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Introduction Water, sanitation, and hygiene (WASH)-related infectious diseases contribute to approximately 5% of the global disease burden. Despite sanitation being a human right, 673 million people worldwide had limited access to toilets. To tackle the same, Swachh Bharat Mission-Gramin (SBM-G) was launched in 2014 to facilitate the construction of over 100 million individual household latrines (IHHLs) across India. However, literature evidence on acceptance of SBM-G in Tamil Nadu, particularly in Coimbatore, is scarce. Objectives The primary objective was to investigate the utilisation of the SBM-G scheme and its associated factors in rural Coimbatore. Materials and Methods In 2022, a mixed-methods study incorporating quantitative (using a purpose-designed questionnaire) and qualitative (using in-depth interviews and focus group discussions) components was conducted among 60 SBM-G beneficiaries in Kovai Medical Center and Hospital Institute of Health Sciences and Research (KMCH IHSR)’s rural field practice area. Quantitative data were analysed using Statistical Package for the Social Sciences (SPSS) v23 and qualitative data using manual thematic content analysis. Results Before IHHL construction, 93.7% of respondents practiced open-air defecation (OAD). The issues perceived with OAD were distance (28.8%) and privacy concerns (12.5%). After SBM-G implementation, 78.3% reported using the IHHL ‘all the time’, reflecting a substantial shift in behaviour. Most respondents received financial aid within about six months (INR 8,000), often in a single instalment. The majority had constructed their IHHLs before 2015. The expenditures incurred varied significantly, with 58.3% spending extra costs ranging between INR 10,000 and 30,000. Water supply to households significantly influenced IHHL usage. Conclusion While rural villagers appreciate the SBM-G financial assistance for IHHLs, concerns about the inadequacy of the sanctioned amount for proper piped water supply and septic tanks persist. Nonetheless, there is a clear demonstration of positive behavioural change, marked by reduced OAD and increased IHHL usage.

Background: Millions of children worldwide suffer from chronic asthma, a serious respiratory disease that has a major influence on everyday living and health outcomes. There are significant public health concerns regarding the estimated 10-15% frequency of asthma in children in India. Vitamin D, which is recognized for its immunomodulatory qualities, according to recent studies reduces the severity. In this study, children aged 6 to 12 years old's vitamin D levels and the severity of their asthma were examined. Materials and Methods: At a tertiary care teaching hospital, 100 children between the ages of 6 and 12 who were presenting with acute exacerbations of bronchial asthma were the subjects of a prospective cohort study from August 2021 to August 2022. ELISA was used to evaluate serum 25-hydroxyvitamin D levels, and the GINA recommendations were used to determine the severity of asthma. Based on their levels of vitamin D, the kids were divided into three groups: sufficient (>30 ng/mL), insufficient (20–30 ng/mL), and deficient (

Introduction: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents a broad spectrum of clinical manifestations, from asymptomatic cases to severe pneumonia and acute respiratory distress syndrome (ARDS). Chest computed tomography (CT) has become a critical diagnostic tool, especially in regions with high disease prevalence. This study aims to assess the common CT findings, patterns of lung involvement, and severity of disease in RT-PCR positive COVID-19 patients to better understand and manage this pervasive disease. Materials and Methods: This observational cross-sectional study was conducted at Dr. Kamakshi Memorial Hospital, Chennai, from 2020 to 2021. The study included RT-PCR positive COVID-19 patients aged 18 to 95 years who presented to the fever clinic or COVID casualty and were referred to the radiology department for chest CT evaluation. Exclusion criteria included pregnancy, age under 18 years, and refusal to consent. Non-contrast chest CT scans were performed using a TOSHIBA Aquilion Lightening 16-slice CT machine. Scans were acquired in a single inspiratory breath-hold from the lung apex to the costophrenic angle. CT findings were analyzed and reported by two experienced radiologists, with discrepancies resolved through consensus. Results: Out of 349 patients, 213 (61%) were male and 136 (39%) were female, with a mean age of 47.7 years. The distribution of CT findings showed significant variability among the four groups. Group A had the highest percentage of normal CT scans (22%) and ground-glass opacities (52%). Group B exhibited a reduction in normal CT scans (9%) and an increase in ground-glass opacities (57%). Group C showed further decrease in normal CT scans (10.6%) with increased crazy paving (17.3%) and reticulation (14.6%). Group D had similar normal CT scans (10.8%) but significantly higher incidences of reticulation (24.3%) and ground-glass opacities (64%). Conclusion: This study highlights the critical role of chest CT in monitoring the progression of COVID-19 pneumonia. The findings demonstrate a clear temporal evolution of lung involvement, from ground-glass opacities in the early stages to more complex patterns such as crazy paving and reticulation in later stages.

