Background: Hypospadias is a common congenital abnormality, affecting approximately 0.3-0.8% of male live births. While one-stage repair of hypospadias has gained popularity, it is not without limitations. The two-stage Bracka's method, on the other hand, offers a unique combination of versatility, reliability, and refinement, making it suitable for a wide range of proximal hypospadias deformities, whether for primary repair in a child or salvage surgery in an adult. Purpose: The purpose of this study is to evaluate the effectiveness of the two-stage Bracka’s procedure for repairing proximal hypospadias, with a focus on the use of oral mucosa graft. Methods: Between May 2011 and April 2012, 13 patients with proximal hypospadias underwent the two-stage Bracka’s procedure. The first stage involved correcting chordee, excising the urethral plate (in cases of fibrous unhealthy skin, such as re-operative cases), splitting the glans, and using an oral mucosa graft to cover the ventral defect. The second stage of the surgery included neourethra formation from the grafted ventral area, utilizing dartos fascia as an intermediate protective layer, and applying the Z-plasty technique for outer skin closure. Patient ages ranged from 15 months to 15 years, with a mean age of 5.5 years. The interval between the two stages was 4-6 months, and follow-up occurred 2-6 months after the second stage. Results: In the first stage, all 13 patients underwent the operation, while 10 patients proceeded to the second stage. One patient required a revision of the first stage due to residual chordee. Among the 10 patients involved in the second stage, three developed fistulas, but no residual chordee was observed. None of the patients developed meatal stenosis, and 70% achieved a vertical slit-like meatus in the glans. Conclusions: The use of an oral mucosa graft proved effective in preventing significant graft contracture, resulting in a more supple and predictable size for the neo-urethra in the second stage surgery. The incorporation of dartos fascia and the Z-plasty technique in the second stage contributed to increased success rates and decreased complications in proximal hypospadias repair.

Background: Tuberculosis (TB) is still a problem because children are most likely to get severe forms and it is hard to tell who has it. The goal of this paper was to describe how TB showed up in children at a tertiary level hospital, how often it happened, how it was diagnosed, and how they responded to treatment. Methods: The study looked at cases of TB in children that showed up in different ways, both inside and outside of the lungs. Polymerase chain reaction (PCR) for M. tuberculosis nucleic acids, chest X-rays, and clinical assessment were all used to diagnose the disease. All people who might have TB were given antituberculosis treatment while they waited to find out for sure. In the intensive phase of treatment, people took four drugs, and in the support phase, they took two drugs (HR). In cases where the meninges were affected, steroids were given. There were follow-up assessments. Results: In this group of cases, the symptoms of pediatric tuberculosis (TB) were different and not typical. In Case 1, a 14-year-old boy was first wrongly diagnosed with celiac disease. Later, he was found to have constrictive pericarditis and TB, which shows how important it is to think about TB when someone has a fever for a long time and other strange symptoms. In Case 2, a 2-year-old girl with TB showed up with discolored skin and at first negative PCR results. This shows how hard it is to diagnose pediatric TB. Case 3 was about a 5-year-old boy who was having neurological problems and whose brain MRI showed multiple tuberculomas. This showed how serious neurological problems can be caused by pediatric TB. In Case 4, a 2-year-old boy with stroke-like symptoms and a fever responded well to anti-TB treatment, even though the initial PCR results were negative. This shows how important it is to treat pediatric TB as soon as possible, even when diagnostic tests aren't clear. Conclusions: Pediatric TB can show up in many different and unusual ways, which makes it hard to diagnose. PCR testing was a key part of making a diagnosis. Even though the diagnosis wasn't confirmed, these cases turned out well because antitubercular treatment was started quickly. This study shows how important it is to think about TB in children who have symptoms and a history that suggest it.

