This study systematically examined the multifaceted dimensions of the posttransplantation experiences of Indian kidney recipients through a meticulous narrative analysis of clinical interview data sourced from 111 male and 28 female recipients. The mean age of recipients was 39.63 ± 11.61 years, while donors exhibited a mean age of 48.68 ± 11.81 years. A predominant 33.8% of all donors were identified as maternal contributors. A central thematic construct, "fear of graft rejection," emerged from the data. Subsequently, five subordinate themes were discerned: (i) Maintenance immunosuppressants and disease vulnerability, (ii) Translating gaze as nazar (evil eye), (iii) Decisions within families, donations by women, and (iv) Graft as a gift of life. This comprehensive elucidation of the recipients' perspectives augments the scholarly comprehension of the intricate challenges and decision-making processes inherent in the landscape of Indian kidney transplantation, characterized by a preponderance of living donations within familial networks.

Background: Stunting is an important predictor of growth and development of children under 5 years of age, and it remains the significant problem in LMIC. However, LBW emerges as risk factor, but its association with LMIC needs attention. Objective: This systematic review and meta-analysis aimed to investigate the association of low birth weight with the risk of childhood stunting among the age group of 0–5 years in LMICs. Methods: PubMed, Google Scholar, MEDLINE, Embase, and Web of Science databases were searched from January 1, 2010 untill December 20, 2021. Cross-sectional, cohort, and case-control study designs were included in the meta-analyses. The pooled odds ratio with a 95% confidence interval was reported considering the random-effects and the quality-effects models. The subgroup analysis and meta-regression were conducted for study design, geographical location, and sample size. Results: Low birth weight was associated with >2-fold increased risk of childhood stunting (pooled OR: 2.32; 95% CI, 2.05–2.62). Asian studies have shown relatively higher risk than African studies in stratified analyses. The cohort studies predicted a higher risk of childhood stunting, followed by case-control and cross-sectional study designs, and the sample size stratification showed that studies with sample size <1,000 predicted much higher risk than relatively to the studies with sample size >1,000. The meta-regression was performed in all three subgroups, but none of the models appeared significant. Conclusion: This meta-analysis confirmed the association of low birth weight with the higher risk of childhood stunting among the 0–5 years’ age group and suggests a moderately higher risk in Asia as compared to Africa.

Introduction:Hypertension (HTN), the third risk factor driving death and disability as per Global Burden of Disease 2019, is a major public health concern. Prehypertension, the intermediate stage between HTN and normal blood pressure (BP), is associated with subclinical atherosclerosis and target-organ damage. Evaluating the prevalence of prehypertension is imperative to prevent disease progression. Prehypertension, alike HTN, is a complex disorder that manifests when genes are triggered by the environment. The current study attempts to evaluate the prevalence of prehypertension in a tribal population of Northern India. Further, the association with extensively studied renin-angiotensin system (RAS) pathway genes with prehypertension has been explored.Methods:A cross-sectional study was conducted on adults of 20-60 years old belonging to a tribal community, Rang Bhotia of Northern India. Information on demographic, lifestyle, and anthropometric risk factors was collected. The blood sample was collected for lipid and genetic analysis. DNA extraction and genotyping of five genetic markers of RAS-related pathway were performed. Chi-square and t-tests were used for assessing significant differences between the groups. Logistic regression was used to examine the association of genes with prehypertension and HTN.Results:Among 254 adults participating in the study, 39% and 42% had prehypertension and HTN, respectively. T allele of M235T genetic marker was found to be posing two-fold risk for prehypertension (odds ratio [OR] = 2.9; 95% confidence interval [CI] =1.10-7.72; P = 0.03 in dominant model and OR = 1.83; 95% CI = 1.09-3.09; P = 0.02 in additive model) after adjusting for age and sex. On the other hand, G allele of A6G polymorphism was found to be providing protection toward prehypertension (OR = 0.32; 95% CI = 0.11-0.92; P = 0.03 in recessive model and OR = 0.55; 95% CI = 0.32-0.94; P = 0.03 in additive model).Conclusion:More than one-third of individuals exhibited prehypertension, suggesting an impending burden of HTN and comorbidities among the tribal population in the near future. Moreover, increased genetic susceptibility toward elevated BP commands immediate attention. Effective management strategies including interventions on lifestyle, diet modification, and weight management need to be introduced to combat increasing HTN among the tribal population.