Introduction: Back pain is a prevalent global health issue, particularly among women during the postpartum period. Neuraxial anesthesia, commonly used in procedures such as cesarean section, is associated with complications, including postspinal back pain (PSBP). However, limited data exist on its incidence and characteristics, especially within specific demographic groups. This study aimed to examine the prevalence and features of PSBP among women who underwent neuraxial anesthesia for cesarean section in a tertary care center in south India. Materials and Methods: A cross-sectional study was conducted involving 168 women who underwent spinal anesthesia for cesarean section between January 2015 and December 2018. Data were collected through telephone interviews, utilizing a structured proforma covering sociodemographic profiles, pain characteristics, and disability assessment using the Oswestry Disability Scale. Descriptive statistics and chi-squared test were used for data analysis. Results: Among the participants, 40.5% reported experiencing back pain after neuraxial anesthesia, with 39.3% experiencing pain post-delivery and 1.2% since their first delivery. The majority of participants were under 30 years old (78%) and homemakers (92.3%). Severity of back pain varied, with 22.06% classified as mild, 35.29% as moderate, and 42.65% as severe. Statistical analysis revealed a significant association between the number of children and the incidence of back pain (p

Objectives: To determine the proportion of Phase I MBBS students regretting their choice of joining medical profession; and to assess the reasons for regretting their choice of joining medical profession. Methods: This was a questionnaire based, mixed-methods, cross-sectional study conducted among Phase I medical students pursuing Bachelor of Medicine, Bachelor of Surgery (MBBS) in MCI/NMC recognised institutions across India. Results: In this study involving 1060 Phase I MBBS students, 32.0% regretted their decision to pursue medicine. Factors contributing to regret included societal pressure, demanding nature of education and profession, lack of support systems, negative patient attitudes, and COVID-19 stress. Notably, 53.7% of those regretting cited the pandemic's influence, while 51.3% desired super specialization. Those regretting were more likely to doubt their career choice before joining (58.1%), compared to 21.6% who didn't regret. Additionally, 56.3% of regretful students preferred clinical specialization, and 34.0% had taken education loans. Demographics showed significance in parental medical background (11.2% regretful vs. 7.2% non-regretful with doctor fathers). Qualitative analysis emphasized the need for parental guidance reconsideration and systemic improvements to alleviate stress and enhance support structures within medical education. Conclusion: The findings underscore the complex interplay of personal, environmental, and systemic factors shaping students' perceptions of their chosen profession. To mitigate the negative consequences of regret and promote career satisfaction among medical students, targeted interventions and support services are needed.

Introduction: Low back pain (LBP) is a prevalent health issue associated with morphological changes in paravertebral muscles. Magnetic resonance imaging (MRI) is effective in identifying muscle steatosis, with MR spectroscopy (MRS) considered the gold standard. However, MRS is limited by technical challenges, prompting interest in Dixon sequences for fat quantification. Materials and Methods: We conducted a study comparing Multi Echo VIBE Dixon with single-voxel MR spectroscopy in quantifying fat fractions in lumbar multifidus muscles of chronic LBP patients. Ninety-eight measurements from 49 patients were analysed. Qualitative and quantitative image analyses were performed, and statistical analysis was conducted using SPSS 27. Results: Significant positive correlation (correlation coefficient: 0.992, p < 0.001) was found between Dixon and MRS fat fraction measurements. Intra-class correlation coefficient was 0.991 (p < 0.001), indicating strong agreement. No proportion bias was observed. Factors such as age, sex, and spinal degeneration correlated positively with multifidus fat atrophy. Conclusion: T2*-corrected Dixon imaging aligns well with spectroscopic measurements, offering an accurate alternative for estimating paraspinal muscle fat content in chronic LBP patients. Further studies are needed to establish threshold values for Dixon imaging. Chronic LBP is associated with multifidus muscle atrophy and fat infiltration, highlighting the need for effective management strategies.

