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INTRODUCTION: Head and neck malignancies are responsible for 30% of all cancers in India with a dramatic increase in numbers due to widespread tobacco consumption. This study aims to assess the epidemiological and histopathological spectrum of these tumors. MATERIALS AND METHODS: A large retrospective review of 5469 biopsy-proven patients presenting between 2018 and 2022 with head and neck cancers was done. Tumors were analysed for distribution according to sites of presentations, gender, age and histopathological profiles. RESULTS: With a male-to-female ratio of 4.2:1, men constituted 80.80% of the study population. Mean age of presentation in women was 53.5 years, whereas men presented at an earlier age of 47.2 years. Oral cavity was the commonest site involved (59.7% cases) followed by the oropharynx (23.8% cases). Buccal mucosa was the commonest subsite involved with 1112 cases followed by tongue lesions with 1088 cases. Larynx was responsible for 17.04% of cases. All subsites were more commonly affected in men with the highest Male: Female ratio of 8.29:1 seen in larynx. The lowest ratio of 1.02:1 was seen in lesions of the face and scalp. Squamous cell carcinoma (SCC) was the most common histopathological diagnosis encountered in 88.97% of cases followed by basal cell carcinoma which was seen in 2.10% lesions. CONCLUSION: Oral cavity lesions constitute the bulk of head and neck cancer presentations in India. The disease is more prevalent in men overall and men present at a younger age in comparison to women. SCC is the most prominent histopathology encountered in our study.

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Context: There has been an increasing prevalence of hypertension (HTN) affecting all populations of the world including the special occupational groups and industries workers. Aims: To estimate the prevalence of hypertension and to determine the associated factors among industrial workers in the Haryana state of India. Settings and Design: A cross-sectional study was conducted among 323 industrial workers of Faridabad, Haryana. Materials and Methods: A semi-structured and validated questionnaire was used to collect information regarding sociodemographic characteristics of the workers, their personal habits, and occupational history. The investigator also recorded the height, weight, blood pressure, blood glucose, and lipid profile of the workers. Statistical Analysis Used: Analysis of the data was done using SPSS Vs 21. Results: The prevalence of hypertension among industrial workers was 48.6%. Age of the worker, presence of smoking or alcohol consumption, having a longer duration of employment, and having deranged total cholesterol/TG/LDL-C levels, diabetes, or obesity were found to be independently associated with hypertension. Conclusion: Screening is required for early detection and prevention of complications. Lifestyle modification is of utmost importance. Employers should implement guidelines issued by the government to protect the health of the productive population.

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Stigma, discrimination, poor help seeking, dearth of mental health professionals, inadequate services and facilities all adversely impact the mental health treatment gap. Service utilization by the community is influenced by cultural beliefs and literacy levels. We conducted a situational analysis in light of the little information available on mental health related stigma, service provision and utilization in Haryana, a state in Northern India. This involved: (a) qualitative key informant interviews; (b) health facility records review; and (c) policy document review to understand the local context of Faridabad district in Northern India. Ethical approvals for the study were taken before the study commenced. Phone call in-depth interviews were carried out with a purposive sample of 13 participants (Mean = 38.07 years) during the COVID-19 pandemic, which included 4 community health workers, 4 people with mental illness, 5 service providers (primary health care doctors and mental health specialists). Data for health facility review was collected from local primary health and specialist facilities while key policy documents were critically analysed for service provision and stigma alleviation activities. Thematic analysis was used to analyse patterns within the interview data. We found poor awareness and knowledge about mental illnesses, belief in faith and traditional healers, scarcity of resources (medicines, trained professionals and mental health inpatient and outpatient clinics), poor access to appropriate mental health facilities, and high costs for seeking mental health care. There is a critical gap between mental health related provisions in policy documents and its implementation at primary and district level.

