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Introduction: Scabies affects 200–300 million individuals annually around the globe and it is a serious public health issue causing social stigmatisation in patients. With this background and its substantial impact on morbidity, this study was undertaken with the objective to find the demographic profile, clinical morphology and quality of life in patients suffering from scabies in urban slums of Ludhiana. MATERIALS AND METHODS: A cross-sectional, time-bound hospital-based study was carried out for a period of 2 months. A total of 173 patients with a diagnosis of scabies comprising all adults and children >5 years of age attending skin outpatient department were included in the study. The collected information was entered in Microsoft Excel sheet and analysed using SPSS. Results: The mean age of the study population was 34.85 ± 17.48 years. The most affected age groups were 18–40 years (46.9%), followed by 41–60 years (26.0%) and 17.9% in children. The majority of patients had difficulty in working and feelings of embarrassment, and in three-fifths of patients, their sexual relationship was affected due to scabies. In children, more than half experienced teasing and feeling of embarrassment and their routine activities such as playing were affected. Conclusion: In the present study, scabies moderately affected the quality of life of the patients in the form of embarrassment and stigma associated with disease. As it is a contagious disease, early diagnosis and prompt treatment can be helpful in the prevention and control of disease.

A middle-aged woman presented with history of fatigue, low mood, swelling of limbs, and facial puffiness. On detailed history taking, she also complained of salt craving, secondary amenorrhea, and loss of libido for almost a decade. Investigations revealed pan-hypopituitarism. She was started on appropriate hormonal therapy which saw a rapid resolution of symptoms within 2 weeks. Sheehan’s syndrome may have an acute presentation or chronic. The symptoms may be subtle like fatigue or overt like hypotension and syncope. A high degree of suspicion of Sheehan’s syndrome is essential for its timely management, and goes a long way in preserving the quality of life.

This research article delves into the development of a reinforcement learning (RL)-based continuous authentication system utilizing behavioral biometrics for user identification on computing devices. Keystroke dynamics are employed to capture unique behavioral biometric signatures, while a reward-driven RL model is deployed to authenticate users throughout their sessions. The proposed system augments conventional authentication mechanisms, fortifying them with an additional layer of security to create a robust continuous authentication framework compatible with static authentication systems. The methodology entails training an RL model to discern atypical user typing patterns and identify potentially suspicious activities. Each user’s historical data are utilized to train an agent, which undergoes preprocessing to generate episodes for learning purposes. The environment involves the retrieval of observations, which are intentionally perturbed to facilitate learning of nonlinear behaviors. The observation vector encompasses both ongoing and summarized features. A binary and minimalist reward function is employed, with principal component analysis (PCA) utilized for encoding ongoing features, and the double deep Q-network (DDQN) algorithm implemented through a fully connected neural network serving as the policy net. Evaluation results showcase training accuracy and equal error rate (EER) ranging from 94.7% to 100% and 0 to 0.0126, respectively, while test accuracy and EER fall within the range of approximately 81.06% to 93.5% and 0.0323 to 0.11, respectively, for all users as encoder features increase in number. These outcomes are achieved through RL’s iterative refinement of rewards via trial and error, leading to enhanced accuracy over time as more data are processed and incorporated into the system.

Introduction: In this era of epidemiological transition where noncommunicable diseases are on a significant rise, cancer is a major public health problem globally. Out of all cancers, breast cancer is the most common female cancer worldwide. Aim: To determine the knowledge of breast cancer and its risk factors and breast self-examination (BSE) practice amongst urban women of North India. Patients and Methods: A cross-sectional study was carried out amongst 370 women aged between 20 and 60 years of age using pretested self-administered questionnaire. The collected information was entered into Microsoft Excel sheet and analysed using SPSS. Results: Mean age of the study participants was 40.3 ± 12.1 years and majority of the study participants (87%) were married. It was seen that the proportion of women who were aware increased as their literacy status increased, and this was statistically significant (P = 0.00). About 18.4% of the participants were aware regarding BSE. The most mentioned reason for not practicing BSE amongst those who were aware was that they considered themselves healthy (63.2%). Conclusions: In the current study, half of the women were aware of breast cancer and few were aware of BSE and very few were practicing BSE. It was seen that women with a higher level of education had better knowledge regarding breast cancer than women with low educational status. For the prevention of breast cancer, women are the most important stakeholder. There is a need to sensitise women regarding risk factors of breast cancer and preventive practices like BSE.

