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Colors are an inextricable element of the world we live in, and their influence on how people perceive their surroundings is irrefutable. It is a subtle stimulator with silent impact on physical, physiological, psychological, and sociological aspects in every day human lives. An interior designer can use color theory and alter characteristics of rooms by pleasing color plan for interiors to match the purpose and interests of residents. Therefore, the author had undertaken a study and interviewed people from different walks of life to assess their perception about the use of colors in interiors and concluded that people expressed color as an important factor in interior design. They prefer different colors as per the size and space of each room and considered quality material, availability of natural light, and matched the color of interiors. They also believe that color affects health, mood, and emotions of the person.

Background: Floods comes with devastating effects on individual and family worldwide. Flash floods are very common in India. Indian citizens have experienced a variety of floods at Uttarakhand, Kerala, Chennai, and Assam etc. The aftermath of floods can be seen on quality of life (QOL) and mental health as post-traumatic stress disorder (PTSD) among victims which should be improved. The present study was aimed to assess the effectiveness of the virtual teaching tool (VTT) on measures to improve QOL and PTSD among adolescents who experienced flood at Uttarakhand. Methods: Mixed method research approach and exploratory research study, one-group pre-test-post-test designs were adopted for this study. Using a non-probability, convenient sampling technique, forty adolescents who experienced flood were selected from the Bhatwadi, Uttarkashi district of Uttarakhand. Tools includes demographic data, WHOQOL-BREF, PCL-5 and one subjective question. Results: VTT on measures to improve QOL and PTSD was administered after pre-test. The mean and standard deviation of post-test WHOQOL-BREF score 275.37±38.01 was higher than the mean and standard deviation of pre-test WHOQOL-BREF score 227.30±36.52. The mean and standard deviation of post-test PTSD (PCL-5) score 1.00±.00 was lower than the mean and standard deviation of pre-test PTSD (PCL-5) score 1.67±.474. There were no association between sociodemographic variables with WHOQOL-BREF score and PTSD (PCL-5) scale. There is a correlation in pre-test QOL and PTSD. People were afraid of floods, loss of lives and households, and there is acceptance to the aftermath of flood and ready to accommodate. Conclusions: VTT on measures to improve QOL and PTSD is effective and can bring the community change after among adolescents who experienced floods. Key words: Adolescents, flood, PTSD, QOL, virtual teaching tool.

This study aims to assess the perception and attitude of health care personnel regarding integration of nursing education and nursing services. Using purposive and stratified random sampling technique, 92 medical faculty, 32 nursing faculty and 346 nursing officers were enrolled. A three-point Likert scale consisting of 15 items and six open ended questions was used to collect the data. Overall, the concept of integration of nursing education and nursing services at their institute was welcomed by 74.4% of health care personnel. Medical faculty (47.8%), nursing faculty (37.5%) and nursing officers (57.5%) scored the concept of integration as very good.

Aim and objective To reduce the incidence of infiltration and phlebitis by 50% over 2 months among children admitted to the emergency room (ER) of a tertiary care hospital. Materials and methods The study was conducted in the pediatric ER of a tertiary care hospital in North India. All children aged >28 days, receiving intravenous (IV) medication and/or fluids, were enrolled between June (2017) and September (2017). Existing practices of IV line insertion and maintenance were observed and recorded. The visual infusion phlebitis score and infiltration assessment scale were to grade the extent of two. The intervention classified as “IV line insertion and maintenance bundle” included the introduction of low-cost mobile sterile compartment trays, audit and feedback, organizational change, introduction of infection control nurse and quality improvement (QI) team formations were implement in different Plan-Do-Study-Act (PDSA) cycles. Reduction in the “incidence of phlebitis and infiltration” was outcome measures while “scores on checklist of IV line insertion and IV line maintenance and administration of drugs” were process measures. Result The process measures, for IV line insertion, maintenance and administration of drugs through IV line, revealed an increase in scores on the checklist. There was a significant decrease in the incidence of infiltration and phlebitis from 82.9 and 96.1% to 45 and 55%, respectively, postimplementation of all PDSA cycles. Conclusion Multifaceted QI IV line insertion and maintenance bundle reduced the incidence of infiltration and phlebitis. These interventions when integrated into daily work bundles along with continuous education and motivation help in sustaining the goal and attaining long-term success. How to cite this article Singh N, Kalyan G, Kaur S, Jayashree M, Ghai S. Quality Improvement Initiative to Reduce Intravenous Line-related Infiltration and Phlebitis Incidence in Pediatric Emergency Room. Indian J Crit Care Med 2021;25(5):557–565.

