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Background: The Health and Family Welfare Department of Gujarat implemented a mHealth Programme called TeCHO+ (Technology for Community Health Operations) in 2018. TeCHO+ is aimed at making progress across all dimensions of the comprehensive primary healthcare services. Objective: The objective of this study is to record the document rollout and early implementation experience of TeCHO+ programme in Gujarat. Methods: The present participatory process documentation exercise was undertaken in Gujarat. The various steps for process documentation were decided after participation in multiple task force meetings and state/district- and taluka-level action seminars and reviewing the TeCHO+ programme data and progress reports. The perceptions of the health officials and field staff were gathered using key informant interviews from five districts of Gujarat: Bharuch, Narmada, Gandhinagar, Mahisagar, and The Dangs. In addition, stakeholders involved with TeCHO+ Programme were interviewed to understand the process of rollout, implementation challenges, and success. Results: In the initial phase, the TeCHO+ application focussed only on updating the Family Health Survey to improve the quality of data captured in the system. FHWs log-in the mobile application daily to access their daily work plan for which SMS alerts were are also generated. Most FHWs were in their 50s and were first-time smartphone users. Although, they were enthusiastic and open to the new technology, initially they faced certain difficulties in operating the application. The programme had a strong troubleshooting mechanism in terms of the use of WhatsApp group, helpline numbers, and voice calls in addition to supportive supervision. Discussion: TeCHO+ showed the potential to enhance the quality of the collected data and also service coverage. However, poor technology literacy of old FHWs, the launch of multiple programme memes at the same time, and target-driven task assignments pose major challenges.

Background: Contraceptive methods play a vital role in family planning and has been established a cornerstone in reducing maternal and infant mortality rate. Family planning is encouraged as a tool to address the reproductive health needs of men and women, as well as the pivotal problem in regard to rapid population increase. The total fertility rate in Uttarakhand is 2.1 children per woman with couple protection rate of 53%, according to National Family Health Services. Aims and Objectives: We aimed to assess the knowledge regarding contraceptives and its usage among married women of reproductive age group in urban area. Materials and Methods: The study was a cross-sectional study using a quantitative survey questionnaire of duration 5 months. Women in reproductive age-group (15–45 years) were included in the study. A total of 102 study participants were enrolled. Results: Mean ± standard deviation of study participants was 29.09 ± 5.04. "Knowledge" questions had over 90% of correct responses. The attitude of study participants toward contraceptive usage was mostly favorable. Contraception usage practice was fairly good. Conclusion: There is a need to promote positive attitude among the general public so that they can create an environment to raise awareness among the general public regarding contraception.

Background: Uttarakhand, a hilly state in north India, reported the first coronavirus disease (COVID) case on 15 March 2020. Since then, the case numbers rose multiple folds. As Uttarakhand has been on a 'war-footing' amidst the recent second wave and is gearing up to fight against the third wave, the present study aims to uncover baseline clinical profile and in-hospital outcomes of COVID patients in Dehradun district (Uttarakhand) during the first wave. Methods: A record-based descriptive analysis was carried out for 671 COVID patients admitted to a private dedicated COVID hospital in Dehradun district between August 2020 and February 2021. Data was collected from medical records on a standardized abstraction form. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: The present study showed most admitted COVID patients were males, aged 40 years and above, moderately ill, had co-morbidities with about one-fourth lately succumbed to death. The proportions of deaths, moderate-to-severe and severe category of illness were invariably high for those with co-morbidities irrespective of the gender. Females, age

Objectives: To study the prevalence and various environmental risk factors related to Road Traffic Accidental injuries in district Dehradun. Material and Methods: A cross-sectional descriptive study was conducted in rural and urban areas of district Dehradun. Multistage stratified random sampling method was used to reach the desired sample size. Overall 4000 individuals were interviewed using a structured pretested questionnaire. The data was entered in computer and analyzed by using SPSS software version 20. Results and conclusion: Maximum numbers of Road Traffic Accident (RTA) victims were in the age group of 20 – 29 years (33.6%). Males (79.5%) were involved significantly more as compared to females (20.5%). Most of the RTAs (61.9%) occurred during evening hours (4 – 10pm) and on crowded municipality roads (43.9%). Rural area had significantly more accidents (69.6%) as compared to urban area (30.8%). Maximum RTAs (78.7%) happened to occur on good roads.

