Stroke is a disease with a high prevalence in the world. Data from WHO shows that at least 15 million people worldwide have had a stroke. The prognosis is poor and results in death in the age range 55-85 years. Likewise, the prevalence of stroke in Indonesia is also a disease that many Indonesians suffer from, with an incidence reaching 9.7% of the causes of death that occur in Indonesia. Stroke is a disease that is guaranteed by national health insurance through the INA-CBG’s tariff by BPJS in Indonesia. The aim of this study is to review the comparison of real costs in stroke care compared to INA-CBG's claims and identify factors that cause high inpatient costs for stroke patients. This research was carried out by analysing a total of 7 articles obtained through selection of 984 articles available in the database. Articles are selected that really suit the topic. The results of this review show that there is a difference in the real costs of treating stroke patients with INA-CBG's claim rates. This especially occurs in cases of haemorrhagic stroke where the patient's hospitalization costs are higher than the INA-CBG's claim rates. The high costs incurred are due to several factors such as high drug costs, intensive care treatment that uses certain medical facilities and equipment, and suboptimal compliance with clinical pathways (CP). Thus, hospitals must carry out strict quality control and cost control in cases of treating stroke patients in hospitals.

Glaucoma, a leading cause of global vision impairment, often manifests asymptomatically in its early stages, emphasizing the critical need for heightened awareness and routine eye examinations. This study focuses on Himachal Pradesh, a region marked by unique cultural diversity, aiming to unravel the understanding of glaucoma among its residents. Material & Methods: A cross-sectional survey design was employed in Himachal Pradesh from August to November 2023. The study included 400 adults aged 18 and above, utilizing a Google Form questionnaire encompassing socio-demographic details and 20 structured knowledge-related questions on glaucoma and its risk factors. Data analysis involved Epi Info V7 Software, applying appropriate statistical tests. Results: Among the 400 participants, 25.75% demonstrated very good knowledge, 33.5% good knowledge, 24.5% fair knowledge, and 16.75% poor knowledge regarding glaucoma and its risk factors. Knowledge gaps were identified, notably in areas such as advanced diagnostic tests, treatment approaches, and the perception of glaucoma as a common eye condition in Himachal Pradesh. Conclusion: This study provides valuable insights into the current state of glaucoma awareness in Himachal Pradesh, revealing varying knowledge levels among its diverse population. Regional disparities, sociodemographic influences, and specific challenges were identified, emphasizing the need for targeted community interventions and awareness campaigns.

Hypertension, a global cardiovascular health concern, requires heightened awareness for effective prevention and management. This study delves into the awareness and knowledge of hypertension among the residents of District Kinnaur, Himachal Pradesh, in the unique backdrop of the Himalayan region. Materials & Methods: A cross-sectional survey design was employed to evaluate the awareness and knowledge levels among 400 adults residing in District Kinnaur. A structured questionnaire, encompassing socio-demographic details and 20 knowledge-related questions, was distributed using online platforms. The survey duration spanned from August 2023 to November 2023. Data analysis involved descriptive statistics using Epi Info V7 Software. Results: Among the participants, 35.25% exhibited very good knowledge, 38% demonstrated good knowledge, 18.25% had fair knowledge, and 8.5% showed poor knowledge regarding hypertension. The respondents demonstrated notable awareness of risk factors (78%), lifestyle contributions (77.75%), and dietary recommendations (54.5%). However, understanding of "white coat syndrome" was observed to be lacking (44%). Notably, 57% were aware of healthcare resources for hypertension management. Conclusion: This study reveals a promising level of awareness and knowledge about hypertension among the residents of District Kinnaur, Himachal Pradesh. Despite positive findings, specific gaps in knowledge were identified, indicating areas for targeted interventions. Community-based awareness campaigns and educational initiatives are crucial for enhancing overall hypertension management in this region.