Background: Hernia is a common medical condition with global implications for public health and individuals' well-being. Despite its prevalence, limited awareness often leads to delayed diagnosis and treatment, exacerbating the health and economic burden. This study aimed to assess hernia awareness and knowledge among the residents of Lima, Peru. Methods: A cross-sectional survey was conducted in Lima, Peru, between March and May 2023. The study included 400 adult residents who were surveyed using a structured questionnaire. Knowledge levels regarding hernias, their types, risk factors, symptoms, and treatment options were assessed. Data analysis was performed using Epi Info V7 Software. Results: The study revealed that 68.5% of participants correctly identified what a hernia is, with 64.75% recognizing typical locations and 65.75% identifying common symptoms. However, awareness about treatment options (45.75%) and surgical techniques (41.25%) was comparatively lower. Approximately 62% acknowledged the role of specific activities in hernia risk, while 51.25% recognized the importance of preventive measures. A significant proportion demonstrated fair (25.25%) and poor (15%) knowledge scores. Conclusion: While Lima residents exhibit a foundational understanding of hernias, there is a need for improved knowledge regarding treatment options, surgical techniques, risk factors, and preventive measures. Strengthening public awareness can enhance early detection and management, contributing to improved health outcomes.

Background: Cardiovascular Disease (CVD) is a global health challenge with significant public health implications. India, like many other countries, is witnessing a surge in CVD cases, imposing a considerable burden on healthcare systems. This study focuses on District Moga, Punjab, a region grappling with the escalating prevalence of CVD, to assess the level of awareness and knowledge about CVD and its risk factors among its residents. Methods: A descriptive cross-sectional survey was conducted in District Moga, Punjab, between April and June 2023. The study targeted adults aged 18 and above who had been residents for at least 12 months. A sample size of 400 participants was determined. Data was collected using a structured questionnaire covering socio-demographic information and 20 knowledge-related questions about CVD risk factors and prevention. Validity of the questionnaire was ensured through expert reviews. Data was collected using online modes and analyzed using Epi Info V7 Software. Results: Among the 400 participants, 26.5% demonstrated very good knowledge (16-20 marks), 39.5% had good knowledge (12-15 marks), 19.25% had fair knowledge (8-11 marks), and 14.75% exhibited poor knowledge (<8 marks) regarding CVD risk factors and prevention. The majority of respondents correctly identified common cardiovascular diseases, major risk factors, and the importance of a balanced diet and physical activity. However, knowledge gaps existed concerning terms like "atherosclerosis" and the role of genetics in CVD risk. Additionally, a significant proportion had not attended health workshops on CVD prevention (24.25%). Conclusion: This study highlights a commendable level of awareness and knowledge regarding CVD and its risk factors among District Moga's residents. However, specific knowledge gaps were identified, suggesting a need for targeted health education initiatives. Strengthening community engagement and implementing educational programs can further enhance CVD awareness and contribute to reducing its burden in this region.

Intoxication by heavy metals is a major health issue, especially in poorly developing countries. The presented study, herein, was developed to identify critical prophylactic effects of silymarin extract (SE) against the nanocadmium (NCd)-induced intoxication of the reproductive system in male rats, manifested by sex hormonal and antioxidant features. The experiment was conducted by using 60 male rats (190 ±10gm and 90 days of age). These rats were separated into six groups (10 rats/group). These groups were a control (CL) group that received distilled water only, a group that received 10mg/kg NCd (10NCd group), a group that received 200mg/kg SE (200SE group) for 28days. In addition, a group that received 10mg/kg NCd for 14 days then 200mg/kg SE for 14 days (NCdSE group). Moreover, a group that received 200mg/kg SE for 14 days then 10mg/kg NCd for 14 days (SENCd group). The last group received both substances in a combination (CBT group) for 28 days. All groups received the treatment compounds using oral gavage. After the end of the experiment, blood samples were collected from all groups to measure hormonal changes (FSH, LH, and testosterone) and antioxidant enzymes and oxidative stress marker, which included superoxide dismutase (SOD), glutathione (GSH), and malondialdehyde (MDA). The results demonstrated that the groups exposed to NCd revealed significant (p<0.05) decreases in the levels of the hormones. However, these levels were significantly (p<0.05) repaired when SE was used, especially in the SENCd group, in which SE was used first for 14 days. The findings recorded that the groups exposed to NCd revealed significant (p<0.05) decreases in the levels of the SOD and GSH and increases in the levels of MDA. However, these levels were significantly (p<0.05) corrected when SE was used, especially in the SENCd group, in which SE was used first for 14 days. The present study results provide important prophylactic features of silymarin extract against the nanocadmium-induced intoxication of the reproductive system in male rats.

