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Cardiovascular diseases (CVDs) are evolving as a cause of mortality and morbidity among young adults. Young adults, particularly those pursuing professional courses in colleges, face unique challenges that may influence their risk of developing CVD. Despite screening guidelines, CVD risk factors often go undetected in the young population, highlighting the need for increased awareness among adolescents. Sleep is an essential indicator of well-being, and its impact on cardiovascular risk factors is increasingly being recognized. An observational cross-sectional study was conducted among young adults aged 18 to 24 years pursuing professional courses in Dehradun, Uttarakhand, India. A total of 156 participants were recruited through multistage, systematic random sampling, and snowball sampling. Data on sleep patterns and cardiovascular morbidity were collected using a pretested questionnaire. Among the study participants, 46.8% reported having less than four hours of sleep on average, and 25% were suffering from sleep problems. The prevalence of diagnosed CVDs was low, with 6.14% reporting arrhythmias and 3.84% reporting hypertension. An association was found between sleep duration, sleep problems, and the presence of CVDs. Participants with shorter sleep durations and more severe sleep problems had a higher prevalence of CVDs. The findings suggest that sleep duration and sleep problems may be modifiable risk factors for CVDs among young adults. Effective health promotion activities focusing on behavior and lifestyle modifications are essential to preventing CVDs from an early age. The study emphasizes the importance of early intervention and health promotion strategies to reduce CVD risk factors in this population. Community-based research and behavior change communication initiatives are recommended to promote healthy sleep habits and prevent cardiovascular diseases among young adults beyond the college setting., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Nautiyal et al.)

Background The increasing production, distribution, promotion, and availability of substances contemporaneous with the changing values of society have resulted in rising substance abuse as an emerging public health concern in India. A prevalence of 32-37% has been reported for substance abuse in various studies conducted in Uttarakhand but there is a dearth of data on socio-epidemiological factors affecting substance abuse. Materials & methods A facility-based observational cross-sectional study was conducted in selected de-addiction and rehabilitation centers of district Dehradun. Data were collected using multistage systematic random sampling from clients admitted to the facility. Results The mean age of in-facility participants was 28 ± 8 years and most of them started taking drugs after the age of 18 years. The most common substance of abuse was alcohol (61.7%) followed by tobacco smoking (15.6%). Both 'peer pressure' and 'curiosity' play a major role in predisposition to substance use. Further, we found that age (p=0.002), and level of education (p <0.001) were important determinants for substance abuse. At the same time, among other factors, the influence of occupation notably did not have a statistically significant association. Conclusion Sensitization and capacity building of both providers and the community is integral to effective strategizing for the prevention and control of substance abuse. Regional studies including the current study can be of help in framing drug policies and management guidelines including prioritizing the importance of the establishment of de-addiction and rehabilitation centers at the district level., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Zahin et al.)

Migraine affects about one billion people worldwide yearly and is one of the most common neurologic illnesses, with a high prevalence and morbidity, particularly among young adults and females. Migraine is associated with many comorbidities, including stress, sleep difficulties, and suicidal ideation. Migraine, despite its widespread occurrence, is underdiagnosed and undertreated. Because of the complicated and primarily unknown mechanisms of migraine formation, several social and biological risk factors, such as hormone imbalances, genetic and epigenetic impacts, and cardiovascular, neurological, and autoimmune illnesses, have been proposed. Through the mid-20th century diversion of the now-defunct vascular theory, the pathophysiology of migraine has developed from a historical study of the "humours" to a distinct entity as a neurological disorder. The range of therapeutic targets has broadened significantly, increasing the number of specialized clinical trials. Understanding the biology of migraine through careful research has resulted in the identification of major therapeutic classes: (i) triptans, serotonin 5-HT1B/1D receptor agonists, (ii) gepants, calcitonin gene-related peptide (CGRP) receptor antagonists, (iii) ditans, 5-HT1F receptor agonists, (iv) CGRP monoclonal antibodies, and (v) glurants, mGlu5 modulators, with further targets being explored. This review provides a comprehensive overview of the most recent literature on epidemiology and risk factors and exposes knowledge gaps., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Gawde et al.)

The immediate postpartum period is a great time to encourage the acceptance of contraceptive methods; the time is influenced by both emotional and physical factors. At this stage, the administration of intrauterine contraceptives is relatively easier with lesser complications due to the prior obstetric event. A single-center cross-sectional study was conducted using a self-constructed questionnaire-based interview on 331 women in their immediate postpartum period who had delivered a healthy live-born infant. The majority (59.8%) of study participants had unplanned pregnancies. We conducted behavior change communication sessions for postpartum family planning which resulted in 89% of participants accepting the methods with the prime reasons for acceptance being temporary child spacing (41%) and a definitive desire for no more children (34%). The odds were higher in women with more than five pregnancies [adjusted odds ratio (AOR) = 1.951, 95% CI = 1.389-2.925] and women whose last pregnancy was planned [AOR = 1.248, 95% CI = 1.002-3.215].The hindrance to adopt and adhere to postpartum contraception stems from a variety of socio-economic factors which are unique to low-income countries. Individually tailored behavior change communication/counseling approaches may help overcome misconceptions and meet the heterogeneous needs for family planning in the immediate postpartum phase., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Pal et al.)