Breast cancer poses a significant global health challenge, demanding nuanced interventions that account for regional variations. This study focuses on District Mandi, Himachal Pradesh, exploring awareness levels and practices related to breast cancer and self-examination among women of reproductive age. Material & Methods: A descriptive cross-sectional survey was conducted from August to November 2023. The study involved 400 women in District Mandi, Himachal Pradesh, using a structured questionnaire to assess knowledge, attitudes, and practices related to breast cancer and self-examination. Data analysis employed Epi Info V7 Software, emphasizing frequencies and percentages. Results: Among 400 respondents (60.25% rural, 39.75% urban), knowledge levels were commendable, with 26% demonstrating very good, 40.5% good, 21.5% fair, and 12% poor understanding. Participants displayed positive awareness of warning signs, the importance of self-examination, and misconceptions. However, the frequency of self-examination practices necessitates attention. Conclusion: The study provides valuable insights into breast cancer awareness in District Mandi, Himachal Pradesh, emphasizing the need for targeted interventions. While knowledge levels are promising, promoting regular self-examination practices and addressing misconceptions remain crucial. Public health initiatives can leverage these findings to tailor interventions for improved breast health outcomes.

Background: Cervical cancer poses a significant global health challenge, demanding attention to disparities in awareness and healthcare access. This study, set against the captivating landscapes of District Kangra, Himachal Pradesh, investigates knowledge levels regarding cervical cancer among local residents, addressing risk factors, early signs, screening methods and preventive measures. Materials & Methods: Employing a descriptive cross-sectional survey design, our study spanned District Kangra, Himachal Pradesh, with data collected from 400 adults between August and October 2023. A Google form questionnaire assessed socio-demographic details and knowledge on cervical cancer. Scoring was based on correct responses, categorizing participants into very good, good, fair or poor knowledge groups. Statistical analysis utilized Epi Info V7 Software. Results: Of the 400 respondents, 24% exhibited very good knowledge, 37.75% good knowledge, 24.5% fair knowledge and 13.75% poor knowledge. While awareness about cervical cancer basics was commendable, gaps existed, particularly regarding human papillomavirus (HPV) and vaccination. Regional variations emphasized the need for context-specific interventions. Conclusion: This study unveils the nuanced knowledge landscapes of cervical cancer in District Kangra, Himachal Pradesh. Despite substantial awareness, targeted interventions are crucial, especially concerning HPV and vaccination. The findings provide a foundation for collaborative efforts involving healthcare providers, policymakers and community leaders, aiming to elevate cervical health awareness and practices in the region.

Oral cancer poses a significant global health challenge, necessitating a comprehensive investigation into its prevalence, awareness levels, and knowledge base across diverse populations. This study delves into the enchanting landscapes of District Shimla in Himachal Pradesh, India, serving as a microcosm reflecting broader challenges faced by diverse communities in oral health. Materials & Methods: A cross-sectional survey was conducted from August to November 2023 in District Shimla. The study included 400 adults aged 18 and above, residents for a minimum of 12 months. A Google Form questionnaire encompassing socio-demographic details and 20 knowledge-related questions on oral cancer was employed. Data were analyzed using Epi Info V7 Software, employing appropriate statistical tests. Results: The study revealed commendable awareness levels, with 91.75% having heard about oral cancer. Notably, 69.5% could identify common risk factors, but gaps exist in screening frequency understanding (25.5%). While 69.75% reported awareness of preventive measures, only 22.25% participated in oral health awareness programs. Despite the majority (59.25%) acknowledging the impact of oral cancer on daily life, gaps persist in screening knowledge. Conclusion: District Shimla exhibits a baseline awareness of oral cancer, providing a foundation for targeted interventions. Bridging gaps in screening knowledge and community engagement is crucial. Comparisons with other Indian studies emphasize the need for tailored regional interventions to address oral health disparities.

