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Objectives: The aim of this study was to study the patients working in stone crushing units presenting with respiratory symptoms for occupational lung disease, silicosis. Patients and Methods: Over a span of 2 years, 176 consecutive new stone crusher workers diagnosed with silicosis were clinically evaluated, including radiological investigations, spirometry, and sputum for acid-fast bacilli. Results: All patients were male manual workers with average age and duration of stone dust exposure of 42.9 years and 20.11 years, respectively; 57 (32.3%) gave a history of smoking; 33% of patients had taken anti-tubercular treatment in the past. However, sputum of none of the patients was found positive for acid-fast bacilli. Only 4 (2.2%) patients mentioned the use of gloves and masks during work shifts. Breathlessness was the most common symptom (92%), followed by cough (61.9%), chest pain (48.3%), expectoration (6.8%), hemoptysis (5.7%), and wheezing (2.8%). Chest radiograms showed opacities-small (up to 10 mm, 57.95%) and large (>10 mm, 17.04%); pleural thickening (97.2%), diaphragmatic thickening (97.2%), and calcifications (71%) etc., Predominant lesions on high-resolution computerized tomography scan of the thorax were mediastinal lymphadenopathy (94.3%), round opacities (90.3%) followed by parenchymal bands (59.1%) and linear opacities (52.8%). On spirometry, 71 (40.3%) patients had findings within the normal limits. Conclusion: It is reiterated that silicosis has severe debilitating effects on the health of subjects, and the situation warrants continuous monitoring.

Objectives and Background: To determine the pooled prevalence of depression among medical students of India by undertaking meta-analysis of published original research studies Materials and Methods: Systematic search was undertaken using PubMed and Google Scholar databases for freely available original articles published between 2014 and 2018 on the subject depression among Indian medical (MBBS) undergraduate students using PRISMA guidelines. Results: A total of 28 original research articles were identified involving 7046 medical students from different medical colleges of India. The median number of students was 284.5 (range, 86–444). All the original research articles had used standardized and validated global screening instruments for identifying depression, and none was based on clinical diagnosis. Meta-analysis of pooled prevalence estimate of depression among medical students in India by random-effects model was 40% (confidence interval [CI]: 32%–47%). Girls had a slightly higher risk of depression than boys (odds ratio = 1.06; 95% CI: 0.81–1.38). There were a total of 16 (57.1%) research articles with the presence of psychiatrist as a co-author and had a pooled prevalence of 39% (95% CI: 29%–49%). The remaining 12 studies without psychiatrist as co-author also reported a nearly similar finding, with prevalence of 44% (95% CI: 33%–54%). On subgroup analysis, it was revealed that the pooled prevalence of depression was 37.9% (95% CI: 22–55), 45% (95% CI: 42–52), and 34% (95% CI: 24–50) in research articles using study instruments Beck Depression Inventory, Depression Anxiety Stress Scale, and other miscellaneous screening instruments, respectively. Conclusion: Within study limitations, the high prevalence of depression was noted among medical students of India and the situation warrants comprehensive management by stakeholders.

Background: Substance abuse is a common practice among health-care workers across the globe. Aim: To assess prevalence and practices of tobacco, alcohol, and non-medicinal drug consumption practices among MBBS (including intern) and medical laboratory technology (MLT) students. Materials and Methods: A cross-sectional study was conducted and students underwent a face-to-face confidential interview using a predesigned, pretested, semi-structured interview schedule adapted from the Global Health Professional Student Survey. Results: A total of 283 (MBBS = 206 and MLT = 77) students participated in the study giving a response rate of 83.3%. The mean age was 20.92 (±1.75) years; 56.9% were male. Among medical students who had “ever” undertaken such practices were as follows: smoking (cigarette) (83, 40.2%), alcohol (98, 47.5%), and drug (38, 18.4%) intake, respectively; current (past 30 days) smokers were 34 (16.5%), and current (past 30 days) alcohol drinkers were 61 (29.6%). Males had a slightly higher prevalence of consumption of all substances in comparison to females except alcohol (P > 0.05). A statistically higher proportion of medical compared to paramedical (29.9% and 3.9%) students had ever drunk alcohol or consumed drug (P < 0.05). About 40 (14.1%) students had consumed all the three substances. On multiple regression analysis it was found that students staying in hostel (OR: 2.57; 95% CI: 1.3–4.8) had ever tried smoking in comparison to day-scholar (P = 0.003). Similarly, medical students (OR: 2.94; 95% CI: 1.1–7.5; P = 0.02) in comparison to paramedical students were ever alcohol drinker, and finally, drug intake was found to be statistically significant with age (above 20 years in reference to

Objective: To assess patients preference for preselected doctor attire in outpatient department (OPD) setting of a government hospital. Materials and Methods: An anonymous, predesigned, pretested, semistructured interview schedule was administered to adult (>18 years) ambulatory coherent patients. The brief questionnaire captured selected sociodemographic details of patients, department visited, and use of aprons (white coat) by attending doctor observed and desired practice. To the item—“Was your attending doctor in OPD wearing apron (white coat)?”, the possible response was yes/no. For the item—“Would you like to see your attending doctor wearing apron (white coat)?”, again the possible answer was yes/no. When a patient responded to this item as “no,” we further explored their reason for the same. The patients were shown four colored pictures each for male and female doctor in different dress. They were probed regarding their preference that they would like to see their attending doctor to be wearing. These attires were labeled as 1 = cool casual, 2 = casual, 3 = professional informal, and 4 = professional formal. Result: The mean age of 547 patients was 35.34 (±12.81) years; 322 (58.9%) were males. Out of 547 patients, nearly 395 (72.2%) wanted (desired) to see their attending doctor to be wearing apron; however, only 256 (46.8%) reported that attending doctors were actually wearing the apron in the outpatient department. Only 152 (27.7%) patients responded that it does not matter to them whether attending doctor was wearing white coat (apron) or not. Majority of patients preferred male doctor to be wearing professional formal (42.3%) and professional informal (40.9%) attire, whereas for female doctor, also majority preferred professional formal (38.7%) and professional informal (37.5%), respectively. Casuals were the least preferred attire. Conclusion: It is reiterated that majority of patients in our OPD setting preferred formal attire of attending doctor with apron, a clear and loud message for future physician in training.

