Publications

INTRODUCTION: At present, there are many significant gaps in understanding the clinical needs of Indian women with allergic rhinitis. To address a critical gap in clinical practice, the consensus group created an innovative questionnaire tailored to assist Indian clinicians in the diagnosis and management of allergic rhinitis among female patients.

METHODS: The modified Delphi survey utilized a systematic approach to group communication in addressing research questions and resolving conflicting viewpoints through detailed evaluation of various arguments. In total, 80 statements were developed focusing on disease burden, risk factors, clinical presentation, comorbidities, symptoms, and treatment of allergic rhinitis.

RESULTS: Out of 61 statements reviewed by the expert panel, around 38 statements received over 80% agreement, leading to a consensus.

CONCLUSION: Allergic conditions are more common among Indian women, impacting them disproportionately. A high level of consensus indicates that many Indian women spend most of their time indoors, which can result in heightened exposure to indoor allergens and pollutants, consequently increasing their vulnerability to allergies. The experts also offered real-world clinical recommendations while assessing and managing modifiable and nonmodifiable allergens in Indian women with allergic rhinitis.

It is not a rare occurrence where a patient who has been declared dead in the hospital comes alive either during transport back home or while performing the last rites. But in recent times we are witnessing a steady rise in such incidences.1-4 Though it is a global phenomenon, in our country it has brought a lot of negativity and adverse publicity against medical professionals and hospitals. These incidences are casting serious doubt in the minds of the public about the ability and knowledge of medical professionals in declaring someone dead and have eroded the public trust in doctors. On many occasions it is being perceived as serious negligence or total irresponsibility on the part of a medical professional. A patient who has been declared dead but comes alive could put medical professionals under serious mental stress with long-lasting emotional trauma as well. Beyond the medical realm, such cases raise legal and ethical dilemmas. Families go through unnecessary mental trauma, funeral services are disrupted, and, in some cases, patients wake up in morgues or coffins-an unimaginable horror. In India we have neither any data on such occurrences nor a well-accepted protocol or guidelines for the determination and declaration of death. While cases of the "dead" coming back to life remain rare, they highlight the gaps in medical practices that need urgent attention, and there is a pressing need for a foolproof protocol for pronouncement of death that is acceptable legally and medically and with a pan-India application.

Despite a number of issues in its collation, the dataset published by Oswalt et al. (1976) remains a key resource for operationalising cross-cultural technological variability and understanding the socioecological drivers of cultural change in small-scale societies. At the same time, however, it has not been comprehensively explored using up-to-date contextual metrics of subsistence, climate, and demographic structure in each population. In this paper, we present a novel evolutionary framework for understanding technological change in both modern and past populations, according to the complex fitness landscapes of cultural evolution present in different environments. We then use this framework as a lens to explore the drivers of toolkit composition and complexity among hunter-gatherer populations to assess how they relate to the adoption of particular behavioural strategies. We suggest a hierarchy of interlinked influences on the nature of technology: resource distributions exert the most proximate influence on their character, but demography (especially the size of seasonally-aggregated groups) and climate (especially seasonality and inter-annual predictability) are themselves critical in constraining technological possibilities. Finally, we argue that landscape knowledge is crucial in driving access over time to the highest-return technological strategies that are possible in any given environmental context.

Modern medicine, especially oncology in low- and middle-income countries (LMICs), requires clinicians to remain updated in a rapidly evolving field of medicine in the face of a high clinical load. Clinicians need to be able to critically evaluate published evidence and make informed decisions about the individual patients they treat. A clinical culture that encourages clinicians to question and think critically would produce high-quality research from parts of the world that have highest disease burden but lowest contribution to published research. A two-day research methods course was conducted jointly by the Tata Medical Center, Kolkata and the West Bengal Chapter of the Indian Psychiatric Society on 22nd-23rd August 2025. We report on our experience of organising this course and the lessons learned from interacting with the audience in an LMIC setting. Live anonymous participant responses were captured using Mentimeter software during the training, and written anonymous feedback were provided by majority of attendees. The three main barriers to conducting research that our participants reported were: 'lack of training in research', 'difficulties in writing a research paper' and the 'researcher's personal circumstances'. The participants in our course comprised both men and women clinicians, mostly in their early careers and this group of learners appreciated hands-on training on literature search, reference management and working with the SPSS statistical software to conduct standard statistical tests. To achieve this, institutions and individuals need to foster a conducive environment for research, inspiring those who will be responsible for the future health care delivery.

