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Introduction: Children who are born with disability, more so intellectual disability are dependant on their parents for their daily needs. The presence of disabled child in the family adds to the caregiver burden which may read to emotional distress manifesting as anger, depression, stigma, etc. The study aimed to assess both the positive and negative impacts of having a disabled child in the family on caregivers. Methodology: The present, cross-sectional study was conducted in a rural area of Jammu district using simple random sampling, two health zones out of eight were selected for the conduct of the study. All the disabled children were identified and their parents were interviewed using National Institute of Mental Health-Disability Impact Scale Scale after taking an informed consent from them (IECGJ)(NO: IEC/GMC/2019/892). Results: During the course of the study, a total of 101 caregivers of disabled children were interviewed. Both negative and positive impact on the caregivers was found to be in close approximation to the tune of 15%–16%. Among the negative impacts, financial burden was the most dominant domain followed by physical care of the child and caregiver health being affected. Conclusion: It would be pertinent to conclude that we need to empower the caregivers as an important step for the inclusion of these special children in the society. In this context, few recommendations have been discussed in the present study.

Background: Postpartum depression refers to non-psychotic depressive episode that begins immediately after childbirth. Although delivering a baby is a happy event but many females develop depressive symptoms. About 13% of postpartum women experience a mental disorder, primarily depression worldwide. The aim is to estimate the prevalence of Postpartum depression among the mothers and to determine the association of Perceived Social Support, socio demographic and other obstetric variables with Postpartum depression. Methodology: The study was conducted among the Postpartum mothers attending the immunization section of a Tertiary care hospital, Jammu, India. Tools used are- Edinburgh Postnatal Depression Scale (EPDS), Hamilton depression Rating Scale (HDRS) and Multidimensional Scale of Perceived Social Support (MSPSS). SPSS software was used to analyse the data. Results: Prevalence of Postpartum Depression was found to be 16.1%. Variables like residence, occupation, h/o domestic violence, family h/o mental illness, eventful antenatal period, h/o hospitalization of baby, unwanted parenthood and low social support emerged to be independent predictors of Post Partum depression. Conclusions: Postpartum mothers particularly those, who were having poor social support are highly vulnerable to depression. Every postpartum mother should be screened for postpartum depression and timely referred to the psychiatrists. Also, family members need to be counselled.

Background: Food insecurity is a matter of public health concern as it is associated with adverse health outcomes particularly among vulnerable population. Accessibility and availability of nutritious and culturally appropriate food is paramount to achieve zero hunger. To assess the prevalence of household food insecurity, to estimate the household dietary diversity and its association with household food insecurity. Material and Methods: Using multistage sampling 381 rural households were surveyed. Household Food Insecurity Access Scale and House hold Dietary Diversity Scale were used as study instruments. Chi square test was used to compare the two groups and P < 0.05 was considered to be statistically significant. Results: Prevalence of household insecurity was 33.3% (127) among the surveyed households and 8.1% (31) had severe food insecurity. The mean HFIS score was 6.85 ± 4.82. The household Dietary diversity score was 8.14 ± 1.54 for food secure and 6.51 ± 1.38 for severely food insecure households. There was a statistically significant difference in intake of milk and milk products, fruits, eggs and meat/poultry among food secure and insecure households (P < 0.001 respectively). Conclusion: Food insecurity was high in rural households and was associated with lower dietary intake of foods from protein group, necessitating a need to reinforce the food security programmes in rural India with focus to enhance protein rich diet.

Background: Snakebite envenoming, a neglected tropical disease (NTD), is an important public health problem that is responsible for more than 1 lakh deaths annually across the world. However, the majority of the data in this regard is from health institutions and data from community settings are scarce. The aim of the current study was to develop valid and reliable qualitative tools for assessing the burden of snakebites and the health-seeking behavior of the community. The tools developed thus will serve in creating a community connection and thereby strengthen primary care teams engaged in managing snakebites at the primary care level. Methods: A four-step design was used; (a) review of the available literature on the burden of disease, tools used to assess the burden, and the guidelines on snakebite (b) development, laying out, and contextualization of questions/items for the tools (c) pilot testing and establishment of validity. Results: A focus group discussion guide, key informant interview schedule for health professionals, community leaders, and traditional faith healers were matured for the implementation. Conclusion: A reliable and valid qualitative tool was developed to discern the speculations related to snakebites and its management in rural field settings.

