Cases had significantly raised brachial hemodynamics (blood pressure, heart rate, rate pressure product), arterial stiffness (augmentation pressure, augmentation index, pulse wave velocity, total arterial stiffness, pulse pressure amplification), and central hemodynamics (central blood pressure, cardiac output, stroke work) than controls. In the case group, female gender, BMI ≥ 23, and physical inactivity were the significant factors affecting results (arterial stiffness more than central hemodynamics); glycemic control and duration were not. Heart rate was the major predictor of study parameters. Brachial pressure parameters were not significant predictors of corresponding central pressure parameters. CONCLUSION: Gujarati diabetics not using any antihypertensive had adverse profile of beyond brachial blood pressure discrete cardiovascular parameters, independent of duration and glycemic control, related to gender, BMI, and physical activity, indicating vascular progeria in the absence of hypertension. This baseline study suggests further work on these potential parameters.

Abnormal sympathetic functioning is linked to familial hypertension in nonathletic young males.

BACKGROUND: Sympathetic overactivity mediates abnormal cardiovascular outcome that is affected by stress, lack of physical activity (PA), and familial hypertension (HTN). It can be assessed by blood pressure-based sympathetic function tests. OBJECTIVE: We studied sympathetic function tests in young nonathletic males in relation to measures of obesity, PA, and familial HTN. METHODOLOGY: We recruited 100 males (mean age: 19 years) and measured body mass index (BMI) and body composition parameters by tetrapolar bioelectrical impedance such as total body fat, visceral fat, subcutaneous fat, and skeletal muscle mass. Using instrument cardiac autonomic neuropathy system of Recorders and Medicare System Company, India, blood pressures (supine, standing, and post hand grip) were recorded and studied quantitatively and qualitatively. RESULTS: Physically active and inactive individuals (n = 50 each) had comparable age, BMI, measures of obesity, and sympathetic function tests. However, individuals with familial HTN (n = 37) showed significantly higher obesity measures and blood pressures (supine: systolic blood pressure [SBP] - 133 vs. 115 and diastolic blood pressure [DBP] - 79 vs. 76; standing: SBP - 136 vs. 122 and DBP - 80 vs. 76; post hand grip: SBP - 136 vs. 125 and DBP - 86 vs. 81). Qualitatively, postural hypotension was seen in only two individuals, while worst grading was in post hand grip test significantly and more so in physically inactive group (30%, 28%, and 42% vs. 16%, 20%, and 64%) and individuals with positive familial HTN (32%, 38%, and 30% vs. 17%, 13%, and 70%). CONCLUSION: Familial HTN, but not physical inactivity, affects sympathetic functioning in nonathletic young male medical personnel. It asks for other lifestyle modifications for better cardiovascular health as primary prevention.

Pulse wave analyzed cardiovascular parameters in young first degree relatives of hypertensives.

BACKGROUND: First-degree relatives (FDRs) of hypertensive (HT) are predisposed to hypertension (HTN) which accelerates cardiovascular aging. Same can be studied noninvasively by pulse wave analysis (PWA), encompassing central hemodynamics such as central blood pressure (cBP), cardiac output, and stroke work (SW) and vascular stiffness parameters such as pulse wave velocity (PWV) and augmentation index at HR 75 (AIx@75). We studied PWA-derived cardiovascular parameters in FDRs of HT compared to controls. MATERIALS AND METHODS: We conducted a case-control study in 119 FDRs of HT and 119 matched controls. Oscillometric PWA was performed by Mobil-o-Graph (IEM, Germany) and cardiovascular parameters were compared. P < 0.05 was considered statistically significant. RESULTS: Groups were comparable with gender, age, height, weight, body mass index, and physical activity. FDRs of HT had significantly higher brachial and cBPs, SW (101.41 ± 25.44 vs. 88.31 ± 20.25, P = 0.001), rate pressure product-119.40 ± 25.34 vs. 108.34 ± 18.17, P < 0.0001), PWV (5.22 ± 0.46, P < 0.0001), and AIx@75 (31.48 ± 9.01 vs. 27.95 ± 9.4, P = 0.002) than control. Dependent study variables correlated with brachial blood pressure more in magnitude and significance level than age or anthropometric variables. PWA results of FDR with maternal inheritance did not differ significantly from those with paternal inheritance. CONCLUSION: PWA reveals early cardiovascular aging in young FDRs of HTs. It clues to future cardiovascular disease including HTN itself, need for primary prevention, and further study for consolidation of these results.

