Mining activities by the community on the border of the Paguyaman River cause pollution in river waters. The direct impact can be seen in the quality of the waters. This study aimed to analyze the water quality of the Paguyaman River in the rock mining area of Motoduto Village, Boliyohuto District. This research was conducted in 2022 on the Paguyaman River. Water sampling was carried out in three places, namely before the mine site as a control, at the site of illegal mining activities during activities and after the mining site. Water quality parameters include brightness, pH and Dissolved Oxygen (DO). Total dissolved solids (TDS), Total Suspended Solid (TSS), temperature and ammonia, Biological Oxygen Demand (BOD) and Chemical Oxygen Demand (COD). The measurement results will be displayed in graphical form and discussed descriptively concerning the PP quality standards No. 22 of 2021 (Appendix VI). The laboratory analysis showed that the TSS and Surfactant parameters passed the water quality standards for Class II. The concentration of TSS in the control location was 98 mg/l and 0.009 mg/l surfactants. The concentration of TSS around the mine site is 119 mg/l and the Surfactant is 0.02 mg/l. The concentration of TSS after the mine site was 148 mg/l and the Surfactant was 0.021 mg/l. The TSS quality standard for Class II River water is 50 mg/l and the Surfactant is 0.001 mg/l. The concentration of TSS in the control location was 98 mg/l and 0.009 mg/l surfactants. The concentration of TSS around the mine site is 119 mg/l and the Surfactant is 0.02 mg/l. The concentration of TSS after the mine site was 148 mg/l and the Surfactant was 0.021 mg/l. The TSS quality standard for Class II River water is 50 mg/l and the Surfactant is 0.001 mg/l. The concentration of TSS in the control location was 98 mg/l and 0.009 mg/l surfactants. The concentration of TSS around the mine site is 119 mg/l and the Surfactant is 0.02 mg/l. The concentration of TSS after the mine site was 148 mg/l and the Surfactant was 0.021 mg/l. The TSS quality standard for Class II River water is 50 mg/l and the Surfactant is 0.001 mg/l.

There are technical problems due to the macro phenomenon of the transfer of management of the Family Planning Instructor (PKB), the reorganization of the Office for Population Control, Family Planning and Women's Protection in Lumajang Regency to only become a sector, namely the Population Control and Family Planning Sector at the Health Service, Population Control and Family Planning (DKPPKB) Lumajang Regency, has the potential to raise problems in management or institutions. The objectives of this study are: In accordance with the developing study questions, the objectives of this study are directed at: First, to describe and analyze the dynamics of PKB management transfer in supporting the optimization of institutional management in DKPPKB Lumajang District. Second, make a proposal for a model strategy for optimizing institutional management after the transfer of PKB management to the DKPPKB of Lumajang Regency. The study method used in this study uses an approach qualitative. The author does not just collect data once and then processes it, but step by step during the review process from start to finish, to be able to explore the dynamics of institutional management after the transfer of management of PKB in DKPPKB Lumajang Regency. Based on the results of the study and discussion it can be concluded: First, the dynamics of PKB management transfer in its implementation still give rise to dynamics that contribute to less optimal institutional management in DKPPKB Lumajang District. This is because the authority in fostering PKB discipline seems normative because the limitations of discipline development are not explained technically, giving rise to uncertainty for DK PPKB Lumajang Regency to enforce discipline for Civil Servants (PNS), and there is potential for dual loyalty to PKB due to employment status as Central PNS empowered in the regions, causing a decrease in PKB's commitment to the KB regional apparatus organization (OPD) in the regions which has an imp

This study analyzed the time series nature of the indicators of expenditure on health and, growth and expansion of economic activities using the traditional Augmented Dickey Fuller (ADF) unit root( henceforth UR) and test of  stationarity with structural breaks for East, Southern and West African regions  for the 1990 to 2020 period. Conventionally, our UR test indicated that all our selected series were not were not stationary at levels. The ADF test identified single most important breakpoints at levels and at first difference for each region. The identified breakpoints occurred essentially during the mid-1990s ( specifically 1993,1994 and 1996) and the early parts of 2000s when either ,or , or all expenditure on health series experienced uncommon breaks as a result of the turning point of the HIV epidemic in the regions of Africa. The case of was not different as breakpoints were also identified for each region for the 1990s and the early part of 2000s. JEL Classification: C12, C32

