A total of nearly 1,000 persons belonging to a number of caste, religious and tribal groupings in Kerala and the Nilgiri Hills of South India have been tested for genetic variation in 4 blood group, 5 serum protein and 17 enzyme systems as well as haemoglobin. The distribution of blood groups, serum protein and enzyme groups is similar to that reported for other South Indian populations. Of particular interest is the presence of LDH ‘Calcutta-1 variants in three of the Hindu and Muslim communities, as well as in two of the tribal populations. At locus 1 of phosphoglucomutase a new allele of the ‘slow’ variety was detected in more than 10% of the Malayarayan, in Kerala, but no examples of this variant were found in neighbouring populations. Abnormal haemoglobins were detected in several populations, HbS being present in more than 20% of the Irula and Kurumba in the Nilgiri Hills. In the Kerala populations there were 4 examples of Hb AD and 1 of Hb AE. Genetic distance estimates using the gene frequency data indicate that the closest groups are the Nayar and Izhava and the Brahmin and Nayar. The tribal populations are approximately twice as far from the Nayar as they are from the Izhava. The Todas of the Nilgiri Hills are somewhat closer to the Brahmin of Kerala than they are to the other tribal populations.

Background:  Patient satisfaction is as important as other clinical health measures and is a primary means of measuring the effectiveness of health care delivery. Patient-centered outcomes have taken central stage as the primary means of measuring the effectiveness of health care delivery. To evaluate the level of patient satisfaction with OPD services in terms of describing the experience of patients about medicine OPD services and accessibility to services among the patients who attended the medicine OPD of Jaiprakash hospital.Methods: As a cross -sectional descriptive study, we have taken patients who were registered in Medicine outpatient department of Jaiprakash Hospital of Bhopal over a period of two months. The research instrument for a data collection was a structured questionnaire for assessing the patient satisfaction. The experience and accessibility were categorized into good and poor while satisfaction into high and low using best criteria. Statistical analysis: Convenience sampling done for selection of patients registered in Medicine OPD. The data was analysed on statistical software SPSS VS.20.Results: The patients had the highest level of experience from medicine department OPD about helpfulness of nurses, about light and ventilation inside the OPD and about the good communication from the pharmacist. The poor experience was from the number of doctors in OPD and about the diagnostic place. As far as accessibility is concerned, 66% of patients had good accessibility towards medicine OPD while remaining 34% had poor accessibility towards Medicine OPD.Conclusions: Maximum number of respondents had very good experience while just small number of respondents had poor experience and majority of the patients had good accessibility regarding waiting time, service process and working hours.

A population genetic study among the Kota of the Nilgiri Hills, South India, involved tests for abnormal haemoglobins, 5 red cell antigen systems, 4 serum protein and 13 red cell enzyme systems. Twelve systems are invariant in the Kota. The most distinctive characteristics are extremely low frequency of the A₁gene and complete absence of A₂in the ABO system, r(cde) in the Rh system, LDH^Cal-1among the enzyme systems as well as absence of abnormal haemoglobins. A comparison of gene frequencies in those systems, which show variation, suggests that the Kota are more similar to the Toda than to any other tribal or caste population of the area. Genetic distance as well as principal component analysis also reveals that the Toda and Kota are close to each other, in agreement with tradition.

Background: Paediatric tuberculosis (TB) indicates presence in the community of sputum -positive pulmonary tuberculosis, presence of childhood risk factors for disease and stage of epidemic. This "orphan disease" exists in the shadow of adult TB and is a significant child health problem, but is neglected. As a result both research and surveillance data in the field of childhood TB has been greatly limited. Objective of the study was to find out the socio-demographic profile of paediatric TB patients registered under RNTCP in Bhopal city.Methods: A study was conducted in all tuberculosis treatment units (TU) of Bhopal city. All paediatric patients in the age group of 0 to 14 years diagnosed as TB and registered under RNTCP and fulfilling inclusion criteria during January to June 2013 (six months) were included in the study. The data was analysed on statistical software SPSS VS.20.Results: The maximum numbers of patients (66.06%) were in the age group of 1-10 years. More than half of the mothers and fathers of paediatric patients are either illiterate or having low educational status. In our study 92.72% of patients belonged to low socio economic status and also 69.09% of paediatric patients lived in overcrowded households and were malnourished.Conclusions: The study concluded that tuberculosis in children affects mainly the age group of 1-10 years and is more common in females. Poor housing conditions contribute to tuberculosis incidence as majority of the paediatric patients lives in semi Pucca and Kaccha house and gave a history of dwelling in overcrowded houses. Majority of children were malnourished.

