Preparedness,knowledge,and perception of nursing students about climate change and its impact on human health in India

Higher education plays an important role in all aspects of sustainability.Infusing climate change and sustainability into the curriculum is important to prepare future health-care professionals for climate change and sustainability actions to build resilient health systems.In this study,we evaluated the preparedness,knowledge,and perception regarding climate change and its impact on human health among Indian nursing students.A quantitative descriptive survey was conducted among 644 undergraduate nursing students studying in three institutes in the southern,northern,and western parts of India.We used a structured online questionnaire with established validity and reliability to collect data.The data were analyzed using Statistical Package for the Social Sciences version 26 software.The results showed that more than half of the students reported experiencing excessive increase(362;56.2%)and decrease(374;58.1%)in temperature in recent years.Though more than three quarters of the students(494;76.7%)accepted the general truth that climate change is mainly caused by human activities,only less than half of the students(309;48.0%)perceived the impact of climate change to be high.Three quarters of the students(483;75.0%)had a high level of knowledge regarding climate change.The students who had a high level of knowledge about climate change exerted a high perceived impact of climate change(χ^(2)=75.47;P<0.01).More than half of the students(50.9%)felt that they needed information about climate change to be included in the nursing curriculum,and only one sixth of the students(16.1%)were highly confident about engaging in climate change-related conversation with patients.Most of the students who participated in the study had basic knowledge about climate change and its impact on human health.However,there is an observed gap between knowledge and their preparedness and confidence to engage in climate change actions.Hence,we propose to strengthen the nursing curriculum by integrating various curricular and co-curricular activities related to climate change,so that future nurses are empowered to become climate change advocates.

Role of self-help groups on socioeconomic development and the achievement of Sustainable Development Goals(SDGs)among rural women in Cooch Behar District,India

This study examines the transformative role of self-help groups(SHGs)in the socioeconomic development of rural women in Cooch Behar District,India,and their contribution toward achieving Sustainable Development Goals(SDGs)of the United Nations.In this study,we explored the effect of SHGs on rural women by specifically addressing SDGs,such as no poverty(SDG 1),zero hunger(SDG 2),good health and well-being(SDG 3),quality education(SDG 4),and gender equality(SDG 5).Given this issue,a cross-sectional survey and comparison analyses are needed to assess the socioeconomic development of rural women and their awareness level before and after the participation of rural women in SHGs.The survey conducted as part of this study was divided into three sections,namely,demographic characteristics,socioeconomic development,and awareness level,with each focusing on different aspects.A group of 400 individuals who were part of SHGs completed the questionnaire survey form.The results showed that the participation of rural women in SHGs significantly improved their socioeconomic development and awareness level,as supported by both mean values and t test results.Memberships in SHGs and microcredit programs were the major elements that boosted the socioeconomic development of rural women,which also achieves SDGs 1,2,3,4,and 5.This study revealed that participation in SHGs and related financial services significantly aided rural women in economically disadvantaged communities in accumulating savings and initiating entrepreneurial ventures.Moreover,participation in SHGs was instrumental in enhancing the self-confidence,self-efficacy,and overall self-esteem of rural women.Finally,doing so enabled them to move more freely for work and other activities and to make family and common decisions.

Charting the course:India's health expenditure projections for 2035

Objectives Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket(OOP)expenses.The current study analyzed health expenditure patterns in India and forecasted future trends and patterns until 2035.Methods Data on health expenditure in India from 2000 to 2019 was collected from the Organisation for Economic Co-operation and Development(OECD)iLibrary and National Health Accounts 2019 databases.Gross domestic product(GDP)data from the World Bank was also utilized.Descriptive statistics analyzed the composition and pattern,while the exponential smoothing model forecasted future health expenditures.Results The findings revealed that expenditure made by OOP is the primary health financing source,followed by government and pre-paid private spending.The percentage of GDP allocated to total health expenditure remains stable,while the per capita health expenditure fluctuates.Variations in expenditure among states are observed,with Karnataka relying heavily on pre-paid private coverage.Future projections suggest a decline in per capita and total health expenditure as a share of GDP,with a slight increase in the government’s share.Pre-paid private expenditure per capita and OOP health expenditure as a share of the total is projected to remain relatively constant but still high in absolute terms.Conclusion The study highlights variations in health spending in India,characterized by high OOP spending,limited public coverage,and a need for investments,and reforms to improve healthcare access and equity.