Background The burden of cognitive, behavioral, and functional impairments after traumatic brain injury (TBI) is still not highlighted much, but its impact on caregivers is socio-economically relevant. The objectives of the study were to assess cognitive, behavioral, and functional impairments in patients of TBI and its impact on caregiver burden. Materials and Methods A descriptive cross-sectional study was conducted using a total enumeration sampling technique. Mini-mental status examination, neuropsychiatric inventory and Rappaport’s disability rating scale were used to assess patients’ cognitive, behavioral, and functional impairments, respectively. Zarit Caregiver Burden Scale was executed to quantify the caregiver burden. Results Fifty patients of TBI and their caregivers were enrolled. Among these, 24% had moderate cognitive impairments. Among behavioral symptoms, 40% had agitation, 24% had depression, 18% had anxiety, and 16% had irritability. Moderate functional disability was reported by 18% of the patients, while 2% reported severe functional disability. Moderate to severe caregiver burden was reported by 8% of caregivers. Patients’ behavioral (r = 0.507, p < 0.001), functional (r = 0.473, p = 0.001), and cognitive (r = –0.438, p = 0.001) impairments had significant correlations with caregiver burden. Conclusion Patients develop cognitive, behavioral, and functional disability after TBI. The caregiver burden increases significantly with cognitive dysfunction, behavioral symptoms, and impaired functional status of patients. Therefore, appropriate support is to be provided to caregivers as well as patients.

Context: Chronic kidney disease (CKD) patients have suboptimal quality of life (QOL). Various studies/researches have revealed that breathing exercises have a positive and favorable impact on different systems of the body. Aims: This study aims to assess the effect of a breathing training program on QOL in patients with predialysis CKD. Settings: The study was a single-center study conducted at PGIMER, Chandigarh. Design: Randomized controlled trial. Methods: Sixty individuals were enrolled and randomized using lottery method. QOL was assessed or evaluated by Kidney Disease and QOL questionnaire (KDQOL™-36). Breathing exercises were taught to the intervention group. Patients included in control group continued with the routine care. Assessment of QOL was done after 4 weeks in both the groups. Results: Change in KDQOL™-36 scores showed significant difference between control and the intervention group. The mean scores of control group in the subscale effects of kidney disease, SF-12 Physical functioning (Physical Health Composite) and SF-12 Mental functioning (Mental Health Composite) were 84.79, 39.16 and 37.40, respectively, whereas in intervention group, the respective mean scores were 91.88, 43.92, and 44.16. The difference was statistically significant (P = 0.04, P = 0.01, and P = 0.003, respectively). Conclusions: Breathing training program improves QOL in patients with predialysis CKD.

BACKGROUND Although skin diseases are among the most common problems observed in healthcare settings, the skin health is relatively ignored. Besides the morbidity, skin diseases also pose a huge financial and psychological burden for the patients and their families, but there is lack of population-based prevalence data related to skin disorders. OBJECTIVE To assess the prevalence of skin problems in the selected population of peri-urban community of Chandigarh from patients’ point of view. METHODS A cross sectional study design was used to assess the prevalence of skin problems. Data was collected with the help of an interview schedule, including demographic parameters, family income and hygiene practices. All skin problems as perceived and reported by the respondent were included in the study. Patients who had sought healthcare services were asked additional questions regarding type of treatment received and the facility visited. RESULTS A total of 3807 participants were enrolled from various households, irrespective of age and gender. Overall, 159 participants reported having a skin problem. Point-prevalence of self-reported skin problems in the present study was 41.7 per 1000 population. Skin problems were most prevalent in 31-45 years age group (30.4%). Allergy was the most common self-reported skin problem (10.8 per 1000 population) followed by itching (7.1 per 1000) and fungal infection (6.3 per 1000). About one-fourth (23.9%) of patients were not receiving any treatment for their skin problem. CONCLUSIONS Skin diseases were common in the studied community, affecting both genders and all age groups. Focus on management of few common conditions may greatly reduce the overall burden of skin diseases. An alarming number of patients not receiving treatment or seeking treatment from quacks highlights the gaps in health care.

