Rabies death in a prisoner: necessity for medical history documentation

Rabies is a zoonotic illness with a high mortality rate that attacks mammals' central nervous systems. It is a viral illness that may be avoided with immunization. Up to 99% of the human rabies transmissions occur in dogs, making them the primary cause of rabies mortality in humans. It is a case-report of rabies death in a 55-years old male, a prisoner from Phulbani Jail (Kandhamal), who was presented to MKCG Medical College and Hospital casualty with with chief complaints of difficulty in breathing and difficulty in drinking water since last night on 17 July 2023, at 11:19 pm. The patient had a history of dog bite exposure four years ago, for which he had not received any post-exposure prophylaxis. The patient was identified as having a likely case of rabies based on his previous history of animal bite and clinical manifestations. Patient was declared dead on 18 July 2023 at 10:30 am. Rabies diagnosis was confirmed by pathological examination of brain sample which showed presence of Negri bodies. This case-report focuses on the importance of proper medical history information including any animal bite exposure especially for convicts before admitting in prison so as to avoid later morbidity and its legal consequences. Such kind of incident also shows that there is lack of awareness regarding rabies in community. In this instance, mortality may have been prevented if the patient had finished the anti-rabies vaccine regimen and made it to a higher center in time for immunoglobulin. Increasing rabies vaccination awareness among the general public can help reduce rabies-related deaths.

The impact of COVID-19 pandemic on diet and lifestyle of undergraduate medical students of South India-a cross sectional study

Background: COVID-19, infectious disease caused by the Corona virus, caused economic and social disruptions all over the World. In order to contain this pandemic, complete/partial lock down was declared in different parts and thus restricting all human activities. Lifestyle behaviours, especially eating habits, physical activity and sleep patterns changed causing complications such as obesity, diabetes and cardiovascular disorders. The prevalence of depression, anxiety and stress increased among the public. Methods: The study is conducted among medical students to find out the extent of after effects of COVID pandemic on the diet and life style of medical students. Online questionnaire was used to access the lifestyle and exercise patterns of medical students across South India. Results: The study reveals that the pandemic has led to notable shifts in the daily routines, eating habits, and overall well-being of this demographic. Factors such as increased stress, remote learning, and limited social interactions have played a crucial role in these changes. Significant change in hours of sleep, and change in sitting and screen time has been observed. Slight increase in the daily intake of fruits and vegetables, intake of balanced diet and immunity-boosting food, consumption of junk food/fast food and fried food has been observed. The consumption of unhealthy food when bored or stressed is also slightly increased. There is also slight change in quality of sleep and participation in exercise.

Non-alcoholic fatty liver disease among patients undergoing ultra-sonography abdomen and its associated factors in a tertiary care hospital, Kakinada

Background: Non-alcoholic fatty liver disease (NAFLD) presents a growing global health concern, characterized by the accumulation of hepatic lipids in the absence of significant alcohol consumption. Its prevalence has surged worldwide, including in India, where it has reached alarming levels. Despite its silent progression, NAFLD can lead to severe complications, including liver cirrhosis and hepatocellular carcinoma. Objectives of the study to assess prevalence and its associated factors, which are essential for effective management and prevention strategies. Methods: An observational, analytical cross-sectional study was conducted in a tertiary care hospital in Kakinada, Andhra Pradesh, from June to July 2022. Among 100 subjects, chosen through the simple random sampling. Ethical approval was granted before conducting study. Data on demographics, lifestyle risk factors, anthropometry, and ultrasound findings were collected using a pretested and validated case record form. Statistical analysis was carried out using SPSS software, employing appropriate tests to explore associations between NAFLD and various variables. Results: Among 100 participants, the prevalence of NAFLD was found to be 41%. Significant associations were observed between NAFLD and variables such as BMI (p=0.034), waist-hip ratio (p=0.002), and history of diabetes mellitus (p=0.000). Lifestyle factors, including increased cooking oil consumption, were identified as significant risk factors. Conclusions: The study highlights the high prevalence of NAFLD among subjects undergoing ultrasound abdomen in Kakinada. Significant associations were observed with BMI, waist-hip ratio, and diabetes mellitus history. Promoting healthy behaviours is crucial for NAFLD prevention and management.

