Background:Stroke remains a leading cause of death and disability worldwide, with timely recognition of symptoms and immediate response measures being critical to improving outcomes. In underserved regions like Shimla, Himachal Pradesh, disparities in healthcare access and public knowledge exacerbate delays in recognizing and managing stroke symptoms, increasing the burden of disease.Materials and Methods: A descriptive cross-sectional study was conducted from August to October 2024 among 400 Shimla residents aged 18 and above. Data were collected via a structured questionnaire covering stroke symptoms (e.g., FAST acronym), response measures, risk factors, and prevention strategies. Awareness scores were categorized as Very Good (>80%), Good (60–79%), Fair (41–59%), and Poor (<40%). Statistical analysis included descriptive statistics and cross-tabulations to explore correlations between socio-demographic factors and knowledge levels.Results: Among 400 participants, 51.50% were female, 60.50% resided in rural areas, and 31.25% were aged 26–35 years. While 62.00% identified smoking as a key stroke risk factor and 61.50% recognized blood pressure control as a preventive measure, only 44.00% were aware of the critical 4.5-hour treatment window. Symptom recognition was moderate, with 45.50% identifying facial drooping, 51.00% recognizing arm weakness, and 46.50% noting speech difficulty as key indicators of stroke. Knowledge of immediate response, such as calling emergency services, was also limited (47.25%). Overall, 21.50% demonstrated comprehensive knowledge, scoring "Very Good," while the majority scored "Good" (36.00%) or "Fair" (32.00%), underscoring substantial knowledge gaps.Conclusion:This study highlights significant gaps in stroke awareness, particularly in recognizing symptoms and understanding the urgency of timely response. Rural and less-educated populations were the most underserved, indicating a need for targeted community-based health campaigns. Public health strategies emphasizing the FAST acronym, timely intervention, and stroke prevention are critical to reducing morbidity and mortality in Shimla.

Background: Torticollis, a condition characterized by abnormal tilting or twisting of the neck, is a significant pediatric health concern that can impede a child’s physical and developmental progress if untreated. Despite advancements in diagnosis and management, public awareness of torticollis, particularly in rural communities like Hamirpur, remains inadequate. Assessing the level of knowledge and identifying gaps can guide interventions aimed at early recognition and effective treatment.Material and Methods: A descriptive, cross-sectional study was conducted among 400 residents of Hamirpur, Himachal Pradesh, from August to October 2024. Participants were selected using a multi-stage random sampling technique. Data collection utilized a structured, pre-validated questionnaire divided into socio-demographic details and 20 knowledge-based questions covering symptoms, causes, prevention, and management of torticollis. Responses were analyzed to classify awareness levels into four categories: very good, good, fair, and poor. Data were processed using Microsoft Excel and Epi Info V7, with descriptive statistics used to assess awareness and its correlation with demographic variables.Results: The study population comprised 45% males and 55% females, predominantly from rural areas (64%). While 75% identified torticollis as a curvature of the neck, only 62% recognized the risk of recurrence if left untreated. Knowledge of birth trauma as a potential cause (69.5%) and the role of physical therapy (77.5%) was moderately high. Notably, 81% emphasized the importance of public awareness programs. Knowledge scores revealed 27% of participants in the very good category, 36% in good, 28% in fair, and 9% in poor, indicating a wide disparity in awareness levels.Conclusion: The findings highlight the need for targeted educational interventions to bridge knowledge gaps about torticollis in Hamirpur. Community-driven health programs, integrated with existing maternal and child health services, can enhance awareness and ensure early diagnosis and effective management of the condition. By addressing socio-economic and educational barriers, such initiatives can improve outcomes and quality of life for affected children and their families.