Objective: To assess sleep and quality of life among chronic obstructive airway disease patients. Materials and Methods: Patients with primary, mild-to-moderate, stable chronic obstructive airways disease [asthma and chronic obstructive pulmonary disease (COPD)] on treatment visiting outpatient department of a government hospital were interviewed using a predesigned, pretested, semi-structure schedule. The patients were then administered standardized Pittsburgh sleep quality index (PSQI), St. George’s respiratory questionnaire (SGRQ), and Epworth sleepiness scale (ESS) questionnaires. Patients with any other known chronic disease, chest deformity, or long-term oxygen therapy were excluded. Using purposive sampling frame, 120 chest patients (asthma and COPD) and in addition, 30 ambulatory patients without having any underlying chronic respiratory diseases were also recruited for comparison purpose. Results: Mean age was 50.2 years. Mean duration of sleep during night was 5.40 h [±1.6; 95% confidence interval (CI) = 4.98–5.82] for patients with COPD; 5.53 h (±1.6; 95% CI = 5.11–5.95) for patients with asthma, and 6.97 h (±1.0; 95% CI = 6.57–7.36) for control patients (P < 0.001). It was noticed that 63.3% of control patients had at least 6 h of night sleep in comparison to 23.3% of chest patients (P < 0.01). Good PSQI score (up to 5 points) was found in 86.6% of control patients while it was found only in 35.0% of chest patients (P < 0.01); mean PSQI score among asthma was 8.08, 8.06 (COPD), and 3.46 among control patients, respectively. All the control patients (100%) reported good score for quality of life while chest patients reported good score for SGRQ (activity, impact, and symptoms) as 64.1, 83.3, and 82.5%, respectively (P < 0.01). Based on ESS, none of the patients complained of daytime sleepiness. To conclude, poor sleep was noticed in our study sample.

Objective: To assess students’ opinion and perception regarding education environment in a government medical college of Delhi, India. Materials and Methods: Dundee Ready Educational Environment Measure (DREEM), a universal, culturally nonspecific, generic 50-item inventory tool was used. Each item is rated on a five-point Likert scale with score ranging from 0 to 4 where 0 = strongly disagree, 1 = disagree, 2 = unsure, 3 = agree, and 4 = strongly agree. MBBS students of three batches (2nd, 3rd, and 4th year) were considered in the present cross-sectional study. Results: A total of 117 (84.1%) available students could be contacted in person, out of whom 71 (60.7%) were males; 94 (80.3%) passed their 12th class from private/convent school; nearly 88 (75.2%) students opined that administration is student-supportive; and 111 (94.8%) were in self-assessment state of “happiness.” The overall mean DREEM inventory score (range, 0–200) among all the respondents was 130.34 (±15.76), which is suggestive of “more positive than negative.” Statistically (P < 0.05) higher DREEM score was found among senior medical students [score, 136.5 (4th year) vs. 131.9 (3rd year) vs. 123.6 (2nd year)]; those medical students who were globally satisfied (score, 131.2 vs. 119.3); satisfied getting admitted in current medical college (score, 133.0 vs. 115.7); and who opined that administration is student-supportive (score, 133.4 vs. 120.9). Gender, type of school, marks in 12th class, native place, current residence, supplementary (extra attempt) in university exam, current mental state (sad/happy), and professional satisfaction had no statistical bearing on overall DREEM score. Overall, none of the inventory item (score range, 0–4) had an avg. score more than 3.5, but the score of the majority (42/50, 84.0%) of question items in the present study was in the range of 2–3 points indicating the aspects of the environment that could be improved or enhanced. Conclusion: Within limitations, the study gauges the experiential learning environment from the students’ perspective indicating overall positive results and moving in right direction. Some challenges inherent with medical education and critical areas requiring strengthening were listed including social and leisure time student involvement.