Relation of radial artery occlusion after trans-radial percutaneous coronary intervention with the duration of hemostatic compression

Background: Trans-radial percutaneous coronary intervention (PCI) in cardiac procedures accesses coronary arteries through the wrist's radial artery. Post-PCI, hemostatic compression on the radial artery prevents bleeding and aids healing. Radial artery occlusion (RAO), a possible complication, involves blockage of the radial artery. This study aimed to assess the relationship between radial artery occlusion after trans-radial percutaneous coronary intervention with the duration of hemostatic compression. Methods: This prospective observational study was conducted in the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh, spanning from September 2018 to August 2019. The study enrolled 140 patients who underwent percutaneous coronary intervention (PCI) through the trans-radial approach (TRA), randomly assigned to two groups: Group I (2-hour hemostatic compression after PCI) and Group II (6-hour hemostatic compression post-procedure). Data analysis was performed using SPSS version 23.0. Results: In this study, early radial artery occlusion was observed in 4.3% of patients in group I and 12.8% in group II (P=0.04), while late radial artery occlusion occurred in 2.8% of patients in group I and 11.4% in group II, with a statistically significant difference (P=0.04). Multivariate logistic regression analysis identified a 6-hour hemostatic compression duration (P=0.01), post-procedural nitroglycerine use (P=0.03), and procedure time (P=0.03) as predictors of radial artery occlusion. Conclusions: Reduced hemostatic compression duration is linked to a decreased occurrence of both early and late radial artery occlusion following trans-radial intervention.

Barriers to the accessibility of health insurance in elderly patients attending NCD clinic in a tertiary care hospital Trichy, Tamil Nadu: a mixed-method study

Background: Health insurance schemes launched by governments have been inadequate to provide health coverage to the vulnerable elderly population. This research aimed to study the prevalence, preference, and pattern of health insurance coverage among the study participants and barriers to its accessibility. Methods: It was a facility-based Sequential explanatory mixed-method study where patients above 60yrs attending the non-communicable disease OPD were recruited by systematic random sampling and enquired using a semi-structured questionnaire for the prevalence, preference, and pattern of health insurance. Focussed Group discussions (FGD) were later conducted to explore the barriers faced by participants in accessing health insurance. Results: Health Insurance coverage among the study participants was 74.5%. Of the participants who had any type of health insurance, 86.7% had public health insurance. About three fourth (73.8%) of those who had health insurance were covered under the CMCHIS. Mean health insurance coverage provided was significantly higher by private health insurance (INR170897.4) as compared to both the LIC and CMCHIS (p<0.01) while premium charged was significantly higher for LIC (INR 10003.3/yr.) as compared to others (p<0.01). Institutional issues, lack of awareness, and economic dependence on children were considered as barriers to the accessibility of health insurance among elderly. Conclusions: A dedicated universal Health Insurance Programme with higher monetary coverage and low premium involving all elderly populations may provide necessary financial risk protection and reduce out-of-pocket health expenditure.

Patient centric factors affecting delay in self-diagnosis and seeking medical care for oral cancer: a cross-sectional study

Background: Oral cancer is often detected in the advanced stage, with a low survival rate of 5 years and with increase in mortality which, affects patient quality of life. The early diagnosis would reduce the mortality rate and morbidity rate, by bringing a change in the quality of life. Methods: The study utilized convenient sampling method to select the participants. Participants who were diagnosed with oral cancer currently at 3rd and 4th stage. Data collection was done using pre-validated self-administered questionnaire, which was provided to the participants through Google forms. Results: The study demonstrated 43.1% people diagnosed with stage-3 oral cancer had an average delay of 34.6 months and 26% of stage-4 cancer patient had an average delay of 59.9 months to their first visit to treatment center. In this study 34% of the study participants were unaware and had lack of knowledge about oral cancer related symptoms. Self-medications/herbal medications, fear for the treatment, socio-economic factors, COVID-19/ lockdown restriction were also other reasons reported by patients. Conclusions: The prompt treatment is necessary in both advanced cases and early cases of oral cancer. Radiotherapy, chemotherapy, and surgery are all part of the treatment when given timely. Thus, early diagnosis plays a vital role in saving many live.

