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The worldview that portrays a serial killer as being a white male an evil monster with unusual appearance having dysfunctional behaviours and relationship, engaging in animals torture or being sexually abused in childhood and therefore sadistically killing a targeted or specic population for sexual gratication should be challenged (Bearby-2004) Every serial killer drives to kill multiple victims which may be unique, dependent on his/her childhood history and experiences We try to nd out commonalities and differences between them as route to identify possible life events and factors that converted a normal man into serial killers Following factors were identied Ÿ Stress and trauma Ÿ Need for belonging and loneliness Ÿ Power or Control Ÿ Low self-esteem Ÿ Sexually sadistic and violent pornography Ÿ Parents relationship pattern Ÿ Neurodevelopment complication

Introduction: Hand Hygiene is the cheapest, easiest and the single most effective measure to reduce cross-transmission of infection from one patient to another and from the healthcare workers to patients and vice versa. Multiple studies have shown a decrease in healthcare-associated infections (HCAIs) rates after improvement in hand-hygiene compliance. Despite being the simplest procedure adherence to the hand hygiene recommendations remains well below 50% and healthcare workers repeatedly observed as being poor compliers. Objective: This study was planned to access the impact of covid-19 pandemic on the compliance of infection control practices at a tertiary health care centre in India. Methods: Institution-based cross-sectional study was used to assess the impact of covid-19 pandemic on attitude, knowledge and on the compliance of hand hygiene practices at a tertiary health care centre in India. Results: A marked difference was observed in the availability of resources for hand hygiene i.e., 48 (96%) locations and the display of instructions for hand hygiene 50 (100%). A significant difference was also observed among the knowledge of the steps of hand hygiene {2019: 16(32%; 2020: 33 (66%)} and of the moments of hand hygiene {2019: 27 (54%); 2020; 44 (88%)}. (ϰ2 = 79.2, df =1, p = 0). In 2020 (during COVID -19 pandemic) a significant increase in compliance was noted in most of the departments with highest compliance rate of ICUs (100%), followed by OTs (91.7%), paediatrics (95.8%) obstetrics and gynaecology (90.6%), surgery (86.5%), blood bank and laboratories (85.7%). However, unlike the other parameters, the compliance of hand hygiene during the previous year (2019) and during 2020 (COVID -19 pandemic, was poor with no significant difference in compliance of hand hygiene practices even during the pandemic. Of all the 5 moments suggested by WHO, maximum compliance (36% in 2019 and 60% in 2020 pandemic) was after body fluid exposure. Conclusions: Hand Hygiene should be made a national priority. Active involvement by healthcare administrators, national and local governments should be committed to make hand hygiene a mandate for patient safety. Accessibility to hand hygiene products like soap and water and/or alcohol-based hand rubs and written and verbal reminders to staff are essential to improve the compliance of hand hygiene. Thrust should also be given to hand hygiene as a research subject.

India is home to more than one quarter of the world's TB burden, and has reported 24.04 lakh new Tuberculosis cases in the year 2019. This number was before the pandemic struck whereas Tuberculosis notication rates fell by 25% during the period of January-June 2020 compared with the same period in 2019. To curb the spread of COVID-19, India announced a nationwide lockdown for 21 days beginning March 2020 that further was extended to several more weeks. This lockdown proved a major hurdle to Tuberculosis patients seeking health care and may result in a delay in diagnosis, treatment interruptions and disease transmission in household contacts. Lockdown has also forced many migrant workers to return to their homes, leading to treatment interruption. In addition to this, since Tuberculosis resembles symptoms of COVID19, this furthermore leads to hesitation and fear in care seeking behaviour leading to decreased Tuberculosis notication rates throughout the country.

Background: Worldwide, 20% of children and adolescents experience a disabling mental illness, almost half of which begin by the age of 14. Puberty, also marks a transition in risks for depression and other mental disorders, psychosomatic syndromes, and antisocial behavior. The increase in stress during adolescence due to nutritional and pubertal transition may impact physical health and behavior. Objectives: The current study aimed at determining the association between psychological morbidity and nutritional status, as well as the association of psychological morbidity and physical activity, sleep duration, and dietary behavior. Methods: This study was based on a world health organization (WHO) Global School Health Survey (GSHS) conducted on 13- to 15- year-old age group. The study was held at 3 different schools of Aligarh. Strength and difficulties questionnaire (SDQ) was used to measure psychological morbidity and its association with obesity, physical activity, sleep duration, and dietary behavior. Results: A total of 1456 students were included in the study and the prevalence of psychological morbidity was 9.75%. Those with psychological morbidity had higher odds for being obese (35.36), physically inactive (1.78), having sleep duration inadequacy (5.42), and poor dietary behavior (7.46) on multivariate analysis. Conclusions: Psychological problems were present in seemingly normal adolescent student population in India. Most of these stu- dents and their parents/teachers were either unaware of this problem or thought that these problems were not worthy of attention. The association of these problems with lifestyle, dietary behavior, and physical activity warrants special attention.