Purpose: To assess the frequency and distribution of retinal changes in children suffering from cerebral malaria (CM), study the correlation between fundal changes and severity of disease, visual outcome, and survival of patients. Methods: An observational, cross-sectional study was done on pediatric patients, suffering from CM in a tertiary care center in eastern India. A complete ophthalmological examination was done and findings were tabulated. Their hospital admission records were checked for severity of coma, recovery, and prognosis. Data were analyzed with SPSS software, and P value < 0.05 was considered statistically significant. Results: Total 113 children of age group 0–18 years (mean age 7.88 ± 0.56 years) were enrolled in the study. Seventy-seven children (68.14%) had retinal changes. Most common retinal signs associated with malarial retinopathy were white centered hemorrhage and papilledema (53.09% each), followed by retinal whitening (51.33%) and vessel changes (39.82%). The correlation between the presence of white centered retinal hemorrhages and visual prognosis was found to be statistically significant (P = 0.001). Patients with Grade 4 parasitemia showed maximum retinal signs with a significant correlation between the severity of papilledema and parasite load (P = 0.037). Eighty-six patients (76.11%) survived and 27 patients (23.89%) died. All 27 patients who died showed all four signs of malarial retinopathy. Out of these, patients with retinal whitening suffered from severe coma, and this correlation was found to be statistically significant (P = 0.002). Conclusion: Presence of retinal signs in patients with CM is associated with severe disease (high parasite load), poor visual outcome, and increased mortality.

Objectives: The Prospective Randomized On-X Mechanical Prosthesis Versus St Jude Medical Mechanical Prosthesis Evaluation (PROSE) trial purpose was to investigate whether a current-generation mechanical prosthesis (On-X; On-X Life Technologies/Artivion Inc) reduced the incidence of thromboembolic-related complications compared with a previous-generation mechanical prosthesis (St Jude Medical Mechanical Prosthesis; Abbott/St Jude Medical). This second report documents the valve-related complications by individual prostheses and by Western and Developing populations. Methods: The PROSE trial study was conducted in 28 worldwide centers and incorporated 855 subjects randomized between 2003 and 2016. The study enrollment was discontinued on August 31, 2016. The study protocol, and analyses of 10 demographic variables and 24 risk factors were published in detail in 2021. Results: The total patient population (N = 855) included patients receiving an On-X valve (n = 462) and a St Jude Medical valve (n = 393). The overall freedom evaluation showed no differences at 5 years between the prostheses for thromboembolism or for valve thrombosis. There were also no differences in mortality. There were several differences between Developing and Western populations. The freedom relations at 5 years for mortality favored Western over Developing populations. Valve thrombosis was differentiated by position and site: aortic

Background: Posterior capsule tear (PCT) during phacoemulsification affects the type, site, and timing of intraocular lens (IOL) implantation. Aim: The aim was to evaluate the visual outcomes and complications following sulcus implantation of single-piece foldable acrylic IOL after PCT during phacoemulsification. Setting and Design: The retrospective observational study was conducted at a tertiary care center in eastern India. Methods: Records of patients between July 2017 and March 2020 were reviewed. Thirty-six eyes of 36 patients, in whom PCT had occurred during phacoemulsification, were included. Statistical Analysis Used: Microsoft Excel 2007 and SPSS 108 software were used. Preoperative and postoperative visual acuity was compared using paired t-tests. Postoperative visual outcomes and complications were assessed in percentage. Results: Postoperative visual acuity was ≥6/12 in 22 (61.11%) patients on day 1 and 30 (83.33%) patients on day 30, with a statistically significant improvement compared to preoperative vision (P < 0.05). On the first postoperative day, corneal edema was seen in 8 (22.22%) patients, increased anterior chamber reaction in 5 (13.89%) patients, and raised IOP in 4 (11.11%) patients. After 3 months, 2 (5.56%) patients needed antiglaucoma medications for IOP control, 1 (2.78%) had iridocyclitis, and 1 (2.78%) had chronic cystoid macular edema. The mean follow-up duration was 17.44 ± 12.15 months (range: 3–46 months). Conclusion: To conclude, sulcus implantation of posterior chamber IOL during phacoemulsification surgery complicated with PCT may be considered if the adequate lens is not available, and sufficient capsular support exists. Our study revealed a good final visual acuity with minimal complications, though more research to ascertain our results is warranted.