Background: Gynecological cancers, including cervical, ovarian, and endometrial cancers, are among the leading causes of morbidity and mortality among women globally. Early detection and timely intervention can significantly reduce mortality rates. However, awareness of the early signs and risk factors for gynecological cancers remains limited, particularly in rural and resource-constrained areas like Kangra, Himachal Pradesh. Understanding public knowledge about these cancers is essential for developing effective awareness and prevention programs.Materials and Methods: A descriptive, cross-sectional study was conducted among 400 women aged 18 years and above in Kangra district, Himachal Pradesh, over three months. A structured questionnaire, validated by experts, was used to assess socio-demographic characteristics, awareness of early signs, and knowledge of risk factors associated with gynecological cancers. Responses were analyzed using descriptive statistics, and knowledge levels were categorized as Very Good, Good, Fair, or Poor.Results: The study revealed that 67% of participants were from rural areas, with 60% having completed secondary education or higher. While 79.5% were aware of Pap smears as a critical screening tool, only 64% identified obesity as a risk factor, and 66% recognized the significance of family history. Knowledge distribution showed that 27% scored Very Good, 35% Good, 29% Fair, and 9% Poor. Awareness of early warning signs like abnormal vaginal bleeding was moderate (72.5%), indicating gaps in knowledge that require targeted intervention.Conclusion:While foundational awareness of gynecological cancers exists, significant gaps in knowledge, particularly regarding risk factors and comprehensive early signs, highlight the need for targeted health education initiatives. Community-based programs and the integration of gynecological health education into primary healthcare services can address these gaps, fostering earlier detection and better outcomes.

Background: Prostate cancer is one of the most prevalent cancers affecting men globally, with increasing incidence in India. Early detection and awareness of risk factors, preventive measures, and treatment options significantly improve outcomes. In rural and semi-urban areas such as Himachal Pradesh, awareness of prostate cancer remains low, with limited access to diagnostic and educational resources. Understanding the knowledge gaps among the population is crucial for developing effective public health strategies.Materials and Methods: A descriptive, cross-sectional study was conducted among 412 individuals in Himachal Pradesh using a structured questionnaire. The questionnaire assessed socio-demographic details and knowledge of prostate cancer, including its risk factors, symptoms, diagnostic methods, and treatment options. Participants were categorized into four knowledge levels based on their responses: very good (>80%), good (60–79%), fair (41–59%), and poor (<40%). Data were analyzed using descriptive statistics and chi-square tests to explore correlations between socio-demographic variables and knowledge scores.Results: Of the 412 participants, 59.3% were male, and 40.7% were female. Rural residents comprised 60.5% of the sample, with 38.5% falling into the middle-income category (INR 10,001–20,000 monthly). While 73.5% recognized men over 50 as a high-risk group, awareness of lifestyle-related risk factors such as smoking (49.3%) and physical inactivity (59.5%) was moderate. Knowledge of early detection methods, including PSA testing, was reported by 61.8%, and 65.3% were aware of treatment options like radiation therapy. Knowledge scores revealed that 59.8% of participants had good to very good awareness, while 40.2% fell into fair or poor categories.Conclusion: The study highlights a foundational awareness of prostate cancer among the general public in Himachal Pradesh but identifies critical gaps in technical knowledge and preventive practices. Targeted community-based education initiatives, integrating culturally appropriate and accessible materials, are essential to bridge these gaps. Public health strategies focusing on rural and underserved populations can promote early detection, healthier lifestyles, and better prostate cancer outcomes.

