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Background: H/ACA small nucleolar ribonucleoproteins (snoRNP) form a complex with multiple proteins to accomplish the pseudouridylation of rRNA. The assembly of H/ACA small nucleolar ribonucleoproteins (snoRNP) is initiated by H/ACA ribonucleoprotein Assembly factor, that is, SHQ1. Mutations in SHQ1 have been reported to cause two disorders namely, dystonia-35 childhood onset (OMIM*619921) and neurodevelopmental disorder with seizures and dystonia (OMIM*619922), both of which are inherited in an autosomal recessive manner. Considering the high genetic and clinical diversity of SHQ1-related clinical features and the importance of SHQ1 in the assembly of the H/ACA snoRNP complex, it is important to take a systematic approach to delineate the genetic diagnosis and impact of mutations on protein structure and stability. Methods: Whole exome sequencing followed by Sanger validation was performed in an individual with the clinical features of neurodevelopmental disorder with seizures and dystonia (OMIM*619922). Protein modeling studies of all the reported SHQ1 variants to date were performed using freely available web servers Interactive Tree of Life, String, BioGrid, ShinyGO, DAVID, and Pathvix. Protein structures were visualized using Pymol. Results and Discussion: We identified compound heterozygous variants, one known frameshift deletion c. 828_831del, p.(Asp277Serfs*27) and the other novel missense variant c. 1157A>C, p.(Tyr386Ser) found in an individual with neurodevelopmental disorder, seizures, movement disorder, and hypomyelination leukodystrophy on neuroimaging. Protein-interactome studies identified potential genetic interactors that include GAR1, NAF1, TRUB1, UTP15, DKC1, NOP10, NPHOSPH 10, KRR1, NOP58, NOP56, FBL, RRP9, NHP2, RUVBL1, and RUVBL2. Ribosome biogenesis in eukaryotes, RNA polymerase, RNA transport, spliceosome, ribosome, cytosolic DNA-sensing pathway, DNA replication, mismatch repair, base excision repair, nucleotide excision repair, and basal transcription factors process were identified as the linked pathways with the prioritized genes. Conclusion: In conclusion, a sophisticated genotype and phenotype correlation followed by linking the genes to the key biological pathways opens new avenues to understand disease pathology and plan for therapeutic interventions. [ABSTRACT FROM AUTHOR]

Patients with head and neck cancer (HNC) have ongoing pain but Stellate ganglion block which is a sympatholytic block may be a viable therapy for treating it. The data were retrospectively collected from five histopathologically confirmed HNC patients who had completed chemotherapy and radiation doses. Stellate ganglion block was given to these patients and was subsequently monitored for 3 months to assess pain alleviation and overall satisfaction. Over a 3-month period, there was a decrease in the pain levels with a better quality of life so the stellate ganglion block can be a promising modality for reducing the pain of HNC. [ABSTRACT FROM AUTHOR]

Background: Ageing is a universal process. It is influenced by a person's genetic makeup, lifestyle, and environmental factors. Nutrition plays a significant role in modulation of ageing. In developing countries like India, the health and nutritional status of the elderly population is not satisfactory. Objectives: The current study was done to assess undernutrition amongst the elderly population and to find the various associations with sociodemographic factors and social determinants. Materials and Methods: This cross-sectional study was done from February 2023 to July 2023 in rural area of District Gautam Buddha Nagar, Uttar Pradesh. The elderly participants who were 60 years of age and more and who met the inclusion criteria were selected by simple random sampling technique for the study. Undernutrition was assessed by Mini Nutritional Assessment Tool (MNA). Result: Out of the total of 400 elderly persons, 18% were found to be undernourished and 38% were at risk of undernutrition. The association between undernutrition and age group, gender, occupation, family type, living arrangements that is staying with family or not, financial dependence, any co-morbid illness, smoking, and physical activity was found to be significant. Conclusion: The present findings reveal that undernutrition is not an uncommon problem in the elderly, and further studies are needed in this regard. [ABSTRACT FROM AUTHOR]

Background: Reproductive tract infections (RTIs) and gynaecological morbidities constitute a significant proportion of morbidities in women of the reproductive age group. Objective: To find out the proportion of reproductive age group women in an urban resettlement colony having the symptoms of gynaecological morbidities and RTI/sexually transmitted infection (STI) and to explore the healthcare seeking behaviour of the women during such ailments. Materials and Methods: A community-based cross-sectional study was conducted from January to June 2023 among 317 females aged 15 to 49 years in an urban resettlement area of Gautam Buddh Nagar district in Uttar Pradesh. Statistical analysis used included descriptive statistics and Chi-square test. SPSS 23 was used for data analysis. Results: There was a prevalence of 65.3% of at least one self-reported symptom suggestive of RTI/STI or gynaecological morbidity among the respondents. Among the symptomatic respondents, 54.1% were found to seek treatment. Among the reasons given for not seeking treatment in any health facility, the majority (83.1%) responded 'lack of awareness that the problem needed medical treatment' and 'stigma related with the problem' to be the main reasons. Conclusion: The reproductive healthcare seeking behaviour was found to be inadequate, with only 54.1% of symptomatic respondents seeking treatment. Enhanced health awareness sessions can be planned in the short term, and skilled communicators within or outside of the health system in the long term may be deployed to disseminate information in the community regarding sexual and gynaecological morbidities in reproductive age group women and their timely intervention. [ABSTRACT FROM AUTHOR]

Context: Hypertension is the leading cause of mortality and disability-adjusted life year (DALY) all over the world. World Health Organization defines quality of life (QOL) as an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns. Aims: The study was aimed to compare the the QOL of adult hypertensive patients with healthy study subjects and to determine the factors associated with poor QOL among the hypertensive subjects. Materials and Methods: A community-based cross-sectional study was conducted from January 2021 to June 2022 in Gautam Budh Nagar District. The study was carried out among 250 hypertensive patients and 50 healthy persons based on World Health Organization-Quality of Life-BREF questionnaire Manual. Statistical Analysis Used: Data collected were entered and statistically analyzed using statistical software (SPSS-22). Results: Overall QOL and general health scores were significantly lower among hypertensive subjects showing worsening of QOL among diseased persons (P value <0.001). Factors significantly associated with poor overall QOL were low educational status (P value <0.001), home makers (P value <0.001), lower socio-economic class (P value < 0.001), and subjects with co-morbidities (P value <0.001). Conclusion: The findings revealed that QOL was poor among the hypertensive subjects as compared to healthy subjects. [ABSTRACT FROM AUTHOR]

Stress has been defined in many ways as a state of psychological arousal that results when the external demand is beyond what one can cope with. Stress is caused by various factors called stressors. Medical students are subjected to different kinds of stressors, such as pressure of academics with obligation to succeed, an uncertain future and difficulties of integrating into the system and different teaching protocols, which may affect their learning ability and performance. Stress has a great impact on brain mainly in the form of impaired memory and on cardiovascular function in the form of increased heart rate and blood pressure. The study was planned to assess the effects of examination induced stress on memory and blood pressure. The study was longitudinal in nature conducted at Department of Physiology, Santosh Medical College, Ghaziabad, India. Initially 100 subjects were selected from 17-24 years of age group then all the subjects were divided into two groups of 'slow-learners' and 'fast-learners' based upon their past academic performances. Readings were taken at two stages of academic year, 05 months before pre-prof examination and 03 days before pre-prof examination. Blood Pressure were measured and the memory assessments were done by using 10 subtests of PGI memory scale. We found a significant increase in stress level 3 days before the examination, compared to 5 months before the examination which in turn affected both blood pressure and memory functions. But, slow-learners were affected more compared to fast-learners. [ABSTRACT FROM AUTHOR]

Introduction: Acne is a common dermatological condition primarily seen in teenage and adolescent patients and is a major concern for cosmological issues. Along with environmental factors, the proliferation of basal keratinocytes in the sebaceous-pilosebaceous unit, abnormal desquamation of follicular corneocytes, and metabolic abnormalities play a significant role in the pathogenesis of acne development. Aim: To study the causal relation between acne vulgaris and insulin resistance by calculating Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and identify the relation between insulin resistance and the severity of acne. Materials and Methods: This was a retrospective study, where the data of patients with persistent Acne Vulgaris who were referred to the Endocrine department for evaluation of the hormonal and metabolic causes for acne vulgaris were analysed. The patient's clinical records were evaluated in whom there was no significant hormonal or metabolic abnormality identified known to cause persistent acne were included after proper consent and HOMA-IR was calculated. Results: Of several patients with persistent acne, 150 patients were included in our study with the male-to-female ratio was 23:27. The mean age of patients was 33.2 years. The mean HOMA-IR in our acne patients was 1.62 ranging from 0.9-3.7. Sixty four (42.67%) patients had HOMA-IR more than 2.0, thereby suggesting insulin resistance. Conclusion: Our study suggests the prevalence of insulin resistance in 42.67% of patients with acne, thereby providing the possibility of use of insulin modifiers as an adjunct acne treatment and stratifying the possible risk of metabolic syndrome in patients with acne. Also recommended is the control of dietary factors and lifestyle modification for the management of acne with insulin resistance. [ABSTRACT FROM AUTHOR]

