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Aim: The aim of the study was to compare the fracture resistance and push-out bond strength of glass fiber post (GFP) with composite core and single unit post and core system luted with two different resin cements. Methods: Sixty-four mandibular premolars were chosen as the sample for the study. Sample preparation was done, and specimens were randomly divided into two groups (n = 32) each according to the type of post used: Group I – RelyX GFP, Group II – Edelweiss post and core. They were further subdivided in two subgroups based on luting cements: subgroup A: RelyX U200 Adhesive Resin cement and subgroup B: SoloCem resin cement. Fracture resistance was measured in half of the prepared specimens by subjecting a load of 1 mm/min. The load was subjected along the long axis of the tooth at an angle of 45° until failure occurred using the universal testing machine. Half of the samples were divided into three horizontal thirds, i.e., coronal, middle, and apical, and push-out bond strength was evaluated at a rate of 0.5 mm/min. The scores were subjected to statistical analysis using independent t-test and SPSS Version 22.0. Results: Group I showed nonsignificantly better fracture resistance than Group II irrespective of type of luting agent used. Subgroup B showed nonsignificantly higher fracture resistance than subgroup A irrespective of the post used. Subgroup B was nonsignificant better push-out bond strength than Subgroup A (P < 0.05). Push-out bond strength of Group II was significantly better than Group I irrespective of the luting agent. Conclusion: Fiber post showed nonsignificantly better fracture resistance than Edelweiss post and core system. SoloCem showed nonsignificantly better fracture resistance and push-out bond strength with Edelweiss than RelyX U200.

Abstract Chronic lumbopelvic pain (CLPP) and its associated disabilities significantly affect women's social, professional, and personal lives. However, the specific factors contributing to CLPP in women remain unclear. To address this gap, this prospective cross-sectional study aims to identify the risk factors predicting CLPP in women and develop a prediction model that can predict CLPP in women. The study was conducted across Delhi, India, where free health camps were held, and 2400 women were assessed. Among the assessed individuals, the study revealed a high prevalence rate of CLPP among Indian women, standing at 70.4%. Seven risk factors namely, hamstring muscle tightness (> 20° on passive knee extension test), increased lumbar lordosis (> 11.5 cm of the lumbar lordotic index), reduced hip flexibility (> 15 cm on bent knee fallout test), altered foot posture (≥ 20 on foot posture index score), increased perception of psychological stress (> 25 on cohen’s perceived stress scale-10 score), reduced physical activity level (

Background and Objective: Diabetic-range hyperglycemia has been reported for the first time in many patients during their hospitalization with coronavirus disease 2019 (COVID-19). This study was undertaken to determine the proportion of such patients who actually have new-onset diabetes mellitus rather than transient hyperglycemia during acute illness. Methods: This descriptive study included patients with diabetic-range hyperglycemia first detected at or during admission for COVID-19 but no prior history of diabetes. The study protocol involved patient identification, data recording from the case-notes, and telephonic follow-ups. Blood sugar levels done at least two weeks after discharge or the last dose of steroids, whichever was later, were recorded, and patients were categorized as diabetic, pre-diabetic, or non-diabetic accordingly Results: Out of 86 patients, ten (11.6%) were found to have developed diabetes, and 13 (15.1%) had pre-diabetes on follow-up. About 63 (73.3%) patients had become normoglycemic. Eight (80%) out of the ten patients with new-onset diabetes were on treatment, with five (50%) achieving the target glycemic levels. The associations of new-onset diabetes with age, gender, comorbidities, intensive care stay, and steroid administration were not found to be statistically significant (p-values 0.809, 0.435, 0.324, 0.402, and 0.289, respectively). Interpretation and Conclusions: While a majority of post-COVID patients with diabetic-range hyperglycemia returned to a normoglycemic state after the acute illness had settled down, one in ten developed new-onset diabetes, and an additional one in seven had impaired glucose tolerance. Thus, regular glucose screening is crucial for such patients and lifestyle modifications should be encouraged to reduce the risk of diabetes. Loss to follow-up and reliance on a single set of blood sugar readings for classification were some of the limitations of this study.

Background: Adequate management of hypertension is crucial for decreasing the likelihood of cardiovascular ailments and associated complications. Nonetheless, in the Indian context, maintaining compliance with prescribed hypertensive therapies presents a notable hurdle, impeding the attainment of favorable health outcomes. Thus, this study was conducted with the aim to evaluate the prevalence of treatment adherence and explore the diverse factors that impact adherence patterns among individuals diagnosed with hypertension. Material and Methods: A community-based cross-sectional questionnaire-based study was carried out among the diagnosed hypertensive patients from 12 purposefully selected villages of Khagaul block, Patna. A total of 262 participants were recruited in the study by using non-probability sampling. The 8-item Morisky Medication Adherence Scale (MMAS-8) was used for measuring adherence. The Statistical Package for the Social Sciences (SPSS) for Windows version 21.0 (SPSS Inc; Chicago, IL, USA) was used for statistical analysis of data. Result: As per MMAS scores, 10 (3.8%) had high, 133 (50.8%) moderate, and 119 (45.4%) poor adherence. However, good adherence was reported among geriatric patients [1.65 (1.01–2.7)], those with a history of absence of comorbidities [2.15 (1.21–3.85)], more than 5 years' duration of hypertension [3.2 (1.89–5.41)], once-a-day drug intake [2.8 (1.61–4.87)], and having controlled blood pressure [5.2 (3.08–8.96)]. Controlled blood pressure (AOR = 0.048, 0.023-0.098), perception of high benefit of treatment [0.497 (0.255–0.97)], and absence of comorbidity [0.016 (0.168–0.832)] were identified as predictors of good treatment adherence. Conclusion: Overall medication adherence in the current study was 54.6%. Achieving treatment adherence frequently demands proactive patient engagement, highlighting their active role in disease management. Also, involving the patient's caregivers can offer an additional tactic to tackle non-adherence stemming from forgetfulness of the patient.