Background: The World Health Organization in January 2020 declared an outbreak of novel coronavirus disease, COVID-19, an international public health emergency. The suddenness of this calamity with no end in sight caused a great deal of stress, anxiety, and depression throughout the world. Aim: The aim of this study was to assess the psychological impact during the developing COVID-19 situation among female health professionals. Methods: This was an observation-based cross-sectional study conducted for a total of 3-month duration between August and October 2020. A structured questionnaire to assess the psychological impact was sent via the (email) electronic mail system, and responses were obtained from 343 female doctors. Results: The mean ± standard deviation values for age were found to be 39 ± 8 years. Insomnia, stress, and anxiety were seen in a majority of the respondents. Conclusions: The present study has shown severe psychological impact associated with the pandemic on female health-care workers and highlights the major factors associated.

Background: Hepatitis C virus (HCV) infection is considered one of the growing public health problems. Identification of HCV-associated risk factors is pivotal for developing appropriate prevention strategies. Objectives: To determine the epidemiological variables of HCV infection in a tertiary care hospital. Methods: This hospital-based case-control study was conducted in a tertiary care hospital in Punjab on 320 subjects, including 160 cases and controls each. Cases and controls were matched by age (±5 years), gender, and residence. A patient ≥18 years of age fulfilling the biomarker criteria with or without clinical criteria diagnosed in the last 1 month was considered as a case. The information on socio-demographic characteristics and previous exposures to selected risk factors was collected through detailed interviews of the subjects. Analysis was performed using SPSS 20 statistical software. Odds ratio (OR) with 95% confidence interval (CI) was calculated to measure the strength of association between cases and controls for each risk factor. Results: Odds of having HCV infection was significantly higher among those with a history of blood transfusion (OR: 2.30, 95%CI: 1.14–4.63), dental procedure (OR: 4.82, 95%CI: 2.38–9.77) and intravenous injection/infusion from quacks (OR: 3.26, 95%CI: 1.47–7.19), injectable drug use (OR: 26.69, 95%CI: 3.55–200.24), non-injectable drug use (OR: 2.37, 95%CI: 1.44–3.90), tattooing (OR: 7.91, 95%CI: 2.31–27.08), and piercing from street hawkers (OR: 2.25, 95%CI: 1.18–4.29). Multivariate analysis identified history of blood transfusion, dental procedure, intravenous injection/infusion from quacks, injecting drug use, and piercing as independent risk factors for HCV infection. Conclusion: The study identified multiple risk factors for acquiring HCV infection and suggest appropriate interventions targeting high-risk populations.

Context: The ongoing corona pandemic has created medical crises all over the world. An increased surge in the number of COVID-19 cases was observed in the month of August, September and October 2020. Punjab has around 10 Lakh migrant workers. Intensive rapid antigen testing was done during this surge among factory workers. With this background, the study aims to find out the positivity rate of rapid antigen testing and to find out the final outcome of the COVID positive cases in terms of morbidity. Materials and methods: Screening of factory workers working in various factories was done for COVID-19 by rapid antigen testing from 26th august to 31st October 2020. Those who tested positive were clinically examined, counseled, and followed up telephonically to get information regarding their course of illness. The collected information was entered in Microsoft excel sheet and analyzed using SPSS. Results: A total of 11045 factory workers were screened using the rapid antigen test. The mean age of subjects was 33.37 ± 10.97 years. The majority of them were males (88.3%) and migrants (who did not belong to Punjab) (97.3%). The majority of the subjects (97.3%) had no symptoms at the time of screening. COVID-19 positivity rate increased with age, was found to be higher in males (2.3%) as compared to females. Conclusion: The positivity rate was higher in asymptomatic males and local resident workers. Rapid antigen testing is an important public health measure to prevent the further spread of the disease during a pandemic due to its quick results and detection of asymptomatic patients.