Background: Global breast cancer incidence is increasing at an annual rate of 3·1%. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%). However, the data from different parts of India are still lacking and the study was conducted to assess the burden of disease at tertiary referral centers in central India. Material and Methods: Retrospective record analysis (June 2013--June 2017) of data from outdoor clinics and pathology reports. The patients aged <15 yrs, nonresidence of Chhattisgarh, and diagnosed outside the study period were excluded. The triple assessment was used to diagnose all breast lumps (sensitivity 99%). Results: Eighty patients were diagnosed having breast carcinoma. The mean age for breast cancer was 39 ± 3.028 years (ranged 31--50 years). Twenty patients had locally advanced breast carcinoma. The predominant religion was Hindu 55.00%. The referral pathway to seek medical care for breast cancer was via a gynecologist in 40% (32/80). Familial breast cancers were in 0.03% (3/80) of patients. None breast cancer patients have previous histology-proven benign breast disease. The mean size of the breast cancer lump was 3.56 cm (ranged 1.0--11.0 cm). Overlying skin ulceration (n = 2), skin infiltration/peau-d'-orange (n = 2), skin tethering (n = 4), and bloody nipple discharge were found in one patient. Breast cancer was diagnosed during lactation (postnatal period) in one patient. The maximum number of patients have tumor size >5 cm (72.6%). Immunohistochemistry and pathological analysis was done on core biopsy (n = 20) and surgical procedure (n = 60). Modified radical mastectomy was done in 52, breast conservative surgery with Sentinal Lymph node biopsy and axillary lymph node dissection in 6, and toilet mastectomy in two patients. The predominant tumors were solid (n = 79/80), with both solid and cystic types (1/80). The solid and cystic lesion on FNAC was of C3b type, and an excision biopsy revealed medullary carcinoma of the breast. Invasive ductal carcinoma-no special type (IDC-NST) was observed to be the most common histopathologic type (n = 70/80), followed by medullary carcinoma (n = 2), metaplastic carcinoma (n = 1), papillary carcinoma (n = 4), Paget disease with DCIS (n = 1), mucinous carcinoma (n = 1), invasive lobular carcinoma (n = 1). One male patient with breast cancer and two female patient having bilateral breast cancer also have IDC-NST.Scarff Bloom Richardson Grade was predominantly graded 2 in 46.25% (37/80) of breast cancer patients (Grade 1 = 9, Grade 2 = 37, Grade 3 = 34). Lymphovascular (LVI) and perineural invasion (PNI) were predominantly without LVI and PVI. (Lymphovascular present and perineural invasion present = 4, Lymphovascular present and perineural invasion absent = 32, Lymphovascular absent and perineural invasion absent = 42, Lymphovascular absent and perineural invasion present = 2). Histological examination of axillary lymph nodes showed the presence of malignant cells in all. Triple-negative breast carcinoma was 26.58% (21/79). Most breast cancer presented at stage II A = 37.5% (30/80) and II B = 28.7% (23/80) of the AJCC staging system. Conclusion: The clinico-epidemio and histological profile of breast cancer in Chhattisgarh is similar to other parts of India. Scarff Bloom Richardson Grade was predominantly grade 2 in 46.25% (37/80) contrary to Grade III (70%) in other series from India. [ABSTRACT FROM AUTHOR]

Background: Open defecation continues to prevail among toilet owners despite effective implementation of the Swachh Bharat Mission (Gramin). We conducted this study to determine toilet utilization rates and learn about the barriers to toilet use in the rural areas. By understanding the barriers, physicians can provide targeted education and become better equipped to manage their patients' conditions and advocate for their demands. Materials and Methods: We conducted a cross-sectional study on the households of the rural field practice areas of the department in central Uttar Pradesh by the census method. House listing was procured from the departmental records. The questionnaire was directed at both the household level and individual level. Results: The proportion of households with access to a toilet was found to be 91.1% of which 504 households were included in the study. Among the toilet owners, 115 (22.8%) households were not using toilets exclusively by all the members. At the individual level, age groups (of 20-59 years, and ≥60 years) and female gender were found to be significantly associated with open defecation. At the household level, government assistance for toilet construction and livestock keeping was found to be associated with open defecation. Major barriers to toilet use were childhood habits, dearth of toilets in the farming grounds/workplace, women during menstruation and having a non-functional toilet. Conclusion: This study indicates that merely installing a household toilet does not ensure exclusive utilization of toilet and the practice of open defecation might continue to be prevalent if corrective measures are not undertaken. [ABSTRACT FROM AUTHOR]

Context: In India, the use of social security schemes by the rural population has not been evaluated with much consideration. The awareness of these social security programs plays a vital role in their use. Aims: This research was conducted to evaluate the awareness among the rural population regarding government-initiated social security schemes and to provide recommendations based on the results of the study. Settings and Design: A community-based cross-sectional study was conducted in a rural health care center. Methods and Material: A sample of 250 individuals in the rural health care center of a dental college was subjected to a questionnaire regarding the awareness of the government-launched social security schemes—Sukanya Samridhi Yojana, Pradhan Mantri Suraksha Bima Yojana, Atal Pension Yojana, Pradhan Mantri Jeevan Jyoti Bima Yojana, Ayushman Bharat Yojana, and Pradhan Mantri Kisan Samman Nidhi Yojana. Statistical Analysis Used: The study data were analyzed by Epi InfoTM 7 software package. Descriptive statistics were assessed and differences between the two groups were compared using the Chi-square test and the P value of < 0.05 was considered to be significant. Results: In the present study, 212 rural people were aware of any one of the recently initiated social security schemes, and the awareness level of these social security schemes was higher in those with age more than 30 years, males, literates, and classes 3 and 4 economic groups of population. Conclusions: The rural population's knowledge of the government's social security schemes is strong, and it is affected by people's age, gender, literacy level, and socioeconomic status. [ABSTRACT FROM AUTHOR]

Objective: The English version of the Summary of Diabetes Self-Care Activities (SDSCA) measure is the most often used self-reporting instrument assessing diabetes self-management. This study was aimed at translating English SDSCA into the Hindi version and validating and evaluating its psychometric properties. Methods: The Hindi version of SDSCA was developed based on the guidelines provided by the World Health Organization (2008) for translation and adaptation of tool. Following steps were adopted: (1) Cultural and linguistic validation, (2) content validity testing, (3) construct validity testing, and (4) internal validity testing. Sixty women diagnosed with GDM were selected for the purpose of this study. Results: The tool showed promising and satisfactory results. Of mention are the results related to Cronbach's alpha (0.82). The exploratory factor analysis showed three factors that fit the data satisfactorily. Conclusions: This study provided evidence for the reliability and validity of the Hindi Summary of Diabetes Self-Care Activities instrument, which may be used in the future to assess diabetes self-management activities among the pregnant women diagnosed with gestational diabetes mellitus among Hindi-speaking population. [ABSTRACT FROM AUTHOR]

Introduction: Anaemia is one of the micronutrient deficiency disorders that have global public health implications. The present study aims to determine the association of minimum dietary diversity (MDD) with anaemia among children aged 6–59 months in rural North India. Methods: In Rohtak (a north Indian city), a cross-sectional survey was conducted in 2018–19 (n = 266). Univariate and bivariate analyses were performed. The Chi-square test was used for assessing the significance level during bivariate analysis. Further, multivariable regression analysis was used for determining the factors for anaemia prevalence among children aged 6–59 months. Results: About 62.4% (n = 166) of the children aged 6–59 months were found to have anaemia in the study area. The prevalence of MDD was 35.3% (n = 94). It was found that children with no MDD have a higher prevalence of moderate (42% vs. 25.5%; P < 0.001) and severe (12.8% vs. 8.5%; P < 0.001) anaemia. It was revealed that the children with no MDD had a significantly higher likelihood of being anaemic than children with MDD in model-1 [aOR: 2.09; CI: 1.23, 3.55] and model-3 [aOR: 1.70; CI: 1.01, 3.01]. Children with mothers who never attended school had significantly higher odds for anaemia in reference to those children whose mothers ever attended school in model-2 [aOR: 3.62; CI: 2.07,6.34] and model-3 [aOR: 3.00; CI: 1.62,5.56]. Conclusion: Measures to alleviate under-five anaemia should include empowering and educating women, expanding access to supplementation, fortification programmes, and promoting and raising awareness about feeding diverse foods, while also considering the socioeconomic status. [ABSTRACT FROM AUTHOR]

