Background: The present study was done for comparative evaluation of hemodynamic Changes in Trendelenburg and Reverse Trendelenburg Position in patients undergoing Laparoscopic Surgery. Material & Methods: This was a prospective cohort study conducted in Department of Anaesthesia to determine hemodynamic Changes in laparoscopic surgeries in Trendelenburg and Reverse Trendelenburg position. Group A included 16 patients with Trendelenburg position and Group B included 30 patients with Reverse Trendelenburg position. Results: The mean age of patients in Group A was 44.44±11.11 years whereas the mean age of patients in Group B was 45.50±11.78 years (p>0.05). Group A comprised of 2(12.5%) males and 14(87.5%) females whereas Group B comprised of 12(40%) males and 18(60%) females. (p>0.05).The mean BMI of patients in Group A was found to be 22.28±1.58 kg/m2 and mean BMI of patients in Group B was 22.57±2.54 kg/m2 (p>0.05). Group A comprised of 11(68.8%) patients with ASA status I and 5(31.2%) patients with ASA status II. On the other hand, Group B had 15 cases each with ASA status I and II. (p>0.05). The average duration of surgeries in Group A was 80-90 minutes whereas the average duration of surgeries in Group B was 70-80 minutes. The comparison between mean heart rates, Mean Systolic Blood Pressure, Mean Diastolic Blood Pressure, Mean arterial blood pressure and Spo2 of two groups of patients in Trendelenburg and Reverse Trendelenburg Position was not found to be statistically significant at any time interval (p>0.05). Conclusion: We concluded that two groups of patients in Trendelenburg and Reverse Trendelenburg Position were comparable in respected to  various haemodynamic parameters like mean heart rates, Mean Systolic Blood Pressure, Mean Diastolic Blood Pressure, Mean arterial blood pressure and Spo2 at any time interval.

Background: The present study was done to evaluate the diagnostic performance of 68Ga-PSMA PET/CT with reference to gold standard (biopsy) in Prostate Cancer Patients. Material and Methods: Forty four patients with suspected PCa on clinical assessment and/or raised serum PSA levels (>4ng/ml) were prospectively recruited. Patient who underwent prostatic biopsy prior to 68Ga-PSMA PET/CT and mpMRI, deranged renal function tests or coagulogram and refused consent were excluded. Forty four patients underwent 68Ga-PSMA PET/CT and 33 patients underwent biopsy. Any focal tracer uptake on 68Ga-PSMA PET/CT was regarded as pathological. Histopathology was taken as gold standard. Results: Malignancy was detected in 16/33 (48.5%) patients who underwent biopsy while in 17/33 (51.5%), no evidence of malignancy was noted. 68Ga-PSMA PET/CT showed that 15 patients had positive results and among these 13 patients were found to have adeno-carcinoma on biopsy. Two patients with positive results on 68Ga PSMA PET/CT but negative biopsy (Considered False positive) were closely followed up with serum PSA values. Three patients had negative 68Ga PSMA PET/CT (homogenous/inhomogeneous uptake) but malignancy was detected on biopsy (False negative on 68Ga PSMA PET). In this study, 15 patients had negative results both on biopsy as well as on 68Ga-PSMA PET/CT. The sensitivity, specificity, PPV, NPV and accuracy of 68Ga-PSMA PET/CT to detect PCa was 81.25%, 88.24%, 86.67%, 83.33% and 84.85% respectively. Conclusions: Present study concluded that patients with suspected prostatic adenocarcinoma can be accurately diagnosed with 68Ga PSMA PET/CT, which has a much higher PSMA uptake in malignant tumours.

Staphylococcus aureus is a pathogen which colonizes the epidermis and nasal passages of the anterior slits, the alimentary canal, the genitourinary tract, and the pharynx. There are numerous ailments that this bacterium can cause, from mild infections of the skin to fatal pneumonia and sepsis. Bacteria from S. aureus can pass easily through one genus to another. The transition from humans to animals. S. aureus infections are zoonotic. It can be spread from animal to person by bites, scratches, working with diseased animal body parts or bones, and skin sores developed during contact with sick or carrier animals. The treatment of infections that caused by S. aureus is complicated by resistance of the antibiotic, and there is no effective vaccination. The incredibly high number of toxins as well as other virulence factors produced by S. aureus, as well as their impact on disease, have sparked ongoing and growing interest.

Hormonal and metabolic changes in reaction to tissue damage or acute stress are known collectively as the stress response. It's all a component of the body's systemic response to damage, which includes hormonal, immune, and blood-related changes. Stress reactions to various forms of surgery were recorded after the initial focus on the stress response to unintentional damage. It is for this reason that the effects of anesthesia and neural blockade on the body's hormonal and metabolic responses have been so intensively investigated. This article discusses the hormonal and metabolic adjustments that occur during surgery, as well as the modulatory roles played by anesthetic and analgesic protocols.

Short-term symptoms associated with infection by the SARS-CoV-2 virus are common and often include fever, respiratory/nasal congestion, and physical fatigue—among other things. However, recent studies have indicated the presence of severe long-term symptoms in certain individuals, lasting sometimes for several weeks or months. In this study, we designed and presented a questionnaire to individuals at a tertiary care hospital, who had at some point since the onset of the COVID-19 pandemic, contracted the virus. In an attempt to gather data on their current physical and mental symptoms and also identify correlations between their illness severity, vaccination status, and other physiological parameters, over 120 patients from different departments of the hospital were voluntarily interviewed. The results indicated that elderly age groups might face an increased risk of experiencing severe long-term post-COVID symptoms and that being vaccinated against the virus can prove to be significantly beneficial across age groups in preventing long-term phsyiological abnormalities.

Background: An injury that breaks or fractures a bone is excruciatingly painful. It is crucial to administer first aid right away for broken bones. This study's objective was to assess the first aid expertise of Ortho OPD patients at Regional Hospital, Keylong in the Himachal Pradesh’s district of Lahaul and Spiti with reference to fractures. Material & Methods: A convenience sample method was employed to select Ortho OPD patients from Regional Hospital, Keylong in District Lahaul & Spiti of Himachal Pradesh between July 2022 and September 2022 for this cross-sectional study. A self-administered, pre-tested, semi-structured questionnaire was used to collect data on the participants' sociodemographic characteristics and first aid knowledge regarding fractures. Data were assessed using suitable statistical procedures and the programme epi info v7. Results: In the current study, 64% (256) of the patients were over 40 years old, compared to 36% (144) of the patients who were under 40. Male patients made up 59.75% (239) and female patients made up 40.25% (161). Maximum of 300 patients (or 75%) said that the first step in treating a fracture is to immobilise the injured area. This was followed by 288 (72%), applying pressure to the wound with a sterile bandage, a clean cloth, or a clean piece of clothing, 204 (or 51%), applying a splint to the area above and below the fracture sites, 190 (47.5%), stopping any bleeding, and 190 (47.5%) prescribing painkillers to the patient. Still, 68 (17%) people were unaware of any first aid procedures for fractures. Conclusion: The results of the study showed that the participants' knowledge of the first aid treatment of fractures was either insufficient or unsatisfactory. Any negligence could aggravate the pain and bleeding from the wound while also damaging the neighbouring tissues. This could later result in problems with the repair and healing of the harm.

