Comparative evaluation of pre-emptive analgesic efficacy of Posterior Transversus Abdominis Plane block with Fascia Transversalis Plane Block in adult patients undergoing unilateral inguinal hernia repair: A prospective, randomized, single-blind, two-arm parallel study.

Introduction: Abdominal wall blocks, in conjunction with multimodal analgesia, have demonstrated efficacy in providing post-operative analgesia, reducing opioid requirements in patients undergoing inguinal hernia repair. The inguinal region is primarily innervated by the ilioinguinal nerve (IIN) and iliohypogastric nerve (IIH). Posterior transverse abdominis plane block (pTAP) and fascia transversalis plane block (TFP) have been observed to reliably block IIN and IIH. We hypothesized that posterior TAP block (pTAP) owing to its potential paravertebral spread will provide better post-operative analgesia than TFP block in patients undergoing unilateral open inguinal hernia repair. Methods: This prospective, randomized, single-blind, two-arm parallel study was conducted over a duration of one year for which sixty patients undergoing unilateral open inguinal hernia repair under spinal anesthesia were enrolled. They were equally and randomly assigned to receive either preoperative pTAP block or TFP block. The primary aim of the study was to compare median static and dynamic NRS scores during a 24-hour period, with the secondary aim to compare the number of patients who required rescue analgesics in each group. Results: All enrolled patients completed the study. Results showed no statistically significant difference in median static NRS scores between Group pTAP and Group TFP at the designated time of observation during the 24-hour period [1.2 (0.4-1.60 vs. 1 (0.6-1)]. Group pTAP reported a higher median dynamic NRS scores during the 24-hour period [2.6 (1.2-3) v/s 2 (1.6-2.4); P < 0.035], although this difference was clinically insignificant. The mean time to request for the first rescue analgesia was comparable (11.7 h v/s 12 h; P = 0.99). In all the patients of both groups, loss of pinprick and cold touch sensation was observed at T10, T12, and L1 dermatomal levels. However, sensory assessment at T6 and T8 levels showed variability between the two groups (P > 0.05). Conclusion: In conjunction with background analgesia and the use of dexamethasone as an adjuvant, both blocks (pTAP and TFP) were observed to be equally effective for post-operative pain relief with similar patient satisfaction scores.

Incidence of Different Characters of Neuropathic Pain in Cancer Patients Coming to Tertiary Care Centre in North India Over A Period of 1 Year - An Observational Study.

Objectives: Pain is classified as nociceptive, neuropathic, or nociplastic. Neuropathic pain presents as variable phenotypes (characters) based on specific aetiology and pathophysiology. This study aimed to find out among cancer patients the incidence of different phenotypes of neuropathic pain and form specific phenotypic clusters based on the underlying neurophysiology and association of sensory profile with various organ systems - A prospective observational study. Materials and methods: The Institutional Ethical Committee clearance (IEC code: 2020-49-MD-EXP-15) https://ctri.nic.in/Clinicaltrials/showallp.php?mid1=44886&EncHid=88651.15716&userName=CTRI/2020/09/027964 approval was obtained. After written and informed consent, patients of age group 18-80 years, registering in the pain and palliative outpatient department or radiotherapy department with complaints of pain and not taking any anti-neuropathic pain medications, were enrolled. They were assessed using Leeds assessment of neuropathic symptoms and signs (LANSS) pain score, and a score of >12 was eligible for assessment of neuropathic pain phenotypes. Results: Out of 210 cancer patients complaining of pain, a neuropathic component with LANSS >12 was found in 73 (34.76%). The most predominant phenotypes, allodynia> tingling> pricking = burning, were found in 72.60%, 56.16%, and 43.84% of patients, respectively. Phenotypes were clustered into Nodes 1 and 2 based on clinically significant separation of phenotypes. Node 1 had neuropathic pain of spontaneous origin found predominantly in gastrointestinal tract (GIT) and genitourinary tract (GUT) cancers. Node 2 had stimulus-evoked negative and positive characters which occurred in head and neck, thoracic, and spinal metastatic cancers. Conclusion: Careful patient assessment reveals the incidence of neuropathic pain in 34.76%; allodynia and tingling astable the most prominent phenotypes. Broadly, sensory characters were clustered into spontaneous and stimulus-evoked sensations with GIT and GUT cancers presenting with Node 1 symptoms.

An Application of Social Vulnerability Index to Infant Mortality Rates in Ohio Using Geospatial Analysis- A Cross-Sectional Study.

