All India Institute of Medical Sciences, Nagpur (AIIMS Nagpur) is a medical research public higher education institute located at the Multi-modal International Cargo Hub and Airport at Nagpur (MIHAN), Nagpur, Maharashtra, India. It is one of the four "Phase-IV" All India Institutes of Medical Sciences (AIIMS) announced in July 2014..
Anatomical variations in the sphenoid sinus (SS) and adjacent neurovascular structures differ between sexes, impacting surgical approaches such as endoscopic sinus surgery and transsphenoidal procedures. This study evaluates sex-based morphometric and structural differences in the SS using computed tomography (CT). A prospective CT-based analysis was performed to assess sphenoid sinus volume, pneumatization patterns, and the anatomical relationship of surrounding neurovascular structures in male and female patients. Linear distances and frequency of structural protrusions and dehiscence were compared between sexes using statistical analysis. This study comprehensively evaluated anatomical variations of the sphenoid sinus in a cohort of 200 individuals aged 14 to 87 years, with the aim of identifying clinically significant differences across age groups and between genders that are crucial for surgical planning, particularly in transsphenoidal and endoscopic skull base procedures. The mean age was 46.05 ± 15.75 years, with a male predominance (60
BACKGROUND:In India, estimates of salt intake vary widely due to cultural and regional dietary patterns, and an updated comprehensive synthesis was lacking. OBJECTIVE:The objective of this study is to estimate the pooled mean salt and sodium intake and the prevalence of high salt intake across diverse Indian populations, and to explore regional, demographic, and temporal variations. DATA SOURCES:A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Embase until December 2, 2024, following PROSPERO registration (CRD42024618201). METHODS:Studies reporting mean salt or sodium intake or the prevalence of excess intake were included in the study. A random-effects meta-analysis was conducted, and heterogeneity was assessed using the I² statistic. Subgroup analyses were performed by region, locality, sex, hypertension status, and study year. RESULTS:Eighty-three studies were included in the study. The pooled mean salt intake from 30 studies was 9.01 g/day (95% confidence interval [CI]: 8.23-9.79), whereas the mean sodium intake from 23 studies was 3.49 g/day (95% CI: 2.72-4.25), both exceeding the World Health Organization-recommended limits. The pooled prevalence of high salt intake was 61% (95% CI: 48%-73%), with wide variation by intake definition. Subgroup analyses showed higher intake in rural populations, males, and hypertensive individuals. CONCLUSION:Salt and sodium intake in India remains significantly above recommended levels, with considerable variability across regions and populations.
The habit of chewing betel leaf, or "paan", is prevalent in different parts of India. Betel leaves, areca nut, and lime are common ingredients of paan. Preclinical studies have demonstrated that betel leaf and areca nut affect thyroid function. Lime, due to its high calcium content, adsorbs levothyroxine (LT4) tablets. It is worthwhile to consider paan consumption as a possible etiology of "refractory hypothyroidism" in individuals being treated with a standard LT4 replacement dose in India. Chronic paan chewing causes reddish discoloration of the tongue. Encountering such a finding on examination in a patient with persistently elevated thyroid-stimulating hormone (TSH) should prompt the treating physician to meticulously inquire about dietary patterns and other habits. This is important when there is a consistent denial of noncompliance and an absence of clinical suggestions of malabsorptive and systemic diseases. We describe here a patient with primary autoimmune hypothyroidism with persistently elevated TSH, despite being on an unusually high dose of LT4, due to his habit of paan chewing. The red- colored tongue provided us a clue about the habit. TSH normalization was achieved with the standard replacement dose of LT4 following the cessation of paan consumption.
Abstract Background Access to health care among tribes is a significant challenge. Traditional healers have acted as a major resource for healthcare provision since the earliest ages of humanity. Efforts to create an entry point through them require a detailed understanding of their role, beliefs, and treatment approaches. This study aimed to capture the role of traditional healers in improving access to health care and their practices from the perspectives of the community, health care providers and traditional healers. Methods This study was part of an implementation research project aimed at improving access to healthcare among the tribal population in Maharashtra in 2021. In-depth interviews with traditional healers and health care providers were conducted by trained field assistants in participant’s homes and facilities. An interview guide with open-ended questions explored perceptions of disease, treatment approaches, reasons for preference and challenges in utilizing public health facilities. With consent, interviews were audio recorded, verbatim transcripts prepared, and three independent reviewers inductively coded the data, and emerging themes were identified. Results A total of 32 health care providers, 24 key informants, and nine traditional healers participated. All traditional healers interviewed were men aged 40–65 years with experience ranging from four to 35 years. Many practice a healing as a part-time job, attributed disease to black magic and lifestyle factors. Dietary restrictions, purgation, and topical herbal medicines were common treatment approaches. They claimed their role as the first point of contact for healthcare, a health guide, an escorting agent, and a link between the tribal Community and the health system. Round-the-clock availability, convenient time, affordability, and respectful attitudes were reasons they were preferred. Lack of awareness, economic vulnerability, preference for private services, and limited trust in the public health system were shared as reasons for poor utilization of services from public facilities. Health care providers viewed health seeking from traditional healers as illegal and a deterrent to timely care. Conclusion With their close geographical and cultural association, and credible and affordable service provision, traditional healers can act as an entry point to improve health access among the tribal population and achieve universal health coverage.