Background: The word Climacteric is shrouded in a culture of silence in our country, more so in the vast rural swathes of India. This survey was carried out to assess the knowledge and perceptions regarding climacteric in rural females of the Jammu district. Materials and Methods: The present study was conducted in the Kot-Bhalwal health block of Jammu district. A sample of 215 was calculated assuming a minimum prevalence of 65% of menopausal symptoms. Using a two-step simple random sampling technique, a total of 245 postmenopausal women from four villages of the health block were interviewed using a semi-structured questionnaire. Results: Among the sources of information about climacteric, family and friends were prime sources followed by community elders. About one-third (35.10%) of the respondents had no discussion about climacteric with anyone. The majority of the participants had a positive perception of climacteric and described it as a feeling of relief. About 77.9% of study participants rated their health as poor to fair. However, about one-fourth of women had taken health checkups for menopause-related symptoms. None of the respondents had any clue about oncological screening. Conclusion: Despite positive perceptions, there is a need to dispel the misconceptions with rigorous awareness and counseling. The role of village-level health workers along with ANM at Sub Health Centers/Health and wellness centers is the game-changer in this context. Every opportunity including Antenatal clinics should be utilized to educate as well as screen menopausal females for various health problems.

Purpose: The purpose of this study was to review the effect of the pre-operative use of clopidogrel and aspirin on peri-operative bleeding, blood product transfusion, and resource utilization after coronary artery bypass grafting (CABG). Materials and Methods: A total of 1200 patients who underwent off-pump CABG (OPCABG) between 2010 and 2012 were retrospectively studied. Patients were divided into three groups: group 1: discontinued aspirin and clopidogrel 6 days prior to surgery (n = 468), group 2: discontinued both drugs 3 to 5 days prior to surgery (n = 621), and group 3: discontinued both drugs 2 days prior to surgery (n = 111). The bleeding pattern and blood product transfusion were studied and compared between the groups. Patients having history of other drugs affecting the coagulation profile, other organ dysfunction, on-pump CABG, and the combined procedure were excluded from the study. Results: Group 2 patients had a higher rate of bleeding and a reduced mean value of hemoglobin (Hb) as compared to other groups. The same results were seen in blood and blood product transfusion. Patients of group 2 and group 3 were associated with higher blood loss in terms of drainage at 12 and 24 hours. Post-operatively, this was statistically significant. Re-exploration was statisitically significant in group 3 patients (9.01%) than in group 2 (2.58%) and group 1 (1.07%) patients. Conclusion: The pre-operative use of clopidogrel and aspirin in patients undergoing OPCABG showed limited clinical benefits; however, its use significantly increased the risk of bleeding and blood transfusion, thus increasing morbidity and resource utilization. Hence, clopidogrel and aspirin should be stopped at least 6 days prior to surgery.

Abstract Objectives The PROSE trial purpose is to investigate whether the incidence of thromboembolic—related complications is reduced with a current generation mechanical prosthesis (On-X Life Technologies/CryoLife Inc.—On-X) compared with a previous generation mechanical prosthesis (St Jude Medical—SJM). The primary purpose of the initial report is to document the preoperative demographics, and the preoperative and operative risk factors by individual prosthesis and by Western and Developing populations. Methods The PROSE study was conducted in 28 worldwide centres and incorporated 855 subjects randomized between 2003 and 2016. The study enrollment was discontinued on August 31, 2016. The preoperative demographics incorporated age, gender, functional class, etiology, prosthetic degeneration, primary rhythm, primary valve lesion, weight, height, BSA and BMI. The preoperative and operative evaluation incorporated 24 risk factors. Results The total patient population (855) incorporated On-X population (462) and the St Jude Medical population (393). There was no significant difference of any of the preoperative demographics between the On-X and SJM groups. The preoperative and operative risk factors evaluation showed there was no significant difference between the On-X and St Jude Medical populations. The preoperative and operative risk factors by valve position (aortic and mitral) also documented no differentiation. The dominant preoperative demographics of the Western world population were older age, male gender, sinus rhythm, aortic stenosis, congenital aortic lesion, and mitral regurgitation. The dominant demographics of the Developing world population were rheumatic etiology, atrial fibrillation, aortic regurgitation, mixed aortic lesions, mitral stenosis and mixed mitral lesions. The Developing world group had only one significant risk factor, congestive heart failure. The majority of the preoperative and operative risk factors were significant in the Western world population. Conclusions The preoperative demographics do not differentiate the prostheses but do differentiate the Western and Developing world populations. The preoperative and operative risk factors do not differentiate the prostheses BUT do differentiate the Western and Developing world populations.