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Background and Aims: There is an increasing recognition of reinfection in coronavirus disease 2019 (COVID-19). We studied the reinfection of COVID-19 disease among doctors at a tertiary care centre in Northern India. Methods: All COVID-19 patients readmitted for COVID-19 disease after any duration with at least a positive Real time- polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 were included. Their clinical profile, vaccination status, outcome and Centre for disease control (CDC), Atlanta, USA reinfection criteria screening were recorded. Results: A total of 57 (0.53%) doctors were identified and 56 of them satisfied the CDC criteria. It included 13 (20.3%) females and 89.3% of cases were from clinical specialities; 98.2% of individuals had the first infection in 2020 and mean duration between 2 infections was 156.29 ± 76.02 (35-298) days. Duration between two episodes of the disease with more than 90 days apart was in 80.3% cases. One (1.8%) patient developed severe disease and two (3.6%) cases were of moderate severity. Symptoms were similar in both infections except significantly higher number of extra-respiratory complaints (2.2% vs. 9.1%). There were 37.5% cases who had received first dose of vaccination of any duration at the time of second infection. Nine (16.1%) and four (7.1%) patients with more than 4 weeks after the first and second dose of vaccination developed the second infection, respectively. Conclusion: Majority of reinfection were symptomatic and developed after 90 days and so majority followed CDC criteria. Breakthrough infections among vaccinated healthcare worker are real, and with sustained exposure to the virus, they should continue to use precaution including hand hygiene and mask in order to prevent reinfection.

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Present studies were carried out to find the effect of different multigrain viz., finger millet, foxtail millet and little millet on litti. The multigrain powder was blended in whole wheat flour. Litti composite flour was studied for nutritional, rheological, gluten, sedimentation value, falling number and compared with regular wheat flour. Flaxseed and soybean were blended with barley, besan, spices for inner composite stuffing and samples were evaluated for proximate analysis. Shelf life studies of litti were assessed for 1 month at room temperature 25 ± 2℃ and freezer at 4℃. This research work explores with the aim to have benefits of multifunctional ingredients for the improvement of litti to have a healthy product; and increase the popularity of litti all over India to make it a commercially important product because of the incorporated multifunctional ingredients. The RDA calorie for human can be met with 4-5 litti per day.

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Purpose: With millions of people being affected by COVID-19, people living with post COVID-19 clinical symptoms (PCS) are expected to rise further. The primary aim of the study was to comprehensively assess self-reported PCS and its associated risk factors among beneficiaries of Hospital Employee Scheme of a tertiary healthcare institution in Delhi. Patients and Methods: An online cross-sectional study was conducted using a semi-structured questionnaire developed by employing nominal group technique among individuals aged 18 years and above who were novel SARS-CoV-2 positive from January to April 2021. Participants were telephoned first, before sending the online survey link. Socio-demographic data, information on PCS along with potential risk factors, pre-existing morbidities, vaccination status, severity of acute illness and management were collected between June and July 2021. PCS was presented as relative frequency; Chi-Square test and odds ratio; adjusted values were used to rule out any association between PCS and predictors. Results: In total, 773 of 1801 eligible participants responded to the survey (completion rate 42.9%), with a median age of 34 years (IQR 27-44). Males accounted for 56.4% and PCS was present in 33.2%. The most prevalent symptoms were fatigue (79.3%), arthralgia (33.4%), myalgia (29.9%), hair loss (28.0%), headache (27.2%), breathlessness (25.3%), and sleep disturbance (25.3%). The prevalence of PCS was reduced to 12.8% at 12 weeks. Female gender, older age, oxygen supplementation, severity of acute illness, and pre-existing co-morbidities were positively associated with PCS. Vaccination (second dose) reduced the odds of developing PCS by 39% compared to unvaccinated participants (aOR 0.61; 95% CI 0.40-0.96). Conclusion: PCS affects almost all organ systems of the body, regardless of the severity of acute COVID-19 illness. Two doses of vaccine hel reduce the development of PCS.