Introduction: Spinal muscular atrophy (SMA) is a neuro-muscular disorder caused by biallelic variations in Survival Motor Neuron 1 gene (SMN1) located on chromosome 5q13.2. It is the most common hereditary cause of neonatal death. Ethnicity specific studies are desirable for estimating the prevalence of carrier status of this disease in a population. Objectives: To estimate the carrier frequency of SMA among individuals of a reproductive age group in a North Indian cohort. Methods: SMA carrier screening was offered to individuals of a reproductive age group (>18 years) visiting a tertiary care center. Multiplex ligation-dependent probe amplification (MLPA) and quantitative real-time polymerase chain reaction (PCR) were the molecular techniques used to detect the carrier status. Results: A total of 198 individuals without a family history of SMA were screened in this study. The carrier frequency of heterozygous deletion of SMN1 gene in our cohort was found to be 1 in 30 (~3/100). Conclusion: The carrier frequency of SMA is high in our country. The data from the study emphasize the need of a population carrier screening program on SMA in India. [ABSTRACT FROM AUTHOR]

Background: Negative pressure wound therapy (NPWT) is the treatment of choice for diabetic foot ulcers (DFUs), and the role of NPWT in the management of DFU is limited. The aim of the study was to compare the effects of NPWT versus conventional dressing (CD) on wound healing in DFU. Materials and Methods: A total of 55 patients were included and divided into two groups: 23 patients were treated with NPWT and 32 patients with CD. The NPWT dressings were changed every 7 days, while the CDs were changed daily. Wound culture sensitivity, wound size, granulation tissue, and pain evaluation (assessed by Visual Analog Scale) were all measured at the start and 3 weeks or until the ulcer was healed. The wound margin temperature was measured at four random sites for thermometric evaluation, and normal limb temperature was also measured for comparison. Patients' satisfaction and treatment costs were also compared. Results: On days 14 and 21, the wound size was reduced significantly in the NPWT group (P < 0.001 and P < 0.001, respectively). The percentage reduction in wound size from baseline to days 7, 14, and 21 was significantly higher in the NPWT group (P = 0.013, P = 0.001, and P = 0.029, respectively). On days 7, 14, and 21, the granulation tissue score was significantly higher in the NPWT group (P = 0.001, P = 0.001, and P < 0.001, respectively). On days 14 and 21, the mean VAS score was significantly low in the NPWT group (P < 0.001 and P < 0.001, respectively). The majority of wounds in the NPWT group were sterile on day 21 compared to those in the CD group (P = 0.008). The majority of patients in the NPWT group had excellent patient satisfaction (P < 0.001). The average material cost was significantly higher in the NPWT group (P = 0.001). The mean wound temperature of the affected limb was significantly higher compared to that of the unaffected limb (P < 0.001). Conclusion: In terms of early formation of granulation tissue, faster wound size reduction, less discomfort, and patient satisfaction, the study indicated that NPWT appeared to be superior. An initial rise in temperature in a DFU may indicate the presence of a pre-ulcerative lesion. [ABSTRACT FROM AUTHOR]

Background: Kawasaki disease is a pediatric, systemic, vasculitic disorder. Its exact etiology is still unknown. Genetic polymorphisms are being investigated as susceptibility factor for this disorder. These are likely to vary among different populations. Aim: To investigate the association of single nucleotide polymorphism (SNP) rs113420705 of CASP3 in Kawasaki disease (KD) from North India. Settings and Design: Observational, case–control study. Methods: Polymerase chain reaction and bidirectional Sanger sequencing was used for determining genotypes of SNP rs113420705 in 45 cases of KD and 50 healthy age- and sex-matched controls. Allele and genotype frequencies were assessed and compared between the groups. Results: Among 45 cases, 32 had TT (71.1%), 13 had CT (28.9%) and none had CC genotype of SNP rs113420705. No significant differences in allele, genotype, or carrier frequencies of rs113420705 were found between the two groups. A comparison was also made between subgroups of KD with coronary abnormality (7 children; 15.5%) and KD with normal coronaries (38 children; 84.4%). The C allele was significantly overexpressed in KD with coronary abnormality group (P = 0.005). However, no difference was noted in the genotype frequencies. Conclusion: CT genotype of rs113420705 of CASP3 showed a trend to significance with the occurrence of KD in children in North India. However, we could not establish any association between minor allele C and susceptibility to KD. C allele appeared to be over expressed in children with KD with coronary abnormalities. Larger studies will help us to reach conclusive evidence applicable to all ethnicities. [ABSTRACT FROM AUTHOR]

Mucormycosis or black fungus is a rare fungal infection, but cases are rising amidst the Coronavirus pandemic. The disease mostly infects immunocompromised patients including diabetics and those receiving corticosteroid therapy. The most common etiological agent is Rhizopus arrhizus, from the Mucorales family of fungi. The fungal spores may affect the nose and sinuses, the respiratory tract, renal tract, cutaneous tissues, or may be disseminated throughout the body. Early detection can be done by PCR technique, but direct microscopy is also commonly done. Treatment is most commonly done using high-cost liposomal Amphotericin B injections. Surgical debridement of the affected tissues may sometimes be necessary. Knowledge of the disease and its management techniques is absolutely essential for healthcare professionals in the current scenario. Early diagnosis may improve prognosis. In this narrative review, we seek to provide an overview of the most essential features of Mucormycosis, especially in association with SARS-CoV-2. [ABSTRACT FROM AUTHOR]

Background: Smoking and chewing tobacco carry significant risks for the development of oral cancer and premalignant lesions. The present study was conducted to find the prevalence of tobacco-related habits in Hazaribagh population and its association with oral mucosal lesion. Methodology: The present study was carried out on patients who visited the Department of Oral Medicine And Radiology, Hazaribagh College of Dental Sciences And Hospital. A total of 5,000 subjects were screened for tobacco-related habits and associated mucosal changes. Detailed clinical history about tobacco-related habits was obtained. Oral mucosal lesions were screened using the WHO format for diagnosis of oral lesions. The findings were tabulated and analyzed statistically. Results: Of the 5,000 subjects enrolled for the study, 1,085 (21.7%) used tobacco in some forms. Habit of smoking tobacco was present among 273 (25.2%) and using smokeless tobacco among 811 (74.7%) individuals. Tobacco pouch keratosis (46.1%) was found to be most common lesion, followed by oral submucous fibrosis (OSMF) (16.1%), lichenoid reaction (14.1%), smokers palate/melanosis (12.2%), leukoplakia (7.2%), erythroplakia (2.3%), and oral cancer in (2%). Conclusion: The results provide insight into prevalent tobacco habits and associated oral mucosal lesions in Hazaribagh population. These may act as baseline data for the formulation of preventive programs and help future studies explore the prevalence of tobacco-associated lesions in vulnerable populations. Current knowledge, including findings from the present study, about the prevalence of tobacco use and various oral lesions associated with it may help primary health care physicians to promote among patients visiting them the awareness about the adverse effects of tobacco consumption and treatment options available for tobacco-related lesions at the early stage. [ABSTRACT FROM AUTHOR]

Context: Tobacco use is the leading single preventable cause of deaths worldwide. India is the second largest consumer of tobacco in the world. Aims: To study the prevalence of tobacco use among the adult population >15 years age of District Gautam-Budh Nagar and find the association of various socio-demographic factors with the tobacco usage. Settings and Design: Cross-sectional community-based study conducted in urban and rural areas of District Gautam-Budh Nagar, Uttar-Pradesh. Subjects and Methods: The study was conducted among 1461 adults aged 15 years and above in the District Gautam-Budh Nagar. Multistage sampling was used to select the study subjects. The questionnaire used for the interview consisted of questions related to socio-demographic profile, smoking habits and smokeless tobacco use, intention to quit and exposure to second-hand smoke. Statistical Analysis: The data were entered and analyzed in SPSS Software version 20.0. The prevalence of tobacco use was expressed in percentages. The association between various socio-demographic factors and tobacco use was assessed by Chi-square test. P value < 0.05 was taken as significant. Results: Prevalence of tobacco usage in this study was found to be 50.4% (65% among males and 28.8% among females). The prevalence of smoking and smokeless tobacco use in our study was 37.2% and 21.3%, respectively. Increasing age, male gender, and lower educational status were found to be significant risk factors for tobacco use in our study. Conclusions: India needs to gear up the efforts more and can still do more to make the proven tobacco control tools work for its citizens' well-being. [ABSTRACT FROM AUTHOR]

