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Background: According to the WHO, antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness, and death and is a global issue and measures to halt this is the need of the hour. Aims and Objectives: This study aims at identifying awareness as well as knowledge, attitude, perception, and practice regarding AMR and antibiotic use among medical undergraduate students, so to get insight and take appropriate actions to enhance their knowledge that will help in reducing AMR as they are the future prescribers. Materials and Methods: A descriptive cross-sectional study was conducted among 483 undergraduate medical students enrolled in government medical college, Haldwani. A pretested, semi structured questionnaire was designed to collect data from participants through Google forms regarding sociodemographic profile, and behavior of the participants regarding antibiotic use which comprises: Attitude, perceptions, and practice. Results: Majority of study participants have heard about AMR before (97%) of which most of them got information about antibiotic resistance by web/internet (35%). Majority of study participants were aware (>90%) of phenomenon of antibiotic resistance, 98.9% of them were correctly able to identify Amoxicillin and Penicillin as antibiotics, most of them had correct knowledge about role of antibiotics. Majority (83.6%) of participants take antibiotic only after the prescription of doctor, 78.9% of them reported use of antibiotics in the last year. Conclusion: A fair good amount of awareness, knowledge, attitude, perception, and practice regarding AMR and its use was found among study participants. Still, there is scope of improvement in it that can be addressed through giving more emphasis on this in undergraduate teaching curriculum.

Background: Low birth weight is associated with higher morbidity and mortality including impaired growth and development, malnutrition etc. Worldwide, one- fifth of newborns delivered are low birth weight. Aims & objectives: To estimate frequency of low birth weight & its associated factors among newborns delivered in a tertiary care hospital. Materials & Methods: A cross sectional analysis of 290 newborns delivered in tertiary care hospital, Banda, Uttar Pradesh during period of 15th February 2021 to 31st December 2021 was done for estimating low birth weight frequency & its associated factors including child characteristics, mother characteristics & father characteristics using data from medical record section of hospital. Frequency, percentages, mean, standard deviation, chi square test & independent t- test was used. P value

Background: India saw one of the stringent lockdowns during the COVID-19 pandemic. In the wake of this period, the normal functioning of medical services was affected. People were reluctant to seek medical attention and notification of Tuberculosis dipped. The aim of the study was to estimate the proportion of non-adherence to anti-tubercular treatment and to identify the factors affecting the non-adherence to treatment. Methods: A retrospective community-based study was conducted among 284 tuberculosis patients. They were interviewed using a pre-designed questionnaire consisting of WHO dimensions of non-adherence and lockdown related questions. Results: The proportion of non-adherence to treatment was found to be 5.3%. Factors like chronic diseases, depression, without knowledge on how the disease is transmitted and that medication can be discontinued once the symptoms subsided, alcohol consumption, and trouble accessing medicine were found to be the determining factors in non-adherence to the treatment. Conclusions: Non-adherence to anti-tuberculosis treatment in our study was low but the various dimensions of adherence along with lockdown related factors had significant impact on it. To further minimize non-adherence during emergency like the lockdown due to COVID-19 pandemic, corrective measures must be explored and implemented.

Introduction: With time there have been major changes in the management of TB. No longer TB sanatoriums are preferred. However, in this 21st century, few sanatoriums do exist but are no longer in their original forms, to explore the admission patterns and duration of stay at the TB sanatorium Bhowali, Uttarakhand. Methodology: We retrieved the data between 1st January 2018 to 31st July 2021 from the inpatient Department (IPD) of TB sanatorium Bhowali. Data were extracted in an extraction sheet and descriptive data analysis was done to see the admission patterns and duration of stay. The place of residence was analysed as per the district-wise distribution. Results: There were 1247 admissions. These admissions were limited to six states, and the majority were from the state of Uttar Pradesh (50.7%) and Uttarakhand (46.7%). The highest cases were in the year 2018, and during April to July. As per the district-wise distribution, Udham Singh Nagar had the highest proportion of admissions (18.6%), followed by Bareilly (15%), Nainital (11.4%), and Rampur (10.9%). The mean (SD) and median (IQR) duration of stay were 22.7 days (SD–24.7) and 14 (IQR 7– 8) days, respectively. The median duration of stay was significantly higher for females (25.1 days) compared to males (21.6 days). Conclusion: TB sanatorium Bhowali (Uttarakhand) caters majority of the patients from the neighbouring state of Uttar Pradesh. The admissions were high during the spring and summer seasons. The median duration of hospital stay for patients admitted with TB was two weeks.

