A Scoping Review of Barriers and Facilitators for Preconception Care: Lessons for Global Health Policies and Programs.

Preconception care (PCC) encompasses a set of actions taken before pregnancy to support the health and well-being of women before conception to improve maternal and child health (MCH) outcomes. The utilization of PCC services is influenced by multifaceted factors that can either enable or impede women's capacity to access and utilize them effectively. This scoping review examines the barriers and facilitators influencing the utilization of PCC services among women of reproductive age (15-49 years) at both individual and community levels. Through an extensive review of published articles from 2004 to 2021, including peer-reviewed sources, barriers and facilitators were identified. At the individual level, barriers included limited knowledge about PCC, neglect of self-health, and financial constraints. Community-level barriers encompassed insufficient supply of supplements, restricted access to health care, high health care costs, and setbacks due to delayed delivery of MCH services. Conversely, individuals reported that credible sources of information, such as friends, family, and community health volunteers, facilitated their engagement with PCC services. At the community level, facilitators included government-regulated supply chains for supplements and the involvement of community workers in health monitoring. Understanding and addressing these factors can help improve the utilization of PCC services among women of reproductive age (WRA) and improve MCH outcomes.

Comparison of Surgical Techniques for the Treatment of Congenital Nasal Pyriform Aperture Stenosis: A Systematic Review.

INTRODUCTION: Congenital nasal pyriform aperture stenosis (CNPAS) is a rare condition that results in neonatal respiratory difficulty. The purpose of this systematic review was to compare surgical outcomes of drilling versus dilation techniques in the treatment of CNPAS. METHODS: Pubmed, Embase, and Cochrane Clinical Trials databases were searched for terms "congenital nasal pyriform aperture stenosis" or "pyriform aperture stenosis" from 2010 to 2021. Twenty-five studies were included that evaluated pediatric patients treated surgically for CNPAS with available outcomes data including complications, revisions, and length of stay. RESULTS: A total of 51 patients with CNPAS were pooled from included studies. The median age was 29 days, 56.9% were female, and 54.9% were born full-term. The median pyriform aperture width before surgery was 5.00 mm (IQR = 4.10, 6.45). Forty (78.4%) patients underwent sublabial drilling, while 6 had a dilation procedure performed with hegar cervical dilators, 2 had a balloon dilation, and 3 were dilated with either an acrylic device, endotracheal tube, or bougie. There were no post-operative complications for 76.5% of patients, while a second surgery was required in 9 (17.6%) patients. The median length of stay was 11 days (IQR = 4, 26). No statistically significant difference was observed between sublabial drilling and surgical dilation techniques with respect to complications, need for revision surgery, or length of stay. CONCLUSION: Current literature is insufficient to determine if drilling or dilation is more effective in the treatment of CNPAS.

Role of Cerebral Embolic Protection Devices in Patients Undergoing Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis.

BACKGROUND: Cerebral embolic protection devices (CEPD) capture embolic material in an attempt to reduce ischemic brain injury during transcatheter aortic valve replacement. Prior reports have indicated mixed results regarding the benefits of these devices. With new data emerging, we performed an updated meta-analysis examining the effect of CEPD during transcatheter aortic valve replacement on various clinical, neurological, and safety parameters. METHODS AND RESULTS: A comprehensive review of electronic databases was performed comparing CEPD and no-CEPD in transcatheter aortic valve replacement. Primary clinical outcome was all-cause stroke. Secondary clinical outcomes were disabling stroke and all-cause mortality. Neurological outcomes included worsening of the National Institutes of Health Stroke Scale score, Montreal Cognitive Assessment score from baseline at discharge, presence of new ischemic lesions, and total lesion volume on neuroimaging. Safety outcomes included major or minor vascular complications and stage 2 or 3 acute kidney injury. Seven randomized controlled trials with 4016 patients met the inclusion criteria. There was no statistically significant difference in the primary clinical outcome of all-cause stroke; secondary clinical outcomes of disabling stroke, all-cause mortality, neurological outcomes of National Institutes of Health Stroke Scale score worsening, Montreal Cognitive Assessment worsening, presence of new ischemic lesions, or total lesion volume on diffusion-weighted magnetic resonance imaging between CEPD versus control groups. There was no statistically significant difference in major or minor vascular complications or stage 2 or 3 acute kidney injury between the groups. CONCLUSIONS: The use of CEPD in transcatheter aortic valve replacement was not associated with a statistically significant reduction in the risk of clinical, neurological, and safety outcomes.

