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Uterine leiomyosarcoma (ULMS) is a rare malignancy arising from the myometrial smooth muscle wall, and cardiac metastases are extremely rare. Metastasis to the heart is a very unusual finding, and atrial metastasis is even rarer. Here, we report a case of a 45 year old woman who presented with dyspnea and pleural effusion and had a significant history of hysterectomy done for ULMS. Magnetic resonance imaging revealed a left atrial mass, which was resected and revealed to be a metastasis of leiomyosarcoma on histopathology and immunohistochemistry. Metastatic ULMS may rarely present as a left atrial mass with acute clinical presentation. Detailed clinical history and accurate diagnosis are vital for further management.
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Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40–80. The best way to manage primary open?angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods: An open?label, real?world, multicentric, observation?based 3?month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first?line therapy. Diurnal IOP measurements, best?corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day?1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results: Four hundred and sixty?nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once?daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion: We found that netarsudil 0.02% w/v solution monotherapy when used as the first?line treatment in primary open?angle glaucoma and ocular hypertension was both safe and effective.
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Objectives: Cerebral palsy (CP) is a motor impairment syndrome leading to disorders of movement and posture. Screening of electrophysiological parameters Hoffman reflex (H-reflex and nerve conduction velocities) becomes a necessary for the early detection and management of the disease. The study aimed to assess the various electrophysiological parameters of nerve conduction velocity in CP and age-matched normal children. Matrials and Methods: The present cross-sectional study was performed between children suffering from CP and healthy control. A total of 27 children of 12–24 months of age of either sex were examined. Among them, six children were normal (with age match), seven were diagnosed with spastic CP and remaining 14 children were diagnosed with hypotonic CP The electrophysiological parameters were recorded in the right lower limb (posterior tibial nerve-soleus muscle) of all children. Results: In electrophysiological parameters, H-reflex latency in secs values was significantly decreased in all CP children. The maximum amplitudes of reflexly excitable motor neurons (Hmax) (mV) and Hmax/maximum amplitude of motor response ratio in the gastrocnemius-soleus muscle were significantly increased in spastic CPas compared to control. H-reflex conduction velocity (HRCV) was significantly higher than motor nerve conduction velocity (MNCV) in hypotonic CP children. Conclusion: The electrophysiological parameters were altered in spastic CP children. The electrophysiological parameters in hypotonic CP were within range, indicating they did not suppress the neuronal motor pool. However, HRCV was significantly more than MNCV in hypotonic CP, suggesting some myelination process defect/white matter injury in motor neurons. We concluded that the electrophysiological parameters of the nerve conduction study are a reliable test for the assessment of tone of muscles in children. Thus, it may help in the early initiation of the treatment and therapies in CP children.
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Background & objectives: Vaccination and natural infection can both augment the immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but how omicron infection has affected the vaccine-induced and hybrid immunity is not well studied in Indian population. The present study was aimed to assess the durability and change in responses of humoral immunity with age, prior natural infection, vaccine type and duration with a minimum gap of six months post-two doses with either ChAdOx1 nCov-19 or BBV152 prior- and post-emergence of the omicron variant. Methods: A total of 1300 participants were included in this observational study between November 2021 and May 2022. Participants had completed at least six months after vaccination (2 doses) with either ChAdOx1 nCoV-19 or an inactivated whole virus vaccine BBV152. They were grouped according to their age (? or ?60 yr) and prior exposure of SARS-CoV-2 infection. Five hundred and sixteen of these participants were followed up after emergence of the Omicron variant. The main outcome was durability and augmentation of the humoral immune response as determined by anti-receptor-binding domain (RBD) immunoglobulin G (IgG) concentrations, anti-nucleocapsid antibodies and anti-omicron RBD antibodies. Live virus neutralization assay was conducted for neutralizing antibodies against four variants – ancestral, delta and omicron and omicron sublineage BA.5. Results: Before the omicron surge, serum anti-RBD IgG antibodies were detected in 87 per cent participants after a