This research aims to analyze the risk management of zakat fund management in BAZNAS of West Nusa Tenggara Province through the Zakat Core Principles (ZCP) framework, whih includes the risk of reputation and the risk of losing Muzakki (ZCP 12), the risk of distribution (ZCP 13), and the risk of operational and sharia compliance (ZCP 14). This research uses a descriptive qualitative approach. The results showed that the BAZNAS management has implemented rules in accordance with law and regulation and has an integrated zakat information system. The results also indicated that BAZNAS of West Nusa Tenggara Province has periodically carried out risk prevention strategy in the form of data examination, system maintenance, financial inspection, and evaluation. In terms of zakat fund distribution strategy, zakat is distributed based on priority standards setting through direct coordination with Mustahik. Furthermore, the results revealed that BAZNAS of West Nusa Tenggara Province has applied the management of operational risks and sharia compliance risks, although it is still limited to risk reduction and monitoring. They also do not have a specific methodology for risk identification and measurement.  In addition, the existence of periodic supervision and control of the zakat receipt and distribution system shows that BAZNAS of West Nusa Tenggara Province already has a governance structure related to distribution.

Background: In Himachal Pradesh, a limited number of studies have been carried out to determine the population's level of awareness and understanding of the risk factors and measures to prevent Diabetic Mellitus (DM). The objective of this study was to measure this knowledge among the general population of Himachal Pradesh. Material and Methods: This cross sectional survey was conducted from January 2021 to March 2021 using Google forms among the people residing in the state of Himachal Pradesh. The questionnaire was circulated among both rural and urban residents of the state for responses using online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin till the 400 responses were collected.  Information regarding their socio-demographic characteristics and knowledge, regarding risk and preventive factors for Diabetes Mellitus were obtained. Data was analyzed using Epi info v7 software using appropriate statistical tests. Results: A total of 400 respondents including 150(37.5%) were from urban area and 250(62.5%) were from rural area were participated in the study. Among the participants of the majority 268(67.0%) were males, 182(45.5%) were between 18-30 years, 152(38.0%) were Graduate, 254 (63.5%) were employee, 247(61.75%) were married and 383 (95.75%) were Hindu. In the present study 66(16.5%)  study participants had very good knowledge (9-10 marks) towards risk factors for Diabetes, 259(64.75%) had good knowledge  (7-8 marks), 70(17.5%) had fair knowledge  (4-6 marks) and 5(1.25%) had poor knowledge  (<4 marks) towards risk factors for Diabetes. Similarly, 39(9.75%) study participants had very good knowledge (9-10 marks) towards preventive measures about Diabetes, 288(72%) had good knowledge (7-8 marks), 54(13.5%) had fair knowledge (4-6 marks) and 19 (4.75%) had poor knowledge (<4 marks) towards preventive measures about Diabetes. Conclusion: Many survey participants were still unaware of the risk and protective factors for diabetes mellitus. There is a need for community health education programmes about DM risk factors and preventive measures.

Stunting is a condition of chronic malnutrition accompanied by complications of the disease. The prevalence of stunting in children under five in Indonesia is 29.9% and in Lampung province, 27.4% as well as most in rural areas. The condition of prevalence of stunting in Lampung is in the position of below the national figure but still above 20% (the WHO target is less than 20%). Regency Tanggamus number edit decreased to 3.3%, however, thereby 25 villages have a number stunting prevalence above 10%. Village with land The average yard is wide enough to be used by maximum as land economical and needs handling, so it can be an acceleration program stunting prevention. Destination This study explains the effect of fertility and utilization of land yards against _ stunting in Tanggamus Regency. The method uses a case-control design with locations in 16 villages in the Tanggamus district working area with as many as 200 respondents, using multiple logistic regression analysis. There are 3 variables from 12 variables that simultaneously affect the incidence of stunting, namely the motivation of the head of the family in utilizing the yard of the house, the experience of the head of the family in utilizing the land of the home yard and the level of soil fertility in the yard. The low fertility rate with motivation-experience of using poor yard land, indirectly affects the incidence of stunting in Tanggamus Regency by 27.6% and 73.4% is influenced by other factors.