Introduction: Magnetic resonance imaging (MRI) has emerged as the primary modality for diagnosing and evaluating central nervous system (CNS) tumors, transitioning from structural to functional assessment. Advanced MRI techniques, including MR spectroscopy and perfusion imaging, offer insights into functional, metabolic, and hemodynamic changes in addition to structural abnormalities. The study aims to assess the role of PSR (Post-Contrast Signal Recovery) alongside rCBV (Relative Cerebral Blood Volume) and rPSR (Relative Percentage of Signal Recovery) in differentiating grade IV glioma, solitary brain metastasis, and primary CNS lymphoma. Materials and Methods: An observational study was conducted on 38 patients with lymphoma, metastases, and grade IV glioma, utilizing DSC (Dynamic Susceptibility-Weighted Contrast-Enhanced) perfusion imaging and histopathology reports. Sociodemographic, clinical, and MRI parameters were collected. PSR measurements were obtained from perfusion maps using dedicated software. Statistical analysis was performed using SPSS version 27.0. Results: Among the study population, the mean age was 54.16±12.47, with male predominance (63.2%). Conventional imaging characteristics revealed significant differences, including T2 hypo intensity in lymphoma and FLAIR hyperintensity in all gliomas. Perfusion parameters showed higher rCBV in metastases and grade IV glioma compared to lymphoma, whereas PSR and rPSR were higher in lymphoma. PSR and rPSR effectively differentiated among the tumor types (p

Background: The glenohumeral joint is characterized by its ball and socket configuration, offering the widest range of motion among major human joints. However, its shallow glenoid socket predisposes it to instability. This instability is mitigated by static and dynamic stabilizers. Glenoid bone loss, including Osseous Bankart and compression deformity, contributes to recurrent instability. Various imaging modalities, such as CT and MRI, are employed to assess glenoid bone loss, with methods like the Griffith Index and best-fit circle used for quantification. This study aims to evaluate MRI's accuracy in quantifying bone loss in glenoid compared to 3D CT in participants with anterior shoulder instability. Materials and Methods: The research was carried out at a specialized medical facility offering tertiary care services in south India. Approval was obtained from the ethical committee, and consent waiver was granted for PACS utilization. MRI and CT examinations were performed on participants to assess glenoid bone loss. MRI utilized a 1.5-T Ingenia system, while CT scans were conducted using multidetector CT scanners. Image analysis involved the best-fit circle method was employed to quantify bone loss. Results: Fifty-seven male participants with an average age of 30.72 ± 7.32 years participated. Bone loss measurements were comparable between CT and MRI. ICC and correlation coefficients indicated strong agreement between CT and MRI measurements. MRI detected Hill-Sachs lesions more frequently than CT (p

Introduction: Rotator cuff tears are common musculoskeletal injuries, often associated with fatty degeneration (FD) of the rotator cuff muscles. While MRI has been the gold standard for assessing FD, dual-energy CT (DECT) shows promise in providing quantitative measurements. This study aims to compare FD quantification using DECT and MRI fat fraction values in patients with rotator cuff tears. Materials and Methods: Thirty patients diagnosed with rotator cuff tears underwent DECT and MRI scans for FD assessment. Imaging parameters and techniques were standardized for both modalities. Fat fraction values were obtained using region-of-interest (ROI) analysis. Results: The mean age of participants was 55.73 ± 10.16 years, with a majority classified as Goutallier stage 1. Significant differences were observed between fat fraction values measured by DECT and MRI. The ICC revealed moderate reliability (0.549, p

Background: COVID-19 is primarily a respiratory illness and the severity of lung involvement can have a substantial effect on the prognosis of the disease. The state of Kerala was among the most affected in India. The objective of this cross-sectional study was to assess the lung involvement among those infected with COVID-19 Pandemic at the time of second wave in Kerala, India. Methodology: The study was done in 2021 and included COVID-19 patients who underwent CT scan of thorax. The socio-demographic variables and vaccine status of the patients were collected. Results: The results showed that the severity of lung involvement increased with age, with more than 60% of the study population being above 55 years of age. Additionally, unvaccinated patients had more severe lung involvement compared to vaccinated patients, with males being more affected than females. Conclusion: The study highlights the importance of vaccination and early intervention in managing severe COVID-19 cases.