Background: Today, it is evident that a substantial fraction of people suffer from low back pain (LBA). It is a problem that affects many people and is the main cause of disability worldwide. The purpose of this study was to evaluate the knowledge about preventive factors & Practices followed for low backache among Ortho OPD patients at Regional Hospital, Keylong in district Lahaul and Spiti of Himachal Pradesh.Material & Methods: Ortho OPD patients at Regional Hospital, Keylong were selected between July 2022 and September 2022 for a cross-sectional study utilizing a convenience selection method. To learn more about their socio-demographic characteristics, awareness of LBA prevention, and strategies they followed, a self-administered, pre-tested, semi-structured questionnaire was employed. The required statistical tests were performed on the data using the Epi info v7 programme.Results: In the current study, 45.25 percent (181) of the patients were over 40 years old whereas 54.75 percent (219) were under 40. 44.5% (178) of patients were female, whereas 55.5% (222) of patients were men. Maximum 319 (79.75%) of the total patients said that regular exercise helps prevent low back pain, followed by maintaining good posture (226; 56.5%), taking calcium and vitamin D supplements (130; 32.5%), and avoiding heavy lifting (115; 28.75%). The majority of patients 341 (85.25%) reported using pain killing gels to treat low back pain, followed by taking painkillers 319 (79.75%), engaging in regular exercise 242 (60.5%), practicing yoga 216 (54%) and taking calcium and vitamin D supplements 210 (52.5%).Conclusion: Many survey respondents were still ignorant of the factors that can prevent LBA. Programs for community health education about LBA prevention are required. By maintaining proper posture, sitting and standing up straight, exercising frequently, maintaining a healthy weight, taking calcium and vitamin D supplements, and avoiding heavy lifting, we may protect our backs and prevent back pain.

The world health organization (WHO) claims that cataracts are the most common cause of vision loss and blindness in the world today, with corneal illnesses coming in second. About 6.8 million Indians suffer corneal blindness, defined as having vision less than 20/200 in at least one eye, and one million of them have bilateral corneal blindness.(1) By 2020, it is anticipated that there will be 10.6 million corneally blind individuals in India. Ocular trauma and corneal ulceration are thought to cause 1.5 to 2 million new cases of corneal blindness annually worldwide. They are currently known as a silent pandemic because 90% of them happen in developing nations.

This study was conducted at the Iraqi University, College of Education, from 1/3/2021 to 1/6/2021, and included the collection of three clinical isolates of the bacterial species Staphylococcus aureus, Klebsiella pneumoniae and Acinetobacter baumannii, from swabs of wounds and burns, which were collected from the Hospital of Baghdad Medicine City.  Where the bacterial samples were cultured on Macconkey agar medium to ensure their purity and incubated in the incubator at a temperature of 37 °C for 24 hours.  The effect of the cold aqueous extract and the hot aqueous extract of common mistletoe was tested and the effect of these two extracts was studied against Staphylococcus aureus, Klebsiella pneumoniae and Acinetobacter baumannii, by well method, in this study we are using five different concentrations: 1gm, 0.8mg, 0.6mg, 0.4mg, 0.2mg. High inhibitory activity of the hot aqueous extract against Klebsiella pneumonia and Acinetobacter baumannii, as the results showed that 1 gm concentration was the most effective concentration against bacteria except for Staphylococcus aureus, intermediate activity against Klebsiella pneumonia and Acinetobacterbaumannii, while a concentration of 0.6 mg had intermediate activity against Acinetobacter baumannii and did not show any activity against Klebsiellapneumonia and Staphylococcus aureus. While ( 0.2 mg and 0.4 mg)  did not show any effectiveness in inhibiting the growth of bacterial isolates. As for the cold aqueous extract, it did not show any effect on any of the three isolates. 

Background: The present study was done for Quantitative Analysis of 68Ga-PSMA PET/CT in Prostate Cancer Patients. Material and Methods: Forty four patients with suspected PCa on clinical assessment and/or raised serum PSA levels (>4ng/ml) were prospectively recruited. Patient who underwent prostatic biopsy prior to 68Ga-PSMA PET/CT and mpMRI, deranged renal function tests or coagulogram and refused consent were excluded. Forty four patients underwent 68Ga-PSMA PET/CT and 33 patients underwent biopsy. Any focal tracer uptake on 68Ga-PSMA PET/CT was regarded as pathological. Histopathology was taken as gold standard. SUVmaxof the lesions were measured for quantization. Results: Mean age of patients was 66.61±9.3 years and median PSA level was 13.4 ng/ml (IQR 13.9). Malignancy was detected in 16/33 (48.5%) patients who underwent biopsy. The median SUVmax for cases with confirmed malignancy (n=16) was found out to be 17.6 (IQR 18.9). Median SUVmax for cases with no evidence of malignancy was 6.3 (IQR 2.80). The difference between the two groups was found to be statistically significant (Mann Whitney U test, P =0.002). Conclusions: The present study concluded that SUVmax (PSMA expression) was significantly higher in Prostate cancer cases as compared to benign cases.

Background: The study was conducted to assess the Correlation between HbA1c & Central Macular Thickness (CMT) among Patients of Type 2 Diabetes Mellitus present at Ophthalmology OPD of Tertiary Care center. Material & Methods: This was a cross-sectional study on type 2 diabetes patients conducted in the department of ophthalmology, Indira Gandhi Medical College Shimla (H.P) for a period of one year. Patients who fulfilled the inclusion criteria were interviewed regarding the duration of diabetes mellitus and treatment history. A complete ophthalmologic examination including Central Macular Thickness (CMT) was performed to all patients. They also underwent investigations like HbA1c etc. Results: A total of 260 eyes from 130 patients (87 males, 43 females; mean age 56.88±8.26 years) were included in this study. CMT in right eye ranged from 189–751 μm with mean value of 260.41±101.66. CMT in left eye ranged from 180–561 μm with mean value of 255.69±88.89. Out of 130 patients 21.5% (n=28) had HbA1c level <6.5%, 33.1% (n=43) had HbA1c level between 6.5-8% and 45.4% (n=59) had HbA1c level >8%. Mean value of CMT for both eyes in study group with uncontrolled level of HbA1c (HbA1c ≥6.5) was 266.24±103.61 μm. In controlled HbA1c group (HbA1c <6.5) mean CMT value was 228.19±45.02μm. Mean CMT for both eyes was significantly raised in uncontrolled HbA1c group compared to controlled HbA1c group with a ‘p’ value of 0.02. Conclusion: Present study concluded that mean Central Macular Thickness (CMT) for both eyes was significantly raised in uncontrolled HbA1c group compared to controlled HbA1c group.