Abstract Background Chronic lymphatic filariasis patients in Bihar, India, need management of lymphedema to live a disability-free life. For patients who have recurrent attacks of acute dermato-lymphangio-adenitis (ADLA), World Health Organization (WHO) has recommended simple home-based measures that include maintaining hygiene, skin care, and limb movement. However, patients in rural areas are unable to adopt them, resulting in a vicious cycle of ADLA attacks. There might be multiple realities from patients’ and healthcare workers’ perspectives that were unexplored. Qualitative research was deemed best suitable to identify the barriers to carrying out home-based lymphedema practices that adversely affected quality of life. Methods The qualitative descriptive study was conducted in two villages in the rural field practice area under a tertiary care hospital in Bihar. Researchers purposively selected ten participants, including patients affected by lymphedema, their caregivers, the grassroots healthcare workers, and the block health manager. In-depth interviews were conducted using a semi-structured interview guide. Data were entered into QDA Miner Lite, where researchers did attribute, in-vivo, process, descriptive, emotion, and holistic coding, followed by content analysis, where categories and themes emerged from the codes. Results Three themes emerged: the inherent nature of disease, patient-related factors, and healthcare system-related factors. The fifteen identified barriers were low awareness, low adherence, low health-seeking behavior, poor personal hygiene, and categories like signs and symptoms, seasonal factors, hampered activities of daily living, hopelessness from not getting cured, psychosocial difficulty, lack of capacity building and receipt of incentives by healthcare workers, unavailability of laboratory diagnosis and management of complications at the facility, inconsistent drug supply, and no financial assistance. Conclusions Accessibility to WaSH, regular training of home-based care, increasing the capacity and motivation of grassroots workers, and the generation of in-depth awareness among the patients are required to achieve the elimination of filariasis, with MMDP as a key component of that strategy for endemic districts across the whole country. Graphical Abstract

Introduction: Bihar has experienced high nutritional public health problem among children and women over the years. In this background, this study was planned to find the level of food insecurity and identify contributing factors in rural Bihar. Material and Methods: We conducted community-based cross-sectional study among 255 families residing in villages catered by RHTC, Naubatpur. A pretested semi-structured interview schedule and HFIAS were used. Result: A total of 27.8% of the 255 households were food insecure, of which 73.3% were severely food insecure. Kutcha houses, dispossession of agricultural land, and lower SES were found to be predictors. Conclusion: Around one in three families experienced food insecurity, and it was more among families residing in kutcha houses, without possession of agricultural land and belonging to lower socioeconomic status.

Introduction: Incorrect posture habits and reduced physical activity can predispose individuals to various changes in the muscular and skeletal structures. Rounded Shoulder Posture (RSP) is one such clinical manifestation that deforms the normal relationship of various structures. Different treatment protocols have been devised for correcting RSP; however, postural changes in the musculoskeletal system can also be addressed by focusing on muscular imbalances elsewhere in the biomechanical kinetic chain. Aim: To analyse and investigate the efficacy of ankle muscle stretching and strengthening exercises in enhancing the correction of RSP in young adults. Materials and Methods: The present pilot study was conducted at Amity Institute of Physiotherapy in Noida, Uttar Pradesh, and Prime Hospital and Ortho Centre in Faridabad, Haryana, India, from January 2021 to July 2021. A total of 30 young adults with RSP were randomly allocated into two groups of 15 each. Group 1 (control group) received six weeks of conventional exercises consisting of scapular stabilisation and stretching of the pectoralis minor muscle. Group 2 (experimental group) received ankle plantar flexor stretching and ankle dorsiflexor strengthening in addition to the conventional exercises, three times per week for six weeks, with each session lasting between 30 to 45 minutes. RSP and ankle Dorsi-Flexion (DF) were assessed using the posterior Acromion to Table Distance (ATD) in a supine lying position and a universal goniometer, respectively, pre-intervention and post-intervention for the dominant and non-dominant sides. For statistical analysis, after determining the normality of the data, either a Paired-test or Wilcoxon rank sum test was used to compare the data within each group. Further, either a two-sample Independent t-test or WilcoxonMann-Whitney U test was used to find statistical differences between the two groups at a 5% level of significance. Results: The subjects had an average age of 24.8±4.07 years and a Body Mass Index (BMI) of 24.10±4.39 kg/m2 , with 11 male and 19 female participants (p-value=0.70), with the right side being the dominant side for all. At baseline, there was no significant difference in the variables between the two groups (p-value>0.05). After the six-week intervention, a significant difference was found in the ATD (dominant pre: 6.17±1.02, dominant post: 3.47±1.05, p-value

Background: Bihar is one of the focus states under Swachh Bharat Mission (SBM) in India. A study was conducted to estimate the prevalence and to determine the factors associated with the practice of open defecation among adults having household toilets, in rural Patna, Bihar. Methods: An analytical cluster cross-sectional study was conducted for a duration of one year among 609 participants using cluster sampling in rural block of Patna. The prevalence was calculated with 95 % confidence interval and binary logistic regression analysis was done to determine factors associated with open defecation. Results: Out of 609, 391(64.2 %, 95 % CI: 60–68 %) were practising open defecation despite having a household toilet. Male gender (AOR, 1.684; 95 % CI, 1.1–2.4), scheduled caste community (AOR, 2.168; 95 % CI, 1.3–3.4), family gross monthly income Rs. 35 years (AOR,1.453; 95%CI, 1.0–2.0), absence of government supply as water source (AOR: 2.106, 95 % CI: 1.088–3.410) were the independent factors associated with practice of open defecation. Conclusions: Nearly two-third of adults were practising OD despite having a household toilet. Male gender, schedule caste community, family gross monthly income Rs. 35 years, lack of government supply as water source were the factors associated with the practice ofOD.

Objectives Coronavirus disease 2019 (COVID-19)–associated mucormycosis (CAM) has emerged as a formidable infection in patients with COVID-19. The aggressive management of CAM affects quality of life (QOL); thus, this study was designed to assess the QOL in patients with CAM at a tertiary healthcare institution. Methods This cross-sectional study of 57 patients with CAM was conducted over 6 months using a semi-structured standard questionnaire (the abbreviated World Health Organization Quality of Life questionnaire [WHO-BREF]) and a self-rated improvement (SRI) scale ranging from 0 to 9. Cut-off values of ≤52 and

Background: Adolescence is the most complex stage of development that causes the greatest difficulties in their life because of frequent physical and emotional issues including deviated character and behavioral disorders. Aim: This descriptive comparative study was intended to compare self-esteem between heinous and non-heinous male delinquent adolescents residing in observation homes. Materials and Methods: A quantitative research approach with a non-experimental descriptive comparative design was adopted. One hundred and seventy-nine male delinquent adolescents (Heinous = 74, Non-Heinous = 105) residing in two observation homes were selected by convenience sampling technique based on the type of crime committed. The standardized Rosenberg's self-esteem scale was used to collect the data. Results: We analyzed the data with Chi-square for homogeneity of sample characteristics, an independent t test for comparison of self-esteem between groups, an independent t test, one-way ANOVA for the association, and stepwise regression for predictors. There was a statistically significant difference in self-esteem between groups, a significant association of self-esteem with age and duration of stay in the heinous group and with the father's education in the non-heinous group, and the father's education, mother's occupation, substance use, and order of birth had predicted the self-esteem in non-heinous group. Conclusion: The study concluded that self-esteem significantly varied between heinous and non-heinous group delinquents. This study is the first of its kind and provided initial evidence by filling the gap in the literature to understand the difference in the level of self-esteem among delinquent adolescents according to the type of crime committed.