BackgroundFever is one of the common clinical symptoms found among children suffering from various illnesses. India carries a substantial burden of febrile illness among under-five children which heighten the risk of malnutrition, mortality and morbidity. This study aims to determine the factors associated with delay in treatment-seeking for fever among under-five children in India.MethodsA cross-sectional study was carried out using the large-scale nationally representative data from the National Family Health Survey (NFHS-4), conducted in 2015-2016. The data were collected by using four survey questionnaires i.e., Household Questionnaire, Woman's Questionnaire, Man's Questionnaire, and Biomarker Questionnaire. Delay in treatment-seeking was defined as taking a child for treatment after 24 hours of fever onset. Bivariate and multivariate logistic regression models were performed to assess the factors associated with delay in treatment-seeking behaviour for fever in under-five children.ResultsIn India, 31.12% (n = 7229) of the caregivers sought treatment for children after 24 hours of the onset of fever. Findings show no significant differences in delay in treatment-seeking behaviour by age groups and sex of children. Multivariate analysis revealed that the odds of delay in treatment-seeking behaviour of fever were higher among children from the poorest wealth quintile (AOR: 2.06; 95% CI: 1.85, 2.31), belonging to the scheduled tribe (AOR: 1.35; 95% CI: 1.24, 1.48), children who resided in rural areas (AOR: 1.14; 95% CI: 1.07, 1.22), children from the northeast region (AOR: 1.29; 95% CI: 1.14, 1.46), and children of caregivers who perceived distance to health facilities as a 'big problem' (AOR: 1.16; 95% CI: 1.09, 1.23).ConclusionThe study shows a high prevalence of delay in seeking treatment for fever among caregivers of under-five children in India. Delay in seeking treatment is associated with socio-demographic and socio-economic factors. Therefore, there is a need for intensified health promotion programs to sensitize caregivers on the importance of early health-seeking behaviour.

In this paper, we have described the health care problem (maldistribution of doctors) in India. Later, we have introduced the concept of artificial intelligence and we have described this technology with various examples, how it is rapidly changing the health care scenario across the world. We have also described the various advantages of artificial intelligence technology. At the end of the paper, we have raised some serious concerns regarding complete replacement of human based health care technology with artificial intelligence technology. Lastly, we concluded that we have to use artificial intelligent technology to prevent human sufferings/health care problems with proper caution.

To protect our masses, primary care institutes were developed in many countries, all over the globe. In the previous era, labour was valuable to produce crops and protect native countries from enemies as no substitute for raw labour was available to do these jobs. The scenario has changed after the era of automation. After the agricultural revolution, technological revolution took place. Hence, most of the manual jobs in agriculture sector and industry sector were automated. As a result, “new” type of jobs has emerged which was based, so far, on mainly of cognitive skills, e.g., learning, analysing, communication, and understanding human emotions. As the technology is advancing day by day, the role of humans as individual is becoming less and less except for some extraordinary persons or elite groups. Now the important question is, will elites and governments will go on valuing every human being even when it pays no economic dividends? Will the development of mass medicine/primary care will continue? Will governments/bureaucrats fund adequately for the protection of the health of these useless classes merely on the humanitarian ground? We assume that due to technological advancement and greater role of elite classes, the norm of shifting non-normal people to normality may not require any more, the previous practice of treatment (health for all concept) may not repeat in future and it is quite natural. Experiences from Japan highlight that society may prefer theses elites to the useless average class. The gap between the two classes regarding availing health facilities may widen further. This is because the government may focus more on the health of elites than common masses. One step further the government/ bureaucrat may try for immortality/divinity for this elite class, at any cost for maintaining supremacy over the poor masses.