In the captivating landscapes of Himachal Pradesh, nestled amidst the Himalayan ranges, thyroid disorders remain an underexplored facet of public health awareness. The thyroid gland's pivotal role in regulating bodily functions makes understanding its disorders crucial. Despite global prevalence and varied environmental factors, the awareness and knowledge of thyroid disorders among Himachal Pradesh's populace have yet to be comprehensively investigated. Material & Methods: This cross-sectional survey, conducted between July and October 2023, targeted 400 adults residing in Himachal Pradesh for at least 12 months. Utilizing a Google Form questionnaire, participants provided socio-demographic details and responded to 20 knowledge-based questions on thyroid disorders. Scoring criteria categorized knowledge levels into very good, good, fair, and poor. Data analysis employed Epi Info V7 Software, presenting frequencies and percentages. Results: Among 400 respondents, 54.75% were from urban and 45.25% from rural areas. Analysis revealed varying knowledge levels, with 30.25% exhibiting very good knowledge, 36.75% good knowledge, 21% fair knowledge, and 12% poor knowledge. While respondents excelled in defining hypothyroidism and hyperthyroidism, naming symptoms, and understanding diagnostic procedures, gaps existed in identifying risk factors and symptoms of hyperthyroidism. Conclusion: This study unveils a spectrum of thyroid awareness in Himachal Pradesh, emphasizing the need for targeted public health interventions. Bridging identified knowledge gaps, particularly in symptom recognition and risk factors, is crucial. The study's insights contribute not only to local discourse but also offer valuable perspectives to the broader global conversation on thyroid awareness.

This study delves into the intricate landscape of awareness concerning pregnancy, childbirth, and postpartum care among women in District Kangra, Himachal Pradesh. The distinctive socio-cultural setting of this region necessitates a comprehensive exploration of maternal health awareness, considering the transformative journey that encompasses these crucial phases in a woman's life. Material & Methods: Employing a descriptive research approach with a cross-sectional survey design, this study spanned District Kangra, Himachal Pradesh, from August 2023 to October 2023. The participants included 400 women of reproductive age, residing in the district for a minimum of 12 months. A structured questionnaire, pre - tested for clarity, covered socio-demographic details and assessed knowledge about pregnancy, childbirth, and postpartum care. Data were collected through online platforms and analyzed using Epi Info V7 software. Results: Of the 400 respondents, 66.50% hailed from rural areas, and 33.50% from urban areas. The knowledge assessment revealed variations, with 32% demonstrating very good knowledge, 35.25% good knowledge, 21% fair knowledge, and 11.75% poor knowledge regarding maternal health. While commendable awareness was observed in areas like signs of early pregnancy and breastfeeding initiation, gaps existed in recognizing preterm labor, conditions like preeclampsia, and postpartum depression. Conclusion: The findings unveil a nuanced understanding of maternal health awareness in District Kangra, highlighting both strengths and knowledge gaps. Tailored interventions are essential to address specific areas of deficiency, aligning with the socio-cultural context. This research serves as a foundation for future studies and targeted programs to enhance overall maternal care in District Kangra, Himachal Pradesh.

Background: Chronic renal failure is a chronic medical condition characterized by a progressive and irreversible loss of kidney function. Up to 50% of patients undergoing dialysis experience symptoms of depression and anxiety. The purpose of this research is to evaluate the physical, anxiety and insomnia, social dysfunction, and depressive symptoms, as well as any associations between these symptoms and demographic and clinical factors, of individuals with chronic kidney disease. Methods: This research used a descriptive cross-sectional design to examine the experiences of people with chronic renal failure in Holy Karbala City. Fifty patients with chronic renal disease who sought treatment at Imam Hussein Medical City were included in the analysis.  Results: The results of the study showed that most of the patients with chronic kidney disease had moderate psychological problems. Also, showed there was significant association between psychological aspect and sociodemographic characteristic variables like age, residency and marital status while there was no significant association with other demographic variables like gender (p = 0.111), educational level (p = 0.069), economic status (p = 0.690), number of child in family (p = 0.366) and family size (p = 0.787). Conclusion:  The effects of chronic kidney disease on patients' mental and physical well-being were found to be statistically significant, and the authors concluded that these effects were correlated with socio-demographic variables.

