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Abstract In urban areas with dense populations and high water demands, effective management of water resources is crucial for sustainable development. It includes optimizing water usage and recycling wastewater to balance supply and demand. Urban rivers, which now carry sewage year-round due to increased urban water consumption, are increasingly used for irrigation in peri-urban regions. This study aims to assess the suitability of an urban stream for irrigation compared to catchment groundwater, using hydrochemical parameters to evaluate water quality indices. Analysis of major ion distribution from upstream to downstream reveals a significant increase of TDS (r2 = 0.65; p

Teachers are the backbone of any country, the pillars upon which all aspirations and dreams converge, if we paraphrase 11th President of India, Dr A P J Abdul Kalam,. A teacher of a Medical college has immense potential to shape the foundation and basic wisdom/ technical skills of a young student and resident. So, teachers’ absence makes the learners bereft of these gifts- making them vulnerable to construct poor reasoning and judging clinical scenarios inappropriately: deriving incorrect or false interpretation from a given case presentation. For this reason, when the National Medical Commission (NMC) comes up and pushes for an idea ensuring physical presence of workforce at their respective workplaces, everyone should welcome the move. Nevertheless, like every fixture the virtual solution has its unique challenges, requiring nuances for proper assessment, demands reasoned and detailed dissection of actual ground -level situation; hence, I want the regulatory body to tweak the attendance -system to make it suitable for diverse atmosphere, varying working -conditions and rapidly -changing environment. Such formulation should have two- way communication channels between man (and woman) power as well as their regulators. Only then fine -tuning may be expected to be achieved to derive the maximum benefit while reducing chances of error/ omission/ glitch/ incompleteness and fault.

Background: SARS-COV-2 is primarily a respiratory illness. However, beyond respiratory illness and associated acute and long-term medical complications, it manifests as stroke, including acute ischemic stroke and hemorrhagic stroke. Clinical evidence reported the occurrence of both venous and arterial thromboembolic complications in SARS-COV-2 positive patients due to hypercoagulable state, hyperinflammatory response, cardiomyopathy, and endothelial inflammation. Materials and Methods: This is a retrospective, single-center cohort study, which includes confirmed SARS-COV-2-positive patients hospitalized between March 2021 and February 2022. Clinical and biochemical data were analyzed. Noncontrast computed tomography of the brain was performed to assess the area and type of stroke. Results: Among all the included 703 patients with SARS-COV-2, 42 patients developed stroke. SARS-COV-2 patients who developed stroke were older and had multiple comorbidities. Patients had higher quick sequential organ failure assessment (qSOFA) score on hospitalization (P < 0.05), higher in-hospital mortality, and had poor clinical outcomes (P < 0.0001). In multivariate regression analysis, there were higher odds of in-hospital mortality linked with higher qSOFA scores (odds ratio 4.47, 95% confidence interval 1.21–16.5; P = 0.025). SARS-COV-2 patients developing stroke had high total leukocyte counts, high neutrophil counts, low platelet counts, low lymphocyte counts, raised C-reactive protein, raised ferritin levels, raised interleukin-6, raised fibrinogen, and D-dimer as compared to those without stroke. Conclusion: Patients with SARS-COV-2 who developed stroke had more severe clinical symptoms, poor clinical outcomes, and higher in-hospital mortality rates compared to those without stroke.

Ground -level health care workers provide us a unique perspective of immunization programs. While our official data may be too rosy to be true, a casual / unscheduled /anonymous conversation with such foot- soldiers may bring us face -to- face with reality through another angle If we want our programs to be robust having a wide coverage, Mantra of success lies not only in making good policy while sitting in ivory -towers but also in folding our sleeves up, sweating under the tropical hot Sun, going to hinterlands and initiating a dialogue with those humble low- level workers who sometimes are invisible to us otherwise, not listened to and with whom sometimes promises are not kept. Promised amount for achieving some target may be small for us but for them that may not necessarily be true. Let’s just enter their shoes for a while and try to observe the situation from their point -of- view. In our siloed system of administration when everyone has knowledge of his/ her territory, let us share our wisdom and field -experience. As an expert in one field may not be having much knowledge about another one.

Introduction: Covid-19 is an unprecedented challenge in our times leaving a trail of destruction and mayhem affecting almost all of us during the last 2 years. Various data sources are available around the globe to measure its impact using various yardsticks. Material and Methods: By carefully looking at data available at the website maintained by Government of India, we can draw some useful conclusions. Results: There is a dip in the number of online registrations at our hospital coinciding with second wave and resultant lockdown. Conclusion: Tracing digital footprints of an event as huge as the Covid pandemic may help us for future planning when we learn its lessons well.

Introduction: Chronic kidney disease (CKD) patients have impaired immune status; that's why these patients are prone to develop infection-related complications. The current study compares non-haemodialysis chronic kidney disease and end-stage renal disease (NO-HD-CKD and ESRD, respectively) patient outcomes, the data of which is sparse. Methods: Patients diagnosed with COVID-19 infection through reverse transcriptase polymerase chain reaction (RT-PCR) were retrospectively studied using electronic health records. Patients were divided into three categories: non-chronic kidney disease (NO-CKD), NO-HD-CKD, and ESRD, and the outcome was assessed. Results: Out of 745 patients, 92 (12.34%) had NO-HD-CKD and 31 (4.16%) had ESRD. CKD patients who were not on haemodialysis had higher rates of comorbidities and D-dimer and C-reactive protein (CRP) values compared to ESRD patients. The overall unadjusted mortality rate was found to be 17.44%, and it was 10.45% in case of NO-CKD patients, 58.69% for NO-HD-CKD patients, and 48.39% for ESRD patients. It was observed that patients having NO-HD-CKD had greater odds ratio of overall expiry in comparison to those without CKD in univariate analysis (OR: 1.58; 95% CI: 1.31–1.91). It was not significant in fully adjusted models (OR: 1.11; 95% CI: 0.88–1.40). Conclusions: During the third wave of COVID-19, we found higher mortality rates for cases with NO-HD-CKD and, to a lower extent, ESRD. However, patients with ESRD were observed to have good outcomes in comparison to those with NO-HD-CKD. Primary care physicians are the first point of contact for patients. Hence, it is critical for them to manage and to do proper referral of comorbid patients to higher centres.

Introduction: Government runs teaching hospitals to impart a high-quality medical education to budding medicos and paramedical students in training. The experiences these trainees at various tenure positions get then and there shape their worldview for rest of the life and have an indelible impression. The Covid-19 pandemic disrupted all the routines at the hospitals around the world—including ours—and we make an attempt to measure it in one dimension in this study. Materials and Methods: We obtained attendance data of patients at out patient department and in patient department of our hospital. During the pandemic for a certain duration offline (physical) registrations were closed and they were attended only by online ones. Hence that data (actually a part of it) got captured electronically and we analyzed it to get an idea of the traversed course of the scourge. Results: When the pandemic surged during the spring and summer of 2021, our hospital was turned into a Covid facility. Hence average routine attendance of patients got reduced to a significant extent, elective surgeries/interventions and procedures were postponed and this data is reflected in an electronic system, perhaps making a long-lasting effect on the budding trainees. This fact needs to be realized so as to take appropriate action. Conclusion: We need to realize that the effects of the viral communicable disease may be enduring, not only for the infected patients and their families but also for those who learn on those patients. Therefore, the transmissible diseases disabled not only our society, economy, and health care services when they ascended but pedagogy too. Online learning came to rescue but only up to a certain extent and with several caveats and limitations.