BACKGROUND: Ohio ranks 43rd in the nation in infant mortality rates (IMR); with IMR among non-Hispanic black infants is three times higher than white infants. OBJECTIVE: To identify the social factors determining the vulnerability of Ohio counties to IMR and visualize the spatial association between relative social vulnerability and IMR at county and census tract levels. METHODS: The social vulnerability index (SVICDC) is a measure of the relative social vulnerability of a geographic unit. Five out of 15 social variables in the SVICDC were utilized to create a customized index for IMR (SVIIMR) in Ohio. The bivariate descriptive maps and spatial lag model were applied to visualize the quantitative relationship between SVIIMR and IMR, accounting for the spatial autocorrelation in the data. RESULTS: Southeastern counties in Ohio displayed highest IMRs and highest overall SVIIMR; specifically, highest vulnerability to poverty, no high school diploma, and mobile housing. In contrast, extreme northwestern counties exhibited high IMRs but lower overall SVIIMR. Spatial regression showed five clusters where vulnerability to low per capita income in one county significantly impacted IMR (p = 0.001) in the neighboring counties within each cluster. At the census tract-level within Lucas county, the Toledo city area (compared to the remaining county) had higher overlap between high IMR and SVIIMR. CONCLUSION: The application of SVI using geospatial techniques could identify priority areas, where social factors are increasing the vulnerability to infant mortality rates, for potential interventions that could reduce disparities through strategic and equitable policies.

Ethical obstacles in health systems research in India: Need for focused guidelines.

This paper focuses on the ethical tensions seen in health systems research by researchers owing to their scientific obligations to their research, ethical obligations to study participants, and social obligations to the community. Health systems research differs from other public health research fields in terms of the participants selected, power relations within health systems and the socio-political environment. The study seeks to answer the following questions through experiences in health system research. 1. What are the ethical tensions experienced by researchers in field work? 2. How are the existing guidelines used in resolving tensions arising in field work in India? To understand these ethical tensions, the World Health Organization's Ethical Considerations for Health Policy and Systems Research were applied to research conducted in the health system settings. These tensions faced by researchers are explained through four emerging themes: the researcher's position in the health system; voluntariness of participation: participation; and social justice.

Interacting within an asynchronous online interprofessional education workshop focused on social determinants of health.

BACKGROUND: Meaningful interprofessional education (IPE) involves students from at least two professions interacting to learn with, about, and from one another. Our objective was to describe a novel online approach used to create meaningful IPE within a social determinants of health (SDoH) workshop. INTERPROFESSIONAL EDUCATION ACTIVITY: This online workshop integrated four different professions' perspectives on SDoH (social-work, public-health, nursing, and pharmacy). Each six-student interprofessional team was assigned a local neighborhood. This week-long workshop had numerous activities (pre- and post-workshop quizzes, a SDoH-primer video, video self-introduction to teammates, a windshield questionnaire with two subsequent clinical cases, a post-workshop reflection, and post-workshop evaluation). For discussion, asynchronous video-based responses were used instead of traditional text-based discussion-boards. DISCUSSION: Quantitatively comparing quiz scores, students' SDoH knowledge increased with this workshop. Qualitatively from evaluations, most students found this workshop helpful and meaningful. Supporting use of video-based responses, many students' favorite aspect was interacting and collaborating within their interprofessional teams, although some students desired synchronous activities instead. Faculty facilitators confirmed that meaningful IPE interactions occurred. IMPLICATIONS: In short, students from multiple health-professions learned SDoH-content and, using video-based responses, interacted asynchronously during this online workshop. This report demonstrated one tool available to help facilitate meaningful IPE asynchronously. This asynchronous, online IPE workshop appears to be a promising format to be integrated with other in-person IPE sessions.

Impact of COVID-19 Pandemic on Health Behaviors and Outcomes by Age Group and Race Ethnicity: Results From Behavioral Risk Factor Surveillance System Data.