Background: In order to supply the necessary nutrients and energy for continuing growth and development, complementary feeding is required. The current study was conducted in Himachal Pradesh to assess the understanding of complementary feeding among females of reproductive age. Methods: This cross-sectional survey of females in the state of Himachal Pradesh who are of reproductive age was carried out between July 2022 and September 2022 using Google forms. Until 400 replies were gathered, the google form was distributed among female residents of the state in the reproductive age group for responses via online means including email and social networking sites like Whatsapp groups, Facebook, Instagram, and Linkedin. We gathered details about their sociodemographic make-up and their understanding of complementary feeding. Epi info v7 software was used to evaluate the data using the necessary statistical tests. Results: A total of 400 females were participated in the survey. Among them, maximum 196 (49%) were having age between 26-30 years, educated up to Matric & Senior Secondary 160 (40%), Hindu 378(94.5%) and housewife 361 (90.25%). In the present study 7.75% (31) participants had very good knowledge (16-20 marks) towards complementary feeding, 71.5% (286) having good knowledge (12-15 marks), 17% (68) having fair knowledge (8-11 marks) and 3.75% (15) having poor knowledge (<8 marks). Conclusions: Participants in the study had adequate knowledge of complementary feeding. To increase mothers' complementary feeding knowledge and feeding practises, appropriate complementary feeding education that emphasises prompt commencement and meal variety is required.

The Iraqi economy has been suffering from the phenomenon of stagflation for many years as a result of wars and political and economic fluctuations that the country has witnessed. The Iraqi government is trying to take the necessary measures, and through the important and effective role of fiscal policy in regulating economic activity, to address the phenomenon of stagflation through its well-known tools.. The current study sought to explore the impact of fiscal policy in treatment the phenomenon of stagflation in the Iraqi economy during the period (2003-2020) and to show the effectiveness of its tools based on the main premise that fiscal policy plays an important role in addressing stagflation in Iraq, as data analysis was conducted Regarding the variables, standard analysis and its tools such as multiple linear regression were used after testing the stability of the time series through the program (Eviews.12) in estimating the effect of financial policy tools in treatment this phenomenon in Iraq The study found that there is no clear correlation between the variables of the study, and that the policy did not play an active role in addressing the recessionary inflation in the country due to several factors, and recommended the need to promote the optimal use of fiscal policy instruments and increase the effectiveness of performance in order to stimulate the economy and get rid of the stagnation affecting the economy in the country.

Background: Screen-based media have become an important part of human lifestyle. In view of their easy availability, increasing use in Indian children & their excessive use is being linked to physical, developmental and emotional problems. Excessive screen hours has been found to be associated with various health problems in children. This study was done to evaluate the pattern of Screen hours among school going children of New Delhi. Methods: A cross-sectional study was performed in January to March 2022 among 400 students chosen using a simple random sampling procedure in New Delhi. Data was collected through school teachers based on their observation and analyzed using Epi info version 7. To predict the relationship between the screen hours and its associated factors, a univariate analysis was done. At a p-value of 0.05 was taken as statistically significant. Results: Present study included 180(45%) females and 220(55%) males school children from New Delhi. Among them 243(60.8%) were ≤10 years while 157(39.2%) were >10 years old. Among the total 317(79.3%) school children had screen hours <2 hours per day while 83(20.7%) had ≥2 hours per day. 355(88.8%) school children watched TV <2 hours per day while 45(11.2%) watched ≥2 hours per day. 349(87.3%) school children using smart phone <2 hours per day while 51(12.7%) using ≥2 hours per day. 344(86.0%) school children had habit of internet surfing <2 hours per day while 56(14.0%) had ≥2 hours per day. 363(90.7%) school children play videogames/games on mobile <2 hours per day while 37(11.2%) play ≥2 hours per day. 251(62.7%) school children didn’t have habit of watching Mobile/TV before sleeping while 149(37.3%) had this habit. In the present study there was no significant difference duration of screen hours, duration of watching TV, Duration of using smart phone, duration internet surfing, duration of videogames/games on screen and habit of watching Mobile/TV before sleeping among male and female school children. Similarly, school children who were more older than 10 years had significantly more duration of screen hours, more duration of watching TV, more duration of using smart phone, more duration internet surfing and more often had habit of watching Mobile/TV before sleeping while there no significant difference between duration of videogames/games on screen according to age groups. Conclusion: The present study findings suggest that many school children were spending more than the recommended duration in front of screen and necessitates actions at family, school, community, government and policy level actions to reduce screen hours associated with smart phone , television, internet surfing and video game use.