It is critical for hospital management information systems to understand their impact on user satisfaction. Hospitals are complex institutions with many interrelated departments and functions. To run their operations efficiently, hospitals need a management information system that can manage and unify various aspects, from patient administration to inventory management. The research method used in this research is a qualitative research method, in general the data collection method used is the literature review model. The results obtained were 6,350 articles. Furthermore, 6,340 articles were excluded, with details of 4,090 articles being duplicates, 1,990 articles not being suitable, and 260 articles being inappropriate. Thus, 10 articles were obtained that were appropriate to the topic and reviewed. This research can be concluded that the satisfaction of Management Information System (MIS) users in hospitals is very satisfied. Apart from that, it was also found that technology quality, system quality and service quality are factors that contribute to satisfaction for Management Information System (MIS) users in hospitals.

Introduction: Field company industry develop fast be one center income the largest region of West Java, has routine strict work as well as Still found incident accident Work or 1-2% human error related performance tightly For minimize it with enhancement effort prevention safety health work .Goal: Analyze connection between effort prevention with accident work on workers industry in companies in the West Java region.Research Method: Research method type descriptive correlation cross sectional approach. Amount sample as many as 125 workers with technique taking sample using random sampling. Instruments used is valid and reliable questionnaire covers questionnaire effort prevention (Cronbach Alpha value 0.986) and questionnaires accident work (Cronbach Alpha value 0.934). Univariate data analysis use calculation distribution frequency and bivariate data analysis using the Chi-Square test. Results:Research results show part large (73.6%) effort prevention on workers industry in companies in the West Java region high and partial large (57.6%) in workers industry in companies in the West Java region high, no experience incident accident work . There is connection between effort prevention (p-value 0.001) with accident Work on workers industry in companies in the West Java region. Conclusion: Recommendation for Indonesian workers need increase competence self through training or routine follow workshops about effort prevention accident Work for minimize accident work.

Background: Access to clean and safe drinking water is vital for public health, yet many regions, including the picturesque hill station of Shimla in Himachal Pradesh, India, face challenges related to waterborne diseases. Waterborne diseases, caused by pathogenic microorganisms contaminating water sources, pose significant health risks. This study assesses the awareness and knowledge of Shimla's residents regarding waterborne diseases. Materials and Methods: A descriptive cross-sectional survey was conducted from April to July 2023. The study included 400 adults residing in Shimla for at least 12 months. A structured questionnaire comprising socio-demographic data and 20 knowledge-related questions was used. Knowledge levels were categorized as very good (>80%), good (60-79%), fair (41-59%), and poor (<40%). Data analysis employed Epi Info V7 software. Results: Respondents demonstrated strong awareness in several areas, including understanding waterborne diseases' causes (81.5%), recognizing common symptoms (79.75%), and identifying risk factors (78%). However, gaps in knowledge were evident, particularly regarding vaccination awareness (24.5%) and the role of water treatment facilities (31.25%). Overall, 31.5% had very good knowledge, 36.75% had good knowledge, 21% had fair knowledge, and 10.75% had poor knowledge of waterborne diseases. Conclusion: Shimla's residents exhibit commendable awareness and knowledge of waterborne diseases, with opportunities for improvement in specific areas. Targeted public health campaigns and educational initiatives are essential to bridge these knowledge gaps effectively, ensuring that Shimla's water remains a source of life and not a cause of illness.

The early identification of hearing loss in children is paramount for fostering optimal communication and developmental outcomes. This review delves into the realm of pediatric auditory assessment, elucidating a comprehensive array of diagnostic methodologies. Ranging from newborn hearing screening to specialized behavioral and physiological tests, these approaches collectively contribute to a thorough understanding of the child's auditory capabilities. Techniques such as Auditory Brainstem Response (ABR), Otoacoustic Emissions (OAE), Visual Reinforcement Audiometry (VRA), and Pure-Tone Audiometry are discussed, highlighting their respective merits and target age groups. Moreover, the significance of timely auditory processing evaluations and the insights they provide regarding the intricate mechanisms of sound processing are also addressed. By amalgamating these diagnostic tools, healthcare professionals can tailor interventions to cater to each child's unique hearing needs, thereby optimizing language acquisition and overall developmental trajectories.