Background:This study aimed to investigate the prevalence of dental traits and anomalies in five North Indian populations (Khas Bodhi, Jaat, Khatri, Garhwali, and Gujjar) and predict the population of origin based on these traits and anomalies for forensic applications. Methods:We assessed dental traits and anomalies in 454 individuals through intraoral examination. Neural network analysis was employed to predict the population of origin based on a combination of dental traits and anomalies. Results:Shovel-shaped incisors exhibited the highest prevalence among the studied traits and anomalies, occurring in 65.4% of the sample. Moreover, shovel-shaped incisors were found to be the most important predictor of population. Neural network analysis indicated that the most accurate population prediction among the studied populations was for the Garhwali origin, achieving a recall rate of 78.3%. While this may appear relatively low, it is crucial to emphasise that the proposed method serves as a corroborative tool for various forensic investigations. Conclusion:This study suggests that dental traits and anomalies can be valuable in predicting the population of origin within Indian populations for forensic purposes. The work enhances the forensic identification process by providing an additional layer of evidence for consideration in identifying both individuals and their ethnic backgrounds. Further research is necessary to enhance the robustness of prediction models.

Background The rollout of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines has significantly enhanced immunity against coronavirus disease 2019 (COVID-19), leading to a reduction in the severity of illness, hospitalizations, and deaths. While various side effects of the vaccine have been reported, its impact on the menstrual cycle remains unclear. Methods We conducted a cross-sectional study involving university students who had received either partial or full vaccination against SARS-CoV-2. Data was gathered through a questionnaire designed to assess the relationship between menstrual changes and the SARS-CoV-2 vaccination. Results A total of 773 participants, with a mean age of 20.6 ± 1.7 years, were included in this study. The participants reported a significant increase in the irregularity of the menstrual cycle. We observed a slight increase in the length of the menstrual cycle, from 30.0 ± 4.0 days (pre-vaccination) to 30.5 ± 5.6 days (post-vaccination), which was statistically significant (p<0.001). The duration of menstruation also increased, from 4.9 ± 1.7 days (pre-vaccination) to 5.0 ± 1.7 days (post-vaccination). However, this increase in menstrual length due to vaccination was not statistically significant (p = 0.898). Notably, there was a significant increase in pain reported by the participants after receiving the SARS-CoV-2 vaccine (p = 0.004). Conclusion The SARS-CoV-2 vaccination significantly impacted the regularity of the menstrual cycle, length of the menstrual cycle, and pain during menstruation, though temporarily. Our study found no significant differences in menstrual changes or the type of vaccine administered (Covishield and Covaxin).

Microscopic traits and ultrastructure of hair such as cross-sectional shape, pigmentation, curvature, and internal structure help determine the level of variations between and across human populations. Apart from cosmetics and anthropological applications, such as determining species, somatic origin (body area), and biogeographic ancestry, the evidential value of hair has increased with rapid progression in the area of forensic DNA phenotyping (FDP). Individuals differ in the features of their scalp hair (greying, shape, colour, balding, thickness, and density) and facial hair (eyebrow thickness, monobrow, and beard thickness) features. Scalp and facial hair characteristics are genetically controlled and lead to visible inter-individual variations within and among populations of various ethnic origins. Hence, these characteristics can be exploited and made more inclusive in FDP, thereby leading to more comprehensive, accurate, and robust prediction models for forensic purposes. The present article focuses on understanding the genetics of scalp and facial hair characteristics with the goal to develop a more inclusive approach to better understand hair biology by integrating hair microscopy with genetics for genotype-phenotype correlation research.