Removal of heavy metals from wastewater by aerogel derived from date palm waste.

Cellulose that has been sourced from date palm leaves as a primary component was utilised. This cellulose served as the foundational material for the development of an aerogel composite. During this process, MXene (Ti3C2Tx) played a pivotal role in enhancing the overall composition of the aerogel. To ensure the stability and durability of the resulting aerogel structure, calcium ions were introduced to the mix. These ions facilitated the cross-linking process of sodium alginate molecules, ultimately leading to the formation of calcium alginate. This cross-linking step is crucial for the enhanced mechanical and chemical stability of the aerogel. Incorporating alginate and Ti3C2Tx into the cellulose aerogel enhanced its structural integrity in aqueous conditions and increased its adsorption capacity. When evaluated with synthetic wastewater, this composite exhibited remarkable adsorption capacities of 72.9, 114.4, 92.9, and 123.9 mg/g for As, Cd, Ni, and Zn ions, respectively. A systematic study was carried out to see the effect of various parameters, including contact time, MXene concentration, pH, and temperature on the adsorption of these elements. Peak adsorption was achieved at 60 min, favoring a pH range between 6 and 8 and exhibited optimal sorption efficiency at lower temperatures. The adsorption kinetics adhered closely to a pseudo-second-order, while the Freundlich model adeptly described the adsorption isotherms. An interesting result of this research was the aerogel's regenerative potential. After undergoing a basic acid treatment, the MXene/cellulose/alginate aerogel composite could be restored and reused for up to three cycles, all while maintaining its core performance capabilities even after the rigorous cross-linking processes. In three consecutive cycles, the removal percentages for As, Cd, Ni, and Zn were 48.15%, 80.38%, 56.51%, and 86.12% in cycle 1; 37.35%, 65.63%, 45.97%, and 78.42% in cycle 2; and 28.60%, 56.22%, 34.70%, and 65.83% in cycle 3, respectively. The composite was tested in conditions resembling seawater salinity. Impressively, the aerogel continued to demonstrate a significant ability to adsorb metals, reinforcing its potential utility in real-world aquatic scenarios. These findings suggest that the composite aerogel, integrating MXene, cellulose, and alginate, is an effective medium for the targeted removal of heavy metals from aquatic environments.

Americans with disabilities act cases initiated by individuals with cochlear implants in the United States.

OBJECTIVE: The Americans with Disabilities Act (ADA) is a federal law that forbids discrimination against individuals with certain disabilities, including hearing impairment. This study aimed to determine the nature of ADA discrimination complaints in individuals with cochlear implants. METHODS: A search for court decisions containing the terms "cochlear implant" and ("Americans with Disabilities Act" or "ADA") from 1985 to 2021 was performed with the Westlaw Campus Research legal database. Cases were included and analyzed if at least one of the plaintiffs had a cochlear implant and was claiming discrimination related to their hearing impairment based on the ADA. RESULTS: 24 cases initiated between 2003 and 2021 in 19 US states were identified based on inclusion criteria. The highest number of cases occurred in California (N = 4, 16.7 %). The alleged discrimination most frequently took place at a K-12 school (N = 9, 37.5 %), workplace (N = 7, 29.2 %), or during an encounter with police/correctional officers (N = 4, 16.7 %). Fourteen (58.3 %) cases involved complaints under Title II (Public Services) of the ADA. Seven (29.2 %) involved Title I (Employment) and 4 (16.7 %) involved Title III (Public Accommodations). Summary judgment was given in favor of the defendant or the case was dismissed entirely in 16 (66.7 %) of the cases. CONCLUSION: Patients with cochlear implants are still at risk of discrimination because of their disability. Cochlear implantees, school employees, workplace supervisors, and law enforcement personnel can benefit from ADA education.

Leveraging men's education as an effective pathway for improving diet quality: Evidence from rural India.

Investing in nutrition sensitive sectors such as education can be an effective strategy for combatting malnutrition. In this paper we analyze the role that men's education plays in determining dietary diversity outcomes using primary data from 3600 households across four districts of India. Dietary diversity scores were calculated to reflect the quality of food intake, for households and women. Men's education level was considered as the primary driver of diet diversity. To establish a causal link between men's education and diet diversity, the education level of parents and siblings were used as instrumental variables. We find that men's education levels are associated with significantly higher diet diversity scores both for the household and for women. The role of men's education continues to be a significant determinant of diet quality after controlling for household and individual- level confounding factors including the education level of the woman. The results are consistent across different definitions of the diet diversity score and reference period. Methodologically we extend the evidence on the education-nutrition pathway from being associational to causal in nature. Results from this study point to the benefits of leveraging men's education as an effective pathway for improving nutritional outcomes within households.