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The association between aerosol and lightning has been investigated with long-term decadal data (2005-2014) for lightning, aerosol optical depth (AOD), relative humidity, and effective cloud droplet size. To understand the complex relationship between aerosol and lightning, two different regions with different climatic and weather conditions, a humid region R1 (22°-29° N, 89°-92° E) and an arid region R2 (23°-28° N, 70°-76° E) of northern India, were chosen for the study domain. The results show that lightning activity was observed to occur more over the humid region R1, i.e., 1141 days (1/3 of total days), than over the arid region R2, i.e., 740 days (1/5 of total days). Also, over the humid region R1, the highest lightning flash density was recorded as nearly 4.6 × 10-4 flashes/km2/day observed for 18 days (1.5%); on the contrary, over the arid region R2, the maximum lightning flash density was observed to be 2.5 × 10-4 flashes/km2/day and occurred for about 22 days (2.9%). The analysis shows that a nonlinear relationship exists between aerosol and lightning with a highly associated influence of relative humidity. A very significant positive and negative co-relation that varies with relative humidity has been observed between AOD and lightning for both humid and arid regions. This shows relative humidity is the key factor in determining the increase or decrease of lightning activity. This study also shows that the larger the cloud droplet size, the higher the relative humidity and vice versa. This study emphasizes that aerosol concentration in the atmosphere influences cloud microphysics by modulating the size of cloud droplets and thereby regulating the lightning frequency. The atmospheric humidity is the driving factor in deciding the positive or negative co-relationship between aerosol and lightning. Supplementary Information: The online version contains supplementary material available at 10.1007/s00024-022-02981-6.

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AIM: The aim of this study is to study the prevalence, incidence, and the epidemiological characteristics of the patients of acquired dacryocystitis at a tertiary eye care center of Northern India. MATERIALS AND METHODS: It was a prospective, cross-sectional study carried out over a period of 2 years (July 2016-July 2018). The prevalence, incidence, and the epidemiological characteristics of acquired dacryocystitis were studied and analyzed. Chi-square test was used to test the qualitative distribution. RESULTS: A total of 212 cases were included in the study. The prevalence rate of dacryocystitis was 19.5 cases per 10,000 patients, and the incidence rate was 15 cases per 10,000 patients. Chronic dacryocystitis (183; 86.30%) was more commonly encountered clinical type than acute dacryocystitis. Majority of cases (204; 96.23%) were due to the primary acquired nasolacrimal duct (NLD) obstruction, whereas eight cases (3.78%) were due to the secondary acquired NLD obstruction. Females were more commonly affected (156; 73.58%). The mean age was 44.44 ± 18.95 (range: 12-86) years. Majority of the patients 108 (50.94%) belonged to 3rd-6th decades of life. The disease was more prevalent in people belonging to lower-middle socioeconomic class (92; 43.40%) living in rural areas (130; 61.32%) and the majority of them were housewives (125; 59%). CONCLUSIONS: The incidence and prevalence of acquired dacryocystitis were 15 and 19.5 cases per 10,000 patients. It was much more common in females of lower socioeconomic status and is seen commonly in the 3rd to 6th decades of life.

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OBJECTIVES: This study investigated the occurrence of extended-spectrum ß-lactamase (ESBL) genes coexisting with carbapenemase, AmpC and aminoglycoside resistance gene in uropathogens in India. METHODS: Antimicrobial susceptibility testing was performed by disk diffusion. Antimicrobial resistance genes were detected by multiplex PCR. RESULTS: Of 1516 consecutive urine samples, 454 (29.9%) showed significant bacteriuria with a single micro-organism, predominantly Escherichia coli (n=343), followed by Klebsiella pneumoniae (n=92), Pseudomonas aeruginosa (n=10) and Proteus mirabilis (n=9). Among the uropathogens, 61 ESBL-producers were identified containing blaCTX-M-15 (n=32), blaCTX-M-15+blaOXA-2 (n=15), blaCTX-M-15+blaOXA-2+blaTEM-1 (n=6), blaOXA-2 (n=5), blaOXA-2+blaSHV-76 (n=1), blaTEM-1+blaSHV-76 (n=1) and blaTEM-1 (n=1). All ESBL genes were located on horizontally transferable plasmids of incompatibility types HI1, I1, FIA+FIB, FIA and Y. Among the 61 ESBL-producers, 59 harboured carbapenemase genes, including blaNDM-5 (n=48), blaNDM-5+blaOXA-48 (n=5), blaNDM-5+blaIMP (n=5) and blaNDM-5+blaIMP+blaVIM (n=1). ESBL-producing uropathogens also harboured 16S rRNA methylase genes, including rmtB (n=9), rmtA (n=4), rmtC (n=1) and armA (n=1). ESBL-positive isolates also contained AmpC genes, including blaCIT (n=8) and blaDHA-1 (n=1). Imipenem and gentamicin had the lowest resistance rates against the uropathogens. CONCLUSION: This is the first report showing the high prevalence of carbapenemases in ESBL-positive isolates in this area. Regular surveillance for such resistance mechanisms will be useful for health personnel to treat infections by these multidrug-resistant pathogens.