Impact of diabetes mellitus on tuberculosis treatment outcomes: a cohort study in Bengaluru, India

Background: Tuberculosis (TB) remains a significant global health challenge, particularly in regions with a high prevalence of diabetes mellitus (DM). This study aims to evaluate the impact of DM on the treatment outcomes of TB patients in Bengaluru, India. Methods: In this cohort study, we examined 592 patients with smear-positive pulmonary TB, half of whom had a comorbid diagnosis of DM. Conducted in the Bruhat Bengaluru Mahanagara Palike area, the study included patients registered under the national TB elimination programme (NTEP). Data were collected on demographic characteristics, treatment adherence, sputum positivity, and treatment outcomes over six months. Results: The study revealed a high prevalence of DM among TB patients. Significant associations were observed between DM and various challenges, including higher rates of sputum positivity, poor adherence to anti-TB and anti-diabetic medications, increased adverse drug reactions (ADRs), and a higher default rate. TB patients with DM had a 1.5 times higher risk of unsuccessful treatment outcomes compared to non-diabetics. Furthermore, the risk of poor outcomes, particularly relapse, increased substantially in the TB-DM group during the six-month follow-up. Conclusions: Our findings highlight the crucial need for integrated TB and DM management strategies. This includes routine DM screening for TB patients, personalized treatment regimens, and enhanced patient education and support. These measures are essential for improving treatment outcomes in TB patients with comorbid DM.

Hemovigilance: knowledge, attitude and practice among postgraduates and interns of a tertiary care hospital

Background: Adverse reactions due to transfusion of blood and blood products should be reported for the betterment of patients health and to minimize such effects in the future. A Program was initiated to report and reduce incidence of adverse reactions to blood products which is hemovigilance program of India. Aim was to evaluate the knowledge, attitude and practice of haemovigilance among postgraduates and interns. Methods: This was a cross-sectional questionnaire-based study conducted among 159 participants of a tertiary care hospital for a period of 1 month. Results: Results obtained were analysed using descriptive and qualitative statistics. About 83.6% of the participants were aware about the concept of Haemovigilance. Only 23 out of the 159 had reported transfusion reactions in the past but the attitude towards this concept was satisfactory. Conclusions: Overall the participants had a less satisfactory overview of this concept and hence educational interventions can aid in serving the purpose.

Effects of chest physiotherapy and cognitive behavioral therapy in preventing post-operative complications in a patient who has undergone double barrel ileostomy: a case study

Bowel obstruction is a common complication in advanced ovarian cancer with a reported obstruction rate between 5�%, which is treated with resection and anastomosis. Post-operative complications (PPCs) generally occur due to immobility, decreased chest expansion, reduced thoracic mobility, weakness of respiratory muscles, severe pain at the suture site, and bandaging, making it difficult for the patient to cough. Thick and sticky mucus and depressed mucociliary clearance as an effect of anesthesia, cause accumulation of secretions in the lungs and can lead to PPCs. All this leads to prolonged hospital stays for the patient and delays recovery. Hence, our study aims to study the effects of chest physiotherapy and cognitive behavioral therapy in preventing post-operative complications in a patient who has undergone double barrel ileostomy. A 47-year-old female presented with the chief complaint of pain in the abdomen, for 2 months, which was dull aching and did not relieve with medication. She underwent double barrel ileostomy surgery. Following surgery, a 1- week exercise program was designed for the patient, which included the combination of chest PT and cognitive behavioral therapy with pre- and post-assessment of 3 scales, HAM-A, MGS-2, and POP DST, which showed remarkable differences in the pre and post values of the patient. Our present study concluded that post-operative physiotherapy intervention of chest PT and cognitive behavioral therapy was effective in preventing post-operative complications in the patient and promoted her early discharge from the hospital.