The RIGHT Scoring System for the Medicolegal Classification of Head Injury.

Background: In India, in case of an allegation of assault, the medical officer is required to classify the nature of injury into simple, grievous, and dangerous based upon the Indian Penal Code, which is outdated and has numerous gray areas. Objective: The aim of this study is twofold: first, to formulate an objective scoring system for the medicolegal classification of head injuries and Second to validate the proposed scoring system on patients with head injury. Methods and Material: A panel of experts consisting of neurosurgeons, radiologists, and forensic specialists came up with an objective scoring system, coined as the RIGHT (radiological-intervention-Glasgow Coma Scale (GCS)-based head trauma) scoring system consisting of three parameters, namely, the motor subscore of the GCS, computerized tomography image findings, and management of the patient. This was used to classify head injuries-into simple, grievous, and dangerous. A single-centre pilot study was planned-including patients with head trauma reporting to the emergency department. Medicolegal nature of the head injury was classified according to the proposed RIGHT score. A 6-month follow-up was performed using the Glasgow Outcome Score (GOS). Results: In total, 130 patients with head injury reported to the emergency department. There was a significant correlation between the RIGHT score assigned upon admission and the GOS at 6 months (P < 0.001). Conclusions: As the scoring system could be applied objectively and a significant correlation between nature of injury given by RIGHT score and 6-month outcome was present; therefore, the RIGHT scoring system proved to be an effective method in unambiguously classifying the nature of head injury for medicolegal opinions.

Advance directives among community-dwelling stroke survivors.

OBJECTIVE: Advance directives (ADs) are integral to health care, allowing patients to specify surrogate decision-makers and treatment preferences in case of loss of capacity. The present study sought to identify determinants of ADs among stroke survivors. METHODS: In this cross-sectional study (Care Attitudes and Preferences in Stroke Survivors [CAPriSS]), community-dwelling stroke survivors were surveyed on ADs; validated scales were used to query palliative care knowledge and attitudes towards life-sustaining treatments. Logistic regression was used to determine variables associated with ADs. RESULTS: Among 562 community-dwelling stroke survivors who entered the survey after screening questions confirmed eligibility, 421 (74.9%) completed survey components with relevant variables of interest. The median age was 69 years (IQR 58-75 years); 53.7% were male; and 15.0% were Black. Two hundred and fifty-one (59.6%) respondents had ADs. Compared to stroke survivors without ADs, those with ADs were more likely to be older (median age 72 vs. 61 years; p<0.001), White (91.2% vs. 75.9%, p<0.001), and male (58.6% vs. 46.5%, p = 0.015), and reported higher education (p<0.001) and income (p = 0.011). Ninety-eight (23.3%) participants had "never heard of palliative care". Compared to participants without ADs, participants with ADs had higher Palliative Care Knowledge Scale (PaCKS) scores (median 10 [IQR 5-12] vs. 7 [IQR 0-11], p<0.001), and lower scores on the Attitudes Towards Life-Sustaining Treatments Scale (indicating a more negative attitude towards life-sustaining treatments; median 23 [IQR 18-28] vs. 29 [IQR 24-35], p<0.001). Multivariable logistic regression identified age (OR 1.62 per 10 year increase, 95% CI 1.30-2.02; p<0.001), prior advance care planning discussion with a physician (OR 1.73, 95% CI 1.04-2.86; p = 0.034), PaCKS scores (OR 1.06 per 1 point increase, 95% CI 1.01-1.12; p = 0.018), and Attitudes Towards Life-Sustaining Treatments Scale scores (OR 0.91 per 1 point increase, 95% CI 0.88-0.95; p<0.001) as variables independently associated with ADs. CONCLUSIONS: Age, prior advance care planning discussion with a physician, palliative care knowledge, and attitudes towards life-sustaining treatments were independently associated with ADs.

Does Medical School Rank Impact Matching into Otolaryngology?

