Kempegowda Institute of Medical Sciences is a medical college in the Indian state of Karnataka, affiliated to the Rajiv Gandhi University of Health Sciences, Jayanagar, Bangalore.
Abstract Background Traffic police personnel in rapidly urbanizing Indian cities are chronically exposed to hazardous noise levels, placing them at high risk for noise-induced hearing loss (NIHL). Conventional pure-tone audiometry (PTA) often fails to detect the earliest signs of cochlear damage. This study aims to evaluate and compare the utility of high-frequency audiometry (HFA) and distortion product otoacoustic emissions (DPOAE) in detecting early auditory damage in traffic police personnel with normal conventional audiograms. Methods A cross-sectional comparative study was conducted at a tertiary care teaching hospital in Bangalore over 13 months on 120 participants. The cohort was divided into Group 1 (60 traffic police personnel) and Group 2 (60 office workers). All participants had normal conventional PTA thresholds (≤ 25 dB HL at 0.25–8 kHz). Participants underwent HFA (10–16 kHz) and DPOAE testing. Results Despite normal conventional hearing, Group 1 exhibited significantly higher thresholds in HFA at 12.5 kHz and 16 kHz (p < 0.001). DPOAE analysis revealed significantly reduced signal-to-noise ratios (SNR) and lower emission amplitudes in Group 1, particularly at 4 kHz and 6 kHz. Conclusion Traffic police personnel suffer from latent cochlear damage missed by routine screening. HFA and DPOAE are sensitive tools for the preclinical detection of NIHL and should be considered for occupational surveillance protocols.
Rabies is a preventable zoonotic disease, yet timely and complete post-exposure prophylaxis (PEP) remains a major operational challenge in endemic countries. Compliance to the full vaccination schedule is critical for ensuring protection against rabies virus following category II and III exposures. A prospective observational study was conducted at the Anti-Rabies Clinic, Kempegowda Institute of Medical Sciences Hospital, Bengaluru, India, among all animal bite victims attending for PEP between October 2021 to December 2022. Data on socio-demographics, exposure characteristics, health-seeking behavior, vaccination compliance, and reasons for drop-out were collected using a structured case record form. Compliance was defined as completing all five doses of intramuscular anti-rabies vaccine according to the Essen regimen. A total of 735 animal bite victims were enrolled; 80.4
Background Chronic musculoskeletal disorders (MSDs) are a leading cause of disability worldwide, and long-term treatment with nonsteroidal anti-inflammatory drugs, corticosteroids, and opioids is frequently limited by adverse effects. We developed the Unified Musculoskeletal Dysfunction Index (UMDI) and Unified Musculoskeletal Aging Index (UMAI) as multidomain quantitative tools to assess musculoskeletal dysfunction and estimate model-derived musculoskeletal biological age. Methods In this 16-week randomized controlled trial, 180 adults with chronic MSDs were randomized (1:1) to receive either a standardized oral and topical multi-target phytotherapeutic intervention or standard management. The primary outcome was the change in UMDI. Physical domains, including symptom and functional disability, gait, structural asymmetry, mobility restriction, and anthropometric risk, together with biological domains comprising inflammation, muscle–cartilage degeneration, bone turnover, cardiometabolic status, and neurovascular function, were integrated into the Composite Musculoskeletal Dysfunction Index (CMDI) and Composite Biological Musculoskeletal Index (CBMI) using random-effects standardized mean differences (Cohen's d ). Weighted integration of CMDI and CBMI generated the UMDI, from which the UMAI and model-derived musculoskeletal biological age were estimated. Treatment effects were evaluated using mixed-effects models. Results Compared with standard management, the phytotherapeutic intervention significantly improved all primary and secondary outcomes (all P < 0.001), except suprapatellar, infrapatellar, and thigh girth measurements, which did not differ significantly between groups . CMDI and CBMI effect sizes were 0.73 and 0.92, respectively. UMDI decreased from 2.64 to 0.846, UMAI from 0.264 to 0.0846, and model-derived musculoskeletal biological age from 68.55 to 64.10 years, reducing the biological age acceleration gap by 67.9%. Conclusions A standardized oral and topical multi-target phytotherapeutic intervention significantly improved multidomain clinical function and biological biomarkers in adults with chronic MSDs. The newly developed UMDI and UMAI provide integrated quantitative measures of treatment response and estimated musculoskeletal biological age, supporting their use as multidimensional outcome measures in phytotherapy research and musculoskeletal medicine.