Background: Physical activity and yoga are vital for overall health and well-being, yet their awareness and understanding among the population in District Bilaspur, Himachal Pradesh, remain understudied. Materials and Methods: A descriptive cross-sectional survey was conducted between April and June 2023 in District Bilaspur, Himachal Pradesh. A sample of 400 adults, residing in both urban (63.75%) and rural (36.25%) areas, completed a Google Form questionnaire. The survey assessed knowledge about physical activity and yoga, engagement in these practices, barriers faced, and recommendations for increasing awareness. Results: The study revealed a positive level of awareness among participants, with 78% understanding the importance of physical activity for overall health and 67.5% naming health benefits. However, only 46.25% were aware of recommended weekly physical activity guidelines, and 44.5% recognized various yoga styles. Approximately 53.5% engaged in regular physical activity, and 35.5% attended yoga classes. More than half (58.25%) identified specific barriers to participation, while 80.25% believed schools should include physical activity and yoga in their curriculum. Participants provided recommendations for increasing awareness, including community workshops and media promotion. Conclusion: District Bilaspur residents demonstrated a reasonable level of awareness regarding physical activity and yoga, with opportunities for improvement in specific knowledge areas. Identifying local barriers and embracing community-based initiatives may enhance engagement and awareness, contributing to a healthier and more active lifestyle in the region.

Background: Cardiovascular diseases (CVDs) are a global health challenge, and the incidence of cardiovascular emergencies is on the rise. Immediate intervention through Basic Cardiovascular Life Support (BCLS) is critical in these life-threatening situations. This study assessed the BCLS knowledge among medical officers in District Shimla, Himachal Pradesh, given the region's unique healthcare challenges. Materials and Methods: A cross-sectional survey design was employed between April 2023 and July 2023. The study included 100 medical officers with at least 12 months of experience. A structured questionnaire covering BCLS knowledge was administered, and data were analyzed using Epi Info V7 Software. Participants were categorized based on their knowledge scores. Results: The findings indicated varying levels of BCLS knowledge among medical officers. While (82) correctly identified BCLS and its objective, areas such as understanding the Chain of Survival (59) and recognizing signs of cardiac arrest in adults (69) showed room for improvement. Assessment of responsiveness (72) and airway management (53) demonstrated moderate proficiency. Knowledge about compression rate (67) and depth (64) for CPR in adults was fair. Awareness regarding the use of automated external defibrillators (39) and differences in BCLS across age groups (47) highlighted the need for targeted training. The study categorized participants as very good (28), good (37), fair (22), or poor (13) based on their knowledge scores. Conclusion: This study revealed varying levels of BCLS knowledge among medical officers in District Shimla. While foundational understanding was strong in some areas, others showed room for improvement. These findings underscore the importance of regular BCLS training programs to enhance proficiency among medical officers, ultimately contributing to improved outcomes in cardiovascular emergencies.

Background: Post-anesthesia care is a critical phase in perioperative management, profoundly impacting patient outcomes. This study assesses awareness and knowledge among Resident Anesthetists in Himachal Pradesh regarding extubation, recovery room monitoring, and pain management in the immediate post-operative period. Materials and Methods: A cross-sectional survey was conducted in Himachal Pradesh from April to June 2023. The study involved Junior and Senior Residents of Anesthesia in medical colleges. A sample of 100 participants was determined. A structured questionnaire assessed knowledge, scored as very good, good, fair, or poor. Data were analyzed using Epi Info V7. Results: The majority demonstrated good to very good knowledge levels across all domains, including extubation, monitoring, pain management, and communication. Criteria for discharge, PONV management, and documentation requirements were well understood. Areas for potential improvement included the use of regional anesthesia techniques and managing pediatric patients. Conclusion: Resident Anesthetists in Himachal Pradesh exhibit a strong foundation in post-anesthesia care, ensuring patient safety and quality care. Ongoing education and refinement of certain skills could further enhance their proficiency.

