India's need to integrate its socio-cultural and scientific epistemology to position itself as a global leader.

Somewhat pitch-forked into a role it had been envisioning for itself for a long time now by the rapidly changing politico-administrative dynamics of the nations across the world and emerging and re-emerging crises limited not the least to wars and pandemics, India needs to leverage its strengths to deliver on the promise it has long held. But India's struggle to stem the outward flow of many of the brightest may just be one among the many factors that can play a spoilsport. The civilizational strength of India has been its cultural-scientific epistemology, strengthening the exploration of which will help it position itself as the global leader. The freedom to question and seek answers, no matter how successful a hypothesis has been in the past, is consistent with its (India's) epistemology, both scientific and cultural.

Prevalence of type 2 diabetes among tribal population of india: a multi-centric cross-sectional study.

BACKGROUND: The perception among healthcare workers is that the Indian tribal (indigenous) population are less affected by diabetes. This paper reports the prevalence of type 2 diabetes and its associated factors among tribal populations from six districts across India. METHODOLOGY: Random blood glucose (RBG) and fasting blood glucose (FBG) were measured for 8486 and 3131 adults, respectively, with a glucose meter. FBG ≥ 126 mg/dL (7.0 mmol/L) and RBG ≥ 200 mg/dL (11.1 mmol/L) were used to diagnose diabetes. In addition, blood pressure, anthropometric (height, weight, waist and hip circumferences), socio-demographic (age, gender, education, type of tribe and type of village) and behavioural data (tobacco smoking, non-smoking tobacco use and alcohol consumption) were collected. RESULTS: The overall prevalence of type 2 diabetes, based on RBG, was 4.77% (95% CI: 4.33-5.25). The prevalence of type 2 diabetes and prediabetes, based on FBG, was 6.80% (95% CI: 5.95-7.74) and 8.69% (7.72-9.73), respectively. The prevalence of type 2 diabetes was significantly associated with age (p<0.001), smokeless tobacco use (p < 0.05), hypertension (p < 0.001) and obesity (p < 0.01). CONCLUSION: The prevalence of type 2 diabetes among the Indian tribal population reported in this study is less than the national average of 7.3% for the general population. Hypertension and obesity were the major risk factors. Due to changing behavioural patterns, including dietary behaviour, there is likely to be an increase in the prevalence of hypertension and obesity, which further leads to increased prevalence of type 2 diabetes. Hence, appropriate interventions are to be initiated by the primary healthcare system.

Hypertension Prevalence, Awareness, Treatment, Control and Risk Factors in Tribal Population of India: a Multi-Centric Cross-Sectional Study.

The prevalence of hypertension is increasing in the tribal population of India. Lifestyle modifications, including dietary changes and acculturation, are the main reasons for the high prevalence of hypertension among the Indian indigenous (tribal) population. This paper reports hypertension prevalence, awareness, treatment, control and risk factors among tribes in five districts of different geographical zones of India. A cross-sectional study was conducted among the adult tribal population of 7590 from these states. Data related to blood pressure, anthropometry, demographic and behavioural variables were collected with prior consent from the participants. The prevalence of hypertension is 34.0% and 28.3% among men and women, respectively. Of the total hypertensives, 27.5% were aware of their hypertension status; of them, 83.9% were receiving treatment, and blood pressure was in control among 33.5% of patients who were receiving treatment. Age, alcohol intake, sedentary lifestyle, Particularly Vulnerable Tribal Groups status and body mass index are found to be significantly associated with the prevalence of hypertension. The prevalence of hypertension is high among these tribal populations, which could be due to modernization and acculturation. Awareness and treatment-seeking behaviour are poor. Hence, early screening, awareness campaigns for seeking treatment, and health promotion are immediately required. Comprehensive health promotion programs need to promote lifestyle modification and re-orientation of the primary health care system to improve availability and accessibility to hypertension screening and treatment.

Democracy, economics, or health-Time to look to the east for leadership.

While the capabilities of the low and middle-income countries (LMIC) have always been defined as "doubtful" to deal with public health crises of Covid pandemic magnitude, a flip-flop and incoherent response by the high-income countries (HIC) was unexpected. In the unprecedented moment of the pandemic, it is that we are beginning to find among ourselves, across the globe a search for stronger, resilient, scalable, and economy-efficient foundations in health systems that are capable of delivering healthcare to all. The apparently underperforming international health bodies have only increased this willingness of individual nations to look towards multilateralism as the foundational principle for not just the exchange of ideas but to deliver on these. India, a vibrant and the largest democracy, has showed her willingness to overcome, for example, the limitation of the vaccines during COVID to a few by making availability and possible delivery of a safe and effective vaccine to populations across the world. This has not only been seen as a hope to surmount challenges through help from others but also as a show of human resilience in the face of adversity.

Do current concepts of One Health suffer from the physics envy.

The current models of One Health appear to be suffering from a elevated emphasis on a small area of interface involving humans, environment and animals. This may largely be because of an extension of our understanding of physical science to biological world, which, though is far more complexer.

Is it "the conflict of interest" that is influencing our efforts on Climate change, tobacco control and primary care?

What seems to work against making climate change relevant, tobacco control necessary or primary care a felt need despite the efforts being claimed to the contrary? Emerging evidence points to a conflict of interest with academic institutions and academics fighting on both sides with clear support from the industry and others.

"Vasudaiva kutumbakam-one earth, one family, one future: "- India's mantra for a healthy and prosperous earth as the G20 leader.