Background: Anemia is a major and serious public health problem. Its prevalence is disproportionately high in developing countries due to its low socio-economic status and poor access to health services. Consequently, this study was conducted to sought the prevalence of anemia as well as its association with the sociodemographic characteristics among the beneficiaries of Anemia Mukt Bharat test and treat campaign in an Urban Health Training Centre in Bihar. Aims and Objectives: The aim of the study was to assess the prevalence of anemia among patients attending an Urban health training center in Bihar. Materials and Methods: It was a retrospective record based study conducted at Urban Health Training Centre running under Department of Community and Family Medicine of a Tertiary care teaching hospital. The registered cases from September 2018 to August 2019 were taken up and case records were retrieved. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS Inc., Chicago, State of Illinois, United States) version 21 software. Results: Screening of total 2042 was done over the study period of 1 year. The overall prevalence of anemia among the beneficiaries was 64.3% (95% CI: 62.3–66.5%) in the study. Significantly higher prevalence of anemia was noted among the adolescent girls (62.5%), pregnant women (62.4%), and reproductive age female (71.1%). Whereas, only 32.3% male were found to be anemic. Furthermore, illiteracy (73.5%), non-consumption of non-vegetarian diet (69.3%), and IFA tablet (84.6%) were found to be associated with anemia. Conclusion: The association of anemia with few socio demographic and dietary factors has been highlighted through the study findings. Screening programs for anemia, awareness campaigns, deworming program, fortification of food and salt with iron and folic acid, and non-pharmacological interventions such as cooking in iron utensils are some of the measures that can be implemented.

Aim: The study aims to comparatively evaluate various irrigating techniques in removing calcium hydroxide (CH, aqueous/silicon oil based) from simulated internal resorptive cavity and subsequent adaptability of thermoplasticized gutta percha (GP) to root canal walls. Methods: One hundred and sixty extracted human mandibular second premolars with single root were chemomechanically prepared to a size F3 (size 30, 6% taper). Standardized internal root resorption cavities were prepared, and samples were randomly divided into two main groups (n = 80) according to type of CH medicament used: Group I - silicon oil based (Metapex) and Group II - aqueous based (RC Cal) and four subgroups (n = 20) according to the technique used for removal of CH: Subgroup A - passive ultrasonic irrigation, Subgroup B - XP Endo Finisher (XP), Subgroup C - sonic irrigation, Subgroup D - conventional syringe irrigation. Half of the samples were evaluated for the quantity of remaining CH and the remaining half were evaluated for the adaptability of thermoplasticized GP under a stereomicroscope. The statistical analysis of the obtained scores was done using a nonparametric test, Kruskal–Wallis test, followed by Mann–Whitney U-test. Results: XP showed maximum removal of CH and adaptation of GP in both the groups. Adaptability of GP to the dentinal wall was better in Group II than in Group I. Conclusions: Complete removal of CH (both formulations) was not possible with either of the experimental irrigation techniques from simulated internal root resorptive defects.

Background: Body mass index (BMI) is the most frequently used method to determine the nutritional status in adolescents. School-going population in developing countries like India are susceptible to undernutrition due to several socioeconomic, demographic, and nutritional factors. Poor dietary habits, sedentary lifestyles and improper hygiene can have a deleterious effect on their BMI. Methods: The aim of the study was to determine any association of BMI with physical health, nutrition, and personal hygiene among the school-going adolescents near Patna, Bihar. Analytical cross-sectional study was conducted among 160 school-going adolescents, chosen by stratified random sampling. They were given Indian Adolescent Health Questionnaire which had close-ended questions about physical activity, nutritional, and hygienic practices. BMI was calculated from self-reported height and weight. Pearson's correlation, independent t test, ANOVA, and Chi-Square test of proportions were done. Significance level was set at P < 0.05. Results: Only 39.4% adolescents had normal BMI, and almost half were underweight. Pearson's correlation of BMI with age showed a weak positive correlation (r = 0.124, P = 0.118). Participants perceiving themselves overweight, did physical exercise to lose weight (P < 0.001), whereas who stated that they rarely consumed cooked vegetables, had the self-perception of being underweight (P = 0.009). This self-perception of their weight, physical activity, handwashing after using toilet/latrine and weekly frequency of brushing teeth significantly predicted the BMI in these adolescents (F = 10.895, df (4,155), P < 0.001, R2 = 21.9%, Adj. R2 = 19.9%). Conclusion: Malnutrition can lead to infection, impaired reproductive health, anaemia and other long-term morbidities into adulthood. Hence there is need of more objective nutritional assessment in adolescence for prevention of disease burden in the community.

Introduction: Glide path preparation permits predictable debridement and shaping of radicular space while reducing procedural errors like apical extrusion of debris and microorganisms which can postpone healing. The aim of this study was to comparatively evaluate the effect of glide path files with different metallurgy on apically extruded Enterococcus faecalis. Materials and Methods: Forty human mandibular bicuspids were selected, decoronated, and autoclaved. The samples were placed in a test apparatus of sterilized glass vials and inoculated with E. faecalis. The specimens were randomly allocated into four major groups (n = 10) each depending on the glide path file used – Group I with Proglider, Group II with EdgeGlidePath Files, Group III with Neoniti GPS, and Group IV without rotary glide path instruments using HyFlex electrical discharge machining (EDM). After glide path preparation, final canal preparation was done with HyFlex EDM. The apically extruded E. faecalis was counted as colony-forming unit and was converted into log values. Statistical analysis was evaluated using Kruskal–Wallis H Test and Mann–Whitney U-test using SPSS software; version 22.0 (SPSS INC., Chicago, IL, USA). Results: Group IV without glide path preparation technique showed maximum extrusion of E. faecalis in comparison to other groups (P < 0.05). Groups I and II showed a similar quantity of extruded bacteria. Group III showed significantly higher bacterial extrusion than Groups I and II. Conclusions: Glide path preparation groups showed less amount of apically extruded E. faecalis. EDGEGlidePath files showed lesser apically extruded E. faecalis in comparison to Proglider and Neoniti GPS.