To determine the effect of earmuffs on stability of physiological parameters i.e. heart rate, respiratory rate, and oximeter saturation (SpO2) in preterm neonates. Non-randomized, cross-over study. 60 stable preterm neonates observed without and with earmuffs for 2 hours each (control and intervention periods, respectively). The above parameters were recorded every 60 seconds. Spikes of parameters and fluctuation [by coefficient of variation (CoV)] were compared between periods. Spikes of all parameters as a proportion of observations, were significantly less in intervention period. Median (IQR) spikes per subject were lower in intervention vs control: tachycardia [2.5 (2.5, 18) vs. 20.5 (2.2, 37.7); P

Introduction: Stroke nurse is functioning as a vital member of the stroke team. She/he provides care to the stroke patients in acute as well as post-acute periods. She/he coordinates among other team members to facilitate the stroke care continuum. Post-stroke care is always a challenge for health care professional as well as caregivers. During current pandemic conditions, it is essential to provide quality care at their home. Purpose: To develop a mobile application to provide home based care for prevention and management of post stroke complications among survivors. Methods: Survey was carried out among 170 bedridden stroke survivors and their caregivers to assess problems faced like aspiration pneumonia, bedsore, urinary tract infection, deep vein thrombosis, frozen shoulder, contractures, and caregiver burden. On the basis of findings ‘Stroke home care’ a bilingual (in Hindi and English) mobile application was developed which contains step by step nursing-care-procedural videos to prevent bedsore, bedsore dressing, positioning change, Ryle’s tube feeding, Foley’s catheter care, active and passive range of motion exercises, hand washing with soap-water as well with sanitizer, psychological support to patients. Results: Through this intervention, caregivers of bedridden stroke patients get trained for care procedures so that they can provide best possible nursing care to their patients at home and can prevent post stroke complications and ultimately enhances quality of life of survivors and reduce caregivers’ burden. Conclusion: ‘Stroke Home Care’ is a novel intervention developed by a stroke nurse which has been developed and tested not just for its feasibility and acceptability but also proven for its clinical applicability through PROBE designed study. This web based intervention can provide rehabilitation services to bedridden stroke survivors at their home in this pandemic.

Introduction: Stroke rehabilitation and caregivers training is central to improve post stroke care and reduce caregivers’ burden. Mobile applications(app) may provide a patient and caregiver centric modality to improve stroke care Aim: To develop and evaluate feasibility of a medical application for delivering post stroke care. Methods: A mobile app was developed on an android operating system following a preliminary assessment of post stroke complications to train caregivers. App consists of videos of home based care strategies for bedsore prevention, feeding, mouth care, ROM exercises, catheter care, psychological support to patients etc. App includes awareness videos on stroke, problems faced after stroke, follow up schedule, feedback option. App feasibility was assessed among 25 bedridden stroke survivors and their caregivers selected purposely. App validation was done by 16 stroke experts including neurologists, nurses, psychologists, physiotherapists using semi-structured-questionnaire for data collection. Following this, final "Stroke Home Care" app was developed. Results Feasibility: Mean age of patients and caregivers was 52.6±14.8 and 32.4±8.9years, respectively. 64% patients females, 75% caregivers males. 56% lived in rural. Median NIHSS 14 (IQR: 12-17). Complications were 56% Ryle’s tube, 72% Foley’s catheter, 12% bedsore. 64% caregivers were graduates. 52% sons. All caregivers responded that app contents, videos and language was understandable and appropriate. 92% preferred ‘Hindi’ language. All agreed to App enhancing their stroke knowledge. All were satisfied. Validation: Mean age of experts was 33.2±4years. 75% females. 56% nursing experts and postgraduates,19% MDs. 50% Nursing teachers, 19% Neurology fellows. None faced any app installation problem. 81.3% experts highly satisfied with app functions, its contents, voice clarity, video clarity and duration, contents’ sequence, understandability. Discussion/Conclusion: “Stroke Home Care” App is feasible, pragmatic and user-friendly for use by caregivers of stroke survivors in a resource limited setting/developing country. It should be tested by an RCT to evaluate its efficacy in reducing post stroke complications and reducing caregivers’ burden.