Epidemiology of EGFR Mutation in Adenocarcinoma NSCLC Patients in India: A Systematic Review and Meta-Analysis

Studies reporting the Indian prevalence of Epidermal Growth Factor Receptor (EGFR) mutation are mostly single centers with small sample sizes. This systematic review and meta-analysis summarized the available evidence of EGFR mutation epidemiology in Indian patients with adenocarcinoma (ADC) Non-Small Cell Lung Cancer (NSCLC). We conducted a structured literature search in PubMed, and EMBASE databases from January 2004 through October 2019. The primary outcome of interest was prevalence of EGFR mutation by gender, smoking status, and mutation subtype. The review included 34 studies. EGFR mutation prevalence was 39.5% in patients with ADC, and significantly higher in females, non-smokers, and patients with exon 19 deletions. The EGFR mutation frequency in Indian patients with ADC was higher than reported in Caucasians but at a lower range of that reported in East Asians. These findings support the use of EGFR mutation testing to guide choice of treatment.

Offshore high-grade limemud resources of west coast of India:Economic potential and industrial applications

Limestone is one of the essential raw materials in the cement,paint,steel,ceramic,glass,chemical,pharmaceutical,paper,and fertilizer industries.In India,only 8%of the limestone resources are placed under the reserve category,of which 97%is of cement grade.Thus,India depends on imports to bridge the demand‐supply gap of steel,blast furnace,and chemical‐grade limestone.Efforts of Geological Survey of India(GSI)to locate alternate sources for limestone led to the discovery of enormous quantities of carbonate minerals called limemud from the continental shelf margin of the west coast of India.GSI carried out systematic studies to explore the nature of the disposition,quality,quantity,and suitability of the offshore limemud for various industrial applications.A preliminary estimate of resources using high‐resolution subbottom profiling and sediment core sample studies established the occurrence of more than 172 billion tonnes of high‐grade(The content of CaCO3 is greater than 80 wt%)limemud in 0.4–28.0m thick stratified sediment layers spread over an area of 18000 km2.Chemical,physical,mineralogical,beneficiation,and agglomeration studies found the offshore limemud as a potential replacement for limestone in the cement,filler,blast furnace,steel melting shop,lime production,paint,and Grade‐I steel industries.An assessment of mining and transportation costs indicates that the offshore limemud(USD 5–6/ton)is more cost‐effective than that imported from other countries(USD16‐18/ton).With several advantageous factors like low impurity,mode of occurrence in overburden‐free stratified form,fine‐grained slurry nature,and shallow water depth,sustainable mining of offshore limemud could be a future reality with controllable technological,economic,and environmental challenges.

Assessing the role of forest resources in improving rural livelihoods in West Bengal of India

Forest resources play a vital role in supporting the livelihoods of rural communities residing in forest-rich areas.In India,a forest-rich country,a significant proportion of non-timber forest products(NTFPs)is consumed locally,supporting numerous rural communities relying on forests for essential resources,such as firewood,timber,and NTFPs.This study focuses on two forest-dominant districts in West Bengal of India,namely,Jhargram District and Paschim Medinipur District.Furthermore,this study aims to enhance the understanding of forest-dependent communities by comparing the standard of living among different village classes.Thus,we categorized villages into three classes based on the distance from home to forests,including inner villages,fringe villages,and outer villages.Through focus group discussions and household surveys,we explored the sources of local economy,income sources of household,and reasons for economic diversification in different village classes.The study findings confirm that substantial variations existed in the income sources and the standard of living in these villages.Forest income varied dramatically among the three village classes,with inner villages having greater forest income than fringe villages and outer villages.Meanwhile,households in outer villages depended on forests and engaged in diverse economic activities for their livelihoods.Compared with inner and fringe villages,households in outer villages derived a significant portion of their income from livestock.This discrepancy can be attributed to challenges,such as inadequate transportation,communication,and underdeveloped market chains in inner villages.Moreover,these findings emphasize the need to develop sustainable forest management practices,create alternative income-generation opportunities,and improve infrastructure and market access in inner villages,as well as promote economic diversification in outer villages.Through targeted policy measures,these forest-rich regions can achieve improved livelihoods,enhanced standard of living,and increased resilience for their communities.

