Digoxin did not reduce overall mortality, but it reduced the rate of hospitalization both overall and for worsening heart failure. These findings define more precisely the role of digoxin in the management of chronic heart failure.

Purpose The purpose of this paper is to investigate the effect of health-care service quality (HCSQ) dimensions on patient satisfaction and behavioural intentions in selected corporate hospitals from South India. Design/methodology/approach Based on Parasuraman et al.’s SERVQUAL variables, the study tried to identify the effects of each variable to patient satisfaction and behavioural intentions. Data were collected through systematic random sampling among 500 in-patients of corporate hospitals with minimum four days stay were considered for the in-patients’ sample. Structural equation modelling technique was used to investigate the effect of HCSQ dimensions on patient satisfaction and behavioural intention. Findings The findings suggest that in addition to “patient satisfaction”, the only HCSQ dimension that directly affects behavioural intention is “empathy”. In addition, “empathy” affects “responsiveness”, “assurance” and “tangibles” which, in turn, have only an indirect effect to behavioural intention through “patient satisfaction”. Research limitations/implications This research investigated the HCSQ dimensions effects on patient satisfaction and behavioural intention from the perspective of patients and corporate hospitals run by the private players. This paper contributes to the body of academic knowledge by shedding more light into the role of HCSQ dimensions, and especially “empathy”, in the intentions for corporate hospital patients. Practical implications An understanding of the direct and indirect effect of HCSQ dimensions on patient satisfaction and behavioural intentions is important to corporate hospital marketing managers because it offers them the opportunity to take certain actions for improving patients’ satisfaction and these actions increase their intention to revisit. Originality/value The paper manages to investigate the effects of HCSQ dimensions on patient satisfaction and behavioural intention, especially in the health-care marketing sector.

Background:Psychological autopsy is the reconstruction of events leading to death. There are few studies on psychological autopsy.Aim:To understand the profile of suicide completers and find out ways of dealing with it.Methods:Fifty suicide cases were analysed. Using a semi-structured, self-designed questionnaire, the family, friends and relatives of the deceased were interviewed.Results:The presence of some type of psychiatric disorder and stressful life events are two important reasons for committing suicide.Conclusion:Psychological autopsy is a very important tool for assessing the causes and precipitants of suicide. More and more studies in this field are required with a larger sample size for the evaluation of suicides.

We assembled an ancestrally diverse collection of genome-wide association studies of type 2 diabetes (T2D) in 180,834 cases and 1,159,055 controls (48.9% non-European descent). We identified 277 loci at genome-wide significance (p<5x10-8), including 237 attaining a more stringent trans-ancestry threshold (p<5x10-9), which were delineated to 338 distinct association signals. Trans-ancestry meta-regression offered substantial enhancements to fine-mapping, with 58.6% of associations more precisely localised due to population diversity, and 54.4% of signals resolved to a single variant with >50% posterior probability. This improved fine-mapping enabled systematic assessment of candidate causal genes and molecular mechanisms through which T2D associations are mediated, laying foundations for functional investigations. Trans-ancestry genetic risk scores enhanced transferability across diverse populations, providing a step towards more effective clinical translation to improve global health.