Adolescence marks a critical phase in human development, where lifelong habits and behaviors are established. Personal hygiene and care habits play a pivotal role in overall health and well-being. This study assesses the knowledge and awareness of personal hygiene and care practices among school-going adolescents in Himachal Pradesh, India, aiming to identify areas for improvement and inform targeted interventions. Methods: A cross-sectional survey was conducted among 400 school-going adolescents using a structured questionnaire. The survey covered various aspects of personal hygiene and care, and knowledge was categorized into four levels: very good, good, fair, and poor. Data analysis was performed using Epi Info V7 software. Results: The study reveals that a substantial proportion of adolescents exhibited commendable knowledge in personal hygiene and care practices. Notably, 81.75% recognized the importance of personal hygiene for overall health. Participants also demonstrated a good understanding of dental hygiene (79.5%) and proper handwashing techniques (80.75%). However, areas requiring attention include knowledge related to food safety (66.25%) and eye and ear hygiene (66.5%). Overall, 35.75% of participants exhibited very good knowledge, 42% had good knowledge, 11.75% had fair knowledge, and 10.5% had poor knowledge regarding personal hygiene and care habits. Conclusion: This study underscores the importance of personal hygiene and care awareness among school-going adolescents in Himachal Pradesh. While many adolescents demonstrate commendable knowledge in several areas, targeted educational interventions are needed to address specific gaps and reinforce existing understanding. Comprehensive hygiene education programs can empower adolescents to make informed choices about their health, contributing to their improved well-being.

Erythema infectiosum (fifth disease) is a common benign pediatric condition caused by BI9 parvovirus. It can be identified clinically by a "slapped cheek" appearance that is often followed by reticulated exanthem on the trunk and extremities. This case report provides a concise overview of erythema infectiosum in a 7 year old girl child who presented with a fairly prominent classic rash and generalized symptoms.

Antimicrobial resistance (AMR) is a global public health threat that jeopardizes the effectiveness of antibiotics and antimicrobial treatments. Understanding the levels of awareness and knowledge about AMR among the general public is crucial for developing targeted interventions. This study assessed AMR awareness and knowledge among the residents of Shimla, Himachal Pradesh, India. Materials and Methods: A cross-sectional survey was conducted in District Shimla, Himachal Pradesh, from April 2023 to June 2023. The study included 400 adult participants residing in both urban (67.75%) and rural (32.25%) areas. A structured questionnaire covering socio-demographic information and 20 knowledge-related questions on AMR was administered. Data were analyzed using Epi Info V7 Software, and results were presented as frequencies and percentages. Results: The study revealed varying levels of AMR awareness and knowledge among respondents. Approximately 50.5% of participants understood AMR's significance for public health. However, only 21.75% could name at least three microorganisms prone to antibiotic resistance. While 47.75% recognized individual roles in preventing AMR, specific best practices for responsible antibiotic use were known to 38% of respondents. A notable 49% acknowledged the role of healthcare professionals in AMR prevention. Moreover, 30% of participants recognized the importance of reducing antibiotic use in agriculture. Awareness of international organizations or initiatives combating AMR stood at 20.5%. Conclusion: The study highlights moderate AMR awareness among Shimla's residents, but significant knowledge gaps persist regarding contributing factors and practical guidelines for responsible antibiotic use. Tailored public health campaigns and educational initiatives are essential to bridge these gaps and inspire proactive measures in the community. Collaboration between public health authorities, educational institutions, and community organizations is vital to address AMR effectively and safeguard public health.