Rapid antigen test has a very important value as one of tools to address the Covid pandemic. Though this test is not as accurate as polymerase chain reaction (PCR) testing. As viral antigen appears before antibody formation in infected person. It is a specific marker of virus. Therefore, for detection of this highly infectious disease at an early stage, viral antigen testing can be a useful strategy in scenario of community transmission to prevent further spread. In India an advisory was issued by ICMR (on 14th June 2020) regarding usage of RAT for quick detection of COVID-19 positive patients. During second wave, Rapid antigen testing was advised only in symptomatic individuals and immediate contacts of laboratory confirmed positive cases. Though no test is perfect when it comes to the attributes of accuracy, accessibility, affordability, and timeliness of results. However, Rapid antigen test can be used as a useful test in public health that can benefit the larger population in breaking the chain of transmission if used wisely in different settings and according to the timeline of symptoms.

Food allergy affects approximately 2–4% of children and adults. This guideline provides recommendations for managing food allergy from the Global Allergy and Asthma European Network (GA2LEN). A multidisciplinary international Task Force developed the guideline using the Appraisal of Guidelines for Research and Evaluation (AGREE) II framework and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. We reviewed the latest available evidence as of April 2021 (161 studies) and created recommendations by balancing benefits, harms, feasibility, and patient and clinician experiences. We suggest that people diagnosed with food allergy avoid triggering allergens (low certainty evidence). We suggest that infants with cow's milk allergy who need a breastmilk alternative use either hypoallergenic extensively hydrolyzed cow's milk formula or an amino acid-based formula (moderate certainty). For selected children with peanut allergy, we recommend oral immunotherapy (high certainty), though epicutaneous immunotherapy might be considered depending on individual preferences and availability (moderate certainty). We suggest considering oral immunotherapy for children with persistent severe hen's egg or cow's milk allergy (moderate certainty). There are significant gaps in evidence about safety and effectiveness of the various strategies. Research is needed to determine the best approaches to education, how to predict the risk of severe reactions, whether immunotherapy is cost-effective and whether biological therapies are effective alone or combined with allergen immunotherapy.

Background: This study was a randomized double-blind sham-controlled trial examining the effects of transcranial direct current stimulation (tDCS) augmented cognitive training (CT) in children with Fetal Alcohol Spectrum Disorders (FASD). Prenatal alcohol exposure has profound detrimental effects on brain development and individuals with FASD commonly present with deficits in executive functions including attention and working memory. The most commonly studied treatment for executive deficits is CT, which involves repeated drilling of exercises targeting the impaired functions. As currently implemented, CT requires many hours and the observed effect sizes are moderate. Neuromodulation via tDCS can enhance brain plasticity and prior studies demonstrate that combining tDCS with CT improves efficacy and functional outcomes. TDCS-augmented CT has not yet been tested in FASD, a condition in which there are known abnormalities in neuroplasticity and few interventions. Methods: This study examined the feasibility and efficacy of this approach in 44 children with FASD. Participants were randomized to receive five sessions of CT with either active or sham tDCS targeting the dorsolateral prefrontal cortex, a region of the brain that is heavily involved in executive functioning. Results: The intervention was feasible and well-tolerated in children with FASD. The tDCS group showed nominally significant improvement in attention on a continuous performance test compared to sham (p = .043). Group differences were observed at the third, fourth and fifth treatment sessions. There was no effect of tDCS on working memory (p = .911). Further, we found no group differences on a trail making task (p = .659) or on the verbal fluency test (p = .826). In the active tDCS group, a significant correlation was observed between improvement in attention scores and decrease in parent-reported attention deficits (p = .010). Conclusions: These results demonstrate that tDCS-augmented CT is well tolerated in children with FASD and potentially offers benefits over and above CT alone.