Verbena officinalis L. (V. officinalis) is one of the medical plants that plays an important role in the treatment of many diseases. The purpose of this study was to determine the cytotoxic and antioxidant effects of V. Officinalis on breast carcinoma cell lines (MCF7). Two patrs of experiments were carried out: The first assessed antioxidant effect of V. Officinalis using Scavenging effect on 2, 2-diphenyl-1-picrylhydrazyl (DPPH) and the second evaluated the cytotoxicity for the extract on MCF-7 cells were determined by MTT assay. The antioxidant properties of the ethanolic V. Officinalis. Extract were effective, with IC50 of 94.12 μg/ml for DPPH radical scavenging. The MTT results revealed anti-cancer activity and viability of cells decrease against MCF-7 cells, with an IC50 of 47.78 μg/ml. In summary, V. Officinalis. ethanolic extract showed strong antioxidant and cytotoxic effects against the MCF-7 cell line.

Healthcare professionals face a difficult problem when treating pain after total knee replacement. In addition, quick healing and early ambulation are essential for regaining function and avoiding postoperative problems. The best postoperative analgesia preserves motor power while providing adequate pain reduction with little to no opioid use. Techniques for regional analgesia are frequently utilized to meet these objectives. Although femoral nerve blocks are widely used, there are some potential drawbacks, like motor weakness. The possibility of an epidural hematoma raises doubts about the use of lumbar epidurals. More and more discussion is being had about relatively recent procedures like adductor canal blocks and local infiltration analgesia. The current evaluation weighs known advantages and risks of various forms of anaesthesia for total knee arthroplasty and what prospects it has for future.

This paper was conducted to enumerate, isolate, and identify bacteria using cultural, morphological, and biochemical characteristics of different soil types (sandy, Clay, and Loamy) contaminated with crude oil in Birnin Kebbi Local Government Area, Kebbi State, Nigeria. The study was conducted between August and December 2020. 12 artificially polluted soil samples were collected and tested using appropriate methods (Grams staining, coagulase test, catalase test, oxidase test, urease test, citrate test, nitrate reduction test, etc.) in the study. The result of bacterial populations estimated in each original and saturated sample showed that the control (oil free) soil was found to be higher than the crude oil treated soil at different concentration (2.3 x 1010 CFU/g, 1.8 x 1010 CFU/g and 1.9 x 109 CFU/g for Loamy Clay and Sandy soil respectively). In loamy treated soil, the organisms show growth even at 15% crude oil (3.0 x 108 CFU/g, 1.8 x 107 CFU/g and 1.1 x 106 CFU/g for 5%, 10% and 15% crude oil respectively), whereas in clay soil the organisms were recovered at 5 – 10% crude oil (1.4 x 107 CFU/g and 1.0 x 106 CFU/g at 5% and 10% respectively). In sandy soil, the growth was only observed at concentration of 5% crude oil which was 1.3 x 108 CFU/g. 21 hydrocarbon-degrading bacterial species were isolated and identified, the highest potential to utilize crude oil as a source of carbon and energy are as follows; Pseudomonas aerogenusa (A09 andC04), Acinetobacter (A04, B03), Bacillus cereus (A02, B05, and C01), Bacillus polymyxa (A07) Micrococcus luteus (B02, C07), Enterobacter (A06), Providentia spp (A03). In conclusion, this finding supports the fact that crude oil-degrading bacteria is widely distributed in the environment and therefore can be "easily" collectible from sites with no apparent history of crude oil pollution as it was in our case study.

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. Material & 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.

Mechanical ventilation is necessary for a sizable majority of newborns admitted to the NICU, and mechanically ventilated neonates have a high mortality rate. The most common reasons for neonates to need mechanical ventilation are post-resuscitation, following surgery, and respiratory failure caused by respiratory distress syndrome (RDS), apnea, hypoxia, meconium aspiration syndrome (MAS), sepsis, pneumonia, and transient tachypnea of the newborn (TTN). In this article we describe the clinical profile and short term outcomes of neonates requiring assisted mechanical ventilation. Sepsis has been observed the most frequent complication, with a 60% survival rate, compared to 100% fatality rates for shock, intraventricular haemorrhage, disseminated intravascular coagulation, air leak syndrome, and pulmonary haemorrhage. Favourable outcome was seen in patients with APGAR score more than 7.

Background: The present study was aimed to compare the Oropharyngeal leak Pressure among three different techniques of i-gel insertion i.e. standard, rotational, triple airway maneuver in anaesthetised paralysed adults. Material & Methods: During the study period, 150 patients were enrolled in this prospective randomised trial at the anaesthesia department of Dr. R.P.G.M.C. Kangra in Tanda. Three groups of 50 patients each were formed from the patients. Patients in groups A and B received the usual procedure; those in groups C received the triple airway maneuver. Results: In our study, Oropharyngeal leak Pressure (OLP) was 23.54±1.47, 23.36±1.76, 24.86±1.73 in standard, rotational and triple airway maneuver group respectively. On comparison, OLP was significantly higher in triple airway maneuver group in comparison to standard (24.86±1.73 vs. 23.54±1.47; P<0.0001) and rotational group (24.86±1.73 vs. 23.36±1.76: P<0.0001). This might be due to wider pharyngeal space and decrease in the incidence of epiglottic downfolding in triple airway maneuver technique. Conclusion: Present study concluded that OLP was significantly higher in triple airway maneuver technique in comparison to standard and rotational techniques, thus providing better seal with respect to both techniques.