Background: Post stroke care is a major challenge in resource poor settings due to lack of trained caregivers. Mobile application(m-app) based care strategy may provide low cost solution to counter this burden.MAPSS tested m- app in a pilot randomised control study on bed ridden stroke patients. Objectives: To develop smartphone based medical application for delivering post stroke care strategies and to evaluate its efficacy in reducing post stroke complications. Methods: Patients within 3 months of stroke were randomised to either routine care (Controls) or App based care (MAPPS). Major inclusions were: Modified Rankin Score(mRS) >3, caregivers/patients with smartphone and internet facility and willing to use an app as health care tool.Major exclusion: Patients with no caregiver or hired /illiterate caregiver. MAPSS group was additionally given routine care with booklet. "Stoke Home Care" app was installed in caregiver smartphone and explained its use.Follow up was at 3 months which was blinded. Primary outcomes were a.) composite incidence of bed-sores, aspiration pneumonia, catheter associated UTI (CAUTI), shoulder pain and deep vein thrombosis (DVT) b.) Patient’s Health related Quality of Life(HRQOL) and Caregiver stress index (CSI). Results: 166 patients were recruited (83 each group and one caregiver per patient).Mean age was 54.98±15.76 yrs and 73.5% males (Controls were matched);.53% were ischemic strokes.65% had mRS 5,Median NIHSS was 13. At 3 months,3.6% MAPSS vs 6% controls lost to follow up ,12% MAPPS vs 24.1% controls were dead.33.8% MAPSS vs 56.4% controls developed at least one post stroke complication (composite) (P=0.004); 5% MAPSS vs 15.4% control had bedsore (P=0.031). Trend of reduced aspiration pneumonia in MAPSS (P=0.055) seen. Median HRQOL score was 68 (IQR: 50-80) in MAPSS vs 50 (IQR: 38-61) in controls (P=0.001); CSI- 9 (IQR: 5-13) in MAPSS vs 15 (IQR: 13-20) controls(P=0.001). Multivariate analysis favored MAPPS- composite post stroke complications (aOR: 0.311, 95% CI: 0.151 - 0.643; P=0.002) and mRS (3-6) (aOR: 0.312, 95% CI: 0.098 - 0.998; P=0.049) Conclusions: MAPPS is superior to routine care in preventing major post stroke complications and associated with better QOL in stroke patients and reduced caregiver stress.

Background Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality in India. CVDs are to a large extent preventable with the availability of wide range of interventions focusing on primary and secondary prevention. However human resource deficit is the biggest challenge for implementing these prevention programs. Task shifting of the cardiovascular risk assessment and communication to nurses can be one of the most viable and sustainable option to run prevention programs. Methods The study was quasi experimental in nature with 1 year follow up to determine the effect of CVD risk assessment and communication by nurses with the help of risk communication package on primary and secondary prevention of CVDs. The study was done in the outpatient departments of a tertiary health care center of Northern India. All the nurses (n = 16) working in selected OPDs were trained in CVD risk assessment and communication of risk to the patients. A total of 402 patients aged 40 years and above with hypertension (HTN) were recruited for primary prevention of CVDs from medicine and allied OPDs, whereas 500 patients who had undergone CABG/PTCA were recruited from cardiology OPDs for secondary prevention of CVDs and were randomized to intervention (n = 250) and comparison group (n = 250) by using block randomization. CVD risk modification and medication adherence were the outcomes of interest for primary and secondary prevention of CVDs respectively. Results The results revealed high level of agreement (k = 0.84) between the risk scores generated by nurses with that of investigator. In the primary prevention group, there were significantly higher proportion of participants in the low risk category (70%) as compared to baseline assessment (60.6%) at 1 year follow up. Whereas in secondary prevention group the mean medication adherence score among intervention group participants (7.60) was significantly higher than that of the comparison group (5.96) with a large effect size of 1.1.(p Conclusion Nurse led intervention was effective in risk modification and improving medication adherence among subjects for primary and secondary prevention of CVDs respectively. Trial registration Trial registration no CTRI/2018/01/011372 [Registered on: 16/01/2018] Trial Registered Retrospectively.

