Indiscriminate disposal of Bio-Medical Waste (BMW) and exposure to such waste pose a serious threat to the environment and to human health. Appropriate waste segregation is an important part of biomedical waste management. Improper segregation of waste impacts public health. Hence, it is necessary for every health care professional to be aware of the various aspects of biomedical waste management, including segregation at source. The foundation course for first-year MBBS undergraduates includes skill training on BMW disposal to equip them about BMW management. The Objective of the study is to assess the effectiveness of skill-based learning on BMW management and skill retainment among first year MBBS students of a Government Medical College, Visakhapatnam. A cross-sectional descriptive study was done among 115 first professional year MBBS students who have attended Skill- based training on BMW management of foundation course in 2019. Fifty-seven percentage of the students had good skills and 80% of the students segregated correctly into a blue colour bag. Skill-based learning in the foundation course was found to be effective in the retainment of knowledge on BMW management.

Introduction This study aims at bringing out the problems faced by Muslim adolescent boys of Khaja Bazaar area of Kalaburgi in relation to health, disease, social, psychological, economical, sexual and other problems. This study looks to bring out the correlation between the morbidity status among the study population and its socioeconomic status. Methodology This cross-sectional study was carried out in the urban field practice area of Department of Community Medicine, KBNIMS, Kalaburagi, Karnataka. A house-to-house survey w­as carried out. Households were included in the study by using A Systematic Random Sampling technique10 where every 5th house was selected (By obtaining the ratio of the total population to the sample size desired). The study was carried out on health status of 260 Muslim adolescent boys who were selected by employing simple random sampling from the entire target population on the basis of the percentage of adolescents in the country i.e., 20.9%11. A pre designed, pre tested questionnaire was used to collect the information. The subjects were interviewed after obtaining informed consent. The answers were therefore coded and quantified. All ethical boundaries were maintained and clearance for the same has also been obtained in the regard. Results 57.30% of the study group was Healthy while 42.69% displayed one or the other kind of Morbidity. Among the Morbidities, highest prevalence was that of Micronutrient deficiencies (35.0%), followed by Wax Impaction (29.61%), stained teeth (23.07%), Malnutrition (16.15%) and Caries (12.69%). Conclusion In the view of the High Prevalence and Incidence of Morbidity, it may be suggested that there be regular and periodical check-ups and educational camps to promote positive Health. Free Medical check-ups could be organised to diagnose and treat diseases of public health importance.

Background and Objectives: Neonatal hyperbilirubinemia is treated safely and effectively with phototherapy. Despite its international applicability, Turning the newborn is thought to be one of the ways to improve, but despite its widespread use, issues about how to maximise effectiveness remain unanswered. Sensory-neural hearing loss, athetoid spasticity and abnormalities of the gaze and vision are all symptoms of the condition known as kernicterus, which is characterised by severe infant hyperbilirubinemia. Furthermore, it might be connected to mental disability. This study aimed to compare the efficacy of intermittent and continuous phototherapy. Methods: From March 2021 to September 2022, 210 newborns participated in the study at tertiary health care center, Banglore. The inclusion criteria included weight greater than 2500 gm, no concurrent diseases and hyperbilirubinemia not requiring exchange transfusion. Two groups of newborns were randomly divided into. While the continuous phototherapy group underwent phototherapy for two hours on and 30 minutes off, the intermittent phototherapy group underwent phototherapy for one hour on and one hour off. Results: Patients in the continuous and intermittent phototherapy groups had an average age of 3.231.42 and 3.30+1.59 days, respectively. Their mean baseline bilirubin levels were 15.43mg/dL 1.99 and 15.68mg/dL+1.95, respectively, while their mean follow-up bilirubin levels were 13.79mg/dL 2.15 and 14.23mg/dL+2.29, respectively and the mean difference between the baseline and follow-up bilirubin between both group was 1.63 (p = 0.001) and 1.45 (p = 0.001) respectively. For both groups, the difference in mean age, mean baseline bilirubin and mean follow-up bilirubin was statistically insignificant. For both groups, the mean drop in bilirubin was statistically significant. Conclusion: Intermittent and continuous phototherapies were found to have no difference in therapeutic effect of intermittent and continuous phototherapy.