Introduction: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) causing coronavirus disease 2019 (COVID-19) has led to a global health crisis. Health workforce has been working vigorously in COVID-19 management. So, we have planned this study with an aim to assess the psychological profile of healthcare and allied workers involved in SARS-CoV2 pandemic and to look for associated factors. Methodology: A cross-sectional observational study was planned at All India Institute of Medical Sciences, Patna. Study population comprised of Health care workers and allied health care workers involved in COVID-19 management. Results: Data from 254 study participants have been included in the study. The prevalence of severe and extremely severe depression among study participants was 8.3 and 3.1 percent. Severe and extremely severe anxiety prevalence was found to be 9.4 and 13.8 percent. The prevalence of severe and extremely severe stress was 2.4 and 2.4 percent each. Education till post-graduation, unmarried, occupation of doctor, Comorbidity of headache and occurrence of influenza-like illness in last 3 months had a statistically significant association with high depression score. With high Anxiety score and high-stress score statistically significant association was seen in education till postgraduation, unmarried, occupation of doctor, duration of 1 COVID-19 duty of ≥8 hours. Conclusion: The study highlights high psychological comorbidities in the form of depression, anxiety and stress among health care workers and allied health care workers working in COVID-19 pandemic. Prevalence of psychological morbidity is higher among doctors compared to nurses and allied health workers. COVID-19 duty of ≥8 hours have been found to be hampering mental health.

Background: Adolescents with higher resilience levels are reported to be less vulnerable to psychological illnesses. The study examined resilience level, its determinants and its effect on psychological well-being among school-going adolescents of Patna, Bihar, India. Methods: Adopting cross-sectional design we examined resilience levels among the study participants reading in the sixth, seventh and eighth standards of selected schools of Patna district using the Child Youth Resilience Measure-Revised questionnaire during March 2021. Psychological well-being was assessed using Patient Health Questionnaire-4. Data of in total 468 enrolled participants were analysed using SPSS 22.0. Results: The mean resilience score was observed to be 62.4 ± 8.8. In multiple linear regression analysis using backward method; increasing age (unstandardised beta [β]: 0.564, standard error [SE]: 0.271, P: 0.038), male gender (β: 2.753, SE: 0.775, P < 0.001), high per capita monthly family income (≥18 USD [median]) (β: 1.829, SE: 0.743, P: 0.014), academic satisfaction (β: 2.003, SE: 0.962, P: 0.038), no history of abuse (physical or mental) in the past 30 days (β: 2.752, SE: 1.220, P: 0.025) and increasing self-esteem score (measured by Rosenberg Self-Esteem Scale) (β: 0.808, SE: 0.098, P: < 0.001) were found to be positive determinants of the total resilience level. Resilience was found to be positively correlated with psychological well-being (spearman rho correlation co-efficient [ρ]: 0.363, P < 0.001). Conclusions: Abuse, academic satisfaction and self-esteem were the modifiable determinates of resilience that could be elucidated in this investigation. Resilience level positively influenced psychological well-being.

The soluble urokinase plasminogen activator receptor (suPAR) has been proposed as a biomarker for risk stratification of patients presenting with acute infections. However, most studies evaluating suPAR have used platform-based assays, the accuracy of which may differ from point-of-care tests capable of informing timely triage in settings without established laboratory capacity. Using samples and data collected during a prospective cohort study of 425 patients presenting with moderate Covid-19 to two hospitals in India, we evaluated the analytical performance and prognostic accuracy of a commercially-available rapid diagnostic test (RDT) for suPAR, using an enzyme-linked immunosorbent assay (ELISA) as the reference standard. Our hypothesis was that the suPAR RDT might be useful for triage of patients presenting with moderate Covid-19 irrespective of its analytical performance when compared with the reference test. Although agreement between the two tests was limited (bias = -2.46 ng/mL [95% CI = -2.65 to -2.27 ng/mL]), prognostic accuracy to predict supplemental oxygen requirement was comparable, whether suPAR was used alone (area under the receiver operating characteristic curve [AUC] of RDT = 0.73 [95% CI = 0.68 to 0.79] vs. AUC of ELISA = 0.70 [95% CI = 0.63 to 0.76]; p = 0.12) or as part of a published multivariable prediction model (AUC of RDT-based model = 0.74 [95% CI = 0.66 to 0.83] vs. AUC of ELISA-based model = 0.72 [95% CI = 0.64 to 0.81]; p = 0.78). Lack of agreement between the RDT and ELISA in our cohort warrants further investigation and highlights the importance of assessing candidate point-of-care tests to ensure management algorithms reflect the assay that will ultimately be used to inform patient care. Availability of a quantitative point-of-care test for suPAR opens the door to suPAR-guided risk stratification of patients with Covid-19 and other acute infections in settings with limited laboratory capacity.

Study Design This study is a single-blind, parallel, three-group, and randomized controlled trial. Purpose This study aimed to investigate the effectiveness of electrical stimulation-augmented virtual reality training in improving balance in individuals with incomplete spinal cord injury (iSCI). Overview of Literature Individuals with iSCI often face significant balance and mobility impairments affecting their quality of life. Scientific studies focusing on standing balance training in the iSCI population are limited. Virtual reality-based balance training has shown positive results in several neurological populations. Electrical stimulation has also proved to be effective in improving voluntary muscle strength in partially paralyzed muscles after iSCI as well as promoting neuroplasticity. Methods Forty-eight iSCI participants will be recruited based on the inclusion criteria. The participants will be randomly assigned to any of the three groups: virtual reality-based balance training along with the electrical stimulation group, virtual reality-based balance training along with sham stimulation group, or virtual reality-based balance training group. The intervention will be delivered as 60-minute sessions, thrice a week for 4 weeks. Results The performance of the participants will be assessed using the lower extremity motor score, static and dynamic balance assessment using TechnoBody ProKin tilting platform and Berg Balance Scale, Walking Index for Spinal Cord Injury, and World Health Organization Quality of Life-BREF at pre-intervention, after 4 weeks post-intervention, and at 1-month follow-up. Conclusions The trial will provide new knowledge about the effectiveness of electrical stimulation-augmented virtual reality training in improving balance in individuals with iSCI. The study results will contribute to the design of better rehabilitation programs for individuals with iSCI.