OBJECTIVE(S): To describe how medical school rank may be associated with matriculation into otolaryngology residency programs. METHODS: A list of medical students who matched into otolaryngology residencies in 2020, 2021, and 2022 was obtained from Otomatch (Otomatch.com). For each student, their medical school, U.S. News & World Report Best Medical School (Research) ranking, and region based on the U.S. Census divisions were recorded. The medical schools were divided into four Tiers according to rank: 1-40 (Tier 1), 41-80 (Tier 2), 81-124 (Tier 3), and 125-191 (Tier 4). Residency programs were also grouped by region, whether they were large (>3 residents/year) or small (<3 residents/year), and their Doximity reputation ranking: 1-31 (Tier 1), 32-61 (Tier 2), 62-91 (Tier 3), and 92-125 (Tier 4). RESULTS: Nine hundred and ninety-five medical students were included in this study. The majority of residency matriculants were MDs (N = 988, 99.3%) who came from Tier 1 (N = 410, 41.2%) or Tier 2 (N = 313, 31.5%) medical schools. Those who attended higher-tier medical schools were more likely to match into higher-tier residency programs (p < 0.001). 57.8% (N = 237) of the applicants who attended Tier 1 medical schools matriculated into a Tier 1 residency program, whereas only 24.7% (N = 42) of the applicants from Tier 4 medical schools matriculated into a Tier 1 residency program. CONCLUSION: Applicants who attend top-tier medical schools represent significantly more residents at top-tier otolaryngology residency programs than those from lower tier medial schools. LEVEL OF EVIDENCE: NA Laryngoscope, 133:3353-3357, 2023.

Looking for opportunities to co-enroll: The DISCOVERY study experience.

BACKGROUND: Conducting high-quality stroke trials is complex and costly. Often these trials compete for the attention of researchers and the availability of patients. Enrolling patients in more than one study concurrently has the potential to accelerate recruitment into individual studies. DISCOVERY is a multicenter, inception cohort study of cognitive impairment and dementia following ischemic or hemorrhagic stroke. At the request of site investigators, a DISCOVERY committee reviews individual studies for approval of possible concurrent co-enrollment into DISCOVERY. The purpose of this report is to summarize the characteristics and outcomes of studies reviewed by committee for possible co-enrollment. METHODS: This analysis covers studies reviewed from 07/01/2020 to 04/26/2022 by the Site Management Committee (SMC) of the DISCOVERY Recruitment and Retention Core. Characterization of each study included study type, number and length of follow-up visits, and whether there were protocol-required blood draws, brain imaging studies, or cognitive tests. Studies were scored for patient burden and scientific overlap with Discovery. The primary outcome was SMC approval to co-enroll. RESULTS: 59 studies were reviewed, and 69.5% (n = 41, 21 clinical trials; 20 observational studies) were found by the SMC to be appropriate for co-enrollment. Higher patient burden and greater scientific overlap with DISCOVERY reduced the rates of approval for co-enrollment. CONCLUSION: A large number of diverse stroke studies are being run concurrently across the DISCOVERY study network, however, about two-thirds of the studies were considered appropriate for consideration of co-enrollment. Future studies should study how co-enrollment might improve trial network efficiency.

Botox and Dermal Fillers in Orthodontics - A Review.

Botulinum toxin and derma fillers have made their way into dentistry in recent years for both cosmetic and medicinal purposes. They are here to stay, and with more and more intraoral applications, they are quickly becoming a standard element of dental treatment. They offer the most important, minimally invasive procedures at a cheap cost and with little to no downtime. Botox and derma fillers are used together for rejuvenation and esthetic operations nowadays. The mechanism of action and numerous uses of Botox and derma fillers in the maxillofacial areas, as well as their future implications in dentistry are discussed in this article.

Multi-class motion-based semantic segmentation for ureteroscopy and laser lithotripsy.