Context: India is considered “diabetic capital” of the world with many cases remaining undiagnosed. IDRS is a simple and cost-effective screening tool that can be used to identify undetected and high-risk individuals for developing diabetes. Aims: To study correlation between Indian Diabetic Risk Score and HbA1C levels in newly diagnosed diabetics. Settings and Design: Cross-sectional observation study. Materials and Method: In this cross-sectional observational study, newly diagnosed patients who fulfilled the inclusion criteria were enrolled.  Statistical Analysis Used: Analysis of data was done using Statistical package for social science 22.00 (SPSS 22.00 for windows; SPSS Inc., Chicago, USA). For each assessment point, data were statistically analysed using factorial ANOVA. Difference between two groups were determined using chi square test and the level of significance was set at p<0.05. Results: When the HbA1c level was analysed for diabetes control, it was found that all 42 patients (100%) under high risk IDRS category had poor glycaemic control (HbA1C levels >8%). Among the 42 patients with moderate risk, 24 patients (57.14%) had HbA1c levels >8%. Among the 4 patients with low IDRS score, 25% had HbA1c levels between 6.5-7% and rest 3 patients (75%) had HbA1c levels between 6.5-7% (Table 3). The results indicated that the patients with higher IDRS score had poorer glycaemic control compared to those with lower IDRS score (p value <0.01). Conclusion: Higher score of IDRS is associated with poor blood glucose control reflected by higher HbA1C levels. Moreover, IDRS would help to do selective screening instead of universal screening.

Currently, one of the big challenge to diagnostic the Cushing’s syndrome. Due to the disorders of hormones it will create major health problems such as hypertension, diabetics, rapid weight gain etc. It is a rare medical condition, usually caused by adrenal gland excessive cortisol secretion following a high adrenocorticotropic Hormone (ACTH) production from pituitary adenoma, excessive hypothalamic Corticotropin-Releasing Hormone (CRH) secretion, lung tumors, any other ectopic production, or exposure to glucocorticoids and chronic stress. In this present study is to describe a special case of Cushing’s syndrome and its diagnostic and symptoms. A 15-year-old Omani male patient diagnosed with ACTH dependent Cushing’s disease secondary to pituitary adenoma. Patient underwent two surgeries before disappearing his symptoms. He has also developed adrenal insufficiency due to hydrocortisone suspension. We highlight the importance of an accurate diagnosis and follow-up for successful management. In conclusion, Cushing’s syndrome is a rare medical problems and it diagnostic is complicated. When the patient diagnostic completed then it could be curable by surgical treatment.

Background and Aims: Hypertension is one of the emerging public health problems in developing and Low middle income country like India. Among complications of hypertension, Myocardial Infarction is most distressing. Although, myocardial infarction is life threatening disease, it is yet preventable. Good knowledge and practice are required for prevention and control of myocardial infarction. Therefore, this study intended to assess knowledge and practice of hypertensive patients regarding prevention of myocardial infarction. Methods: Hospital based cross- sectional study was conducted among 96 hypertensive patients in outpatient departments of Dr RPGMC Tanda, Zonal Hospital Dharamshala and Civil Hospital Kangra, located in Kangra district of Himachal Pradesh. Purposive sampling method was used to select calculated number of study participants. Data was collected by interview method using structured questionnaire and descriptive and inferential statistics was used to analyse the data. Results: More than half of the participants (60.4%) had high level of knowledge of prevention of myocardial infarction whereas 39.6% had low level of knowledge. Similarly, 57.3% had good practice; however, 42.7% had poor practice. This study found significant association of knowledge with gender, education and socio-economic status. In the same manner, there was significant association of practice with awareness of disease. Conclusion: Only around half of the hypertensive patients had good knowledge and practice of the prevention of myocardial infraction. Therefore, awareness level should be increased and identified factors needs to be addressed.

Although early RA treatment improves results, the ultimate objective of RA management should be disease prevention. The rising body of research showing that RA-specific indicators appear before the onset of clinically evident RA makes the idea of preventing RA more alluring and feasible to achieve. However, what is meant by RA prevention will vary depending on the investigator. It might entail identifying those who have developed RA-related autoimmunity without overt IA and putting medicines into place to stop the disease from progressing. Lastly, it can entail modifying RA-related risk factors at the individual or population level to stop the disease from developing in the future. Below, methods for each of these sorts of prevention are covered in further detail.

Evidence suggests that current Rheumatoid Arthritis (RA) treatment methods should prioritise early identification and diagnosis, followed by early introduction of DMARD medication. Early RA treatment-ideally less than three to six months after the onset of symptoms-improves the likelihood of reaching disease remission and lessens joint damage and disability. Utilising initial DMARD mono-or combination therapy with quick escalation to target low disease activity or remission is a viable approach, even though the ideal treatment plan for early RA is not yet known. The prevention of inflammatory joint illness and, thus, the prevention of disability, should be the ultimate goal of RA care.