Background: Hospitalisation is a stressful situation especially for children. Health care providers (HCPs) play an important role in caring for the sick children. Objective: To assess the health care providers’ collaboration and satisfaction about care decisions and parents’ satisfaction about care provided to the patients admitted in Pediatric Intensive Care Unit. Materials and Methods: This was a descriptive study conducted among 32 HCPs working in PICU and 50 parents of children admitted to the PICU of a tertiary care teaching and referral hospital in India. The subjects were selected by total enumeration sampling method. Information profile details and data related to parental satisfaction were gathered using a structured interview schedule. Data related to HCPs’ collaboration and satisfaction about care decisions were gathered using a structured questionnaire. The data were analyzed using SPSS (Version 20.0). Results: Majority of the parents were highly satisfied (92%) with the care provided by the HCPs. More than two-third (87.5%) of the HCPs were highly satisfied with the collaboration among them related to care decisions. Conclusion: Majority of the parents of children admitted to PICU, were highly satisfied with the care provided to their children. Furthermore, most HCPs showed a high level of collaboration among themselves and were satisfied with the care decisions related to the PICU children.

Objective: To evaluate the effectiveness of interventional package on the level of anxiety, depression, and fatigue. Methods: The study was conducted in room no. 5, first floor, B Block, Department of Radiotherapy, Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh Quasi experimental pretest-posttest design was used in the study. A total of 60 patients receiving radiotherapy/chemotherapy were assigned in two groups of 30 each, through total enumeration sampling technique. The tools used for the study were Zung Anxiety Scale, Beck Depression inventory, and Fatigue Scale. The protocol used for the study includes the Jacobson's Progressive muscle relaxtion technique, counsling and home care techniques. Results: Sociodemographic variables and clinical profile of participants in both groups were comparable. Interventional package significantly reduces the anxiety, depression, and fatigue (P < 0.001 in 3 variables) in experimental group. Conclusions: Interventional package for patients with cervical cancer proved to be an effective modality in reducing the anxiety, depression, and fatigue.

Objective: The study was conducted to assess the effectiveness of “percutaneous coronary intervention (PCI) care program” among patients undergoing PCI. Subjects and Methods: A quasi-experimental design was adopted, and purposive sampling technique was used to enroll the patients in the experimental and control groups. Different tools were used to collect the data, which include numerical pain and comfort rating scale, Barthel Index for activities of daily living, assessment for the presence of vascular complications, modified CADEQ-SV questionnaire, State-Trait Anxiety Inventory scale, self-structured satisfaction scale, and PCI manual. Results: There was a significant decrease observed in state anxiety (P < 0.001), pain level at 12 h (P = 0.03), discomfort within 12 h (P < 0.001) and 24 h (P = 0.002), improving knowledge regarding coronary artery disease (CAD) (P < 0.001), and activities of daily living as well as significant increase in satisfaction level (P < 0.001) among patients undergoing PCI in the experimental group than the control group. Conclusion: The study concluded that this program was effective in reducing anxiety, pain, and discomfort and increased satisfaction level, knowledge regarding CAD, and independence in self-care activities for PCI patients.

Background: Expressed emotions (EE) are the critical, hostile and emotionally over- involved attitude of relatives towards a family member who is suffering from a disorder. It is a measure of the expressed attitude of the relatives towards their psychological patient in their absence. As, in bipolar affective disorder (BPAD) alternating/recurring periods of depression and elevated mood occurs which leads to varied levels of stress and expressed emotions in the patient as well as their caregivers.Methods: An exploratory study was conducted in psychiatry ward and psychiatry outpatient department (OPD) of PGIMER, Chandigarh on BPAD patients and their caregivers (N=50 each) using purposive sampling technique. Data was collected in the month of March for 10 days. Interviews were conducted using the modified perceived stress scale by Sheldon Cohen and Hooley’s expressed emotions scale for assessing expressed emotions levels, respectively. Results: Data analysis done with the help of statistical package for the social sciences (SPSS) 22 version 16.0 through descriptive and inferential statistics. The study revealed that 64% of caregivers face criticism from their patients whereas 62% of patients receive criticism from their caregivers. The study also showed that 68% of caregivers were given emotional support by their patients. 66% of caregivers and patients, both displayed moderate level of perceived stress.Conclusions: It can be concluded that both EE and perceived stress are significant stressors for the BPAD patients and their caregivers.