Gallbladder cancer:Progress in the Indian subcontinent

Gallbladder cancer(GBC)is one of the commonest biliary malignancies seen in India,Argentina,and Japan.The disease has dismal outcome as it is detected quite late due to nonspecific symptoms and signs.Early detection is the only way to improve the outcome.There have been several advances in basic as well as clinical research in the hepatobiliary and pancreatic diseases in the West and other developed countries but not enough has been done in GBC.Therefore,it is imp-ortant and the responsibility of the countries with high burden of GBC to find solutions to the many unanswered questions like etiopathogenesis,early diagn-osis,treatment,and prognostication.As India being one of the largest hubs for GBC in the world,it is important to know how the country has progressed on GBC.In this review,we will discuss the outcome of the publications from India highlighting the work and the developments taken place in past several decades both in basic and clinical research.

Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?

BACKGROUND Liver transplantation(LT)for hepatocellular carcinoma(HCC)has been widely researched and is well established worldwide.The cornerstone of this treatment lies in the various criteria formulated by expert consensus and experience.The variations among the criteria are staggering,and the short-and long-term outcomes are controversial.AIM To study the differences in the current practices of LT for HCC at different centers in India and discuss their clinical implications in the future.METHODS We conducted a survey of major centers in India that performed LT in December 2022.A total of 23 responses were received.The centers were classified as high-and low-volume,and the current trend of care for patients undergoing LT for HCC was noted.RESULTS Of the 23 centers,35%were high volume center(>500 Liver transplants)while 52%were high-volume centers that performed more than 50 transplants/year.Approximately 39%of centers had performed>50 LT for HCC while the percent distribution for HCC in LT patients was 5%–15%in approximately 73%of the patients.Barring a few,most centers were divided equally between University of California,San Francisco(UCSF)and center-specific criteria when choosing patients with HCC for LT,and most(65%)did not have separate transplant criteria for deceased donor LT and living donor LT(LDLT).Most centers(56%)preferred surgical resection over LT for a Child A cirrhosis patient with a resectable 4 cm HCC lesion.Positron-emission tomography-computed tomography(CT)was the modality of choice for metastatic workup in the majority of centers(74%).Downstaging was the preferred option for over 90%of the centers and included transarterial chemoembolization,transarterial radioembolization,stereotactic body radiotherapy and atezolizumab/bevacizumab with varied indications.The alphafetoprotein(AFP)cut-off was used by 74%of centers to decide on transplantation as well as to downstage tumors,even if they met the criteria.The criteria for successful downstaging varied,but most centers conformed to the UCSF or their center-specific criteria for LT,along with the AFP cutoff values.The wait time for LT from downstaging was at least 4–6 wk in all centers.Contrast-enhanced CT was the preferred imaging modality for post-LT surveillance in 52%of the centers.Approximately 65%of the centers preferred to start everolimus between 1 and 3 months post-LT.CONCLUSION The current predicted 5-year survival rate of HCC patients in India is less than 15%.The aim of transplantation is to achieve at least a 60%5-year disease free survival rate,which will provide relief to the prediction of an HCC surge over the next 20 years.The current worldwide criteria(Milan/UCSF)may have a higher 5-year survival(>70%);however,the majority of patients still do not fit these criteria and are dependent on other suboptimal modes of treatment,with much lower survival rates.To make predictions for 2040,we must prepare to arm ourselves with less stringent selection criteria to widen the pool of patients who may undergo transplantation and have a chance of a better outcome.With more advanced technology and better donor outcomes,LDLT will provide a cutting edge in the fight against liver cancer over the next two decades.