INTRODUCTION: Tata Memorial Centre (TMC) in collaboration with Bhaktashreshtha Kamalakarpant Laxman Walawalkar Hospital (BKLWH), Dervan, a rural cancer hospital in Ratnagiri, started a population-based cancer registry (PBCR) in Ratnagiri district, Maharashtra, India in February 2009. Testicular cancer survival is a less-explored area of oncology research. This paper aims to present the 10-year survival of testicular cancer patients in Ratnagiri district for the years 2009-2018.

METHODS: The registry follows an active method of case registration. Major sources of the cancer registry are TMC and BKLWH. Data quality control was conducted by TMC, Mumbai. Follow-up was performed by house and village visits/phone calls by registry staff. For survival analysis, the date of diagnosis was the starting date, and the last follow-up date was 31 December 2023. The 5-year and 10-year overall survival was calculated using the Kaplan-Meier method and relative survival (RS) by the Pohar Perme method.

RESULTS: A total of 43 testicular cancer cases were registered in Ratnagiri PBCR, with incidence and mortality rates of 0.6 and 0.2 per 100,000 population. The 10-year RS of testicular cancer was 63.3% (95% confidence interval: 45.4-76.7). Survival was 100% for localised cases. Other prognostic factors were age at diagnosis (<40 years), histology (seminoma), 'surgery' as a treatment modality and 'completed' treatment status.

CONCLUSION: Good health infrastructure and linkage of rural hospitals with the tertiary cancer centre play a pivotal role in improved testicular cancer outcomes. Continued efforts in research and education for health professionals serving as the first point of contact for the population will be essential to enhance testicular management in India.

Water pollution represents a major global health concern, especially in low- and middle-income countries where toxic metals (TMs) and pesticides can contaminate drinking water through industrial, agricultural and urban activities. Children are particularly susceptible due to their developing physiology and higher water intake relative to body weight. This review aims to explore the association between exposure to TMs and pesticides in drinking water and the risk of childhood leukaemia (CL), highlighting the broader significance for environmental health and child safety. A structured search in PubMed, Scopus and Google Scholar (2001-2024) identified studies on acute lymphoblastic leukaemia or acute myeloid leukaemia in individuals under 20 years of age, assessing exposure to trace metals or pesticides via drinking water. Observational designs were included, excluding studies unrelated to water exposure or lacking paediatric data. Records were screened and reviewed independently by four authors. Findings were heterogeneous, with several studies suggesting potential links between specific contaminants like arsenic, hexavalent chromium, pentachlorophenol and certain pesticides and an increased risk of leukaemia in children, while others found no significant associations and noted methodological challenges such as small sample sizes and difficulties in exposure measurement. Although current evidence remains inconclusive regarding a direct causal relationship, this review underscores the need for rigorous, long-term research to clarify the role of waterborne pollutants in CL and to guide public health strategies.

Erich Fromm (1900-1980) was a sociologist, psychoanalyst and a social and human philosopher of German-Jewish origin who fled from Germany via Geneva to the United States of America in 1934. He became globally known as the author of the book The Art of Loving (Fromm, 1956) and stated that the only way to lead a sane and satisfying human existence is through love. This psychobiographical study aims to capture the theme of love throughout the life of Erich Fromm and within selected creative works. The research methodology used is qualitative in nature and applies a psychobiographical study approach. Psychobiographies explore the lives of extraordinary individuals through psychological theories. This study focuses on the life of Fromm as a single purposefully selected individual. Data was collected from literature search in the public domains and analysed through content analysis. The study used a five-step-content analysis process of familiarisation with the data, coding and categorisation, analysis, data reconstruction and presentation. Findings trace the development of the concept of love in the life and work of Fromm. Fromm viewed love as an "art" which needs to be learned, and requires discipline, focus, concentration and patience. It is an active skill that needs effort and understanding. Different forms of love exist, such as the love of God, the love within family (motherly love, brotherly love), love in love relationships (erotic love) and the love for the self (self-love). The four core aspects of love are care, responsibility, respect and knowledge. In this article, we draw selected conclusions on how Fromm's concept of love may have grown from his lived experience. These findings and conclusions might deserve more detailed analyses in future research.