We describe a patient with recurrent embolic strokes who was found to have a persistent left superior vena cava draining into a pulmonary vein. Transcatheter placement of a vascular plug resulted in successful occlusion of the superior vena cava. Repeat bubble study on follow-up imaging was negative for a right-to-left shunt. (Level of Difficulty: Advanced.)

Context: The spread of COVID-19 pandemic poses a great challenge to health care organizations and unprecedented need for information. This study aims to identify possible factors causing delay and losing precious time during diagnosis and treatment of COVID-19 at home and health facility level. It also aims to highlight perceptions and experiences of family members of deceased regarding diagnosis and treatment of COVID-19 infection in hospital. Methods: A retrospective study was done to review COVID-19 deaths from 18th March to 5th June 2020 in Punjab, India. A total of 48 laboratory confirmed (RT-PCR) COVID-19 deaths were reported during this period. Socio demographic profile, sequence of events including clinical symptoms, medical aid taken, time of confirmation of diagnosis and treatment before death were noted from the records on a predesigned proforma. Family members of deceased were also interviewed and asked open-ended questions regarding their experiences at various health facilities. Descriptive statistics was presented in percentages, mean, and median. Results: Mean age of subjects was 56.3 ± 18.3 years. Majority (82.2%) had three or more than three comorbidities. Median time from appearance of first symptom to first medical contact and confirmation of diagnosis was 1 and 5 days, respectively. On the basis of interview with deceased's relative, various themes like delay in diagnosis and treatment, dissatisfied with hospital system and lack of communication between relative and patient were generated. Conclusion: Presence of comorbidities was the most important risk factor. Health seeking behavior of patients immediately after appearance of symptoms was found to be satisfactory.

Background: Hereditary angioedema (HAE) is often caused by low serum levels or functional deficiency in C1 inhibitor (C1-INH); however, in some cases, C1-INH serum level and function are measured as normal (HAE-nl-C1INH). Management of HAE-nl-C1INH is similar to management of HAE with C1-INH deficiency, including on-demand therapy for angioedema attacks and, potentially, prophylaxis. Recombinant human C1 esterase inhibitor (rhC1-INH) is indicated for treatment of acute HAE attacks. This study assessed the clinical profile and treatment outcomes in an HAE-nl-C1INH population with a history of rhC1-INH treatment. Methods: Medical records containing patient-reported outcomes from ten US treatment centers were analyzed retrospectively for medical history, angioedema attack characteristics, attack treatments, and clinical outcomes. Results: Twenty-three patients were included, with wide US geographic representation. Most patients (87.0%) were female; median age was 36.0 years (range, 19–67 years). Of 20 patients with available data, 4 had their first angioedema attack during childhood (aged

Poncet's disease is a rare form of tuberculosis (TB). It is described as a hypersensitivity reaction of extra-articular TB, which manifests as acute-onset non-destructive polyarthritis of large joints. It resolves completely on anti-tubercular therapy. We describe a case of a young female patient who presented with symmetrical polyarthritis on a background of tubercular lymphadenitis. The workup for rheumatological diseases was negative. A diagnosis of Poncet's disease or tubercular rheumatism was made by exclusion. There was complete resolution of symptoms of joint disease following anti-tubercular therapy. Poncet's disease should be kept under suspicion in TB endemic areas while investigating patients of arthritis. In a resource-limited setting, in patients with TB, the response of coincident inflammatory arthritis to anti-tubercular therapy may be first observed, before subjecting them to further investigations and/or empirical therapy.