Introduction: Rapid decline in physical functionality has an adverse impact on both physical and psychological health. Deteriorating sleep quality during the pandemic is one such common manifestation, that further affects the general well-being. Therefore, safe non pharmacological treatments are warranted, and the practice of suryanamaskar is one such intervention. Aim: To find the effectiveness of suryanamaskar on sleep quality and general well-being among young adults. Materials and Methods: This quasi-experimental study was conducted in Physiotherapy Department at Ashirwad Bhagwat Multispecialty Clinic, Sonipat, Haryana, India, from March to July 2021. A total of 30 young adults were enrolled in the study and randomly divided into two groups of 15 participants each. The experimental group practiced eight weeks of suryanamaskar yogic exercise, also known as sun salutations, which comprises of 12 different postures performed with controlled breathing. The control group performed 20 minutes of walk. Sleep quality and General Well-being (GWB) were evaluated preintervention and postintervention using the Pittsburgh Sleep Quality Index (PSQI) and Psychological General Well-Being Index (PGWBI) respectively, along with the resting Heart Rate (HR) and Blood Pressure (BP). A higher PGWBI score denotes greater psychological well-being and a total PSQI score of 5 or more indicates poor sleep quality. The effect of the intervention on GWB, sleep quality, BP and HR were assessed using Wilcoxon signed-rank test within the group and the Mann-Whitney test was used to find a statistical difference between the two groups. Results: After eight weeks of yoga training, a significant difference was found in the overall sleep quality (9.53±1.68, p-value=0.001), GWB (78.33±14.76, p-value=0.001), HR (77.07±5.48, p-value=0.001), SBP (116.67±2.99, p-value=0.001) and BMI (23.01±3.17, p-value=0.019) in the experimental group. However, the control group revealed a significant difference only in the GWB (50.80±13.87, p-value=0.019) postintervention. Additionally, when compared to the control group, the experimental group revealed statistically significant results for sleep quality (p-value=0.001), GWB (p-value

Introduction: There is a risk of chronic hepatitis B virus (HBV) infection to the newborn through perinatal transmission from a hepatitis B surface antigen (HBsAg) positive mother that can later cause liver cirrhosis or hepatocellular carcinoma. This study was undertaken in a primary health center (PHC) in the Patna district to determine the prevalence of HBV among pregnant women and assess their knowledge across different characteristics. Methodology: A cross-sectional study was done among 275 pregnant women attending the PHC for the first time, using consecutive sampling. The study duration was 12 months. Socioeconomic, obstetric, risk history, and levels of knowledge about hepatitis B were collected followed by rapid diagnostic test (RDT) for serum HBsAg. Univariate analysis was used to compare the knowledge levels across different background characteristics. The significance was set at P < 0.05. Results: Hepatitis B-positive pregnant women were 0.4%. Out of the 275 participants, only 43 had heard about hepatitis B. The mean knowledge score was 0.65 (±1.73) with 1.45% having adequate knowledge. The knowledge score was significant across education (P 0.040), category (P 0.022), hepatitis B immunization status (P 0.003), and risk factor (P 0.039). Conclusion: Knowledge was higher in the literate women belonging to the general category and higher social class, who received hepatitis B vaccination. However, the overall level of knowledge among the pregnant women was very poor, so they should be targeted for quality health education. Additionally, identifying the afflicted pregnant women through point-of-contact diagnosis will aid in community prevention of chronic hepatitis B.

Introduction: Identification of untreated depression could be a chance of opportunity in outdoor settings. Earlier findings show a high proportion of depression among patients visiting outdoor at the tertiary level of care. We want to estimate its burden in an outdoor setting at the primary level of care. Material and Methods: The current study was a facility-based cross-sectional study which was conducted for 3 months at a primary health center (PHC) in a rural area of Patna (Naubatpur), Bihar. Patient health questionnaire (PHQ)-9, along with sociodemographic variables, was included in the development of a semi-structured questionnaire. A trained data collector took one-to-one interview using this questionnaire. Results: The proportion of male and female were almost equal (49% vs. 51%). The mean age of the study subjects was 38.80 ± 13 years. Most study subjects were suffering from depression (59.60%). One-third of them had mild, one-fourth had moderate, and rest had a moderately severe and severe category of depression. The mean score was 6.67 ± 5.08. In mild to the moderate category of depression, higher age group of the study subjects was more affected. In the severe category of depression, younger age group was affected worse. The prevalence of depression was almost doubled in females as compared to males in all category of depression, and this was statistically significant. The prevalence of moderately severe depression was highest in the study subjects who were illiterate. Conclusion: PHQ-9 can be used at PHC to screen the patients with depression.

Background: Deep dentin tubular penetration of the sealer provides a three dimensional sealing of root canal space Aim: To evaluate the effect of final irrigant on depth of tubular penetration of resin based root canal sealer and bioactive sealers using Confocal Laser Scanning Microscope (CLSM) Materials and Method: Ninety- six freshly extracted human mandibular first premolar teeth were decoronated at 15 mm from the apex. Cleaning and shaping procedure was accomplished using Hyflex CM rotary files till F3. The sample were divided into three groups(n=32) according to final irrgant used : Group A (17 % EDTA), Group B (QMix 2 in 1), Group C (Distilled water). The final irrigation in each respective group was performed with EndoVac system. The samples were further subdivided into 4 subgroups (n=8) according to the type of sealer used for obturation with 6% guttapercha cones - Subgroup I (AH Plus), Subgroup II (Gutta Flow Bioseal), Subgroup III ( Endosequence BC ), Subgroup IV (EndoSeal MTA). Two mm horizontal sections were obtained at 2 mm (apical sections), 5 mm (middle sections) and 7 mm (coronal sections) from the root apex using CLSM to evaluate the maximum depth and percentage of sealer penetration into the dentinal tubules by using Kruskal-Wallis test for overall analysis and a series of Mann-Whitney U tests for pairwise comparison. Result: Endosequence BC showed maximum depth of penetration and penetrated percentage perimeter, while Gutta Flow Bioseal showed least values. Q Mix 2 in 1 showed better penetration values than EDTA and distilled water. Conclusion: Irrigants, nature of sealer and level of root canal affected sealer penetratio.