Background and objective The coronavirus disease 2019 (COVID-19) pandemic has highlighted the shortcomings worldwide in terms of preparedness protocols related to epidemics. A key area of research that is evidently overlooked across the globe is the mental health of family caregivers taking care of patients with COVID-19. In light of this, this study aimed to engage in a comparative analysis between the two worst affected countries, India and the United States of America (USA), which differ considerably in their demography, socio-epidemiological factors, and health system efficiency. Methods A cross-sectional study was conducted among 1,250 family caregivers of patients with COVID-19 in India and the USA to assess their stress, anxiety, and sleep disturbance levels using the 10-item Perceived Stress Scale (PSS-10), the 7-item Generalized Anxiety Disorder (GAD-7) scale, and the Pittsburgh Sleep Quality Index (PSQI), respectively. Psychological assessment questionnaires were administered through online mode, which gathered demographic information and responses on several self-reporting scales. The main outcome measures were self-reported ratings on PSS, GAD-7 scale, and PSQI. Results We found that 75.4% of the family members of COVID-19 patients suffered from mental health issues. The scores of all three scales were higher in caregivers from the USA than in India, more evident and pronounced in caregivers of hospitalized patients. The test scores were statistically significant (p<0.05) indicating a negative impact of having a dependent member in the family, being married, being of younger age, and having a longer duration of COVID-19 infection. Vaccines were found to have a life-enhancing effect. Conclusion Our findings highlight that the mental health of family caregivers is an ignored aspect and must be addressed. We recommend the implementation of well-researched and appropriate legislation, treatment programs, and health policies that involve not only the patients but also their families., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Sethi et al.)

Background COVID-19 has now lasted for more than two years as a pandemic and has had enduring effects on the health of people as the post-COVID syndrome. Recent literature has shown the long-term effects of COVID-19 on various organ systems, including but not limited to respiratory, cardiovascular, neurological, musculoskeletal, and gastrointestinal systems. Methods and objectives We aimed to estimate the prevalence of post-acute COVID symptoms in a tertiary care center in northern India; observe the effects of the demographic profile of age, BMI, gender, and presence of comorbidities on the persistence of post-COVID syndrome, and explore any correlation between the severity of COVID-19 disease and the persistence of post-COVID symptoms. We designed a survey containing structured questions evaluating post-COVID symptoms beyond three weeks (post-acute COVID phase), six weeks (post-COVID phase), and 12 weeks of acute illness. It was administered online.  Results Prevalence of post-COVID symptoms both after three and six weeks was reported to be 16.67% and 7.37%, respectively. The most common symptoms to persist were musculoskeletal symptoms (fatigue), followed by upper respiratory symptoms. Disease severity (p<0.05), BMI (p<0.05), and comorbidities were seen to affect post-COVID symptoms significantly, whereas gender and age of the patient had no significant effect. Disease severity significantly affected the persistence of post-COVID symptoms up to 12 weeks; however, this effect does not hold true in long COVID haulers. Also, the risk of developing persistent post-acute COVID symptoms was more in moderate to severe disease than in mild disease. Conclusion The pandemic might be close to over, but it is not out of our lives yet, and the persistence of post-COVID symptoms is exigent., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Uniyal et al.)

Introduction Viral illnesses like mumps, cytomegalovirus (CMV), and Cocksakievirus have been shown to affect the endocrine system, specifically the thyroid as a product of their systemic inflammatory process. The thyroid gland, having high levels of angiotensin-converting enzyme 2 (ACE2) is also predisposed to dysfunction due to coronavirus disease 2019 (COVID-19). Methodology A cross-sectional study was conducted using retrospective data of thyroid function tests in patients with COVID-19. Results The majority of patients with COVID-19 had normal thyroid function while low serum T3, seen in 47.3% of patients with severe disease, stood out as the most common thyroid abnormality in the acute phase of the disease. The disease severity was seen to correlate with the extent of thyroid function abnormalities, with severely diseased patients having lower T3 values and normal to low thyroid-stimulating hormone (TSH) values. Furthermore, a significant negative correlation was seen between TSH and the bio-inflammatory marker, C-reactive protein (CRP). Conclusion The acute phase of COVID-19 affects thyroid function in direct correlation with the severity of the disease., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Sethi et al.)

