Cardiovascular disease and mobility disability in rural older indians: the mobility and independent living in elders study (MILES)

Increase in older population is most rapid in developing countries and will have major impact on public health. Indian older population is not well described and there is an urgent need to estimate the burden of prevalent disease, disability and risk factors. To accomplish this, we established a longitudinal cohort study – MILES, in a rural population of older Indians. We enrolled a random sample of 562 men and women aged 60+ from rural India. Baseline visit consisted of a comprehensive clinical examination and interview. We examined the prevalence of CVD and its relationship with traditional CVD risk factors in MILES. CVD was defined as a composite of self-reported history of CVD, major ECG abnormality or peripheral artery disease (PAD). Prevalence of CVD was 24.6% in men and 25.6% in women. In multivariate analyses among men, BMI, hypertension and physical inactivity were associated with higher prevalence of CVD. Among women, chewing tobacco, hypertension and physical inactivity were associated with higher prevalence of CVD. Additionally, we estimated the prevalence and risk factors for mobility disability in MILES population by using inability to attempt or complete a 400-meter usual paced walk as a measure of mobility disability. Mobility disability prevalence was much higher in women (43.8%) compared to men (27.9%). In men, knee pain, fair vision, chronic lung disease and greater number of depressive symptoms were associated with mobility disability. Among women, waist circumference, depressive symptoms, knee pain, poor vision, CVD history and PAD were associated with mobility disability. Mean walking times were high in those men (435 seconds) and women (503 seconds) who completed the walk. Higher walking times were associated with higher waist circumference, knee pain and use of walking aid in both men and women. This dissertation has major public health significance. In this dissertation, we identified the rural older Indian population to be very frail, and with high prevalence of disease and mobility disability. There is a high prevalence of risk factors, low heath awareness and poor health care access. These data indicate urgent need for primary prevention measures and increasing availability of treatment to prevent further complications

Structural aspects of virtual twin groups

Study of certain isotopy classes of a finite collection of immersed circles without triple or higher intersections on closed oriented surfaces is considered as a planar analogue of virtual knot theory with the genus zero case corresponding to classical knot theory. Alexander and Markov theorems are known in this setting with the role of groups being played by a class of right-angled Coxeter groups called twin groups, denoted $T_n$, in the genus zero case. For the higher genus case, the role of groups is played by a new class of groups called virtual twin groups, denoted $VT_n$. A virtual twin group $VT_n$ contains the twin group $T_n$ and the pure virtual twin group $PVT_n$, an analogue of the pure braid group. The paper investigates in detail some structural aspects of these groups. We prove that the pure virtual twin group $PVT_n$ is an irreducible right-angled Artin group with trivial center and give it's precise presentation. We show that $PVT_n$ has a decomposition as an iterated semidirect product of infinite rank free groups. We also give a complete description of the automorphism group of $PVT_n$. As applications, we show that $VT_n$ is residually finite and $PVT_n$ has the $R_\infty$-property. Along the way, we also obtain a presentation of $VT_n'$ and a freeness result on $PVT_n'$.Comment: 26 pages, 6 figure

Congruence subgroups and crystallographic quotients of small Coxeter groups

Small Coxeter groups are precisely the ones for which the Tits representation is integral, which makes the study of their congruence subgroups relevant. The symmetric group $S_n$ has three natural extensions, namely, the braid group $B_n$, the twin group $T_n$ and the triplet group $L_n$. The latter two groups are small Coxeter groups, and play the role of braid groups under the Alexander-Markov correspondence for appropriate knot theories, with their pure subgroups admitting suitable hyperplane arrangements as Eilenberg-MacLane spaces. In this paper, we prove that the congruence subgroup property fails for infinite small Coxeter groups which are not virtually abelian. As an application, we deduce that the congruence subgroup property fails for both $T_n$ and $L_n$ when $n \ge 4$. We also determine subquotients of principal congruence subgroups of $T_n$, and identify the pure twin group $PT_n$ and the pure triplet group $PL_n$ with suitable principal congruence subgroups. Further, we investigate crystallographic quotients of these two families of small Coxeter groups, and prove that $T_n /PT_n^{'}$, $T_n/T_n^{''}$ and $L_n /PL_n^{'}$ are crystallographic groups. We also determine crystallographic dimensions of these groups and identify the holonomy representation of $T_n/T_n^{''}$.Comment: 25 pages, to appear in Forum Mathematicu

Virtual planar braid groups and permutations

Twin groups and virtual twin groups are planar analogues of braid groups and virtual braid groups, respectively. These groups play the role of braid groups in the Alexander-Markov correspondence for the theory of stable isotopy classes of immersed circles on orientable surfaces. Motivated by the general idea of Artin and a recent work of Bellingeri and Paris \cite{BellingeriParis2020}, we obtain a complete description of homomorphisms between virtual twin groups and symmetric groups, which as an application gives us the precise structure of the automorphism group of the virtual twin group $VT_n$ on $n \ge 2$ strands. This is achieved by showing the existence of an irreducible right-angled Coxeter group $KT_n$ inside $VT_n$. As a by-product, it also follows that the twin group $T_n$ embeds inside the virtual twin group $VT_n$, which is an analogue of a similar result for braid groups.Comment: 29 pages, 4 figures, 2 table

To assess awareness regarding rational drug therapy and fixed dose combinations amongst interns and II MBBS students in tertiary care teaching hospital in Maharashtra, India

Background: The present study was designed to assess awareness regarding rational drug therapy and fixed dose combinations (FDC) amongst interns and II MBBS students in a tertiary-care teaching hospital in Maharashtra, India.Methods: This cross-sectional, questionnaire-based study containing MCQ and analytical questions on rational drug therapy, fixed dose combinations and role of Pharmacist in dispensing correct drug to the patients was carried out in both interns (n=80) and II MBBS students (n=100). The completed questionnaires were then collected and analysed statistically for responses.Results: Mean average score obtained by II MBBS students (score - 36.66marks) was significantly better than interns (score- 20marks) which probably may be due to pharmacology teaching they were undergoing. II MBBS students were found to be better informed as compared to the interns (p0.05). However, on question related to justification of FDC, interns were found to be better informed as compared to the II MBBS students (p<0.05). On single question pertaining to role of pharmacist, interns were found to be better informed than II MBBS students possibly due to their better understanding of patient-pharmacist relationship.Conclusions: Our study highlights the significance regarding knowledge of rational drug therapy and fixed dose combination (both rational and irrational), both rational and irrational, amongst both interns and II MBBS students while identifying the possible areas of interventions to make them rational clinicians