Objective: The objective of this study was to determine the prevalence of depression, anxiety, and stress among medical students. Materials and Methods: Students underwent face-to-face interview using predesigned, pretested, anonymous interview schedule using standardized survey instrument and Depression Anxiety Stress Scale 21 item. Information was also collected on sociodemographic, academic profile, and personal characteristics of students. All the students enrolled in the medical college from first to final year were invited to participate, and the study was conducted during mid-semester to ensure that there was no university examination or college festival/event. Results: A total of 187 students participated in the study giving a response rate of 94%. The participants were predominantly male (66%) and majority (65.8%) residing in hostel. It was noted that 7.5% reported parental conflict; 15.0% were “always” fearful about future life; 21.9% had poor relationship with family members; 22.5% were not satisfied with their body image; and 18.7% were globally dissatisfied. It was observed that 60 (32.0%), 75 (40.1%), and 82 (43.8%) students were affected by symptoms suggestive of depression, anxiety, and stress, respectively. On bivariate analysis, higher proportion of students with anxiety had a history of some medical condition (P < 0.05). Similarly, family history of chronic noncommunicable disorder was significantly (P < 0.05) associated with stress only while students with family history of mental illness had a higher proportion of depression (P < 0.05) only. It was also found that dissatisfaction with body image and global dissatisfaction with life was statistically (P < 0.05) associated with depression and anxiety while fair (poor) relationship with family members was statistically (P < 0.05) associated with depression only. Subjective (self) assessment of ability to cope with medical syllabus was inversely associated (P < 0.01) with ability, i.e., as the student's ability to cope with syllabus increases by one unit, the probability of occurrence of depression and anxiety decreases by 1.29 units and 0.71 units, respectively. Conclusion: It is noted that emotional distress is common among medical students, and there is an urgent need for attention, support, and personalized counseling.

Objective: The aim of the study was to determine dominant hand for routine activities and ear preference for listening among medical students. Mobile phone usage was also studied. Methodology: Medical students of three batches (2nd, 3rd, and 4th year) studying in a government medical college of Delhi (India) were considered. Out of 150 permitted (50 per batch) seats, only 139 were filled. Thus, after seeking an informed consent, a total of 117 (84.1%) available students could be contacted in person who completed the survey capturing details such as Section-I: Sociodemographic background; Section-II: Dominant hand (right/left) for undertaking routine activities, ear (right/left) preference for listening say mobile phones; and Section-III: Selected details of their mobile phones. Results: There were 71 (60.7%) males and 46 (39.3%) female students; It was found out that out of 117 students, 110 (94.0%) were right handed while 7 (5.9%) were left handed. Out of all the right-handed persons (n = 110), 94 (85.4%) preferred right ear, 14 (12.7%) left ear, and 2 (1.8%) either of the ears for listening phone. Similarly, out of all the left-handed persons (n = 07), 6 (85.7%) preferred left ear and only 1 (14.2%) right ear for listening mobile phone. Right-sided (right hand-right ear) laterality was observed in 85.4% and left-sided (left hand-left ear) laterality in 85.7% with overall (same hand-same ear) laterality of 85.4% among study participants (P < 0.01). Most common color of mobile phone was black (59, 50.4%), white (30, 25.6%), golden (13, 11.1%), silver (6, 5.1%), etc. Average time spent per day by medical students on mobile phones (either communication, Internet/WhatsApp/Facebook, listening songs, playing games, or reading E-books) was 3.83 (±2.1) h and average monthly expenditure on mobile phone was 10% of personal expenditure, i.e., Rs. 532 (±374.4). Conclusion: Our descriptive study reiterates that most participants were right handed (dominant limb) and majority of them preferred right ear for listening phones.

Objective: To assess knowledge, attitude, and practices regarding organ/tissue donation. Materials and Methods: A cross-sectional descriptive study was conducted among ambulatory, consenting adult (>18 years) visitors of a mid-level government hospital using a predesigned, pretested, semistructured interview schedule. Data were analyzed by calculating proportion, Chi-square test, and odds ratio (OR). Results: Of 450 respondents, 271 (60.2%) were aged more than 31 years, 264 (58.7%) were male, 345 (76.7%) were married, 374 (83.1%) were Hindu, 304 (67.6%) had studied up to 10th class, 278 (61.8%) were working, 217 (48.2%) had 0–2 previous visit to this hospital, and 142 (31.6%) reported history of hospitalization. Majority (337, 74.9%) of the respondents had heard the term organ donation (OD). On probing further, nearly 87.3% and 82.4% of respondents had ever heard of eye and kidney donation, respectively. Encouragingly, more than half of respondents, i.e., 261 (58.0%), showed willingness for OD. Statistically (P < 0.001) higher odds for OD willingness was found among participants who were aware of the term OD (unadjusted OR [UOR] = 2.8, 95% confidence interval [CI]: 1.82–4.39), eye donation (UOR = 3.2, 95% CI: 1.78–5.76), and kidney donation (UOR = 4.0, 9.5% CI: 2.40–6.84). Similarly, higher willingness was found among single/separated participant and with higher level of education (P < 0.05). About one-fourth (120, 26.7%) of respondents had donated blood in the past, but this practice had no statistical bearing on the willingness for OD (P = 0.61). Nearly half of the respondents, i.e., 239 (53.1%), were aware that organs could be removed from both living and dead person; 373 (82.9%) of respondents were aware that organs cannot be removed from the body without authorized permission (UOR = 2.7, 95% CI: 1.57–4.88 and adjusted OR [AOR] = 2.6, 95% CI: 1.27–5.66). However, only 119 (26.4%) respondents consented to sign a pledge card for OD. Higher odds (AOR = 12.8, 95% CI: 5.02–32.75) for OD willingness was found among those who consented to sign a pledge card. A high of 364 (80.9%) respondents had no misconception that a person will be born with missing organ following donation of organ/tissue in this life. Conclusion: A high awareness but low level of positive attitude and practices was noticed among sampled metropolitan respondents toward organ/tissue donation.

