Abstract: The utilization of the broad-spectrum antibiotic chloramphenicol has been associated with the occurrence of a negative outcome recognized as aplastic anemia. This outcome is infrequent yet carries significant gravity. This study provides a comprehensive analysis of chloramphenicol-associated aplastic anemia, including its epidemiology, clinical features, diagnostic approaches, proposed mechanisms, treatment outcomes, risk factors, and reporting characteristics. Epidemiological data indicate the variations in the incidence rates across different populations, with higher rates observed in Southeast Asia. The clinical features include pancytopenia, fatigue, pallor, infections, and bleeding tendencies, with variations in disease severity and progression. Diagnostic approaches involve evaluating clinical history, physical examination findings, and laboratory investigations, although challenges and limitations exist in diagnosing this condition. Management strategies encompass supportive care, blood transfusions, and hematopoietic stem cell transplantation for severe cases. Risk factors encompass genetic predisposition, patient age, duration of exposure, and concurrent medication utilization. Reporting bias and publication characteristics are evaluated, highlighting the need for future research. This study provides valuable insights into chloramphenicol-associated aplastic anemia, aiding clinicians in recognizing and managing this adverse effect.
Leadership is a vital competency for medical professionals, yet its integration into undergraduate medical education (UGME) remains inconsistent worldwide. While Western institutions incorporate structured leadership training, many developing countries rely on informal experiences, leading to varying levels of preparedness among medical graduates. This systematic review synthesizes evidence on leadership training approaches, competency development, and institutional barriers in UGME to identify best practices and implementation strategies. A comprehensive literature search was conducted in PubMed and Google Scholar following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Twenty-nine studies published between 2014 and 2024 met the eligibility criteria. Thematic analysis was used to categorize leadership training methodologies, assessment strategies, and regional differences. Simulation-based learning and mentorship programs emerged as the most effective training methods, enhancing decision-making, teamwork, and crisis management. However, major barriers included curricular constraints, faculty shortages, and a lack of standardized assessments. Western curricula emphasized strategic leadership and policy-making, whereas Indian UGME focused more on patient-centered leadership. Bridging leadership gaps in UGME requires structured education, standardized assessments, and faculty development. Future research should explore longitudinal impacts, cross-cultural comparisons, and artificial intelligence-driven training models to enhance leadership education globally.
INTRODUCTION: The type of foot and its anthropometric measurements are crucial in designing footwear for the entire population. However, in India, the foot type is often overlooked during the footwear design process, leading to fitment issues among users. This study aims to identify the foot types of school-going children in North India. A pilot study was conducted to measure and analyze the anthropometry of the feet using a 3D foot scanner. Three hundred and sixty-nine participants were involved in the study, comprising 222 boys and 147 girls. Variations in foot type and anthropometric features were observed within the studied population. Existing published data on foot types in Indian school-going children and adults are limited. The findings of this study reveal that the Egyptian foot type is the most prevalent, accounting for 84% of the population. These observations will be valuable for human factors professionals, industry experts, and footwear designers, as they emphasize the importance of considering foot type and its anthropometric dimensions during the early stages of the design process to create better footwear and related tools, such as footwear lasts. CONTEXT: Experimental. AIMS: This study aims to identify the different foot types among school-going children in North India. A pilot study was conducted to measure and analyze the foot anthropometry and types using a 3D foot scanner. SETTINGS AND DESIGN: The study was conducted in a laboratory setting at the Center of Excellence at the Footwear Design and Development Institute in India. All participants had no prior history of foot or other health problems. Before data collection, the study’s objectives and procedures for measuring feet were clearly explained to each participant. The experiments were conducted following the Helsinki Protocol (1964–2013) and