To study and compare the outcomes of the endoscopic versus microscopic approach to Myringoplasty in 60 patients. In this prospective study, the outcomes of 60 ears of 60 patients (40 male and 20 female) who underwent Myringoplasty were evaluated. The age range of the patients was 15-55 years. Group 1 underwent Myringoplasty with an endoscopic technique (n = 30), and Group 2 underwent Myringoplasty with the conventional microscopic technique (n = 30). A temporalis fascia graft was used in both groups. The outcomes were analyzed in terms of the hearing gain, duration of surgery, graft success rate and advantages and disadvantages of endoscopic versus microscopic approach to Myringoplasty. In both groups, the postoperative air-bone gap (ABG) was significantly lower than the preoperative ABG. There were no significant differences between the preoperative and postoperative ABG values (in dB) in either group. The mean operative duration in Group 1 (96.32 min) was significantly lower than that in Group 2 (136.09 min). In the preoperative evaluation of patients in Group 1 had small, medium, large perforations are 16 (53 %), 12 (40 %), and 02 (7 %), respectively. In Group 2, had small, medium, large perforations are 12 (40 %), 15 (50 %), and 03 (10 %), respectively. Perforations (wet ear) were detected in 10 (33 %), 06 (20 %), and 04 (12 %) of the patients in Group 1 at postoperative months 1, 3, and 6, respectively. Perforations (wet ear) were detected 09 (30 %), 06 (20 %) and 03 (10 %) patients in Group 2 at postoperative months 1, 3, and 6. At 6 months postoperatively, there were smaller perforations and reduced rate of perforations as compared to 1st and 3rd month in Group 1 and Group 2. The difference between the perforation conditions (larger vs. smaller) was not significant in either group. The preoperative and postoperative increases in the ABG were associated. At the end of 6 months all (100 %) patients in the Group 1 rated their cosmetic result as excellent as compared in the Group 2. Unlike the microscope, the endoscope is easily transportable and hence is ideal for use in ear surgery camps conducted in remote places. In patients undergoing Myringoplasty, especially if the external ear canal is narrow and the anterior canal wall is prominent, the endoscopic and microscopic approaches appear to give equal results in terms of easy visualization of the entire tympanic membrane and no requirement for extra intervention to evaluate the ossicular system. A shorter operative duration and excellent cosmetic result is an advantage of the endoscopic Myringoplasty technique.

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Background:Specific learning disabilities (SLDs) are an important cause of academic underachievement in children and are also associated with comorbidities like attention deficit hyperactivity disorder (ADHD) which further have an impact on the child's education.Aims:To estimate the prevalence and psychosocial profile and psychiatric comorbidities in children with SLD in two settings, i.e., on special (remedial) education and schools and to compare the findings with normal children.Materials and Methods:This study was carried out in schools situated in urban and semi-urban areas and special education schools. A total of 96 children were chosen for the study. After taking informed consent from the parents, the details about socioeconomic status, family, developmental history, and school history of the children were collected on a semi-structured pro forma and then the children were screened for SLD. They were administered colored/standard progressive matrices and Malin's intelligence scale for assessing their intelligence quotient and NIMHANS SLD index and developmental psychopathology checklist to study psychopathology. Chi-square test and ANOVA were done.Results:The prevalence of SLD in schools is found out to be 6.6%. There was a significant association with prematurity, cesarean section, delayed speech, and family history of SLD. Among comorbidities of SLD, association with ADHD alone has been found to be significant.Conclusion:The most common type of SLD is combined type comorbid with ADHD. There is a need for early identification of learning disabilities in schools so that with early recognition and remedial intervention children can be helped with to cope with studies.

Background The human papillomavirus (HPV) is an important aetiological agent in cancer but its involvement in retinoblastomas (RBs) is controversial. Methods 64 formalin-fixed paraffin-embedded tissue blocks and 19 fresh-frozen specimens were subjected to multiplex PCR using PGMY09/11 primers, HPV genotyping, non-isotopic in situ hybridisation and immunohistochemistry for pRb and p16 INK4a . Results 24% of RBs contained HPV DNA. 90% of HPV genotypes were of high-risk (HR) type and 10% were of intermediate-risk (IR) type. HR HPVs 45, 59, 68 and 52 were detected for the first time, as were IR HPVs 82 and 73. There was only one HPV 18-positive case. Interestingly, no low-risk genotypes were identified. Nine formalin-fixed paraffin-embedded HPV-positive cases showed nuclear HPV positivity by non-isotopic in situ hybridisation. Immunohistochemistry did not show pRb expression in 67% of cases. 34% expressed nuclear p16 INK4a , of which 20 cases were also positive for HPV by multiplex PCR. A statistically significant association between HPV and pRb expression status was observed (p¼0.0001).The association of HPV with p16 INK4a expression was also statistically significant (p¼0.0001).Conclusions While the presence of HPV in a subset of RB was demonstrated, its role in carcinogenesis needs further elucidation.