Introduction: India, with its massive population, witnessed a surge in COVID-19 cases leading to a nationwide lockdown, profoundly affecting the education sector. The closure of schools for an extended period exacerbated the learning gap among students, prompting a swift transition to online education. This abrupt shift posed challenges for teachers unfamiliar with e-learning methods, necessitating a paradigm shift in teaching approaches. While virtual classrooms introduced logistical hurdles, they also spurred innovations like state-run education TV channels and doorstep education schemes. Materials and Methods: Ethical clearance was obtained, and a mixed-method survey was conducted among government and private school teachers in Western Tamil Nadu, using online platforms. The questionnaire covered teaching styles, online teaching difficulties, impact on physical well-being, gadget usage, and more. Data from 44 participants were analyzed using SPSS version 27, employing descriptive statistics, Chi-square tests, and Mann-Whitney U tests. Results: Of the 44 participants, 84.1% were females, and 61.4% were above 40 years. A majority (95.4%) taught in private schools, and 70.4% taught state board syllabus. While 72.7% spent 0-2 hours daily on online classes, 88.6% preferred live online classes. Network issues (75.7%) were the primary difficulty faced, and 56.8% felt the need for technology training. Health-wise, 47.7% spent 6-10 hours on gadgets, and 90.9% invested in gadgets for online classes. Conclusion: The study identified age-associated perceptions in schoolteachers regarding online teaching challenges but found no significant association between age and health issues due to increased screen time.

Background: Viral hepatitis is increasingly being recognized as a public health problem, requiring special attention. The World Health Organization (WHO) estimated that in 2019, 296 million people globally (3.8%) had chronic hepatitis B virus (HBV) infection, and 58 million people (0.8%) were living with hepatitis C virus (HCV). To add to this, every year, about 1.5 million people are newly infected with either hepatitis B or C viruses. The Global Health Sector Strategy (GHSS) has aimed to eliminate viral hepatitis as a major public health problem by 2030. Methods: We conducted a desk review to identify strategies for preventing viral hepatitis and develop a roadmap to attain the sustainable development goals (SDG) target by 2030 (particularly in low- and middle-income countries). A search was done in PubMed via Medline on 1 December 2022. Results: The focus has to be on key interventions, including hepatitis B vaccination (part of the routine child immunization along with rescheduling the birth dose to up to 7 days post-term, adult vaccination, for targeted groups like health care providers, rag pickers, waste handlers, and sanitation workers), ensuring safe injection practices and blood transfusion, harm reduction interventions for people who inject drugs (PWID), adequate testing for early diagnosis, and ensuring appropriate treatment. Conclusion: It is the need of the hour to prioritize key interventions identified in the review for preventing viral hepatitis.

Introduction: Chemical peels have become a useful modality in the management of acne in addition to topical and systemic medications. Studies done to evaluate the effectiveness of peels have compared only lower concentration of Glycolic Acid (GA) (35%) and Salicylic Acid (SA) peels. Higher concentrations of glycolic acid i.e., (70%) are reported to be safe and more effective than lower concentrations. Despite reported advantages of higher concentration of glycolic acid peel, no published data is available regarding its efficacy, safety and tolerability in comparison with other peels. Aim: To compare the effectiveness of 70% GA peel with 30% SA peel in the management of mild to moderate acne. Materials and Methods: The present study was a cross-sectional retrospective study conducted from December 2021 to April 2022 in which, 60 participants were enrolled. They were diagnosed with mild to moderate acne, based on the Indian Acne Alliance (IAA) grading system and all of them underwent chemical peel treatment. Among them 30 had received 70% GA peel (group 1) and 30 had received 30% SA peel (group 2). The number of sittings and the individual lesional count at baseline and at each sitting were recorded. Acne lesional count (sum of comedones, papules, pustules, and nodules) was recorded at baseline, 2, 4, 6 and 8 weeks. Categorical variables were presented as frequency and percentages. Continuous variables were presented as Mean±Standard deviation. Results: There was a significantly greater decrease in mean acne lesional count in group 2 from the baseline of 25.73 to 13.83 at the end of 2nd weekin comparison to group 1 wherein the values reduced from 26.30 to 17.73 (p-value of 0.003). At the end of eight weeks, the mean acne lesional count of both groups (group 1- 2.17 and group 2-1.50, p-value of 0.097) were comparable. Conclusion: Higher concentration of GA (70%) has comparable effectiveness to 30% SA peel in management of mild to moderate acne. SA peel has an advantage of earlier decrease in lesional count.