Objective: Evaluation of knowledge, attitude, and practices (KAPs) based published Indian research on selected parameters. Methodology: A bibliometric analysis of Indian KAP research manuscript published in journals indexed in PubMed for the last 2 years and/or published in Indian Journal of Community Medicine (IJCM) and Indian Journal of Public Health (IJPH) for the last 15 years (year 2000–2014) was undertaken under certain criteria. Results: PubMed (n = 196) revealed maximum KAP research undertaken from the states of Karnataka (16.8%) followed by Delhi (9.6%), Maharashtra (9.1%), and more than two states (11.7%). There was poor reflection with no publication of KAP-based research from the states of Chhattisgarh, Himachal Pradesh, Jammu and Kashmir, and Rajasthan, in IJCM and IJPH journals. The geographical representation of country through published manuscript in IJCM was slightly more diverse than IJPH and more than one-fourth manuscripts in IJPH were published from West Bengal only. It was evident that IJCM (n = 71) has published more KAP manuscripts than IJPH (n = 47). Higher proportion of community-based KAP research was published in IJPH (80.8%) than IJCM (57.7%). Highest single research domain in PubMed indexed journals was those related to oral cavity (14.2%) conducted by dental professionals while rest (85.8%) could be largely ascribed to community physician/public health personnel, etc. The first research domain was followed by family planning/contraceptives (6.1%), tobacco control (5.6%), and AIDS-HIV (5.1%), for the year 2013–2014. Highest KAP-based research domain of articles published in IJCM was those related to family planning/contraceptives (10.0%) followed by AIDS-HIV (8.5%) while it was tobacco (16.6%) and AIDS-HIV (14.5%) in IJPH. Number of authors/manuscript was slightly higher in journals indexed in PubMed (4.7) than IJCM (3.8) and IJPH (3.7). The average page/manuscript was higher in PubMed (6.4) indexed journals while it was similar in both Indian journal (IJCM [3.6] and IJPH [3.8]). Approximate time incurred in decision announcement toward acceptance of KAP manuscript (2000–2014) by IJCM from the date of submission was 7 months (median) while for comparison purpose, it was 6 months (median) for a sample of articles published during 2015.Average citations per KAP document within 2 years of publication were 1.9 (IJCM) and 1.2 (IJPH), respectively, in Google scholar. Conclusion: This bibliometric study, probably first of its kind in India, provides objective snap-shot of diverse published research in the country that may also aid scholar to explore new avenues of KAP especially non-communicable diseases in future. In-addition, postgraduate training could lay emphasis on the use of bibliometrics.

Bathtub shape has important connotations in public health and the concept could be reflected in two novel ways: (1) engineering (2) epidemiological model. Typical bath-tub curve is a combination of three failure rates, that is, decreasing, constant, and increasing failure rate, and different techniques are utilized to reduce these failures. This brief study highlights the concept of bath-tub, related theory, application, and how data modeling could be undertaken considering bath-tub failure rate.

This article reviews and describes the theoretical concept of organ donation (OD) and transplantation, historical milestones, need, shortage, status of global activities, health system capacity, survival outcome, and update on legislative environment in India, Central/State contribution and Nongovernment Organizations actively involved in OD.

This manuscript reviews and describe the burden of cervical cancer in world and India, epidemiology of HPV infection, screening methods, prevention, control strategy, types of HPV vaccines, schedule, age of administration, dose, route, anatomical site of human papillomavirus vaccination, cold chain, vaccine coverage and roll out plan in Delhi, India.

In modern era, India witnessed its first successful corneal, kidney and cardiac transplant in the year 1960, 1967 and 1994 though the reverberations for organ donation and transplantation (ODT) existed since time-memorial with roots existing in Hindu mythology along with vivid example of Guru Dadheech and lord Ganesha. No country in the world is able to meets its organ requirement. Government of India promulgated Transplantation of Human Organ and Tissues Act in 1994 and with the view to enlarge its scope and promote organ donation government has brought new amendments as of year 2014 and 2017. In the background of this journey many new developmental milestones have been achieved in the country however organ donation which has assumed public health significance has been consistently lower than expectations. This manuscript highlights the current status of ODT in the country; legislative environment, limitations, challenges, health education activities, and newer initiatives.

INTRODUCTION: Emotional intelligence (EI) is the ability to understand and manage our own feelings and of others. It has emerged as one of the vital elements of success and interpersonal relations in everyday life. There are individual differences of EI depending on characteristics and behaviors of an individual, which determines their personality. AIMS AND OBJECTIVES: The present study assesses the EI and personality traits of medical students and determines the relationship of EI with personality traits of the medical students. MATERIALS AND METHODS: This was a cross-sectional study and was conducted among students of a government medical college, located in New Delhi. A total of 210 participants were included in the study. After obtaining written informed consent from all participants, a questionnaire consisting of demographic information, Ten-Item Personality Inventory and Schutte EI Scale, was administered. The means and proportions were calculated. Chi-square test and Pearson's correlation test were used to test significance. P < 0.05 was considered statistically significant. RESULTS: The mean (standard deviation) age of the study participants was 21.54 (±1.98) years. The majority (65.7%) of the students were male. 51% of the students had moderate EI, and high EI was seen in 49% of the students. A positive and significant relationship between personality traits and EI was found in the study. CONCLUSION: Personality traits and EI are related to one another and could influence student academic achievement. Since EI influences academic performance so personality trait assessment and empathic perceptions exploration can facilitate to aid the academic performance of the students.

