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Introduction: Improvements in newborn health with study of present status, progressive perfection of practices, and data diligence for future is desirable. Methods: Study of mortality and morbidity patterns. Analyze findings for focus areas and for favourable advancements in practices. Corroborate with existing evidence and practice protocols. Setting: Tertiary care referral hospital. Protocols: Preterm babies given special attention. This includes, in addition to the WHO 10 main recommendations, meticulous monitoring and health education for care. Neonatal jaundice evaluation on the basis of risk factors and clinical monitoring. Results: A total of 1749 live, born babies (2018–2020) were studied. The neonatal mortality rate in the study was 6.29. Preterm births were 102 (5.83%), with mortality of 7.84%, that is, 8 out of 102 preterm babies, and overall 4.57 premature deaths per 1000 live births. Prematurity was the commonest cause of mortality, responsible for 8 out of 11 deaths (72.73%). Birth asphyxia incidence was 5.26% (92 babies) with a case fatality ratio of 4.35%. Newborns with severe birth asphyxia were 7, and of these 4 (all premature) had fatal outcome. The low birthweight (LBW) incidence was 13.32% with the majority (79.83%) in the 2000–2499 g range. Preventive practices for hypothermia were 100% successful. An unusual rise in incidence and severity of hyperbilirubinemia during December 2018 to February 2019 when winter was severe was noted. Conclusion: Mortality reduction requires focusing on prematurity. Meticulous monitoring and health education for them improves results. The unusual rise in incidence and severity of hyperbilirubinemia in severe winter points towards the need for vigilance. We need to be forewarned and forearmed for frequent extreme weather events.

”Radiation uses and ubiquitousness: The good, bad, and limits” an earlier review was published before launch of 5th Generation (5G) mobile networks technology. Now with 5G technology's upcoming use, its advantages need to be used for advancing healthcare. All this for best applications possible and as safely as possible. The review update aims at reviewing the 5G technology benefits, risks, and its reduction. All this is important for rationale use. We searched the MedLine database and relevant statutory government recommendations. Results are discussed and put in proper perspective. Advantages are higher data transmission rates, lower latency and better quality of service. 5G technology will be beneficial for health services with shortened time and space. It will aid overcoming some of the current challenges to healthcare. The advantageous applications are elaborated for (1) proper assessment, (2) pertinent treatment, (3) progress monitoring, (4) prevention applications, and (5) professional standards. The concerns about possible adverse effects to human health needs to be addressed. The health effects of frequencies in the range 450 to 6,000 MHz are cautioned. There is a need of studies on nonthermal effects of the higher frequencies. In our present state of understanding and evidence, the useful strategies suggested are the “3Rs”: (1) risk-reducing devices, (2) risk-reduction necessarily, and (3) risk-reduction engineering and environment. Balancing risks and rewards are the best strategy forward. Robust communication will make excellent healthcare reach all, always and especially in times of need.

Radiation is important in health and disease. It is imperative to use properly and prevent misuse or overuse. Pertinent trends of increasing radiation in the environment need analysis. We gleaned important information, from published evidence and authoritative resources, for practicing safely and preventing harm. Science & technology progress is for the betterment of mankind, and all efforts should be made to prevent any untoward effects. Children and paediatric patients deserve special attention because of their vulnerability due to multiple reasons. Effective investigations & interventions in medical settings should be done based on best evidence. All those ordering radiological investigations should take into consideration the radiation exposure values & especially decide on clinical impact of the investigation. Prenatal exposure to radiation has risks. Computed Tomography is responsible for 24% of all radiation exposure. Dual-energy X-ray absorptiometry is useful for measuring changes in body tissue composition. Radiologists should tailor imaging individually. Radiotherapy is administered to more than half of all cancer patients. Acute toxicity alleviation and chronic toxicity consideration is important. Radiation emergencies can occur in isolation or as major catastrophe. Emergency life-support is needed. Decontamination along with using the ABCDE reduction approach components are elucidated. With increasing use of mobile phones the electro-magnetic fields produced by mobile phones use needs consideration. UV radiation overexposure prevention is with shade, clothing and hats. Applying sunscreen essential on those parts of the body that remain exposed like the face and hands. All the safety measures need popularization and continuous practice with precision & perfection.