Low birth weight is one of the leading factors for infant morbidity and mortality. To a large extent affect, various maternal risk factors are associated with pregnancy outcomes by increasing odds of delivering an infant with low birth weight. Despite this association, understanding the maternal risk factors affecting term low birth weight has been a challenging task. To date, limited studies have been conducted in India that exert independent magnitude of these effects on term low birth weight. The aim of this review is to examine the current knowledge of maternal risk factors that contribute to term low birth weight in the Indian population. In order to identify the potentially relevant articles, an extensive literature search was conducted using PubMed, Goggle Scholar and IndMed databases (1993 – Dec 2020). Our results indi­cate that maternal age, educational status, socio-economic status, ethnicity, parity, pre-pregnancy weight, maternal stature, maternal body mass index, obstetric history, maternal anaemia, gestational weight gain, short pregnancy outcome, hypertension during pregnancy, infection, antepartum haemorrhage, tobacco consumption, maternal occupation, maternal psychological stress, alcohol consumption, antenatal care and mid-upper arm circumference have all independent effects on term low birth weight in the Indian pop­ulation. Further, we argue that exploration for various other dimensions of maternal factors and underlying pathways can be useful for a better understanding of how it exerts independent association on term low birth weight in the Indian sub-continent.

The Pliocene was a period of major faunal shift in India as older primate lineages slowly went extinct, leaving the niches vacant for cercopithecoids, specifically cercopithecids (Old World monkeys), to occupy. Among them, Presbytis sivalensis, Macaca palaeindica and Procynocephalus subhimalayanus are important, as they are potential kin to many of the South Asian and Southeast Asian monkeys living today. Further in the Pleistocene, as ecology shifted to a more grassland environment, primates such as Theropithecus delsoni and the first people of Homo sp. migrated into the subcontinent and occupied central India. All of these primate fossils are known only from a handful of fragmentary fossil remains. This article aims to discuss the discovery of fossils and the nature of these fossils from the Pliocene and the Pleistocene. Information regarding the phylogenetic affinities of these fossil primates is sporadic as well. There is a need to learn more about these primates by reanalysing existing discoveries and conducting further research into the lives of these primates of a bygone era. Such research, using modern tools and methods, will surely make significant contributions to palaeoanthropology.

Background More than 250 loci have been identified by genome-wide scans for type 2 diabetes in different populations. South Asians have a very different manifestation of the diseases and hence role of these loci need to be investigated among Indians with huge burden of cardio-metabolic disorders. Thus the present study aims to validate the recently identified GWAS loci in an endogamous caste population in North India. Methods 219 T2D cases and 184 controls were recruited from hospitals and genotyped for 15 GWAS loci of T2D. Regression models adjusted for covariates were run to examine the association for T2D and fasting glucose levels. Results We validated three variants for T2D namely, rs11634397 at ZFAND6 (OR = 3.05, 95%CI = 1.02-9.19, p = 0.047) and rs8042680 at PRC1 (OR = 3.67, 95%CI = 1.13-11.93, p = 0.031) showing higher risk and rs6813195 at TMEM154 (OR = 0.28, 95%CI = 0.09-0.90, p = 0.033) showing protective effect. The combined risk of 9 directionally consistent variants was also found to be significantly associated with T2D (OR = 1.91, 95%CI = 1.18-3.08, p = 0.008). One variant rs10842994 at KLHDC5 was validated for 9.15mg/dl decreased fasting glucose levels (SE = -17.25-1.05, p = 0.027). Conclusion We confirm the role of ZFAND6, PRC1 and TMEM154 in the pathophysiology of type 2 diabetes among Indians. More efforts are needed with larger sample sizes to validate the diabetes GWAS loci in South Asian populations for wider applicability.

AbstractBackgroundAnemia is a deficiency of red blood cells and a public health burden in India. There needs to be more reporting of the prevalence of this condition in adults consisting of both males and females in a rural setting. Hence, this study is undertaken to address this gap.Materials and methods1460 participants were recruited during a household survey in the Churachandpur district of Manipur. Data on personal, social demographic, and lifestyle variables were collected along with anthropometric measurements. Anemia status was tested with the help of a standardized portable hemoglobinometer.ResultsThe prevalence of anemia was 42% and 46.4% among Kuki and Paite tribal communities of Manipur, respectively, which is significant within the communities. Type of occupation and lifestyle factors were also found to contribute to anemia. Age was also found to be inversely proportional to the prevalence of anemia.ConclusionThe present study found a high prevalence of anemia and malnutrition, a matter of concern. The studied population, the tribals, are the deprived section of society that needs to be taken care of to achieve the United Nations Sustainable Developmental Goals (SDGs). They stay in remote areas which are not easily accessible, and hence they should be prioritized in terms of health and various other developments. Also, this high prevalence of anemia can lead to various health complications like cardiovascular diseases if not treated. Iron supplements should act as an intervention for the high prevalence of anemia and should be delivered timely to vulnerable populations.