Background: Sanitation has been identified as one of the important determinants of the health and hygiene since ages. Sanitation and hygiene are critical to health, survival and development. Hygiene causes a global health challenge especially in the developing world. Considering the importance of hygiene, a cleanliness drive has been started in India i.e., Swach Bharat Abhiyan (SBA). The study was conducted to assess knowledge, perception and practices regarding SBA and to know the perception between medical and non-medical students towards clean India.Method: A cross sectional study done for a period of 5 months. A self-explanatory semi-structured questionnaire were used in this study with close ended questions. Sample size was taken as 416.Results: 98.1% of students were aware of SBA. Only 20.9% were agreed over building infrastructure like public toilets etc. which can help to achieve clean India while all others were disagreed. 65.1% people said that there is no decrease of vector borne disease while 34.9% people said it is. The perception regarding disposal of solid waste is mainly in the community bins by the students.Conclusions: The current study reflects that majority of the population were aware of SBA and its objective and the amount spent in SBA and the students of central university had shown positive attitudes and perception towards it to make India clean. SBA could have been much more impactful if it was clubbed with issuance of certain ordinance

Primary health care is an evidence-based priority, but it is still inadequately supported in many countries. Ironically, on one hand, India is a popular destination for medical tourism due to the affordability of high quality of health care and, on the other hand, ill health and health care are the main reasons for becoming poor through medical poverty traps. Surprisingly, this is despite the fact that India was committed to 'Health for All by 2000’ in the past, and is committed to 'Universal Health Coverage’ by 2022! Clearly, these commitments are destined to fail unless something is done to improve the present state of affairs. This study argues for the need to develop primary care as a specialization in India as a remedial measure to reform its health care in order to truly commit to the commitments. Three critical issues for this specialization are discussed in this review: (1) The dynamic and distinct nature of primary care as opposed to other medical specializations, (2) the intersection of primary care and public health which can be facilitated by such a specialization, and (3) research in primary care including the development of screening and referral tools for early diagnosis of cancers, researches for evidence-based interventions via health programs, and primary care epidemiology. Despite the potential challenges and difficulties, India is a country in dire need for primary care specialization. India's experience in providing low-cost and high quality healthcare for medical tourism presages a more cost-effective and efficient primary care with due attention and specialization.

Introduction: With the highly effective antiretroviral treatment, HIV is transforming into a chronic condition, whose management is now experiencing problems of other chronic diseases, where quality of life (QoL) plays a central role. This study was conducted with the objective of determining the QoL among people living with HIV/AIDS (PLHA) taking Anti-Retroviral Therapy (ART) and examine the factors affecting it. Material and Methods: A cross-sectional study was conducted at ART center, Aligarh. 434 PLHA on antiretroviral therapy, were interviewed using a pretested questionnaire, assessing QoL with the World Health Organization (WHOQoL) HIV-BREF. For domain-based analysis, we examined the association of various factors with the individual domain. The P Results: The mean score in all the domains of WHOQoL was maximum for the level of independence (15.7 ± 2.6) followed by the physical domain (15.5 ± 3.0), while environment domain (11.7 ± 1.8) had the least mean. All the domains, including overall QoL scored above average QoL. This study also showed that a strong relationship exists between QoL with lower socioeconomic status, presence of side effects from ART and depression. Conclusion: The QoL of HIV patients taking ART from Aligarh was adequate, reflecting the efforts of NACO and other agencies in managing the disease. With respect to its determinants, providing good family support, better employment opportunities, reducing stigma, and proper and timely management of side effects and depression could further increase levels of QoL.