Fish oil supplementation in obese rats ameliorates metabolic syndrome response

Accumulation of visceral adipose tissue is associated with metabolic syndrome (MS), insulin resistance, and dyslipidemia. Here we examined several morphometric and biochemical parameters linked to MS in a rodent litter size reduction model, and how a 30-day fish oil (FO) supplementation affected these parameters. On day 3 post-birth, pups were divided into groups of ten or three. On day 22, rats were split into control (C) and small litter (SL) until 60 days old. Then, after metabolic disturbance and obesity were confirmed, FO supplementation started for 30 days and the new groups were named control (C), FO supplemented (FO), obese (Ob), and obese FO supplemented (ObFO). Comparison was performed by Student t-test or 2-way ANOVA followed by Tukey post hoc test. At the end of the 60-day period, SL rats were hyperphagic, obese, hypoinsulinemic, normoglycemic, and had high visceral fat depot and high interleukin (IL)-6 plasma concentration. Obese rats at 90 days of age were fatter, hyperphagic, hyperglycemic, hypertriacylgliceromic, hipoinsulinemic, with low innate immune response. IL-6 production ex vivo was higher, but in plasma it was not different from the control group. FO supplementation brought all biochemical changes to normal values, normalized food intake, and reduced body weight and fat mass in obese rats. The innate immune response was improved but still not as efficient as in lean animals. Our results suggested that as soon MS appears, FO supplementation must be used to ameliorate the morpho- and biochemical effects caused by MS and improve the innate immune response.

Impact of COVID-19 on socio-behavioural, health and oral health-related aspects on spinal cord injury patients: a cross-sectional study

Background: Spinal cord injury (SCI) is a damaging, life-altering injury, which is estimated to have an annual global incidence of 40 to 80 cases per million population and is two to five times more possible to die prematurely. This study aims to evaluate the impact of COVID-19 on socio-behavioural, health, and oral health-related aspects of spinal cord injury patients. Methods: This cross-sectional study was conducted among 50 spinal cord injury patients in the rehabilitation center in Chennai, Tamil Nadu, which was conducted between May and June 2022. Results: The comparison of mean distribution scores based on DMFT showed that complete injury patients had a lower DMFT score of 6.40 when compared to incomplete injury (8.41). The periodontal status assessment revealed that SCI with complete injury had a lower mean number of teeth with gingival bleeding and periodontal pocket (3.81 and 2.31 respectively) when compared to incomplete injury (7.12 and 4.49). Moreover, the impact of COVID-19 on the socio-behavior and health status was found to be higher in complete injury than that in incomplete injury patients. Conclusions: Therefore, this pandemic highlights the need to advocate the development of a nationwide SCI registry or surveillance system is fundamental to an understanding of the epidemiology and, hence, the prevention of this emerging health burden.

Knowledge and attitude towards pharmacovigilance among healthcare students at a medical college in Nepal

Background: Pharmacovigilance is the science and activities relating to the detection, assessment, understanding, and prevention of adverse drug reactions (ADRs) and any other possible drug-related problems. Under reporting of adverse drugs reactions are the global health problem. The adequate knowledge and skills towards pharmacovigilance and adverse drugs reactions reporting are crucial for the health care students to ensure patients’ medication safety. This study aims to assess the knowledge and attitude of the health care students towards pharmacovigilance and ADRs. Methods: A closed ended, structured, self-administered questionnaire was administered to 204 undergraduate health care students to collect the data. Data were analyzed using SPSS version 21. Non-parametric tests (Mann Whitney U test and Kruskal Wallis test) were used for analysis. Results: Among 204 respondents, the majority of them had a poor knowledge (91.18%) and positive attitude (87.25%) towards Pharmacovigilance. The inter quartile range (median) score of the respondents’ knowledge was 5.0±2.211 and attitude was 27.0±2.88 towards Pharmacovigilance and ADRs reporting. The main reason for under reporting of ADRs was difficulty to decide whether ADR has occurred or not (32.4%) due to the lack of appropriate knowledge and training. There is a poor knowledge and positive attitude towards Pharmacovigilance. Conclusions: Adequate coverage of Pharmacovigilance and ADRs reporting issues should be covered in the curriculum as well as hand on training and workshop should be conducted to increase the knowledge and confidence in detecting, monitoring and reporting ADR in their clinical posting.