Background: Development during the early childhood, especially from fetus to two-year-old, is crucial in determining the nutrition, health and productivity status in the whole life course. The study was conducted to assess the developmental milestones’ achieve- ment of the children under study and also to find the association any between nutritional status and developmental achievement. Material & methods: A cross sectional community based study was conducted among under 5 years age children, in an urban slum of Agra. Nutritional status was assessed and classified as per WHO 2006 Growth Standards. Developmental Milestone Chart (DMC) was used to assess the childhood developmental status. Results: Overall 12.2 % of the children were found to be develop- mentally delayed. Prevalence of developmental delay increased significantly from infancy (0-11 months) (5.7 %) to 12-23 months of age, peaking at 12-23 months age (20.3 %), thereafter showing a decreasing trend to 15.3 % as the age of the child increased to more than 2 years. There was a close positive link observed between the nutritional status of the children and their development status. Mothers' education and low birth weight of the child were found to be significant influences on children's development. Conclusion: Childhood nutrition has received due attention, but the overall development of the child needs more focus.

Background: Hypertensive disorders during pregnancy occur in women with preexisting primary or secondary chronic hypertension, and in women who develop new-onset hypertension in the second half of pregnancy. The present study was undertaken to study the prevalence and correlates of hypertension in pregnancy in a rural block of Haryana. Materials and Methods: This cross-sectional study was carried out in the all 20 subcenters under Community Health Center (CHC) Chiri, Block Lakhanmajra. All the pregnant women registered at the particular subcenter at a point of time of visit were included in the study. Appropriate statistical tests were used for analysis. Results: A total of 931 pregnant women were included in the present study. Prevalence of hypertension in pregnancy was found to be 6.9%. Maternal age ΃25 years, gestational period ͳ20 weeks, history of cesarean section, history of preterm delivery, and history of hypertension in previous pregnancy were found to be significantly associated with prevalence of hypertension in pregnancy. Conclusion: Nearly one in 14 pregnant women in rural areas of Haryana suffers from a hypertensive disorder of pregnancy. Early diagnosis and treatment through regular antenatal checkup is a key factor to prevent hypertensive disorders of pregnancy and its complications.

Objective: To determine proportion of correct inhalation technique amongst patients with asthma and chronic obstructive pulmonary disease. Methodology: A cross-sectional study involving 100 known subjects of either disease condition using inhaler device for atleast one-year reporting at chest OPD of government hospital were interviewed using pre-tested semi-structured interview schedule and inhalation technique determined by standard observation checklist. Each step was given a score of ′one′ if undertaken by patient and ′zero′ in case of non-compliance. Results: There were 62% male patients; 27% were illiterate; 92% were married; 32% were current smokers; average age was 50.3 (±14.5) years; 55% and 45% had asthma and COPD respectively; 60% were on MDI device and 40% were using DPI; 23% reported co-morbid (HT/DM) condition and 27% reported occupational dust exposure while more than one-third (36%) reported hospitalization during last one-year due to disease condition. Inspite of clinical requirement, 45% were not taking inhaler therapy regularly and reasons elicited were lack of knowledge (32%), casual attitude (07%), financial constraints (04%) and stigma (01%). On a positive note, patients undertaking regular visit to doctors were also taking inhaler regularly (P < 0.05). However, these positive practices did not translate into satisfactory inhaler performance. Majority (93%) of patients were not taking inhaler as per standard procedure i.e., only three were found undertaking all the 13-steps for MDI while four were following all the 8-steps for DPI use. Mean score (steps undertaken) for MDI user was 6.71 (±3.3) with a range of 0-13 points and 4.4 (±2.4) with a range of 0-8 score for DPI user. On further evaluation, satisfactory performance (minimum essential steps) with regard to either inhaler device was demonstrated by 25% patients only and found to be statistically associated with those not reporting any co-morbidity (P = 0.02). Conclusion: Proper training and compliance could improve inhalation technique.

Background: In a resource-limited and high burden disease setting, satisfied human resource is an asset in terms of high productivity, efficiency and quality care. Aim: To assess job satisfaction among permanent employees working in a government hospital. Materials and Methods: A sample of 200 staff members was interviewed using 34-item, Likert response based, modified job satisfaction scale. Key factors for job satisfaction were identified after subjecting data to principal component analysis, varimax rotation and multivariate analysis using step-wise regression procedure. Results: The mean job satisfaction index was computed to be in a similar range, but was found to be highest for nurses (0.68), followed by doctors (0.66), support staff (0.63) and technicians (0.62). Nine uncorrelated and critical factors related to job satisfaction that explained 68.09% of the variability was identified, that is, communication, pay/salary, working conditions, organization supervision system, co-workers, workload, benefits, career aspects and rewards. A positive association was reported between job satisfaction score and factor scores (units) of communication (0.133), benefits (0.110), working condition (0.027) and co-workers (0.032) and a negative relation with organizational supervision system (0.118), workload (0.093), rewards (0.035), pay/salary (0.034) and career prospects (0.017) respectively for all categories of respondents. However in case of doctors, co-workers (0.023 units) showed a negative relation. Conclusion: There is scope for interventions to enhance job satisfaction and concomitant continuous monitoring can be useful in determining various service aspects that necessitate improvement. By enhancing job satisfaction, hospital administrator can improve not only the mental, psychological and social well-being of work-force, but also the financial health of an organization.