Monitoring graft health and detecting graft rejection is crucial for the success of post-transplantation outcomes. In Western countries, the use of donor-derived cell-free DNA (dd-cfDNA) has gained widespread recognition as a diagnostic tool for kidney transplant recipients. However, the role of dd-cfDNA among the Indian population remains unexplored. The recipients were categorized into two groups: the post-transplant recipient (PTR) group (n = 16) and the random recipient (RR) group (n = 87). Blood samples were collected daily from the PTR group over a 7-day period, whereas the RR group’s samples were obtained at varying intervals. In this study, we used a targeted approach to identify dd-cfDNA, which eliminated the need for genotyping, and is based on the minor allele frequency of SNP assays. In the PTR group, elevated dd-cfDNA% levels were observed immediately after transplantation, but returned to normal levels within five days. Within the RR group, heightened serum creatinine levels were directly proportional to increased dd-cfDNA%. Sixteen recipients were advised to undergo biopsy due to elevated serum creatinine and other pathological markers. Among these sixteen recipients, six experienced antibody-mediated rejection (ABMR), two exhibited graft dysfunctions, two had active graft injury, and six (37.5%) recipients showed no rejection (NR). In cases of biopsy-proven ABMR and NR, recipients displayed a mean ± SD dd-cfDNA% of 2.80 ± 1.77 and 0.30 ± 0.35, respectively. This study found that the selected SNP assays exhibit a high proficiency in identifying donor DNA. This study also supports the use of dd-cfDNA as a routine diagnostic test for kidney transplant recipients, along with biopsies and serum creatinine, to attain better graft monitoring.

BackgroundInfertility is a very distressing condition. It is often associated with long-term stress, which can emerge as anxiety and depression. AimTo understand the effect of socio-demographic variables, reproductive trajectories, and lifestyle variables on stress, depression, and anxiety independently and to understand the relationship of psychological variables with each other among infertile and fertile women. MethodsThis cross-sectional study recruited 500 women which included 250 primary infertile cases and 250 age-matched fertile controls of the age group 22-35 years. A pretested modified interview schedule was administered which included demographic variables, lifestyle variables, and reproductive trajectories. In addition, psychological tools like PSS, GAD-7, and PHQ-9 were used to collect the data pertaining to Stress, anxiety, and depression, respectively. Data analysis was performed with the statistical software version SPSS, IBM version 24. ResultsInfertile women are more prone to various psychological disorder (stress, anxiety and depression). None of the demographic and lifestyle variables were associated with stress, anxiety, and depression among infertile women. Only reproductive trajectories were found to be causing stress, anxiety, and depression respectively among infertile women. In addition, stress is leading to both anxiety and depression among infertile women but only to depression in fertile women. ConclusionInfertile women should be counselled by medical experts regarding reproductive trajectories. Infertile couples should be guided and counselled to incorporate mental health screening and treatment in their routine check-up.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global healthcare crisis. Kidney transplant (KTx) patients and the patients with chronic kidney disease are two of the most vulnerable populations to the risks of coronavirus disease 2019 (COVID-19). A systematic literature search on PubMed and Web of Science was conducted. We analyzed published case reports, case series and articles on COVID-19’s clinical presentation, management, outcomes and vaccination among kidney transplant recipients. A total of 33 studies were included in the study, which included 1676 KTx recipients and 108 waiting list patients infected with COVID-19. These studies reported the clinical presentation, management and immunosuppressive adjustment among the KTx recipients. The remaining studies focused on other aspects, such as vaccination and transplantation, during the COVID-19 pandemic. Mortality due to COVID-19 was observed to be the highest for KTx recipients, followed by patients on hemodialysis, and lowest in the general population. There is no definitive treatment of COVID-19 yet, and managing transplant patients is enigmatic of this: the treatment is based on symptom management. There is an urgent need for guidelines on managing kidney transplant recipients and immunosuppressive adjustments for the course of COVID-19 treatment.