Background: Parental awareness and knowledge play a pivotal role in early recognition, prevention, and care of common pediatric infections. This study aimed to assess the knowledge and awareness of parents in Chamba, Himachal Pradesh, regarding common pediatric infections and their prevention.Material and Methods:This descriptive, cross-sectional study was conducted from August to October 2024 in Chamba, Himachal Pradesh. A total of 400 parents, selected through stratified random sampling, participated in the study. Data were collected using a structured, pre-validated questionnaire comprising two sections: socio-demographic variables and knowledge assessment of pediatric infections. Knowledge scores were categorized into four levels: very good (>80% correct responses), good (60–79%), fair (41–59%), and poor (<40%). Data analysis was performed using descriptive statistics and chi-square tests for associations.Results: The study included 55% mothers and 45% fathers, with 67% residing in rural areas. The majority of participants were aged 26–45 years (67%), and 27% had secondary-level education. Awareness of key preventive measures, such as routine vaccinations (84.5%) and exclusive breastfeeding (82.5%), was high. However, knowledge of specific symptoms of pediatric infections, such as rash for measles (65%) and persistent cough for pneumonia (69%), was moderate. Overall, 29.5% demonstrated very good knowledge, 36% scored good, while 24% and 10.5% fell into the fair and poor categories, respectively. Barriers to knowledge included geographic isolation, limited education, and misconceptions about infection causes and treatments.Conclusion: This study highlights a foundational understanding of pediatric infection prevention among parents in Chamba while identifying critical gaps in knowledge related to symptoms and treatment. Targeted, community-based educational interventions, strengthened immunization programs, and increased access to healthcare resources are essential to bridge these gaps and improve child health outcomes. Engaging community health workers and leveraging digital platforms can further enhance the effectiveness of these initiatives.

Background: Despite its importance, public knowledge and preparedness to administer CPR remain inadequate, particularly in rural and resource-constrained regions like Keylong, Himachal Pradesh. The region's geographic isolation, limited healthcare access, and educational disparities emphasize the need to assess community awareness and preparedness for effective emergency response.Materials & Methods: This descriptive, cross-sectional study was conducted from August to October 2024, involving 400 adult residents of Keylong. Data were collected using a pre-validated structured questionnaire distributed through both online and in-person surveys. The questionnaire assessed socio-demographic details, knowledge of CPR's purpose and techniques, preparedness to perform CPR, and perceived barriers. Correct responses were scored, and knowledge levels were categorized as Very Good (>80%), Good (60–79%), Fair (41–59%), and Poor (<40%). Data analysis was performed using descriptive statistics in Epi Info V7 software.Results: The study population comprised 52% females and 48% males, with 68% residing in rural areas. Educational levels varied, with 30% holding undergraduate degrees, and only 14% had prior CPR training. While 80% of participants recognized CPR's primary purpose as restoring blood flow and breathing, technical knowledge showed gaps: 49% knew the correct chest compression rate (100–120/min), and 53% were aware of the compression-to-breath ratio (30:2). Awareness of AED functionality (58.5%) and compression depth (45.5%) was also limited. Knowledge scores indicated that 25.5% of participants achieved Very Good scores, 34% Good, 27.5% Fair, and 13% Poor. Key barriers included fear of causing harm (64%) and lack of confidence due to insufficient training (79.5%).Conclusion: While foundational knowledge of CPR among Keylong residents is encouraging, significant gaps in technical skills and confidence persist. These findings underscore the urgent need for community-centered CPR training programs, integration of CPR education into school curriculums, and public awareness campaigns. 

Introduction: Diabetes mellitus (DM) is a non- communicable , metabolic and chronic disease, marked by high blood glucose level due to either absolute or relative insulinhormone deficiency.This study aims to examine age related trends in prevalence of sensorineural hearing loss among type 2 DM.Methodology: A cross-sectional study was conducted at Dr. RPGMC Tanda involving 150 patients aged 30-55 years with type 2 DM. Participants were selected based on specific inclusion and exclusion criteria. Data on demographic and clinical characteristics were collected, and hearing loss was assessed using pure tone audiometry. The degree of hearing impairment was charted on audiograms.Results: The mean age of participants was 45.19 ± 7.03 years, with the majority being female (51.3%), homemakers (46%), and residing in rural areas (82%). The prevalence of SNHL was 50%. Most participants had diabetes for 1-3 years (42%), with FBS >126 mg/dL (50.7%), PPBS >200 mg/dL (62%), and HbA1c ≥6.5% (82.7%). SNHL was present in 50% of participants. A significant association was found between age and SNHL (p<0.001), with higher prevalence in older age groups. Conclusion: The study highlights significant association between SNHL andage. These findings underscore the importance of monitoring hearing health in diabetic patients to manage and mitigate potential hearing impairments.