Background: Patients with thyroid swelling are anticipated difficult airway due to the anatomical complications associated with it leading to restricted neck movements and distorted laryngeal anatomy. The aim of this randomized prospective study was to compare Macintosh laryngoscope and Airtraq video laryngoscope for endotracheal intubation in patients with thyroid swelling. Methods: Eighty adult American Society of Anesthesiologist (ASA) grades I-II patients were taken and randomly divided into two groups of 40 patients in each. After induction of general anesthesia, tracheal intubation was done with either of the technique using a flexometallic tube. Time taken for intubation, hemodynamic variations during and after intubation, any optimization maneuver used during intubation, Cormack-Lehane score, Percentage of Glottic Opening (POGO score), Intubation Difficulty Score (IDS), and postoperative airway symptoms were noted. Results: Mean time required for intubation with Airtraq was more than Macintosh; P = 0.003. But Cormack-Lehane score, IDS score, and POGO score were better in the Airtraq group. Hemodynamic variations in both groups were comparable. Optimization maneuver required and postoperative airway symptoms were more in the Macintosh group. Conclusion: In patients with thyroid swelling, Airtraq video laryngoscope provides better visualization of the glottis, requires less manipulation during intubation, and less post-operative complications than Macintosh laryngoscope but requires significantly more time for intubation. [ABSTRACT FROM AUTHOR]

Background: Children are very much vulnerable to adverse drug reactions (ADRs) and also tend to have more severe form of adverse effects compared to adults. Though ADR is a significant problem in children, paediatricians seem to neglect this aspect. Knowledge, attitude and practice (KAP) studies related to pharmacovigilance among paediatricians are lacking in literature. Hence, this study was planned to know the gaps in KAP among paediatricians of Odisha and factors related to underreporting of ADR. Materials and Methods: Google Form containing the questions was shared to paediatricians of Odisha state working in both private and government organisations. The questionnaire was prepared based on previous studies and some new questions relevant to our scenario were added. The questionnaire contained six questions based on knowledge, four on attitude and three on practice of ADR. Apart from that, it contained questions to know their response regarding the factors that discourage paediatricians to report ADRs. There were 60 responses. Results: Among the paediatricians, 70%–80% were aware of the pharmacovigilance programme running in India. Also, 80%–90% agreed that ADR reporting is crucial in paediatric health care, while most of them were trained regarding ADR reporting. But only 50% of them had reported an ADR in their clinical practice, which clearly indicates towards underreporting. Conclusion: The motivation for voluntary reporting of ADRs among paediatricians for preventing the morbidity and mortality in this vulnerable population could be of immense importance, and hence, various workshops and CMEs should be conducted to improve the KAP of these doctors, so that the problem of underreporting could be minimised. [ABSTRACT FROM AUTHOR]

Background: It is evident from the research in recent years that short sleep has been found as a risk factor for obesity. However, we still need enough evidence in this field. Therefore, we explored the directionality of the association between sleep duration and sleep quality with body mass index (BMI). Aims: The aim of this study is to evaluate the association of sleep duration and sleep quality with BMI among young adults. Objectives: (a) To assess the association of sleep duration with BMI. (b) To assess the quality of sleep with BMI. Methods: In this cross-sectional study, 88 individuals selected from King George's Medical University were taken as participants. Majority of patients were males (67%). There were 29 (33.0%) females. Sex ratio of study was 2.03, and we used Pittsburgh sleep quality index (PSQI) questionnaire to assess time spent in bed and sleep quality. BMI was divided into 3 categories. Underweight (BMI <18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23–24.9 kg/m2), obese grade I (25–34.9 kg/m2), obese grade II (35.0 kg/m2), and above. Results: We observed that short sleep duration ± SD (h) <6 h/day f = 9.04; P < 0.001 is associated with greater chances of being overweight and obese and mean sleep quality (mean PSQI ± SD) f = 12.24; P < 0.001 was poor in obese grade I and II. Mean neck and waist circumference also showed a significant increasing trend with increasing BMI category (P < 0.001). Conclusion: This study concludes that short sleep duration and poor sleep quality were associated with overweight obesity among young adults. [ABSTRACT FROM AUTHOR]

Background: Bone health is an important requirement for healthy aging. Osteoporosis is an important cause of both mortality and morbidity among older adults. If we can predict the risk of future osteoporosis by cost-effective methods, we can prevent it up to certain level and plan intervention accordingly. That's why the present study aims to estimate the likelihood of osteoporosis in patients attending the outpatient department (OPD) in a selected community health center (CHC). Methods: A cross-sectional study was conducted in a CNC in Siwan, Bihar, India. An equal number of male and female patients were recruited by quota sampling. A semi-structured proforma was prepared for data collection using the Fracture Risk Assessment (FRAX) tool without performing a bone mineral density (BMD) test in order to assess major osteoporotic fractures and risk for hip fractures with other requisite information Results: The collected data were organized using Microsoft Excel and analyzed using the statistical software SPSS Statistics 20. As data were gleaned and put under different categories, a statistical analysis based on the Chi-square test was carried out, and an ROC (receiver operating characteristic) curve was also drawn for statistical inference of the data gathered. The main findings of our analyses include the following: Approximately 15% males and 30% females in the study sample had a higher risk of osteoporosis and about 9% males and 36% females had a higher risk of hip fracture. Overall, the findings showed a statistically significant association (p < 0.05) between the gender of the participants and the FRAX risk scores for osteoporosis and hip fracture. Conclusion: Previously osteoporosis was thought of as a disease that affected only women; nevertheless, emerging findings show that osteoporosis is not unusual in men. The FRAX tool can be used as a screening tool before going for a BMD test. [ABSTRACT FROM AUTHOR]

Background: In 2019, the global number of malaria cases was estimated at 229 million. An estimated 409,000 deaths were attributed to malaria in 2019. Under-five children are the most susceptible to malaria, accounting for 67% (274,000) of all malaria deaths worldwide in 2019. This study aimed to assess knowledge and practices regarding malaria among Village Health Sanitation Committee (VHSC) members in rural Uttar Pradesh. Methodology: This cross-sectional study was conducted in the villages of four districts of Uttar Pradesh with high malaria burden. In the present study, 484 participants were interviewed from four districts of Uttar Pradesh. Results: Nearly all the participants (97.1%) have heard about malaria. Majority of the participants (97.1) were aware that mosquito bites spread malaria. However, many participants were also having a false awareness that malaria is spread by other modes like drinking contaminated water, touching each other, eating contaminated food, and so on. More than half of the participants told that mosquitoes are responsible for malaria breeds in stagnant clean water (25.6%) and stagnant dirty water (28.5%). Nearly half of them were aware that mosquitoes' biting time was sunset (42.1%) and sunrise (7.8%). Conclusion: In the present study, many participants were having a false awareness that malaria is spread by other modes like drinking contaminated water, touching each other, eating contaminated food, and so on. Even the knowledge regarding any government program for the prevention and control of malaria of the mosquitoes was very weak. There is an urgent requirement of increasing knowledge among the VHSC members to reduce the malaria burden in the country. [ABSTRACT FROM AUTHOR]

Introduction: Oral diseases are considered a public health problem due to their high prevalence. It is the primary concern of oral health educators to impart positive oral health knowledge and behavior in the society. Health workers' knowledge, attitude, and practices (KAP) toward oral health to a great extent influence the community as they can extend health education at the first contact in the community. Thus, the aim of the study was to assess the knowledge, attitude, and practices of health care workers. Material and Methods: A descriptive cross-sectional survey was designed to assess the knowledge, attitude, and practices towards oral health among health care workers. The study was conducted among health care workers aged between 20 and 60 years working in Primary Healthcare Centres and Community Healthcare Centres of Lucknow district. Informed consent was obtained from health care workers before the start of the study. The data were collected via a predesigned and pretested questionnaire. The data were analyzed using IBM SPSS Statistics-version 21. Results: The results of the study showed that 70.2% of the respondents ever visited the dentist due to somereason of which 19.2% visited once in a year. In addition, 38.9% of the respondents were daily smokers of which the majority belonged to the age group 20–40 years. A total of 63.9% of the respondents were daily chewable tobacco users, and 12.4% were routine users of alcohol. Conclusion: The present study gives a brief insight into the oral health knowledge, attitude, and practices of health care workers which were of fair degree. [ABSTRACT FROM AUTHOR]