Background: The purpose of the present study was to evaluate the expression of cell adhesion molecules, E-cadherin and β-catenin in different grades of oral squamous cell carcinoma and to assess their role as biomarkers and potential prognosticators in oral carcinogenesis. In the present study, the expression of E-cadherin and β-catenin is evaluated with the help of immunohistochemical examination. Materials and Methods: Biopsies/specimens of all suspected cases of oral squamous cell carcinoma were fixed in 10% neutral buffered formalin solution. Histopathological diagnosis was made on hematoxylin and eosin (H&E) stained sections and typed into different grades of oral squamous cell carcinoma.The expression  of E-cadherin and β-catenin is assessed by immunohistochemistry. Results: In the present study, a total of 71 cases (35 cases of well differentiated squamous cell carcinoma, 25 cases of moderately differentiated squamous cell carcinoma and 11 cases of poorly differentiated squamous cell carcinoma) were subjected to E-cadherin and β-catenin immunostaining. E-cadherin immunohistochemistry showed high immunoreactivity in 91.43 % cases, and low immunoreactivity in only 8.57% cases. β-catenin immunoreactivity was high in 77.14% cases of well differentiated carcinoma and low in 22.86% cases. Conclusion:  The suppression of E-cadherin and β-catenin expression is considered as one of the main molecular events responsible for dysfunction in cell-cell adhesion, which leads to local invasion and ultimately tumor development.

Background:The incidence of hip fracture varies by age and sex; it is more common in older people. Hip fracture in elderly osteoporotic patients most often results from low-energy trauma such as falling down. Since fracture neck of femur prevalence increases exponentially with age, as population age and longevity increases worldwide, these injuries are likely to occur at accelerated rates. This is important because among those who sustain fracture neck of femur and survive, an increasing number continue to experience various degrees of subsequent disability including a high risk for falls and further injury likewise. The incidence of hip fractures is increasing and the annual number worldwide is estimated to rise from 1.7 million in 1990 to 6.3 million by the year 2050. This will be a major challenge to the health care system and society. Thus, the present study was carried out to determine the Incidence and co-relates of mortality among elderly patients after surgical intervention for fracture neck of femur. Methodology: An open cohort, prospective study, was conducted in patients with fractures neck of femur (age 60 years and above) presenting to the Department of Orthopaedics, Dr. R. P. G. M. C., Kangra at Tanda and undergoing surgical intervention. All cases presenting to the department and fulfilling the criteria were studied for a period of one year starting from the date of start of the study. Results: 57.1% (n=486) of the patients were males while remaining 42.9% (n=36) of the patients were females. 52.4% (n=44) had fracture of right femur while remaining 47.6% (n=40) patents had fracture of left femur. 63.1% (n=53) of the patients underwent bipolar hemi-arthroplasty while 34.5% (n=29) underwent total hip replacement (THR). CRIF with DHS and PTCS was done in 1 patient each. Out of 84 patients, 1 patient died within 9 months of surgery and total of 5 patients died in one year with a peri-operative mortality rate of 5.95%. Mean age of the patients who died, was comparable to the mean age of the patients who survived (76.2±10.28 vs. 71±7.0; P=0.08). All the patients who died were females. Conclusion: With the increase in population of elderly in Indian Subcontinent, a policy focused in injury management should take into consideration for peri and post-operative mortality after fractures around the hip region.

Introduction: Mycetoma is an infective process leading to numerous draining sinuses with exudates containing coloured grains. It can be caused both by bacteria as well as fungi. In this case report we present a 24-year female who complained of multiple discharging sinuses from the left foot. She was examined and was being conservatively treated but increased pain for the last one month. Her left leg was amputated as she was not responding to any treatment. Clinical history, radiology and histopathology were used to diagnose the condition. Conclusion: Madura foot must be kept in mind in patients presenting with discharging sinuses as it is notorious for its chronicity.

Ocular trauma is a substantial contributor to blindness globally, especially when it coexists with glaucoma. Traumatic glaucoma can develop as a result of direct injury from blunt or penetrating trauma, bleeding, inflammation, lens-related issues, orbital and brain vascular diseases associated with trauma, and chemical injuries. Depending on the mechanism of harm, some conditions can be managed easily by removing the underlying cause, while others can be difficult to control. Poor visual results may result from improper management. We go over a variety of trauma-related processes that might elevate intraocular pressure as well as how to treat them (1).

Background: Adults in Shimla have been reported to have poor sleeping patterns and habits. As a result, we designed this study to evaluate the Sleep Patterns & Habits among Adult Population of Shimla city. Methods: It was a Cross sectional community based study conducted in Shimla city from November 2021-April 2022 among Adult population having age between 18-60 years. A pre-tested self-administered, anonymous, semi-structured questionnaire was used to evaluate the sleep pattern and sleep habits. The collected Data was thoroughly screened, entered in Microsoft Excel spreadsheet 2007 and analyzed by using Epi Info v7 software. Results: In the present study a total of 408 adults age between 18-60 years selected from all 34 municipal  wards  of  Shimla  city   were   participated.   Out   of   which, 312 (76.5%)  participants used mobile for chatting on social media/ playing   games/watching   movie   before   going   to   sleep   in   bed, 129 (31.6%) stay awake late at night and watch TV before going to sleep in bed and 94 (23%) participants read books or magazines before going to sleep in bed. 187(45.8%) participants were easily awakened by noise, 104 (25.5%) participants had problem of snoring, 235 (57.6%) participants slept alone whereas 173 (42.4%) participants slept with family members, 119 (29.2%) participants stated that they had interrupted sleep, 194 (47.5%) participants wake up in the middle of sleep at night, 238 (58.3%) participants  slept with in 2 hour after eating ,  156 (38.2%)  participants  had  habit  of  day  time  sleeping, 258 (63.3%)  participants  had  problem  of  dreams  while  sleeping, 145 (32.5%) participant reported that they had trouble in sleeping once awake, 94 (23%) participants didn’t feel fresh after wake up in the morning and 12 (2.9%) participants had habit of using any sleeping pills for sleep. Conclusion: Our study concluded that most of the participants used mobile before going to sleep, used mobile for >4 hour in a day, slept with in 2 hour after eating and had problem of dreams while sleeping, easily awakened by noise, didn’t feel fresh after wake up in the morning and took 2 or more cups of coffee or tea in a day.