received ethical clearance (HMC/IEC/FDDI/01). All ethical protocols were strictly adhered to during the experiments involving participants. SUBJECTS AND METHODS: In this study, a total of 369 school-aged children from North India participated, including 222 boys and 147 girls. None of the participants had a history of foot issues or any other health problems. Details about the participants are presented in Table 1. The study’s objectives and procedures for measuring feet were clearly explained to each participant before data collection. Experiments were conducted following the Helsinki Protocol (1964–2013) and received ethical clearance (HMC/IEC/FDDI/01). Participant information, such as name, age, and gender, was collected; however, this information was kept anonymous and not shared with anyone, as explained to each participant. The anthropometric measurement of feet was conducted using a 3D Foot Scanner® from Shenzhen 3-DOE Technology Co., Ltd., China, which provides high measuring precision with a standard error of <0.5 mm. The instrument measured various parameters, including length, width, breadth, and toe type, with an error margin of <0.5 mm. Each participant was asked to stand on the 3D Foot Scanner® steadily, and both foot measurements were taken with great care, as illustrated in Figure 1. Measurements for each participant’s feet (left and right) were conducted separately. Initially, the left foot was placed on the 3D scanner for measurement, followed by the right foot, as shown in Figure 1. STATISTICAL ANALYSIS USED: The collected data were further analyzed using a Minitab® with version 21.1.0; the data were divided into different types of feet, male and female, foot length, and width, as shown in Tables 2-4. RESULTS: The results of the present study are presented in Tables 2-4. Both feet of the participants were measured using a 3D Foot Scanner® from Shenzhen 3-DOE Technology Co., Ltd., China. Table 2 displays the identified foot types among school-going children in the North Indian population (n = 369). The results indicate that the Egyptian foot type is the most prevalent, with a total of 620 occurrences, followed by the square foot type (60), Roman foot type (30), and Greek foot type (28). The study findings reveal that the highest number of Egyptian left feet was found in boys (186), while the count for girls (58) was lower than that of boys. Similarly, for the Egyptian right foot, boys had 185 occurrences compared to 64 for girls, which is also less than the boys. Additionally, girls exhibited a lower count of Greek right feet (2) compared to boys. For the square left foot, boys had 14 occurrences, while girls had 8, indicating a similar trend in the case of the Greek right foot. Finally, for the Roman left foot, girls had 3 occurrences, which is less than the boys, and in the Roman right foot, girls had 5 occurrences, also lower than the boys. The percentage distribution between foot types is illustrated in Table 3. In a study of North Indian school-going children, it was found that 84% have an Egyptian foot type. Among these, 25.2% of boys have an Egyptian left foot, compared to 17.34% of girls, resulting in a percentage difference of 7.86% between boys and girls. For the right foot, 25.06% of boys and 16.39% of girls have an Egyptian foot, showing a percentage difference of 8.67%. The second most common foot type among these children is the Roman foot, which was found in 8.12% of cases. This includes 2.98% of boys and 1.08% of girls with a Roman left foot, resulting in a percentage change of 1.9%. On the right side, 2.57% of boys and 1.49% of girls have a Roman foot, reflecting a percentage change of 1.08%. The third most prevalent foot type is the square foot, present in 8.12% of the children. This includes 1.08% of boys and 0.67% of girls with a square left foot, showing a percentage change of 0.41%. For the right side, 1.49% of boys and 0.81% of girls have a square foot, with a percentage change of 0.68%. Finally, the Greek foot type was identified, found in 3.77% of children. On the left side, it appears in 0.81% of boys and 0.81% of girls, resulting in no percentage change. On the right side, 0.94% of boys and 1.21% of girls have a Greek foot, showing a percentage change of 0.27%. The mean ± standard deviation values for the length and width of the left and right feet (n = 369) were measured, as shown in Table 4. The results indicate that the Egyptian foot has the highest measurements for both length and width, followed by the Greek, Square, and Roman foot types. The percentage differences between the left and right feet are as follows: for the Egyptian foot, the length difference is 0.53% and the width difference is 0.02%; for the Roman foot, both the length and width differences are 0%; for the square foot, the length difference is 2.27% and the width difference is 2.65%; and for