median gap of eight months from the second vaccine dose, with a median titre of 114 [interquartile range (IQR) 32, 302] BAU/ml. The levels increased to 594 (252, 1230) BAU/ml post- omicron surge (P<0.001) with 97 per cent participants having detectable antibodies, although only 40 had symptomatic infection during the omicron surge irrespective of vaccine type and previous history of infection. Those with prior natural infection and vaccination had higher anti-RBD IgG titre at baseline, which increased further [352 (IQR 131, 869) to 816 (IQR 383, 2001) BAU/ml] (P<0.001). The antibody levels remained elevated after a mean time gap of 10 months, although there was a decline of 41 per cent. The geometric mean titre was 452.54, 172.80, 83.1 and 76.99 against the ancestral, delta, omicron and omicron BA.5 variants in the live virus neutralization assay. Interpretation & conclusions: Anti-RBD IgG antibodies were detected in 85 per cent of participants after a median gap of eight months following the second vaccine dose. Omicron infection probably resulted in a substantial proportion of asymptomatic infection in the first four months in our study population and boosted the vaccine-induced humoral immune response, which declined but still remained durable over 10 months
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There is emerging scientic research and evidence which visibly demonstrates that internal body environmental inuences can not only impact genes but also how they are expressed. Scientists have discovered that early experiences can determine how genes are turned on and off and even whether some are expressed at all. Epigenetics is the study of how behaviours and environment can cause changes that affect the way the genes work. Unlike genetic changes, epigenetic changes are reversible and do not change the DNA sequence, but they can change how our body reads a DNA sequence. There is strong inuence of the epigenetics on social life. The ancient Indian systems of Ayurveda and Yoga indeed have strong bases for the same. It would be appropriate to further explore the same through inter disciplinary research
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Objectives: This prospective observational study aimed to identify the current trend of the circulating viral strains responsible for hand foot mouth disease (HFMD) outbreak in four tertiary care centers in Rajasthan, amidst the coronavirus disease (COVID-19) pandemic (April-October 2022). Methods: Cases with suspected HFMD, presenting to our skin outpatient department were assessed clinically and serologically (IgM antibodies against coxsackie virus (CV) A6, A16 and enterovirus 71) for evidence of the disease. Results: We identified 718 new HFMD patients (161 adults) with peaks in May and August, 2022. Male:female ratio decreased with increasing age. Most children were asymptomatic. A total of 385/409 patients assessed serologically, were found positive, most commonly against CV-A6. Conclusion: Though HFMD typically affects young children, an unusually higher proportion of adults were affected during the current pandemic. There were some differences between pediatric and adult presentation of HFMD.
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Background & objectives: Research studies in the 1970s reported that in pre-school children, undernutrition increased the risk of infections and infections aggravated undernutrition. Over decades, there has been a reduction in prevalence of undernutrition and improvement in access to healthcare for treatment of infections. A mixed longitudinal study was undertaken to assess whether over time there were any changes from the earlier reported effect of undernutrition prior to infection on the risk of morbidity and effect of morbidity on nutritional status in pre-school children. Methods: Pre-school (0-59 months of age) children from urban low- and middle-income families whose parents were willing to allow their participation in the study were enrolled. Information on sociodemographic profile of the families was collected at enrolment. Weight of all children and length in infants were recorded every month; length/height in children 12-59 months of age was recorded once in three months. Morbidity information was collected through fortnightly visits. Results: 3888 pre-school children were followed up in 74636 home visits. Among these children, underweight and wasting were associated with a small increase in risk of infections. The odds ratio for risk of infection for underweight children was 1.09 (95% CI: 1.02 to 1.16) and for wasting was 1.18 (95% CI: 1.08 to 1.29). The deterioration in Z scores for weight-for-age and body mass index-for-age in children during illness and convalescence was small but significant (P<0.001). Interpretation & conclusions: The increased risk of infections in undernourished children living in overcrowded tenements in areas with poor environmental hygiene was not significant, perhaps because the risk of infection in normally nourished children was also high. The deterioration in nutritional status following infection was small because of the ready access to and utilization of health and nutrition care.