Background and objectives: Prostate cancer is the primary cause of cancer-related deaths in males; rates range over 25 times globally, with North America, Western and Northern Europe, Australia, and New Zealand having the highest rates. Aim of the study: To study the hormonal and biochemical changes in these patients before and after chemotherapy.  Materials and Methods: The current study is a retrospective observational study was executed in Oncology center/Kirkuk, Iraq from January 25th to July 26th 2024  on 255 patients with mean age (62.07) years and prostate cancer. The patients were tracked on in two different time points, before and after getting chemotherapy. Their hormones and biochemical measured. Results: The present study revealed significant increasing in the LH concentration (25.23 IU/L), this was also true for FSH concentration (30.15 IU/L), Cortisol level (19.62µg/dl), Insulin level (22.77 µIU/ml) and PTH mean level (42.32 pg/ml) after chemotherapy in patients. Moreover the present study displayed significant decreasing in the mean levels of PSA (4.05 ng/ml), Testosterone (57.52 ng/dl) and PAP (2.46 U/L) after treatment. Cholesterol, Glucose, ALP, and LDH levels declined significantly post treatment.   Conclusions: Older ages are more prone to get prostate cancer. Chemotherapy therapy has effective impact on dropping the levels of some hormones and biochemical elements among prostate cancer patients.

Background: Noise-induced hearing loss (NIHL) is a significant occupational risk for traffic policemen, causing irreversible cochlear damage and communication impairment. Despite its impact, data on NIHL prevalence in Indian traffic police are limited. This study examines its magnitude, severity, and risk factors in Mahabubnagar city.Methods: A cross-sectional study was conducted including a total of 186 traffic policemen were enrolled, and their demographic details, years of service, and daily working hours were recorded. Participants underwent a comprehensive otological examination followed by Pure Tone Audiometry (PTA) to determine hearing thresholds. Noise levels at various duty locations were measured using a Sound Level Meter. Statistical analysis was performed to assess the association between NIHL and occupational exposure.Results: Among the 186 traffic policemen, 94 (50.5%) exhibited some degree of noise-induced hearing loss. The hearing impairment was predominantly sensorineural and bilateral, with the most affected frequencies being 4 kHz and 6 kHz. Based on WHO classification, 38 participants (20.4%) had mild hearing loss, 42 (22.6%) had moderate hearing loss, and 14 (7.5%) had severe hearing loss. The mean Sound Pressure Level (SPL) at duty locations ranged from 78.1 dB to 96.2 dB, exceeding the OSHA-recommended limit of 85 dB at most sites. A statistically significant positive correlation (r = 0.68, p < 0.001) was observed between years of service and hearing loss severity. Policemen with >15 years of service had the highest prevalence of NIHL (72.2%), whereas those with <5 years of service had only 12.4% prevalence.Conclusion: Noise-induced hearing loss is common among traffic policemen due to prolonged noise exposure. Preventive measures such as routine audiometric screening, mandatory hearing protection, duty rotation, and noise reduction strategies are essential. Enforcing occupational health programs is crucial to safeguarding their hearing health.