Context: According to various epidemiological studies, the aetiology of recurrent miscarriages (RMs) is multifactorial. The goal of this study is to learn more about the link between genetic polymorphisms and RM. Aim: To evaluate the association of 5-Methytetrahydrofolate-Homocysteine Methyltransferase (MTR) A2756G, 5-Methytetrahydrofolate-Homocysteine Methyltransferase Reductase (MTRR) A66G and cystathionine beta-synthase (CBS) 844INS68 genetic polymorphisms with RM and also to understand the combined effect of the selected genotypes. Setting and Design: This was a hospital-based, case–control, observational study. Materials and Methods: A total of 516 participants were recruited in the present study, of which 200 RM cases and 258 controls were included in the present study. Fasting blood sample (~5ml) was drawn from all the participants and were screened for genetic polymorphisms of MTR A2756G, MTRR A66G and CBS 844INS68. Statistical Analysis Used: The frequency, odd's ratio and Hardy-Weinberg equilibrium were evaluated. SPSS (version 21.0) was used for the data analysis. Results: MTR A2756G genetic polymorphism was not associated with the risk of RM. The ancestral allele of MTRR A66G and the mutant allele of CBS 844INS68 was causing an increased risk of more than two folds for RM. CBS 844INS68 in combination with MTR A2756G was found to pose an increased risk of more than two folds for RM. Conclusion: Genetic polymorphisms particularly MTRR A66G and CBS 844INS68 seems to be elevating the risk and hence making women susceptible for RM.

OBJECTIVE:Systematic review and meta-analysis conducted to investigate the effect of stratified pre-pregnancy maternal body mass index on twenty maternal and fetal/neonatal adverse outcomes. METHODS:PubMed, Google Scholar, Medline, Embase, Web of Science databases were searched from inception till July 11, 2020. Cohort studies were included. The pooled odds ratio with 95% confidence interval was reported considering the random effect and the quality effect model. The sub-group analysis and meta-regression were conducted for BMI cut-offs, geographical region, source of BMI, and sample size. RESULTS:Overall, 86 studies representing 20,328,777 pregnant women were included in this meta-analysis. Our study reveals that overweight and obese mothers are at increased odds of cesarean delivery, elective cesarean delivery, emergency cesarean delivery, gestational diabetes, gestational hypertension, induction of labor, postpartum hemorrhage, pre-eclampsia, pre-term premature rupture of membrane, and the fetuses/neonates of overweight and obese mothers are at increased risk of admission in the newborn intensive care unit, APGAR scores less than 7 at 5 min, large for gestational age, macrosomia, extreme pre-term birth in pregnant mothers compared with standard BMI mothers. However, the underweight mothers showed increased odds for small for gestational age infant and pre-term birth, whereas obese mothers were at higher risk for post-term birth and stillbirths. The subgroup and meta-regression analyses have shown the impact of BMI cut-offs, geographical region, source of BMI, and sample size on several maternal, fetal/neonatal adverse outcomes. CONCLUSION:The meta-analysis confirmed the association of elevated pre-pregnancy maternal BMI with higher odds of adverse maternal and fetal/neonatal outcomes.

Dogs being most commonly present around humans means that their hair has become an important aspect among trace evidence that can be used as associative evidence in the court of law. They can serve as corroborating evidence as well as help in forensic investigations and trials. The morphological and morpho-metrical differences among hair are useful in differentiating dog breeds. This paper attempts to study the features that can aid in individualization as well as the identification of different dog breeds and help in future explorations. Micro-metric measurements and structure of shaft, medulla, and cuticle of hair may vary among different breeds of dogs (Canis familiaris). Hair samples were randomly collected from 42 dogs of different breeds. Examination of cuticle pattern was done by preparing hair casts and indices were calculated using micro-metric standards. Morphological characteristics were examined under stereomicroscope and light microscope for evaluating shaft diameter, medulla diameter, cuticle scale length, medulla patterns, cuticle patterns, and margins. The results of this study indicate that microscopic features can be used to distinguish different breeds of dogs whereas micro-metric values do not show remarkable distinctions. A rare condition - ‘split end’ was seen in Dachshund dog breed. Therefore, we can conclude that there are differences among dog hair if microscopic features can be observed and indices could be used for the forensic identification process, and these findings may contribute to discriminating among dog breeds based on preliminary hair examination.