This study aimed to examine changes in health behaviors and outcomes during early-pandemic (2020) vs pre-pandemic (2019) years by age groups and race/ethnicity. Multivariable logistic regressions were conducted using Behavioral Risk Factor Surveillance System datasets from 2019 (n = 418 268) and 2020 (n = 401 958). All participants reported less likelihood to exercise (aOR, .78; 95% CI: .73-.83) and have poor physical health (aOR, .91; 95% CI: .86-.98) but more likelihood to have excellent general health (aOR, 1.33; 1.17-1.53) during 2020 vs 2019. Compared to 2019, during 2020 (i) Blacks were more likely to exercise (aOR, 1.24; 95% CI: 1.02-1.51) and have excellent general health (aOR, 1.69; 95% CI: 1.13-2.54); (ii) Hispanics were less likely to exercise (aOR, .80; 95% CI: .74-.88), but more likely to have excellent general health (aOR, 2.44; 95% CI: 1.79-3.33) and mental health (aOR, 1.41; 95% CI: 1.15-1.72); and (iii) Whites were less likely to exercise (aOR, .58; 95% CI: .50-.67) and have good physical health (aOR, 0.89; 95% CI: .82-.95). All age groups, except 18-24 years, were less likely to exercise by 18%-39% during 2020 vs 2019. Furthermore, the 55-64 years age-group was 36% more likely to report excellent general health but 14% less likely to have good physical health. Identifying the most vulnerable racial/ethnic and age groups is pivotal to prioritizing public health resources and interventions to mitigate the impact of health crises.

Assessing Organizational Capacity to Advance Health Equity: Mixed-Methods Approach at a Local Health Department.

Local health departments (LHDs) play a leading role in eliminating health inequities as they proactively identify and address barriers to optimal health within the community they serve. This study evaluated a Midwestern County LHD's commitment, collaborations, and capacity to advance health equity in their organization. A total of 81 employees completed the online survey (response rate = 51%) and 12 among randomly selected employees completed the qualitative interviews (31.5%). More than 75% of participants reported that all departments had explicit work plans and 50% had a strong capacity to address social determinants of health. Almost 50% of the participants reported strong internal collaboration, but less than 25% indicated that no external partners were involved during the program planning process. Finally, a few participants identified the need for increased diversity in leadership and expressed the importance of quality training and feedback.

The importance of social risk factors for patients diagnosed with opioid use disorder.

BACKGROUND: Opioid Use Disorder (OUD) is a major public health concern, with mortality rates in individuals who use opioid medications being up to 30 times greater than those of individuals who do not use such medications. Social risk factors influence one's ability to make healthy choices and pose challenges for individuals recovering from OUD. OBJECTIVE: This study aimed to explore the relationship between OUD and social risk factors for patients who have been prescribed opioid medications. METHODS: Data for this retrospective cohort study were obtained from a health care system's comprehensive data warehouses consisting of electronic health records (EHR) with Social Determinants of Health (SDoH) screening information, and medical and prescription claims data. The study compared patients 18 years of age or older with an opioid prescription who were considered users of opioids to patients who had a documented diagnosis of OUD in the EHR. All patients were screened for SDoH. The analyses were performed using Statistical Analysis System (SAS) (SAS Institute Inc, Cary, NC). RESULTS: The study included patients with an outpatient visit at one of the health care system's primary care or oncology facilities between January 1, 2017 and December 31, 2018. There were 5003 patients with an opioid prescription who were considered users of opioids, and 209 patients with an opioid prescription as well as a diagnosis of OUD. Compared to the opioid use group, patients with OUD were more likely to have a lower educational attainment, encounter financial hardship, or be food insecure. Being female, older than 40, and having a higher Charlson Comorbidity Index score were factors associated with lower rates of opioid misuse. CONCLUSION: Identifying social risk factors and providing appropriate services to individuals with OUD is essential in mitigating challenges to recovery and promoting overall health for these individuals.

OsCRY2 and OsFBO10 co-regulate photomorphogenesis and photoperiodic flowering in indica rice.

Cryptochromes (CRYs) are a class of photoreceptors that perceive blue/ultraviolet-A light of the visible spectrum to mediate a vast number of physiological responses in bacteria, fungi, animals and plants. In the present study, we have characterized OsCRY2 in a photoperiod sensitive indica variety, Basmati 370, by generating and analyzing overexpression (OE) and knock-down (KD) transgenic lines. The OsCRY2OE lines displayed dwarfism as shown in their reduced plant height and leaf length, attributed largely by an overall reduction in their cell size. The OsCRY2OE lines flowered significantly earlier and showed shorter and broader seeds with an overall reduced seed weight. The OsCRY2KD lines showed contrasting phenotypes, such as increased plant height and delayed flowering, however, decreased seed size and weight were also observed in the KD lines, along with reduced spikelet fertility and high seed shattering rate in mature panicles. Novel interactions were confirmed between OsCRY2 and members of ZEITLUPE family of blue/ultraviolet-A light photoreceptors, encoded by OsFBO8, OsFBO9 and OsFBO10 which are orthologous to ZEITLUPE (ZTL), LOV KELCH PROTEIN2 (LKP2) and FLAVIN BINDING, KELCH REPEAT F-BOX1 (FKF1), respectively, of Arabidopsis thaliana. Since FKF1 is known to play a role in regulating photoperiodic flowering, OsFBO10 was chosen for further studies. OsCRY2 and OsFBO10 interacted in the nucleus and cytoplasm of the cell and cross-regulated the expression of each other. They were also found to regulate the expression of several genes involved in photoperiodic flowering in rice. Both OsCRY2 and OsFBO10 played a positive role in photomorphogenic responses in different light conditions. The physical interaction of OsCRY2 with OsFBO10, their involvement in common physiological and developmental pathways and their cross-regulation of each other suggest that the two photoreceptors may regulate common developmental pathways in plants, either jointly or redundantly.