Prevalence of obesity,determinants,and its association with hyperglycaemia among community dwelling older adolescents in India

BACKGROUND Globally,obesity and diabetes mellitus(DM)are emergent public health concerns in the adolescent population.India,home to the largest adolescent population and the second largest diabetes cohort is experiencing rapid but unplanned urbanization,with accompanying unhealthy nutritional transition,and sedentary lifestyle.AIM To determine prevalence and determinants of obesity and hyperglycaemia and their association among community-dwelling older adolescents(15-19 years)in India.METHODS This cross-sectional analysis from the national family health survey-5 included data of 258028 adolescents aged 15-19 across India(2019-2021).The survey employed stratified two-stage sampling,with systematic random sampling in rural and urban areas.Statistical analysis included descriptive statistics,bivariate,and multivariable logistic regression,employing generalized linear models.RESULTS The weighted prevalence of DM was 1.09%including 0.77%[95%confidence interval(CI):0.72-0.83]previously diagnosed and 0.32%(95%CI:0.29-0.35)newly diagnosed cases detected on survey screening.On adjusted analysis,increasing age,higher education levels,higher wealth index,and overweight/obesity were the factors significantly associated with presence of DM.Only 61%of the adolescents with previously diagnosed DM were on anti-diabetes treatment.The weighted prevalence of overweight/obesity among older adolescents was 6.9%with significantly higher odds in the male sex,having higher educational levels,urban residence,and those with a higher wealth index.CONCLUSION Nearly one in hundred older adolescents in India have diabetes,with one in three undiagnosed.Strengthening DM screening and treatment access among adolescents through public health programs is urgently warranted.

First Known Case of Carcass Guarding by Black Kite (Milvus migrans) in Urban Landscape, North India

Behavioral traits of species can play an important role in the functioning of the ecosystem and in evolving behavioural adaptations to survive according to environmental conditions.This note documents evidence of adding a rare observation by providing photographic evidence of the entanglement of a carcass of a juvenile Black Kite(Milvus migrans)from a nest and the use of nest by an adult individual,guarding the carcass.Documenting such behavior contributes to our understanding of the natural history and management of native species in an urban environment.Further,scientific studies/observations are needed to be conducted to reach some conclusion as to why species perform such behaviour.

Vice-President Ai Ping Meets Secretary-General Saqib of India China Economic and Cultural Council

On March 26th,CAFIU Vice-President Ai Ping met Secretary-General Mohammed Saqib of the India China Economic and Cultural Council.The two sides exchanged views on China-lndia relations and people-to-people exchanges.Vice-President Ai Ping said that the development of relationship between two states is based on their peoples.Strengthening people-to-people exchanges between China and India and promoting mutual understanding between the peoples are important for the improvement of the relationship between the two countries.

Performance of a Combined Energy System Consisting of Solar Collector, Biogas Dry Reforming and Solid Oxide Fuel Cell: An Indian Case Study

An energy production system consisting of a solar collector, biogas dry reforming reactor and solid oxide fuel cell (SOFC) was assumed to be installed in Kolkata, India. This study aims to understand the impact of climate conditions on the performance of solar collectors with different lengths of parabolic trough solar collector (dx) and mass flow rate of heat transfer fluid (m). In addition, this study has evaluated the amount of H2 produced by biogas dry reforming (GH2), the amount of power generated by SOFC (PSOFC) and the maximum number of possible households (N) whose electricity demand could be met by the energy system proposed, considering the performance of solar collector with the different dx and m. As a result, the optimum dx was found to be 4 m. This study revealed that the temperature of heat transfer fluid (Tfb) decreased with the increase in m. Tfb in March, April and May was higher than that in other months, while Tfb from June to December was the lowest. GH2, PSOFC and N in March, April and May were higher than those in other months, irrespective of m. The optimum m was 0.030 kg/s.