Pertinent perspectives for practical applications is advantageous professionalism. Congenital heart diseases (CHDs) are of varied types, severity, and complexity. Simple scientific approach along with sophistication is required for successful management at all levels. We gleaned important information from published evidence and authoritative resources and have put things in practical perspective. These include current prevention, care, correction, cure, and rehabilitation strategies for robust practices. Prospective prevention is with preconception counseling and addressing environmental factors. Fetal echocardiography and nondirective genetic counseling are important. Early detection and expert diligence is desirable. The suspicion is clinical. A number of clinical and investigative diagnostic modalities are available and should be utilized as guided by the clinical cues. Medical management includes general health maintenance, immunizations, monitoring, and complications treatment. Pediatric interventional cardiology is making rapid strides and treating many types of lesions. Understanding of procedure done is a prerequisite of follow-up care. Surgery is of curative, reparative, or palliative types. After surgical correction in early childhood long-term sequelae are rare. After reparative surgery some have life-long sequelae and some have significant late impairment. The number of postintervention/surgery survivors into adulthood is increasing. Microsurgical techniques are leading the way for precision and fewer complications. Follow-up care with “Ten Points Information and Action Plan (TP-IAP)” is suggested. The Armed Forces scenario involves frequent movements to difficult and harsh conditions. Special precautions for affected children needed. Cardiovascular health is enhanced by avoiding a sedentary lifestyle and obesity. Various intrinsic and extrinsic factors limiting functioning need to be suitably addressed.

We report a case of a 69-year-old male, a known epileptic on phenytoin for 40 years, presented with ecchymotic patches over the right upper and lower extremities. There was a history of right leg pain 3 weeks before presentation, when he was misdiagnosed as deep venous thrombosis (DVT) on the basis of venous Doppler at a nursing home. He was treated with low-molecular-weight heparin followed by acenocoumarol. Subsequently, he developed subcutaneous bleeding followed by sudden drop in haemoglobin, and anticoagulant measures were withheld. He continued to have fresh crops of ecchymosis even 10 days after withdrawal of anticoagulants; hence, he was shifted to our hospital. On evaluation, his activated partial thromboplastic time (APTT) was found elevated and anaemia was present, while prothrombin time and thrombin time were normal. His factor VIII level was identified as low (1%) and factor VIII inhibitor level was elevated. With diagnosis of acquired haemophilia A, he was treated with recombinant factor VII, steroid and cyclophosphamide. There was no cause identified for acquired haemophilia A, even after extensive work-up for malignancy, viral diseases, connective disorders and coagulating disorders. Hence, the diagnosis of idiopathic acquired haemophilia was considered.

Context: Adolescent health information within new global health initiatives is advocated. Global School-based Student Health Survey (GSHS) is among young people 13 to17 years. Early prevention and promotion is beneficial. Aim: To find health behaviors and protective factors at different adolescence physiological stages. Settings and Design: School-based survey in an Army Public School. Methods and Materials: The study parameters were dietary behaviors, hygienic practices, mental health, physical activity, and protective factors. A total of 1232 adolescents were surveyed. Early adolescence (10–13 years) participants were 760 and middle adolescence (14–17 years) were 472. Male: female ratio was 1.819:1. Statistical Analysis: Calculation of percentage ± Standard error using standard methods. Results: The study reveals interesting trends. There is a disparity between body mass index (BMI) findings and effort direction for weight. There is a sharp rise in girls making efforts to lose weight from early to middle adolescence (27.8% and 40.7%, respectively). Hygienic practices are marginally short of 100%. Worry causing the inability to sleep at night most of the time or always reported by 9.2–18.7%. There is a sharp rise in the number of girls feeling this from early to middle adolescence (9.8%–18.7%). Adolescents spending three or more hours per day doing sitting activities are 25.6–38.6%. This is rising from early to middle adolescence, and sharply in girls. Protective factors are trending towards the positive side. Conclusions: First, for advancements of adolescents' health, top priorities are (i) Popularizing importance of ideal BMI, (ii) Betterment of mental health for a smooth transition across stages and being proactive for preventing worsening, (iii) Promoting physical activity early and sustaining efforts, especially amongst girls. Second, the 'GSHS Questionnaire' needs to be modified for fruits and vegetable consumption to how many servings/what part of plate and include questions for details of physical activity likings of girls.