Background: The present study was done for comparative evaluation of Peak Airway Pressure and End tidal carbon dioxide using Ambu Auragain in Trendelenburg and Reverse Trendelenburg Position in patients undergoing Laparoscopic Surgery. Material and Methods: This was a prospective cohort study conducted on 46 patients in Department of Anaesthesia to determine Peak Airway Pressure and End tidal carbon dioxide in laparoscopic surgeries in Trendelenburg and Reverse Trendelenburg position with the use of AmbuAuraGain. Group A included 16 patients with Trendelenburg position and Group B included 30 patients with Reverse Trendelenburg position. Results: The mean age of patients in Group A was 44.44±11.11 years whereas the mean age of patients in Group B was 45.50±11.78 years (p>0.05). Group A comprised of 2 (12.5%) males and 14 (87.5%) females whereas Group B comprised of 12 (40%) males and 18 (60%) females (p>0.05).The mean BMI of patients in Group A was found to be 22.28±1.58 kg/m² and mean BMI of patients in Group B was 22.57±2.54 kg/m² (p>0.05). Group A comprised of 11 (68.8%) patients with ASA status I and 5 (31.2%) patients with ASA status II. On the other hand, Group B had 15 cases each with ASA status I and II. (p>0.05). The average duration of surgeries in Group A was 80-90 minutes whereas the average duration of surgeries in Group B was 70-80 minutes. The comparison between mean Peak Airway Pressure of two groups was found to be statistically significant at all recorded time intervals except after SGA placement and before CO2 insufflation (p>0.05). Peak airway pressure were higher in Group A than Group B. In the present study, the comparison between mean EtCO₂ of two groups was not found to be statistically significant after SGA placement, 1 min and 5 min (p>0.05) but it was found to be significant from 10 minutes till 90 minutes (p<0.05), higher in Group A than Group B but remained within normal range (35-45 mmHg). Conclusion: We found in this study that Peak airway pressure and mean EtCO₂ were always higher in Trendelenburg position as compared to Reverse Trendelenburg position in patients undergoing Laparoscopic Surgery using Ambu Auragain.

The present study was done for comparative evaluation of Postoperative Airway Complications in Trendelenburg and Reverse Trendelenburg Position in patients undergoing Laparoscopic Surgery. Material and Methods: This was a prospective cohort study conducted in Department of Anaesthesia to determine the Postoperative Airway Complications in laparoscopic surgeries in Trendelenburg and Reverse Trendelenburg position. Group A included 16 patients with Trendelenburg position and Group B included 30 patients with Reverse Trendelenburg position. Results: The mean age of patients in Group A was 44.44±11.11 years whereas the mean age of patients in Group B was 45.50±11.78 years. ((p>0.05). Group A comprised of 2 (12.5%) males and 14 (87.5%) females whereas Group B comprised of 12 (40%) males and 18 (60%) females. (p>0.05). The mean BMI of patients in Group A was found to be 22.28±1.58 kg/m2 and mean BMI of patients in Group B was 22.57±2.54 kg/m2. (p>0.05). Group A comprised of 11 (68.8%) patients with ASA status I and 5 (31.2%) patients with ASA status II. On the other hand, Group B had 15 cases each with ASA status I and II. (p>0.05). The average duration of surgeries in Group A was 80-90 minutes whereas the average duration of surgeries in Group B was 70-80 minutes. Sore throat was reported in 5 (18.8%) patients in group A and 1 (6.7%) patient in group B. This was found to be statistically significant (p<0.05), higher in Group A. Only 1 patient reported with hoarseness in Group A and no patient reported with hoarseness in Group B. This was not found to be statistically significant (p>0.05). No patient reported with dysphonia in both the groups. Also, no patient reported with numbness of tongue in both the groups. Conclusion: We concluded that Postoperative airway complications like Sore throat and hoarseness was found more in patients operated in Trendelenburg Position as compared to patients operated in Reverse Trendelenburg Position while No patient reported with dysphonia and numbness of tongue in both the groups.

Background: The present study was undertaken to evaluate the effect of Vedic chants on Anaesthetist’s satisfaction score & Ostetrician’s satisfaction score in Laboring Parturients with Ambulatory Epidural Labor Analgesia. Material & Methods:  A total of 38 patients with full term live cephalic singleton pregnancy in active labor with cervical dilatation 0-4 cm with a request for ambulatory labor analgesia admitted in department of Obstetrics and Gynaecology at Dr. RPGMC Kangra at Tanda were participated in this study. We randomized the patients in two groups A and B. Both groups received epidural labor analgesia with 0.1% ropivacaine and 1.5ug/ml of fentanyl. Patients in group A were made to listen Vedicchants (Gayatri mantra) in 4 sessions of 30 min each with 15mins break in between the sessions. In group B, patients received only ambulatory epidural labor analgesia without any Vedic chants listening. These two groups were observed for the various parameters till the delivery of the baby. Results: The two groups were comparable in terms of age, height, weight, BMI, occupation, parity and POG and were statistically non-significant (p>0.05). Mean anaesthetist’s satisfaction score of the patients in group A was comparable to that in group B (2.75±0.58 vs. 2.68±0.57; p = 0.719). Mean obstetrician’s satisfaction score of the patients in group A was comparable to that in group B (2.62±0.62 vs. 2.36±0.85; p = 0.303). Conclusion: Present study concluded that after receiving epidural labor analgesia, there was no effect on ambulation and maternal expulsive efforts during labor. Study also concluded that in both the groups we achieved good quality of labor analgesia.

Background: Inguinal hernia constitutes an important public health problem and therefore inguinal hernia repair is one of the most commonly performed surgery. Present study was done to evaluate the Socio-Clinical Characteristics of Patients admitted with Inguinal Hernia in a Tertiary Care Hospital. Material & Methods: The study was conducted on a total of 50 patients with inguinal hernia of different types and presenting in different settings admitted in department of General Surgery at Dr. RPGMC Kangra at Tanda. All the patients who met the inclusion criteria were enrolled in the study and further subjected to open inguinal hernia repair with various techniques. Results: In our study population the mean age group of the patient was 50+13.5 years. Majority of them, 98% were male, 30% were between 51-60 years range, 52 % of participants were farmer and Mean BMI of study participants was 23.4+2 Kg/m2. The most common side of hernia was right side which constituted 76%, shape of the swelling on examination were funicular in 52 % of the cases, among 90% of the patients examined cough impulse was present, tenderness was present over the swelling in 8% of the cases and 90 % of the patients had reducible swelling. Digital rectal examination Finding was normal in 82% of cases, BPH Grade I was found in 12% patients while BPH Grade II was found in 6% of patients. In 46% of patient’s final diagnosis of direct reducible inguinal hernia was made while 34% had indirect reducible inguinal hernia, 10% had indirect irreducible inguinal hernia and 10% had Reducible pantaloon hernia. According to Nyhus classification Type, 44% patients were in Type 2, 46% were in Type 3a and 10% were in Type 3b. In our study all the patients were subjected to open inguinal hernia repair. 98% of the patients underwent lichtenstein tension free mesh hernioplasty, 2%of them underwent Bassini’s repair. Conclusion: Our study concluded that most of patients of inguinal hernia were male, between 51-60 years range, farmer had hernia of right side , funicular shaped swelling , had cough impulse, reducible swelling and direct reducible inguinal hernia on final diagnosis and majority of patients underwent lichtenstein tension free mesh hernioplasty.

