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Background: Health and wellness canters component were launched under the ambit of Ayushman Bharat Yojana. In Kashmir, there was scarce data regarding health and wellness centers implementation therefore this study was undertaken to identify the gaps in implementation of the program at grassroot levels. Objective: to assess and compare the existing staff, services, lab services and infrastructure at health and wellness centers across ten districts of Kashmir valley. Methodology: a descriptive cross-sectional study was done to evaluate the implementation of health and wellness centers in ten districts of Kashmir valley. study population: staff at health and wellness centers study setting: selected health and wellness centers in 10 districts of Kashmir valley sampling: convenient sampling and random sampling 10 % of upgraded health and wellness center in each district at the beginning and 12 months of study. study timeline: 15months data collection 12 months interpretation 3 months study tools: preformed checklist, semi open questionnaires interviews Results: the results of the study indicated that there was still a gap in implementation of program as per guidelines. there were deficiencies in terms of yoga and wellness, proper space for health and wellness centers and staff was not trained properly about the program. Conclusion: this study was done in Kashmir valley to asess the implementation of health and wellness center component of Ayushman Bharat yojana. the study highlighted important deficiencies during the implementation of the program as per guidelines.

Background: Adherence to antihypertensive therapy is an important factor in determining the clinical course of hypertension. This study was planned to estimate adherence to antihypertensive therapy and its determinants among OPD patients attending two primary care hospitals in Kashmir valley. Methods: This study employed a cross-sectional study design. All subjects who reported to OPD between October and December 2020 and had been prescribed antihypertensive medications for at least 1 year were included. Sociodemographic information was collected on a pretested schedule and adherence to medications was assessed by using the-14 item Hill-Bone HBP Compliance to High Blood Pressure Therapy Scale (HB-HBP). Mann–Whitney test and Spearman's rank correlation coefficient were used. Results: A total of 406 subjects were included in the final analysis with a mean age of 58 years for women and 56 years for men. The sample comprised 54% women. More than 60% of subjects were currently married, urban area residents, and belonged to middle strata of social class. The mean score obtained in the HB-MAS (maximum score 56) was 19.26 (SD ± 4.3). Subjects aged 60 years and above, those belonging to lower socioeconomic class, and subjects prescribed three or more drugs with more than once-daily dosing regimen had higher odds of having poor adherence. Conclusion: There is suboptimal adherence among OPD patients at primary care level. There is a need for enhanced counselling regarding medication adherence particularly for elderly, poor, illiterate persons and those prescribed multiple medicines with more than once-daily dosing. [ABSTRACT FROM AUTHOR]

Breast cancer demonstrates geographical and ethnic variation in its incidence reflecting the effect of local environmental conditions and lifestyle. The genesis of the disease has further been complexed by the involvement of a number of genes with small effects and above all by population heterogeneity. Accordingly, variations in genes, including breast cancer 1, early onset (BRCA1)/breast cancer 2, early onset (BRCA2), that have been markedly associated with the breast cancer phenotype exhibit a scattered mutational pattern in different populations. The present study was aimed to analyze the sequence variations in BRCA2 gene in a case control manner in ethnically pure Kashmiri population using PCR. Sequencing of BRCA2 exons revealed the presence of five sequence variations, four of which present in exon 11 alone were somatic and one was germline located in the U-terminal region (UTR) of exon 2. Out of these, the two somatic mutations comprised of substitutions, one representing a missense mutation leading to an amino-acid substitution at codon 991 and the other was a silent mutation at codon 1131, whereas the other two mutations located in exon 11 represented a loss of polymorphism. Codons for amino acid position 846 and 868 were demonstrated to be heterozygous polymorphic variants in 66% of the normal breast tissue samples, whereas the heterozygous polymorphic variant codons at the two loci were replaced by a homozygous genotype in associated tumor tissue in 88% of cases. These two mutations were always linked. Germline variation observed in exon 2 was located in the UTR region at contig position 13870572 (rs1799943). Other screened exons of BRCA2 did not demonstrate any sequence variation. These variations may contribute to breast cancer susceptibility along with variations in other low penetrating genes in sporadic types of breast cancer in this cohort of the population. [ABSTRACT FROM AUTHOR]

Background: Nitric oxide (NO) turnover is vital for proper endothelial function to maintain a healthy vascular system. Various risk factors responsible for hypertension and diabetes may disrupt this homeostasis, leading to decreased bioavailability and/or bioactivity of NO, which potentiates endothelial dysfunction. Plasma NO is a useful indicator of NO homeostasis and vascular endothelial function. Since endothelial function plays a key role in the development and progression of diseases like diabetes and hypertension, we sought to investigate the NO profile in patients having diabetes and hypertension and determine the relationship of NO turnover with the disease., Materials and Methods: For this purpose, three groups were studied for the NO production. The first group consisted of 74 hypertensive patients, the second group consisted of 72 diabetic patients and the third group consisted of 60 healthy controls. Nitrate synthase activity was evaluated by measuring nitrate level using an automated sample injector connected to an automated NO detector - Ion liquid chromatograph., Results: The plasma concentration of NO was found to be significantly lower in both essential hypertensive patients and diabetic patients without complications as compared to the healthy controls (P < 0.05)., Conclusion: This data confirms that different factors like hyperglycemia and blood pressure are seen to have immense influence on NO production.

There are no population-based data available on cancer pattern in Kashmir and our study is the first kind which represents the trend in cancer pattern in the valley. The source of our data were cancer patients registered in the Department of Radiation Oncology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, and Department of Radiation Oncology, SMHS, Srinagar during the period Jan 2002 to Dec 2006. These are leading medical centres in the valley and draw most all of cancer patients from all over Kashmir for treatment. During the period a total of 6,943 cases were registered of which 4,345 were males and 2,598 were females. The age standardized incidence rates were 34.9 per 100,000 for males and 24.8 per 100,000 for females. Oesophagus was the leading site of cancer in both sexes (male ASR 11.2; female ASR 8.3) followed by lung (ASR 6.5), brain (ASR 2.2) and head and neck (ASR 2.2) in males and breast (ASR 5.2), skin (ASR 1.6) and rectum (ASR 0.95) in females. The incidence of cervical cancer in females and prostate cancer in males was lower in Kashmir as compared to other Indian registries. Overall cancer incidence was significantly lower and cancer patterns were markedly different in Kashmir. The observed cancer pattern indicates that awareness campaigns, life style and dietary habit changes, tobacco-control measures and early detection of breast cancer are very important for cancer control in this population.