Background: Sexually Transmitted Diseases (STDs), also known as Sexually Transmitted Infections (STIs), pose a significant global public health challenge. In India, STDs remain a prevalent and underdiagnosed health issue. Understanding the levels of awareness and knowledge about STDs among specific populations is essential for effective prevention and management. Material & Methods: This cross-sectional survey study was conducted in Himachal Pradesh, India, between May and July 2023. The study included 400 adults aged 18 and above who had been residents of Himachal Pradesh for at least 12 months. A Google Form questionnaire assessed socio-demographic information and knowledge of STDs. Data analysis was performed using Epi Info V7 Software. Results: The study revealed encouraging levels of awareness and knowledge regarding STDs among the general population of Himachal Pradesh. Approximately 71% of participants could name three common types of STDs, 65.5% understood the primary modes of transmission, and 64.5% identified common risk factors for contracting STDs. Moreover, 70% recognized that STDs are not spread through casual contact. About 71% understood the importance of addressing STDs promptly, and 60.25% were aware of potential complications of untreated STDs. However, only 32.75% could name government-sponsored sexual health programs, and 36.5% were aware of misconceptions or myths about STDs. Conclusion: This study highlights the need for targeted awareness campaigns and education to bridge knowledge gaps, particularly regarding government initiatives and misconceptions about STDs. Enhancing awareness and knowledge can empower individuals to make informed decisions about their sexual health, ultimately contributing to more effective public health strategies in Himachal Pradesh.

Background: HIV/AIDS remains a significant global public health challenge. Understanding the awareness and knowledge landscape among the general population is crucial for effective prevention and management strategies. This study assesses the awareness and knowledge of HIV/AIDS among the residents of Himachal Pradesh, India. Materials and Methods: A cross-sectional survey was conducted from May to June 2023. A sample of 400 adults from both urban (67.75%) and rural (32.25%) areas of Himachal Pradesh participated. Data were collected using a structured questionnaire covering socio-demographics and 20 HIV/AIDS-related questions. Knowledge scores were categorized as very good (>80%), good (60-79%), fair (41-59%), and poor (<40%). Results: The majority of respondents demonstrated commendable awareness and knowledge regarding HIV/AIDS. Highlights include correct definitions of HIV and AIDS (90.25%), awareness of transmission modes (80.75%), and recognition of the importance of early detection (53.75%). Areas of strength include understanding preventive measures (77.5%) and acknowledging the need to reduce stigma (71.5%). However, knowledge gaps exist in condom usage (66.25%), HIV testing availability (62%), PrEP awareness (44.5%), viral load comprehension (26.25%), and HIV medication side effects (40.25%). Misconceptions about HIV transmission were identified. Conclusion: Himachal Pradesh demonstrates substantial awareness and knowledge of HIV/AIDS among its population, with certain areas of strength. However, targeted education efforts are needed to enhance understanding in specific domains. This study emphasizes the importance of ongoing awareness campaigns and community-based interventions to address knowledge gaps and contribute to global HIV/AIDS control.

Background: Glaucoma, often referred to as the "silent thief of sight," poses a significant global public health challenge, leading to irreversible vision loss if not detected and managed early. This study aimed to assess awareness and knowledge levels regarding glaucoma, its risk factors, and the importance of regular eye exams among the population of District Kangra, Himachal Pradesh. Materials and Methods: A cross-sectional survey involving 400 adults residing in urban and rural areas of District Kangra was conducted between April and July 2023. Participants completed a structured questionnaire covering demographic information and 20 knowledge-related questions about glaucoma. Data analysis was performed using Epi Info V7 Software. Results: The study revealed varying levels of knowledge among participants. Approximately 43% correctly understood what glaucoma is, while 41% could name common glaucoma symptoms. Notably, 64% expressed opinions on improving glaucoma awareness. While some participants demonstrated reasonable knowledge, substantial gaps were observed, particularly in recognizing risk factors and prevention methods. Conclusion: Comprehensive education campaigns are essential to address knowledge gaps and enhance awareness about glaucoma in District Kangra. Improving public knowledge can lead to timely eye care seeking behavior, ultimately reducing the burden of glaucoma-related vision impairment and improving residents' overall quality of life.