Background: Thyroid disorders, including hypothyroidism and hyperthyroidism, pose significant challenges to public health, particularly among women of reproductive age. The thyroid gland's role in regulating metabolism, energy balance, and hormone production underscores its importance in overall well-being and reproductive health. Despite their prevalence and potential health consequences, thyroid disorders remain enigmatic, emphasizing the need for improved awareness and knowledge, especially among this demographic. Materials and Methods: A cross-sectional survey was conducted in District Shimla, a region characterized by diverse demographics and unique healthcare challenges. Over three months in 2023, data were collected from 400 reproductive-age females using a validated Google Form questionnaire, encompassing socio-demographic information and 20 knowledge-based questions about thyroid disorders. Data analysis employed descriptive statistics to assess knowledge levels and identify gaps. Results: The study revealed a mixed landscape of knowledge among participants. While many could define thyroid disorders and recognize common symptoms, specific areas, including thyroid hormone functions, risk factors, and the role of iodine, displayed knowledge gaps. Approximately 29.5% had very good knowledge, 39.25% good knowledge, 18.5% fair knowledge, and 12.75% poor knowledge about thyroid disorders. Notably, lifestyle influences and alternative treatments were areas with limited awareness. Conclusion: This study underscores the importance of enhancing awareness and knowledge of thyroid disorders among women of reproductive age in District Shimla. Addressing knowledge gaps through targeted educational interventions can empower individuals to make informed decisions about their thyroid health, reproductive well-being, and overall quality of life. Improved awareness may lead to early detection, effective management, and better health outcomes in this population.

Background: Scabies is a highly contagious parasitic skin infestation caused by Sarcoptes scabiei var. hominis and remains a significant global public health concern, especially in low-resource settings. Medical officers play a crucial role in identifying and managing scabies cases, making their knowledge and awareness critical in combating the disease effectively. Methods: A cross-sectional survey was conducted among 400 medical officers working in Himachal Pradesh to evaluate their knowledge and awareness regarding scabies. A structured questionnaire was used to assess their understanding of clinical presentation, diagnostic criteria, treatment modalities, and preventive measures for scabies. Data were analyzed using Epi Info V7 software, and knowledge levels were categorized as very good, good, fair, or poor. Results: The majority of medical officers demonstrated good knowledge regarding the etiology and clinical presentation of scabies, with 83.75% correctly identifying its cause and 89% describing typical skin lesions and intense itching. However, only 47.25% understood the pathophysiology of scabies infestation. Knowledge of diagnostic criteria and recommended treatment was satisfactory (74.5% and 80.5%, respectively), but only 43.25% recognized the importance of contact tracing in scabies control. Overall, 28.5% had very good knowledge, 40% had good knowledge, 21.75% had fair knowledge, and 9.75% had poor knowledge regarding scabies. Conclusion: Medical officers in Himachal Pradesh exhibited good knowledge and awareness of scabies, but certain areas showed room for improvement. Enhancing knowledge in these specific domains through targeted educational interventions can aid in early diagnosis and effective management of scabies, ultimately reducing the disease burden in the region and similar epidemiological contexts.

Background: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder among women of reproductive age, characterized by hormonal imbalances and ovarian cysts. Despite its high prevalence, there is limited information on the level of awareness and knowledge about PCOS among women attending outpatient departments. Methods: A descriptive, hospital-based cross-sectional survey was conducted in the outpatient department of Civil Hospital Theog, Himachal Pradesh. A sample size of 400 women aged above 18 years was selected using convenience sampling. A structured questionnaire consisting of 20 knowledge-related questions was used to assess awareness about PCOS. Data were analyzed using appropriate statistical tests. Results: The study revealed that 24.75% of participants had very good knowledge, 36.5% had good knowledge, 28% had fair knowledge, and 10.75% had poor knowledge regarding PCOS. While participants demonstrated awareness of PCOS definition, signs and symptoms, there were gaps in knowledge related to risk factors, long-term consequences, and dietary guidelines. Conclusion: The findings highlight the need for targeted educational interventions to improve knowledge and understanding about PCOS. Healthcare providers and policymakers should emphasize accurate information on risk factors, long-term consequences, and lifestyle management. Addressing emotional and psychological aspects and providing specialized care and resources for women with PCOS can enhance overall well-being.