Background: The study was conducted to assess the Severity of Diabetic retinopathy (DR), Central Macular Thickness (CMT), Clinically significant macular edema (CSME) and Best Corrected Visual Acuity (BCVA) among Patients of Type 2 Diabetes Mellitus present at Ophthalmology OPD of Tertiary Care center Material and 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), Severity of Diabetic retinopathy (DR), clinically significant macular edema (CSME) and Best Corrected Visual Acuity (BCVA) were performed to all patients. Results: 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. Among 130 study subjects best-corrected visual acuity of right eye was 6/9 or better in 68.5% (n = 89), between 6/12–6/24 in 20.0% (n = 26), between 6/36–6/60 in 8.5% (n = 11) and worse than 6/60 in 3.1% (n = 4). Best-corrected visual acuity of left eye was 6/9 or better in 67.7% (n = 88) subjects, between 6/12–6/24 in 20.8% (n = 27), between 6/36–6/60 in 7.7% (n = 10) and worse than 6/60 in 3.8% (n = 5). Clinically significant macular edema (CSME) was present in 30% (n = 39). There were 24.6% (n = 32) with no diabetic retinopathy, 20.8% (n = 27) with Very mild NPDR, 20% (n = 26) with Mild NPDR, 19.2% (n = 25) with Moderate NPDR and 15.4% (n = 20) with Severe NPDR. Conclusion: Present study concluded that a complete ophthalmologic examination including Central Macular Thickness (CMT), Severity of Diabetic retinopathy (DR), Clinically significant macular edema (CSME) and Best Corrected Visual Acuity (BCVA) is necessary among all Patients of Type 2 Diabetes Mellitus.

Background: Global statistics recorded that there were 1,116 welding accidents, of which 19.8% ended in death. Welding workers in Bandung Raya often have accidents that result in lost working days. Therefore, it is necessary to take risk control efforts based on the identification and risk assessment of workers. Material and Methods: This study uses a descriptive observational research design. The study was conducted by field observation to 15 welding kiosks, the results of which were summarized. The risk assessment method uses JSA with risk assessment steps that refer to the welding work steps. Results: Based on the results of the study, it can be seen that the stages of the welding process for informal sector workers are, preparing materials, cutting iron, welding processes, and finishing. The results of the hazard identification identified three hazards, namely physical, chemical, and ergonomic. The results of the initial risk assessment show that there are 2 extreme risks, 7 high risks, and 5 moderate risks. While the remaining risk is 8 high risk, 1 moderate risk, and 5 low risk. Recommended efforts include using safety googles, face shields, safety shoes, safety gloves, providing light fire extinguishers, and providing seats.

Background: This study compared the Rescue analgesic requirement in ultrasound-guided 4-in-1 nerve blocks with Bupivacaine and Dexmedetomidine in two doses for knee and below-knee orthopaedic operations. Material and Methods: Patients who were scheduled for below-knee and knee procedures under SAB underwent a comparison study. 100 patients in all were divided into two groups at random. In a USG-guided 4 in 1 block, Group a received 29 ml of 0.125% bupivacaine along with 0.5 g/kg of dexmedetomidine to make a total 30 ml solution, while Group B received 29 ml of 0.125% bupivacaine along with 1 g/kg of dexmedetomidine to make a total 30 ml solution. Results: In this study, time to first rescue analgesia in-group A and group B was 579.12±62.43 min and 730.66±93.15 min respectively. Patient’s in-group a required early intervention in terms of rescue analgesia. It was significantly longer in-group B in comparison to group A (p = 0.0001). Duration of post-operative analgesia in group A and group B was 666.48±82.45 min and 801.96±92.97 min respectively. In this study, duration of analgesic effect was significantly longer in-group B in comparison to group A (p = 0.0001). In this study, total rescue analgesic doses per patient were significantly more in group A in comparison to group B (p = 0.0001). In this study, total number of bolus doses of rescue analgesia was 123 in group A and 62 in group B which is almost double in group B in comparison to group A. Conclusion: Present study concluded that time to first rescue analgesia was significantly longer in group B in comparison to group A. Similarly, total rescue analgesic doses per patient were significantly more in-group A in comparison to group B and Total bolus doses of rescue analgesia is almost double in group A as compared to group B.

Complementary and Alternative Medicine (CAM) refers to a group of medical and health-care systems, practices, and products that are not considered to be part of conventional medicine. Medical therapies that are used in addition to or instead of traditional (mainstream) therapy are referred to as alternative medicine. It is sometimes referred to as "integrative" or "complementary" medicine. More than half of all adults in the United States say they utilize complementary and alternative medicine. The aim of the current report is to describe setup and the services and treatment selection of the complementary medicine clinic in Fayoum city, Egypt. The ethnographic approach utilized in this study was inspired by Spradley's method. Ethnography is the most venerable of qualitative research methods. The authors concluded that Complementary alternative medicine is very important effective treatment branch usually in simple complaints as headache, obese patients and bone ache and symptoms at start of disease,  but is not work alone especially in chronic or debilitating diseases, and have useless outcomes in patients with late stage diseases, over age patients and acute emergency cases, so that complementary therapy complete treatment with medical therapy in variety of cases, not rather than or alternate the medical treatment.

