A Rare Presentation of Pellet Injury in the Neck

Penetrating neck injuries are dangerous and deserve emergency treatment by virtue of the vital structures present underneath. There is a potential risk of unrecognized vascular injury and retained foreign bodies with their associated complications in these wounds. Therefore, an early diagnostic workup to localize the site of injury and an immediate neck exploration are important

Challenges in setting up a large population-based prospective cohort study in India – learnings from the LoCARPoN cohort

Population-based prospective cohort studies can yield vital new evidence. However, they are difficult to setup especially in non-western contexts such as India. We describe our experience in establishing the Longitudinal Cognition and Aging Research on Population of the National Capital Region (LoCARPoN) cohort, which was the first-of-its-kind public-funded study with target sample size of 15,000, 3 sites, and funds of approx. US$ five million for eight years (2014–2022). LoCARPoN aimed to study incident stroke and dementia in adults aged ≥50 years in urban and rural populations of north India. Among the numerous challenges encountered, important were inadequate funding, lack of adequate space for medical and field sites, difficulty in hiring manpower, lack of IT infrastructure, non-availability of storage facility for biological samples, and absence of dedicated MRI machines. Meticulous planning, adequate funding, trained personnel, institutional and community support are critical for establishing such cohorts in the non-western contexts. Funding: The LoCARPoN cohort study was funded by the Department of Biotechnology (Grant No. BT/IN/Netherlands/03/KP/2012 dated 14/02/2014); and Department of Health Research (Grant No. R.11012/15/2018-HR, dated 09/08/2018), Government of India. The Erasmus component was funded through the Erasmus Medical Centre, Rotterdam, The Netherlands, and the Erasmus University, Rotterdam ( Alzheimer Nederland WE.15-2014-09).</p

Antifungal Resistance Profile of Fungal Isolates from Fungal Rhinosinusitis Patients: A Study from Tertiary Care Hospital

Purpose Fungal rhinosinusitis is on the rise worldwide and it is endemic especially in North India. The main purpose of this study was to determine the antifungal resistance profile of fungal isolates from the cases of fungal rhinosinusitis. Methods Antifungal susceptibility testing of isolated fungi to fluconazole, amphotericin B, itraconazole, and voriconazole was determined by standard CLSI broth microdilution method. Results Sixty-eight fungal isolates of Aspergillus spp. (n = 49), Rhizopus spp. (n = 9), Candida spp. (n = 4), Penicillium spp. (n = 2), Mucor spp. (n = 2), Bipolaris spp. (n = 1), and Alternaria spp. (n = 1) were obtained from 60 different clinical samples as exudate from nasal mucosa (n = 28), allergic mucin (n = 8), nasal lavage (n = 2), tissue biopsy from nasal polyps (n = 14), and intraoperative nasal mucosa (n = 8). Of the 68 isolates, 75% were resistant to fluconazole, 13.23% were resistant to itraconazole, 2.94% to amphotericin B, and none were resistant to voriconazole. Aspergillus flavus (5%) was the only fungi found resistant to amphotericin B, while against itraconazole, A. flavus (7.5%) and A. niger (100%) were found resistant. All the isolates of A. flavus, A. fumigatus, A. niger, and Penicillium spp. were resistant to fluconazole. Conclusion Although amphotericin B stills remains to be the most effective drug, more prospective studies are needed for the requirement of knowledge of the sensitivity pattern for optimal treatment and reduction in morbidity in the long run

Identifying Pathways Mediating Obstructive Sleep Apnea and Obesity in Indian Children

Objective Overweight and obesity in children is associated with several metabolic and cardiovascular impairments, including obstructive sleep apnea (OSA). However, the causal pathway from OSA to obesity is not fully known yet. The aim of this study was to explore the association between OSA and obesity-related metabolic outcomes in obese Indian children. Methods An observational, cross-sectional study was conducted. Obese children referred to the Otorhinolaryngology Department at the Maulana Azad Medical College (New Delhi, India) for suspicion of OSA were consecutively enrolled.OSA was diagnosed by polysomnographic parameters. Homeostasis model assessment (HOMA) was calculated to measure insulin sensitivity and HOMA > 4.39 was considered as a threshold for insulin resistance. The association between various polysomnographic measures and HOMA, adiponectin and various urinary catecholamines was assessed. Results Complete polysomnographic parameters were available for 45 children; of these 29 were found to suffer from OSA. OSA children had significantly higher glucose concentrations compared to non-OSA ones (p value = 0.012) but no differences were found in insulin resistance and urinary catecholamines levels. Older age was significantly associated to lower levels of catecholamines. No significant associations were found between polysomnographic parameters and both HOMA and adiponectin. Only age was found to be significantly associated with HOMA (p = 0.03) and adiponectin (p =0.01). Conclusions A better understanding of the role played by OSA on obese children\u2019s metabolic functions is crucial to implement specific prevention strategies to reduce the public health burden of non-communicable diseases

Physical Activity Patterns Among School Children in India

OBJECTIVE: To assess the prevalence of physical activity and its relation with socio-demographic variables and eating habits among school-aged children in India. METHODS: The study incorporated secondary analysis of anthropometric measurements and questionnaires on lifestyle and dietary habits of 1,680 school children aged between 3 and 11 y, obtained while carrying out the OBEY-AD project. The inventory contained questions about several variables concerning to physical activity, educational background, lifestyles and eating habits for both children and parents. Questions were organized along specific contents, which could be informative topics, picture choices and multiple answers choices. RESULTS: Prevalence of inactivity was 21% and exhibited significant variations between cities. Physical activity was significantly associated to socio-economic status and consumption of fruits and vegetables. No association could be revealed with children's BMI. CONCLUSIONS: Health-promotion interventions aimed at improving healthy lifestyles in Indian children should focus on population strata with low socio-economic status

Inhaled foreign bodies in children: a global perspective on their epidemiological, clinical, and preventive aspects

While several articles describe clinical management of foreign bodies injuries in the upper air tract, little epidemiological evidence is available from injury databases