Background: Diabetes enhances the risk of stroke which is one of the leading causes of morbidity and mortality. Aims and Objectives: The study was done to analyze the clinical profile and pattern of stroke in diabetic and non-diabetic patients. Materials and Methods: This was a hospital-based cross-sectional study done in 130 stroke patients (with/without diabetes – 65 each) presenting to outpatient department\inpatient department general medicine department, Dr. Sushila Tiwari Hospital of Government Medical College, Haldwani during January 2020–September 2021. A detailed history, neurological examination along with assessment of risk factors, pattern, and subtype were done. Results: The mean age was significantly higher among stroke patients with diabetes (66.38±11.99 years). The proportion of systemic hypertension was significantly higher in stroke patients without diabetes (89.2%). Abnormal ECG was significantly more reported in stroke patients without diabetes (73.8%). The mean hemoglobin and mean random blood sugar were significantly higher in stroke patients with diabetes (8.82±1.72 and 291.17±107.39, respectively). The mean high-density lipoprotein was significantly higher in stroke patients without diabetes (43.06±5.1), whereas mean low-density lipoprotein, mean triglycerides, and mean total cholesterol were significantly higher in stroke patients with diabetes (126.28±33.19; 186.97±45.91; and 229.31±39.83, respectively). The presenting complaints observed were altered consciousness (67.7%) right hemiparesis (55.4%), left hemiparesis (41.5%), abnormal body movement (28.5%), etc. Ischemic stroke was significantly higher in patients with diabetes (90.8%). Lacunar (34%), basal ganglia (27%), cortical (23%), etc., were stroke subtypes seen among study patients. Conclusion: Significant difference was observed between stroke patients with/without diabetes in terms of age, several risk factors, presenting symptoms, pattern, and its subtype.

Electroencephalogram (EEG) is a recording of the electrical movement of the brain from the scalp. For sleep disorder analysis the EEG test is done while the subject is sleeping. In this paper discuss about recording of brain signal (EEG) and how these signal play major role to finding in different brain diseases. EEG data can be different when subjects are asleep or when exhausted or when some sort of action takes place. When the patient is awake standard EEG test can be taken, but it may not demonstrate any unusual electrical action. During the sleep, brainwave patterns alter and may show more unusual electrical action.

Introduction: Lymphatic filariasis results in severe disability that leading to severe social and economic burden at each level from individual to family, and community. This study was carried out to assess the coverage and compliance of MDA. Methods: From 300 households (1837 individuals) in both rural & urban area were covered in coverage evaluation survey by systematic selection of subunits using probability proportionate to size (PPS). Each household was visited by WHO designated team and data were collected using predesigned questionnaire. Data was compiled on MS-excel spreadsheet, frequency and percentage were calculated. Results: The overall effective coverage for all drugs was low (19.1%). The coverage was low, compliance was higher in urban as compared to rural area. Females had better coverage and compliance than males. The primary reasons for drug not offered was nobody came to offer drug, drug not swallowed was not sick, drug swallowed was useful information from drug administrator (DA). Only one female reported adverse effect. Conclusion: Increase in coverage along with decrease in coverage-compliance gap is needed to achieve filariasis elimination that warrants intense IEC activities using different platforms, development of better drug delivery strategies and strengthening monitoring system.

Periodic Limb Movement (PLM) Sleep Disorder is a type of sleep disorder characterized by involuntary and repetitive movements of the limbs, which can lead to sleep disturbances and disruptions. It is a common condition that can affect people of all ages and can significantly impact quality of life, In this paper review the symptoms, diagnosis, and treatment of PLM Sleep Disorder. In this paper discuss the various methods for diagnosing PLM Sleep Disorder, including polysomnography. Additionally, In this paper discuss the importance of timely diagnosis and treatment of PLM Sleep Disorder to improve quality of life for those affected by this condition.