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Elevated ozone (O3) pollution is observed every spring over the Northern Indian region including the Himalayan foothills, with a maximum typically in the month of May. However, studies investigating influences of photochemistry and dynamics in the valleys of Central Himalaya are limited. Here, in situ surface O3 observations conducted at Dehradun (77.99° E, 30.27° N, 600 m above mean sea level) in the Doon Valley during April-July 2018 are presented. These O3 observations reveal the prevalence of an urban environment over Dehradun with enhanced levels during noontime (66.4 ppbv ± 11.0 ppbv in May) and lower levels during night (26.7 ppbv ± 11.5 ppbv). Morning time O3 enhancement rate at Dehradun (7.5 ppbv h-1) is found to be comparable to that at Bode (7.3 ppbv h-1) in another valley of Himalayan foothills (Kathmandu), indicating stronger anthropogenic emissions in the Doon Valley as well. Daily average O3 at Dehradun varied in the range of 13.7-71.3 ppbv with hourly values reaching up to 103.1 ppbv during the study period. Besides the in situ photochemical O3 production, the entrainment of O3-rich air through boundary layer dynamics also contributes in noontime O3 enhancement in the Doon Valley. Monthly average O3 at Dehradun (49.3 ppbv ± 19.9 ppbv) is observed to be significantly higher than that over urban sites in Northern India (35-41 ppbv) and Bode (38.5 ppbv) in the Kathmandu Valley during May. O3 photochemical buildup, estimated to be 30.3 ppbv and 39.7 ppbv during April and May, respectively, is significantly lower in June (21.2 ppbv). Copernicus Atmosphere Monitoring Service (CAMS) model simulations successfully reproduce the observed variability in noontime O3 at Dehradun (r = 0.86); however, absolute O3 levels were typically overestimated. The positive relationship between CAMS O3 and CO (r = 0.65) together with an O3/CO slope of 0.16 is attributed to the influences of biomass burning besides anthropogenic emissions on observed O3 variations in the Doon Valley. O3 observations show an enhancement by 35-56% at Dehradun during a high-fire activity period in May 2018 as compared to a low-fire activity period over the Northern Indian region in agreement with the enhancement found in CAMS O3 fields (10-65%) over the region in the vicinity of Dehradun.

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Diphtheria, a vaccine preventable disease in children, is still being reported from India. Details of 99 children with a clinical diagnosis of diphtheria admitted to a paediatric tertiary care teaching and referral hospital between January 2008 and December 2015 were collected retrospectively and analysed. The median (interquartile range [IQR]) age of the study group was 7.0 years (IQR = 5.0-8.0 years). Nearly two-thirds were unimmunised. Clinical features included fever (97%), dysphagia (82%), sore throat (67%), bull neck (54%), stridor (40%), neuropathy (27%) and nasal discharge (14%). Throat swab for Albert stain was positive in only 21% of cases and C. diphtheriae was isolated in only 28%. Complications included airway compromise (61.7%) followed by myocarditis (35.4%), acute kidney injury (22.3%), thrombocytopenia (25.3%) and neuropathy (27.3%). In all, 66% survived, 23% died and 11% opted for discontinuity of care owing to unfavourable prognoses. On multivariable logistic regression analysis, shorter duration of symptoms before presentation to our hospital was an independent predictor of unfavourable outcome (adjusted odds ratio = 0.88, 95% confidence interval = 0.79-0.99, P = 0.03).