Background: The purpose of the current study was to evaluate the duration of analgesia following knee and below-knee orthopaedic surgery using an ultrasound-guided 4-in-1 nerve block with Bupivacaine combined with Dexmedetomidine in two doses. Material and Methods: A comparative study was carried out among patients planned to undergo knee and below knee surgeries under SAB. A total of 100 patients were randomly divided into 2 groups. Group A was given 29ml of 0.125% bupivacaine with 0.5µg/kg dose of dexmedetomidine (1ml) making it to a total 30ml solution, in USG guided 4 in 1 block while Group B was given 29 ml of 0.125% bupivacaine with 1µg/kg dose of dexmedetomidine (1ml) making it to a total 30 ml solution, in USG guided 4 in 1 block. In the study, Duration of analgesia or Total pain free period was defined as the time interval between the pain free periods after administration of the spinal block to the first rescue analgesic administration. Results: In this study, mean age of the participant was 40.64±11.44 years in Group A and 40.12±12.55 years in Group B ranging from 18 years to 60 years. Maximum participant in Group A (n = 18) aged between 41 and 50 years and in Group B (n = 17) were aged between 30 and 40 years. Only 10 participants aged below 30 in both the groups. The study population comprised of 36 males in Group A and 31 males in Group B and 14 females in Group A and 19 females in Group B. There was no significant difference of gender between both groups (p = 0.287). Duration of post-operative analgesia in group A and group B was 666.48±82.45 min and 801.96±92.97 min respectively. In this study, duration of total pain free period was significantly longer in-group B in comparison to group A (p = 0.0001). Conclusion: The study concluded that duration of total pain free period was significantly longer in-group B in comparison to group A.

Background: The present study was aimed to compare the Fibreoptic assessment of three different techniques of i-gel insertion i.e. standard, rotational, triple airway maneuver in anaesthetised paralysed adults. Material and Methods: A total of 150 patients were included in this Prospective Randomised Trial at Department of Anaesthesia, Dr. R.P.G.M.C. Kangra at Tanda during the study period. The patients were divided into 3 groups with 50 patients each. The patients in group A included standard technique, group B with rotational technique, and group C included triple airway maneuver. The three groups were graded after Fibreoptic assessment using the Brimacombe scale, which consists of a four-point scoring system. Results: In our study, in standard group fibreoptic assessment was grade 4 in 82% of the patients, grade 3 in 12% and grade 2 in 6%.In rotational group, fibreoptic assessment was grade 4 in 86% of the patients, grade 3 in 12% and grade 2 in 2%. In triple airway maneuver group fibreoptic assessment was grade 4 in 94% of the patients, grade 3 in 4% and grade 2 in 2%. There was no significant difference in fibreoptic assessment between three groups (p = 0.365). Conclusion: Present study concluded that all the three groups were comparable according to grading after Fibreoptic assessment using the Brimacombe scale.

Background: Sufficient sleep is essential in school children as it directly impacts mental and physical development. However, chronic sleep loss continues to increase in our country. This study was done to evaluate the sleep pattern among school going children of New Delhi. Methods: A cross-sectional study was performed in January to March 2022 among 400 students chosen using a simple random sampling procedure in New Delhi. Data was collected through school teachers based on their observation and analyzed using Epi info version 7. To predict the relationship between the Sleep pattern and its associated factors, a univariate analysis was done. At a p-value of 0.05 was taken as statistically significant. Results: Present study included 180 (45%) females and 220 (55%) males school children from New Delhi. Among them 243(60.8%) were ≤ 10 Years while 157(39.2%) were >10 years old. In the present study, 198(49.5%) school children had adequate sleep hours of 6-8 hours, 174(43.5%) had sleep hours of more than 8 hours and 28(7%) had sleep duration of less than 6 hours. 364(91%) school children had onset of sleep with in 30 minutes after going to bed while 36(9%) had after 30 min or more than that. 251(62.7%) school children didn’t have habit of watching Mobile/TV before sleeping while 149(37.3%) had this habit . In the present study there was no significant difference in Average duration of sleep per day on a weekday, Onset of sleep after going to bed and Habit of watching Mobile/TV before sleeping among male and female school children. In the present study the school children who were less than 10 years had significantly more adequate duration of sleep of 6-8 hours and had onset of sleep with in 30 minutes after going to bed and significantly less habit of watching Mobile/TV before sleeping as compared to children who were more than 10 years old. In the present study, 216(54%) school children rate their sleep quality to highest of 5, 135(33.8%) rate to 4, 41(10.3%) rate to