Background: Cancer patients suffer from pain along the cancer continuum, cancer pain is an unpleasant feeling arises from a tumor compressing or infiltrating to the adjacent body parts, interferes with a person's quality of life, 40% of all cancer patients report moderate to severe pain, 75% suffer from severe pain in advanced stages, this study will be theoretically guided by Roy adaptation model Purpose: to assess risk factor for cancer pain severity on quality of life among cancer patients in military cancer center in Jordan. Methodology: A descriptive, cross-sectional design were conducted on a convenience sample among Jordanian cancer patients' who treated in military cancer center, online brief pain inventory and EORTC QLQ C-30 (version 3.0) questionnaires were used, Data were analyzed by using SPSS- version 23, descriptive analysis and logistic regression were also used. Results: Jordanian cancer patients had moderate mean total scores for pain severity and mean total scores for quality of life. 300 patients were include in this study, 179 (59.7%) were females and 121(40.3) were males. The mean age of the study subjects was 53.9 years. 137 (45.6%) patients had income lower than 500 JD/month. Breast cancers were most common among the patients accounting for 115 (38.4%) followed by gastrointestinal cancers 65 (21.6%). One hundred (33.3%) patients were presented with stage 3 cancers, while 45 (15%). Logistic regression analysis revealed that patient age (OR = 2.219, 95% CI: 1.113-15.005, p = 0.034), female patient (OR = 2.303, 95% CI: 1.207-15.343, p = 0.024), gastrointestinal malignancy (OR = 3.613, 95%CI: 1.082-20.579, p = 0.031), advanced stage (OR = 2.512, 95% CI: 1.102-16.021, p = 0.023), education level (OR = 1.583, 95% CI: 1.965-9.385, p = 0.044), income (OR = 1.783, 95%CI: 1.112-11.216, p = 0.01) and smoking (OR = 3.812, 95%CI: 1.009-22.821, p = 0.004) were all identified as significant independent risk factor for degree of pain severity Conclusion: there is an inverse relationship between pain severity and QOL, it's highly recommended to get a structured training and teaching program in pain medicine, develop polices and action plans for cancer pain management and implement palliative care model in governmental hospital'ssetting.

Background: Prospective studies on growth in adopted Chinese girls are scarce and are limited to short-term follow-ups. The objectives of this study were to provide data on the longitudinal growth and timing of thelarche and menarche in girls adopted from China. Materials and Methods: Prospective cohort study on 30 Chinese girls adopted in Spain between the years 2001-2007 in which growth and pubertal development were controlled after adoption during a 15-year follow-up. Weight, height and head circumference were measured and recorded in a standardized way and Body Mass Index (BMI) was calculated. The anthropometric parameter values and ages at thelarche and menarche, were compared with the China growth and pubertal development references. Results: Initial evaluation (1.33 years): weight Z-score, -1.55; height Z-score, -1.4; BMI Z-score, -0.72; head circumference Z-score, -1.1. At 2 years of age, there had been significant catch-up growth in weight and height (Z-score -0.74 and -0.62, respectively). Growth pattern: they weighed less up to 14 years and more between 15-16 years (at 16 years, +0.64 kg); they measured less in all ages (at 16 years, -2.83 cm); BMI was lower between 1.33-2 years and 10-12 years and higher between 14-16 years; head circumference was lower at all ages (at 6 years, -0.96 cm). There were no statistically significant differences. Mean age at thelarche was 10.08 years (median, 10 years) and at menarche 12.17 years (median, 12.5 years). Conclusion: In the cohort of adopted Chinese girls, the growth potential was lower and the pubertal development was slightly later, although without significant differences, compared with the China growth and pubertal development references.

Background: Diabetes represents a significant global public health burden. DPN is a microvascular complication of T2DM attributed to chronic hyperglycaemia, defined as the presence of peripheral nerve dysfunction in diabetics after exclusion of other causes. Screening for DPN in the clinical practice using a simple objective tool is essential. The Aim of the study was to determine the proportion of peripheral neuropathy in patients with Type 2 diabetes mellitus using Michigan Neuropathy Screening Instrument and comparison with other screening methods. Method: A cross sectional study is conducted among type 2 diabetes mellitus patients attending OPD and In-patients in a Tertiary Care Hospital. Study is conducted using detailed clinical examination and Michigan Neuropathy Screening Instrument (MNSI) which includes a pre-tested, pre-designed questionnaire and clinical examination, used to assess distal symmetrical polyneuropathy. Result: Among the 100 patients 54 are males and 46 are females. The mean duration of DM is 9.42±4.28 years. Based on clinical examination and MNSI Overall, 51% were found to have DPN. Based on the scoring of MNSI patient version, 39% patients have DPN. Whereas based on MNSI examination version 46% patients have DPN. Out of 100, patients who have HbA1c >6.5%, increasing age and diabetes duration of >5years are found to have higher proportion of DPN with a significant p value (<0.05).