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Background & objectives: Developmental dysplasia of the hip (DDH), when detected early, can usually be managed effectively by simple methods. A delayed diagnosis often makes it a complex condition to treat. Late presentation of DDH is fairly common in developing countries, and there is scarcity of literature regarding the epidemiology and reason for late presentation. Through this study, we attempted to identify the reasons for late presentation of DDH in children more than 12 months of age. Methods: Fifty four children with typical DDH and frank dislocation of hip in whom treatment was delayed for 12 months or more were included. Parents were interviewed with a pre-structured questionnaire and data were collected for analysis with Microsoft Excel 2016 and SPSS version 26. Results: Diagnostic delay was the most common reason for late presentation and was observed in 52 children (96.2%). The mean age at diagnosis was 24.7 months. The mean age at treatment was 37.3 months with a mean delay of 12.5 months from diagnosis and 22.1 months from initial suspicion. Physician-related factors contributed 55.3 per cent, while family and social issues accounted for 44.7 per cent of overall reasons for diagnostic and treatment delays. Interpretation & conclusions: Late presentation of DDH in walking age is common. Physician- and family-related factors accounted for most of these cases. Failure or inadequate hip screening at birth by the attending physician is a common reason for late diagnosis. The family members were unaware about the disorder and developed suspicion once child started walking with an abnormal gait
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Purpose: To evaluate the effect of deep thermal punctal cautery in eyes with post?conjunctivitis cicatrization. Methods: This retrospective study consisted of patients who underwent deep thermal punctal cautery for post?conjunctivitis dry eye (PCDE). The diagnosis was based on a history suggestive of viral conjunctivitis in past followed by the onset of present clinical features of aqueous deficiency dry eye (ATD). All patients underwent a rheumatological evaluation to rule out underlying systemic collagen vascular disease as a cause for dry eye. The extent of cicatricial changes was noted. Best?corrected visual acuity (BCVA), Schirmer’s test, and fluorescein staining score (FSS; total score of 9) were analyzed pre? and post?cautery. Results: Out of 65 patients (117 eyes), 42 were males. The mean age at presentation was 25.769 ± 12.03 years. Thirteen patients presented with unilateral dry eye. Pre?cautery BCVA (logarithm of the minimum angle of resolution [logMAR]) and Schirmer’s test (mm) improved from 0.5251 ± 0.662 to 0.372 ± 0.595 (P value = 0.000, 95% confidence interval [CI]: 0.09–0.22), and 1.952 ± 2.763 to 4.929 ± 4.338 (P value = 0.000, 95% CI: ?3.79–?2.17); post?cautery, respectively. The pre?cautery FSS of 5.9 ± 2.82 reduced to 1.58 ± 2.38 (P value = 0.000, 95% CI: 3.46–5.17) post?cautery. The mean follow?up was 11.22 ± 13.32 months. No progression in cicatricial changes was noted in any eye during the follow?up. Re?canalization rate was 10.64%, and repeat cautery was performed with successful closure of puncta. Conclusion: Symptoms and clinical signs of ATD in PCDE patients improve with punctal cautery
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Purpose: To evaluate effectiveness of omega?3 fatty acid supplements in relieving dry eye symptoms and signs in symptomatic visual display terminal users (VDT). Methods: A randomized controlled study was done; eyes of 470 VDT users were randomized to receive four capsules twice daily for 6 months (O3FAgroup), each containing 180 mg of eicosapentaenoic acid and 120 mg docosahexaenoic acid. The O3FA group was compared with another group (n = 480) who received four capsules of a placebo (olive oil) twice daily. Patients were evaluated at baseline, 1, 3, and 6 months, respectively. The primary outcome was improvement in omega?3 index (a measure of EPA and DHA ratio in RBC membrane). Secondary outcomes were improvement dry eye symptoms, Nelson grade on conjunctival impression cytology, Schirmer test values, tear film breakup time (TBUT), and tear film osmolarity. Means of groups (pre?treatment, 1, 3, and 6?months) were compared with repeated measure analysis of variance. Results: At baseline, 81% patients had low omega?3 index. In the O3FA group, a significant increase in omega?3 index, improvement in symptoms, reduction in tear film osmolarity, and increase in Schirmer, TBUT, and goblet cell density was observed. These changes were not significant in the placebo group. Improvement in test parameters was significantly (P < 0.001) better in patients with low omega3 index (<4%) subgroup. Conclusion: Dietary omega?3 fatty acids are effective for dry eye in VDT users; omega?3 index appears to be the predictor to identify potential dry eye patients who are likely to benefit from oral omega?3 dietary intervention
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Background & objectives: Due to lack of appropriate statistical knowledge, published research articles contain various errors related to the design, analysis and interpretation of results in the area of biomedical research. If research contains statistical error, however, costly, it may be of no use and the purpose of the investigation gets defeated. Many biomedical research articles published in different peer reviewed journals may retain several statistical errors and flaws in them. This study aimed to examine the trend and status of application of statistics in biomedical research articles. Study design, sample size estimation and statistical measures are crucial components of a study. These points were evaluated in published original research articles to understand the use or misuse of statistical tools. Methods: Three hundred original research articles from the latest issues of selected 37 journals were reviewed. These journals were from the five internationally recognized publication groups (CLINICAL KEY, BMJ Group, WILEY, CAMBRIDGE and OXFORD) accessible through the online library of SGPGI, Lucknow, India. Results: Among articles assessed under present investigation, 85.3 per cent (n=256) were observational, and 14.7 per cent (n=44) were interventional studies. In 93 per cent (n=279) of research articles, sample size estimation was not reproducible. The simple random sampling was encountered rarely in biomedical studies even though none of the articles was adjusted by design effect and, only five articles had used randomized test. The testing of assumption of normality was mentioned in only four studies before applying parametric tests. Interpretation & conclusions: In order to present biomedical research results with reliable and precise estimates based on data, the role of engaging statistical experts need to be appreciated. Journals must have standard rules for reporting study design, sample size and data analysis tools. Careful attention is needed while applying any statistical procedure as, it will not only help readers to trust in the published articles, but also rely on the inferences the published articles draw.