Objectives We verified subnational (state/union territory (UT)/district) claims of achievements in reducing tuberculosis (TB) incidence in 2020 compared with 2015, in India.Design A community-based survey, analysis of programme data and anti-TB drug sales and utilisation data.Setting National TB Elimination Program and private TB treatment settings in 73 districts that had filed a claim to the Central TB Division of India for progress towards TB-free status.Participants Each district was divided into survey units (SU) and one village/ward was randomly selected from each SU. All household members in the selected village were interviewed. Sputum from participants with a history of anti-TB therapy (ATT), those currently experiencing chest symptoms or on ATT were tested using Xpert/Rif/TrueNat. The survey continued until 30 Mycobacterium tuberculosis cases were identified in a district.Outcome measures We calculated a direct estimate of TB incidence based on incident cases identified in the survey. We calculated an under-reporting factor by matching these cases within the TB notification system. The TB notification adjusted for this factor was the estimate by the indirect method. We also calculated TB incidence from drug sale data in the private sector and drug utilisation data in the public sector. We compared the three estimates of TB incidence in 2020 with TB incidence in 2015.Results The estimated direct incidence ranged from 19 (Purba Medinipur, West Bengal) to 1457 (Jaintia Hills, Meghalaya) per 100 000 population. Indirect estimates of incidence ranged between 19 (Diu, Dadra and Nagar Haveli) and 788 (Dumka, Jharkhand) per 100 000 population. The incidence using drug sale data ranged from 19 per 100 000 population in Diu, Dadra and Nagar Haveli to 651 per 100 000 population in Centenary, Maharashtra.Conclusion TB incidence in 1 state, 2 UTs and 35 districts had declined by at least 20% since 2015. Two districts in India were declared TB free in 2020.

Background: Demographic transition has resulted in population aging, which has led to advancement in multiple geriatric problems including cognitive impairment (CI) and depression. Objectives: The objective was to find the prevalence and determinants of CI and depression in the rural elderly population. Materials and Methods: This was a community-based cross-sectional study conducted in a rural area. The prevalence of CI was measured using the Mini-Mental State Examination scale and depression was assessed using the Geriatric Depression Scale. The data so collected were analyzed using PSPP software. Results: The mean age of the study participants was 67.47 ± 6.43 years. The prevalence of CI and geriatric depression was found to be 36% (153/425) and 29.1% (124/425), respectively. Variables which were found to have independent significant association on multivariate analysis with CI were literacy, memory complaints, and depression. For geriatric depression, an independent association was seen with literacy, socioeconomic status, memory complaints, stress in the family, and presence of CI. CI and geriatric depression were found to be strongly correlated with each other (r = −0.252, P < 0.001). Conclusions: Almost one-third of the geriatric population is suffering from depression (29.1%) and CI (36%). This necessitates for accurate and timely diagnosis, so as to ensure proper care and support to the elderly population with emphasis on geriatric mental health care.

The World Health Organization defined palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual. The patient centric primary care model (PCCM) promises to provide a solution to control these health-care challenges. The model is largely based on the chronic care model (CCM) and the model developed by the Organized Medicine Academic Guild (OMAG) for delivering health care in India.

Background: The incidence of coronary artery disease (CAD) has risen considerably in developing world due to industrialization, urbanisation and lifestyle changes, especially among Indians and South Asians. The onset of CAD has been seen to occur at an early age and the severity of the disease and mortality associated with CAD has also increased. The pathology of atherosclerosis needs to be re-evaluated to develop targeted therapy which can contain the disease process at the earliest stage. Aims and Objectives: Most of the morphological studies on atherosclerosis have been done on autopsy cases. In this study, we have analysed the morphological spectrum of atherosclerotic lesions in live patients. Materials and Methods: We retrospectively analysed the histopathology slides of 85 cases whose endarterectomy plaques were received in the Department of Pathology over a period of three and half years (January 2014 to June 2017) and classified the lesions according to Modified American Heart Association classification of atherosclerosis. Results: The average age of patients was 60 years and male to female ratio of 4.3:1. Left anterior descending artery was the commonest vessel involved (52.4%). Majority of the cases had fibrocalcific plaques,followed by fibrous cap atheroma and calcified nodules. Conclusion: Coronary artery plaques were found even in patients less than 40 years old. Aggressive lipid defense therapy needs to be the cornerstone of management of CAD.