Aims: To assess the level and factors of motivation amongst permanent government employees working in a tertiary health care institution. Material and Methods: A sample of 200 health personnel (50 in each category) i.e. doctors, nurses, technician, and support staff were contacted through face to face interview. Motivation was measured as the degree to which an individual possessed various identified motivation domains like Drive, Control, Challenge, Relationship and Rewards. Each domain was represented by 4 dimensions- accordingly a closed-ended statement represented each of these dimensions and responses were assessed on a Likert based scale. Data management was done using SPSS, ver. 19. Results: The average age for different health personnel were: Doctors 48.68 (±8.53), nurses 40.72 (±7.76), technician 38.4 (±10.65) and support staff 43.24 (±9.52) years. The average year of work experience was: Doctor 19.09 (±9.77), nurses 17.2 (±8.420), technician 14.84 (±10.45), support staff 18.24 (±10.28). A comparison of overall motivation index (mean score) revealed that nurse had highest level (3.47), followed by support staff (3.46), doctor (3.45) and technician (3.43). Based on their individual mean scores, the healthcare providers were categorised into three different levels of motivation and it was found that majority of the health personnel i.e.70% of support staff, 62% nurse, 56% doctor and technician, had high to very high level of motivation index. The mean scores for all the five factors as well as their respective ranks were also found out and it was deduced that "relationship" assumed first rank for doctors (mean score: 3.71) and technician (mean score: 3.75), whereas "control" assumed greatest significance for nurses (mean score, 3.62) and support staff (mean scores, 3.61). Based upon the mean scores, "reward" assumed third rank among all the four categories. Kruskal-Wallis test was applied to test if the different categories of health personnel varied with respect to five factors of motivation and it was found that their orientation towards the various motivational components differed significantly only with respect to Drive (P < 0.01). Conclusion: There is scope for enhancing staff motivation.

Objective: To assess alcohol consumption practices amongst adult males in a rural block area. Materials and Methods: Using multi-stage random sampling frame, at least 12 households were identified from selected anganwadi centers (n = 27), and one resident adult male from each household was interviewed in confidence using pre-designed, pre-tested, semi-structured interview schedule after seeking informed consent. In households with more than one adult male respondent, the elder member was recruited. For operational purpose, a drinker was defined as a person who had consumed at least one alcoholic drink in 1 year immediately preceding the survey. Results: A total of 345 adult males were covered with a mean age of 46.6 (±14.2) years. Nearly 64.6% had 5 years of schooling, 46.4% were farmers, 54.2% lived in joint family system and 59.7% had monthly family income up to Rs 10,000. Nearly 150 (43.5%) subjects had some correct knowledge regarding adverse effects of alcohol consumption. Of all the study subjects, 326 (94.4%) males had consumed at least one alcohol-based drink and of which 66.3% consumed country liquor. Nearly 239 (73.3%) drank at either their respective homes or their friends′ homes. Two hundred and eighty-one (86.2%) procured alcohol from a shop within the village; average expenditure per month was Rs 500-900 for 132 (40.5%) respondents; and 38.3% subjects did not consume any snacks with alcohol intake. Drinking had become a habit for 194 (59.5%) males; however, based on self-assessment, 131 (40.2%) considered alcohol consumption as a problem and intended to stop drinking. Conclusion: Within study limitations, high prevalence of alcohol consumption was noted in this study, which may not only eventually lead to health/social issues but also adversely influence the younger generation for easy and early uptake of alcohol.

A 20-year male college student, nonsmoker, nonalcoholic, average built presented with sudden onset cough since last 1 day along with diffuse swelling in the neck, difficulty in swallowing both liquids and solid since 1 day. There was history of rhinorrhea alternating with nasal block intermittently with change of seasons since last 3-4 years. There was no history of weight lifting, drug intake, tuberculosis or trauma, or family history of allergy. A case report of self-limiting spontaneous pneumomediastinum following a sudden bout of coughing with no underlying lung lesion is being reported.

Aim: To describe morbidity and mortality profile of patients discharged from chest ward of a university hospital. Materials and Methods: Prospectively selected information (age, gender, residence, length of stay, outcome and primary diagnosis) of all consecutive in-patients was recorded for six month reference period. Results: Out of 967 patients, mean age was 50.64 years (±15.71); M:F = 3.5:1; 81.3% were from rural area. Primary diagnosis was tuberculosis/sequel among 528 (54.60%) and non-TB among 439 (45.4%) patients (chronic obstructive pulmonary diseases [COPD] - 20.3%; pneumonia - 15.8%; lung cancer - 5.0%; asthma - 1.6%; bronchiectasis - 0.9%, lung abscess - 0.8%, miscellaneous - 1.0%). Total deaths observed was 142 (14.7%) of all discharges and 54.25% of deaths occurred within 48 hours of admission suggesting criticality/late presentation; time distribution of death was similar considering 8-hourly period of 24-h cycle. Average length of stay for all patients was 6.91 (±5.14) days while it was 7.38 (±4.98) days for discharge live and 4.19 (±5.21) days for expired patients. Conclusion: Study provides a snapshot of patients discharged from chest ward that may aid in decision making, improving quality of care and initiation of educational activities at primary level.

Background: Registration of birth is mandatory in India however due to various issues compliance for timely birth registration has been poor. Objective: The objective of this study was to determine time elapsed between birth and registration and describe the socio-demographic profile of registered births at a rural center. Materials and Methods: A cross-sectional descriptive study was undertaken and all births registered at a primary health center of a block during the period 2010 and 2011 were retrieved and data collection carried using structured proforma based on birth formats under civil registration system (CRS). House to house visit was undertaken to identify births without registration. Results: A total of 340 and 276 births were registered during 2010 and 2011 respectively. Time elapsed between birth and registration was computed to be lower, i.e., 9.38 days (±7.46) during 2011 in-comparison with 10.52 days (±8.73) in 2010. On a positive note, higher level of education and marriage of women beyond legal age of 18 years was noticed in 2011 in comparison with 2010. Overall, institutional birth stood at a very encouraging note (66.2%). All (100%) births during the study period were registered at this (rural) or higher center (urban) depending on the place of delivery. An omission/commission of birth format is highlighted that needs urgent attention of the authorities. Discussion: Majority (>92%) of birth registration occurred with-in the stipulated period of 21 days as prescribed under CRS and our study indicates early birth registration in a rural area of Haryana, India.