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Background: In line with global trends, India has witnessed a sharp rise in C-section (CS) deliveries, especial-ly in the private sector. Methodology: Study attempts to explore change in CS delivery in India at national, regional and State/UT lev-els. We have used factsheet data from the most recent nationally representative survey data i.e., NFHS to ex-amine changes in private and public healthcare facilities, and to determine a difference in rural and urban in CS deliveries. Results: The CS rate has increased from 17.2% to 21.5% in 2019-21. CS was more than twice (40.9%) amongst the private healthcare facilities during the fourth round of NFHS which has shown a considerable in-crease during the fifth round of NFHS (47.4%). There is equal distribution (12.8% during 2015-16 to 17.6% in 2019-21 in rural areas v/s 28.2% during 2015-16 to 32.3% in 2019-21in urban areas) of CS deliveries amongst the rural and urban areas to the total deliveries. Conclusion: Study found that with every one in five deliveries being caesarean, the figure is significantly high as per the recommended cut off by WHO. Thus, it is essential to explore factors regarding emergency or elec-tive caesarean section and to understand if the health facilities are following the recommended protocols for performing CS deliveries.
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Purpose: To investigate the knowledge of myopia and its natural history including complications and clinical approaches for management adopted by optometrists across India. Methods: An online survey was distributed to Indian optometrists. A pre?validated questionnaire was adopted from previous literature. Respondents provided information about their demographics (gender, age, practice location, and modality), myopia knowledge, self?reported practice behaviors relating to childhood myopia, the information and evidence base used to guide their practice, and perceived extent of adult caregiver engagement in making management decisions for myopic children. Results: A total of 302 responses were collected from different regions of the country. Most respondents demonstrated knowledge of the association between high myopia and retinal breaks, retinal detachment and primary open?angle glaucoma. Optometrists used a range of techniques to diagnose childhood myopia, with a preference for non?cycloplegic refractive measures. The most common approaches to management were single?vision distance despite most optometrists identifying orthokeratology and low?dose (0.01%) topical atropine as two potentially more effective therapeutic interventions for controlling childhood myopia progression. Almost 90% of respondents considered increasing the time spent outdoors to be beneficial for reducing the rate of myopia progression. The main sources of information used to guide clinical practice were continuing education conferences, seminars, research articles, and workshops. Conclusion: Indian optometrists appear to be aware of emerging evidence and practices, but are not routinely adopting measures. Clinical guidelines, regulatory approval, and sufficient consultation time may be of value for assisting practitioners in making clinical decisions based on the current available research evidence
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Background- Rag picking is one of the inferior economic activities in the urban informal sector, largely undertaken by children belonging to weaker sections of society for their survival and for supplementing their family income. Rag picking is one of the most dangerous activities in India. Rag pickers are working in a filthy environment surrounded by dust, dogs, and pigs. They suffer from many diseases, such as respiratory problems, anemia, fever, and other problems which include cuts, rashes, and injuries. Waste pickers are the general term adopted by the 1 st World Conference of Waste Pickers in 2008. Objective- [a] To assess the socio-economic condition of ragpickers in Varanasi, [b] To know the health condition and treatment behavior of ragpickers in Varanasi. Materials and Methods- A community-based descriptive cross-sectional study in which ragpickers reside in the slum area of Varanasi. All men and women present at the time of the interview who were involved in rag picking from the last 6 months were included. Seriously ill men and women were excluded. Since we had no prior knowledge about the proportion of cases (P) so a pilot study was conducted in which prevalence of health problem found in rag pickers in the last 6 months (P) = 0.90. Total estimated sample size is 100. In this study, Simple Random sampling was used. By using this sampling 100 individuals were selected randomly, fulfilling the inclusion criteria. Results-82 (82.0%) rag pickers were not educated in which 75 (91.5%) rag pickers suffered from health problems. Maximum 74 (74.0 %) rag pickers were migrants. Maximum 74 (74.0%) rag pickers were married in which 36 (48.0 %) rag pickers were married between 14- 18 ages. 80 (80.0%) rag pickers had not used any precautionary measure during rag picking in which 73 (91.2%) rag pickers faced health problems. Maximum 39(39.0%) were affected by dust during rag picking. Only 17(17%) ragpickers preferred government hospitals for treatment. 