Background: It is an established fact that healthy children build healthy nation. Proper management of Paediatric Tuberculosis is very essential for the control of tuberculosis as children also act as a source of infection within a community. The objective of the study was to determine the treatment outcome of paediatric TB patients registered under RNTCP in Bhopal city and to determine the relationship of socio-demographic profile and other selected factors with treatment outcome in Paediatric TB patients registered under RNTCP in Bhopal city.Methods: In this longitudinal study, data of all the paediatric TB patients (0 to 14 years of age group) diagnosed as TB and registered under R.N.T.C.P and fulfilling inclusion criteria during January 2013 to June 2013 were collected after obtaining informed consent from parents/guardians by using a structured questionnaire during their visit to designated microscopic centre (DMC) cum DOTS centre. The data was analysed on statistical software SPSS VS.20.Results: In our study 93.33% of paediatric patients were treatment completed, 4.84% were declared cure and 0.60% patients each were transferred out, declared treatment failure and died respectively. Educational status of mothers of paediatric patients (X2=40.569 and p=0.019, df=24), BCG vaccination (X2=11.299 and p=0.023, df=4) and nutritional status of children (X2=26.342 and p=0.049, df=16) are significantly associated with treatment outcome.Conclusions: Majority of paediatric patients were declared cured or treatment completed depending upon the result of sputum examination. In our study educational status of mothers of paediatric patients, BCG vaccination and nutritional status of children are significantly associated with treatment outcome. No association of treatment outcome was found with other selected factors such as age, gender, religion, type of family and socio economic status of paediatric patients.

Background: Asthma is the most common chronic respiratory disease among children characterized by reversible airway obstruction. Vitamin D plays an important role in many immune and allergic diseases and it may have a role in asthmatic patients, however this association yet remains uncertain. The present study was designed to assess the level of serum Vitamin D in patients with bronchial asthma and it’s correlation with disease severity.Methods: A prospective observational study was performed from April 2019 to February 2020 in the Paediatric OPD of LNMC and JK Hospital Bhopal. All 90 children with physician diagnosed bronchial asthma (mild, moderate and severe) aged 10 to 18 years of both genders who have come in the OPD (total enumeration sampling) during the above mentioned period were enrolled in to the study. The patients were grouped on the basis of Vitamin D sufficiency and Vitamin D levels were correlated with disease severity.Results: The study comprised 54 boys (60%) and 36 girls (40%) with mean age of 15.1±3.96. Out of 90 children enrolled, 46 had good control over asthma and 37 had uncontrolled asthma. As regards asthma control, 25-OH Vitamin D was lowest among patients with uncontrolled asthma.Conclusions: Vitamin D deficiency was highly prevalent in asthmatic patients and there was a direct and a significant relationship between serum Vitamin D levels, severity of asthma, control of asthma, serum IgE levels and blood eosinophils count. Thus, measuring serum levels of Vitamin D followed by supplementation could be considered in the routine assessment of patients with bronchial asthma.