Background: Mental illnesses including depression and anxiety are very common across all age groups. Even individuals with minimal or undetectable COVID-19 symptoms have felt the effects of this burden, which the COVID-19 pandemic has intensified. Methods: A cross-sectional study was conducted on 346 COVID-19 patients with asymptomatic or mild illness. Depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS), and perceived social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSP). Version 16 of SPSS was utilised to analyse the data. We employed ANOVA, Pearson's rank correlation, independent t-tests, and multivariate linear regression. P values less than 0.05 were considered statistically significant. Results: 13.8 percent patients had comorbid depression and 32 percent, anxiety. 35.2 percent patients did not have enough support. Significant correlation between depression and anxiety, depression and social support, and anxiety and social support was observed. Regression analysis showed age, marital status, covid case in family, and hypertension had significant association with both anxiety and depression. Association of diabetes mellitus with anxiety was also observed. Perceived social support was found to be significantly associated with age, covid case in family, and presence of diabetes mellitus and hypertension. Conclusion:Significant number of COVID-19 patients displayed signs of anxiety, depression and lack of social support. Clinico-social factors found associated with anxiety, depression and perceived social support should be better taken care of in a future crisis like COVID-19.

Pathophysiological changes secondary to cirrhosis predispose patients of chronic liver disease to develop various electrolyte disturbances which have a significant impact on morbidity, mortality, and prognosis of these patients. This study aims to estimate the level of electrolyte disturbance and its association with the severity, complication, and outcome in chronic liver disease patients attending a hospital in the Kumaon region of Uttarakhand.Our study was a hospital-based cross-sectional study conducted on 100 chronic liver disease patients at the OPD/IPD Department of Medicine, Dr. Sushila Tiwari Hospital, Haldwani, Uttarakhand, from January 2020 to September 2021.Hyponatremia was observed in 49% of the patients, hypokalemia in 30%, and hypocalcemia in 16% of the patients. The electrolyte levels were similar irrespective of the disease severity and presence of complications. The sodium and potassium levels had a significant association with the outcomes.Hyponatremia was the commonest electrolyte disturbance seen in the study patients. No significant association was observed between the electrolyte and severity of the disease and complications.

Neurological disorders are one of the most complex disorders and are difficult to understand because there occurrence is highly erratic and there reasons are not known considerably till now. Most of the neurological disorders manifest themselves into the biosignals that are recorded from the brain. These signals are termed as EEG (electroencephalogram) signals, and they are recorded using a EEG machine.

Hypertension is widely prevalent across India. The rule of halves is commonly used to describe the attrition and gaps in the care cascade of hypertension management across detection, availing treatment, and having controlled blood pressure (BP) on treatment.Using nationally representative data, we aimed to assess the rule of halves in hypertension management in different states of India and across sociodemographic, health system, and personal factors.A descriptive analysis of secondary data from the National Family Health Survey-4 was conducted. We included 770,662 individuals (112,122 men and 658,540 nonpregnant women) of 15-49 years of age. The proportion of individuals not aware of hypertension status among those with high BP, known hypertensives not availing of treatment, and uncontrolled BP among those on treatment were expressed as percentage with a 95% confidence interval (CI).Of those with high BP, 48.5% (95% CI: 47.8%-49.3%) were not aware of their hypertensive status. Among known hypertensives, 72% (95% CI: 71.2%-72.8%) had not availed treatment for hypertension. Among those on treatment, 39.8% (95% CI: 38.7%-40.9%) had uncontrolled hypertension.The rule of halves of India shows that the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke has made relatively good progress with the detection of hypertension and achieving BP control among those on treatment. However, with three-fourth of known hypertensives not availing treatment, more dividends from the detection of hypertension efforts could be realized. The program needs to especially focus on ensuring the treatment for those detected with hypertension.