The Need, Feasibility and Willingness to Explore "Meditation on Twin Hearts" as a Self-administered Tool for Mental Health Management among Transgender Women: An Exploratory Survey.

Hijras are the transgender community and have been socio-economically marginalized and hence their mental healthcare needs to be addressed. This was a descriptive, qualitative study, conducted in Mysore, India to examine the mental health status of 33 transgender women (TGW) and their response to the "Meditation on Twin Hearts (MTH)" intervention. Assessment of anxiety, depression and suicidality was carried out before the meditative session followed by a single session of MTH. Their feedback on meditation experience was collected, coded, and transformed into quantitative data. Among total participants, 39.4% of TGW exhibited severe anxiety, 21.2% has severe depression and 75.8% of them were at suicidal risk. Depression was positively correlated with anxiety and suicidal behavior. Most participants reported MTH was useful with signs of improvements in mental state. Thus, a single session of MTH has shown good signs of improvement in mental state among TGW.

Evaluation of adsorption properties of sulphurised activated carbon for the effective and economically viable removal of Zn(II) from aqueous solutions.

The prospective application of sulphurised activated carbon (SAC) as an ecofriendly and cost-effective adsorbent for Zinc(II) removal from aqueous phase is evaluated, with an emphasis on kinetic and isotherm aspects. SAC was prepared from sugarcane bagasse pith obtained from local juice shops in Sree Bhadrakali Devi Temple located at Ooruttukala, Neyyattinkara, Trivandrum, India during annual festive seasons. Activated carbon modified with sulphur containing ligands was opted as the adsorbent to leverage on the affinity of Zn(II) for sulphur. We report batch-adsorption experiments for parameter optimisations aiming at maximum removal of Zn(II) from liquid-phase using SAC. Adsorption of Zn(II) onto SAC was maximum at pH 6.5. For initial concentrations of 25 and 100mgL(-1), maximum of 12.3mgg(-1) (98.2%) and 23.7mgg(-1) (94.8%) of Zn(II) was adsorbed onto SAC at pH 6.5. Kinetic and equilibrium data were best described by pseudo-second-order and Langmuir models, respectively. A maximum adsorption capacity of 147mgg(-1) was obtained for the adsorption of Zn(II) onto SAC from aqueous solutions. The reusability of the spent adsorbent was also determined.

Four-quadrant osteoplastic decompressive craniotomy: A novel technique for refractory intracranial hypertension - A pilot study.

BACKGROUND: Decompressive craniectomy (DC) with duroplasty is the gold standard for refractory intracranial hypertension despite paucity of randomized controlled trials. There are several morbidities associated with DC of which the persistence of bony defect is of paramount importance. Studies have shown that many of the morbidities associated with DC get reversed following replacement of the bone flap. AIM: To design a novel technique for control of refractory intracranial pressure (ICP), as well as to study its safety and efficacy compared to the conventional DC technique. MATERIAL AND METHODS: We conducted a prospective, comparative, observational pilot study comparing four-quadrant osteoplastic decompressive craniotomy (FoQOsD) with conventional DC. The demographic features, postoperative variables such as operating time, number of days of intensive care unit (ICU) stay and survival, as well as radiographic variables such as change in the midline shift (MLS) and expansion of the compressed brain were analyzed using relevant statistical tests. RESULTS: Twenty patients were selected and grouped into two groups of 10 patients each. The male: female ratio in the two groups were 8:2 and 7:3, respectively, and the mean age at presentation was 42.7 ± 1.45 years in the FoQOsD group and 43.6 ± 1.32 years in the DC group. Both the groups were comparable in relation to the duration of surgery, duration of ICU stay, and survival (P > 0.05). There was significant brain expansion and reversal of MLS (P < 0.001) in the FoQOsD group, factors which were comparable to that in the DC group. CONCLUSIONS: FoQOsD may be as effective as conventional DC in managing intracranial hypertension. This procedure mainly avoids a revision cranioplasty. A prospective randomized controlled trial with a large sample size may be initiated for obtaining more accurate data.

Assessment of genetic diversity in Brassica juncea (Brassicaceae) genotypes using phenotypic differences and SSR markers.

Brassica mustard species represent one of the most important oilseed crops in India, nevertheless, their genetic diversity is barely known. A better understanding on this topic is essential for the proper utilization of genotypes in breeding programmes. We evaluated the genetic diversity among 44 Indian mustard (Brassica juncea) genotypes including varieties/purelines from different agro-climatic zones of India and few exotic genotypes (Australia, Poland and China). For this, we used A and B genome specific SSR markers and phenotypic data on 12 yield and yield contributing traits. Out of the 143 primers tested, 134 reported polymorphism and a total of 355 alleles were amplified. Dendrograms based on Jaccard's similarity coefficients and Manhattan dissimilarity coefficients were generated based on an average linkage algorithm (UPGMA) using marker data and phenotypic data. Genotypes were grouped into four clusters based on genetic distances. Both the clustering patterns based on Jaccard's similarity and Manhattan dissimilarity coefficients, independently, discriminated the genotypes effectively as per their pedigree and origin. PCoA revealed that, the grouping of genotypes based on SSR marker data is more convincing than phenotypic data, however, the correlation between phenotypic and genetic distance matrices was observed to be very low (r = 0.11). Hence, for diversity studies reliability on molecular markers is worth proving and SSR markers are the stronger tools than quantitative traits in discriminating B. juncea genotypes.