Analysis of Genetic Variability and Correlation in Rice (Oryza sativa L.) Recombinant Inbred Lines (F6) for Yield and Its Component Traits

grain yield and its component traits in 150 rice recombinant inbred lines, their parents and six checks at ICAR-IIRR, Hyderabad and AHRS, Kathalagere in wet 2022. The experiments were laid out in an augmented block design with five blocks. Phenotypic coefficients of variance were higher than genotypic coefficients of variance for all the traits across the locations. A joint consideration of high heritability in broad sense (h2) and genetic advance as per cent mean estimates were obtained for plant height, number of tillers, number of productive tillers, panicle length, number of grains per panicle, test weight, grain yield per plant suggesting that the traits were primarily under genetic control. Furthermore, high heritability (h2) and GAM recorded in these characters could be explained by additive gene action. However, high estimates (h2) combined with moderate GAM recorded for days to 50% flowering could be due to non-additive gene effect. Grain yield per plant recorded positive and significant correlation with the total number of grains per panicle (0.32***, 0.30***) and number of productive tillers per plant (0.21***, 0.26***) at both the locations. This result indicates that selection based on these two traits will be highly effective for yield improvement in rice.

Human X-cromosome non-coding variation in latin american populations: a review / Variación no codificante del cromosoma X humano en poblaciones latinoamericanas: una revisión

ABSTRACT The human X-chromosome non-coding markers, such as short tandem repeats (STRs), single nucleotide polymorphisms (SNPs), insertion-deletions (INDELs) and Alu insertions, are useful for revealing relationships among populations and for the identification of individuals. In the last decades, a number of studies have been performed to determine the genetic structure of Latin American populations by using X-chromosome markers. These studies provided useful information regarding the genetic composition of these populations and their relationship with Native American, Asian and European populations. One of the most interesting findings achieved by X-chromosome studies is the bias in the sex ratio of individuals that gave rise to the current Latin American populations, as it was previously observed through the analysis of uniparental markers, and which is undoubtedly evidenced in the differential inheritance of X-chromosome in comparison to autosomes. Besides, the genetic drift process that affected Native American populations is more pronounced in X-chromosome markers than in autosomes. The present review summarizes our current knowledge concerning X-chromosome non-coding polymorphisms studied in Latin American populations.

RESUMEN Los marcadores no codificantes del cromosoma X humano, como las repeticiones cortas en tándem (STR), los polimorfismos de un solo nucleótido (SNP), las inserciones-deleciones (INDEL) y las inserciones Alu, son útiles para revelar la relación existente entre poblaciones, y también para la identificación de personas. En las últimas décadas, se han realizado una serie de estudios para determinar la estructura genética de las poblaciones latinoamericanas, utilizando marcadores de cromosoma X. Estos estudios proporcionaron información útil sobre la composición genética de estas poblaciones y su relación con las poblaciones nativas americanas, asiáticas y europeas. Uno de los hallazgos más interesantes logrados en estos estudios es el sesgo en la proporción de sexos de los individuos que originaron las poblaciones latinoamericanas actuales, tal como se observó previamente a través del análisis de marcadores uniparentales, y que queda evidenciado por la herencia diferencial del cromosoma X en comparación con los autosomas. Además, el proceso de deriva genética que afectó a las poblaciones nativas americanas actuó de manera más pronunciada en los marcadores del cromosoma X que en los autosomas. La presente revisión resume nuestro conocimiento actual sobre los polimorfismos no codificantes del cromosoma X estudiados en poblaciones latinoamericanas.