Ureteroscopy with laser lithotripsy has evolved as the most commonly used technique for the treatment of kidney stones. Automated segmentation of kidney stones and the laser fiber is an essential initial step to performing any automated quantitative analysis, particularly stone-size estimation, that can be used by the surgeon to decide if the stone requires further fragmentation. However, factors such as turbid fluid inside the cavity, specularities, motion blur due to kidney movements and camera motion, bleeding, and stone debris impact the quality of vision within the kidney, leading to extended operative times. To the best of our knowledge, this is the first attempt made towards multi-class segmentation in ureteroscopy and laser lithotripsy data. We propose an end-to-end convolution neural network (CNN) based learning framework for the segmentation of stones and laser fiber. The proposed approach utilizes two sub-networks: (I) HybResUNet, a hybrid version of residual U-Net, that uses residual connections in the encoder path of the U-Net to improve semantic predictions, and (II) a DVFNet that generates deformation vector field (DVF) predictions by leveraging motion differences between the adjacent video frames which is then used to prune the prediction maps. We also present ablation studies that combine different dilated convolutions, recurrent and residual connections, atrous spatial pyramid pooling, and attention gate models. Further, we propose a compound loss function that significantly boosts the segmentation performance in our data. We have also provided an ablation study to determine the optimal data augmentation strategy for our dataset. Our qualitative and quantitative results illustrate that our proposed method outperforms state-of-the-art methods such as UNet and DeepLabv3+ showing a DSC improvement of 4.15% and 13.34%, respectively, in our in vivo test dataset. We further show that our proposed model outperforms state-of-the-art methods on an unseen out-of-sample clinical dataset with a DSC improvement of 9.61%, 11%, and 5.24% over UNet, HybResUNet, and DeepLabv3+, respectively in the case of the stone class and an improvement of 31.79%, 22.15%, and 10.42% over UNet, HybResUNet, and DeepLabv3+, respectively, in case of the laser class.

COVID-19 and women's nutrition security: panel data evidence from rural India.

In response to the COVID-19 pandemic, India implemented a stringent nationwide lockdown. Although food value chains and allied activities were exempted from the lockdown, there were widespread disruptions in food access and availability. Using two panel-datasets, we distinguish the pandemic's impact on non-staples versus staples in relation to household food availability and women's diet diversity at the national, state, and district levels in four economically backward districts of Uttar Pradesh (Maharajganj), Bihar (Munger), and Odisha (Kandhamal and Kalahandi). Both the primary and secondary data indicate a decline in household food expenditures and women's dietary diversity in May 2020 compared to May 2019, particularly for non-staples like meats, eggs, vegetables and fruits. This occurred despite special PDS, direct benefit transfer, and ration from aanganwadis rations reaching 80%, 50%, and 30% of surveyed households, respectively. While national and state-level expenditures recovered to the pre-lockdown levels by June 2020, the district-level expenditures did not recover. Our findings contribute to the growing body of evidence of women's disproportionate vulnerability to economic shocks, the impact of a staple grain focused safety net program, and restricted markets on the access and availability of diverse nutritious foods. This paper makes a case for policy reforms towards PDS diversification to include nutrition-rich foods and market reforms to remove supply-side bottlenecks and expansion of direct benefit transfers for healthy food access. We also highlight the importance of gender-responsive safety nets and their increased coverage for improving intrahousehold nutritional disadvantages.

Endoscopic Surgical Excision of Ectopic Tooth in Left Nasal Cavity.

Ectopic teeth in the nasal cavity are a rare phenomenon. They are often associated with a variety of symptoms and future complications, ranging from nasal crusting and obstruction to chronic infections. In most reported cases, their removal is recommended. Here, we report a case of an ectopic intranasal tooth in a symptomatic adult. The tooth was removed endoscopically with good results.

Is peripartum maternal fever alone a reliable predictor of neonatal sepsis? A single-centre, retrospective cohort study.

AIM: To determine the incidence rate of early-onset neonatal sepsis (EONS) among term neonates (gestation greater than 37 weeks) admitted to the neonatal intensive care unit for suspected sepsis and the association of EONS with maternal fever (temperature greater than 38°C). METHODS: A single-centre retrospective cohort study of all term neonates (gestation >37 weeks) admitted to and treated in the neonatal unit at the Townsville University Hospital between March 2015 and March 2020. Neonatal sepsis was confirmed with positive neonatal blood culture. Data on neonatal birth/stay and maternal pregnancy were collected from the electronic medical records and neonatal database. RESULTS: Data from 737 neonates who were admitted for treatment of EONS were analysed. Sixty % (426) reported maternal intrapartum fever, with 1.1% (5) of neonates developing blood culture-proven sepsis. Forty % did not report intrapartum fever (311), with 3% (9) of neonates developing sepsis. As such, the sensitivity and specificity of maternal fever are 1.14% and 97%, respectively. The positive predictive value was 35.7%, and the negative predictive value was 40.1%. Fourteen neonates developed EONS, and all of them were symptomatic. Seventy-eight % (334/426) of the women in the febrile group received epidural analgesia compared to 5% (16/311) in the afebrile group. Of the 95 neonates born to women with chorioamnionitis, one (1.0%) of the neonates born to women with chorioamnionitis developed sepsis. CONCLUSIONS: Intrapartum maternal fever is an unreliable predictor for EONS and leads to unnecessary antibiotic treatment. Symptoms in the neonate are a more reliable indicator of an ill neonate with blood culture-proven sepsis.