Introduction: Motivational enhancement therapy is characterized as a directive, client-centered intervention which helps in modification of behavior by helping subjects in identifying and resolving the ambivalence toward a change in self. In order to free one from the vicious cycle of the alcohol trap one needs self-efficacy, which serves a protective role to prevent from relapses. The study aims to assess and compare the effectiveness of MET on the self-efficacy of individuals pre and posttest with control design were applied. Methods: A total of 40 subjects, alcohol-dependent persons fulfilling International classification of Diseases-10 criteria were selected through purposive sampling method from Outdoor and Indoor Service of Psychiatry Department IMS BHU, Varanasi, were randomly divided into two groups. 1st group 20 subjects were given motivational enhancement therapy session for 10 sessions along with treatment as usual (MET + TAU), whereas 2nd group control group were given treatment as usual (TAU) at the end of intervention post level of self-efficacy were measured through self-efficacy scale. Modified Kuppuswamy Socioeconomic Status Scale, Alcohol use disorder identification test, Self-Efficacy Scale as tools were used. Result: The result shows that the mean value of self-efficacy in (MET + TAU) group before intervention was 56.30 ± 2.99 and mean value of self-efficacy in (MET + TAU) after intervention was 60.75 ± 2.65 which shows significant difference is found in self-efficacy after intervention. Conclusion: Motivational enhancement therapy tries to decrease ambivalence so as to enhance the change in the subject's self-efficacy which assists the individuals in abstinence from alcohol. [ABSTRACT FROM AUTHOR]

Aim and Objectives: This study assessed the knowledge, attitude, and practice of patients with ESIC, who are insured patients with the public health sector about COVID‑19. Materials and Method: This was a cross‑sectional observational study that used a questionnaire developed for the purpose of the survey. The questionnaire was divided into five parts including the demographic variables and environmental variables that are enablers for positive preventive practices of COVID‑19, knowledge, attitude, and preventive practices followed with respect to COVID‑19. Results: The mean age of the study population was 36.96 ± 13.05 (18–73) years with almost an equal proportion of males and females. The knowledge about measures to be taken for prevention of corona infection such as Balanced diet, Lockdown, Social distance, frequently wash hands often, using face mask and regularly cleaning with disinfectant surfaces was significantly better among females. Majority of the subjects displaying good attitude toward the corona disease prevention. Preventive practices were found to be satisfactory among the study population. Use of soap and handwashing was more than the use of sanitizer. Hand washing, use of mouth mask, and taking bath after returning home from outside was significantly better among males. Conclusion: There are increased worries and apprehensions among the public regarding acquiring the COVID‑19 infection. People have higher perceived needs to deal with their anxiety towards acquiring the infection. [ABSTRACT FROM AUTHOR]

The metabolic syndrome (MetS) (also known as insulin resistance syndrome, syndrome X) is a cluster of factors associated with increased risk of developing coronary heart disease or type 2 diabetes mellitus. Several studies in the past have reviewed an association between MetS and periodontitis. Periodontal disease is considered an infectious and chronic inflammatory disease, and it has been considered to be a potential risk in cardiovascular and respiratory diseases and diabetes, and has implications in adverse pregnancy outcomes, osteoporosis, and so on. These systemic disorders have been documented as capable of affecting the periodontium or treatment of periodontal disease. Oral inflammatory lesions have different basic mechanisms concerning the possible association with systemic diseases. They concern local spread, metastatic spread, or immunologic cross-reactivity. In many studies, sometimes contrasting, periodontal pathogens have been evaluated in atheromatous plaques isolated from patients with chronic periodontitis. Oral inflammatory lesions have been shown unequivocally to contribute to elevated systemic inflammatory responses. In some studies, intensive periodontal therapy showed a significant reduction in c-reactive protein levels, interleukin-6, and low-density lipoprotein cholesterol after 2 months. The aim of this article is to reflect the association between MetS and periodontitis and to suggest an understanding to promote interprofessional practice; with proper oral care and plaque control, we can reduce the severity of MetS. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to assess the functionality of labour rooms by evaluating the labour room infrastructure with reference to the standard guidelines, the status of the availability of human resources, the availability of essential equipment and consumables in the labour room and by documenting the knowledge of the healthcare provider in terms of labour room practices. The study also explored the facility parameters associated with its delivery load taking the facility as a unit of analysis. Design: A cross-sectional analytical study. Setting: India has realised the importance of improving the quality of care in public health facilities, and steps are being taken to make healthcare more responsive to women's needs. With an increase in the proportion of institutional deliveries in India, the outcome of the delivery process can be improved by optimising the health facility components. Participants: The study was conducted in 52 health facilities and healthcare providers involved in the delivery process in the selected facilities. Results: The infrastructure of the facilities was found to be the best for medical college followed by district hospitals, Community Health Centres (CHCs), Primary Health Centres (PHCs) and subcentres. Similar findings were observed in terms of the availability of equipment and consumables. Lack of healthcare providers was observed as only 20% of the posts for health personnel were fulfilled in CHCs followed by PHCs, subcentres and district hospitals where 43, 50 and 79% of the available vacancies were fulfilled. The level of knowledge of healthcare providers in terms of partograph, active management of the third stage of labour and post-partum haemorrhage ranged as per their designation. The specialists were the most knowledgeable while the Auxiliary Nurse Midwife (AMNs) were the least. All the components of structural capacity, i.e. infrastructure (r2 = 0.377, P value < 0.001), equipment and consumable (r2 = 0.606, P value < 0.001) and knowledge of healthcare providers (r2 = 0.456, P value < 0.001) along with the overall facility score were positively correlated with the average delivery load of the health facility. The results from multivariate linear regression depict significant relation between the delivery load and availability of equipment and consumables (t = 4.015, P < 0.01) and with the knowledge of healthcare providers (t = 2.129, P = 0.039). Conclusions: The higher facilities were better equipped to provide delivery and newborn care. A higher delivery load was found at high-level facilities which can be attributed to better infrastructure, adequate supply of equipment and consumables and availability of trained human resources. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic is still spreading throughout the world along with its strange and frightening mutations, and the World Health Organization (WHO) has declared it as a global pandemic. Objective: The present investigation aims to evaluate the effect of SARS-CoV-2 infection on mother and newborn outcomes and the vertical transmission potential of this virus. Study Design: This was a cross-sectional study conducted at a tertiary care dedicated COVID-19 hospital. A total of 40 pregnant females (RT-PCR positive for SARS-CoV-2) and their 41 neonates (including stillbirths and a twin delivery) were included in the present study. Results: All the mothers in the study were SARS-CoV-2 positive on the RT-PCR test, but none had any COVID-19 symptoms (pneumonia-like fever, cough, fatigue, sore throat, shortness of breath, and diarrhea). Out of 41 newborns, 38 (92.7%) were healthy, one (2.4%) was a stillbirth, and two newborns (4.9%) could not be revived. All the 41 (100.0%) neonates, including stillborn and preterm were negative for the SARS-CoV-2 RT-PCR test. Twenty-Six neonates (63.4%) were delivered by caesarean section, whereas 15 cases (36.6%) had a normal vaginal delivery. Conclusion: The present study showed no suggestion of vertical transmission of SARS-CoV-2 in pregnant females. Therefore, the placenta might function as a barrier to the SARS-CoV-2 virus. Also, there were no complications come upon during the delivery of any neonate in the present study. [ABSTRACT FROM AUTHOR]

A simultaneous presence of intrauterine and extrauterine gestation is called as heterotopic pregnancy (HP). The incidence of spontaneous HP is 1: 30000, which is very rare. In this case report, we are reporting a rare case of spontaneous HP in a 40-year-old lady with intrauterine gestational trophoblastic neoplasia (GTN) and ruptured tubal ectopic pregnancy in a remotely located secondary care hospital. The lesson learnt from our case report is that detection of intrauterine gestation does not rule out the possibility of the presence of ectopic pregnancy. Also, HP can occur without any obvious risk factors like in our case. It should be always kept in mind that HP can occur in any woman of reproductive age group. In the end, our patient was fortunate that she presented to us in a stable haemodynamic condition in spite of having ruptured tubal ectopic with spontaneous stoppage of bleeding from the ruptured tube. Hence, to achieve a great chance of favourable obstetric outcome, all treating doctors including family physicians should have a high index of suspicion to have accuracy in early diagnosis and treatment of a various variety of HP as these can occur with or without predisposing risk factors. [ABSTRACT FROM AUTHOR]

