Evaluation of the SARC-F Questionnaire as a Diagnostic Tool for Sarcopenia in Geriatric Age-group in India.

INTRODUCTION: With medical science advancing in leaps and bounds, average lifespan is now trending upward, and we are now facing an increasing prevalence of diseases of the elderly, sarcopenia being one of them. Unfortunately, sarcopenia, especially in India, remains to be frequently overlooked, underdiagnosed, and largely understudied. One of the greatest hindrances to the diagnosis of sarcopenia is high costs and limited availability of diagnostic modalities such as magnetic resonance imaging (MRI) and dual energy X-ray absorptiometry (DEXA) scan. Accessible, feasible, and affordable means to diagnose sarcopenia is thus the need of the hour. MATERIALS AND METHODS: We performed a cross-sectional observational study among 300 patients aged 65 years or above (including both outpatient and inpatient departments) at MM Institute of Medical Sciences, Mullana between June 2021 and June 2022. Patients were evaluated as per the European Working Group for Sarcopenia in Older People (EWGSOP) algorithm using bioelectrical impedance analysis (BIA) and the results were compared with results of the SARC-F questionnaire. Statistical analyses were then carried out using IBM Statistical Package for the Social Sciences (SPSS) Statistics version 26. RESULTS: Out of 300 patients, 56 (18.7%) were sarcopenic. Sarcopenia showed no significant association with sex (p = 0.74). SARC-F showed a sensitivity of 73.2% and a specificity of 37.3% with a positive predictive value of 86.51% and a negative predictive value of 32.84% in diagnosing sarcopenia. SARC-F showed good internal reliability with a Cronbach's α > 0.7. CONCLUSION: The SARC-F questionnaire can be used as a bedside screening tool for sarcopenia, especially in a developing country like India where diagnostic resources are frequently scarce.

Shades of Blue: A Case Series of Acquired Methemoglobinemia.

Acquired methemoglobinemia (MetHb) is a rare but potentially life-threatening condition that has varied etiology, usually toxin- or drug-induced. We had five cases of acquired methemoglobinemia during six months. Their presentation varied from an asymptomatic state to respiratory distress. The presence of cyanosis and low oxygen saturation (SpO2), despite normal partial pressure of oxygen (PaO2) and chocolate brown-colored blood, were diagnostic clues present in all cases. A high level of methemoglobinemia was detected on arterial blood gas (ABG), confirming the diagnosis. Methylene blue was used as an antidote along with supportive care in symptomatic cases. All these cases of methemoglobinemia recovered completely. A high index of suspicion for methemoglobinemia should be maintained in cases presenting with persistent hypoxia or cyanosis despite normal PaO2.

Artificial intelligence predicts normal summer monsoon rainfall for India in 2023.

Inaccuracy in the All Indian Summer Monsoon Rainfall (AISMR) forecast has major repercussions for India's economy and people's daily lives. Improving the accuracy of AISMR forecasts remains a challenge. An attempt is made here to address this problem by taking advantage of recent advances in machine learning techniques. The data-driven models trained with historical AISMR data, the Niño3.4 index, and categorical Indian Ocean Dipole values outperform the traditional physical models, and the best-performing model predicts that the 2023 AISMR will be roughly 790 mm, which is typical of a normal monsoon year.

A Comparative Study of the C-Reactive Protein and the ST-Score (ECG) as Prognostic Indicators in Acute Myocardial Infarction in a Rural Resource-Constrained Hospital Setting in Central India: A Cross-Sectional Study.

CONTEXT: The electrocardiogram remains a crucial tool in identification of acute myocardial infarction (AMI). High sensitivity C-reactive protein (hs-CRP) has been found to be strong predictor of coronary artery disease (CAD) and future cardiovascular events. AIMS: The aim of the present study was to compare hs-CRP and ST-Score (STS) as prognostic indicator in acute ST segment elevated myocardial infarction (STEMI) in central rural India. SETTINGS AND DESIGN: Cross sectional study, rural hospital in central India. MATERIAL AND METHODS: In all patients of STEMI, STS, ST index and hs-CRP were measured on admission and serially. The Primary outcome was all cause mortality at 30 days. Secondary outcome were heart failure, life threatening arrhythmia, cardiogenic shock, re-infarction, hospital stay and re-admission. STATISTICAL ANALYSIS USED: We used Student's t test to compare means, Chi-square test to compare proportions and Mann Whitney test to compare medians. P value <0.05 will be considered significant. Crude odds ratios were computed to assess the strength of association between risk factors and independent variable along with 95% confidence intervals. RESULTS: STS was significantly higher in patients with poor outcome, when compared with good outcome (20.27mm vs.12.47mm, P = 0.002). On multivariate regression model STS was significant predictor of composite outcome events (OR = 2.74; 95% [CI], 1.46 to 5.17; P = 0.002). The area under the ROC curve was 0.70, with sensitivity of 73.5%, specificity of 58.7%; PPV of 68.3% and NPV of 64.2%. hs-CRP in patients with poor outcome vs. good outcome (6mg/L vs. 3.74mg/L, P = 0.003) and (P = 0.06, 0.85 and 0.12) respectively. CONCLUSIONS: STS on admission is independent predictor while hs- CRP is not in resource constrained settings.