A rare case report of 32 years old female suffering from lupus panniculitis as an initial sign of systemic lupus erythematosus

This case report describes a rare case of lupus panniculitis (LEP) in a 32-year-old Egyptian lady who did not have any history of chronic illness. The patient initially presented with leg pain, erythematous nodules, and back ulcers. In addition to proteinuria and increased erythrocyte sedimentation rate (ESR) levels, laboratory tests revealed atypical ANA titers and positive results for anti-DNA, anti-Scl 70, anti-SSa, and anti-SSb antibodies. There was a decline in C3 and C4 levels. A physical examination revealed well-defined ulcers on her back and subcutaneous lumps in both of her legs. The diagnosis of LEP was confirmed by a nodule biopsy. Systemic lupus erythematosus (SLE) was finally determined to be the patient's diagnosis in accordance with the classification standards of the American College of Rheumatology. Methylprednisolone therapy resulted in the resolution of ulcers and nodules, as well as normalization of CBC and C3 levels and a drop in ANA titer. In order to enhance patient outcomes, this example highlights the necessity of treating LEP as a symptom of SLE and the value of early diagnosis and treatment.

Comparison of various pulpotomy techniques: coronal, cervical, and full pulpotomy

The preservation of deciduous teeth is crucial in pediatric dentistry to maintain normal speech, development, and self-esteem, while also preventing secondary issues like space loss and tooth impaction. Different materials and approaches have been explored over time, ranging from mummification to maintaining pulp vitality and promoting healing. In today's conservative dentistry, techniques like indirect pulp treatment and partial pulpotomy (PP) have gained popularity. Adults diagnosed with irreversible pulpitis due to deep caries often receive root canal therapy (RCT). However, coronal pulpotomy treatment (CPT) has emerged as an affordable alternative for those unable to afford RCT. CPT removes the coronal pulp, allowing the remaining pulp to remain vital. PP and complete pulpotomy are explored as treatments for teeth with signs of irreversible pulpitis. Success depends on eliminating infected tissue, using aseptic techniques, and achieving a tight restorative seal. Materials like MTA have shown favorable outcomes. Direct pulp therapy and PP can effectively preserve vital pulp in primary and young permanent teeth. The choice of pulpotomy material, such as MTA, plays a significant role in success rates.

Determinants of neonatal mortality in Margaret Kenyatta Mother Baby Wing at Nakuru level 5 hospital, Nakuru County, Kenya

Background: Nakuru county has 41.9 neonatal deaths per 1000 live births, more than double the national average of 19. This study examined Nakuru level 5 hospital neonatal mortality risk factors. Methods: A retrospective mismatched case-control study was used. The 429 neonates (143 cases and 286 controls) were estimated assuming a 1:2 case-to-control ratio and 18% prevalence of exposure among controls. Binary logistic regression measured dependent-independent variable correlation. Results: The study found that high parity, high number of stillbirths, positive HIV, HBsAg, syphilis, pregnancy-induced hypertension, antepartum hemorrhage, PROM 18hours, and maternal peri-partum increased the risk of neonatal. Similarly, mothers who had fewer ANC visits throughout their pregnancy had a higher risk of neonatal mortality compared to mothers who attended more than three ANC clinics, with mortality risk reducing by 69% and 59% for 1-2 visits and more than 3 visits, respectively, compared to non-attendance. Vaginal aided birth had an or of 2.188 and vaginal unassisted OR=4.533 compared to caesarian delivery. Antibiotics and prenatal dexamethasone decreased maternal mortality. Antibiotics lowered NMR or 0.381. Newborns admitted from referral facilities or labor wards had or 1.11 and or 6.220 death rates. Low birth weight, admission weight, gain weeks, and congenital defects increased mortality. In this study, birthweight decreased newborn mortality. Conclusions: The study concluded that maternal characteristics, neonatal complications are key to improving neonatal outcomes. The study recommends regular training of staff working in the maternity and newborn unit on emergency care and neonatal resuscitation.

