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INTRODUCTION: The COVID-19 pandemic produced an unprecedented crisis across the world. Long-term cohort studies were stalled, including our longitudinal aging cohort study in rural India. METHODS: We describe approaches undertaken to engage with our cohort (n = 1830) through multiple rounds of calls and how we provided useful services to our subjects during the lockdown period. Consenting subjects also underwent telephonic assessments for depression and anxiety using validated, self-report questionnaires. RESULTS: Subjects reported benefitting from our telephonic engagement strategies, including the COVID-related safety awareness and counselling service. The proportion of subjects with depression increased from 7.42% pre-COVID to 28.97% post-COVID. DISCUSSION: We envisage that such engagement strategies would improve subject rapport and cohort retention, and thus, could be adopted by similar cohort studies across the world. This marginalized, rural Indian community had severe, adverse psychological impact in this pandemic. Urgent public health measures are needed to mitigate this impact and develop appropriate preventive strategies.

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Background: Malaria has been one of India's most considerable health problems since 1940. The objective of our study is to determine the status of the National Malaria Elimination Programme in India by using epidemiological indicators. Methods and Materials: The annual reports of malaria for the years 2014-2021 and monthly reports for 2020 and 2021 were collected from the official web portal and were analysed for study specific assessments. Results: The API has shown a statistically significant reduction from 2017-2021 in all states along with category-1(P=0.003) and category-2(P=0.029) states/UTs, but there was no statistically significant reduction from 2017-2021 in category-3 (P=0.166) states/UTs. The zero indigenous cases had not been achieved in category-1 states/UTs. The overall percentage reduction in number of malaria cases in 2020 at the national level compared with 2014 was 83.6%. Despite states with strong health systems such as Gujarat, Maharashtra and Karnataka, have not shown zero indigenous cases in 2020 and the malaria cases noted were very far from reaching the targets. Conclusions: Although we observed a significant drop in malaria incidence from 2014 to 2020, demonstrating that the country is moving nearer to malaria elimination, it is crucial to implement the strategies to reduce Plasmodium falciparum% and re-establish surveillance programmes and execute national and state programmes in order to achieve the success of the National Malaria Elimination Programme. The recategorization of states/UTs are in accordance to the API, and implementation strategies were also needed.

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BACKGROUND: Pre-operative evaluation is a cornerstone in identifying patients with a risk of difficulty in intubation. Thyromental distance (TMD) is the most commonly used predictor of difficult intubation. However, it's not a reliable indicator of difficulty during intubation because it differs with patients' body & size proportion. The present study was done for the evaluation of the ratio of height to thyromental distance (RHTMD) and ratio of height to sternomental distance (RHSMD) as difficult airway predictors.  Methods: Data was taken from 400 consecutive patients posted for the need for anesthesia with intubation during surgery. Preoperatively examination of RHTMD and RHSMD was done. Difficulty during intubation has been explained in this current study with Cormack and Lehane grade 3 or 4. The positive and negative predictive values, as well as sensitivity and specificity of individual tests, were calculated as per the recognized formula. RESULTS: The study enrolled 400 patients, which include a maximum number of participants (138 [34.5%]) from the 41-50 year age group. On analyzing RHTMD and RHSMD, the former was found to have a better predictive value than RHSMD (p=0.001). RHTMD & RHSMD was found to have 62.5% & 37.50% sensitivity, respectively. RHTMD was found to have better specificity, positive & negative predictive values, and accuracy than RHSMD. CONCLUSION: RHTMD was observed to have superior precision in anticipating difficulty in intubation compared to RHSMD.

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Background Upper gastrointestinal bleed (UGIB) is a life-threatening condition that presents as hematemesis (fresh blood), coffee-ground vomiting, or melena. Multiple scoring systems are developed to predict different clinical outcomes, which are important to managing UGIB and are essential to determining low and high-risk patients. The study aimed to compare the sensitivity and specificity of risk scoring systems and their optimum cut-off values in the assessment of UGIB. Methods The prospective cross-sectional study included patients (N = 81) with acute UGIB. Four different proposed scores [Glasgow-Blatchford score (GBS), AIMS65, pre-endoscopic Rockall, and full Rockall scoring system] were used for evaluating patients with UGIB. The optimum cut-off values of these risk scores were used to predict the clinical outcomes. Results The AIMS65 score [Area Under the Receiver Operating Characteristic curve (AUROC): 0.91, cut-off: >1, sensitivity: 100%, specificity: 76.62%] and pre-Rockall were similar (AUROC: 0.91, cut-off: >0, sensitivity: 100%, specificity: 93.51%) at predicting mortality. The GBS (cut-off: >9, AUROC: 0.79, sensitivity: 69.23, specificity: 87.50) and AIMS65 scores (cut-off: >0, AUROC: 0.67, sensitivity: 72.31, specificity: 62.5) were good predictors of need for ICU care. Conclusion GBS was superior in predicting categorization into high risk and low risk, and endoscopic intervention, blood transfusion, and intensive care unit (ICU) care in UGIB patients. Pre-Rockall score and AIMS65 score were similar in predicting the mortality rate in UGIB.