Background: The present study was undertaken to evaluate the effect of Vedic chants on labor progression, mode of delivery and Maternal complications in Laboring Parturients with Ambulatory Epidural Labor Analgesia. Material & Methods: A total of 38 patients with full term live cephalic singleton pregnancy in active labor with cervical dilatation 0-4 cm with a request for ambulatory labor analgesia admitted in department of Obstetrics and Gynaecology at Dr RPGMC Kangra at Tanda were participated in this study. We randomized the patients in two groups A and B. Both groups received epidural labor analgesia with 0.1% ropivacaine and 1.5ug/ml of fentanyl. Patients in group A were made to listen Vedicchants (Gayatri mantra) in 4 sessions of 30 min each with 15 mins break in between the sessions. In group B, patients received only ambulatory epidural labor analgesia without any Vedicchants listening. These two groups were observed for the various parameters till the delivery of the baby. Results: Mean cervical dilatation of the patients in group A was comparable to that in group B (3.9±0.6 vs. 4.1±0.6; p=0.331), at time of epidural insertion. One contraction per 5-minutes was noted in all the patients in two groups at time of epidural insertion. In Group A 14 (87%) of women delivered through normal vaginal delivery and 2 (13%) through emergency lower segment caesarian section. In Group B 15 (68%), 5 (23%), 1 (4.5%) and 1 (4.5%) delivered through NVD, ELSCS, vacuum and forceps respectively. Mean duration of labor of the patients in group A was comparable to that in group B (5.2±1.6 vs. 4.9±1.7; p=0.556). None of the patients met with any complications like hypotension, bradycardia, nausea, vomiting& pruritus. Conclusion: In our study, both groups were comparable according to Mean cervical dilatation at time of epidural insertion, Mean duration of labor and mode of delivery and none of the patients met with any maternal complications in both groups.

Background: The present study was carried out to evaluate the association of socio-clinical variables with Post Dural Puncture Headache (PDPH) in the obstetrics and non-obstetrics patients. Material & Methods: This was a observational Prospective study carried out at Department of Anaesthesia, Dr. Rajendra Prasad Medical College, Tanda conducted on consecutive patients ASA I and II, aged 20-60 years, obstetric/ non obstetric patients scheduled for surgery under subarachnoid block, over a period of 18 months including data collection, data organization, presentation, analysis and interpretation. After recruitment, the patients were divided into two groups comprising of obstetric and non-obstetric group. Results: The total patients included were 302, being 115 in obstetric group and 187 in non-obstetric group. In our study, out of 302 patients only 17 patients had post dural puncture headache, the total incidence being 5.6%.There were eight (7%) patients in obstetric and nine (4.8%) patients in non-obstetric group, however the difference was not statistically significant (P=0.597). Number of attempts were significantly higher in the patients who had PDPH (P=0.0001). The position of the patients was not significantly associated with incidence of PDPH (P=0.949). BMI of the patients in either group was not significantly associated with incidence of PDPH (P=0.830). Among the patients with median approach, 4.8% patients had PDPH while out of 11 patients with paramedian approach, 27.2% had PDPH. Incidence of PDPH was significantly more with paramedian approach (P=0.0001). With respect to gender in non-obstetric group, the female patients had significantly higher incidence of PDPH (P=0.0002). Patients having PDPH in non-obstetric group belonged to 31-40 yrs age group as compared to only two in the age more than 40years (P=0.0173). Start of ambulation at 10-hourswas significantly associated with incidence of PDPH (P=0.0001). Conclusion: We concluded that in the present study obstetric population had higher incidence of PDPH in comparison to non-obstetric population. PDPH was associated with increased number of attempts; types of approach used, and start of ambulation. Moreover, the incidence of PDPH was more in female gender, younger age as compared to male gender and elderly patients.

Background: Adults in Shimla have been reported to have poor sleeping patterns and habits. As a result, we designed this study to evaluate the Interrupted sleep pattern among Adult Population of Shimla city and its associated socio-demographic characteristics as well as sleeping habits. Methods: It was a Cross sectional community based study conducted in Shimla city from Nov 2021- April 2022 among Adult population having age between 18-60 years. A pre-tested self-administered, anonymous, semi-structured questionnaire was used to evaluate the sleep pattern and sleep habits. The collected Data was thoroughly screened and entered in Microsoft Excel spreadsheet 2007 and analyzed by using Epi Info v7 software. Results: In the present study a total of 408 adults age between 18-60 years selected from all 34 municipal wards of Shimla city were participated. Among the total, 119(29.2%) had interrupted sleep while 289(70.8%) did not have interrupted sleep.  In Our study interrupted sleep pattern was  statistically significantly associated with the males, Urban area , with the time to sleep and wake up,  habit of using mobile before going to sleep, Mobile Use and Watching TV/Computer/ Laptop >2 hours in a day, Problem of dreams while sleeping, Trouble of going back to sleep once awakened, Easily awakened by noise , intake of sleeping pills and  Habit of Smoking and taking alcohol (p<0.05) In the present study, there was no statistically significant difference in the interrupted sleep pattern according to age groups, level of education, religion, read book or magazines or  watched TV before going to sleep, slept alone and who slept with family members, sleep duration, time gap between eating and sleeping, day time sleeping habits, number of cups of coffee or tea intake, pills for mental/psychiatric disorders or any other problems, exercise  or yoga pattern and snoring pattern (p>0.05). Conclusion: Our study concluded that interrupted sleep pattern was statistically significantly associated with the males, Urban area, with the time to sleep and wake up, habit of using mobile before going to sleep, Mobile Use and Watching TV/Computer/ Laptop >2 hours in a day, Problem of dreams while sleeping, Trouble of going back to sleep once awakened, Easily awakened by noise, intake of sleeping pills and Habit of Smoking and taking alcohol.

Background:The incidence of hip fracture varies by age and sex; it is more common in older people. Hip fracture in elderly osteoporotic patients most often results from low-energy trauma such as falling down. Since fracture neck of femur prevalence increases exponentially with age, as population age and longevity increases worldwide, these injuries are likely to occur at accelerated rates. This is important because among those who sustain fracture neck of femur and survive, an increasing number continue to experience various degrees of subsequent disability including a high risk for falls and further injury likewise. The incidence of hip fractures is increasing and the annual number worldwide is estimated to rise from 1.7 million in 1990 to 6.3 million by the year 2050. This will be a major challenge to the health care system and society. Thus, the present study was carried out to determine the Incidence and co-relates of mortality among elderly patients after surgical intervention for fracture neck of femur. Methodology: An open cohort, prospective study, was conducted in patients with fractures neck of femur (age 60 years and above) presenting to the Department of Orthopaedics, Dr. R. P. G. M. C., Kangra at Tanda and undergoing surgical intervention. All cases presenting to the department and fulfilling the criteria were studied for a period of one year starting from the date of start of the study. Results: 57.1% (n=486) of the patients were males while remaining 42.9% (n=36) of the patients were females. 52.4% (n=44) had fracture of right femur while remaining 47.6% (n=40) patents had fracture of left femur. 63.1% (n=53) of the patients underwent bipolar hemi-arthroplasty while 34.5% (n=29) underwent total hip replacement (THR). CRIF with DHS and PTCS was done in 1 patient each. Out of 84 patients, 1 patient died within 9 months of surgery and total of 5 patients died in one year with a peri-operative mortality rate of 5.95%. Mean age of the patients who died, was comparable to the mean age of the patients who survived (76.2±10.28 vs. 71±7.0; P=0.08). All the patients who died were females. Conclusion: With the increase in population of elderly in Indian Subcontinent, a policy focused in injury management should take into consideration for peri and post-operative mortality after fractures around the hip region.