Changes in patient portal adoption due to the emergence of COVID-19 pandemic.

Even though patient portals are recognized as a promising mechanism to support greater patient engagement, questions remain about access and utilization. This study aims to identify factors related to portal adoption in 2019 and 2020 (before and during the COVID-19). Cross-sectional data from the Health Information National Trends Survey (HINTS) cycles- 2019 HINTS 5 cycle 3 (N = 5,438) and 2020 HINTS 5 cycle 4 (N = 3,865) were analyzed using STATA-SE version 17 to factors predicting portal adoption. Next, HINTS 5 cycles 3 and 4 were pooled to identify changes in portal feature use and ease of usage among portal users, and barrier to portal use among non-users. Respondents who were college graduates, high income, and married were more likely to adopt patient portals during 2019 and 2020. Aged 75+ and Hispanic respondents reported less frequency of portal access in 2020 versus 2019. Men were more likely to adopt patient portals in 2019 versus women in 2020. Portal users were more likely to use the portal-system features in 2019 versus 2020. Portal non-users reported having multiple-health records as less of a barrier in 2020 compared to 2019. Patient engagement needs heightened attention during the COVID-19 pandemic.

Examining the effect of discrimination and stigma on utilization of mental health services among college students.

BACKGROUND: Even though onset of three-quarters of mental disorders occurs by age 25, few young adults seek help for their mental health needs. The objectives of this study are to examine the relationship of discrimination and stigma of mental illness on the help-seeking behavior for mental health among college students. METHOD: Undergraduate students (N = 557) at a Midwestern university were surveyed online. Descriptive and logistic regression analysis was conducted using STATA15. RESULTS: College students reporting higher discrimination were more likely to seek help for mental health services (OR = 1.04, CI = 1.01-1.06), after controlling for all covariates. Students with higher personal stigma reported lower odds of help-seeking behavior (OR = 89, CI = .80-.97). Students with higher perceived public stigma did not have an independent significant association on help-seeking behavior initially, but full model revealed a significantly association (OR = 1.02, CI = .99-1.05). CONCLUSION: Developing targeted interventions addressing discrimination and stigma of mental illness is critical among college students.

CRY2 gene of rice (Oryza sativa subsp. indica) encodes a blue light sensory receptor involved in regulating flowering, plant height and partial photomorphogenesis in dark.

KEY MESSAGE: OsiCRY2 is involved in light-regulated plant development and plays a role in regulating photomorphogenesis, plant height, flowering and most strikingly partial photomorphogenesis in dark. Cryptochrome 2 (CRY2), the blue/UV-A light photoreceptor in plants, has been reported to regulate photoperiod-dependent flowering and seedling photomorphogenesis (under low-intensity light). Among monocots, CRY2 has been reported from japonica rice, wheat, sorghum and barley. The two sub-species of rice, indica and japonica, exhibit a high degree of genetic variation and morphological and physiological differences. This article describes the characterization of CRY2 of indica rice (OsiCRY2). While the transcript levels of OsiCRY2 did not change significantly under blue light, its protein levels were found to decline with increased time duration under blue light. For phenotypic characterization, OsiCRY2 over-expression (OX) transgenics were generated in Oryza sativa Pusa Sugandh 2 (PS2) cultivar, a highly scented Basmati cultivar. The OsiCRY2OX transgenics displayed shorter coleoptiles and dwarfism than wild-type under blue light, white, and far-red light. Interestingly, even the dark-grown transgenics were shorter, concomitant with higher OsiCRY2 protein levels in transgenics than wild-type. Histological analysis revealed that the decrease in the length of the seedlings was due to a decrease in the length of the epidermal cells. The fully mature rice transgenics were shorter than the untransformed plants but flowered at the same time as wild-type. However, the OsiCRY2 Arabidopsis over-expressors exhibited early flowering by 10-15 days, indicating the potential and conservation of function of OsiCRY2. The whole-genome transcriptome profiling of rice transgenics revealed the differential up-regulation of several light-regulated genes in dark-grown coleoptiles. These data provide evidence that OsiCRY2 regulates photomorphogenesis, plant height, and flowering in indica rice.