India is a civilization, not just a country, nation, or government. Taking over the leadership of G20 by India, at a time when the world is battling pandemics, war, energy and climate crisis, and resource restriction is not just appropriately suited politico-economically but socio-culturally as well. COVID-19 proved that the unbelievably diverse world was too complex to be packed into a utopian hold-all one size fits all ideas. However, the fact is that COVID-19 may only have uncovered the crisis, which had been in the making for the latter part of the last century and extending into the current. India's leadership of G20 is therefore a window of opportunity for a more sustainable worldview as the ideas are coming from a civilization with a long history of acceptance of the entire world as one family- Vasudaiva Kutumbakam.

Globalization through global citizenship and right to migrate.

All human beings of the world should be equal in status and stature. However, in reality human beings are divided by citizen status of nation states that are members of the United Nations. The human development index differs from one nation to another. Therefore quality of life, health, and life expectancy varies across countries and continents. Much depends on the governments representing human groups living in defined territorial boundaries. Governments defend sovereign territories and compete with other governments for business monopolies, territories and natural resources. From empires to colonisation, the world is passing through the phase of globalisation. There is an uneven divide of natural planetary resources and geographical territories. Also there is a continuous flow of financial resources from the poor nation states and in favour of the rich ones. Globalisation can no longer remain a refined chaotic balance of exploitation of one human territory by another. Travel and migration from one territory to another are highly regulated. The true idea of Globalization will only be realised when it is not linked to race, the level of skills, political affiliation or economic dividends and is able to add to the upward movement of the social structure of the poor. In a globalised world there should be equitable and fast paced distribution of benefits of modern development. Otherwise the global citizens of the world should look for alternatives.

Is typifying systematic reviews and meta-analysis as the top on the ladder justified?

A large number-possibly the large majority-of systematic reviews and meta-analyses produced to date may not be useful for various reasons. This article though not ruling out the usefulness of these, is raising concerns on the way these are conducted or intended for in terms of outcomes.

Seroprevalence of CoVID-19 among health care professionals (HCPs) of tertiary care hospital of northern state of India.

Introduction: Current study was carried out as per the government of India and Himachal Pradesh guidelines to carry out a serosurvey to assess the extent of COVID-19 infection among health care professionals (HCPs) after 6 months of managing COVID-19 cases. Methods: A hospital-based survey was carried out among 1279 conveniently selected HCPs from September 2020 to January 2021. Results: The participants had a mean age of 38.3 (±10.4) years, and almost half (47.4%) were ≤35 years of age. A total of 29 (2.3%) were already tested positive for COVID-19 (RT-PCR: 22; Rapid Antigen Test: 7) before the survey, and the overall prevalence of IgG antibody was 12.7% among the participants (Male: 12.8%; Females: 12.5%). The odds were observed significantly high among administrative staff (aOR: 5.09; 95%CI: 1.27-20.33) and participants tested positive of COVID-19 previously (aOR: 28.41; 95%CI: 11.71-69.00). Conclusion: HCPs were tested about 6 months after the initiation of the COVID-19 pandemic in the state and demonstrated a high and expected level of seroprevalence.

Kerala & Mizoram; High COVID-19 case load but low mortality: Role of precautionary principles.

A small state in Northeast, Mizoram, with credentials in education sector similar to Kerala, like Kerala is attracting attention for the wrong reason; the high COVID-19 case load. So, what may be driving the high case load in these high literacy level states. Is the low mortality level (due to COVID-19) leading to a lack of emphasizing caution to prevent infection transmission behind this surge?

Prevalence and determinants of Internet addiction among the students of professional colleges in the Jammu region.

Background: With ever-increasing digitization, the internet has intertwined into the daily lives of users to a large extent. It holds tremendous educational benefits to college students; however, its excessive usage can lead to addiction and even psychological morbidities. Objectives: To determine the prevalence of internet addiction and its association with various factors including depression, anxiety, and stress. Materials and Methods: A cross-sectional study was conducted among undergraduate students of two professional colleges, i.e., medical and engineering colleges in the Jammu region. A pre-tested, semi-structured questionnaire was used to elicit the information regarding socio-demographic and personal details of students. Young's internet addiction scale was used to assess internet addiction, whereas the DASS 42 scale was used to measure depression, anxiety, and stress. Data thus collected were analyzed using the PSPP software. Results: A total of 480 students constituted the study population. The prevalence of internet addiction was found to be 78.7%, with a significantly higher prevalence seen among the male students in comparison to females (P < 0.005). A significantly positive correlation of internet addiction was found with depression, anxiety, and stress. Conclusions: Internet addiction is significantly associated with psychopathology among the respondents. In this context, there is an urgent need to develop effective strategies for the prevention of internet addiction by promoting awareness among the students.

Sustainability, criticality, transition, fragility; pandemics, war, climate change and resource restriction - A recipe for the end.

The criticality of the system or processes is in the values that the system or process represents. The acceleration to transition point, to fragility and ruin is dependent on our acceptance of an understanding of criticality. Pandemics, wars or climate change; as diverse as situations can be, point to this lack of a collective understanding of criticality of real-world situations.

Training in public health and community medicine without training of precautionary principles is incomplete.

What has been the learning is from the current pandemic. Besides the fact that it taught us the immense potential of pandemics to lead to ruin, it also taught us about our limitations in dealing with it.

Identifying role of public health and primary care as disparate entities in current health system.

Arguably the worst health crisis in recent memory, Covid19 has been a great masterclass, albeit at a cost which no individual or nation would have wanted to afford. Besides other, what are the lessons for the academic medicine in general and primary care, community medicine, family medicine and public health in particular? Perhaps, identifying the roles of each in the healthcare system and building a thought process around these roles is the way forward. Only then will we have a chance to fight a pandemic like the Covid-19.