Background: Subclinical hypothyroidism (sHT) is defined by elevated thyroid-stimulating hormone (TSH) levels with normal free thyroxine (FT4) levels, occurring without overt symptoms of thyroid dysfunctionAim: The aim was to investigate the demographic properties, risk factors, presence of thyroid autoantibodies, and thyroid function tests among children under age of 10 years who received their follow up at Azadi hospital.Materials and Methods: A cross-sectional study was conducted between January and December 2023 at Azadi Teaching Hospital in Kirkuk City, Iraq. The study included 104 children under 10 years diagnosed with sHT based on elevated TSH levels and normal FT4 levels, recruited from the pediatric endocrinology clinic. A control group of 50 healthy children was also included. Children with overt hypothyroidism, on thyroid medications, or with chronic illnesses affecting thyroid function were excluded. Data collection involved demographic, clinical, and laboratory parameters, including TSH, FT4, thyroglobulin antibodies, and thyroid peroxidase antibodies measured using immunoassay and ELISA methods. The study received approval from the Ethics Committee of Azadi Teaching Hospital and ensured the preservation of anonymity and privacy.Results: The analysis revealed that children aged 1-5 years were the most affected group (34.6%), followed by infants (30.8%). A slight female predominance was noted (53.9%). A family history of thyroid disorders was present in 46.2% of cases, and 15.4% had trisomy 21 syndrome, highlighting the significance of possible genetic and syndromic risk factors. Importantly, 50% of children with sHT tested positive for thyroglobulin antibodies, and 38.46% had thyroid peroxidase antibodies, compared to 0% in the control group (p = 0.001 for both), indicating a strong association between sHT and autoimmunity. All children with sHT had elevated TSH levels, while TSH remained within the normal range for all controls (p = 0.001). The study found that children with a family history of thyroid disorders are more likely to have symptoms such as fatigue, cold intolerance, and constipation, indicating a strong association between these conditions and the presence of thyroid autoantibodies Conclusion: The findings highlight the critical roles of genetic predisposition, the presence of thyroid autoantibodies, and the pivotal role of TSH in the diagnostic process. These results underscore the need for practical guidelines for clinicians managing pediatric patients with subclinical hypothyroidism, particularly in identifying at-risk individuals and making informed decisions regarding monitoring and potential treatment strategies.

The most common form of dementia is Alzheimer's disease (AD), which has a significant economical impact because there is currently no proven cure. Apart from heredity and contextual variables. The metabolic syndrome, which is characterized Age, insulin resistance, chromosomal abnormalities, obesity, smoking, depression, hypertension, hearing loss, alcohol & stress. Additional risk factors for AD pathology include head injuries and Down syndrome are strongly linked to AD.Obesity, diabetes, and hypertension are very common conditions that might hasten neurodegeneration and increase the burden of AD. Insulin resistance and enzymes, such as those that degrade insulin, are linked to AD, where the breakdown of insulin takes precedence over amyloid-β.Among these risk factors, there has been extensive research on the relationship between AD and these risk factors. Thus, the issue still stands: Are we getting closer to a solution? Numerous genetic and environmental risk factors, as well as a range of clinical manifestations, highlight the complexity of AD and imply that it is more like a syndrome than a standard disease, with its pathological manifestation indicating the convergence of pathogenic pathways. The purpose of this review paper is to examine the major risk factors associated with Alzheimer and dementia or data supporting biomarkers and diagnostic criteria in Alzheimer disease.

Introduction: Assessment of MF specially position is critical for successful anaesthetic and surgical procedures. AIM: Present study was to assess the most common type and position of MF in Himachal Pradesh population. Material And Methods: Retrospective study was done using 326 digital Orthopantomogram (OPG), patients age ranging from 16 to 65 years. Location and type of MF are identified by tracing inferior alveolar canal and position and type is classified accordingly. Results: The most common location of MF on the both sides were found to be Location “2” i.e. below second Premolar accounting to be 55.50%. No MF was seen in position 3 and 4 i.e. below the Canine and below the first Molar were evident. The most common type of MF seen was type 2 i.e. Separate type, found in 157 subjects accounting for 48.16% on both sides. No subject radiograph with type 4 MF i.e. Unidentified type was seen. Conclusion: The study concluded that there was significant difference in the location and type of mental foramen among Himachal Pradesh population.