Obesity is a chronic life threatening disorder caused by the excessive fat deposition in the body that increases the risk of other co-morbidities. Genetic and epigenetic alterations interplay important role in the development of obesity and metabolic disorders. These changes lead not only obesity but also play important role in the development of co-morbidities such as type-2 diabetes, cancer, thyroid imbalance, heart diseases, non-alcoholic fatty liver disease and hypertension.  Literature search was done with help of PubMed, PubMed-central and Google scholar for the relevant literature. In this review, we are trying to explore genetic and epigenetic signatures in obesity, metabolic dysfunctions and other co-morbidities. Lifestyle also plays important role in the development of obesity and metabolic disorders. Environmental factors affect genes related to metabolism regulation epigenetically without changing genome sequences and leads to obesity and other co-morbidities.

Background: According to the Bio-Medical Waste (Management and Handling) Rules, 1998 of India, "bio-medical waste" refers to any waste, which is generated during the diagnosis, treatment or immunization of human-beings or animals, or in research activities pertaining thereto, or in the production or testing of biologicals. The success of a bio-medical waste management (BMWM) program depends upon the knowledge and practices of the sanitary staff. Objectives: 1. To assess knowledge and attitudes about BMWM among the sanitary staff of the tertiary care hospital. 2. To describe the practices of BMWM among sanitary staff. 3. To study the socio-demographic variables related to the practice of BMWM. Materials and Methods: This hospital-based cross sectional study was conducted among 236 sanitation staff who handled bio-medical waste. They were interviewed using pretested, structured proforma consisting of socio-demographic profiles of the study participants as also questions to assess their awareness, attitudes, and practices regarding BMWM. Data were analyzed using IBM SPSS Statistics for Windows, Version 26.0. Essential statistical tests such as simple proportions and chi-square tests were applied. Results: Basic knowledge of bio-medical waste was possessed by 200 (84.7%) participants. The number of participants who had undergone training in BMWM before joining the institution was 229 (97.0%). Among the participants, 211 (89.4%) reported that bio-medical waste is hazardous. Out of the total number of participants, 234 (99.2%) reported that they wore protective gear. Knowledge of immunization was possessed by 173 (73.7%) sanitary staff members. Knowledge levels about color coding and segregation stood at over 90% among study respondents. Sanitary staff aged below 35 years had better knowledge regarding disposal of human anatomical and animal wastes (96.6%), disposal of soiled dressings (98.3%), and disposal of microbiological waste (93.3%). Among both the genders, women had better knowledge regarding waste-disposal in yellow bags. Staff educated up to the secondary level had better knowledge regarding disposal of human anatomical waste and animal waste (95.3%). Conclusion: Even though knowledge, attitudes, and practices regarding BMWM were found to be generally satisfactory, BMWM practices among sanitary staff need further improvement. Therefore, regular training programs on BMWM and its hazards need to be offered to all sanitary staff. Further, periodic evaluation should of staff-preparedness for BMWM should be carried out.

Background: Vertigo can significantly impact an individual's quality of life, leading to impaired balance, functional limitations, and increased risk of falls. In this context, we aim to investigate the level of understanding regarding vertigo among patients attending the outpatient department of Civil Hospital Jogindernagar, Himachal Pradesh. Material and Methods: This cross sectional study was conducted between January 2023-April 2023 among the patients attending civil hospital Jogindernagar, Himachal Pradesh 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 respondents including 137 (34.25%) were from urban area and 263(65.75%) were from rural area were participated in the study. Among the participants of the majority 260(65.0%) were males, 180(45%) were between 18-30 years, 154(38.5%) were Graduate, 279 (69.75%) were employee, 242(60.5%) were married and 384 (96%) were Hindu. In the present study 19.5% (78)  participants had very good knowledge (16-20 marks) towards vertigo, 29.5% (118) had good knowledge (12-15 marks), 28.75%(115) had fair knowledge (8-11 marks) and 22.25% (89) having poor knowledge  (<8 marks). Conclusion: In conclusion, this study revealed a low level of understanding regarding vertigo among patients. The findings emphasize the need for targeted educational interventions to improve patient knowledge and awareness about vertigo.

