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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.

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.

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.

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.

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.

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.

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.