Measles is a vaccine-preventable disease that continues to be a major cause of morbidity and mortality in children and young adults across the world. Immunization efforts have reduced the incidence of measles over the last 3 decades, but outbreaks are seen in high-transmission areas with susceptible populations, as is seen in hospitals and student campuses. The protection offered by prior vaccination may wean off over time making vaccinated individuals susceptible to infection. Hence, catch-up immunization drives should be undertaken for vulnerable populations such as healthcare personnel, along with routine immunization programs, with the goal to eliminate measles in the future. This case series presents measles in two of our medical residents who got infected despite being vaccinated in childhood.

Background: It is a matter of grave concern that a girl child continues to be insecure and vulnerable in the state of Punjab. To ingrain gender equality in social system, it is very important to make community an important stakeholder to deal with the situation. This study focuses on the awareness and perceptions of anganwadi workers regarding girl child discrimination and female feticide. Materials and Methods: A total of 2206 anganwadi workers between the age group of 20–70 years of different blocks of Ludhiana district, Punjab, were enrolled. They had come for Anganwadi Worker (AWW) Training Workshop, organized at Urban Health Centre, Ludhiana, Punjab. Data were analyzed in terms of proportions. Results: Study subjects showed high level of awareness about female feticide (98.8%). A majority of the subjects (93.3%) agreed to the fact that practice of discrimination is being followed between boys and girls. They were also of the opinion that this practice is harmful and it should be stopped (98.9%). Various contributing factors enumerated by them included sons are intelligent, carry on family lineage, and they take care of their parents in old age. Regarding perception of anganwadi workers for curbing this social evil, 70.7% of subjects were of the view that by giving equal opportunities, equal status to girls, and empowering girls, this practice can be stopped, while 42.4% of the subjects were of the view that increasing awareness among the rural women, parents, and family is the solution to stop this practice. Conclusion: The anganwadi workers had optimum level of awareness about female feticide and almost all of them strongly felt that this harmful practice should be stopped altogether.

The authors describe a patient with hypertrophic cardiomyopathy with concomitant left ventricular outflow tract obstruction and aortic stenosis. Detailed haemodynamic assessment of the serial lesions was performed. Alcohol septal ablation resulted in a significant reduction of gradients across the left ventricular outflow tract.

In the current scenario of digital technology and virtual learning, the electronic display interfaces have become an integral part of children’s livelihood. The changing era towards digitalization increases opportunities for children to learn from multiple sources on digital platforms. The impact of new technologies (smart phones, tablets, laptops, animations, games, apps etc.) in engaging children of variable age groups (0-19) on increasing screen time revealed unfavorable effects on eye health [1].

Climate change adaptation requires communities and policymakers to be flexible in order to cope with high levels of uncertainty in climate projections, particularly of precipitation, flood magnitude and frequency, and changing human exposure and vulnerability to floods—which are even less predictable than the climate. Most of the world’s major rivers are embanked to “protect” communities from floods. Embankments—which represent a significant investment largely of public funds—are a manifestation of the professionalism of engineers and hydrologists. They are also the result of professional and political entrapment and a technological frame that grows in strength (probably non-linearly) by positive feedback to produce technological lock-in. This results in inertia in large socio-technological systems, with little incentive to adopt more adaptive and flexible solutions, including non-structural measures—such as land-use zoning—even in the face of evidence that structural measures do not always reduce damage and, in some cases, actually make it worse. Where embankment breaches are common, damage is likely to increase as climate change induces larger floods, and lock-in and path dependence increase risk. Therefore, there is an urgent need for the mitigation of floods through non-structural measures that complement embankments. The phenomena described in this paper are common in many countries.