Early Screening of Hypertension and Cardiac Dysautonomia in Each Hypertensive is Needed-inference from a Study of QTc Interval in Gujarat, India.

BACKGROUND: Hypertension (HTN) is linked to cardiac dysautonomia that can end up as life-threatening arrhythmias. The same can be screened by simple electrocardiogram (ECG)-based QTc (QT corrected for heart rate) interval which indicates repolarization abnormality. We quantified QTc interval among treated hypertensives in comparison to controls, testing effect of age, gender, and blood pressure. METHODS: We conducted a cross-sectional study was done at a tertiary care teaching hospital of Gujarat, India, on 142 hypertensives on monotherapy (60 males, 82 females) and 72 age-, sex-, and time-matched normotensives. ECG was recorded with minimum 10 complexes of Lead II. QTc was derived from average of 10 values, using Bazett's formula. QTc > 0.43 s in male and > 0.45 s in female was considered abnormal. RESULTS: Hypertensives (mean age 40 and duration 5 years) had significantly higher QTc value than normotensives among males (0.42 vs. 0.40, P < 0.001), females (0.44 vs. 0.41, P < 0.001), and in total (0.43 vs. 0.41, P < 0.001) with 24% prevalence of ECG-based left ventricular hypertrophy. Hypertensives had odds ratio 1.63 in males (P = 0.15), 23.71 in females (P = 0.003), and 3.83 in total (P < 0.001) for prolonged QTc. QTc values were significantly affected by increasing age amongst hypertensives but not by duration of HTN or current blood pressure. CONCLUSIONS: Our study showed a high prevalence of prolonged QTc, both qualitatively and quantitatively, in hypertensives on monotherapy with poor pressure control, associated with female gender and age but not duration or blood pressure. This underscores high risk of repolarization abnormality induced future event, suggesting QTc screening as primary prevention.

Pulse wave analyzed cardiovascular parameters in young first degree relatives of type 2 diabetics- a cross-sectional study.

BACKGROUND: First degree relatives (FDR) of type 2 diabetic (T2D) are predisposed for type 2 diabetes mellitus (T2DM) which accelerates cardiovascular aging. Pulse wave analysis (PWA) gives non-invasive measurement of central hemodynamics like central blood pressure (cBP), cardiac output (CO), stroke work (SW) and vascular stiffness like pulse wave velocity (PWV) and augmentation index at heart rate 75 (AIx@75). OBJECTIVE: To study PWA derived cardiovascular parameters in FDRs of T2D as compared to controls. MATERIALS AND METHODS: We enrolled 117 FDRs of T2D and 117 matched controls for a cross-sectional study. We performed PWA using Mobil-o-Graph (IEM, Germany) by oscillometric method to derive cardiovascular parameters which were compared and correlated for significance. P value less than 0.05 was considered statistically significant. RESULTS: Gender, age, height, weight, body mass index (BMI), physical activity were comparable between groups. FDRs of T2D had significantly higher blood pressure (brachial-systolic 125 vs 118, diastolic 80 vs 77, mean 100 vs 96mmHg and central- systolic 113 vs 105, diastolic 82 vs 79, pulse pressure 31 vs 28mmHg), SW (98 vs 90gm/bt), rate pressure product (RPP- 113 vs 107), PWV (5.14 vs 4.89m/s), AIx@75 (30 vs 27) than control. Dependant variables correlated with brachial BP more than age or anthropometric variables. Result did not differ by maternal or paternal inheritance in case group. CONCLUSIONS: Young, sedentary, non-obese FDRs of T2D have adverse cardiovascular profile which is suggested to worsen before or with onset of T2DM and definitely need attention for life style modification as primary prevention.