75 (75.0 %) rag pickers were addicted to intoxication in which 66 (88.0%) rag pickers faced health problems. 91 (91%) ragpickers affected by any health problems in the last 6 months in which a maximum of 63.7% of rag pickers suffered from fever, 60.4% of rag pickers complained about injuries, 56.2 % of rag pickers suffered from weakness problems, 52.7% of rag pickers affected by cough problems. There is a highly significance between educational status and any kind of intoxication. Discussion- The literacy level among the rag pickers was 18% which is much lower than the average literacy rate of Varanasi 75.60% (2011census). A study on slum dwellers in Dhaka showed the literacy rate higher than the finding of this study (18 vs 25 %). 28.0% of rag pickers adopted this work because they had no education. There is a high significance between educational status and any kind of intoxication. Chances of intoxication are high when no education among rag pickers. It is highly significant between educational status and health problems of rag pickers in the last 6 months. Uneducated rag pickers were not aware of the health effects.
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Objectives: Angina is a symptom of coronary artery disease (CAD). Modulation of cardiac autonomic tone as assessed by heart rate (HR) variability (HRV) is found reduced in patients with CAD; myocardial ischemia, myocardial infarction and some other cardiovascular diseases. Reduced HRV has been found associated with sudden cardiac death in these CAD patients. Several patients present with anginal symptoms clinically in absence of CAD or other diseases. The status of HRV is not much clear in these patients. Thus, we aimed to assess HRV in patients with angina with and without myocardial ischemia and compare it with HRV of healthy subjects of similar age groups and follow-up patients for 1 year for cardiac/health events. Materials and Methods: The study included 61 consecutive male patients clinically presenting with angina and 30 healthy subjects. Based on Thallium-201 myocardial perfusion Single-photon emission computerized tomography (SPECT) imaging, patients were divided into two groups; patients with myocardial perfusion defects (MPD), (n = 33, age 54.91 ± 7.43 years) and patients with no MPD (NMPD), NMPD (n = 28, age 53.04 ± 8.50 years). Short-term HRV was assessed in all patients and subjects in resting supine position following standard protocol. All MPD and 25 NMPD patients could be followed up for 1 year for cardiac/health events. Results: Surprisingly, the NMPD patients showed significantly reduced HRV, Standard deviation of the N-N intervals, The square root of the mean squared differences of successive N-N intervals, Percentage of the number of interval differences of successive N-N intervals greater than >50 ms divided by total number of R-R intervals, low frequency (LF) power, High Frequency (HF) power and total power as compared to both MPD patients and healthy subjects. (Total power [NMPD vs. MPD]: 610.1 [379.9–1072.8] vs. 1508.0 [748.4–2339.4] millisecond squares (ms2 ), P = 0.001), healthy subjects (Total power: 1414.6 [1104.6-2141.5] ms2 , P = 0.001). The markers of sympathetic tone; LF (normalised unit) and LF/HF ratio were higher in NMPD patients as compared to MPD patients resulting in an altered sympathovagal balance. During a 1-year follow-up, sudden death was seen in one MPD patient (3.1%) and two NMPD patients (8%). Conclusion: The NMPD patients showed significantly reduced HRV as compared to both MPD patients and Healthy subjects with an altered sympathovagal balance. Sudden death was also seen in NMPD patients as MPD patients.
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Background: Renal ganglioneuroma is an extremely rare benign tumour that affects neural crest cells. Here we report a case of renal ganglioneuroma with nodal metastasis managed by surgical resection. Case report: A 38-year-old female presented with anorexia and early satiety. On examination, she had a palpable mass per abdomen. CT scan revealed a large heterogenous mass in retroperitoneum in right suprarenal region with enlarged retrocrural lymph nodes. She underwent right radical nephrectomy as the mass was inseparable from the right kidney. Postoperative period was uneventful. HPE revealed renal ganglioneuroma. Conclusion: Primary renal ganglioneuroma is difficrult to differentiate from other etroperitoneal lesions. Surgical resection is the most effective treatment.