Aims: The indigenously developed Indian Council of Medical Research (ICMR)-NIV COVID Kavach IgG enzyme linked immunosorbent assay (ELISA) has been recommended for seroprevalence among vulnerable populations in India, which provided essential services throughout the lockdown. The staff working in the High Court was one such group. We compared anti-SARS-CoV-2 IgG seropositivity among the staff of Jodhpur and Jaipur High Courts, Rajasthan, India. Methods: Asymptomatic judiciary staff of Jodhpur and Jaipur benches of High Courts were enrolled after informed written consent. A questionnaire was filled and 3--5 ml venous blood was collected from participants. The ICMR-NIV COVID Kavach IgG ELISA and EUROIMMUN IgG ELISA were used for detection of Anti-SARS-CoV-2 IgG antibodies. Results: A total of 63 samples (41 from Jodhpur and 22 from Jaipur) were collected between 28th July to 4th August 2020. The overall anti-SARS-CoV-2 IgG seroprevalence was found to be 6.35%. Seropositivity was higher among the staff from Jaipur (13.64%) as compared to Jodhpur (2.44%). The Kavach ELISA results were in complete agreement with EUROIMMUN ELISA. The infection control measures were deemed effective. Conclusion: Seroprevalence among the staff of Jodhpur High Court was found to be lower than Jaipur, reflecting higher susceptibility to COVID-19 in the former. Many offices worldwide are closed till mid 2020 but need to come up with pre-emptive policies eventually. This study may help to anticipate the possible challenges when other government/private offices start functioning. The infection control practices of one workplace may help formulate guidelines for other offices. [ABSTRACT FROM AUTHOR]

Context: Diarrhea is one of the leading causes of death and morbidity in under-five children. Effective management can significantly influence survival of children with diarrhea. Objectives: This study was carried out to assess extent of diarrhea, its source of treatment, and type of therapy. Settings and Design: This snapshot study was conducted in rural setting of India. Methods and Material: This study was conducted on 217 under-five children selected through multistage sampling procedure. Statistical analysis used: Statistical association of diarrhea with age and gender of children was established by computing Chi-square. Results: Period prevalence (Recall period 2 weeks of visit) of diarrhea in rural under-five children was 35.9% (95%C.I. 29.3–42.2%). Highest prevalence in age group 0–12 months (47.8%) and lowest in 49–59 months (18.2%). Number of episode per child is 1.08. Diarrhea was watery in 69.4%. Quacks were treatment provider for 36.4% cases. In 17.6% episodes, no treatment was taken. Only 9.4% episodes were treated in government facilities. For the treatment of diarrhea, antibiotic was used in 71.8% cases, ORS use was 33.3% cases, and zinc was used 21.8% of diarrhea episodes. Conclusions: Diarrhea is a significant problem in under-five children from a rural area of India. In spite of existence of National Program for Control of Diarrheal Diseases (NPCDD) since four decades, management of diarrhea is not on track. Focusing on primary care provision to under-five children can help in bringing the management of diarrhea on track. [ABSTRACT FROM AUTHOR]

Introduction: An estimated 2.25 million new cancer cases with 7 lakh cancer deaths were reported, according to GLOBOCAN 2018 in India. There is a steady rise in cancer cases, but trends and patterns vary within the state depending on the geographic region. Objectives: To study the proportion and site‑wise distribution of neoplasm reported at a tertiary care hospital in district Etawah, Uttar Pradesh, India. Material and Methods: A record based retrospective study was conducted at a tertiary care hospital in district Etawah, Uttar Pradesh. Total four years (from 2015 to 2018) hospital‑based retrospective data were collected from the Medical Record Department. Identification and distribution of malignant neoplasm were done according to the WHO ICD‑10 classification. Results: Total cases diagnosed with malignancy from January 2015 to December 2018 were 3614. Cancer cases reported over the years was 932 (25.8%) in 2015, 1031 (28.5%) cases in 2016, 897 (24.8%) in 2017 and 754 (20.9%) in 2018. It was found that breast carcinoma (24.0%) accounted for the maximum number of cases diagnosed, followed by lung carcinoma (10.9%), cervical cancer (8.7%), gall bladder carcinoma (8%), and oral cavity cancer (7.9%). Conclusion: The present study reveals that the malignancy of the breast is most common, followed by malignancies of lung, cervix, and gall bladder among the patients who were seeking care in a tertiary care hospital of the district Etawah Uttar Pradesh, India. [ABSTRACT FROM AUTHOR]

According to the World Health Organization (WHO), there are 37,704,153 cases and 10,79,029 deaths due to COVID‑19 till the 13th October 2020 in the world. Day by day, rise in the number of COVID‑19 deaths has created great pressure on health facilities, governmental bodies, and health workers. There is a need for knowledge regarding lifecycle, transmission, and different strains of SARSCoV2, so that countries can stop the disease as early as possible. The present study was conducted to review various epidemiological aspects along with measures used in the containment and prevention of this new pandemic. The scientific literature database was searched using the terms: coronavirus, 2019‑nCoV, SARSCoV2, and COVID‑19. Articles with appropriate topics fulfilling the objective of the present work were included. The epidemiological characteristics regarding life‑cycle, intermediate hosts, viability on various surfaces, strains, case fatality rate, and their implication to reduce the transmission of SARSCoV2 have been identified. According to Centers for Disease Control and Prevention, Atlanta (updated till October 05, 2020) people with recurrent or persistent positive COVID‑19 tests in South Korea and USA did not show to have live virus in their bodies. As per WHO web‑page information till 15 October 2020, there were 42 candidate vaccines in clinical evaluation and 156 vaccines are in preclinical evaluation phase. As the virus can easily be transmitted to the people either via droplets, fomites, and may be via the fecal–oral route, knowledge regarding the above‑mentioned areas is needed for time to be prepared for the next waves of the COVID‑19 pandemic. [ABSTRACT FROM AUTHOR]

Context: Internal derangements of temporomandibular joint (TMJ) with associated symptoms which do not respond to conservative therapies are refractory cases of temporomandibular joint dysfunction syndrome (TMD). Minimally invasive techniques like arthrocentesis and platelet rich plasma (PRP) injections are usually employed to improve TMJ symptoms and function in these cases. Aims: To compare PRP with arthrocentesis for evaluating the effectiveness of PRP in relieving symptoms of refractory TMJ pain dysfunction syndrome. Setting and Design: A clinical study was carried out on 52 patients of refractory Temporomandibular joint dysfunction syndrome. The patients were divided in two groups that is Group A - test group and Group B -control Group. Methods and Material: Group A consisted of 26 patients who underwent intraarticular PRP injection in TMJ and Arthrocentesis of TMJ was done in 26 patients of Group B. TMJ pain, Maximium Interincisal opening and TMJ clicking were assessed among the group as well as between the groups over a period of 6 months. Statistical Analysis Used: Repeated Measure ANOVA was used to compare the parameters within the groups and T test was used for group comparison at 0.05 level of significance. Result: There was statistically significant difference in pain intensity improvement 1 ± 0.75 versus 3.17 ± 2.13, maximum interincisal opening 39.86 ± 2.86 versus 37.59 ± 4.03 and clicking 6 versus 16 between the PRP group and arthrocentesis group at P < 0.05. Conclusions: Intraarticular PRP injection for the management of refractory TMD is more effective than arthrocentesis in reducing symptoms and functional improvement. [ABSTRACT FROM AUTHOR]

Measles is a vaccine-preventable disease that continues to be a major cause of morbidity and mortality in children and young adults across the world. Immunization efforts have reduced the incidence of measles over the last 3 decades, but outbreaks are seen in high-transmission areas with susceptible populations, as is seen in hospitals and student campuses. The protection offered by prior vaccination may wean off over time making vaccinated individuals susceptible to infection. Hence, catch-up immunization drives should be undertaken for vulnerable populations such as healthcare personnel, along with routine immunization programs, with the goal to eliminate measles in the future. This case series presents measles in two of our medical residents who got infected despite being vaccinated in childhood. [ABSTRACT FROM AUTHOR]

Context: Comprehensive management of mild COVID infection calls for better understanding of symptomatology in these group of patients as well as early identification and close monitoring of patients at risk, data on which is limited. Aim: To study association between inflammatory markers and clinical presentation with progression of disease and the duration of resolution of symptoms. Settings and Design: This is a retrospective study that has been conducted at a designated COVID -19 medical ward at AIIMS, New Delhi Methods and Material: Fifty healthcare workers and their dependents who were admitted with asymptomatic and mild COVID-19 infection were included. Their records were retrospectively reviewed, entered into a predesigned proforma and analyzed. Results: A total of 50 participants were included in the study of which 70% were healthcare workers. The patients were admitted with mild COVID illness out of which 22 (44%) were males. Most common symptom at presentation was fever (72%). Among patients who had mild disease versus those who progressed to moderate illness (n = 3), the patients with moderate illness were older [mean (SD): 57.33 (10.21) vs. 36.13 (14.05); P = 0.014] and had a longer duration of hospital stay [17 (1.41) days vs. 11.20 (3.86) days; P = 0.04]. Inflammatory markers, C-Reactive Protein (CRP) [2.46 vs. 0.20 (P = 0.024)], and Ferritin [306.15 vs. 72.53 (P = 0.023)] were higher in patients with moderate illness. There is also a significant correlation between the number of days taken for symptoms to resolve with Serum Ferritin (P = 0.007), CRP (P = 0.0256), and neutrophil lymphocyte ratio (NLR) (P = 0.044). Conclusions: Acute phase reactants/Inflammatory markers serve as good indicators of time taken to resolution of symptoms in acute COVID infection. NLR is a simple and inexpensive method to provide insight into symptomatic phase. These may be utility tools for primary care physician in the management in periphery and timely decision. [ABSTRACT FROM AUTHOR]