Objective: To determine body image satisfaction among newly entrant women students in a professional institution. Materials and Methods: A cross-sectional study using body image satisfaction described in words was undertaken, which also explored relationship with body mass index (BMI) and other selected co-variables such as socio-demographic details, overall satisfaction in life, and particularly in academic/professional life, current health status using 5-item based Likert scale. Height, weight, hip and waist circumference measurement was carried out using standard protocol. Data collection was carried through personal interview using pre-designed, pre-tested semi-structured interview schedule by female investigators during August-September 2010 and analysis carried out by computing percentages and Chi-square test. Results: Out of 96 study samples, 16.66%, 51.04%, and 32.29% girl students perceived their body image as fair, good and excellent, respectively while overall 13.54% were dissatisfied with their body image. The body image satisfaction had significant relationship with image perception ( P

Background: Pregnant women inhabiting urban slums are a "high risk" group with limited access to health facilities. Hazardous maternal health practices are rampant in slum areas. Barriers to utilization of health services are well documented. Slums in the same city may differ from one another in their health indicators and service utilization rates. The study examines whether hazardous maternal care practices exist in and whether there are differences in the utilization rates of health services in two different slums. Materials and Methods: A cross-sectional study was carried out in two urban slums of Aligarh city (Uttar Pradesh, India). House-to-house survey was conducted and 200 mothers having live births in the study period were interviewed. The outcome measures were utilization of antenatal care, natal care, postnatal care, and early infant feeding practices. Rates of hazardous health practices and reasons for these practices were elicited. Results: Hazardous maternal health practices were common. At least one antenatal visit was accepted by a little more than half the mothers, but delivery was predominantly home based carried out under unsafe conditions. Important barriers to utilization included family tradition, financial constraints, and rude behavior of health personnel in hospitals. Significant differences existed between the two slums. Conclusion: The fact that barriers to utilization at a local level may differ significantly between slums must be recognized, identified, and addressed in the district level planning for health. Empowerment of slum communities as one of the stakeholders can lend them a stronger voice and help improve access to services.

Objective: To determine level of HIV/AIDS knowledge among first-year MBBS, nursing and pharmacy students of a health university. Materials and Methods: A pre-designed, pre-tested, anonymous self-administered, semi-structured questionnaire was circulated among available 129, 53 and 55 first-year MBBS, nursing and pharmacy students during Oct′ 09. Data entry, management and analysis were carried out using MS excel and software statistical package. Result: Out of the total 237 students, there were 123 (51.9%) female and 103 (44.0%) students from rural native place. A majority of students were able to correctly write the full form of AIDS (95.8%) in comparison to HIV (72.6%) and the difference between two terminologies were known to 87.6%, 81.1% and 70.9% of MBBS, nursing and pharmacy students, respectively. All four common routes of transmission of infection and methods of prevention were known to majority of the lot. However, injecting drug users (IDU) and truck driver as a risk category was correctly reported by 67.5% and 55.3% students, whereas 35.9% incorrectly mentioned that smoking is a risk factor for acquiring infection. A statistically significant (P

Chronic urticaria (CU) is a disturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag sign of a serious internal disease. A multitude of etiologies have been implicated in the causation of CU, including physical, infective, vasculitic, psychological and idiopathic. An autoimmune basis of most of the ′idiopathic′ forms is now hypothesized. Histamine released from mast cells is the major effector in pathogenesis and it is clinically characterized by wheals that have a tendency to recur. Laboratory investigations aimed at a specific etiology are not always conclusive, though may be suggestive of an underlying condition. A clinical search for associated systemic disease is strongly advocated under appropriate circumstances. The mainstay of treatment remains H1 antihistaminics. These may be combined with complementary pharmacopeia in the form of H2 blockers, doxepin, nifedipine and leukotriene inhibitors. More radical therapy in the form of immunoglobulins, plasmapheresis and cyclophosphamide may be required for recalcitrant cases. Autologous transfusion and alternative remedies like acupuncture have prospects for future. A stepwise management results in favorable outcomes. An update on CU based on our experience with patients at a tertiary care centre is presented.

The objective of this study was to assess the various factors affecting endothelial function in essential hypertensives and to establish a relation between them in a regression model. Also, the micro-inflammatory state that is known to exist in essential hypertension was evaluated. Sixty newly detected patients of essential hypertension not on any prior treatment and classified into Stage-1 or Stage-2 hypertension according to the JNC-VII criteria were recruited in the study. After a detailed history and physical examination, investigations including blood urea, serum creatinine, blood sugar (F), S. lipid profile (F), urine for albumin, sugar and sediments, X-ray of the chest, ECG and fundus examination were carried out. Urine for microalbuminuria, Hs-CRP and brachial artery reactivity were tested as markers of endothelial dysfunction and inflammation. The CRP levels, taken as a marker of inflammation in hypertension, were significantly elevated in a majority of the study subjects. Endothelial dysfunction was significantly more quantified in Stage-2 hypertension as compared with Stage-1 hypertension (P < 0.01). The Hs-CRP levels were consistently found to be elevated in both the stages of hypertension in our study, with an insignificant difference between the two groups. A significant association was noted with the stage of hypertension, triglycerides, microalbuminuria, CRP, LDL cholesterol and age, with the stage of hypertension emerging as the most powerful predictor variable (P < 0.0001) followed closely by microalbuminuria (P < 0.0001) in a multiple regression analysis model. The present study reinforces the view that hypertension is in part an inflammatory disorder. Endothelial dysfunction is an important component of essential hypertension, the severity being determined by the stage of hypertension, microalbuminuria, LDL-cholesterol, triglycerides, age and Hs-CRP levels independently. The undesirable inflammatory response can be cost-effectively prevented at various levels by targeting the potentially modifiable risk factors elucidated in the study.