Background To evaluate the effectiveness of short-timed post-meal and one-time daily exercise on glycemic control in patients with T2DM. Methods Sixty-four T2DM patients were randomised into crossover design. Group A (n = 32) underwent post-meal exercise (moderate-intensity brisk walking covering 1500–1600 steps for 15 min, starting 15 min after each meal) from d1 to d60 followed by one-time daily exercise (45 min pre-breakfast brisk walking at stretch covering 4500–4800 steps) from d61 to d120, while it was vice versa for the group B (n = 32). The five-point blood glucose profile was performed on d1, d30, d60, d90 and d120, and HbA1c on d1, d60 and d120. Fitness wrist band was used for step-counting to ensure the intensity of exercise and compliance to exercise protocol. Results Group A patients showed a significant improvement in five point blood glucose profile and HbA1c after performing post-meal exercise (p

To investigate the efficacy of distraction by flippits/distraction cards in relieving pain associated with pediatric venipuncture process in young children.This study was a prospective, non-blinded, randomized controlled trial. The sample consisted of 210 children aged 4 to 6 y undergoing phlebotomy in the sampling room of the Advanced Pediatric Center outpatient department and were randomly assigned to control and intervention groups. Latter were exposed to distraction using flippits/distraction cards during the procedure. Pain was assessed for both groups by using FLACC (Face Legs Activity Cry Consolability) behavior pain assessment scale. In addition, procedural pain was also assessed by Wong Bakers Faces Pain Scale (WBFPS) using children and parents' report.Flippits (distraction cards) had a significant effect on behavioral response to pain in children during blood sampling as evidenced by lower mean pain scores in the intervention group (2.75 ± 0.97) as compared to the control group (3.24 ± 0.85) as per FLACC behavioral pain assessment scale (p 0.001). Parents and self reported pain as per Wong Baker Faces Pain Scale was also lower in the intervention group as compared to the control group (p 0.001). Odds of severe pain/discomfort (total pain score 7-10) were 2.5 times higher in controls as compared to the intervention group (OR 2.5; 95% CI: 1.40-4.45) (P 0.002).The use of simple distraction technique using flippits can significantly relieve the pain associated with blood sampling in children.

Background Behavioral symptoms among postoperative patients with intracranial tumors and distress among caregivers are common. Objectives This article aimed to assess the effectiveness of a brief nurse-led intervention on behavioral symptoms of postoperative patients with intracranial tumors and distress of their caregivers. Methods A randomized controlled trial was conducted on 80 patients with intracranial tumors and their family caregivers in a tertiary care institute in India. A brief nurse-led intervention was provided in the form of individual counseling, and a pamphlet was given to patients and caregivers in the experimental group at the time of discharge. Behavioral symptoms of patients and distress of caregivers were assessed. Findings Patients in the experimental group had significantly fewer behavioral symptoms and less severity of behavioral symptoms as compared to the control group. Caregivers in the experimental group had significantly less severity of distress as compared to the control group.

Background: Alcoholism is considered as a major health as well as a social problem. Often the family members of alcoholics suffer intense psychological, physical and social trauma due to the core drinking problem of the family member. Most deeply affected are the wives of alcoholics. Aim: The present descriptive study aimed to investigate the problems faced and coping strategies used by the wives of alcoholics. Methodology: A total of 30 wives of alcoholic clients seeking treatment in De-addiction Centre were interviewed for the same. The problems were identified using a non standardized 17 item structured questionnaire while coping in wives of alcoholics was assessed using standardized tool. Results: The findings revealed the problems faced by alcoholics wives were in multiple domains viz. physical, psychological and social. While most highly reported were the emotional problems and least reported were the problems of physical violence. Coping strategies used by wives of alcoholics were reported in three major styles: engaged, tolerant and withdrawal. Conclusion and Recommendations: The problems faced by alcoholics have often wedged the attention in society yet finding and applying effective interventions to reduce the pain and suffering of being a partner of alcoholic is still a challenge.