Oral cavity acts as the gateway to the body; it depicts the overall health of the body. General well-being can affect oral health and likewise, oral health can affect general well-being. Diet and nutrition simultaneously affect our oral as well as overall health. To maintain health, the human body needs daily nourishment and here is where the role of micronutrients come into play. The purpose of this review article is to explore, highlight and develop an understanding about micronutrients and their importance in maintaining a healthy oral status.

Background: Myocardial infarction (MI), commonly known as a heart attack, is increasingly being observed in younger populations. Traditionally associated with older adults, the rising incidence of MI in individuals under 45 years poses significant public health challenges. The clinical profile, risk factors, and outcomes in young adults with MI differ from those in older populations. Objective: This review aims to provide a comprehensive overview of the clinical characteristics, risk factors, and outcomes of myocardial infarction among young adults. Methods: A detailed review of literature was conducted using key databases, including PubMed and MEDLINE. The review synthesizes data from clinical studies, case reports, and population-based research to present an up-to-date understanding of MI in young adults. Results: Young adults with MI often present with atypical symptoms and have a different risk factor profile compared to older patients. Smoking, dyslipidemia, and family history of coronary artery disease are predominant risk factors in this population. Despite having fewer comorbidities, young adults with MI may have worse long-term outcomes due to delayed diagnosis and aggressive disease progression. Conclusion: Understanding the clinical profile of MI in young adults is crucial for improving early detection, intervention, and prevention strategies. Targeted public health initiatives and personalized treatment approaches are needed to address the unique challenges posed by MI in this age group.

Scrub typhus, a vector-borne infectious disease caused by Orientia tsutsugamushi, is emerging as a critical public health threat in Himachal Pradesh, India, with a significant rise in cases, particularly during the monsoon and post-monsoon periods. This article explores the epidemiology, clinical manifestations, and diagnostic challenges of scrub typhus in the state, highlighting its increasing incidence, geographic distribution, and severe health impacts, including life-threatening complications. The inadequate healthcare infrastructure and limited public awareness exacerbate the disease burden, especially in rural areas. The article also discusses socio-economic impacts, such as the financial strain on affected families and the potential for social stigma. Effective interventions, including vector control, enhanced surveillance, improved diagnostic facilities, and public health education, are proposed to curb the disease's spread. Strengthening healthcare systems and prioritizing prevention are essential to reducing scrub typhus-related morbidity and mortality in Himachal Pradesh.

This case report explores a rare occurrence of Idiopathic Intracranial Hypertension (IIH) in conjunction with COVID-19 infection, a scenario that has received minimal attention in the literature to date. A 49-year-old female with no significant medical history presented with rapidly progressing bilateral vision loss and was found to have grade 3 bilateral optic disc edema alongside a positive COVID-19 diagnosis. Despite the absence of traditional risk factors for IIH, such as obesity or a prior history of similar symptoms, the patient's clinical presentation suggested a possible link between her IIH and COVID-19 infection. Diagnostic workup included normal cerebrospinal fluid analysis and MRI findings, except for an empty sella turcica. The patient underwent successful bilateral endoscopic optic nerve decompression surgery following medical management that included mannitol, dexamethasone, low molecular weight heparin, acetazolamide, vitamin D3 supplementation, ivermectin, and oxygen therapy. Significant symptomatic improvement was observed postoperatively. This case highlights the necessity for heightened awareness among clinicians regarding the potential for COVID-19 to precipitate or exacerbate IIH, underlining the importance of considering IIH in the differential diagnosis of COVID-19 patients presenting with neurological symptoms to prevent irreversible outcomes. Further research is encouraged to investigate the relationship between COVID-19 and IIH, which could offer new insights into their management and preventative strategies.