the Greek foot, the length difference is 3.39% and the width difference is 3.27%. CONCLUSIONS: The objective of this pilot study is to measure the feet of North Indian school-going children using high-precision measuring techniques and a standardized 3D scanner to understand foot types. Our results indicate that among North Indian school-going children, peasant feet, Germanic feet, Celtic feet, stretched feet, and simian feet were not observed. The study findings reveal that the Egyptian foot type is the most common among these children, with a total of 369 instances (186 boys and 183 girls), representing 84% of the population studied. Specifically, the distribution is as follows: 25.2% of boys and 17.34% of girls exhibited the Egyptian foot type in the left foot, while 25.06% of boys and 16.39% of girls exhibited it in the right foot. Additionally, the following measurements for the Egyptian foot type were recorded: The average length is 231.16 mm for the left foot and 230.63 mm for the right foot. The average width is 87.69 mm for the left foot and 87.94 mm for the right foot. This study mainly focused on a sample of 369 North Indian school-going children, while participants from the south, east, and northeast regions were not included. For a more comprehensive understanding of foot types and anthropometry, future research should involve larger sample sizes and consider participants from these other regions. This is essential for designing footwear that caters to the diverse population of Indian schoolchildren. Currently, there is limited published data on foot types in Indian school-going children and adults, which hampers our understanding. Most existing studies on anthropometry and foot types rely on traditional methods, which may lead to human factors issues, foot pain, chronic discomfort, and balance problems when using footwear. Therefore, it is crucial to consider foot types and their anthropometric measurements early in the footwear design process to prevent fitness issues, injuries, and related human factors problems. The data we have gathered will serve as a reference for designers when creating footwear specifically for the North Indian school-age population.
INTRODUCTION: Malnutrition, in every form, presents a significant threat to human health. Even with the services provided, malnutrition still remains as one of the major problems and needs to be reconsidered to tackle with innovative methods. OBJECTIVES: The objective is to determine the prevalence of malnutrition among preschool children and to assess the effectiveness of “health mix” intervention in reducing malnutrition. METHODOLOGY: This was a nonrandomized, interventional study conducted on preschool children (3–6 years) attending selected Anganwadi centers from March 2022 to February 2023. All the preschool children attending Anganwadi centers belonging to the rural field practice area were screened for malnutrition and assessed for malnutrition using the WHO growth charts. “Health mix” was provided as an intervention to the malnourished children and followed up to 6 months. Health education about low-cost energy dense foods and health foods was provided to all the mothers at each visit. RESULTS: The prevalence of the malnourished children was 119 (41.3%), where 3% of the children belonged to mild category, 32% to moderate category, and 6% to severe malnutrition. The mean preintervention weight of the children was 13.81 kg, and after intervention increased to 15.41 kg and 15.89 kg, respectively, at 3rd and 6th month, respectively, which was found to be statistically significant. CONCLUSION: The prevalence of the malnourished children was 41.3%. With the “health mix” intervention done in the present study, it was found that there was a significant improvement in the weight gain.
Nasopharyngeal carcinoma is common nasopharyngeal malignancies accounting to 98%. The majority deaths of NPC patients are attributed to local recurrence and distant metastases. Most common variant is undifferentiated squamous cell carcinomas with a high tendency to invade adjacent tissues and metastasize to regional lymph nodes at an early stage. Tumors of the parapharyngeal space are uncommon, comprising less than 1% of all head and neck neoplasms and NPC might present rarely as parapharynegeal mass. Here is case of 38yr male with complaints of throat pain and swelling on left side for 1 month. CT scan suggested a prevertebral peripheral sheath tumor suggestive of schwanomma with lymphnode enlargement. On cytology high grade malignancy was considered and cellblock was prepared and IHC performed which confirmed Nasopharyngeal carcinoma (NPC) with epithelial mesenchymal transition. Diagnosis of NPC with EMT (especially nuclear vimentin and cytoplasmic E-cadherin) is important in the progression and clinical outcome as it has significant effects on the targeted therapy.