Context: Burn injuries are one of the most common health issues of the universe. Burn injuries in hand are very frequent, and in spite of appearance that the expanse of the hand represents < 3% of the total body surface area (TBSA) on each hand, burn injury may have major significance on the quality of the life of an individual. Although the studies have shown the association of burn with either functional, motor, or sensory functions, no such study was found which evaluated and related all the three aspects of hand function, i.e., sensory, motor, and functional activities. Subjects and Methods: Individuals aged between 18 to 60 years satisfying the examination process were included for the study. Two groups were allocated, including 10 burned hand patients and 10 controlled subjects. All the 20 subjects were examined for sensory, motor, and functional abilities. Pain, temperature, and 2-point discrimination sensitivities were tested; motor functions were tested using Strickland method, Kleinert method, and Jamar hand dynamometer, and functional impairment was tested using Michigan Hand Questionnaire (MHQ). Statistical Analysis Used: The descriptive data was analyzed using Microsoft Excel and Spearman's rank correlation test was applied using IBM SPSS Statistics for Windows, Version 16.0. Armonk, NY: IBM Corp.” Result: TBSA was significantly related to the pain perceived on the Visual analog scale (VAS) (r = 0.509; P < 0.05). Significant correlation was seen with MHQ work (r = 0.611; P < 0.05), MHQ esthetics (r = 0.788; P < 0.05), and MHQ satisfaction (r = 0.654; P < 0.05) in relation to TBSA. Degree of burn was significantly related to the pain perceived on VAS (r = 0.907, P < 0.05), pain sensation, temperature, and 2-point discrimination (r = 0.59, P < 0.05). Significant correlation was seen with grip strength (r = 0.77, P < 0.05) and further, index finger flexion (r = 0.866), middle finger flexion (r = 0.949), ring finger flexion (r = 0.909), and little finger flexion (r = 0.910) were significantly related (P < 0.05) to degree of burn. MHQ was significantly related (P < 0.05) to degree of burn in terms of overall hand function (r = 0.836), ADL (r = 0.825), work (r = 0.790), pain (r = 0.574), esthetics (r = 0.86), and satisfaction (r = 0.884) in relation to degree of burn. Conclusion: TBSA was significantly co-related with pain in terms of sensory function and showed significant relationship with functional abilities in terms of work, esthetic, and satisfaction. Degree of burn significantly related to the pain, temperature, and 2-point discrimination in terms of sensory abilities, grip strength, Strickland method, and Kleinert method in terms of motor abilities and MHQ in terms of functional capabilities. It also indicates that there was a statistically significant difference in sensory, motor, and functional abilities of the hand that were decreased in patients compared with the control group.

Aim: This study aimed to comparatively evaluate the influence of working length (WL) determined by three different electronic apex locators (EALs) on the apical extrusion of debris following the instrumentation with a rotary NiTi instrumentation system. Methodology: Forty extracted human maxillary or mandibular premolar teeth with single root and canal were selected. Standardized access cavities were prepared, and the samples were divided into four groups according to the method used to determine the WL: Group I (n = 10) – actual working length (AL), Group II (n = 10) – Root ZX mini, Group III (n = 10) – CanalPro™, and Group IV (n = 10) – Propex Pixi™. Each specimen was held in a test apparatus to evaluate the apical extrusion of debris during instrumentation. Instrumentation of all the specimens was done using ProTaper Next till the size X3. The apically extruded debris was collected and calculated by subtracting the initial weight of the tube from the weight of the tube containing dried debris. The apically extruded debris weight score was calculated and tabulated and was subjected to statistical analysis using one-way ANOVA and post hoc Tukey test. Results: Group II and Group III exhibited similar results and exhibited significantly less apical extrusion of debris compared to Groups I and IV. Conclusion: WL determined by EAL (Root ZX mini and CanalPro) showed lesser apical extrusion of debris than AL determination.

Introduction COVID-19 pandemic still poses a serious challenge to health system worldwide. This study was planned to determine exposure characteristics, in-hospital mortality, and predictors of in hospital mortality among COVID-19 patients. Material and methods We retrospectively investigated epidemiological, clinical, and laboratory profile of confirmed COVID-19 patients admitted from 25th March to 31st August 2020. COVID-19 patient profiles were collected from Medical Record Section of the hospital. Results In hospital mortality occurred in 159 (11%) cases. Increasing respiratory rate, higher temperature, higher total leukocyte count, and high blood urea levels were found to be independent risk factors for in hospital mortality whereas higher hemoglobin and higher oxygen saturation at the time of hospital admission were found to be protective against in hospital mortality. Conclusion In hospital mortality among COVID-19 patients is almost 1 in 10 in tertiary care hospital. Patients with advancing age (AOR: 1.048; 95% CI: 1.021-1.076), higher respiratory rate (AOR: 1.248; 95% CI: 1.047-1.489), higher temperature (AOR: 1.758; 95% CI: 1.025-3.016), higher leukocyte count (AOR: 1.147; 95% CI: 1.035-1.270), and higher urea levels (AOR: 1.034; 95% CI: 1.005-1.064) at the time of admission are important predictors of COVID-19 in-hospital mortality.

Background: With changing socioeconomic, demographic, and development scenario, there is a cultural shift in looking after the elderly population which may lead to depression in this age group. Materials and Methods: The study was a hospital-based cross-sectional study conducted in the orthopedic department of a tertiary care setting on 157 elderly individuals. This study was conducted with objectives to estimate the proportion of depression using the Geriatric Depression Scale Short Form (GDS-SF) questionnaire along with its associated factors in geriatric population coming to the orthopedic department of the institute. The study tools were GDS-SF, Katz Index of Independence in activities of daily living (ADL), the Lawton instrumental ADL, and health-related quality of life by the Centers for Disease Control. Results: The proportion of depressed individuals was 70/157 (44.6%) using GDS as a tool. The maximum number was in the age group of 60–74 years. Women outnumbered men (51.3% vs. 38.31%) for depression. The depression using GDS score was more prevalent in rural elderly, illiterate, and elderly who were economically dependent on their children and who belonged to lower middle socioeconomic status. Approximately 98% of the study participants were found to be independent using ADL. Approximately 60% males and 68% females were dependent for the instrumental ADL using Lawton score. Most of the study participants had arthritis as a major impairment sharing almost equal proportion among males and females. Conclusion: The current study concludes that there is a very high proportion of elderly subjects who are experiencing depression using the GDS-SF tool. There should be regular screening for this disease in this age group even in a tertiary care setting.

Background: Population mobility and migration are important processes of human life. It affects broad range of sociocultural parameters. Mobility increases personal interaction and exposure to sexual partners from high-risk group. Although traditional Indian value prohibits premarital or extramarital sexual activities, but this aspect has not been explored in migrant workers. Methods: It was a qualitative study based on indepth interview of participants. The participants were wives of migrant workers. Indepth interviews were conducted by two female field interviewers recruited for the study. A total of 24 study subjects were recruited for the study. An indepth interview guide was prepared which mainly focused on sexual behavior, including premarital, marital, and extramarital, quality of marital relationship, gender roles, peer networks, substance abuse, work-related activities, etc., The transcripts were analyzed in NVIVO and themes were generated. Results: The premarital sex was more common in boys than girls. It is more common in the same age group and has increased in the recent years. Various reasons were cited in relation to premarital sex in rural areas like love affair, delayed marriage, watching bad movies, bad company, allurement for gifts money, etc., Some women had opinion that males belonging to affluent and powerful families had tendency to enjoy sex with other women within and outside village. The major themes which emerged from the study were the sexual activity, type of sexual partners, reasons for multiple sexual partner, and risky and nonrisky sexual activity. Conclusion: The findings of the study provided insights to design and conduct a larger and more representative quantitative study among the wives of migrant workers to understand the dynamic combination of biomedical, behavioral, and sociocultural factors that may influence transmission of infection within marriage.