Background: One of the most significant global public health issues is Tuberculosis (TB). The community still has to be made aware of the problem if TB is to be prevented and controlled. The objective of this study was to evaluate this awareness among the general population of Punjab. Material and Methods: This cross-sectional survey of residents of Punjab was carried out between April 2022 and May 2022 using Google forms. Until 400 replies were gathered, the questionnaire was distributed among state citizens in rural and urban areas via email and social media sites such as 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%) participants had very good (32-40 marks) awareness and Perception about Tuberculosis, 122 (30.5%) had good (24-31 marks), 147 (36.75%) had fair (16-23 marks) and 95 (23.75%) had poor (<16 marks) awareness and Perception about Tuberculosis. Conclusion: According to survey findings, the community's knowledge and perception of Tuberculosis (TB) and efforts to control it are often either insufficient or unsatisfactory.

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 Compare the clinico-epidemiological factors responsible for differential 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 RPGMC 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. Mean BMI of the patients who died, was comparable to the mean BMI of the patients who survived (22.48±1.74 vs. 22.32±1.97, p = 0.325). 20% of died patients had grade 3 Singh’s Index, 20% had grade 2, 20% had grade 6 and 40% had grade 1 Singh’s Index. Singh’s index was comparable between both groups (p = 0.001). 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.

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 analyse the effect of BMI, Bone density and co-morbidities on the outcome and mortality among elderly patients (60 years & above) undergoing 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 RPGMC 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. Udai Pareek scale showed 35.7% of these patients in class IV while 34.5% patients were in class III. Mean BMI of the patients was 22.33±1.95 Kg/m2 with a range from 18.6 to 26 Kg/m2. Bone density measurement by Singh’s index shows that majority of the patients (32.1%; n = 27) were in grade 4 while 22.6% (n = 19) patients were in grade 6 and 21.4% (n = 18) in grade 5. There were 4 (4.8%) patients in grade 1 and 2. 52.4% (n = 44) had fracture of right femur while remaining 47.6% (n = 40) patents had fracture of left femur. Conclusion: The fracture neck of femur and hip fracture pose a significant risk of mortality and morbidity on the society and need to be focused.

Current water safety campaigns include; Keep Watch, Saving Lives in the Water, Play it Safe by the Water; Safe Barriers Save Lives, The Water Safety Reduce Drownings Initiative, and World Drowning Prevention Day. This project is a photographic initiative. Methods; Two photographs were merged in Adobe photoshop; an inside household dome downlight shining on the ocean. The accompanying caption; “Let’s shine a light on water safety in Australia” was to capture attention and create interest. Respondent survey questions were is it A) novel? B) interesting? C) a clear message? D) likely to spark interest? and E) does it convey water safety importance more succinctly and quickly than pages of statistics? Results; 50 surveys were completed [62.5 % completion rate], with almost half male and half female respondents, with 48% of people aged 18-24yo. Answers coded as 1E) Extremely so; 2V) Very much so; 3M) Moderately so; 4S) Somewhat so; 5N) Not at all; 6U) Unsure. Question A]: 1E) 20%; 2V) 48%; 3M) 22%; 4S) 4%; 5N) 2%; 6U) 4%. Question B]:1E) 26%; 2V) 44%; 3M) 24%; 4S) 4%; 5N) 2%; 6U) 0%. Question C]: 1E) 32%; 2V) 42%; 3M) 18%; 4S) 4%; 5N) 4%; 6U) 0%. Question D]: 1E) 18%; 2V) 42%; 3M) 28%; 4S) 10%; 5N) 0%; 6U) 2%. Question E]: 1E) 28%; 2V) 30%; 3M) 24%; 4S) 16%; 5N) 0%; 6U) 0%. Conclusion; Most respondents indicated that this idea was extremely, very, or moderately novel, interesting, clear, likely to spark interest, and conveyed water safety importance well.