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The study focused on analyzing concentrations of metal(loid)s, their geospatial distribution in groundwater around an industrial hub of northern India. Human health risk posed due to the intake of contaminated groundwater was also evaluated. For this, 240 samples were assayed using inductively coupled plasma emission spectrophotometer. For risk assessment, the methodology proposed by US Environmental Protection Agency was adopted. Geometric mean of Al, As, Mo, Cd, Co, Cr, Fe, Mn, Ni, Pb, Se, and Zn was 193.13, 27.35, 4.22, 2.85, 92.81, 14.97, 271.78, 25.76, 54.75, 19.50, 16.94, and 1830.27 µg/l, respectively. Levels of Al (84%), As (63%), Ni (63%), Pb (49%), and Se (41%) exceeded the Bureau of Indian Standards (BIS). Principal component analysis is accounted for ~ 88% of the total variance and reflected pollution loads of Al, As, Mo, Cr, Fe, Se, and Pb in the groundwater. Based on it, four sources of metal(loid)s, namely geogenic (34.55%), mixed (industrial and agricultural, 26.76%), waste dumping (15.31%), and industrial (11.25%) were identified. Semi-variogram mapping model demonstrated significant geospatial variations of the metal(loid)s. Hazard index (HI) suggested potential non-carcinogenic risks to the inhabitants due to As, Al, Ni, Se, and Pb, which were the largest contributors. Based on maximum concentrations of metal(loid)s, HI for child and adult was above unity. Arsenic was identified as the most hazardous pollutant that may have chronic carcinogenic health implications. At western side of study area, carcinogenic health risks exceeded critical threshold of 1 × 10-4, indicating that As posed health risks to residents by intake of groundwater.

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INTRODUCTION: An extensive search on PubMed reveals very little in terms of evidence regarding the current knowledge, attitude, and practices (KAP) of the population in general and rural population, in particular, in this part of the country. Therefore, a study was conducted with the aim to assess the communities' knowledge of malaria transmission, recognition of signs and symptoms, treatment seeking. MATERIALS AND METHODS: A stratified two-stage design was used to conduct a house-to-house survey using a semi-structured questionnaire in RS Pura block of Jammu District of Jammu and Kashmir State in North India. RESULTS: A total of 300 households were included in the study. However, data on 4 households was found to be incomplete at the time of analysis and, therefore, were excluded. Out of 296 study participants interviewed 65.5% were males, while 34.5% females. All of the study participants (100%) had heard of malaria, and the main source of their information was television/newspaper. 92.5% of the study population considered malaria to be a serious health problem, thus reflecting their attitude to the disease. Regarding practices, 71.6% of the study participants preferred going to doctors at government hospitals for malaria treatment, and 56% were willing to seek medical help in <24 h in case of a child has a febrile episode. CONCLUSIONS: Results revealed that KAP among respondents were reasonably good and key sociocultural, and related indicators need to be identified as a part of malaria elimination strategy.

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Cotton is an important crop and its production is affected by various disease pathogens. Monopartite begomovirus associated betasatellites cause Cotton leaf curl disease (CLCuD) in Northern India. In order to access the occurrence and genetic variability of Cotton leaf curl betasatellites, an extensive field survey was conducted in states of Rajasthan, Punjab and Haryana. We selected the betasatellite sequence for analysis as they are reported as important for disease severity and sequence variability. Based on the field observations, the disease incidence ranged from 30% to 80% during the survey. Full genome and DNA ß were amplified from various samples while no amplicon was obtained in some samples. The nucleotide sequence homology ranged from 90.0% to 98.7% with Cotton leaf curl virus (CLCuV), 55.2-55.5% with Bhendi yellow vein mosaic virus, 55.8% with Okra leaf curl virus and 51.70% with Tomato leaf curl virus isolates. The lowest similarity (47.8%) was found in CLCuV-Sudan isolate. Phylogenetic analysis showed that analyzed isolates formed a close cluster with various CLCuV isolates reported earlier. The analysis results show sequence variation in Cotton leaf curl betasatellite which could be the result of recombination. The results obtained by genome amplification and sequence variability indicate that some new variants are circulating and causing leaf curl disease in Rajasthan, Punjab and Haryana.