Abstract Background Transcranial focused ultrasound (tFUS) is a new non-invasive neuromodulation technique that uses mechanical energy to modulate neuronal excitability with high spatial precision. tFUS has been shown to be capable of modulating EEG brain activity in humans that is spatially restricted, and here, we use 7T MRI to extend these findings. We test the effect of tFUS on 7T BOLD fMRI signals from individual finger representations in the human primary motor cortex (M1) and connected cortical motor regions. Participants (N = 5) performed a cued finger tapping task in a 7T MRI scanner with their thumb, index, and middle fingers to produce a BOLD signal for individual M1 finger representations during either tFUS or sham neuromodulation to the thumb representation. Results Results demonstrated a statistically significant increase in activation volume of the M1 thumb representation for the tFUS condition as compared to sham. No differences in percent BOLD changes were found. This effect was spatially confined as the index and middle finger M1 finger representations did not show similar significant changes in either percent change or activation volume. No effects were seen during tFUS to M1 in the supplementary motor area or the dorsal premotor cortex. Conclusions Single element tFUS can be paired with high field MRI that does not induce significant artifact. tFUS increases activation volumes of the targeted finger representation that is spatially restricted within M1 but does not extend to functionally connected motor regions. Trial registration ClinicalTrials.gov NCT03634631 08/14/18

Malaria is a serious health burden in the tropical countries. Jaundice is a known manifestation of complicated falciparum malaria but is unusual with Plasmodium vivax infection. Only a few cases of vivax malarial hepatopathy have been reported till date. Here, we present a rare case of vivax malaria hepatopathy with secondary splenic abscess. No such case of dual complications of vivax malaria in the same patient has been reported till date to the best of our knowledge.

Aluminum phosphide (AlP) is a commonly used pesticide (insecticide) in developing countries like India. It is also one of the most common and deadly causes of suicidal poisoning in rural areas, with a lethal dose of 150–500 mg (unexposed tablet) in adults. Death is due to the rapid release of phosphine gas which causes cellular and mitochondrial toxicity leading to cardiovascular collapse and multiorgan failure. Here, we describe a case of AlP poisoning in a young male who developed severe myocarditis and metabolic acidosis after consumption of 3 g of AlP. In spite of a poor predicted outcome, the patient survived due to prompt and aggressive resuscitative measures.

Introduction: In India, due to some barriers, the parents are not willing to vaccinate their children which lead to 3.2 million of chil- dren still not being vaccinated. Materials and Methods: A descriptive study was conducted on 200 mothers of under-five children residing in filed practice area of UHTC, Shimlapuri. Structured interview questionnaire was ap- plied on mothers to explore the knowledge on immunization & perceived barriers related to it. Results: The study revealed that 50.5% of mothers of under-five children were having below average level of knowledge on child immunization. Child illness and low importance of vaccination were most occurring perceived barriers among mothers. There were other barriers like lack of accompany to go to center for im- munization, and confusion about what age immunization has to be given, etc. Conclusion: Current study necessitates the need to to provide IEC (information, education and communication) sessions programs. This can be achieved by organizing health education campaigns in community. Parents and families need to be sensitized regarding importance of immunization to overcome the perceived barriers.

Background: Obesity is a complex, multi-factorial chronic disease. Overweight and obesity are the fifth leading risk for global deaths. Objectives: To find the prevalence and risk factors for obesity in women aged 20-60 years in Ludhiana city. Methods: The present study is a community based cross sectional study carried out in an urban area of Ludhiana among women aged 20-60 years. Among the study population of 324 women, a pre-designed and pre-tested questionnaire was used to record the socio-demographic and anthropometric profile of women. Chi square test and logistic regression was used to find the association of obesity and hypertension with socio-demographic variables. Results: The prevalence of overweight and obesity was 12.7% and 29.6% respectively. Obesity was found to be more common among middle-aged Punjabi housewives belonging to upper socio-economic strata. There was strong association between overweight/obesity and hypertension.