An overview of chemical enhanced oil recovery and its status in India

India is currently producing crude oil from matured fields because of insufficient discoveries of new fields.Therefore,in order to control the energy crisis in India,enhanced oil recovery(EOR)techniques are required to reduce the import of crude from the OPEC(Organization of the Petroleum Exporting Countries).This review mentions chemical EOR techniques(polymers,surfactants,alkali,nanoparticles,and combined alkali-surfactant-polymer flooding)and operations in India.Chemical EOR methods are one of the most efficient methods for oil displacement.The efficiency is enhanced by interfacial tension(IFT)reduction using surfactants and alkali,and mobility control of injected water is done by adding a polymer to increase the volumetric sweep efficiency.This paper also reviews the current trend of chemical EOR,prospects of chemical EOR in Indian oilfields,the development of chemical EOR in India with their challenges raising with economics,and screening criteria for chemical EOR implementation on the field scale.Furthermore,the review gives a brief idea about chemical EOR implementation in Indian oilfields in future prospects to increase the additional oil recovery from existing depleted fields to reduce the import of crude oil.The outcome of this review depicts all chemical EOR operations and recovery rates both at the laboratory scale and field scale around the country.The additional recovery rates are compared from various chemical EOR methods like conventional chemical flooding methods and conventional chemicals combined with nanoparticles on a laboratory scale.The development of chemical EOR in the past few decades and the EOR policy given by the government of India has been mentioned in this review.The analysis provides an idea about enhanced recovery screening and implementation of chemical EOR methods in existing fields will significantly reduce the energy crisis in India.

The Concurrent Record-breaking Rainfall over Northwest India and North China in September 2021

Extremely heavy rainfall occurred over both Northwest India and North China in September 2021.The precipitation anomalies were 4.1 and 6.2 times interannual standard deviation over the two regions,respectively,and broke the record since the observational data were available,i.e.,1901 for India and 1951 for China.In this month,the Asian uppertropospheric westerly jet was greatly displaced poleward over West Asia,and correspondingly,an anomalous cyclone appeared over India.The anomalous cyclone transported abundant water vapor into Northwest India,leading to the heavy rainfall there.In addition,the Silk Road pattern,a teleconnection pattern of upper-level meridional wind over the Eurasian continent and fueled by the heavy rainfall in Northwest India,contributed to the heavy rainfall in North China.Our study emphasizes the roles of atmospheric teleconnection patterns in concurrent rainfall extremes in the two regions far away from each other,and the occurrence of rainfall extremes during the post-or pre-monsoon period in the northern margins of monsoon regions.

A Study on Factors Influencing Cost Overrun in High-rise Building Construction across India

Cost overrun is a common problem in construction projects worldwide.Most Indian construction projects,particularly those involving high-rise buildings,have had severe cost overruns.For managers,architects,engineers,and contractors,completing building projects within the specified cost budget has become the most important and hard assignment.Since it is common for high-rise building projects to go over budget,the aim of this study is to find out the causes of cost overruns and provide effective measures.The study found 70 cost overrun factors based on a comprehensive literature review and expert opinions.A Google form questionnaire was distributed to 150 construction professionals across India.After following up,101 of the 150 responses were received.A five-point Likert scale was used and the acquired data was analyzed and ranked using the Relative Importance Index(RII)technique.According to the findings of RII,the top ten critical factors influencing cost overruns were frequent change orders during construction by the owner,delay in construction,escalation of material prices,market inflation or deflation,rework,frequent changes in design,inaccurate evaluation of the project timeline,unforeseen ground condition,inaccurate quantity take-off,and delay in progressive payment by the owner.Spearman’s rank correlation test revealed that there is a very significant relationship between the rankings of factors provided by the owner,the consultant,and the contractor.In addition,a factor analysis tool in the SPSS software was also used to categorize the seventy factors into sixteen core components.The top ten critical factors were presented to subject matter experts,and their suggestions were being compiled.These results are expected to help construction professionals minimize cost overruns,improve cost control measures,and initiate future research.