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Diabetes mellitus is becoming a global health issue with more than 80% diabetics living in developing countries. India accounts for 62.4 million diabetics (2011). Indian Council of Medical Research India Diabetes Study (ICMR-INDIAB) study showed highest weighted prevalence rate in the north India among all studied regions. Diabetes in north India has many peculiarities in all aspects from risk factors to control programmers. North Indians are becoming more prone for diabetes and dyslipidemia because rapid westernization of living style and diet due rapid migration to metropolitan cities for employment. North Indian diabetes is plagued with gender bias against females, poor quality of health services, myths, and lack of disease awareness compounded with small number of prevention and awareness programmers that too are immature to counteract the growing pandemic.

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BACKGROUND: Many of the studies have investigated the prevalence and nature of self-medication. It is a common type of self-care behavior among the populace of various countries. World Health Organization promotes the practice of self-medication for effective and quick relief of symptoms without medical consultations to reduce the burden on health-care services, which are often understaffed and inaccessible in rural and remote areas. AIM: The aim of the study was to determine the extent and pattern of self-medication among the population (patients) attending pharmacies at study sites and to note the association of self-medication variables with demographic factors. SUBJECTS AND METHODS: The present study was a community based cross sectional study aimed to gather information about the prevalence of self-medication in the rural town of Sahaswan, Uttar Pradesh from June 2012 to July 2012. The sample size comprised of 600 respondents. Data were collected through a prepared questionnaire. All descriptive data were coded, entered and analyzed using the statistical package for Social sciences program version 17.0 (Chicago, IL, USA). Descriptive data analysis was conducted and reported as frequencies and percentage. RESULTS: The percentage of patients who were seeking self-medication was approximately 50% (300/600). Most of the patients were seeking self-medication for headache and other pain (23.3% [140/600]), fever (14.5% [87/600]), urinary tract infections (9.7% [58/600]) and respiratory tract infections (11.7% [70/600]). The drugs most commonly purchased for practicing self-medication were non-steroidal anti-inflammatory drugs (25.3% [152/600]), medications used for gastro intestinal problems (20.8% [125/600]) and antibiotics (16.7% [100/600]). CONCLUSION: Prevalence of self-medication was high primarily among illiterate males aged above 15 years with a low income. Patient health awareness programs, assistance by community pharmacists and pharmacist continuing education are necessary for controlling self-medication. There is a need for planning interventions to promote rational self-medication through mass medias such as newspaper, magazine and TV.

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BACKGROUND: Dyspepsia and Irritable Bowel Syndrome (IBS) are perhaps one of the most common gastrointestinal diseases universally. The prevalence of dyspepsia ranges from 7-40% while the prevalence of IBS ranges between 3-22% in population based studies worldwide. AIM: This study was conducted to estimate the prevalence, socio-demographic and lifestyle associated risk factors of Dyspepsia and IBS among medical college students of urban Delhi, Northern India. SETTINGS AND DESIGN: It is a cross-sectional study and was carried out from January to March 2014 at Maulana Azad Medical College, New Delhi, India. MATERIALS AND METHODS: A total of 210 students from a Medical College were asked to complete a semi-structured questionnaire based on identification and socio-demographic data, questions pertaining to lifestyle and Rome III criteria. RESULTS: Of the valid 200 subjects, 90(45%) were males and 110(55%) were females, with a mean age of 20.43± 1.05 y. Majority of the subjects (diagnosed with uninvestigated dyspepsia and IBS) were in the age group of 18-20 y with female gender having higher odds for both. The prevalence of dyspepsia was 18% while that of IBS was 16.5%.Consumption of fatty food, cigarettes and low physical activity were observed as most significant correlates. CONCLUSION: Rome III criteria enables symptom based diagnosis of dyspepsia and IBS.The prevalence of dyspepsia and IBS in college students from Delhi is observed to be higher. Association with lifestyle related factors highlights the importance of modifications in their prevention.

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A new bark beetle species, Dryocoetes brownei from Northern India and Afghanistan, is described as a new to science and redescription of Scolytoplatypus kunala Strohmeyer, 1908, previously known only from the female holotype, is provided.