Immune reconstitution inflammatory syndrome is a phenomenon that occurs after initiation of treatment for chronic immunosuppressive illnesses such as human immunodeficiency virus (HIV), tuberculosis and hepatitis B infections. Immune-system resumes activity and results in unmasking of occult infections or worsening of existed infections. We came across a case of a 35-year-old man who was diagnosed with HIV infection with pulmonary tuberculosis. He was started on anti-tubercular treatment initially followed by anti-retroviral treatment 2 weeks later. After a fortnight, he presented with a febrile illness with urinary retention. Clinically, tender enlarged prostate was felt on per rectal examination. On radiological workup, he was found to have focal lesions in the prostate, suggestive of the abscess. Subsequently, the patient underwent transurethral resection of prostate and tissue was sent for histopathological examination. Initially, we suspected tuberculosis but the biopsy report revealed cryptococcal prostatic abscess. The patient was managed with amphotericin B followed by fluconazole. Clinically and radiologically, he improved well.

Anaesthesiologists are playing a decisive role in patient management. Present day anaesthesiology is based on the use of newer and safer drugs, better patient monitoring, pain management and critical care. But the general public knows little of these developments. The study was undertaken to assess the perception regarding the anaesthesiology and anaesthesiologists among the general population. The present study was conducted on 300 persons (patient, patient′s attendant and medical undergraduates) between 18-75 years of age to assess the knowl-edge regarding anaesthesiology and the anaesthesiologists. All collected data were categorized into 5 groups as per the educational status of the study population. Perception of anaesthesiologist as a doctor in illiterate, graduate and postgraduate population was 19.51%, 58.57% and 87.88% respectively. Anaesthesiology as a separate medical discipline was not known to 100%, 73.87%, 64.29% and 51.52% of the illiterate, upto matriculation, graduate and postgraduate population respectively. Among the population who knew something about general anaesthesia, none from upto matriculation and 33.87%, 44.83% and 100% from the graduate, post graduate and medical undergraduate groups respectively knew that anaesthesia is administered with specialized equipments along with monitoring. Illiter-ates did not know about regional anaesthesia, while most of others had some knowledge about it. The results of the study reflect the wide spread ignorance and misconceptions about anaesthesiology and anaesthesiologists still preva-lent in public in India.

The study was designed to compare the efficacy of interpleural and thoracic epidural analgesia after thorac-otomy with regard to quality of analgesia and complications. Sixty patients undergoing elective thoracotomy were randomly and equally placed into either interpleural (IP) or thoracic epidural (TE) group. In IP group an interpleural catheter was placed in paravertebral space under direct vision during surgery and received 0.25% bupivacaine 20 ml with buprenorphine 150 mcg. In TE group an epidural catheter was inserted in the T6-7 / T7-8 interspace and received 0.25% bupivacaine 10 ml with buprenorphine 150 mcg. Dosage were repeated in both the groups to keep a VAS score < 40 for 48 hours post-operatively. Spirometry was done preoperatively and 12, 24 and 36 hours post-opera-tively. Vital parameters were monitored for 48 hours. The mean analgesia time was 331.73±94.03 min and 567.33±127.33 min in IP and TE groups respectively. The VAS score was significantly reduced within the first 30 minutes of injection in both the groups. Post injection VAS was significantly better in TE group. Mean time taken for interpleural and epidural catheter placement was 5.0±0.0 min and 33.83±3.39 min respectively. Postoperative forced expiratory volume in 1 second(FEV1), forced vital capacity (FVC) and forced expiratory ratio (FER) were similar in both the groups while peak expiratory flow rate (PEFR), maximal expiratory flow (MEF) and F50 were slightly better in TE group. Vital parameters showed similar changes in both the groups. The TE group had more complications. Interpleural analgesia, though of shorter duration, is a safe and effective alternative technique for post-thoracotomy analgesia and has a low complication rate.