Background: Men who have sex with men (MSM) are a vulnerable group who are susceptible to high incidence of Sexually Transmitted Infections (STIs) and Acquired Immuno-Deficiency Syndrome (AIDS). The objective of the study was to assess sexual identity, sexual behavior and self-reported medical and psychosocial issues of MSM in Chandigarh, India.Methods: A total 115 MSM were included in the study from two Non-Governmental Organization (NGO) centres of Chandigarh and were selected using simple random sampling. The interview was conducted in the office of NGOs centre with the help of an interview schedule. Results were analysed using descriptive analysis.Results: Nearly half of the participants (48.7%) self-reported their identity as bisexual and 27.8% of them identified them as Kothi (passive partner). Approximately one third of (33.9%) MSMs reported their first sexual relationship as ‘non-consensual’ and 19.1% reported themselves as a victim of child abuse. Six percent participants reported symptoms of depressed mood, 22.6% of MSMs had suicidal thoughts and 11.3% had tried to attempt suicide at least once. STIs symptoms were reported by 15.6% of the participants in the last three months; while 2.6% were HIV positive.Conclusions: Psychosocial issues and health problems are triggering factors for suicidal ideation and suicidal attempt in the MSM population.

Background: Internationally, the implementation of cardiovascular disease (CVD) prevention programs by nurse practitioners is being encouraged. Evidence suggests the effectiveness of nurse-led clinics for the primary and secondary prevention of CVDs. However, in India, nurses are underutilized for this task. The present study was undertaken to check the feasibility of task shifting of CVD risk assessment and management by nurses and have concluded that given appropriate training, nurses can do this task. However, to facilitate the implementation of these tasks by nurses at the larger level, barriers need to be identified and lifted. Hence, the experiences of nurses who participated in the study were assessed. Methodology: Qualitative approach was adopted to explore the experiences of nurses who participated in the study to determine the potential barriers and facilitators to implementing CV risk assessment and management using the World Health Organization/International Society of Hypertension (WHO/ISH) charts as routine practice by nurses. In-depth interviews were conducted with the help of the topic guide. These interviews were transcribed verbatim for analysis. A total of six in-depth interviews were conducted. No new themes emerged after the first four interviews. Results: A total of six nurses participated in the study. All the nurses were female, with the mean age of 38 ± 9.2 years. The analysis resulted in seven key themes which are crucial to the nurses involvement in CVD risk assessment and management. The themes are (1) Use of WHO/ISH charts in routine nursing practice, (2) Lack of contact with patients, (3) Time, (4) Lack of appraisal and Performance-based appraisal, (5) Increasing the scope of task shifting, (6) Infrastructure, (7) Training facilities for nurses, (8) Team member support. Conclusion: The study concludes that despite the challenges and barriers participating nurses expressed their willingness to do the task of CVD risk assessment and management. Appropriate training and continuous feedback from the higher health-care professional is essential for the successful implementation of CVD risk assessment and communication as routine practice by nurses. The availability of adequate workforce and time were the key concerns raised by participating nurses.

The effectiveness of music therapy for relieving pain and anxiety during burn dressing changes has not been reported from India. PURPOSE This study was conducted to assess the effect of music therapy on pain, anxiety, opioid use, and hemodynamic variables during burn dressing change. METHODS Patients in a tertiary care burn unit who were >10 years old, conscious, able to respond, and oriented to time, place, and person participated in a 2-month, quasi-experimental, cross-over pilot study. Each served as his/her own control. Dressings were changed every other day alternating between the control (standard pain management) and experimental (control plus patient-selected music) intervention. Pain was assessed using a numerical rating scale, anxiety was scored using the State Trait Anxiety Test (higher scores indicated more pain and anxiety), and hemodynamic parameters and analgesics were recorded. Wilcoxon Test and chi-squared tests were utilized for statistical analysis. RESULTS Median pain scores (5, interquartile range [IQR] IQR: 3-7; and 6, IQR: 5-8) and median anxiety scores (12, IQR: 8-17; and 14, IQR: 10-19) were significantly lower during the experimental than during the standard dressing change, respectively (P