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A nation is built by its citizens and these citizens with their good health, hard work determines the future of a nation. To ensure a bright and prosperous future we need to focus on the health of a community. Community health is defined as simple services that are delivered by common men outside hospitals and clinics. Community health services can be classified into Preventive Health Services, Promotive Health Services, Curative Health Services, and Rehabilitative Health Services. Preventive health services include measures by which we can avoid the disease before its occurrence Dincharya, Ritucharya, Sadvrit, Tryoupstham, and Vegdharan can be included in this category. Similarly, promotive heath care services include Rasayan, Vaajikaran, Ashtaaharvidhi vishesh ayatan, Sadvrit, Tryoupstham. Curative health services include single-drug therapy for the different diseases called Ekal dravya and treatment of Kaas, Swash, Atisaar, Amlapita which are very common. Rehabilitative health services such as physical therapy, counseling, and other mental health services can be provided by Ashwashan chikitsa, Medhya rasaayan, Yoga, Pathya palan, Padansikkarm palan.
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The world is rapidly ageing but India is still young. India is having Demographic Dividend a window of opportunity, from the year 2020 till 2050. This means that we have the maximum young population (15-64) years of working. The median age of the Indian population is less than 29 years in year 2022 . India has about 67% of its population in the working age group of 15-64byears –the segment we call it as demographic dividend. This window of opportunity is further more advantageous as other nations like USA & Japan have aging population. The need of the hour is tapping the talent powerhouse of our youth. But do we know youth. Do we understand young people. One in seven young person is depressed in India as per UNICEF report 2021. 80% percent of India's workforce reported mental health issued but only half took steps to seek mental help. These ?gures are alarming enough for industry, educational institutes & government to frame policies, take steps to bring back our youth into mainstream with full vigour, con?dence & optimum productivity level. Unless the preparatory work of skilling, reskilling and job creation happens, India stands to lose the opportunity of demographic dividend . To harness the youth potential we ?rst need to understand the problems of youth and then frame polices that are executed to employ youth productively and at the same time their mental and physical health is well taken care of. The session deliberates on problems of youth and suggests practical solutions to these.
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Aims : To calculate the prevalence of Dyslipidemia in patients with Mycobacterium Tuberculosis infection (Mtb) and Diabetes Mellitus (DM). Materials and Methods : A study done on 294 patients infected with Mtb were enrolled in the study. Patients infected with Tuberculosis (TB) were selected from Medicine and Pulmonary Medicine Departments in MLN Medical College Prayagraj. Patients were segregated into two groups on the basis of glucose tolerance; Abnormal Glucose Tolerance (AGT) and Normal Glucose Tolerance (NGT). Results: A total of 294 patients with TB were taken in the study, 143 patients in AGT group and 151 patients in NGT group. The average age of the patients in AGT group was 47.91 years. Among AGT and NGT, Dyslipidemia was found to be statistically significant among AGT group (p=0.01). Mean Serum Triglycerides (209.8, p<0.004) and LDL Cholesterol (144.3, p<0.0001) in AGT group. Conclusion : Patient with TB DM are more prone for Dyslipidemia and atherogenicity
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Background & objectives: The COVID-19 pandemic exposed the strengths and weaknesses of the healthcare systems across the world. Many directives, guidelines and policies for pandemic control were laid down centrally for its implementation; however, its translation at the periphery needs to be analyzed for future planning and implementation of public health activities. Hence, the objectives of this study were to identify the challenges faced by frontline health managers in selected States in India during the pandemic with regard to implementation of the COVID-19-related policies at the district level and also to assess the challenges faced by the them in adapting the centrally laid down COVID-19 guidelines as per the local needs of the district. Methods: A qualitative study using the grounded theory approach was conducted among frontline district-level managers from eight different States belonging to the north, south, east and west zones of India. The districts across the country were selected based on their vulnerability index, and in-depth interviews were conducted among the frontline managers to assess the challenges faced by them in carrying out COVID-19 related activities. Recorded data were transcribed verbatim, manually coded and thematically analyzed. Results: Challenges faced in implementing quarantine rules were numerous, and it was also compounded by stigma attached with the disease. The need for adapting the guidelines as per local considerations, inclusion of components of financial management at local level, management of tribal and vulnerable populations and migrants in COVID context were strongly suggested. The need to increase human resource in general and specifically data managers and operators was quoted as definite requirement. Interpretation & conclusions: The COVID-19 guidelines provided by the Centre were found to be useful at district levels. However, there was a need to make some operational and administrative modifications in order to implement these guidelines locally and to ensure their acceptability.