Ground truthing the cost of achieving the EAT lancet recommended diets: Evidence from rural India.

In this paper, we quantify the divergence in the cost of current diets as compared to EAT Lancet recommendations at the subnational-level in India. We use primary data on food prices and household food purchases, and secondary data on food expenditures for a period of 12 months in 2018-19. The cost of the EAT Lancet dietary recommendations for rural India ranges between $3.00- $5.00 per person per day. In contrast, actual dietary intake at present is valued at around $1.00 per person per day. In order to get to the EAT Lancet recommendations individuals will have to spend nearly $1.00 per person per day more on each of meat fish poultry, dairy foods and fruits. The deficit in current diets relative to recommendations is marked by seasonal variations driven by volatility in the underlying food prices. This paper extends the evidence base for the affordability of the EAT Lancet diet to a subnational-level in India, using the most recent data on prices and expenditures, over time. We highlight the need for tracking rural markets at the subnational level, over time for their nutritional quality and ability to provide affordable, nutritious diets to the poor. Crop diversification, investments in rural infrastructure and well-functioning markets can move rural India towards more nutrition sensitive food environments.

Continuous Glucose Monitoring for the Detection of Hypoglycemia in Patients With Diabetes of the Exocrine Pancreas.

BACKGROUND: Detailed evaluations of hypoglycemia and associated indices based on continuous glucose monitoring (CGM) are limited in patients with diabetes of the exocrine pancreas. Our study sought to evaluate the frequency and pattern of hypoglycemic events and to investigate hypoglycemia-specific indices in this population. METHODS: This was a cross-sectional study comprising 83 participants with diabetes of the exocrine pancreas. CGM and self-monitoring of blood glucose (SMBG) were performed on all participants for a minimum period of 72 hours. The frequency and pattern of hypoglycemic events, as well as hypoglycemia-related indices, were evaluated. RESULTS: Hypoglycemia was detected in 90.4% of patients using CGM and 38.5% of patients using SMBG. Nocturnal hypoglycemic events were more frequent (1.9 episodes/patient) and prolonged (142 minutes) compared with day-time events (1.1 episodes/patient; 82.8 minutes, P < 0.05). The mean low blood glucose index was 2.1, and glycemic risk assessment diabetes equation hypoglycemia was 9.1%. The mean time spent below (TSB) <70 mg/dL was 9.2%, and TSB <54 mg/dL was 3.7%. The mean area under curve (AUC) <70 mg/dL was 1.7 ± 2.5 mg/dL/hour and AUC <54 mg/dL was 0.6 ± 1.3 mg/dL/hour. All of the CGM-derived hypoglycemic indices were significantly more deranged at night compared with during the day (P < 0.05). CONCLUSION: Patients with diabetes of the exocrine pancreas have a high frequency of hypoglycemic episodes that are predominantly nocturnal. CGM is superior to SMBG in the detection of nocturnal and asymptomatic hypoglycemic episodes. CGM-derived hypoglycemic indices are beneficial in estimating the risk of hypoglycemia.

Are Women in Rural India Really Consuming a Less Diverse Diet?

BACKGROUND: It is widely considered that women have less diverse diets than other household members. However, it has been challenging to establish this empirically since women's diet diversity is measured differently from that of other household members. OBJECTIVE: In this article, we compare women's dietary diversity with that of their respective households and thereby generate a measure of "dietary gap." METHODS: We measure women's "dietary gap" by using the difference of homogenized household and woman dietary scores (using the same scales). This is done using primary data on 3600 households from 4 districts in India. Additionally, we show the robustness of our results to variations in scale and recall periods used to construct the diet diversity scores. RESULTS: Mean difference tests indicate that women consistently consume 0.1 to 0.5 fewer food groups relative to other household members, with the results being statistically significant at the 1% level. The food groups driving this dietary gap are nonstaples like Vitamin A-rich fruits and vegetables, meat/fish/poultry, and dairy. CONCLUSIONS: Results point toward the discrimination faced by women in the variety of the food consumed, the importance of considering comparability in creating indices of diet diversity, and the need to collect more detailed information on diets. To our knowledge, this is one of the first studies to examine dietary discrimination faced by women using common scales.