Evidence of the oldest extant vascular plant(horsetails)from the Indian Cenozoic

Equisetum(Equisetaceae)has long been a focus of attention for botanists and palaeontologists because,given its extensive and well-documented fossil record,it is considered the oldest extant vascular plant and a key element in understanding vascular plant evolution.However,to date,no authentic fossil evidence of Equisetum has been found from the Indian Cenozoic.Here,we describe a new fossil species,namely,E.siwalikum sp.nov.,recovered from the middle Siwalik(Late Miocene)sediments of Himachal Pradesh,western Himalaya.We identified fossil specimens based on morphological and epidermal characters.In addition,X-Ray diffraction(XRD)analysis was used to determine the mineral composition of compressed stems of Equisetum.The close affinity of our recovered Siwalik fossils to Equisetum is supported by the presence of both macromorphological and epidermal characters.Because Equisetum generally grows in wet conditions around water reservoirs,our findings indicate that the fossil locality was humid and surrounded by swamp and lowland regions during deposition.Ample fossil evidence indicates that this sphenopsid once existed in the western Himalaya during the Siwalik period.However,at present Equisetum is confined to a particular area of our fossil locality,probably a consequence of severe environmental changes coupled with competition from opportunistic angiosperms.Our discovery of Equisetum fossils in appreciable numbers from the Siwalik sediments of the Himachal Himalayas is unique and constitutes the first reliable recognition of Equisetum from the Indian Cenozoic.

Peraluminous A-type granites formed through synchronous fractionation,magma mixing,mingling,and undercooling:evidence from microgranular enclaves and host Mesoproterozoic Kanigiri granite pluton,Nellore Schist Belt,southeast India

The field and microstructural features coupled with mineral chemical data from microgranular enclave(ME)and host Mesoproterozoic Kanigiri granite(KG)pluton of Nellore Schist Belt(NSB),Southeastern India,have been documented in order to infer the likely processes responsible for the origin and evolution of ME and host KG magma.The ME and host KG bear the same mineral assemblages barring the KG which does not contain amphibole;however,they are modally disequilibrated.The ME in KG is originated due to multiple intrusions of ME magmas into the crystallizing host KG magma chamber.Field and textural features indicate the dynamic magma flow,mingling,and undercooling of the ME against a relatively cooler surface of host KG magma.The presence of NSB country rock xenoliths and its diffuse boundaries suggest the intrusive relation and marginal assimilation by the intruding KG magma.The occasional cumulate texture in the ME appears to have formed by the accumulation of early-formed minerals that crystallized rapidly in the ME magma globules.The ME shows the magmatically deform features developed due to the flowage and erosion by the subsequent intrusions of ME magma pulses into the crystallizing host KG magma chamber.The ME amphiboles show unusual composition as ferro-edenitic hornblende to potassian-hastingsitic hornblende,that crystallized in the subalkaline-alkaline transition,low fO_(2)(reducing to mildly oxidizing)magma.The unusual extremely low Mg/Mg+Fe^(t)=0.015(avg.)of ME amphiboles may be related to the changing physico-chemical(P,T,fO_(2),and H_(2)O)condition of the ME magma or they might have crystallized in equilibrium with more evolved KG magma.The KG(FeOt/MgO=37.04,avg.)and ME(FeO~t/MgO=77.72,avg.)biotites are siderophyllite,and buffered between QFM and NNO syn-crystallizing in the water undersaturated(H_(2O)≈3.58 wt.%in KG;≈3.53wt.%in ME),alkaline anorogenic(A-type)host magmas that were emplaced at mid-crustal(4–5 kbar;17 km)depth.Field,microtextural and mineral chemical evidences suggest that the alkaline KG magma originated from crustal source and evolved through synchronous fractionation,mixing,and mingling with coeval ME magmas in the KG magma chamber.

Glycemic Index of a Diabetes-Specific Nutritional Powder: An Open-Label Study in Healthy Indian Adults