Background: Worm infections, particularly soil-transmitted helminths like roundworms, hookworms, and whipworms, pose significant health risks to children, especially in rural and semi-urban areas such as District Solan, Himachal Pradesh. These infections can result in malnutrition, anemia, cognitive impairment, and reduced school performance. While preventive measures and treatments exist, their effectiveness is often hampered by inconsistent public awareness and practices. Objective: This study aimed to assess the level of public awareness and knowledge regarding the prevention and treatment of worm infections in children among parents, educators, and community members in District Solan. The goal was to identify knowledge gaps and barriers to effective prevention and treatment to inform public health strategies. Methodology: A descriptive, cross-sectional survey was conducted over five months, from January to May 2024, involving 400 participants from District Solan. A structured online questionnaire was used to collect data on socio-demographic characteristics, awareness of worm infections, knowledge of preventive and treatment practices, and community health practices. The data were analyzed using descriptive statistics to identify significant patterns and gaps in awareness. Results: The study found a reasonable level of awareness regarding worm infections, with 79.8% of participants recognizing common worm infections in children. However, gaps were identified in specific areas, such as the importance of boiling drinking water (73.3%) and understanding the role of over-the-counter medications (72.8%). While 89.0% of participants recognized the importance of using clean toilets, only 75.5% were aware that thoroughly cooking food is a preventive measure. Overall, 29.5% of participants demonstrated excellent knowledge, 37.3% had good knowledge, and 22.8% had fair knowledge. Conclusion: The study highlights significant gaps in public awareness and knowledge regarding the prevention and treatment of worm infections in children in District Solan. These gaps underscore the need for targeted public health interventions focusing on comprehensive hygiene practices and the appropriate use of treatment options. 

The fidelity of diagnostic outcomes in clinical microbiology is intrinsically linked to the quality and integrity of patient specimens collected. This review article delves into the critical protocols and best practices governing the acquisition and handling of key specimens—cerebrospinal fluid (CSF), various body fluids, sputum, and throat swabs—each essential for microbiological analysis. It underscores the imperative of rigorous adherence to standardized collection and processing protocols to mitigate pre-analytical errors and enhance diagnostic precision. From the nuanced approach required in CSF collection, ensuring sterile techniques and accurate sample segmentation, to the meticulous collection of body fluids through aseptic aspiration, the review highlights the importance of optimal timing, patient preparation, and appropriate container usage in sputum collection, alongside the precision needed in throat swab collection for diagnosing throat infections. Emphasizing timely specimen transport and the use of suitable transport media, this comprehensive overview aims to fortify the knowledge base of healthcare professionals, facilitating improved diagnostic accuracy and patient care outcomes. By advocating for a steadfast commitment to excellence in specimen collection and processing, the article illuminates the path toward more informed clinical decision-making and enhanced patient management in the field of clinical microbiology.

Herpes Zoster Ophthalmicus is caused by reactivation of varicella zoster virus.It involves eye causing conjunctivitis, keratitis, uveitis, keratitis and rarely cranial nerve palsy and optic neuritis. Here we report case of Herpes Zoster keratouveitis with oculomotor nerve palsy in diabetic patient. 

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder that significantly impacts individuals' quality of life, leading to joint pain, stiffness, and disability. Despite its global prevalence, awareness and understanding of RA, particularly in rural areas like District Kangra, Himachal Pradesh, remain limited. This study aims to assess the awareness and knowledge of RA among the general population in this region to inform public health strategies for better management and prevention of the disease. Materials and Methods: A descriptive cross-sectional survey was conducted between January 2024 and May 2024 among 400 adults aged 18 and above in District Kangra, Himachal Pradesh. A structured questionnaire was disseminated via online platforms to collect data on socio-demographic characteristics and knowledge of RA symptoms, causes, risk factors, prevention, and treatment. The questionnaire was validated by experts and pre-tested for clarity. Data were analyzed using Epi Info V7 software, with results presented as frequencies and percentages. Results: The study revealed that 78.5% of participants had heard of RA, with 72.0% recognizing joint pain as a symptom. However, knowledge of other symptoms, such as joint stiffness (69.0%) and decreased mobility (64.8%), was lower. Awareness of RA as an autoimmune condition was moderate (61.8%), with fewer participants understanding risk factors like genetics (59.5%) and smoking (57.5%). Knowledge of prevention strategies, such as a healthy diet (53.8%) and regular exercise (52.0%), was limited, and awareness of treatment options, including medications (47.8%) and physical therapy (45.8%), was inadequate. Overall, 25.5% of participants demonstrated very good knowledge, while 18.0% fell into the poor knowledge category. Conclusion: This study highlights significant gaps in the knowledge of RA among the residents of District Kangra. While there is a basic awareness of the disease, understanding of its causes, prevention, and management is lacking. Targeted educational interventions and improved healthcare communication are essential to enhance early diagnosis, promote preventive measures, and improve the management of RA. Comprehensive public health strategies are needed to bridge these knowledge gaps and reduce the burden of RA on individuals and the healthcare system.