Numerous physiologic effects occur within the body during pregnancy, and the eye is no exception. This article outlines both normal physiologic changes and pathological changes in the eye that can occur from pregnancy. In the physiological changes in pregnancy, changes in cornea, intraocular pressure, visual field changes, and external changes have been discussed. In pathologic ocular changes, pregnancy induced hypertension, central serous retinopathy, benign intracranial hypertension, occlusive vascular disorders, and other miscellaneous disorders have been discussed.

Background: Work accidents are a problem for the continuity of the company, the potential damage due to work accidents is not only to humans in the form of accidents and occupational diseases but also to property and company profits. Work accidents can be prevented through a behavioral approach by increasing safety performance. Material & Methods: This study aims to analyze the factors that affect the performance of Occupational Health and Safety (OHS) based on the determinants of safety performance. This study is an observational study with quantitative methods and a cross-sectional design. The population of this study was 395 workers with a sample of 78 workers who were taken using a simple random sampling technique. The data collection instrument for the dependent variable used an observation sheet, while the independent variable used a questionnaire with a Likert scale modified from previous research and relevant theoretical indicators. Each questionnaire has favorable and unfavorable statement items with a Likert scale range of 1 to 4. The data analysis used is descriptive analysis and inferential analysis using a binary logistic regression test. Results: The results showed that social support had a significant effect on safety performance with a p-value of 0.016. Safety commitment has a significant effect on safety performance with a p-value of 0.002. OHS performance can be improved through the determinants of safety performance, namely social support and safety commitment.

Introduction: Helicobacter pylori were isolated for the first time and became the subject of studies only in the 80s. Has a cosmopolitan distribution, but its prevalence is strongly related to socioeconomic conditions of each country. It is most prevalent in the developing countries than in developed countries. Factors such as the high density of people in the household, education level, housing conditions and lack of running water has been linked to increased acquisition of infection. The serum-prevalence increases with age, but is also found the same in men and women. Objective: The objective of the work was to determine the relationship between the presence of the pathogen and changes in the gastric mucosa, based on endoscopic and histopathological analysis, as predisposing factors to malignant transformation. Method: This was a cross-sectional semi-quantitative analysis study, where the endoscopic findings were correlated in individuals who were carriers and non-carriers of Helicobacter pylori. Conclusions: Research leads to the conclusion that Helicobacter pylori infection is an important factor in the development of various gastrointestinal diseases including gastric neoplasia.

Neurofibromatosis type 1 (NF1) is a hereditary cancer predisposition syndrome which is characterized by neurologic, dermatologic and orthopaedic manifestations. There is a spectrum of tumors that affects individuals with NF1 at an increased incidence compared to the general population, such as neurofibromas, Malignant Peripheral Nerve Sheath Tumors (MPNST) and gliomas. There has been a growing number of literature reporting an association between NF1 and Gastrointestinal Stromal Tumors (GIST). It is the most common genetic syndrome with an incidence of 1 in 2,500 to 3,000 and a prevalence of 1 in 4,000 to 5,000 [1]. It has an autosomal dominant pattern of inheritance with complete penetrance; however, as many as 50% of affected individuals have been reported to be sporadic cases [2,3]. NF1 is further defined by its variable expression, resulting in a wide array of clinicopathological features and a varying, unpredictable disease course [1,2]. Occurring at an incidence of 6 to 15 per one million GIST is the most common mesenchymal tumor of the gastrointestinal (GI) tract [5]. It is only in recent years that the molecular pathogenesis of GIST has been demonstrated, with aberrant tyrosine kinase activity identified as the key modulator in the majority of cases. This advancement has allowed for molecularly targeted therapy via imatinib, a tyrosine kinase inhibitor [5,6,9]. NF1-associated GIST, however, has been described to comprise a minority of cases, in which there is an alternative molecular pathogenesis. This difference between NF1-related GISTs and that of the general population has important therapeutic implications [9]. We herein report a case of symptomatic GIST in a 62-year-old woman with a neurofibromatosis type 1.

There is an increasing trend in the western world toward the use of disposable or single use equipment to tide over this problem but for a country with low resource settings it would not be feasible. There are several advances in the development of antimicrobial agents and methods of sterilisation, yet several factors still influence their effectiveness. Sterilisation describes a process that destroys or eliminates all forms of microbial life including bacterial spores ensuring acceptable level of sterility. In this article, different types of sterilisation techniques via chemical agents has been described.