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BACKGROUND: Attempts to diagnose and subtype irritable bowel syndrome (IBS) by symptom-based criteria have limitations, as these are developed in the West and might not be applicable in other populations. OBJECTIVES: This study aimed to compare different criteria for diagnosing and subtyping of IBS in India. METHOD: Manning's and the Rome I, II, and III criteria as well as the Asian criteria were applied to 1,618 patients (from 17 centers in India) with chronic lower gastrointestinal (GI) symptoms with no alarm features and negative investigations. RESULTS: Of 1,618 patients (aged 37.5 [SD 12.6] years; 71.2% male), 1,476 (91.2%), 1,098 (67.9%), 649 (40.1%), 849 (52.5%), and 1,206 (74.5%) fulfilled Manning's, Rome I, II, and III, and the Asian criteria, respectively. The most common reason for not fulfilling the criteria was absence of the following symptoms: "more frequent stools with onset of pain," "loose stool with onset of pain," "relief of pain with passage of stool," "other abdominal discomfort/bloating," and, in a minority, not meeting the duration criterion of 3 months/12 weeks. By stool frequency, constipation-predominant IBS (<3 stools/week) was diagnosed in 319 (19.7%), diarrhea-predominant IBS (>3 stools/day) in 43 (2.7%), and unclassified in 1,256 (77.6%). By Bristol stool form, constipation, diarrhea, and unclassified were diagnosed in 655 (40.5%), 709 (43.8%), and 254 (15.7%) patients, respectively. By their own perception, 462 (28.6%), 541 (33.4%), and 452 (27.9%) patients reported constipation-predominant, diarrhea-predominant, and alternating types, respectively. CONCLUSION: By Manning's and the Asian criteria, a diagnosis of IBS was made frequently among Indian patients with chronic functional lower GI symptoms with no alarm features; the Rome II criteria gave the lowest yield. By the stool frequency criteria, a majority of patients had unclassified pattern, unlike by the stool form and patients' perception of their symptoms.

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AIM: The purpose of this study was to evaluate the effect of smear layer on apical seal of endodontically treated teeth. MATERIALS AND METHODS: Sixty freshly extracted human maxillary central incisor teeth were selected and were randomly divided into two experimental groups. Group A of 25 teeth and group B of 25 teeth and a control group of 10 teeth. Cleaning and shaping of the root canals were performed using endodontic K-files up to no. 50 size file in step-back technique. During the process, in root canals of group A, 17% EDTA (ethylenediaminetetraacetic acid) followed by 3% NaOCl (sodium hypochlorite) was used as root canal irrigant. In group B, MTAD (mixture tetracycline citric acid and detergent) was used as a root canal irrigant. In control group, saline was used as root canal irrigant. The root surfaces were then coated with nail polish of both experimental groups and control group. The samples were then immersed in India ink dye for 1 week at 37°C. RESULTS: The statistical analysis of the results showed that the apical leakage was significantly more in teeth, where smear layer was not removed. CONCLUSION: The removal of smear layer improves the longterm apical seal and success of endodontically treated teeth. CLINICAL SIGNIFICANCE: The development and maintenance of apical seal is desirable and considered to be a major prerequisite to improve the outcome of root canal treatment.

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The long term clinical success of composite restoration depends upon appropriate curing light sources. This in-vitro comparative study investigates the influence of conventional halogen and light emitting diode curing sources on the surface hardness, depth of cure and polymerization shrinkage of composites specimens of 8 mm diameter and 10 mm in height were used to study the depth of cure. Specimens of dimension 8.6 mm in diameter and 2 mm in depth were used to measure the surface hardness and polymerization shrinkage. The results showed that in the long run LED's seem to have great potential to achieve a clinically consistent quality of composite cure.

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