Management of neurovascular emergencies with ophthalmic manifestations.

Patients with neurovascular disorders sometimes approach the ophthalmologists with mild ophthalmic clinical features such as conjunctival congestion, slowly progressive proptosis, lateral rectus palsies and at other times with ophthalmic emergencies like sudden increase in proptosis, ophthalmoplegia, diplopia, and ptosis before the onset of neurological manifestations which may be life-threatening if not detected in time. The aim of this article is to focus on ophthalmic manifestations of neurovascular emergencies and role of ophthalmologists in its management. In this communication, to make the ophthalmologist aware of clinical presentations, the imaging modality of choice, diagnostic features, medical and interventional treatments. We have searched PubMed, Web of Science, Google Scholar and reviewed some of the commonly encountered neurovascular emergencies with ocular manifestations such as carotid-cavernous fistula, cerebral venous sinus thrombosis, cerebral artery aneurysms, arterio-venous malformations.

Randomized controlled trial to study the efficacy and safety of ultrasound-guided pectoral nerve block for superficial breast surgeries.

BACKGROUND: Our study aimed to compare pectoral nerve (PEC) block with local anesthetic (LA) infiltration for providing analgesia in superficial breast surgeries. MATERIALS AND METHODS: This prospective comparative randomized study included seventy American Society of Anesthesiologists I and II female patients undergoing excision of fibroadenoma. In Group 1, the LA mixture was infiltrated in the desired planes. In Group 2, PEC I and PEC II blocks were performed under ultrasound guidance. Patients were observed at regular time intervals for pain scores, time to first analgesic request, and the number of patients requiring rescue analgesia with the cumulative analgesic requirement, hemodynamic changes, and any adverse events. RESULTS: The patients were comparable in demographic profile, duration of anesthesia, and hemodynamic parameters. NRS scores at all times after extubation were significantly lower in Group 2 as compared to Group 1 (P < 0.0001). All patients in Group 1 required additional analgesia, while only two in Group 2 received rescue analgesia (P < 0.0001). The time to first analgesic request was significantly longer in Group 1 as compared to group 2 (9.5 + 0.70 h vs. 1.35 + 0.83 h) (P < 0.0001). The cumulative requirement of tramadol in Group 1 (96.88 ± 16.45 mg) was significantly higher than in Group 2 (6.47 ± 26.38 mg) (P < 0.0001). No adverse event was reported in either group. CONCLUSION: PEC block is a useful method for achieving effective and long-lasting analgesia. It is an efficient and safe alternative to LA infiltration in patients undergoing fibroadenoma excision.

Characterization of Cry2 genes (CRY2a and CRY2b) of B. napus and comparative analysis of BnCRY1 and BnCRY2a in regulating seedling photomorphogenesis.

Cryptochrome 2 (CRY2) perceives blue/UV-A light and regulates photomorphogenesis in plants. However, besides Arabidopsis, CRY2 has been functionally characterized only in native species of japonica rice and tomato. In the present study, the BnCRY2a, generating a relatively longer cDNA and harboring an intron in its 5'UTR, has been characterized in detail. Western blot analysis revealed that BnCRY2a is light labile and degraded rapidly by 26S proteasome when seedlings are irradiated with blue light. For functional analysis, BnCRY2a was over-expressed in Brassica juncea, a related species more amenable to transformation. The BnCRY2a over-expression (BnCRY2aOE) transgenics developed short hypocotyl and expanded cotyledons, accumulated more anthocyanin in light-grown seedlings, and displayed early flowering on maturity. Early flowering in BnCRY2aOE transgenics was coupled with the up-regulation of many flowering-related genes such as FT. The present study also highlights the differential light sensitivity of cry1 and cry2 in controlling hypocotyl elongation growth in Brassica. BnCRY2aOE seedlings developed much shorter hypocotyl under the low-intensity of blue light, while BnCRY1OE seedling hypocotyls were shorter under the high-intensity blue light, compared to untransformed seedlings.