Background: Ocular trauma which is an avoidable cause of blindness is a common public health problem and more so in rural areas of developing countries. Purpose: To analyse the epidemiological pattern of ocular trauma in a rural area. Material and Methods: This study was conducted retrospectively by analyzing the two years records of Ophthalmological OPD in a peripheral health institution of Jammu. The data was presented as proportions and test of significance applied was chi square test. Results: Majority of patients (38.10%) were found to be in the age group 31-40 years with a male to female ratio of 1.82:1. Results revealed that 40.88% of the patients had reported in less than 24 hours to the health institution and 52.14% of cases had adnexal injuries. Work related injuries were more common in males in comparison to female cases who reported more of home related injuries. Conclusion: Ocular trauma in normal population is more common in males and predominantly seen in economically productive age group. Common ocular trauma found were adnexal injuries and contusions. People in rural areas should be made aware of early diagnosis and prompt treatment in case of ocular trauma so as to reduce chances of ocular morbidity and blindness.

Background: Preference for a male child by the family leading to a sex-selective abortion has been a leading factor for the skewed sex ratio in India. This has long-term social and demographic consequences. The present study was conducted with the aim to assess the awareness and attitudes regarding prenatal sex determination and preconception and prenatal diagnostic technique act (PC-PNDT) among females of reproductive age group (15–45 years) attending a tertiary care teaching hospital in Jammu district of J and K state in North India. Materials and Methods: A hospital-based cross-sectional study was carried out among 210 females of reproductive age group. The study participants were administered a predesigned and pretested questionnaire. Data thus obtained were analyzed using SPSS Version 20.0 and expressed in percentages. Chi-square test was used as test of statistical significance with P < 0.05 taken as statistically significant. Results: Awareness about sex determination among respondents was 94%. Higher proportion of urban respondents knew about ultrasound as the technique for sex determination than their rural counterparts (P < 0.05). Awareness regarding the PC-PNDT act and determination of sex of a child being a crime was higher among urban respondents (P < 0.05). Among the attitude, more rural females would prefer to know the sex of the child (P < 0.05) than their urban counterparts. Conclusion: Respondents had high awareness about sex determination as well as technique used for it. Awareness about PC-PNDT act was on the lower side. Education programs for the women about gender equality and wider publicity of the act in the mass media need to be scaled up.

Background: Studies suggest that approximately half of patients with raised blood pressure (BP) are undetected, that half of those detected are not treated, and that half of those treated are not controlled, famously described as the “rule of halves.” Importantly, the cornerstone of the primary prevention of cardiovascular diseases is early detection and drug treatment (antihypertensive) of patients with high BP. Studies across populations in developed world have shown that awareness and management of high BP levels are far from optimal. The present study was planned with the aim to assess the knowledge, attitude, and practices (KAP) regarding hypertension in hypertensive patients visiting Tertiary Care Hospital in North-West India. Materials and Methods: Already diagnosed hypertensive patients seeking care at the tertiary care center were selected for this study. The participants were recruited using consecutive sampling technique. All participants were interviewed with the help of a semi-structured questionnaire after obtaining a written informed consent. The components of the KAP were recorded using a score sheet. Results: In all, 394 hypertensive patients of whom majority (239/394; 61%) were males, were included in the study. The KAP score among the study subjects was 88.4%, 90.83%, and 95.83%, respectively. Males had higher knowledge about normal BP levels which was statistically significant (P < 0.01). Among the attitude, regular intake of anti-hypertensive drugs, regular investigations, lifestyle changes, avoidance of salt and allopathic medicines being the best for the treatment of hypertension were found to be significant statistically (P < 0.01). Conclusion: The high score among the study population can be attributed to the fact that all study participants were diagnosed patients of hypertension seeking care in a tertiary care hospital.