Background: Yoga is proven beneficial in improving quality of life among breast cancer survivors receiving chemotherapy, but its effectiveness in lymphoma patients needs to be explored. As chemotherapy-induced neutropenia is very common among lymphoma patients, they are much prone to infections from the environment. Furthermore, trained yoga instructors are not available in every setting, so there is a need to develop home-based yoga program modules for lymphoma patients receiving chemotherapy. Aim: The aim of the study was to explore the feasibility and safety of yogic exercises among lymphoma patients during chemotherapy. Subjects and Methods: An interventional, single-arm prepost design study was conducted at a tertiary health-care center. Patients suffering from malignant lymphoma (18–65 years) with Eastern Cooperative Oncology Group performance status from 0 to 2, planned to receive chemotherapy were administered a home-based yoga program over a period of 2 months from the start of chemotherapy. The primary outcome variables were retention rate, acceptance rate, safety, and adherence. Health-related quality of life (HRQOL), fatigue level, overall sleep quality, depression, anxiety level, and pain were also assessed. Statistical Analysis: Descriptive statistics was used to see the feasibility and adherence. The paired t-test was used to compare various pre and postintervention outcome measures. Results: Fourteen patients (median age: 36 years, range13–65 years) of malignant lymphoma were enrolled in the study. Male-to-female ratio was 9:5. Non-Hodgkin's lymphoma patients constituted 64%. The recruitment rate was 93%. Favorable retention (100%), acceptability (97%), adherence (78.6%), and no serious adverse events following yoga practice were reported. Improvement was also found in HRQOL, fatigue, sleep, depression, and anxiety. However, it needs further validation in a randomized study. Conclusion: Home-based yoga program is safe and feasible among the patients suffering from malignant lymphoma receiving chemotherapy.

Background: Ventriculoperitoneal (VP) shunting is the most common neurosurgical treatment for hydrocephalus. In spite of significant developments in the technology and design of shunt systems, shunt surgery is still associated with morbidity. Aim: To identify the problems faced by children on VP shunt and assess their quality of life (QOL). Setting and Design: A cross-sectional exploratory study. Materials and Methods: A total of 31 children on VP shunt were selected through consecutive sampling technique, and hydrocephalus outcome questionnaire was used to collect the data, with the converted metric score ranging from 0 to 1. Hydrocephalus due to stroke, hemorrhage, and malignant tumors was excluded. Results: The mean age of patients was 11.51 ± 4.26 years. Headache and generalized pain were the common problems experienced (42%). The mean score of QOL was 0.67 ± 0.21. Among the three domains, cognitive domain was the most affected. Among the clinicoradiological factors, multiple surgeries (P = 0.02) had the most significant impact on QOL. Conclusion: Children who underwent VP shunt face various health-related problems in different domains and low QOL. Although cognitive domain was the most affected, multiple surgeries had the most significant impact on QOL. Appropriately focused interventions and holistic management are essential to improve the QOL of children undergoing VP shunt.

School children can act as change agent not only for families but for community. The study aimed to assess effectiveness of information package on knowledge and practices of parents/family members of school children studying in Govt. Sr. Sec. School on food hygiene in Dhanas and Daddu Majra Colony, UT, Chandigarh. A non-randomised controlled trial was conducted on 201 school children studying in VIIth standard and their parents/family members. Purposive sampling technique was utilised to enrol 101 in case and 100 participants in control group. Interview schedule for knowledge assessment and observation checklist for assessing the practices of parents/ family members was used. Pre assessment of both the groups was done by a home visit. Experimental group school children were educated on food hygiene as per the protocol. Pre and post-test knowledge of school children on food hygiene was assessed and were asked to disseminate the information to their parents/family members. After 15 days, second time home visit was done to the parents/family members of both the groups for the post assessment of knowledge and practices. Significant improvement in knowledge and practices of parents/family members related to food hygiene was observed. Hence, school children can be an effective tool in health related knowledge dissemination which can further promote healthy practices.