Background: Allergic rhinitis (AR) is the commonest type of non-infective rhinitis. Genetic and environmental factors play an important role in the development of the disease. Researchers are having interest in knowing the role of vitamin D in the pathogenesis of allergy. Immunoglobulin E (IgE) is integral to the pathogenesis of allergic disorders. However, the relationship between serum IgE levels and AR is still a matter of debate. Thus, this study aimed to know serum IgE and serum 25 (OH) vitamin D levels in patients with clinically diagnosed AR and control group.Methods: A case-control study was performed from May 2019 to October 2019 in LNMC and JK hospital. All 54 children with physician diagnosed AR aged 12 to 18 years of both genders who have come in the OPD (total enumeration sampling) during the above mentioned period were enrolled into the study and their 54 healthy counterparts are taken as controls. Other parameters such as age, gender, occupation and region of residence were also compared between the groups.Results: This study found highly significant difference in the mean serum IgE levels while there is a significant difference in the mean serum vitamin D levels between two groups.Conclusions: The study group with AR had significantly higher mean level of serum IgE and lower mean serum vitamin D levels as compared to control groups. However, upon stratification of vitamin D levels, the differences were insignificant. Further studies should be conducted to know the value of IgE as a prognostic factor of AR severity and to throw more light on association of vitamin D with AR.

Background: Women with early breast cancer routinely face a choice between breast conservation therapy and mastectomy, and assume agency through shared decision making. However, for women with lower socioeconomic power or education, barriers such as access to understandable information, involvement of family in decision making, and a decreased sense of autonomy inhibits this agency. To better empower this population, a simple to understand, online, self-administered, conjoint analysis based decision aid called “Navya Patient Preference Tool” (PPT) is developed to be used outside the physician encounter. PPT is unique in its incorporation of several psychological scales that assess potential confounders of participation in shared decision making. Methodology: This is a pre-planned analysis of the reliability and validity of the psychological scales used in all three arms of an IRB approved randomized controlled trial to assess PPT. Women with operable node negative breast cancer eligible for BCT or MRM at one of Asia's largest academic tertiary cancer centers were eligible. PPT trial consists of an initial conjoint analysis questionnaire analyzing implicit preferences for breast conservation given to the intervention arms. The following psychological scales were given to all patients regardless of randomization: Autonomy Preference Index (API), Traditional-Egalitarian Gender Roles (TEGR), Caregiving Role, Brief Resiliency Scale (BRS), Appearances Scale, and Decisional Conflict Scale (DCS). Cronbach's alpha as a measure of internal reliability for all scales, and correlations of scores with known demographic trends as a measure of external validity are calculated. Results: Of the 102 patients enrolled, 30 completed PPT in English, 39 in Hindi, and 33 in Marathi, (vernaculars). 69/102 were in middle and lower socioeconomic groups (Kuppuswamy Index). 53/102 had completed less than high school education. Internal reliability of all scales were high, with Cronbach's alpha above 0.7: API 0.74, TEGR 0.78, Caregiving 0.7, BRS 0.7, Appearance 0.84. DCS was highly reliable at 0.91, and is the primary outcome measure for the RCT. Correlations in the dataset met those expected in real world data, suggesting external validity. For e.g., education was inversely correlated with traditional gender roles on TEGR (R -0.4, p <0.01), and positively correlated with resilience on BRS (R 0.228, p <0.05). Individual scale items that are unrealistic were not chosen by any of the 102 respondents (e.g.,. My doctor should not participate in my medical decisions), substantiating nuanced reading. 85% of patients “Strongly Agreed” on a 1-5 Likert scale that “The survey questions were easy to understand” (mean score 1.18/5. SD 0.4). Conclusions: Women with limited education and low socioeconomic status complete the online, self administered PPT outside of a physician encounter, with high internal reliability and external validity. Decision Aids such as Navya PPT, which account for psychosocial confounders of agency, have the potential to benefit women otherwise marginalized from shared decision making. Citation Format: Joshi S, Ramarajan L, Ramarajan N, Srivastava G, Begum F, Deshpande O, Tondare A, Nair N, Parmar V, Gupta S, Badwe RA. Accuracy of psychosocial assessments in an online surgical decision aid developed for early breast cancer patients with resource and educational constraints [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-14-07.