Context: Emergency contraception (EC) is use of drug or device to prevent pregnancy after unprotected sexual intercourse. Unlike other regular methods of contraception which are taken prior to the sexual act, EC is used after the unprotected sex. Aim: To assess the knowledge and attitude toward use of emergency contraceptives among medical students. Setting and Design: A cross-sectional questionnaire based study was conducted among all the medical students in the Government Medical College in North-West India. Subjects and Methods: A questionnaire seeking information on knowledge and attitude of undergraduate medical students was administered over a period of 4 weeks in the month of February and March 2014. Statistical Analysis: The data were entered in MS excel and expressed using percentages. Chi-square test was used as a test of statistical significance. Results: About 61.6% (247/401) of the participants were aware about the timing of use of EC. Audio visual media (76.6%; 307/401) was the most common source of information for of these medical students. Conclusions: The lack of appropriate in-depth knowledge of EC among future health care professional should alarm the medical teaching system as EC is the only method that can be used to prevent pregnancy after unprotected sex or contraceptive accident.

Introduction: An extensive search on PubMed reveals very little in terms of evidence regarding the current knowledge, attitude, and practices (KAP) of the population in general and rural population, in particular, in this part of the country. Therefore, a study was conducted with the aim to assess the communities′ knowledge of malaria transmission, recognition of signs and symptoms, treatment seeking. Materials and Methods: A stratified two-stage design was used to conduct a house-to-house survey using a semi-structured questionnaire in RS Pura block of Jammu District of Jammu and Kashmir State in North India. Results: A total of 300 households were included in the study. However, data on 4 households was found to be incomplete at the time of analysis and, therefore, were excluded. Out of 296 study participants interviewed 65.5% were males, while 34.5% females. All of the study participants (100%) had heard of malaria, and the main source of their information was television/newspaper. 92.5% of the study population considered malaria to be a serious health problem, thus reflecting their attitude to the disease. Regarding practices, 71.6% of the study participants preferred going to doctors at government hospitals for malaria treatment, and 56% were willing to seek medical help in

Introduction: Chronic respiratory diseases are an important cause of disability across the globe. The global burden of these diseases is showing a discernible upward trend. It is estimated that 500 million people suffer from them. Materials and Methods: The study was conducted with the aim to estimate the prevalence of chronic obstructive pulmonary disease (COPD) in a rural Indian population. For this, a population-based survey was conducted using modified British Medical Research Council questionnaire. This was followed by subjecting the respondents to Wright's mini peak flow meter to find out the peak expiratory flow rate to diagnose the COPD cases. Results: The prevalence of chronic bronchitis, bronchial asthma, and COPD was found to be 3.36%, 1.18%, and 4.21%, respectively. Conclusions: Chronic respiratory disorders are more prevalent among rural adults hinting to a rural-urban divide. Therefore, the focus of preventive strategies should take into account this difference.

Introduction: Iodine deficiency disorder remains one of the major public health problems, despite it being easily preventable. Initially thought as the disorder of Himalayan goiter belt, the disorder has been found to have a pan-India presence. The study was planned with the aim to assess the prevalence of goiter among 6–12 years school-going children and to identify levels of iodine in salt consumed at the household level in the study area. Materials and Methods: The study was conducted among 3955 school-going (2162 children from Rajouri and 1793 children from Poonch) children age 6–12 years in Rajouri and Poonch districts of Jammu Province. The children were examined clinically to detect and grade the goiter. Salt samples were collected from subsample (n = 400) to estimate iodine content in the salt. Results: The prevalence of goiter in the study population was found to be 18.87% and 9.70% in Rajouri and Poonch districts, respectively. Goiter prevalence was higher in 9–12 years age group as compared to 6–9 years age group and the difference in goiter prevalence in males of these two age groups was statistically significant (P = 0.02). Estimation of iodine content of the salt samples revealed that all of them (100%) had adequate iodine content. Conclusion: Despite the implementation of Universal Iodization Program and adequate content of iodine in salt consumed by the families, the goiter prevalence in both the districts is high. The future research should focus on identifying the reasons for this high prevalence.