The deluge of sequence information in the recent times provide us with an excellent opportunity to compare organisms on a large genomic scale. In this study we have tried to decipher the variation in the gene organization and structuring of a vital bacterial gene called ftsZ which codes for an integral component of the bacterial cell division, the FtsZ protein. FtsZ is homologous to tubulin protein and has been found to be ubiquitous in eubacteria. FtsZ is showing increasing promise as a target for antibacterial drug discovery. Our study of ftsZ protein from 143 different bacterial species spanning a wider range of morphological and physiological type demonstrates that the ftsZ gene of about ninety three percent of the organisms show relatively biased codon usage profile and significant GC deviation from their genomic GC content. Comparative codon usage analysis of ftsZ and a core housekeeping gene rpoB demonstrated that codon usage pattern of ftsZ CDS is shaped by natural selection to a large extent and mimics that of a housekeeping gene. We have also detected a tendency among the different organisms to utilize a core set of codons in structuring the ftsZ coding sequence. We observed that the compositional frequency of the amino acid serine in the FtsZ protein appears to be a indicator of the bacterial lifestyle. Our meticulous analysis of the ftsZ gene linked with the corresponding FtsZ protein show that there is a bias towards the use of specific synonymous codons particularly in the helix and strand regions of the multi-domain FtsZ protein. Overall our findings suggest that in an indispensable and vital protein such as FtsZ, there is an inherent tendency to maintain form for optimized performance in spite of the extrinsic variability in coding features.

Introduction: Violence against women is a significant public health problem, as well as a fundamental violation of women’s human rights. It is one of the most common forms of violence globally and includes physical, sexual, emotional and economic violence. Aims and Objectives: 1.To study the prevalence of Violence against Women (VAW) amongst ever-married women of reproductive age group in district Dehradun.2. To study their awareness regarding protection from such violence. Methodology: The community-based, cross-sectional study was conducted using multistage random sampling method, amongst 880 ever married women aged 15-49 years, in the rural & urban areas of district Dehradun. Results: Out of the surveyed sample of 880 women, receiving obscene phone calls was reported by 11.8 %; eve teasing by 9.4 %; being followed home by 5.7% and unsolicited advances by 3.9%. About 1.0% women reported being forced into unsolicited sexual activity by a person other than a spouse. Overall only 19.2% women had any knowledge about protection laws and agencies for victims of VAW. Conclusion: Nearly 37% women in our study reported suffering from any harassing activity ever in life, it was disheartening to see that only one-fifth had knowledge regarding protection laws. Primary prevention in this scenario becomes very important to disjoin VAW from cultural acceptance.

Introduction: Empathy is the ability to understand others’ experiences and emotional states from their perspective. It is considered as a part and parcel of healthy doctor-patient relationship. The assessment of empathy among undergraduate medical students is an important step towards yielding a better fruitage from medical education in the form of empathetic doctors. Objectives of the study were to assess the empathy level and its determinants among undergraduate medical students. Methodology: This study was conducted among 351 undergraduate medical students studying at Dehradun by using the “Jefferson Scale of Physician Empathy-Student Version (JSPE-S)” and analyzed by SPSS-22. Results: The arithmetic mean (±SD) of empathy scores was 98.89±12.9. Compared with male students, empathy scores were significantly higher in female students (p

Background: Weaning plays a major role in determining the nutritional status of a child. Poor weaning practices during infancy and early childhood, resulting in malnutrition, contribute to impairment of cognitive and social development, poor school performance and reduced productivity in later life. The objective of this study is to know weaning practices of mothers of difficult terrain. Methods: Cross-sectional study was conducted in all villages under Rural Health Training Center, the field practice area of Department of Community Medicine. A total of 500 mothers with children within 3 years of age were included in the study. Pre-tested pre-designed semi-structured questionnaire was used to collect information on weaning practices. Results: Majority of children (51.57%) were weaned at >6 months and were observed to be more under nourished (79.34%) as compared with those between 4 months and 6 months (61.50%). Majority of boys were weaned earlier than girls irrespective of the age of the weaning. Malnutrition was found in majority of those children who were weaned inadequately in terms of both frequency and amount. Conclusions: The present study revealed suboptimal weaning practices among the mothers of hilly region. Thus, appropriate educational strategies should be directed particularly on counteracting various myths related to infant feeding Moreover, promotion of appropriate feeding should target not only on maternal caregivers, but also on other family members, particularly husbands and grandmothers, taking into account the social and cultural situation of the area.