The pollution of food, water, air, noise, and the proper style of living all contribute to making life a chore. Drugs are one of many things that slowly seep into our lives, leaving us open to all kinds of negative repercussions. Although concerns about adverse medication reactions have been more current in recent years due to our growing understanding of the structure and characteristics of the pharmaceuticals employed, they have existed for as long as medicine itself. Modern medications are comparable to nuclear energy. They have the power to move mountains when utilized properly, but when mishandled, they have no effect short of ultimate annihilation.

Introduction. Making functional and subjectively satisfactory prostheses is demanding. In most cases, patients have difficulty getting used to new dentures.The aim of the study was to examine the number of patient visits in the first two months after  rehabilitation with removable dentures. Materials and methods. The research followed 32 (thirty two) patients of the Department of Dental Prosthetics at the location of DZ Stari Grad, Publi institution Health Center of Sarajevo Canton. The inclusion factor was the insertion of one or two new mobile dentures. The number of post-insertion self-initiated control visits during adaptation was recorded. Patients were followed for two months. The age, sex of the patient, and the  type of difficulty were noted. Results. The study involved 21 women and 11 men. The average age of the respondents was 66.6 years, with standard deviation of SD=9.3. There were 46 self-initiated visits in total, with 49 difficulties identified. On average, there were 1.4375 self initiated control visits. Pain and discomfort were identified in 89.8%, and occlusal problems in 10.2% of cases. Conclusion. Difficulties recorded were pain and occlusal disturbances, which is not in accordance with the results of other authors, where the most common problem is insufficient prosthesis retention.

: The most frequent eye condition seen by general practitioners is acute bacterial conjunctivitis, which is thought to account for about 1% of all primary care visits. The classification, aetiology, clinical presentation, complications, differential diagnosis, in vitro tests, and treatment of acute bacterial conjunctivitis are all reviewed in this article. Both doctors and people have typically chosen topical antibacterial medication up until now since it typically shortens the course of the illness [1].

Inflammation of the tissues posterior to the orbital septum within the bony orbit is known as orbital cellulitis (OC), but the word is typically used to refer to infectious inflammation. Eyelid erythema and edoema, vision loss, fever, headache, proptosis, chemosis, and diplopia are some of its symptoms. A sinus infection, an infection of the eyelids or face, or even hematogenous dissemination from afar are the common causes of OC. OC is a rare disorder that can affect people of various ages, but it is more common in children. With improvements in diagnostic and therapeutic options, the condition's morbidity and death rates have decreased; yet, even in the era of modern antibiotics, OC can still result in major consequences that can endanger sight and life.

Erythema Nodosum (EN) is the inflammatory condition of the subcutaneous fat and considered the most common panniculitis. The process usually shows an acute onset and self-limited course. It is classically characterized by the sudden eruption of several erythematous, tender, non-ulcerating nodules and plaques, typically located on the shins, ankles and knees. Occasionally, other areas may be involved, including the thighs, extensor aspects of the arms, neck and even the face. The nodules range from 1 to 5 cm or more in diameter and may become confluent resulting in erythematous plaques. Early lesions show a bright red colour and are raised slightly above the skin. After a few days, they become flat, with a livid red or purplish colour. Finally, they show a yellow or greenish appearance, often taking on the look of a deep bruise, and for that reason the process was classically named ‘erythema contusiformis’ The condition normally resolves spontaneously without ulceration, scarring or atrophy, but recurrent episodes are common. Often, acute bouts of EN are associated with a fever of 38–39°C, fatigue, malaise, arthralgia, headache, abdominal pain, vomiting, cough or diarrhoea [1]. EN is a cutaneous reactive process that may be triggered by a wide variety of infectious and inflammatory disorders and, less commonly, by malignant neoplasms and medications. The most common triggers are Bacterial and Viral infections, Sarcoidosis and Inflammatory bowel disease, often the aetiology remains unidentified. Women seem to be less affected than men, with a ratio of 6:1, and the disease occurs mostly between the second and fourth decades of life even though all ages may be concerned [2].

Aim: This study was designed to determine if there is a correlation between celiac disease in children with autism. Materials and Methods: 40(11 female and 29 male) autistic children aging 4 to 9 years (median age 6.5 years) and 40 healthy age- and sex- matched  (11 female and 29 male ) were participated   in this prospective study , all the patient & control were tested for IgG and IgA anti-tissue transglutaminase antibody and for IgG and IgA antigliadin antibody, none of the patients and controls had symptoms (or positive family history) suggestive of specific gastrointestinal diseases. Results: IgA anti-tissue transglutaminase antibody was found in 3 autistic child (7%) and 2 control (5%) p = 0.64, none of the patient and control were positive for other tests (IgG anti-tissue transglutaminase antibody, IgG and IgA antigliadin). Conclusions: The present study demonstrated that gluten sensitivity is not a major cause in those autistic children examined.

Background: Malnutrition is a health issue that arises from the body receiving insufficient nutrients from meals. Mothers are in charge of feeding their children, and with the right information, they may shield them from this health issue. Present study was carried out to evaluate the knowledge towards malnutrition among mothers having under 5 children attending Primary Health Center, Dhanot of District Kangra. Methods: This cross sectional study was conducted between January 2022- March 2022 among postnatal mothers came in OPD at Primary Health Center, Dhanot of District Kangra and selected by convenience sampling technique. Data was collected through face-to-face interview using a semi-structured questionnaire. Data was analyzed using epi info v7 software using appropriate statistical tests. Results: A total of 400 Mothers came to OPD and having children aged less than 5 year were selected after explaining the purpose of the study. Among the total mothers, maximum 287(71.75%) were having age between 26-30 years, educated up to Matric & Senior Secondary 181(45.25%) Hindu 369(92.25%), Housewife 319(79.75%), Multigravida 299(74.75%) and delivered in government hospitals 293(73.25%). In the present study 8.5%(34) mothers’ had very good knowledge (16-20 marks) towards malnutrition , 68.0%(272) having good knowledge (12-15 marks), 16.75%(67) having fair knowledge (8-11 marks) and 6.75% (27) having poor knowledge (<8 marks). Conclusions: The current study comes to the conclusion that mothers are well-informed about malnutrition. To improve the nutritional status of children under the age of five, appropriate education that emphasizes the prompt commencement of breastfeeding, complementary feeding, and meal variety is required.