This study examined motion segmentation and spatial suppression of motion in central versus peripheral vision, their relationship, and whether scaling peripheral stimuli to match larger middle temporal receptive fields reduces eccentricity effects. Ten adults (mean 27.5 years) completed motion segmentation and motion discrimination tasks across five contrast levels (12%-92%), three eccentricities (0°, 10°, 20°), and two stimulus conditions (scaled, unscaled). In the segmentation task, participants identified the tilt of a motion-defined ellipse within an oppositely moving background; segmentation thresholds were minimum stimulus exposure duration required for accurate tilt discrimination. Participants also judged motion direction of the ellipse in isolation. Segmentation efficiency was the log10 threshold difference between ellipse motion and segmentation thresholds. The motion discrimination task involved identifying the motion direction of the moving background patch in isolation, with a suppression index calculated as the log10 threshold difference between highest and lowest contrasts. In the unscaled condition, eccentricity reduced segmentation efficiency (p < 0.01) and suppression index (p = 0.003), with a significant interaction among suppression, segmentation, and eccentricity (p < 0.001). Correlations between segmentation efficiency and suppression index weakened with eccentricity (Pearson's r = 0.81, p = 0.003 at 0°, r = 0.69, p = 0.26 at 10°, r = 0.48, p = 0.16). Scaling improved segmentation efficiency (p = 0.003) and suppression index (p = 0.043) but did not remove eccentricity effects. Thus our ability to segment moving foreground objects declines with eccentricity, even when accounting for receptive field scaling.

Perturbations to visual feedback disrupt one's ability to use vision to guide movement, leading to disrupted visuomotor control. The visuomotor adaptation mechanism recovers control by updating the visuomotor mapping to accommodate the visual perturbation during movement. A hallmark of adaptation is savings, where individuals demonstrate faster adaptation upon subsequent exposure to the same perturbation. Although faster adaptation to a previously experienced delay has been observed in response to constant visual feedback delays in two-dimensional tracking tasks, they have not been investigated in ecologically relevant contexts where individuals perform more complex visuomotor control tasks with varying delays. Previously, delay variability has been shown to significantly impair performance within these tasks, but it remains unclear how delay variability will impact adaptation and savings. Therefore, we investigated adaptation to constant and varying delays in a driving simulator over four sessions spaced 7 days apart. Across these sessions, participants exhibited savings, reflected in reduced average absolute spatial error, a shift in the average directional road position toward the middle of the road (instructed position), and flatter learning slopes, indicating a faster approach to asymptote. Crucially, there were no significant differences between the constant and varying delay conditions in any measure. Therefore, participants adapted to the delayed visual feedback with increased efficiency upon subsequent exposure to the same temporal perturbation. Additionally, delay variability did not disrupt adaptation or savings within the driving simulator task.

Objects in scenes follow a hierarchical organization, with "scenes" at the top level, followed by "phrases", clusters of objects that share spatial and functional proximity. Within these phrases, "anchor" objects help predict the identity and location of smaller, dependent "local" objects. Previous research has shown that this hierarchy is reflected in the mental representations of objects in adults. The current study examined whether children's object representations already reflect this hierarchy. We implemented an odd-one-out task with 36 object images to collect pairwise similarity ratings from children ages 5 to 10 years. Two different groups of children received different similarity judgment instructions: One group received no explicit definition of similarity, but the other was told to base similarity on actions typically performed with the objects. We created a priori and data-driven scene hierarchy measures to evaluate how well they aligned with children's similarity judgments. Results showed that children's representations were clearly structured at the scene level, as indicated by strong effects in both hierarchy measures. In contrast, we found no reliable phrase-level effects and only a small data-driven object-type effect. Scene-level structure strengthened with age, whereas phrase- and object-type levels showed no reliable age-related change. Importantly, similarity patterns were highly comparable across both tasks, suggesting that children's object representations by default seem to be action based. These results suggest that children organize objects along the scene level of the hierarchy incorporating actions related to the objects in their representations, whereas finer-grained relations are more weakly represented and may be more difficult to detect reliably at this age.