Objectives: The study was conducted to assess the prevalence of risk factors for Chronic Kidney Disease and to find out the prevalence of CKD. Methodology: A community based survey was conducted in the selected urban wards of the district Dehradun to collect the required information of the study. Individuals aged between 40 – 80 years, residents of the area for at least one year were included in the study. Information regarding number of households and population in each ward was obtained. They were informed about the purpose of study. The household in each ward was selected on PPS basis. Out of each selected household, study subject (40-80yrs) was drawn on the basis of “Kish” method basis. After obtaining the written informed consent, they were interviewed using the WHO (stepwise approach for NCDs) questionnaire and SCORED screening test tool to identify risk factors. The subjects who were at risk were screened for chronic kidney disease. The data was compiled, entered & analyzed using SPSS version 19. Results: Raised BP, diabetes and cases of heart attack were more among males as compared to females. The prevalence of CKD was 2.1 percent. Proportion of CKD cases was almost same in both sexes. Chronic kidney disease prevalence was 1.1%, 5.1% and 8.2% in 50-59, 60-69 and >70 year age groups. Conclusion: The prevalence of diseases like hypertension, diabetes was high in the urban population etc. The disease prevalence tends to increase with the advancing age.

Introduction Numerous studies have demonstrated that excessive alcohol consumption and tobacco use are independently associated with a plethora of health-related, social, and economic adverse consequences for the consumers of these legal substances as well as for society at large. Material & Methods: A cross sectional study was done in rural & urban areas of Distt. Dehradun. Multistage Stratified Random Sampling was used for selection of study area, Kish method was applied for the selection of study subjects. Statistical analysis: Proportions, Chi square, Odds ratio was calculated. Results: The overall prevalence of ever use of tobacco was 24.4%. It was observed that prevalence of tobacco was more (32.9%) in rural area as compare to urban area (15.8%). The prevalence of ever smokers was 12.2%. Smoking was more among males [25.6%] as compared to females [3.2%]. Bidi was the main form of smoking i.e. 72.9%. The prevalence of current daily smokeless tobacco user was 16.8%. Khaini was the most commonly used form. Prevalence of ever alcohol use among respondents was 17.4%. Overall 16.6% of male respondents while only 0.8% of females have consumed alcohol in their lifetime. Almost 21.2% of males in rural area and 12.0% in urban area were alcohol users. The prevalence of current alcohol use in rural / urban area was 20.6% & 13% respectively. Conclusion : It can be concluded from our study that the burden of one of the major risk factors for Non Communicable Diseases (NCDs)i.e. substance abuse is quite high among rural & urban areas of district Dehradun.

Background: First few years of life is the most crucial period of life as this age is known for accelerated growth and development, warranting regular monitoring. During this period about 40% of physical growth and 80% of mental development occurs. Any adverse influences during this period may result in severe limitations in their development. Methods: A cross-sectional study was conducted in the field practice area of Rural Health Training Centre. Mothers of children between 0-3 years of age were enquired about the morbidity in the past two months. Results: Diarrhea (47.9%) followed by ARI (22.21%), Pica (13%) and Worm Infestation (9.21%) were the commonest morbidities found in the study population. Morbidities were found to be common in males as compared to females. Amongst the nutritional deficiencies anaemia & Vitamin B deficiencies were the commonest. Conclusion: There was considerable sickness load amongst the toddlers. Morbidity can be reduced by improvement in the health care system at peripheral level.