Background: Few studies have been conducted in Himachal Pradesh to assess the level of awareness and knowledge of the population about diabetes mellitus (DM) risk and preventative factors. The objective of this study was to measure this knowledge among attendees of a primary care center Dhanot of District Kangra. Material & Methods: This cross sectional study was conducted between August-December 2020 among OPD patients attending Primary Health Center, Dhanot of district Kangra selected by convenience sampling technique. Information regarding their socio-demographic characteristics and knowledge, regarding risk and preventive factors for Diabetes Mellitus were obtained using a self-administered, pre-tested, semi-structured questionnaire. Data was analyzed using Epi info v7 software using appropriate statistical tests. Results: In the present study, 35% (140) of the Patients fall were below 40 years of age while 65% (260) were above 40 years. 54% (216) of patients were male and 46% (184) were female. In the present study, 102 (25.5%) participants told the Genetic is the risk factor of diabetes, 189 (47.25%) Ageing 235 (58.75%) Family History, 234 (58.5%) Lack of physical activity/Exercise, 198 (49.5%) Obesity, 87 (21.75%) Smoking, 43 (10.75%) Alcohol, 301 (75.25%) Unhealthy diet, 107 (26.75%) High blood pressure and 47(11.75%) didn’t know any risk factors of Diabetes Mellitus. In the present study, 201 (50.25%) participants told that Maintenance of ideal weight is the preventive factor for diabetes, 308 (77%) Regular Exercise & yoga, 287 (71.75%) Eat healthy food, 102 (25.5%) Reduce your portion sizes, 208 (52%) Stop Smoking, 87 (21.75%) Stop Alcohol Intake, 109(27.25%) Control Blood pressure, 198 (49.5%) Avoid Stress, 175 (43.75%) Skip fad diets and 43 (10.75%) didn’t know any preventive factors for diabetes. Conclusion: Still many respondents didn’t know about the risk as well as preventive factors of Diabetes Mellitus. Programs for health education of the community about DM risk factors and preventive measures are needed.

Background: In India, anemia during pregnancy is a significant public health problem and a major cause of maternal and fetal complications including mortality. Present study was carried out to evaluate the prevalence of anemia among pregnant women at Civil Hospital Salooni in District Chamba, Himachal Pradesh. Methodology: This cross sectional study was conducted for 3 months between March 2022- May 2022 among pregnant women came in Gynecology & obstetrics OPD at Civil Hospital Salooni in District Chamba, Himachal Pradesh selected by convenience sampling technique. Data was collected through face-to-face interview using a semi-structured questionnaire. Data was analyzed using epi info v7 software using appropriate statistical tests. Results:A total of 400 pregnant women came to Gynecology & obstetrics OPD were selected after explaining the purpose of the study. Among the total, maximum 210(52.5%) were having age between 26-30 years, educated up to Matric & Senior Secondary 158(39.5%), Hindu 323(80.75%) ,housewife 372(93%) and Multigravida 276 (69%). In the present study, the mean hemoglobin level among pregnant women in our study was 8.53 g/dL with a standard deviation of 0.72. Out of 400 participants, 68(17%) had mild anemia, 102(25.5%) had moderate anemia, 6 (1.5%) had severe anemia while 224(56%) had no anemia according to WHO Criteria.Conclusion:Although the anemia prevalence among pregnant women has been decreasing in recent years, the prevalence of anemia is still high in pregnant women in Himachal Pradesh.

Background: Present study was carried out to describe the use and preferences of contraceptive methods at Civil Hospital Salooni in District Chamba, Himachal Pradesh. Methodology: Retrospective review of records of Civil Hospital Salooni in District Chamba, Himachal Pradesh covering the period 1st April 2022 to 30th April 2022 was conducted. The pattern of use and preferences of contraceptive methods was retrieved. Data was analyzed using epi info v7 software using appropriate statistical tests. Results:In the present study we found that in the month of April 2022, 350 packets of MALA-N, 5 injections of DMPA, 5 cut insertions and 400 packets of condoms were utilized atCivil Hospital Salooni in District Chamba, Himachal Pradesh.Conclusion: Every men and woman should be counseled and provided proper education regarding contraception and all the misconceptions regarding contraception should be appropriately addressed.

Guillain-Barré syndrome (GBS) is a rare, acute inflammatory disorder of the peripheral nervous system that can lead to significant morbidity and mortality. It is often preceded by an infection, with Campylobacter jejuni being a common trigger. GBS is characterized by acute flaccid paralysis, sensory dysfunction, and autonomic disturbances, with respiratory failure being one of its most feared complications. The prognosis of GBS has improved with the advent of intravenous immunoglobulin (IVIg) and plasma exchange (PE), both of which have been shown to reduce disease severity and duration. However, the ideal treatment approach remains unclear, and differences in efficacy between IVIg and PE exist, particularly in pediatric and severe cases. Early recognition and timely intervention, especially for patients requiring mechanical ventilation, are crucial to improving outcomes. Despite advancements in treatment, the mortality and morbidity rates remain high, and further research is needed to optimize therapeutic strategies and explore new treatment options.

Background: The purpose of this study was to evaluate the Perception regarding Calcium, Vitamin D and Glucosamine supplementation for Healthy Bones and Joints among females of Himachal Pradesh Material & Methods: A descriptive cross sectional survey was conducted amongst the 400 female participants in the age group of 18 to 60 years, using google forms. The questionnaire was circulated among female residents of Himachal Pradesh to gather information about their socio-demographic traits and Perception regarding Calcium, Vitamin D & Glucosamine supplementation for Healthy Bones and Joints. Epi info v7 software was used to evaluate the data using the necessary statistical tests. Results: In the present study, 37% (148) of the females were below 40 years of age while 63% (252) were above 40 years. The results of the study showed that the female participants' understanding of calcium, vitamin D, and glucosamine supplementation for healthy bones and joints was either insufficient or unsatisfactory. Most of the participated females know that the vitamin D, calcium, and glucosamine are crucial for bone health but they had insufficient knowledge regarding the function, usefulness, dose, adverse effects of these nutritional supplements Conclusion: The current study supports educational initiatives and public awareness campaigns about nutritional supplements for bone and joint health, particularly among women.