Artificial intelligence and Psychiatry: An overview.

The burden of mental illness both in world and India is increasing at an alarming rate. Adding to it, there has been an increase in mental health challenges during covid-19 pandemic with a rise in suicide, loneliness and substance use. Artificial intelligence can act as a potential solution to address this shortage. The use of artificial intelligence is increasingly being employed in various fields of mental health like affective disorders, psychosis, and geriatric psychiatry. The benefits are various like lower costs, wider reach but at the same time it comes with its own disadvantages. This article reviews the current understanding of artificial intelligence, the types of Artificial intelligence, its current use in various mental health disorders, current status in India, advantages, disadvantages and future potentials. With the passage of time and digitalization of the modern age, there will be an increase in the use of artificial intelligence in psychiatry hence a detailed understanding will be thoughtful. For this, we searched PubMed, Google Scholar, and Science Direct, China national Knowledge Infrastructure (CNKI), Globus Index Medicus search engines by using keywords. Initial searches involved the use of each individual keyword while the later searches involved the use of more than one word in different permutation combinations.

Health Implications of Racialized State Violence Against South Asians in the USA.

South Asians, one of the fastest growing ethnic groups in the USA today, trace their roots to countries in the Indian subcontinent (e.g., Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, Sri Lanka) and its global diaspora. With a wide range of cultural, religious, and linguistic diversity, as well as immigration experiences and inequality, South Asians have experienced racialized violence and discrimination since first arriving in the USA in the 1700s. Following September 11, 2001, South Asians and other groups racialized as "Brown," including Muslim, Sikh, Middle Eastern, and Arab Americans, have experienced a marked increase in state violence, including racist laws, policies, and immigration enforcement. Despite abundant evidence of the adverse effects of violence on mental and physical health, there is limited research examining the impact of this racialized state violence on the health of South Asians in the USA. We summarize and synthesize existing peer-reviewed and gray literature on the prevalence and types of violence experienced by South Asians in the USA and enumerate their potential detrimental health impacts. We highlight the paucity of public health data and propose a conceptual framework describing how racialized violence and hate have significant implications for health among South Asians in the USA. Ultimately, these findings illuminate the need for change at the highest levels of governance to mitigate and resist hate violence, including through political participation and inclusion and equitable allocation of social and economic resources, to improve the health of South Asians in the USA.

Body composition and metabolic parameters in men with chronic traumatic paraplegia - A pilot study from India.

OBJECTIVE: To study body composition, measures of insulin resistance and dyslipidemia in Indian men with paraplegia as compared to age and body mass index (BMI) matched able-bodied men. DESIGN: Cross sectional study. SETTING: Departments of Physical Medicine and Rehabilitation and Endocrinology. PARTICIPANTS: Males aged 18-45 years with chronic traumatic paraplegia versus age and BMI-matched able-bodied men. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Measures of body composition such as total body fat, lean mass, regional adiposity using dual energy x-ray absorptiometry (DXA), metabolic profile and insulin resistance. RESULTS: Subjects with paraplegia (n = 43), compared to controls (n = 36), had higher %Fat mass (FM) (25.5 (21.2-28.9) vs 20.2 (15.9-22.2); P < 0.01), lower trunk to leg ratio (0.66 (0.51-0.73) vs 0.87 (0.72-0.94); P < 0.01), lower lean mass index (14.38 (2.57) vs 17.80 (2.34); P < 0.01) and lower appendicular lean mass index (5.81 ± 1.26 vs 8.17 ± 1.12; P < 0.01). Fasting blood glucose (mg/dl) was higher (89.0(81.5-96.5) vs 80.0 (74.5-88.2); P < 0.01), Homeostasis model assessment of insulin resistance was higher (1.33 (1.03-2.12) vs 0.94 (0.52-1.78); P = 0.02), Quantitative insulin sensitivity check index (QUICKI) was lower (0.36 ± 0.04 vs 0.38 ± 0.05; P = 0.02) and HDL-C was lower (33.00 (30.00-42.75) vs 38.50 (33.00-43.25); P < 0.02) in cases compared to controls. QUICKI correlated positively with HDL-C and negatively with %FM, estimated VAT volume and TG. Trunk to leg ratio correlated positively with TG even after controlling for %FM. CONCLUSION: Men with chronic paraplegia had lower lean mass, higher total and regional fat mass, increased insulin resistance and low HDL-C when compared with BMI-matched able-bodied controls. Both total and regional adiposity correlated with poor metabolic profile.