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Background: Anxiety and depressive disorders constitute a substantial proportion of the global burden of disease and are projected to form the second most common cause of disability by 2020. Objective: To assess the level of depression and anxiety among middle age women and the possible factors behind it. Materials and Methods: A total of 180 women aged 40-60 years were selected by proportionate sampling technique. Age, education, marital status, socioeconomic status, age at marriage, age at menopause, weight and height were noted. Zung-self-rating scales were used for calculating levels of depression and anxiety in these women. The data were analyzed by using statistical software SPSS. Results: The level of syndromal depression and anxiety was found to be 86.7% and 88.9%, respectively. Most of the subjects had the moderate type of depression (49.5%) followed by mild (29.4%) and severe depression (7.8%). While in case of anxiety, most of the subjects (69.4%) had a mild form of anxiety and 17.8% had moderate anxiety level. A significant difference was observed in the level of depression with respect to marital status (P = 0.009) and in the level of anxiety with respect to age (P = 0.021) in the study subjects. On applying logistic regression, none of the factors studied were found to be significant variables for anxiety or depression in the study population. Conclusion: Depression and anxiety are prevalent among the middle-aged women in rural Punjab. Provision of mental health services in this group is essential.

Background: Drug addiction is on the rise in Punjab,India. There are 15 DDCs which are supported by the Indian Red Cross Society. There is alleged mushrooming of private Drug Deaddiction Centres (DDCs) in the smaller towns, villages and cities of Punjab. Objective: This study aimed to evaluate DDCs in Punjab. Materials and Methods: A total of 10 DDCs were included in the study and scheduled visits were made to collect data by using a pre-tested questionnaire. Results: The duration of treatment was 1 month at the Red Cross DDCs and it was approximately 6 months at private DDCs. The staff at the private DDCs were inadequate. The major drugs which were abused by patients were Propoxyphene, Alcohol, Bhukki and Cannabis. Patients were usually referred to the DDCs either by family members (35.3%) or social workers (29.8%). About 72.5% of patients were married, 36.3% had passed 10th standard and 54.4% were employed. A majority dropped out of the DDCs due to personal reasons and lack of family support. On comparison, more patients were found to be treated at Red Cross centres (75.3%) than at private centres (65.8%). All DDCs had conducted regular sessions of individual, group and family counseling for patients. Red Cross DDCs ensured that ex-clients received follow-ups and home visits. More patients were satisfied with the services which were provided by the Red Cross DDCs. On the contrary, more patients at the private DDCs complained about harassment fromstaff personnel (p>0.05). Conclusion: It is recommended that all DDCs should be checked regularly, and that the private centres should be provided with additional support from the government, to help run them more efficiently.

Context: Teachers play an important role in guiding the adolescents. Adolescents are ill equipped to deal with the impending changes in their body which makes them vulnerable to STDs, HIV/AIDS and premarital sex. This study attempts to study the impact of reproductive health education on the knowledge, attitude and practices of teachers, about which only a few studies are available. Aims: To study the impact of health education on the knowledge, attitude and practices of teachers regarding reproductive health of adolescents. Settings: Senior Secondary schools of Amritsar and Department of Community Medicine, Government Medical College, Amritsar, Punjab, India. Study participants: Male teachers of senior secondary schools of Amritsar teaching class 9th-12th. Study design: Educational intervention study. Sampling method: Purposive sampling. Materials and Methods: The study was started with 155 teachers (teaching class 9th -12th) who willingly participated from 50 senior secondary schools of Amritsar district. It was carried out in three phases. In first phase, after taking informed consent, the teachers filled a pretested questionnaire which was followed by an interactive session on reproductive health in second phase. In third phase, to study the impact of the interactive session and the sustainability of knowledge gained, they were again administered the same questionnaire after a period of 3 months. Statistical Analysis: Microsoft Excel, SPSS, Chi-square test. Results: Maximum 74 (47.7%) teachers were aware of the psychosocial problems of adolescents. Majority 110 (71%) of the teachers had only partial knowledge about pubertal changes. 117 (75.5%) teachers were unaware about genital hygiene. Only 33 (21.3%) teachers had adequate knowledge about different STDs. 91 (58.7%) and 54 (34.8%) of teachers had adequate knowledge about routes of transmission and prevention of AIDS respectively. Only 37 (23.9%) teachers were imparting sex education to students. After intervention significant favorable changes were seen in their knowledge, attitude and practices regarding most of above mentioned topics. Conclusion: Although the baseline knowledge of teachers in most aspects of reproductive health of adolescents was found to be low, significant favourable changes were observed after health education.