Background: A balanced diet with a low glycemic index (GI) plays an important role in controlling and managing type 2 diabetes mellitus (T2DM). Here, we compared the GI of 2 flavors (vanilla and chocolate) of diabetes-specific nutritional (DSN) supplements to its comparator in healthy Indian adults under fasting conditions. Methods: This study was a 39-day open-label, non-comparative, single-center trial involving healthy adults aged between 18 to 45 years. The subjects received equal doses of 2 DSN powder (Treatments A and B), the comparator product (Treatment C), and dextrose monohydrate as a reference (Treatment R). Doses were administered as per the dosing schedule, after an overnight fast for 10 hours, with 2 intervening non-dosing days. Blood samples were collected on the dosing days to assess changes in capillary blood glucose levels. The primary endpoint of the study was the mean GI of Treatments A, B, and C (Defined as low: GI ≤ 55;medium: 55 GI ≤ 70;High: GI > 70), generated using the incremental area under the curve (AUCi) methodology. Safety was assessed throughout the study. Values of all study parameters were represented in ±SD or standard deviation. Results: Fourteen adult male subjects with a mean age of 29.42 ± 4.46 years, and a body mass index of 22.0 ± 1.95 Kg/m2, were enrolled in the study. The mean AUCi for treatments A, B, and C were 104 ± 10, 111 ± 12, and 87 ± 12 mmol min/L, respectively and for Treatment R it was 276 ± 16, 319 ± 28 and 338 ± 25 mmol min/L for Days 1, 6 and 8, respectively. The mean GI of Treatment A was 33 ± 3, Treatment B was 35 ± 3 and Treatment C was 29 ± 5;all GI means were ≤55. Mild adverse events were reported in 2 (14.3%) subjects. No serious adverse events or deaths were reported in the study. All treatments were well tolerated by the subjects. Conclusion: The glycemic index of both test products and comparator was low (i.e., GI 55) as per ISO 26642:2010 standard.

Clinical and epidemiological features of pelvic fractures presenting to the emergency department in a tertiary health care hospital in south India:A retrospective study

Objective:To determine the clinical and epidemiological features of pelvic fracture patients presenting to the Emergency Department.Methods:This prospective observational study was conducted in a tertiary care center in south India.Causes of injury,types of pelvic fractures,the associated injuries,and outcome at the time of discharge were recorded.Results:A total of 140 patients were included in this study.Most patients were classified as type A(n=62),followed by type B(n=48)and type C(n=30).A total of 112 patients were injured due to road traffic accidents,followed by a fall from a height(n=23)and a fall from a heavy object(n=5).Most subjects had facial injuries(n=99,70.7%),followed by head injuries(n=51,36.4%).Five percent of the patients were expired,12%left against medical advice,and 83%were discharged.Conclusions:The incidence of pelvic fractures presenting to the Emergency Department is relatively high in India.Road traffic accidents are the primary cause of pelvic fractures and associated facial and head injuries.The outcomes demonstrate the need for improved prevention strategies and comprehensive management protocols to reduce mortality.

Impact of forest governance and enforcement on deforestation and forest degradation at the district level:A study in West Bengal State,India

According to the United Nations Environmental Programme(UNEP),the world loses 1.0×106hm2forest land through deforestation annually.About 1.6×106people who depend on forests for livelihood are negatively affected by deforestation and forest degradation.The paper attempts to study the impact of forest governance,enforcement and socio-economic factors on deforestation and forest degradation at the local level in West Bengal State,India.The study was based on questionnaire survey data during 2020–2021 collected from three western districts(Purulia,Bankura,and Paschim Medinipur)where deforestation and poverty rates are higher than other districts in West Bengal State.The total number of selected villages was 29,and the total sample households were 693.A stratified random sampling technique was used to collect data,and a questionnaire was followed.Forest governance and enforcement indices were constructed using United Nation Development Programme(UNDP)methodology and a step-wise logistic regression model was used to identify the factors affecting deforestation and forest degradation.The result of this study showed that four factors(illegal logging,weak forest administration,encroachment,and poverty)are identified for the causes of deforestation and forest degradation.It is observed that six indices of forest governance(rule of law,transparency,accountability,participation,inclusiveness and equitability,and efficiency and effectiveness)are relatively high in Purulia District.Moreover,this study shows that Purulia and Bankura districts follow medium forest governance,while Paschim Medinipur District has poor forest governance.The enforcement index is found to be highest in Purulia District(0.717)and lowest for Paschim Medinipur District(0.257).Finally,weak forest governance,poor socio-economic conditions of the households,and weak enforcement lead to the deforestation and forest degradation in the study area.Therefore,governments should strengthen law enforcement and encourage sustainable forest certification schemes to combat illegal logging.