Background: Adequate and high-quality sleep is fundamental to overall health and well-being, yet it is often overlooked or misunderstood. This study aimed to assess the levels of awareness and knowledge about sleep patterns and quality among the general population of District Shimla, Himachal Pradesh, India. Methods: A cross-sectional survey was conducted between April 2023 and July 2023, targeting adults aged 18 and above residing in District Shimla for at least 12 months. A sample size of 400 participants was determined. A structured questionnaire was used to collect data on socio-demographic characteristics and knowledge related to sleep patterns and quality. Data were analyzed using descriptive statistics. Results: Among the 400 participants, 24.5% demonstrated very good knowledge, 25.5% good knowledge, 33.5% fair knowledge, and 16.5% poor knowledge regarding sleep patterns and quality. Over 50% were aware of recommended sleep duration for adults, while 44% reported experiencing sleep difficulties. Notably, 73.5% recognized the impact of stress and anxiety on sleep quality, and 76% were aware of the potential health consequences of chronic sleep deprivation. However, only 26% were familiar with sleep hygiene practices. Electronic devices were believed to affect sleep quality by 71.75% of participants. Cultural practices related to sleep were known to 26.25%, and 18% had sought professional help for sleep-related issues. Conclusion: This study revealed a reasonable level of awareness and knowledge about sleep patterns and quality among the population of District Shimla, Himachal Pradesh. While many participants understood the importance of sleep and its health consequences, there are opportunities for further education, particularly in areas like sleep hygiene practices and understanding sleep stages. These findings provide a foundation for targeted public health campaigns and educational programs to enhance sleep patterns and quality in the region, ultimately contributing to improved overall well-being.

Brain tumors represent a complex and serious public health concern due to their significant impact on morbidity, mortality, and quality of life. Public awareness and knowledge play a crucial role in early detection, timely treatment, and improved outcomes. This study aimed to assess the level of awareness and knowledge regarding brain tumors among the general public of District Shimla, Himachal Pradesh. A descriptive cross-sectional survey was conducted from April to July 2023 among 400 adults aged 18 years and above who had been residing in the district for at least one year. Data were collected using a validated structured Google Form questionnaire consisting of demographic variables and 20 knowledge-based questions on brain tumors. Data analysis was performed using Epi Info V7, applying descriptive statistics such as frequencies and percentages. The findings revealed that while a majority of participants had heard of brain tumors, detailed knowledge regarding risk factors, types, diagnostic methods, treatment options, and support resources was limited. Overall, 25.75% of participants demonstrated very good knowledge, 35.5% had good knowledge, 25.25% had fair knowledge, and 13.5% exhibited poor knowledge regarding brain tumors. The study highlights notable gaps in public understanding, particularly in areas related to prevention, diagnosis, and comprehensive management. These findings emphasize the need for targeted health education and awareness programs to improve public knowledge and promote early detection and informed decision-making related to brain tumors in District Shimla, Himachal Pradesh.

Background: Prostate cancer, a significant global health concern, poses challenges to public health systems and quality of life. Despite its prominence, knowledge gaps among the general public persist. This study aims to assess the awareness and knowledge of prostate cancer among the population of District Shimla, Himachal Pradesh. Methods: A descriptive cross-sectional survey was conducted from April to July 2023. A structured Google Form questionnaire was used to collect data from 400 adults residing in District Shimla for over 12 months. The questionnaire comprised demographic data and 20 knowledge-based questions. Data were analyzed using Epi Info V7 software. Results: Of the respondents, 79.5% had heard of prostate cancer. While 25.5% demonstrated very good knowledge, 39% had good knowledge, 21.75% had fair knowledge, and 13.75% had poor knowledge. Variations in knowledge were observed across questions related to risk factors, symptoms, screening methods, and treatment options. Conclusion: This study reveals moderate levels of awareness and knowledge about prostate cancer in District Shimla. While foundational awareness exists, targeted education is needed to address specific gaps. Enhancing understanding of risk factors, symptoms, and available interventions is essential for promoting early detection and better health outcomes. Tailored awareness campaigns and comprehensive health education are recommended to empower individuals in making informed decisions about prostate health.