BACKGROUND:Subtle gait alterations and inter-limb asymmetry may precede radiographic knee osteoarthritis (OA), but isolated biomechanical variables often lack sensitivity for early detection. We evaluated whether multidomain gait and strength measures improve discrimination of symptomatic individuals without radiographic OA. METHODS:One hundred seventeen symptomatic participants with Kellgren-Lawrence grade 0 knees and 60 age-matched controls underwent assessment of walking speed, step length, knee sagittal-plane range of motion, functional mobility, and knee flexor and extensor strength. Inter-limb asymmetry indices were calculated and aggregated into a Composite Mechanical Dysfunction Index. Circulating inflammatory and tissue-turnover markers were analysed as adjunct physiological measures. Between-group differences were quantified using standardized mean differences and cross-validated receiver operating characteristic analyses. FINDINGS:Compared with controls, symptomatic participants walked more slowly, had shorter step length, reduced knee range of motion, and greater mobility and strength asymmetry (all p < 0.001). Mechanical domains showed small-to-large effects (standardized mean differences up to approximately 1.05), with gait performance demonstrating the largest mechanical difference, whereas biological markers showed larger effects (up to ∼1.7). The composite mechanical index demonstrated excellent discrimination (cross-validated AUC 0.93-0.99). Addition of physiological markers yielded only modest improvement. A simplified four-domain mechanical model retained approximately 82% of full-model performance. INTERPRETATION:Multidomain gait and asymmetry measures identify clinically meaningful functional impairment in individuals with knee symptoms despite normal radiographs. Composite mechanical metrics provide an interpretable and scalable approach for early screening and may support targeted preventive strategies.
AIM:Chronological age does not adequately reflect musculoskeletal biological aging. Although individual biomarkers capture specific processes, a unified quantitative measure of musculoskeletal biological age gap is lacking. This study aimed to develop and evaluate a multidomain composite biomarker index, the Composite OrthoAge Score Index (COASI), to estimate biological age gap in older adults. METHODS:This cross-sectional case-control study included 126 individuals with radiologically confirmed musculoskeletal disorders and 117 age- and sex-matched asymptomatic controls recruited from orthopedic outpatient clinics and community sources in Kolkata, India. Serum levels of 14 biomarkers across six domains were quantified using enzyme-linked immunosorbent assays. Domain-specific scores were calculated using standardized effect size-based weighting and integrated into COASI. Calibration against chronological age was performed in controls, with internal validation using 10-fold cross-validation. RESULTS:COASI showed a significant positive association with chronological age in controls (R2 = 0.578, p < 0.001), with cross-validation demonstrating consistent performance (mean R2 = 0.54 ± 0.06). Individuals with musculoskeletal disorders exhibited a significantly greater biological age gap than controls (+26.7 years; SE ±4.34; p < 0.001). Sensitivity analyses confirmed robustness (+24.9 years; SE ±4.61; p < 0.001). No significant subgroup differences were observed (p = 0.18). Muscle-extracellular matrix and bone-cartilage turnover were dominant contributors. CONCLUSIONS:COASI is a multidomain, biomarker-derived index estimating musculoskeletal biological age and its gap relative to chronological age. It may support early risk stratification; however, it remains exploratory and hypothesis-generating. Further longitudinal validation, external replication in diverse populations, and integration with standardized geriatric functional outcomes (e.g., frailty, physical performance, fall risk) are required prior to any clinical application.