Neuronal degeneration, characterized by progressive and irreversible loss of structure and function of neurons, could be a physiological age related or pathological intervention resulting in death of neuronal tissues. Neurodegenerative disease (ND) like Parkinson's Disease (PD) and Alziemer's Diseases (AD) aving molecular complexity in pathogenesis resulting in prominent loss of normal physiology of an individual. Practically, ND are incurable but by therapeutic approaches the loss of neurons and progress of disease is controlled but these drugs are associated with many unwanted effects. Herbals have been used from ancient times and referred to as conventional treatment methods to treat neurodegenerative disease having natural healing power and less side effects. Phytochemicals like Alkaloids, terpenes, saponins, phenols, flavonoids, etc. have major mechanisms behind management of most of the ND. In this review we briefly discussed some medicinal plants which have neuroprotective activities against ND specially AD and PD along with its mechanism of actions behind their pharmacological activities. Some herbal formulations used as traditional medicines to treat neurodegenerative disease worldwide are also briefly discussed. [ABSTRACT FROM AUTHOR]

The extraordinary human like intelligence acquired by machines has paved a wave of revolution in technologically advanced healthcare field. Recently, machine learning has become popular and a keen interest in the field of early diagnosis, treatment, imaging of several disease in a cost-effective manner. Medical experts are now easily detecting the future condition of any prevalent disease by using previous/past data. Investigation advantage-based computer-aided diagnostics have shown good sensitivity, accuracy and specificity for the detection of minor radiographic abnormalities, with the potential to improve public health. This article gives a broad description about application of artificial intelligence in medical field. Data collection, magnetic imaging and mining algorithm covers 60% of this article. Deep learning includes Recurrent Neural network (RNN), Auto-encoder, Support vector machine (SVM), Deep Belief Network (DBN) and AUROC curve. As the previous treatments were boisterous like EEG and others hence, the detection itself become a challenging task. Only through Artificial intelligence we came to a conclusive diagnosis of diseases with high accuracy other than clinical, Artificial intelligence work great in field of drug design, sports and improving patient assistance. The improvement in disease prediction and treatment has benefited a lot of individuals and increase the mortality rate. AI has improved the work efficiency of industries such as aviation, telecommunication, gaming and IT which reduces the manual work load of humans and save money and time. It leads to more effective use of resources in other work which provide higher earning and profits. It has facilitated the innovation in varied sectors that includes automobile industry (self-driving cars), farming (automatic soil nutrients detection and spraying of weedicide), and handling of hazardous substances. [ABSTRACT FROM AUTHOR]

Background: Clinical and laboratory features of COVID-19 may have regional variations. This study aimed to discern their association with severity of illness and mortality in tertiary setup of Delhi, India., Methods: Retrospective data of hospitalised COVID-19 patients over 3 months (end March to June 2020) were evaluated for symptom profile, blood investigations and chest radiograph data and classified according to COVID-19 severity and as survivors and non-survivors., Results: Average age (n=182) was 46.1 years, male to female ratio 1.4:1. Fever (51.1%), cough (49.4%) and breathlessness (48.3%) were the commonest symptoms, and frequency of all the three increased with severity of COVID-19. Fever duration, leucocytosis, neutrophilia, elevated blood urea, transaminitis and higher Brixia score on chest X-ray were also more in severe COVID-19 compared to mild and moderate categories. Higher age, more comorbidities, fever, breathlessness and chest pain; longer duration of fever, leucocytosis, neutrophilia, lymphopenia, high neutrophil to lymphocyte ratio, elevated serum urea, creatinine, transaminases and hyperglycemia, and higher radiographic Brixia score were observed in non-survivors compared to survivors., Conclusion: Greater prevalence of symptoms (alone and in combination) and derangements in blood biochemistry are seen in severe COVID-19 compared to mild or moderate cases, and also in non-survivors compared to survivors., (© Journal of the Association of Physicians of India 2011.)