Introduction: Avoidable sickness, disabilities and death among under 5 children are prevented by routine immunization against some specific diseases. The percentage fully immunized children was 69.9% in Bihar, India, and was almost same in rural area. Immunization coverage is also associated with various socio-demographic factors. The aim of this study is to assess the immunization coverage among children in rural areas of Bhojpur district and identify socio-demographic factors associated with it. Methods: A cross-sectional study was conducted in rural areas of Bhojpur district during January to May 2015. 2 stage cluster sampling was done. 36 villages were selected randomly as primary selection units and within each village, 10 children of age 12-36 months were selected from the sampling frame of all eligible children in selected village. A pre-designed, pre-tested checklist was used by the trained investigators during their visits. Results: A total of 360 children of age 12-36 months were included in the study, of which 65% of children were fully immunized, 33.9% were partially immunized, and 1.1% were not immunized at all. Mother's education (AOR 2.28 (1.28-4.05), P value = 0.005), place of birth (AOR 29.04 (10.75-78.43), P value = 0.0001) and availability of immunization card (AOR 120.04 (15.82-916.47), P value = 0.001) were significantly associated with immunization status. Conclusion: Immunisation coverage in this area was lower. Socio-demographic factors like mother's literacy, place of birth and availability of immunization cards were significantly associated with full immunization of children. It is needed to focus on health related education among parents regarding immunizing services.

Antibiotic resistance has emerged as a threat to global health, food security, and development today. Antibiotic resistance can occur naturally but mainly due to misuse or overuse of antibiotics, which results in recalcitrant infections and Antimicrobial Resistance (AMR) among bacterial pathogens.These mainly include the MDR strains (multi-drug resistant) of ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species). These bacterial pathogens have the potential to “escape” antibiotics and other traditional therapies. These bacterial pathogens are responsible for the major cases of Hospital-Acquired Infections (HAI) globally. ESKAPE Pathogens have been placed in the list of 12 bacteria by World Health Organisation (WHO), against which development of new antibiotics is vital. It not only results in prolonged hospital stays but also higher medical costs and higher mortality. Therefore, new antimicrobials need to be developed to battle the rapidly evolving pathogens. Plants are known to synthesize an array of secondary metabolites referred as phytochemicals that have disease prevention properties. Potential efficacy and minimum to no side effects are the key advantages of plant-derived products, making them suitable choices for medical treatments. Hence, this review attempts to highlight and discuss the application of plant-derived compounds and extracts against ESKAPE Pathogens.

Objectives This study aimed to assess the lived experiences of palliative care among critically unwell people living with HIV/AIDS (PLHA), caregivers and relatives of deceased patients. It also aimed to understand the broader palliative care context in Bihar.Design This was an exploratory, qualitative study which used thematic analysis of semistructured, in-depth interviews as well as a focus group discussion.Setting All interviews took place in a secondary care hospital in Patna, Bihar which provides holistic care to critically unwell PLHA.Participants We purposively selected 29 participants: 10 critically unwell PLHA, 5 caregivers of hospitalised patients, 7 relatives of deceased patients who were treated in the secondary care hospital and 7 key informants from community-based organisations.Results Critically ill PLHA emphasised the need for psychosocial counselling and opportunities for social interaction in the ward, as well as a preference for components of home-based palliative care, even though they were unfamiliar with actual terms such as ‘palliative care’ and ‘end-of-life care’. Critically unwell PLHA generally expressed preference for separate, private inpatient areas for end-of-life care. Relatives of deceased patients stated that witnessing patients’ deaths caused trauma for other PLHA. Caregivers and relatives of deceased patients felt there was inadequate time and space for grieving in the hospital. While both critically ill PLHA and relatives wished that poor prognosis be transparently disclosed to family members, many felt it should not be disclosed to the dying patients themselves.Conclusions Despite expected high inpatient fatality rates, PLHA in Bihar lack access to palliative care services. PLHA receiving end-of-life care in hospitals should have a separate dedicated area, with adequate psychosocial counselling and activities to prevent social isolation. Healthcare providers should make concerted efforts to inquire, understand and adapt their messaging on prognosis and end-of-life care based on patients’ preferences.

BACKGROUND:Co-infection with Visceral Leishmaniasis (commonly known as Kala Azar, KA) and Human Immunodeficiency Virus (HIV) is increasingly being diagnosed among patients in Bihar. This qualitative study is the first assessment of self-reported quality of life among patients co-infected with KA-HIV in the Asian context. METHODS:We conducted semi-structured, in-depth interviews and adopted an inductive thematic analysis to generate evidence on the quality of life of patients co-infected with KA and HIV. Patients were purposively sampled until saturation was attained. RESULTS:We found that patients highly valued income or livelihood potential and health as indicators of a good quality life, and routinely went into debt accessing care in the private setup. This was due to perceptions of poor quality of care in the government setup and a lack of knowledge regarding available government services at the district level. KA symptoms were often misdiagnosed in the private sector as seasonal fever, while care providers found it difficult to disentangle the clinical symptoms of KA and HIV; hence, patients presented late to district hospitals. Patients perceived a high level of stigma, largely due to their HIV status, and routinely reported that HIV had "destroyed" their life. CONCLUSIONS:Inadequate social support and referral pathways that were not conducive to patient needs negatively impacted patients' quality of life. The dual burden of poverty interacting with the severity and chronicity of KA-HIV co-infection means financial support, increased community engagement, and collaborative decision making are crucial for co-infected patients. Increased provider awareness of co-infection and effective stigma-reduction interventions should be integrated to ensure that appropriate and effective access to care is possible for this vulnerable population. A sustainable long-term strategy requires a people-centered approach wherein the perceptions and life circumstances of patients are taken into account in the medical decision making process.