Background: Despite the swift and assiduous efforts of the government and health authorities, COVID-19 has been responsible for about a million deaths worldwide. The number of cases in India was still shocking. Our study, which was designed to assess general population knowledge, attitudes and practices about COVID-19 in Himachal Pradesh, was developed to further examine this. Material and Methods: This cross-sectional survey of residents of the state of Himachal Pradesh was carried out between Jan 2023 and March 2023 using Google forms. Until 400 replies were gathered, the questionnaire was distributed among state citizens in both rural and urban areas via email and social media sites such WhatsApp groups, Facebook, Instagram and LinkedIn. We collected data on their socio-demographic traits and Knowledge, Attitude and Practices regarding COVID-19. Epi info v7 software was used to evaluate the data using the necessary statistical tests. Results: In the present study, among the total of 400 participants, 42% (168) fall were below 40 years of age while 58% (232) were above 40 years. 59% (236) of participants were male and 41% (164) were female. Among the total, 124 (31.0%) study participants had very good (24-30 marks) awareness regarding COVID-19, 211 (52.75%) had good (18-23 marks), 46 (11.5%) had fair (12-17 marks) and 19(4.75%) had poor (<12 marks) awareness regarding COVID-19. Conclusion: The general population had adequate knowledge, attitudes and practices regarding COVID-19, according to poll results. Our study clearly shows that improved knowledge fosters a good mindset, which in turn influences better practice. Our study also shown how timely adaptation and awarenessraising through education can assist health authorities in developing plans based on areas that need improvement.

Background: Peripheral vascular disease is one of the macro vascular complication of diabetes mellitus. Diabetes accounts for about 50% of all non-traumatic amputations in India because of Diabetic foot. Diabetics are five times more likely to develop peripheral vascular disease than non-diabetics. Objectives: To detect Peripheral Vascular Disease in Type-2 Diabetes Mellitus using Ankle Brachial Index and to correlate the findings of Ankle Brachial Index with duration of diabetes, control of blood glucose, presence or absence of hypertension and smoking. Methods: It is a descriptive cross-sectional study done on 74, type-2 diabetic patients with no symptoms of peripheral vascular disease, at a tertiary care hospital. Detailed history is taken. Ankle brachial index is measured in all patients using a hand held doppler, to screen for peripheral vascular disease. Results: Mean age of study population is 66.65±10.61 years. 38 are males and 36 are females. 18 (24.3%) patients have ABI <0.9. Among these 18 patients, 61.11% have history of smoking (p = 0.007), 83.3% patients are hypertensive (p <0.001) and the mean duration of diabetes mellitus in them is 6.28±4.36 years (p<0.001).  Conclusion: Ankle Brachial Index is a simple screening tool to detect asymptomatic peripheral vascular disease in diabetics. Identification and management of modifiable risk factors has benefit in delaying progression of peripheral vascular disease.

Background: Endocrine diseases involving the thyroid are widespread. These illnesses are frequently not properly diagnosed. In general, patients may go undiagnosed due to a lack of awareness and comprehension of thyroid problem effects. This study intends to determine the general public's degree of knowledge of thyroid disease signs, risk factors and preventive measures. Materials and Methods: This cross-sectional survey of residents of the state of Himachal Pradesh was carried out between June 2021 and August 2021 using Google forms. Until 400 replies were gathered, the questionnaire was distributed among state citizens in both rural and urban areas via email and social media sites such WhatsApp groups, Facebook, Instagram and LinkedIn. We collected data on their socio-demographic traits and awareness about Tuberculosis. Epi info v7 software was used to evaluate the data using the necessary statistical tests. Results: A total of 400 respondents took part in the study, of whom 165 (41.25%) were from urban areas and 235 (58.75%) were from rural areas. 262 (65.5%) of the participants in the majority were male, 174 (43.5%) were between the ages of 18 and 30, 159 (39.75%) had a graduate degree, 259 (64.75%) were in the workforce, 248 (62%) were married and 384 (96.0%) were Hindu. In the present study 36 (9.0%) study participants had very good (24-30 marks) awareness regarding Thyroid Disorders, 122 (30.5%) had good (18-23 marks), 147 (36.75%) had fair (12-17 marks) and 23(5.75%) had poor (<12 marks) awareness regarding Thyroid Disorders. Conclusion: According to survey findings, the general public had either insufficient or not satisfactory knowledge about the thyroid gland, its functioning, risk factors, causes of thyroid illness, clinical symptoms and prevention of thyroid problems. The present study warrants the educational program and awareness campaigns on thyroid disorders for the general population.