Background: Polycystic Ovarian Syndrome (PCOS) is a prevalent endocrine disorder affecting women of reproductive age globally. Despite its significance, the awareness and understanding of PCOS among women remain variable. This study aims to assess PCOS knowledge among women in District Sirmaur, Himachal Pradesh, India, considering its distinct socio-economic and geographical context. Materials and Methods: This cross-sectional study was conducted from April to June 2023 in District Sirmaur, Himachal Pradesh. The study population comprised reproductive-age females residing in the district for at least 12 months. A sample of 400 participants was targeted, assuming 50% adequate knowledge, with a 5% absolute error, 95% confidence level, and 5% non-response rate. A Google Form questionnaire encompassing socio-demographic data and PCOS-related knowledge was administered, including 20 structured questions scored from 0 to 20. Data were analyzed using Epi Info V7 software, employing appropriate statistical tests. Results: Among the 400 respondents, 116 (29%) were from urban areas, and 284 (71%) were from rural areas. The knowledge assessment revealed varying levels of awareness: 32.75% exhibited very good knowledge (16-20 marks), 33.75% had good knowledge (12-15 marks), 22.75% demonstrated fair knowledge (8-11 marks), and 10.75% had poor knowledge (<8 marks). Specific knowledge domains, such as the impact on fertility and long-term health consequences, showed disparities in understanding. Notably, stress's influence on PCOS received relatively higher recognition (43.25%). Conclusion: This study provides crucial insights into PCOS knowledge among women in District Sirmaur, Himachal Pradesh. The observed moderate knowledge levels highlight the need for targeted education, particularly addressing misconceptions related to fertility, long-term health consequences, and holistic management. By comparing these findings with existing research, policymakers and healthcare providers can tailor interventions to enhance women's reproductive health understanding effectively, promoting informed decision-making.

Background: Reproductive health knowledge and effective family planning are pivotal for women's well-being and societal development. Addressing gaps in contraceptive knowledge among females of reproductive age is crucial for gender equality and improved maternal and child health outcomes. This study explores contraceptive knowledge in District Sirmaur, Himachal Pradesh, a microcosm of challenges in reproductive education. Methods: A descriptive cross-sectional survey was conducted between April and June 2023. The study encompassed 400 reproductive-age females residing in District Sirmaur for at least 12 months. A structured questionnaire with demographic information and contraceptive knowledge-related questions was used. Responses were analyzed using frequencies, percentages, and the Epi Info V7 Software. Results: The survey revealed variations in contraceptive knowledge. While 33.5% displayed very good knowledge, 39.25% exhibited good knowledge, 19% had fair knowledge, and 8.25% had poor knowledge. Participants exhibited a solid understanding of family planning's purpose (75.25%) and common contraceptive methods (67%), yet demonstrated lower awareness of hormonal contraception mechanisms (35.25%). Knowledge deficits were observed in emergency contraception (38.5%) and natural family planning (23%).Conclusion: The study underscores the importance of targeted reproductive health education interventions. Participants exhibited mixed knowledge levels across various aspects of contraceptive methods, reflecting the need for tailored strategies to bridge gaps in understanding. Collaboration among healthcare providers, policymakers, and community organizations is essential to disseminate accurate and culturally sensitive reproductive health information.

Tuberculosis has become rare in high income countries, but is still a major public health problem in developing countries like India. Incidence of optic neuropathy can increase multifold and result in significant visual impairment due to increased exposure to anti-tubercular treatment. Present study was done to study the incidence of visual defect in patients treated with Antitubercular drugs under RNTCP in newly diagnosed TB patients (category one). The final study included 82 patients (n =164 eyes). This study was an attempt to assess the incidence of ocular toxicity in patients on antitubercular treatment.  In the patients who received antitubercular treatment, there was a significant decrease in visual acuity.