Background: Prevention of Yellow Fever (YF) in travellers to Yellow Fever endemic zone can be done with YF 17D vaccine which is a live attenuated vaccine and can be given only up to one hour after reconstitution. The objective of this study was to study the demographic and travelling pattern of clients who got vaccinated at newly established Yellow Fever Vaccination Centre (YFVC) at AIIMS Patna and to assess the vaccine wastage by initiating online and telephonic registration system. Methods: We developed a web based portal to register the name of passengers who wanted to take YF vaccine at AIIMS Patna from August to December 2016. General demographic characteristics of travellers and their travelling pattern was also obtained. Results: Total 428 doses used and 409 persons were vaccinated from August to December 2016 with vaccine wastage of less than 5%. Most of them have taken vaccine for travelling to the African endemic countries (81.9%) and the main purpose of their visit was for doing job (85.5%). Conclusion: By using online registration system and twenty four hour accessibility on mobile phone, we have achieved a remarkable achievement in terms of keeping vaccine wastage below 5% level.

Introduction: The purpose of this study was to evaluate the effect of remaining dentinal wall thickness and the effect of remaining cusp height of endodontically treated premolars when restored with composite resin. Materials and Methods: Ninety premolars were divided into 4 test groups (n = 20) and 2 control groups (n = 5). In all groups, except the negative control group (sound teeth), standardized endodontic access cavities were prepared, pulp extirpated, mesioocclusodistal (MOD) cavities prepared and access sealed with Light Cure Glass Ionomer Cement (LC GIC). Test groups were divided as:- Cusp reduction for Groups I and II- 2.5 mm and for Groups III and IV- 1.5 mm. Dentinal wall thickness for Groups I and III- 1-1.5 mm and Groups II and IV- 2-3 mm. The groups were further subdivided into Subgroup A, restored with P60 and Subgroup B, restored with Herculite Precis. Positive control- only access cavity with no cusp reduction and restoration. Fracture resistance was assessed using Universal Testing Machine (UTM). Results: Highest fracture resistance was demonstrated by Group VI and least by Group V. Groups VI, II and I, showed statistically insignificant difference for both the composites (P > 0.05). Groups III and IV showed statistically significant difference only for Subgroup B. Conclusion: When the cusp reduction was 2.5 mm, dentinal wall thickness had no effect on the fracture resistance, for both the composites. When the cusp reduction was 1.5 mm and the remaining dentinal thickness was 1-1.5 mm, Herculite Precis showed inferior results to P60.

Introduction: Depression is one of the under-recognized health problems in adolescents. Emotional instability resulted from childhood to adulthood transition makes adolescents vulnerable to depression. Aims: The aim of the study was to explore the prevalence of depression and its associated sociodemographic factors among school-going adolescents. Materials and Methods: This cross-sectional study was undertaken from January 2016 to June 2016 in adolescents studying in 9–12th standard from forty schools located in an urban area of Patna, Bihar. The self-administered questionnaire of Beck's Depression Inventory II was utilized to assess the prevalence of depression. Statistical analysis was done with Pearson's Chi-square test using SPSS software version 21.0. Results: Among the 1412 selected students, the prevalence of depression was found to be 49.2%, wherein the prevalence of severe depression was 7.7%. The overall prevalence of depression was significantly (P < 0.001) higher among girls (55.1%) than boys (45.8%). The prevalence of depression was found to be higher among students belonging to minorities (Buddhism, Jainism, etc.) (63.3%, P < 0.001). Elder students were found to be more depressed than younger students. Depression was found to be statistically significantly associated with gender and religion (P < 0.005). Guilty feeling (69.48%) was one of the most prominent clinical factors associated with depression followed by pessimism (58.14%), sadness (56.52%), and past failure (55.81%). Conclusions: Mental health is one of the most neglected aspects of our society. There is a need to increase awareness about depression among teachers and parents to identify and help depressed adolescents in the school.

Objectives This study aimed to explore barriers to accessing care, if any, among people living with HIV/AIDS (PLHA) in two districts of Bihar. We also aimed to assess attitudes towards PLHA among healthcare providers and community members.Design This qualitative study used an exploratory study design through thematic analysis of semistructured, in-depth interviews.Setting Two districts were purposively selected for the study, namely the capital Patna and a peripheral district located approximately 100 km from Patna, in order to glean insights from a diverse sample of respondents.Participants Our team purposively selected 71 participants, including 35 PLHA, 10 community members and 26 healthcare providers.Results The overarching theme that evolved from these data through thematic coding identified that enacted stigma and discrimination interfere with each step in the HIV care continuum for PLHA in Bihar, India, especially outside urban areas. The five themes that contributed to these results include: perception of HIV as a dirty illness at the community level; non-consensual disclosure of HIV status; reliance on identifying PLHA to guide procedures and resistance to universal precautions; refusal to treat identified PLHA and referrals to other health centres for treatment; and inadequate knowledge and fear among health providers with respect to HIV transmission.Conclusions The continued presence of discriminatory and stigmatising attitudes towards PLHA negatively impacts both disclosure of HIV status as well as access to care and treatment. We recognise a pressing need to improve the knowledge of HIV transmission, and implement universal precautions across all health facilities in the state, not just to reduce stigma and discrimination but also to ensure proper infection control. In order to improve treatment adherence and encourage optimal utilisation of services, it is imperative that the health system invest more in stigma reduction in Bihar and move beyond more ineffective, punitive approaches.

Introduction: Hypertension (HT) has its origin in childhood and adolescent period but it goes undetected due to absence of sign and symptoms, unless specifically looked for during this period. It has been seen that one with raised blood pressure level in this period will also have raised Blood Pressure (BP) level in their adulthood and elderly period. Aim: The present study was conducted to estimate the prevalence of HT and its risk factor among apparently healthy school going adolescents of Patna district. Materials and Methods: A cross-sectional study among 2913 school going adolescents of eighth to 10th standard was conducted from April 2014 to August 2015 by adopting a two stage cluster sampling technique. The questions pertaining to risk behavior in relation to cardiovascular diseases from WHO’s Global School based Student Health Survey were used for this study. Results: The mean systolic and diastolic blood pressure of study population was 107.4 mm of Hg (95% C.I. 106.93-107.77) and 67.4 mm of Hg (95% C.I. 67.26-67.54), respectively. Prevalence of pre-HT and HT was 10.9% and 4.6% in school going adolescents while prevalence of overweight/obesity was 1.5%. Both systolic and diastolic blood pressures had positive and significant correlation with age, height and body mass index. The proportion of children who had ever taken tobacco was 5.3%, cigarette smoking 4.3%, alcohol consumption 2.1%, and excess salt intake 22.3%. Only 49.1% children were doing physical activity at least one hour a day in past seven days for maintenance of good health. Conclusion: The present study recommends that regular screening of blood pressure level must be initiated in adolescents so that remedial measure can be initiated as early as possible.