Impact of disability in the quality of life of patients with traumatic brachial plexus injuries based on a questionnaire survey in a tertiary center in South India.

Objectives: The aim of the study was to assess the disability and its impact in the health-related quality of life (HRQOL) and its various domains in patients with traumatic brachial plexus injury (TBPI). Materials and Methods: A descriptive cross-sectional questionnaire survey was conducted on 41 patients with TBPI in a tertiary care center in South India. The assessment of disability and HRQOL was done as per the guidelines of the Gazette of India (2001) and WHO BREF questionnaire, respectively. The association between disability and HRQOL was determined using Chi-square test. Results: All patients were males in the age group 16-60 years (mean age 36.8 ± 14.4 years). Etiology was road traffic accident in 90.2% of cases. About 51.2% had pan-plexus injuries and 53.7% had their dominant limb affected. The mean total disability was 80.39 ± 13.86% and the mean total HRQOL score was 188.46 ± 83.44 out of 400. It was found that disability due to TBPI significantly reduced the HRQOL (Fisher's exact P = 0.005) and the psychological domain was the most significantly affected (P = 0.017, Kruskal-Wallis test). Pan-plexus injuries with an involvement of dominant upper limb had significant impact in the HRQOL. Twenty-one patients (51.2%) complained of neuropathic pain and they had a significantly reduced quality of life (QOL) (mean QOL = 23.3, P < 0.001). It was also found that productive age group (26-55 years) had a significantly reduced QOL as compared to the extreme age groups (P = 0.000). Unemployed patients had a significantly reduced QOL as compared to those with permanent/temporary job (P = 0.024). Marital status was found to have no significant relationship with the total HRQOL (P = 0.647). Those belonging to the poor socioeconomic strata (below poverty line) had poor HRQOL as compared to those above poverty line and the relationship was found to be significant (P = 0.000). Conclusion: TBPIs significantly affected all domains of QOL, especially in unemployed patients in the productive age group in the poor socioeconomic strata. The pan-brachial plexus involvement of dominant upper limb and associated neuropathic pain were the most important factors which negatively affected the QOL. Among the codomains of the QOL, psychological domain was the most significantly affected irrespective of the severity of the injury.

Heavy metals in coral reef sediments of Kavaratti Island, India: An integrated quality assessment using GIS and pollution indicators.

The present study aims to document the contamination levels and ecological risks of heavy metals in the sediments of Kavaratti lagoon, India. A total of 15 sediment samples were collected for the analysis of Al, Pb, Cd, Cu, Cr, Mn, Ni and Zn. The decreasing trend of heavy metals was observed in the lagoon sediment as Pb > Zn > Al > Mn > Ni > Cr > Cd > Cu. The Geo-accumulation index (Igeo) results indicate that Cu, Cr, Mn, Ni and Zn were uncontaminated, while Cd was strong to extremely contaminated and Al and Pb were moderately contaminated. The enrichment factors (EF) of Cd and Pb range from moderate to extremely high (EF > 1) indicating that they have anthropogenic origin on Kavaratti Island. The Contamination factor (Cf) indicated that Cd, Pb and Al belong to a high risk of contamination (Cf > 6). The pollution load index (PLI) value near one suggested that a moderate level of pollution occurs in the study area. The modified degree of contamination (mCd) shows that Al, Cd and Pb have an ultra- higher degree of contamination (mCd ≤ 32). The potential ecological risk (RI) index confirmed that Pb and Cd have considerable to the serious thread of ecological risk (RI > 600). Additionally, multivariate statistical analysis and pollution indexes showed that the Kavaratti lagoon is moderate to considerably polluted by heavy metals. Diesel-based power generation, activities related to shipping, untreated sewage, fishing and tourism activities are the main anthropogenic sources of heavy metal pollution on Kavaratti Island.

Degenerative Lumbar Disc Disease: A Questionnaire Survey of Management Practice in India and Review of Literature.