Apraxia is a cognitive-motor planning disorder that expresses itself as an inability to perform purposeful and skilled movements in the absence of sensory or motor loss and hampers patients' ability to perform activities of daily living (ADL). ADL is a set of everyday tasks required for personal care and independent living, executed through a complex interaction between sensorimotor integration and motor learning. We have designed a 'Strategy training' program for apraxia patients by reviewing the existing clinical trial literature on the above-said topic per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Strategy training is an evidence-based standardized occupational therapy program to improve ADL in apractic patients by teaching them a variety of compensatory strategies to combat impairment and improve activity performance. Three basic steps of strategy training include: 1) initiation-development of an action plan, 2) execution-performance of the plan, and 3) control-assessment and result of action performed. The patient group suggested for strategy training comprises post-stroke (past 20 weeks) apraxia patients aged 40-90 years of both genders, highly motivated and fit to perform ADL. After preliminary assessment, 'strategy training' will be specifically executed through an exclusively visual feedback approach in which apraxia patients learn eight ADLs in 8 weeks (three sessions of 30 minutes/week for 8 weeks). They practice two ADLs for 15 minutes each in every session, thus a total of six sessions will be allocated to learn two ADLs simultaneously followed by the next set of ADLs. Strategy training for brushing teeth is described in detail to show how each step of this training program is implemented for a specific ADL. As this strategy training program is based on individual care, attention, and augmenting motivational aspects, it is expected to teach patients compensatory strategies to learn and perform ADL more smoothly, swiftly, and most importantly independently. The program is not aimed at treating clinical motor symptoms of apraxia per se but to help patients function more independently post apractic motor impairment., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Moinuddin et al.)

Introduction Coronavirus disease 2019 (COVID-19) disease attributed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown associations with various fungal opportunistic infections such as mucormycosis, invasive candidiasis, and aspergillosis, which have contributed to the mortality of the disease. In India, the incidence of mucormycosis had risen rapidly during the second wave. There is ample literature demonstrating the role of iron in the pathogenesis of mucormycosis. The hyperferritinemia associated with COVID-19 may have played a significant role in promoting the invasion and extent of the fungus. Aims and objectives The study aimed to analyze the association between serum ferritin levels and the extent of involvement of mucormycosis in patients affected with COVID-19. Methodology A single-center cross-sectional study was conducted using retrospective hospital record data. G*Power statistical analysis software was used to compute the sample size of 62 (31+31). The radiological data were used to determine the extent of involvement. Results A statistically significant difference was seen in levels of serum ferritin (p = 0.008) between the radiologically judged two groups of the mild extent of invasion of mucormycosis (rhinosinusitis) and severe extent of invasion (rhino-orbital/cerebral mucormycosis), with a severe extent seen with the group having higher levels of serum ferritin. Severe extent of invasion was seen in 53.6% of patients with diabetes mellitus and 62.5% of patients with both diabetes and hypertension. Conclusion The hyperferritinemia not only presents as a marker of the systemic inflammatory process in COVID-19 but also indicates increased free iron, which thereby aids the growth and extent of involvement by the fungus ( R hizopus oryzae ). In individuals with diabetes and hypertension, the severity was greater. Controlling catastrophic outcomes in individuals with high serum ferritin levels necessitates extra caution., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Bhadania et al.)

In motor learning, augmented feedback (AF) is the information provided by sources outside the body and encompasses visual feedback, auditory feedback, and multimodal augmented feedback. This review aims to examine the most recent evidence on these different modality types in healthy and diseased populations and athletes. The reporting of this review was guided by the standards of the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)" statement with the aim to examine the most recent evidence on these feedback types in healthy and diseased populations and athletes. The literature search for this review has been limited to electronic journals with the search engines ISI Web of Knowledge, OvidSP EMBASE, and PubMed databases. This review considers visual feedback as the cornerstone of all augmented feedback types by citing its superiority in learning complex skills by medical students and balance maintenance by older adults. The review also deciphers the role of auditory augmented feedback in encumbering already burdened visual connections in the rehabilitation of patients with Parkinson's disease (PD) and prosthetic limbs and further argues why the multimodal feedback model seems to be the most efficient way to offer feedback in learning motor tasks by alluding to multifaceted "skill training communication model" in the prevention of sports injuries such as anterior cruciate ligament tears. Multimodal augmented feedback seems to be the most effective and appropriate way to give feedback during motor learning in healthy and diseased populations and athletes as its stimuli are perceived faster and tend to be retained longer compared with the unimodal stimuli of auditory and visual feedback mechanisms., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Moinuddin et al.)