Background: Leukemia, a malignant disorder of the blood and bone marrow, poses a significant health challenge globally. Despite advancements in treatment, the prognosis of leukemia heavily depends on early detection and public awareness. This study aims to assess the knowledge and perceptions of leukemia among the general population of District Ambala, Haryana, to identify gaps and guide targeted health education initiatives. Materials and Methods: A descriptive cross-sectional survey design was employed to collect data from January 2024 to May 2024. The study population included adults aged 18 and above who had been residents of District Ambala for at least 12 months. A sample size of 400 participants was determined using a 95% confidence level and a 5% absolute error margin. Data were collected using a pre-tested Google Form questionnaire consisting of socio-demographic information and 20 structured knowledge questions about leukemia. Data were analyzed using Epi Info V7 software for frequencies and percentages. Results: The study analyzed responses from 400 participants, revealing a balanced distribution across age groups and a slight male predominance. Knowledge about leukemia was relatively high, with 72.8% correctly identifying the disease. However, specific knowledge varied: 61.8% knew common symptoms, 55.3% were aware of types, and 45.3% understood risk factors. The importance of early detection was less understood, with only 39.3% correct responses. Overall knowledge scores were categorized as very good (23.0%), good (27.0%), fair (30.5%), and poor (19.5%). Univariate analysis showed significant associations between knowledge levels and socio-demographic variables such as age, gender, marital status, religion, employment status, and education level. Conclusion: The study highlights the need for comprehensive health education programs in District Ambala to improve leukemia awareness, particularly regarding risk factors, treatment options, and early detection. Targeted public health initiatives should address gender and educational disparities to foster a more informed community capable of managing leukemia effectively

Background: Cogan Syndrome is a rare autoimmune vasculitis characterized by inflammatory eye disease and vestibuloauditory dysfunction. This condition primarily affects young adults and can lead to severe complications such as blindness or deafness if not promptly diagnosed and treated. Objective: The aim of this review is to provide a comprehensive overview of Cogan Syndrome, focusing on clinical manifestations, diagnostic challenges, and current therapeutic strategies. Methods: A thorough review of the literature was conducted using databases such as PubMed, MEDLINE, and Scopus. This review includes studies published in the last two decades, emphasizing recent advances in understanding and managing Cogan Syndrome. Results: Cogan Syndrome presents with a range of ocular and audiovestibular symptoms that mimic other disorders, making diagnosis challenging. Early recognition and aggressive treatment with corticosteroids and immunosuppressants are critical for preventing long-term complications. Conclusion: Although Cogan Syndrome is rare, its potential for severe outcomes necessitates increased awareness among clinicians. Further research is needed to better understand the pathophysiology and to develop more effective treatment protocols.

Less than four percent of patients with hypothyroidism develop ascites. Ascites as the presenting feature of hypothyroidism is uncommon, hence diagnosis is often delayed. Once it is diagnosed, treatment of hypothyroidism leads to quick clinical improvement in ascites. We report a case of a female patient who presented with ascites secondary to severe hypothyroidism and discuss the diagnostic characteristics of the ascitic fluid in myxedema ascites on the basis of literature review