Bio Efficacy and Economics of Systemic Insecticides against Whitefly in Potato

A field experiment was conducted at Potato Research Station, S. D. Agricultural University, Deesa during 2018-19 and 2019-20 for evaluation of efficacy of insecticides against whitefly in potato. The seven different treatments viz. T1: Control, T2: Seed treatment with imidacloprid (200 SL) @ 0.04% followed by foliar sprays of imidacloprid @60 gm a.i./ha at 85% emergence + second spray with thiamethoxam 25WG @100g a.i./ha, T3: Foliar spray of diafenthiuron 50WP 350 g a.i. at 85% emergence, T4: Foliar spray of diafenthiuron 50WP 350 g a.i. at 85% emergence followed by second spray of diafenthiuron after 10 days, T5: Foliar spray of castor oil @0.05% at 85% emergence, T6: Foliar spray of diafenthiuron 50WP 350 g a.i. at 85% emergence mixed with castor oil @0.05%, T7: Foliar spray of diafenthiuron 50WP 350 g a.i. at 85% emergence mixed with castor oil @0.05% by second spray with diafenthiuron after 10 days. Based on pooled data of two years, the significantly highest per cent reduction (i.e. 68.57 %) after 2nd spray was recorded in T7 i.e. foliar spray of diafenthiuron 50WP 350 g a.i. at 85% emergence mixed with castor oil @0.05% by second spray with diafenthiuron after 10 days which was at par with T4 (Foliar spray of diafenthiuron 50WP 350 g a.i. at 85% emergence followed by second spray of diafenthiuron after 10 days). The tuber highest yield and benefit cost ratio were also recorded with T7.

Investigating the Prevalence and Causes of Escape in Mental Patients

This study summarize and evaluate the articles that have been done in the field of mental patient escape to provide a clearer picture of the prevalence, causes, and factors of escape. Electronic resources were searched in the the period from 2008 to 2023. A combination of Abscond of mental patient, Abscond of mentally ill, Abscond, Escape of mental patient, and Escape was used to search electronic resources. The results of this review study showed that the highest number of escapes from the hospital are in Australia, England, America, India, and Ireland, respectively. A rate of over 25% absconding has been reported in forensic psychiatry in South Africa. Also, young male patients, single, addicts, people diagnosed with bipolar mood disorder, depression, and schizophrenia and patients who have not been admitted for a long time showed more desire to run away. A review of the conducted studies showed that the prevalence of absconding occurred in which countries, in which age group, with which disease, and which gender. According to the results of the research, it is possible to identify the patients at risk of escaping by taking into account the characteristics of hospitalized patients and preventing them from escaping by monitoring them and taking special measures. Encouraging families to visit and support their patients, reducing the feeling of limitation and deprivation in patients, can help reduce the rate of absconding. The results of this research can be used in planning and designing appropriate measures to prevent mental patients from escaping.

Health status and health seeking behaviour in transgenders in Kakinada: a community based cross-sectional study

Background: Transgender (TG) is a term used to define individuals with a gender identity that is incongruent with the gender identity accorded to them at birth. Over the last two decades, health research on TGs has focused mainly on their sexual practices, leading to lack of information on their health problems and healthcare-seeking behaviour beyond STDs /HIV. The current study aimed to gain insight into the health status of TGs. Methods: A community based cross-sectional descriptive study was carried out in transgenders living in an urban area from December 2022 to January 2023 with a sample size of 160. Snowball sampling technique was used till the sample size was achieved. Data was collected using a pretested semi-structured questionnaire. Data was entered and analysed in MS Excel with descriptive statistics. Results: Majority of the study subjects belonged to 20-30 years of age. 43% were illiterates, 87% were living in rented houses. 89% screened for HIV in last 6 months, 57% underwent gender reassignment surgery. All study subjects gave history of suffering from STIs at least once, 11.9% were experienced STDs in past 1 year. 6.9% were tested positive for HIV and were on regular ART. 23.1% were diagnosed with anyone of NCD. First point care is contacting outreach worker in 58.8% of TGs. Conclusions: A more receptive attitude from the entire healthcare system is essential for improving the health status of this community. The inclusiveness promoted by universal health coverage will help each of these people's health statuses improve.