Donor-derived cell-free DNA (dd-cfDNA) is a non-invasive biomarker that is more sensitive and specific towards diagnosing any graft injury or rejection. Due to its applicability over all transplanted organs irrespective of age, sex, race, ethnicity, and the non-requirement of a donor sample, it emerges as a new gold standard for graft health and rejection monitoring. Published research articles describing the role and efficiency of dd-cfDNA were identified and scrutinized to acquire a brief understanding of the history, evolution, emergence, role, efficiency, and applicability of dd-cfDNA in the field of transplantation. The dd-cfDNA can be quantified using quantitative PCR, next-generation sequencing, and droplet digital PCR, and there is a commendatory outcome in terms of diagnosing graft injury and monitoring graft health. The increased levels of dd-cfDNA can diagnose the rejection prior to any other presently used biochemistry or immunological assay methods. Biopsies are performed when these tests show any signs of injury and/or rejection. Therefore, by the time these tests predict and show any unusual or improper activity of the graft, the graft is already damaged by almost 50%. This review elucidates the evolution, physiology, techniques, limitations, and prospects of dd-cfDNA as a biomarker for post-transplant graft damage and rejection.

OBJECTIVE:Studies on One Carbon Metabolism (OCM), Interleukins-10 &-17 (IL-10/-17) & βhCG in pre-eclampsia and its delivery outcome (preterm birth) reveal contradictory results, attributed to clinical heterogeneity (early/late onset pre-eclampsia) or preterm/term birth. Disturbed OCM also influences IL-10 &-17 during pregnancy. We sought to investigate the synergism between OCM and IL-10/-17 mediated immune-regulation through βhCG in Early onset pre-eclampsia (EO-PE) patients, delivering preterm, among North Indian women. STUDY DESIGN:Case-control study with a total of 399 pregnant women (EO-PE delivering preterm = 199; Normotensives delivering at term = 200). Maternal genotypes & biochemical estimations along with fetal genotypes on subset (n = 72) pertaining to OCM and IL-10/-17 regulation were assessed. MAIN OUTCOME MEASURES:Association of 1) maternal plasma levels with EO-PE 2) maternal and fetal genotypes with EO-PE. 3) Effect of Hyper-homocysteinemia (surrogate of disturbed OCM) on differential immune regulation (IL10,-17, βhCG) in EO-PE and mode of delivery. RESULTS:Hyper-homocysteinemia posed an increased risk of three folds for EO-PE. Both, folate and B12 deficiencies were associated with elevated homocysteine in EO-PE. Further, MTHFR 677TT homozygotes was present only in EO-PE indicating its detrimental role. However, maternal IL17-197AA genotype showed decreased risk for EO-PE. Furthermore, elevated maternal plasma IL-17 along with elevated IL-10 & βhCG were observed in EO-PE. Taken together, altered homocysteine metabolism was associated with high IL10 in EO-PE; and was more pronounced in spontaneous vaginal deliveries as compared to induced/caesarean section deliveries. CONCLUSIONS:We report homocysteine mediated IL-10 &17 dysregulation and its influence on mode of delivery in EO-PE, possibly through initiation of cervical ripening. Further, these could serve potential biomarkers of EO-PE & its delivery outcome among vulnerable populations with similar nutritional & genetic predispositions.

Central obesity and body fat distribution measured by waist circumference (WC) and waist hip ratio (WHR) are good predictors of cardio metabolic adversities independent of overall adiposity. There are substantial evidence that body fat distribution is controlled by genetic factors. Even after accounting for body mass index (BMI), individual variation in body fat distribution is heritable, with estimates ranging from 31-76%. Individuals genetically predisposed to store more fat in visceral depots are at higher risk of developing metabolic complications. Several linkage and genomewide association studies (GWAS) for measures of body fat distribution uncovered numerous loci harbouring genes potentially regulating body fat distribution. Additionally, genes with fat depot specific expression patterns (especially, subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT)) have provided plausible candidate genes involved in body fat regulation. Further, sexual dimorphism have revealed a remarkable heterogeneity in the genetic regulation of body fat distribution. More than hundred loci have been identified through GWAS, displaying more pronounced effect in females than males, suggesting that both sexes share potentially different biological architecture in traits related to body fat distribution. Moreover, the handful of genes identified by GWAS have been validated in different population groups. This article aims at reviewing the current knowledge of genomic basis of body fat distribution.