Background: Breast milk gives the infant all the nutrients they need in the right amounts and contributes to their overall health. It guards against diseases including diabetes, cancer, allergies, illness, obesity and many others. Present study was carried out to evaluate the knowledge towards breast feeding among postnatal mothers attending Primary Health Center, Dhanot of District Kangra. Methodology: This cross-sectional study was conducted between January 2022- March 2022 among postnatal mothers attending 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 Post Natal Mothers came to OPD and having children aged less than one year were selected after explaining the purpose of the study. Among the total mothers, maximum 201(50.25%) were having age between 26-30 years, educated up to Matric & Senior Secondary 165(41.25%), Hindu 376(94%), housewife 304(76%), Multigravida 278 (69.5%) and delivered in government hospitals 268(67%). In the present study 16% (64) postnatal mothers had very good knowledge (16-20 marks) towards breast feeding, 64 % (256) having good knowledge (12-15 marks), 19% (76) having fair knowledge (8-11 marks) and 1% (4) having poor knowledge (<8 marks). Conclusion: Every Postnatal Mother should receive appropriate breastfeeding advice and education during their antenatal time and all breastfeeding myths should be appropriately dispelled.

Background: A limited number of studies have been carried out in Himachal Pradesh to determine the population's level of awareness and knowledge of the risk and prevention factors for hypertension. The objective of this study was to measure this knowledge among attendees of a primary care center Dhanot of District Kangra. Material and Methods: This cross sectional study was conducted between January 2022- March 2022 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 hypertension 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 38% (152) of the Patients fall were below 40 years of age while 62% (248) were above 40 years. 53% (212) of patients were male and 47% (188) were female. In the present study, 239 (59.75%) participants told the Alcohol was a risk factor for Hypertension followed by 278(69.5%) Unhealthy diet, 327(81.75%) Increase salt Intake, 167(41.75%0 Family History/Genetic,223(55.75%) Poor Sleep, 232(58%) Ageing, 321(80.25%) Lack of physical activity/Exercise, 301(75.25%) Obesity, 202(50.5%) Smoking and 49 (12.25%) didn’t know about any risk factor for hypertension. In the present study, 329(82.25%) participants told that Reduce salt Intake is the preventive measure for hypertension followed by, 265 (66.25%)Increase fruit intake, 289(72.25%) Eat healthy food, 310(77.5%) Stop Alcohol Intake, 298(74.5%) Regular Exercise & yoga, 278(69.5%) Maintenance of ideal weight, 289(72.25%) Have sound sleep, 178 (44.5%) Stop Smoking, 212(53%) Avoid Stress and 41(10.25%) didn’t know about any preventive measure for hypertension. Conclusion: Even still, many respondents were unaware about the causes of hypertension as well as its risk factors. There is a need for community health education programmes about risk factors and preventive measures for Hypertension.

The importance of measuring the time spent on nursing activities and other processes makes the purpose of this study to identify the time of direct and indirect nursing care in the inpatient unit of Dharmais Cancer Hospital Jakarta. The type of this research is quantitative, with the statistical method used is descriptive statistics. It conducted this research with a work sampling approach by observing the activities carried out by nurses while in the inpatient treatment room for 24 hours. The results of this study show that direct nursing activities take an almost equal portion to indirect nursing activities. It is due to the possibility that the classification of inpatient ward patients is independent. Nurses should be able to analyze the level of patient dependence to provide nursing actions according to the patient's condition and ultimately improve the healing process and client satisfaction.

Background: Tuberculosis (TB) continues to be one of the most important public health problems worldwide. Creating awareness among the community still plays a vital role in preventing and controlling the spread of TB.  The objective of this study was to evaluate this awareness among general population of Himachal Pradesh. Material & Methods: This cross-sectional survey of residents of the state of Himachal Pradesh was carried out between October 2021 and December 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, with 237 (59.25%) coming from rural areas and 163 (40.75%) from urban areas. The majority's participants included 387 (96.75 percent) Hindus, 269 (67.25 percent) males, 173 (43.25 percent) people in their 18 to 30s, 155 (38.75 percent) graduates, 266 (66.5 percent) working people, and 238 (59.5 percent) married people. In the current study, 76 (19.0 percent) of the participants had very good awareness and perception of tuberculosis (32-40 marks), 169 (42.25 percent) had good awareness and perception (24-31 marks), 132 (33.0 percent) had fair awareness and perception (16-23 marks), and 23 (5.7 percent) had poor awareness and perception (<16 marks). Conclusion: Survey results suggested that awareness and perception regarding TB and its control in many of the aspects is either insufficient or not satisfactory in the community