Objective To identify the current management modalities practiced by neurosurgeons in India for degenerative lumbar disc disease. Materials and Methods Survey questionnaires were prepared in Google forms. It covered the following aspects of managing the lumbar disc pathology: (1) Demographic, institutional details, experience of surgeons, (2)choice of surgical procedures, (3) use of endoscopy and minimally invasive techniques, and (4) pre- and postoperative care. Responses obtained were entered in SPSS datasheet and analyzed. Results Of the 300 surveys sent, 80 were returned and response rate was 26.6%. But four surveys were highly incomplete and were discarded from the analysis. So, the study content is from the analysis of practices of 76 spinal surgeons working in different parts of the country. Majority of the spine surgeons ( n = 70) were neurosurgeons, while 6 were orthopaedic surgeons. Fifty-four were from urban area, 12 from semiurban area, and 10 from rural area. Forty-seven spine surgeons practiced in a teaching hospital. Total 73.6% of spine surgeons opted initial medical management. Sixty-three percent preferred microlumbar discectomy (MLD) and only eight neurosurgeons preferred minimally invasive techniques. None of the respondents used in situ fusion. Fifty-three percent of spine surgeons preferred early mobilization (first postoperative day). Fifty-nine percent preferred to follow-up patients clinically and opted for magnetic resonance imaging only when recurrence or infection was suspected. The institutional nature (government teaching, government nonteaching, private teaching, and private nonteaching) and location of the hospital (urban/semiurban/rural) were found to be influencing the preferred surgical technique, trial of medical management, or postoperative care and complications. Considerable practice variations exist for medical and perioperative management. Conclusion The preferred treatment of choice of majority was MLD, although laminectomy and discectomy were still used by many. Consensus lacks in the operative, perioperative, and postoperative management of degenerative disc disease. Present survey points toward the importance of making management guidelines for this common spinal surgical entity.

Registry-based pilot epidemiological study of traumatic brain injury in a tertiary trauma care center in Kerala, India - Difficulties encountered during data collection warranting the need for standardized electronic database.

BACKGROUND: Head injury is referred to as a "silent epidemic" globally. Studies regarding epidemiology of head injury are very few especially in Kerala and most have conflicting reports. Unlike developed countries, there is no well-established system for collecting and managing information on traumatic brain injury (TBI) in India, especially in Kerala. The present study shares the difficulties encountered and the insights acquired by conducting a registry-based epidemiological pilot study for collecting a baseline data of traumatic head injury patients in a tertiary care center in Kerala. METHODS: The pilot study was conducted to know the efficiency of present reporting system of a tertiary hospital in Kerala. We tried to collect retrospective data from December 2018 to December 2019 in the department of neurosurgery. As there was no standardized protocol or electronic database for data collection in hospital, we made a sample proforma for data collection. The patient details were obtained from medical records (case sheets), resident doctor's, and staff nurse's notes which included demography, clinical details, and radiological findings which were analyzed. RESULTS: We were not able to fill the full details regarding demography, prehospital data, and clinicoetiological details which are important as far as head injury management is considered. The hospital records were grossly inadequate for full retrieval of information. Inadequate case definition and lack of centralized electronic reporting mechanisms were some of the major difficulties we faced obviating the need for collecting, managing, and utilizing epidemiological data using an electronic database. CONCLUSION: We believe that the present pilot study will give an insight regarding the difficulties encountered in collecting data regarding TBI. This study will be the first of its kind in Kerala highlighting the importance of maintaining a proper head injury electronic registry. The data from this study would definitely guide future experimental operational research on these unexplored areas which will be relevant in head injury policy-making in Kerala as well as in India.

Occupational stress and radiography.

CONTEXT: Stress is a very common problem. There has been considerable research on stress in certain health care professions; however, very little is known about the importance of occupational stress on radiographers. The studies that do exist indicate that the prevalence and impact of stress on radiographers is considerable and that occupational stress in the radiography field is a very common health problem. OBJECTIVE: The aim of this article is to review the available evidence to assess the effect of occupational stress on radiographers and compare it to health care workers. METHODS: Several major databases were searched using various keywords. Additionally, references from selected articles were used to retrieve other papers relevant to the topic. RESULTS: A review of the literature revealed significant stress-related consequences on the physical and mental health of health care workers. These findings can be applied to radiographers and used to reduce stress in the workplace. SUMMARY: Future research in the area of health promotion, including interventional relaxation and stress relief courses, among radiographers is needed.

Chronic Subdural Hematoma: A Questionnaire Survey of Management Practice in India and Review of Literature.

OBJECTIVE: To identify the current management modalities practiced by neurosurgeons in India for chronic subdural hematoma. METHODS: A questionnaire was prepared for the survey and sent via e-mail to neurosurgeons. It covered the following aspects of managing chronic subdural hematoma: 1) demographic and institutional details; 2) choice of surgical procedure; 3) surgical adjutants such as placing a subdural drain; 4) pre- and postoperative care; and 5) recurrences and management. Responses obtained were entered in a SPSS data sheet and analyzed. RESULTS: Response rate of the survey was 9.3%. The majority of neurosurgeons (75%) preferred to do burr whole drainage for primary chronic subdural hematoma and also for recurrences. Only one third of routinely placed a subdural drain. Considerable practice variations exist for medical and perioperative management. CONCLUSIONS: Bedside twist drill drainage, which is effective and less costly than operative room procedures, has not gained popularity in practice. The present survey points towards the importance of making management guidelines for this common neurosurgical entity.