Objective : To study the antecedent risk factors in the causation of gallstone disease in a hospital-based case control study. Materials and Methods: Cases (n = 150) from all age groups and both sexes with sonographically proven gallstones were recruited over a duration of 3 months from the surgical wards of a tertiary care teaching hospital. Modes of presentation were also noted among cases. Age- and sex-matched controls (n = 150) were chosen from among ward inmates admitted for other reasons. Univariate and multivariate logistic regression analyses were performed for selected sociodemographic, dietary, and lifestyle-related variables. Results : Females had a higher prevalence of gallstone disease than males (P < 0.01). Among males, the geriatric age group (>60 years) was relatively more susceptible (28%). Prepubertal age group was least afflicted (3.3%). Univariate analysis revealed multiparity, high fat, refined sugar, and low fiber intakes to be significantly associated with gallstones. Sedentary habits, recent stress, and hypertension were also among the significant lifestyle-related factors. High body mass index and waist hip ratios, again representing unhealthy lifestyles, were the significant anthropometric covariates. However, only three of these, viz., physical inactivity, high saturated fats, and high waist hip ratio emerged as significant predictors on stepwise logistic regression analysis (P < 0.05). Conclusion : Gallstone disease is frequent among females and elderly males. Significant predictor variables are abdominal adiposity, inadequate physical activity, and high intake of saturated fats; thus representing high risk lifestyles and yet amenable to primary prevention.

A hospital-based cross-sectional study was undertaken to determine proportion of gross congenital malformation (GCMF) occurring at intramural births. Rate of GCMF was found to be 16.4/1000 consecutive singleton births (>28 weeks) with three leading malformation as anencephaly (44.68%), talipes equinovarus (17.02%) and meningomyelocele (10.63%). Higher risk of malformed births were noticed amongst un-booked (2.07%) in-comparison to booked (1.01%) mothers; women with low level of education (up to 8 years [2.14%] vs. at least 9 years of schooling [0.82%]); gravida status of at least 3 (2.69%) followed by 1 (1.43%) and 2 (1.0%) respectively; pre-term (5.13%) vs. term (0.66%); cesarean section (4.36%) versus vaginal delivery (0.62%). Mortality was significantly higher among congenitally malformed (17.35%) than normal (0.34%) newborns. With-in study limitation, emergence of neural tube defect as the single largest category of congenital malformation indicates maternal malnutrition (especially folic acid) that needs appropriate attention and management.

Crescentic nephritis can be a manifestation of Lupus Nephritis. It usually presents with rapid deterioration of renal functions over days to weeks with an active urinary sediment and confers a poor prognosis. Nephrotic range proteinuria is rare in crescentic nephritis. We present an interesting case of (crescentic) Diffuse Proliferative Lupus Nephritis (DPLN) with remarkably preserved renal function and nephrotic range proteinuria. Also noteworthy was the patient′s excellent response to immunosuppressive therapy despite the high frequency of cellular crescents on biopsy.

A 61-year-old male admitted in chest clinic with complaints of left-sided chest pain, sudden onset breathlessness, and cough since last 15 days. Patient was anex-smoker with no past history of tuberculosis. He was diagnosed with esophageal cancer and received radiotherapy 1 year back. On chest X-ray, left-sided hydropneumothorax was found and intercostal drainage insertion was done. A week later patient complained of extrusion of food particles into intercostal drainage bag. On evaluation, esophageopleural (EP) fistula was confirmed.

Hemorrhagic pleural effusion is a common clinical entity still diagnosis is often missed. An unusual and often over-looked cause of pleural effusion is an intra-abdominal process including complication arising due to pancreatitis. We report a rare case of massive left sided hemorrhagic pleural effusion in a patient due to pancreatic pathology.

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Today, it is very important for developed and developing countries to consume electricity more efficiently. Though developed countries do not want to waste electricity and developing countries cannot waste electricity. This leads to the concept: load forecasting. This paper is written for the short-term load forecasting on daily basis, hourly, or half-hourly basis or real time load forecasting. But as we move from daily to hourly basis of load forecasting, the error of load forecasting increases. The analysis of this paper is done on previous year's load data records of an engineering college in India using the concept of fuzzy methods. The analysis has been done on Mamdani-type membership functions and OFDM (Orthogonal Frequency Division Multiplexing) transmission scheme. To reduce the error of load forecasting, fuzzy method has been used with Artificial Neural Network (ANN) and OFDM transmission is used to get data from outer world and send outputs to outer world accurately and quickly. The error has been reduced to a considerable level in the range of 2-3%. For further reducing the error, Orthogonal Frequency Division Multiplexing (OFDM) can be used with Reed-Solomon (RS) encoding. Further studies are going on with Fuzzy Regression methods to reduce the error more.