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Inhalational therapy, today, happens to be the mainstay of treatment in obstructive airway diseases (OADs), such as asthma, chronic obstructive pulmonary disease (COPD), and is also in the present, used in a variety of other pulmonary and even non-pulmonary disorders. Hand-held inhalation devices may often be difficult to use, particularly for children, elderly, debilitated or distressed patients. Nebulization therapy emerges as a good option in these cases besides being useful in the home care, emergency room and critical care settings. With so many advancements taking place in nebulizer technology; availability of a plethora of drug formulations for its use, and the widening scope of this therapy; medical practitioners, respiratory therapists, and other health care personnel face the challenge of choosing appropriate inhalation devices and drug formulations, besides their rational application and use in different clinical situations. Adequate maintenance of nebulizer equipment including their disinfection and storage are the other relevant issues requiring guidance. Injudicious and improper use of nebulizers and their poor maintenance can sometimes lead to serious health hazards, nosocomial infections, transmission of infection, and other adverse outcomes. Thus, it is imperative to have a proper national guideline on nebulization practices to bridge the knowledge gaps amongst various health care personnel involved in this practice. It will also serve as an educational and scientific resource for healthcare professionals, as well as promote future research by identifying neglected and ignored areas in this field. Such comprehensive guidelines on this subject have not been available in the country and the only available proper international guidelines were released in 1997 which have not been updated for a noticeably long period of over two decades, though many changes and advancements have taken place in this technology in the recent past. Much of nebulization practices in the present may not be evidence-based and even some of these, the way they are currently used, may be ineffective or even harmful. Recognizing the knowledge deficit and paucity of guidelines on the usage of nebulizers in various settings such as inpatient, out-patient, emergency room, critical care, and domiciliary use in India in a wide variety of indications to standardize nebulization practices and to address many other related issues; National College of Chest Physicians (India), commissioned a National task force consisting of eminent experts in the field of Pulmonary Medicine from different backgrounds and different parts of the country to review the available evidence from the medical literature on the scientific principles and clinical practices of nebulization therapy and to formulate evidence-based guidelines on it. The guideline is based on all possible literature that could be explored with the best available evidence and incorporating expert opinions. To support the guideline with high-quality evidence, a systematic search of the electronic databases was performed to identify the relevant studies, position papers, consensus reports, and recommendations published. Rating of the level of the quality of evidence and the strength of recommendation was done using the GRADE system. Six topics were identified, each given to one group of experts comprising of advisors, chairpersons, convenor and members, and such six groups (A-F) were formed and the consensus recommendations of each group was included as a section in the guidelines (Sections I to VI). The topics included were: A. Introduction, basic principles and technical aspects of nebulization, types of equipment, their choice, use, and maintenance B. Nebulization therapy in obstructive airway diseases C. Nebulization therapy in the intensive care unit D. Use of various drugs (other than bronchodilators and inhaled corticosteroids) by nebulized route and miscellaneous uses of nebulization therapy E. Domiciliary/Home/Maintenance nebulization therapy; publichealth care workers education, and F. Nebulization therapy in COVID-19 pandemic and in patients of other contagious viral respiratory infections (included later considering the crisis created due to COVID-19 pandemic). Various issues in different sections have been discussed in the form of questions, followed by point-wise evidence statements based on the existing knowledge, and recommendations have been formulated.

“Sustainability” is an integral part of the Indian ethos. The Gandhian philosophy of simple living in harmony with nature and community engagement, the Chipko movement of the 1970 s against deforestation, alternative, green energy projects, emphasis on environmental education in schools and institutes of higher education are only a few examples of Indians consciousness, care and commitment to sustainability issues In this scenario, the focus, in the workplace, is tilting towards a more inclusive and collaborative model of growth and development which values engagement of all stakeholders in safeguarding their larger common interests. This study has the prospect of fulfilment of desire, independence, marriage according to choice, better opportunity for development of children and of own, limitation of family size and above all the role in decision-making. The problems vary according to age, marital status and employment status. The young and unmarried women are more victimized at work place. The unmarried women in their parent house shoulder the responsibilities depending on family environment.

Aim This study was aimed to assess the impact of 6% citric acid and endoactivator as final irrigating adjuncts on clinical & radiographic outcome of pulpectomy in primary teeth & quality of obturation while following standardized biomechanical procedure. Methods 91 primary teeth in 67 children (mean age 5.69 ± 1.896 years) selected for pulpectomy were randomly distributed on the basis of final irrigant into four Groups: Group 1 (CA + E) Citric acid along with endoactivator; Group 2 (CA) Citric acid; Group 3 (SH + E) sodium hypochlorite using endoactivator and Group 4(SH) sodium hypochlorite (Control group). All teeth were assessed radiographically for quality of obturation and followed for 12 months. Results All groups were significantly (p = . 001 ) effective in alleviating pain within 24 h of pulpectomy (60% in citric acid groups & 40% in non citric acid groups). Maximum no. of optimal fillings were observed in Group 1 (CA + E) (33.3%) though it was statistically insignificant. Overall clinical and radiographic success rate was 98.86% & 97.7% respectively. Conclusion Inclusion of 6% citric acid and endoactivator as irrigation adjuncts for primary teeth is beneficial in achieving better quality of obturation and also earlier alleviation of pain.

E. sakazakii has been implicated in necrotizing enterocolitis, bloodstream and central nervous system infections, with mortality rates of 40-80%. Two cases of E. sakazakii infections; one preterm very low birth weight neonate with meningitis and a two month infant with bacteraemia, are described for the first time in India. The first baby succumbed to the infection while the other responded to appropriate therapy. Powdered infant milk formulae have been implicated in causing neonatal infections and the first baby was on formula feed with classic signs of sepsis and meningitis. The second infant was on breast feed and probably developed nosocomial E. sakazakii bacteraemia.