The Pandemic of Coronary Heart Disease in South Asia: What Clinicians Need to Know.

PURPOSE OF REVIEW: South Asia has around 1/6th of the current global population. Epidemiological studies suggest that South Asians living in South Asia and diaspora are at an increased risk of premature atherosclerotic cardiovascular diseases (ASCVDs). This is due to an interplay of genetic, acquired, and environmental risk factors. Due to its increasing share of the global population, clinicians need to know the reasons for this early predisposition, and strategies for early identification and mitigation. RECENT FINDINGS: South Asians have earlier onset of cardiometabolic risk factors such as insulin resistance, hypertension, and central adiposity. This increased risk is seen in both native South Asians and the diaspora. South Asians have earlier onset of ASCVD due to an earlier onset of cardiometabolic risk factors. Health promotion and early identification of these risk factors are essential to mitigate this ongoing crisis.

Gender differences in first authorship of randomized controlled trials from India.

BACKGROUND: It has been established that identity of the trial leadership plays a role in the conduct of the trial. An estimation of the gender composition of RCT leadership in India has not been undertaken. We performed this study to quantify the gender composition of first authors of RCTs published from India for the years 2011 to 2020. METHODS: PubMed database was searched using the keyword "randomized controlled trial". We included studies that were classified as a RCT, had a first author affiliation that belonged to India and were published online between 1st January 2011 to 31st December 2020. The gender of the first authors was determined using Gender-API and manually. RESULTS: Out of the total 4136 RCTs included in our study, the gender of 4056 (98%) first authors were identified. Of the 4056 first authors, 1198 (30%) were women and 2858 (70%) were men. The mean (SD) percentage of yearly distribution of women and men as first authors was 29.53(2.23) and 70.46(2.23), respectively. We did not find any significant change in gender distribution of first authors over the course of ten years [P = 0.78]. CONCLUSION: The persistence of gender disparity in the leadership of RCTs from India demands greater efforts towards inclusion of women as leaders of clinical trials.

Investigation on Gender Differences in Leadership of Stroke-Related Clinical Trials.

BACKGROUND: Gender disparities among principal investigators of clinical trials (CT) can have implications regarding the areas of investigation, methods, conduct, trial enrollment, and interpretation of results. An estimation of the gender gap in the leadership of stroke-related CTs from North America has to date not been undertaken. METHODS: We extracted information about stroke-related CTs between 2011 and 2020 from www. CLINICALTRIALS: gov and PubMed. We examined the gender distribution according to the academic credentials and the trial type. The gender of PIs and authors was determined using gender package in R, which identifies gender using historical data from the United States. Additionally, we obtained information from Association of American Medical Colleges and the Accreditation Council for Graduate Medical Education data resource books on the gender composition of full-time neurology faculty, neurology residents and vascular neurology fellows. RESULTS: In these analyses of 821 CTs registered on Clinicaltrials.gov and 110 trials published on PubMed, we found that gender disparity among the PIs, first and last authors have persisted over the last decade without any significant trend toward parity (P>0.05). On examining the gender distribution according to academic credentials and trial type, we found that men were over-represented in the sub-group of PIs with an MD degree (78.11% versus 21.87%; P<0.01) and those leading acute stroke trials (86.04% versus 13.89%; P<0.01). We also found that a lower proportion of women neurology residents pursued a vascular neurology fellowship during this period (33.5% versus 42.5%; P<0.05). CONCLUSIONS: Our results show that the favorable trend toward gender parity seen in Neurology faculty over the last decade has not translated to the same in the leadership of CTs. Our findings merit further investigation and a re-examination of efforts toward inclusion of women as leaders of stroke-related CTs.

Long-term Outcome of Children with Recurrent Abdominal Pain.

We report on long-term follow-up [mean (SD) duration, 44.7 (4.3) mo] of 48 out of 132 children with recurrent abdominal pain, who were a part of an earlier study at our hospital. 31 (64.5%) children still experienced pain; 26 (54.1%) reported their pain to be better than before, 4 children reported it to be same as before, and one child reported it worse than before. 17 out of 31 children had pain fitting into one of the categories of functional gastrointestinal disorders in the Rome III criteria; most commonly functional abdominal pain (n=6) and functional constipation (n=3). In majority of children with functional recurrent abdominal pain, pain may persist over the next 3-4 years, but shows slight improvement in frequency and severity.