Context: Health care workers (HCWs) are at high risk of COVID-19 infection but data on the risk factors for exposure and infection rate among Indian HCWs are limited. Aims: Our study aims to identify the risk factors and behavior of HCWs which make them high risk for COVID-19 infection and the infection rate among them. Settings and Design: This is a retrospective study conducted at All India Institute of Medical Sciences, New Delhi. Methods and Material: Fifty HCWs quarantined at our institute in April and May 2020 following exposure to confirmed or suspected COVID-19 cases, or due to development of Influenza-Like Illness (ILI) were included. Data was collected from medical records in a predesigned proforma and analyzed. Results: Thirty-eight (76%) of the 50 quarantined HCWs had high-risk exposure and there was a significant breach in personal protective measures. N-95 masks were worn by 59.6%, gloves by 61.7%, and goggles or face shields by 2%. Exposures were more common in non-COVID areas of the hospital. Hydroxychloroquine pre-exposure prophylaxis was taken by 7 (14%). 3 (6%) were confirmed to be COVID-19 positive during the quarantine period. Conclusions: Our study has shown leniency among HCWs in adhering to infection control and personal protective measures resulting in an increased quarantine and infection rate and loss of manpower. The safety of our HCWs must be given paramount importance during this pandemic and should be ensured by educating them about infection control, and persistently reinforcing and strictly adhering to standard precautions. [ABSTRACT FROM AUTHOR]

Objectives: Osteoporosis is a common skeletal disorder affecting postmenopausal women. Data suggest that postmenopausal women are at increased risk of periodontal diseases. Amino bisphosphonates are potent inhibitors of bone resorption and effectively used in the treatment of osteoporosis. Preliminary data indicate that there is a potential role for bisphosphonates in the management of periodontitis. Hence, this randomized placebo-controlled trial was designed to investigate the clinical efficacy of amino bisphosphonate on periodontal disease status among postmenopausal women. Materials and Methods: Thirty patients were randomly allocated to two treatment groups: Group A, which received scaling and root debridement and 70 mg weekly single oral dose of alendronate drug, and Group B, which received scaling and root debridement and placebo drug for 6 months. Clinical periodontal measurements were carried out for all patients at the baseline and 6 months later. Mandibular bone mineral density (BMD) was measured using a dual energy X-ray absorptiometer at the beginning of the study and the end of 6 months. Results: A weekly single oral dose of 70 mg alendronate was well-tolerated. The intragroup comparison showed significant improvement in periodontal parameters in both groups. The intergroup comparison showed a significant increase in BMD after 6 months in Group A when compared with Group B (P = 0.0179). Conclusion: Single oral dose of 70 mg alendronate per week is well-tolerable, gastro-intestinally safe, and improves the clinical outcome of nonsurgical periodontal therapy. [ABSTRACT FROM AUTHOR]

Context: Several studies have reported that PD-L1 has shown therapeutic activity in various tumor types. However, its expression changes in a person on administration of NAC which is reported by very few studies. Aims: To find out the difference in the expression of PD-L1 by tumor cells after the administration of NAC. Settings and Design: This prospective study was conducted on 30 patients who were diagnosed with locally advanced breast carcinoma (LABC) between 2017 and 2019 and those who received NAC followed by surgery. Methods and Material: Breast cancer specimens were collected using core needle biopsy prior to administration of NAC and IHC was performed. Frequency and staining intensity of PD-L1 by tumor cells were analyzed. PD-L1 expression was dichotomized into two groups according to the frequency distributions of the H-scores. Statistical Analysis Used: The differences in expression of PD-L1 along with various parameters were analyzed using Chi-square test and Student's t test. Results: The mean age of the patients in our study was 51.37 ± 11.37 years. The response of NAC according to the RECIST criteria showed that most of patients (83.3%) showed complete response. Of the 30 cases, 11 (36.7%) patients were PD-L1 positive before the administration of NAC. We found a significant change in expression from positive to negative status, i.e., seven patients changed from positive to negative (p = 0.036). Upon comparing the PD-L1 expression before NAC, significant association was observed between the primary tumor (T) and tumor stage with high PD-L1 expression (p = 0.020 and P = 0.034). After NAC, 18 (69.2%) patients who were ER positive and 18 (69.2%) patients who were PR positive showed negative PD-L1 expression while none of them were positive in PD-L1 positive patients (p = 0.018 and P = 0.018). Conclusion: PD-L1 expression in a same person changes upon administration of NAC which may indirectly be used as a predictor of response to NAC. [ABSTRACT FROM AUTHOR]

Background: This is the PhD thesis protocol of an ongoing study entitled 'Effect of Psychoeducation on short- term outcome in patients with Late Life Depression: A Randomized Control Trial'. Psychoeducation is a proof-based therapeutic intervention for patients and their caretakers/family members that provides plenty of information and support for better understanding and coping up with the illness, which is being diagnosed. Aim: The aim is to examine the effect of psychoeducation on short- term outcome in patients with late life depression. Hypothesis: The hypothesis is that psychoeducation will improve outcome in patients with late life depression at 4 weeks. The sample size is 154. Material and Methods: The methodology is that patients aged 60 years and above coming to Out Patient Department (OPD) of the Department of Geriatric Mental Health, King George's Medical University and having the first episode of depression, which has been clinically diagnosed, will be taken. Then, Mini International Neuropsychiatric Interview (MINI) 6.0.0 will be applied for the confirmation of diagnosis. After confirmation, Hindi Mental Status Examination (HMSE) will be done to know the cognitive status, those scoring 24 and above on HMSE will be included in the study. The included patients will be evaluated on Hamilton Depression Rating Scale (HAM-D), Geriatric Depression Scale (GDS) and Knowledge Attitude Experience (KAE) Questionnaire. Next, the patients will be randomized in case group and control group. Case group will be given intervention of 'psychoeducation' through a video, and control group will be given 'placebo' through a video. For both the groups, the first follow up termed as 'booster session' will be at 2 weeks +/- 4 days from the baseline and second follow up will be at 4 weeks +/- 4 days from the baseline. Statistical Analysis: Data will be recorded on the spreadsheet and the results will be analyzed using the statistical software. [ABSTRACT FROM AUTHOR]

Background: After the formal process of developing/revising and implementing the curriculum, the need arises for its 'Evaluation'. A plan of evaluation is an integral part of the process of curriculum development, which ultimately yields an evaluation report, giving us the directives for the curriculum reforms in the future. 'Curriculum Evaluation' is one of the six steps of curriculum development as given by David E Kern. Objective: The present study was undertaken with an objective to evaluate the whole process of curriculum revision and effectiveness of the Physiology curriculum in achieving the goals, objectives, and outcomes. Methodology: A framework or model is developed named 'FIPO model' of curriculum evaluation. According to this, all four components (Formative phase, Input, Process, Output and Outcome) are evaluated for the 'Curriculum'. In addition, the model also states the key/concerned person/persons responsible and the assessment/monitoring modality for each component. Result: All parameters included in the 'Formative phase' of the model, helped to evaluate the initial preparation for carrying out the curriculum revision. For 'Input' evaluation, various resources of Physiology department for curriculum revision, implementation, and evaluation, were assessed. It includes Manpower, Infrastructure, Material, Time, Money, etc. The third component of the FIPO model, i.e. process evaluation dealt with two processes, i.e. curriculum revision and curriculum implementation. Evaluation of 'Output and Outcome' of the entire exercise of undertaking curriculum revision was undertaken. Conclusion: The curriculum evaluation report stated that the curriculum of Physiology subject of MBBS (Phase I) is revised, implemented and evaluated systematically as per the prescribed guidelines using the available resources in an effective and efficient manner. The demonstrable output for the same was the document of 'Revised Curriculum' and significant outcomes were in the form of satisfactory result and distinctions for the subject Physiology. [ABSTRACT FROM AUTHOR]