Primary surface rupture of the 1950 Tibet-Assam great earthquake along the eastern Himalayan front, India.

The pattern of strain accumulation and its release during earthquakes along the eastern Himalayan syntaxis is unclear due to its structural complexity and lack of primary surface signatures associated with large-to-great earthquakes. This led to a consensus that these earthquakes occurred on blind faults. Toward understanding this issue, palaeoseismic trenching was conducted across a ~3.1 m high fault scarp preserved along the mountain front at Pasighat (95.33°E, 28.07°N). Multi-proxy radiometric dating employed to the stratigraphic units and detrital charcoals obtained from the trench exposures provide chronological constraint on the discovered palaeoearthquake surface rupture clearly suggesting that the 15th August, 1950 Tibet-Assam earthquake (Mw ~ 8.6) did break the eastern Himalayan front producing a co-seismic slip of 5.5 ± 0.7 meters. This study corroborates the first instance in using post-bomb radiogenic isotopes to help identify an earthquake rupture.

Knowledge, attitude, and practice of urban Gujarati type 2 diabetics: Prevalence and impact on disease control.

CONTEXT: Type 2 diabetes is the modern epidemic wherein patient care needs multiple approaches, education, and self-awareness being one of them. There are some knowledge, attitude, and practice (KAP) studies from India but very few relating it with disease control. AIMS: We tried to study KAP of treated type 2 diabetics and its correlation with glycemic control. SETTINGS AND DESIGN: Cross-sectional KAP study. SUBJECTS AND METHODS: We formulated KAP questionnaires in the form of KAP - 10 points for each and total 30. We recruited 200 type 2 diabetics (96 males, 104 females) treated by MD physicians with known current glycemic status. They were asked KAP questionnaires one to one by a direct interview in local language and results were associated with various factors and glycemic control. RESULTS: KAP score on was average 19 out of 30 in type 2 diabetics having mean age 58 years, mean duration 9 years. KAP score was unaffected by gender, occupation, duration of disease but significantly affected by current age, and education level. Only 40% patients had good glycemic control who scored better KAP than poor glycemic. There was positive correlation between KAP score and glycemic control, with significance for only glycosylated hemoglobin and not fasting blood sugar, postprandial blood sugar. CONCLUSIONS: Physician treated type 2 diabetics of our region had moderate KAP score, affected by age, education which suggested to affect glycemic control. Lacunae in knowledge regarding incurability of disease, attitudes toward complication, self-care, and good practices like walking, enriching knowledge need improvement so as an optimum glycemic control.

Is the peripheral arterial disease in low risk type 2 diabetic patients influenced by body mass index, lipidemic control, and statins?

OBJECTIVE: To correlate BMI, lipidemic control, and statin therapy with PAD measured by ABI in low risk type 2 diabetics. MATERIALS AND METHODS: A sample of 101 nonsmoking, asymptomatic type 2 diabetics (50 males, 51 females) with known glycemic (fasting blood sugar, postprandial blood sugar, glycosylated hemoglobin) and lipidemic (total cholesterol, lipoproteins, and triglycerides [TGAs]) control was taken. Vascular Doppler was used to derive ABI and PAD was defined as ABI <0.9. ABI values were compared amongst groups and P < 0.05 was considered statistically significant. RESULTS: We found fairly good lipid but poor glycemic control and prevalence of PAD 30%. There was insignificantly low ABI profile in patient having BMI ≥25, hyperlipidemia and absent statin therapy with odds ratio being highest for TGAs ≥150 (3.23) followed by BMI ≥25 (2.61), high-density lipoprotein ≤50 (1.61), low-density lipoprotein ≥100 (1.20), and disuse of statin (1.14) with significance only for BMI. CONCLUSION: We observed small, insignificant PAD risk by dyslipidemia or non-use of statins in low-risk ambulatory T2DM patients, not so by BMI. This suggests importance of good glycemic control, maintenance of optimum weight, and lifestyle modifications as primary prevention rather than opting for costly and inefficient secondary prevention.