Background: Tinnitus is characterized by the perception of various phantom sounds such as ringing, buzzing, hissing, or clicking, which can significantly impact a person's quality of life. The present study aimed to assess the awareness regarding tinnitus among patients attending outpatient department of Civil hospital, Jogindernagar, Himachal Pradesh. Material and Methods: This cross sectional study was conducted between January 2023-April 2023 among the patients attending civil hospital Jogindernagar, Himachal Pradesh 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 respondents including 145 (36.25%) were from urban area and 255(63.75%) were from rural area were participated in the study. Among the total of 400  patients came to OPD, maximum  226(56.5%) were males, 118(29.5%) were having age between 21-30 years, educated up to Matric and Senior Secondary 166(41.5%), Hindu 376(94.0%) and were  employed 301(75.25%). In the present study 14%(56)  participants had very good knowledge (16-20 marks) towards Tinnitus, 30.5% (122) had good knowledge (12-15 marks), 31.25%(125) had fair knowledge (8-11 marks) and 24.25% (97) having poor knowledge  (<8 marks). Conclusion: In conclusion, the findings of this study indicate a considerable lack of knowledge and awareness about tinnitus among patients. The results emphasize the need for educational interventions and awareness campaigns to bridge the knowledge gap and empower patients to seek appropriate management strategies

Hepatitis B transmission takes place via body fluids causing higher mortality rates around the world. Various biochemicals serve as predicting factors for CHB. This study is a cross-sectional study performed over the Uttar Pradesh population to predict various prognostic markers in assessing the effectiveness of various serum levels and liver disparity among CHB infected population of the state. Various biochemical factors were studied with respect to liver adversity by analysing biochemical reports and viral load quantity of CHB patients at the Department of Medicine OPD, KGMU, Lucknow. It was concluded that ALT, AST, creatinine, INR, bilirubin serum levels, and various score (ALBI, APRI) play an important role in diagnosing liver fibrosis and the liver adversity. This study states that there is no correlation between ALT/ AST and HBV DNA levels study would help in predicting the role of serum levels via monitoring of the elevated and demoted levels of biomarkers present in body fluids.

Self-management is the main skill needed in dealing with chronic diseases which is a priority for the health care system because it causes long-term problems with various effects on the physical, psyhchological, and social well-being of the patients [1]. This scoping review determine to find out the importance of self-management among the patients with chronic diseases. Several databases such as Pubmed, Science direct, CINAHL dan EBSCHO were used to udentified relevant articles. Articles retrieved were from 2019 to 2023 using the following mesh terms ("self management"(MeSH Terms) OR "self management"(All Fields) OR ("self"(All Fields) AND "management"(All Fields)) OR "self management"(All Fields)) AND ("chronic disease"(MeSH Terms) OR ("chronic"(All Fields) AND "disease"(All Fields)) OR "chronic disease"(All Fields) OR ("chronic"(All Fields) AND "diseases"All Fields)) OR "chronic diseases"(All Fields)) AND ("adult"(MeSH Terms) OR "adult"(All Fields) OR "adults"(All Fields) OR "adult s"(All Fields)). There were eight articles selected that met the inclusion criteria, of which five were randomized control trials, two were qualitative studies and one was a cross-sectional study. The conclusion obtained is that self-management can increase independence and also quality of life in adult patients with chronic diseases. Hence, self-management should be emphasized in order to prevent further complications that may happen because of chronic diseases among adults.