Introduction: Despite well-described code of conduct for physician the recent increase in litigation against doctors is an issue of concern which says that doctors and health professionals are confronted with many ethical problems regularly. The aim of the present study was to see the ability to recognize different bioethical issues in relation to patient care among 3rd semester undergraduate students and also the change in the pattern of recognition of bioethical issues after formal training. Methods: This cross-sectional study was carried out using self-administered questionnaire among the fifty 3rd semester undergraduate MBBS students. Each question was designed in a "Likert scale" pattern carrying a minimum score of 1 (1 = strongly disagree) and maximum score of 5 (5 = strongly agree). After 6 months of training and bedside clinical exposure, students were assessed again with same set of questionnaire. The statistical analyses were performed using SPSS 17.0. Results: All of the respondents in the study group were of the opinion that medical ethics is very important but only 24% aware about existence of ethics committee in the institute. Changes has been observed after clinical exposure in response like disclosure of patient's condition to close relatives (agreed 54% versus 84% pre and postexposure, respectively) and discussion of related ethical issues with clinical case discussion (agreed 74% versus 94% pre and postexposure, respectively). Some of the issues needs further clarification even after clinical exposure like doctors must not refuse to do abortion (56% disagreed and 38% agreed), consent regarding treatment in children (60% disagreed and 32% agreed), and uses of branded versus generic drugs (76% generic and 26% branded). Conclusion: There is a need to stress the importance of ethical practice in the undergraduate curriculum to make the doctors confident enough to deal the ethical dilemma for themselves and better professional efficiency. [ABSTRACT FROM AUTHOR]

Aim: To assess the oral health status and inflammatory markers in end stage chronic kidney disease (CKD) patients. Objectives: To study and compare oral health status of end stage CKD patients with the control group (matched health individuals) and to study and compare inflammatory biomarkers in study and control groups. Materials and Methods: A cross-sectional study was conducted among 50 patients of end stage CKD and 50 matched healthy individual, who were taken as control in the study. Convenience sampling technique was used. Oral health status was recorded by using WHO proforma (2013). Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured in the both groups. These are inflammatory markers which show systemic inflammation. Statistical analysis was done by using IBM SPSS Statistics-version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) Results: The study revealed that patients on dialysis going for transplantation have evidence of increased inflammation as indicated by raised CRP values. Conclusion: The present study concludes that the oral hygiene of the patients is deteriorated who are having chronic kidney disease. Good oral and dental care in CKD patients can improve the transplant outcomes. [ABSTRACT FROM AUTHOR]

Background: The Swachh Bharat Abhiyan (SBA) is the most significant cleanliness campaign by the Government of India. Youth are the strong pillars of the development of any country. There is a need to bring a big change to the youth about the cleanliness drive. This study aims to assess the perception of SBA and attitude towards cleanliness among dental students of Kanpur city. Materials and Methods: This study is a descriptive, cross-sectional survey, which comprised of 390 undergraduate and postgraduate students. A pretested, self-administered, close-ended questionnaire consisting of 11 questions were included to evaluate the perceptions and attitudes regarding SBA among the dental students. Data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.). Categorical data were compared using the Chi-square test. All values were considered statistically significant for a value of P ≤ 0.05. Results: The results of the study revealed that there is a positive attitude among study participants towards cleanliness, but efforts are still required to emphasize the importance of cleanliness among the many inhabitants. To implement SBA effectively, it is important to highlight the urgent need for public awareness. Conclusion: This study found that the majority of the participants was having positive attitude and perception towards SBA, yet initiatives and approaches are still needed to help bring positive actions among those who are reluctant to follow proper cleanliness, sanitation, and hygiene practices. [ABSTRACT FROM AUTHOR]

Coronavirus infection is a transmissible disease. It was first described in China in December, 2019. It has been said to have a person-to-person transmission after prolonged and unprotected exposure. Patients with a potential SARS-CoV-2 exposure present with symptoms of low-grade pyrexia, dry cough, or shortness of breath. People with these symptoms should contact health-care providers before seeking medical intervention so that appropriate preventive actions may be implemented. Health-care facilities should rapidly isolate suspected individuals and notify local health departments for support involved in performing laboratory tests and efforts in containment. The present article describes the nature of virus, method of detection, and its mode of transmission. [ABSTRACT FROM AUTHOR]

Human nocardiosis is primarily an opportunistic infection affecting immunocompromised patients, however, one-third of them are immunocompetent. CNS involvement is less commonly reported and associated with a grave prognosis. The majority of these patients are organ transplant recipients on immune suppressants. In the recent past, association of Nocardia asiatica with brain abscess has been reported in a few cases. We are reporting a case of isolated cerebellar abscess caused by N. asiatica in an immune-compromised adult with a review of relevant literature. A 53-year-old male presented with complaints of headache and vomiting for 14 days. There was no previous history of any comorbid illness. During presentation, he was having gait ataxia and radiology showed the right-sided cerebellar multiple lesions. Further hematological investigations revealed the patient to be HIV positive. The abscess was tapped and the pus culture showed Nocardia species. Antibiotics were started as per sensitivity and the patient did well at 3-month follow-up. Though rare, Nocardia should be kept as a differential in brain abscess patients. Owing to the different antimicrobial sensitivity patterns among Nocardia species, both appropriate speciation and susceptibility testing of uncommon species such as N. asiatica are required for their successful treatment. [ABSTRACT FROM AUTHOR]

Background: The habit of smoking and chewing tobacco is associated with various types of oral mucosal lesions and conditions, many of which pose a potential threat to cancer growth. The present study aims to evaluate the prevalence of potentially malignant lesions (PML) and oral cancer in North India and to identify the associated risk factors. Materials and Methods: A cross-sectional study was carried out in the Department of Oral Medicine and Radiology Rama Dental College Hospital and research center Kanpur over a period of 5 years with1,10,625 patients. Participants were divided into study group with a positive history of the chewing habit as well as oral lesions and control group who had a positive history of habits with no oral lesions. Detailed case history and clinical examination were carried out under visible light by trained professionals to assess any oral mucosal changes. Results: The study group consisted of 76.31% males and 23.69% females. In total, 84.34% participants in the study group were literate. However, 57.56% subjects were having oral submucous fibrosis, 23.7% were having leukoplakia, 13.12% were having Lichen planus, and 5.62% were having oral cancer. Conclusion: Results from the present study indicate that tobacco smoking, chewing of betel quid with and/or without tobacco chewing are the major risk factors for PML and oral cancer. [ABSTRACT FROM AUTHOR]

Introduction: Increasing age, long-term deleterious habits, and increased bone resorption leading to the gingival recession have become a significant reason for poor geriatric oral health among which root caries are the most prevalent ones among the Indian population. Methodology: A cross-sectional study was conducted among the geriatric population above 60 years of age and those who gave voluntary consent for participating in the study were included in the study and were briefed about the questionnaire. The self-administered questionnaire was given and complete oral examination was done. Results were analyzed using the SPSS 22 version using descriptive analysis and Chi-square test. Result: Percentage of deleterious habits amongst males was higher than that of females i.e. 56%. Thus, males were reported with root caries more than females. The percentage of married people suffering from root caries was 85%. The most prevalent occupation among the geriatric population was found to be the farmers with 37%. Religion with maximum percentage and frequency was found to be Hinduism with 84%. Educational statuses with 6th to 12th standards were reported with maximum root caries, i.e. 55%. Conclusion: The study showed that criteria including income, gender, marital status, occupation, religion, and educational status were significant in assessing the prevalence of root caries. Whereas the risk factors such as habits, methods of cleaning, and brushing techniques influenced the root caries among the geriatric population. [ABSTRACT FROM AUTHOR]

Introduction: Gingivitis is codified as the most familiar oral disease in children and teenagers. Several studies reported that most of the children and adolescents have negative impact on quality of life (QoL) due to gingivitis or destructive periodontal disease or poor oral health status. Existing literature in this context on Indian population is sparse. Hence, this study has been shouldered to find out possible coalition between gingivitis and COHRQoL. Objective: This study desires to evaluate the confederation of gingivitis and child oral health-related quality of life (COHRQoL) among school children of Lucknow. Methods: A cross-sectional survey was conducted in school going children with the age group of 11–14 years, with a representative sample of 400 students in Lucknow city. For data on oral health-related quality of life (OHRQoL), a predesigned questionnaire (CPQ11-14) was used for demographic information and questions on oral symptoms, functional limitations, emotional, and social well-being. Gingival status was evaluated by Gingival index (Loe and Silness 1963). Results: QoL was found to be moderately affected in children with severe gingivitis as compared with children with no gingivitis, mild, and moderate gingivitis, but this difference was found to be statistically nonsignificant (P = 0.896). Conclusion: The present findings indicated that the existence of substantial levels of gingivitis might be fatalistically related with how children perceive their oral health and daily life. [ABSTRACT FROM AUTHOR]