BACKGROUND Infant mortality rate is regarded as an important and sensitive indicator of the health status of a community. It also reflects the living standard of the people and the effectiveness of interventions for improving maternal and child health. Multiple factors related to social and economic conditions, health care and environment have a significant role to play on childhood mortality and improving childhood mortality is a national priority. The present study was planned to 1) determine the mortality rate among neonates and infants. 2) identification of pattern of various factors in relation to infant mortality and 3) to identify the causes of death in this age group. METHOD All the deaths in children under 12 months during July 2005 to June 2006 in Jawan block of district Aligarh, India were recorded. The cause of death was ascertained using the standard verbal autopsy procedure. RESULTS In the study period, 446 live births and 37 deaths in children under one year of age were reported. The neonatal and infant mortality rates were 49.4 and 83.0 per thousand live births respectively. The main causes of infant deaths were birth asphyxia, diarrhoea, pneumonia, prematurity (including Low birth weight and malnutrition). CONCLUSION Most of the death among infants are preventable, though promotion of institutional deliveries, strengthening of referral system, early recognition of danger signs and periodic retraining of health workers.

Introduction: With the so-called modernization, the epidemiological and sociocultural context of adolescents in developing countries is rapidly changing and is affecting their eating behavior and dietary choices. The objective of our study is twofold. First, our study seeks to find whether there is a prevalence of the adverse eating behaviors among the adolescents. Second, our study seeks to examine whether the prevalence of the adverse eating behavior is related to obesity and quantifies their association of with body mass index (BMI) status. Materials and Methods: A cross-sectional school-based study was conducted in 13–15-year-old adolescents from schools of Aligarh, India, with prevalidated study tools and standardized anthropometric measures. The Z-scores were found by the WHO recommended AnthroPlus. Results: The results indicate a high prevalence of different adverse eating behaviors. The dietary behavior was found to be poor in 19.3%, fair in 54.4%, and good in only 26.3% of the study population. The mean BMI for age Z-score was found to be 0.87 and 0.02 in poor and fair dietary behavior. The odds of being overweight and obese were high (1.82 [1.20–2.78]) in those with poor dietary behavior. Conclusions: Our findings suggest that more research and timely intervention in adverse eating behaviors are much needed in India before this widely neglected problem acquires even more alarming and gigantic proportions.

Introduction: Diarrhoea is a major cause of morbidity and mortality in children. Most deaths are caused by dehydration and are easily preventable by using oral rehydration therapy. Early management and recognition of danger signs are key strategies in treating diarrhoeal diseases at home. This study assessed the knowledge and health-care seeking behaviour of families regarding diarrhoeal illness in children aged under five years. Methodology: The study was undertaken during June and July 2009 in an urban slum of Aligarh, Uttar Pradesh, India. Mothers of children (n = 101) suffering from diarrhoea with at least one episode in the last two weeks prior to the interview were included. Information was gathered on a predesigned and pretested questionnaire. Results: Overall prevalence of diarrhoea in children under five was 36%. Life-threatening symptoms which the mothers knew were watery stool (85%) and repeated vomiting (54%). Two thirds (69%) of the mothers continued breastfeeding their children during the episode, while the remaining either withheld or interrupted breastfeeding. The majority visited a nearby unsanctioned health practitioner. Less than half (46.5%) of the mothers knew about oral rehydration salt solution and only 29.8% of those knew the correct method of preparation. Only 38.7% of the respondents knew about suitable fluids available at home, out of which salt sugar solution was the choice in most cases. Conclusion: The study highlights that the mothers' knowledge is not adequate. Educating mothers and caretakers regarding early home-based case management of childhood diarrhoea may substantially decrease morbidity and mortality due to diarrhoea.

Introduction India is a country in transition, the population is graying and the non communicable diseases are rising. In the rural areas of India, the detection of hypertension is poor because of limited healthcare facilities and poor awareness among the people. In one such village, Mirzapur, adopted by the Aligarh Muslim University, there is a planned project to control hypertension in the villages through some innovative approaches. This study was the assessment phase of this project for mass management of hypertension to steer and guide the next phase of the project. Aim The main objectives of this study were: to determine the prevalence of hypertension in residents ≥ 40 years in Mirzapur village, Aligarh, and, to assess the presence of rule of halves in hypertension. Results and discussion The present study in residents more than 40 years of age in the Mirzapur village in Aligarh found that the prevalence of hypertension in the study population was 41.9%, with a higher prevalence in older age groups. The mean blood pressure of the study population was found to be 100.03±13.17 mm Hg. The high prevalence reported in the present study reflects and reaffirms the increasing trend of hypertension in not only the urban, but also rural India, at least in the older age group. The problem of hypertension, due to its silent and asymptomatic nature, frequently depicts a rule of halves in places with weaker health system and an equally weaker health awareness and information among populations and the same is true for this village. Conclusion There is an urgent need to conduct similar researches in other adopted villages of the country for the sake of inclusive development to find the exact burden of this silent and asymptomatic killer. More importantly, there is a need to find innovative solutions to combat the problem of hypertension detection and management.