Introduction: Quality of life (QOL) is an important area of concern among elderly which reflects the health status and well-being of this vulnerable group of population. The present study was con- ducted with an objective of assessment of QOL and its associated factors among rural and urban elderly population. Methodology: A community based cross-sectional study was conducted among 390 elderly subjects residing in rural and urban areas of Jammu. Brief version of the WHO QOL scale (WHOQOL- BREF) was used to assess the Quality of Life. Analysis of results was done using Independent sample t- test and multiple linear re- gression analysis. Results: A sample of 200 rural and 190 urban elderly subjects was analysed. Overall mean score for different domains of QOL was 59.19± 11.87 with a significantly higher score for urban subjects, indicating a better QOL as compared to their rural counterparts (p

Introduction: Dengue and chikungunya are Aedes mosquitoborne viral diseases of major public health concern in India. Recently, there is a gradual rise in number of dengue and chikungunya positive cases in various states of Northern India and a similar emergence and increase of dengue positive cases has been observed in Jammu since 2011. Among the mosquitoborne diseases dengue has become a regular seasonal disease while chikungunya has recently emerged in 2016 and Zika the third aedes borne viral infection is needed to be under surveillance under national guidelines. Aim: To report the emergence of chikungunya and analyse the status and pattern of dengue over a period of one year along with serosurveillance of Zika which was done under Central Government guidelines. Materials and Methods: A total of eight hundred eight (808) samples from patients suspected of dengue infection over a period of one year from January 2016 to December 2016 from all the districts of Jammu Province, were tested serologically at our tertiary care centre for dengue NS1 antigen and IgM anti - dengue antibodies. Besides three clinical suspects of chikungunya, 167 dengue (7 positive and 160 negative) sera were tested by National Institute of Virology (NIV) CHIK IgM Capture ELISA, as there is an overlap of clinical symptoms. For Zika testing, the stored negative samples of dengue and Chikungunya (215) were sent to NIV Pune. Results: Recurring dengue infection with periodic upsurge since last few years and emergence of chikungunya was reported in Jammu region. Of the 808 sera tested for dengue and 170 tested for chikungunya, 17.82% and 18.2% were positive respectively. The results for Zika testing were negative. The association of dengue on the basis of sex was found to be highly significant (p=0.009276). Conclusion: In the absence of specific treatment and vaccine for dengue and chikungunya fever, early diagnosis is important in the management of these infections. This also demands continuous seroepidemiological surveillance of the locally prevalent and emerging arthropod borne infections for timely formulation and implementation of effective arboviral control programme.

BACKGROUND: Advances in scientific research necessitates updating of the curriculum and the Medical Council of India now Board of Governors have proposed a new competency-based undergraduate curriculum for the Indian Medical Graduate. The authors wanted the views of medical students about basic sciences teaching in the form of feedback, their perceptions and attitudes toward the basic sciences and their opinions about the relevance of these subjects, and finally any ideas about improvement in teaching of basic sciences. MATERIALS AND METHODS: The present cross-sectional study was conducted in two medical colleges of Northern India and 250 medical students from each medical school were the study participants. Students of the 1st year were not included, but interns were included. A pretested questionnaire having twenty questions with answers in the form of “yes” and “no” was used. Chi-square was the test of significance. RESULTS: Almost all the participants considered the basic sciences as an integral part of medical curriculum and a higher number of Government Medical College respondents opined that their knowledge made it easier to understand clinical subjects (P < 0.05). However, higher proportion of ASCOMS (Acharya Shri Chandra College Medical Sciences) of respondents emphasized that the focus should be on clinical subjects and that current student–teacher ratio be increased (P < 0.05). Majority of the respondents labeled Anatomy having the immense syllabus, while Physiology was designated as more relevant and having a better recall during clinical discourse (P > 0.05). CONCLUSION: Basic sciences lay strong foundation for subsequent clinical learning. Medical education is best taught with hybrid use of lectures, tutorial, group discussions, audio-visual aids, and integrated teaching. The new proposed competency-based curriculum and the Attitudes, Ethics and Communication Module are likely to improve the overall medical education and health-care scenario.

The rehabilitation of patients with acquired defects of the maxilla is a challenge in terms of re-establishing oronasal separation. In most patients these goals are met by means of prosthetic rehabilitation with an obturator prosthesis. Prosthetic rehabilitation can be achieved satisfactorily if all facets of treatment planning and design consideration are taken well into account prior to the rehabilitation process. In many cases effective obturation is achieved but in the relative majority, the prosthesis is usually rejected by the patient as being non-retentive and the outcome is a failure. So, making the prosthesis hollow and the placement of attachments can have a dramatic effect on the stability and retention of the obturator prosthesis in partially dentulous maxillectomy patients. This paper describes a clinical case of post maxillectomy due to adenocystic carcinoma, rehabilitated with the hollow bulb obturator stabilized with Dalla Bona type of radicular attachment.