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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.

Background Epidemiological transition has caused increase in burden of non-communicable diseases like hypertension especially in developing countries like India which are further responsible for significant number of deaths among patients.Untreated hypertension can lead to numerous complications in patients However, there is inadequate adherence to therapeutical regimen observed among hypertensives with range varying from 19-96% in our country. Hence, this study was done in a rural area of Ludhiana to determine adherence to anti-hypertensive treatment among hypertensive patients and explore various socio-demographic and lifestyle factors associated with adherence Methodology A cross-sectional study was conducted among clinically diagnosed cases of hypertension attending OPD at Rural health Training centre, Pohir over 3-month period, aged above 18 years of age and were on treatment for at least 6 months. A pre-designed semi-structured questionnaire was used to assess the patient’s socio-demographic profile, treatment seeking behaviour, duration and type of treatment and presence of any complication of hypertension. Life style related habits like consumption of junk food, extra salt and alcohol, smoking and daily physical exercise were also assessed. The patients who took medication for less than 80% of week (?5days) were considered as non adherent. Weight and Height of the patients were measured and Body mass index (BMI) was calculated by using formula (weight/height2 ). For categorization of BMI, Asia Pacific Classification was used. Results Of the 203 total diagnosed cases of hypertension, 184 patients were enrolled in the study, consisting of 104 males (56.5%) and 80 females (43.5%). The mean age of the subjects was 59.9±11.75 years. Among 184 patients, 128 (69.5%) were adherent to treatment regimen and 56 (30.5%) were non adherent. Medication adherence was significantly more among literate as compared to illiterate subjects. On assessing lifestyle related habits of the subjects, it was observed that adherence was significantly higher in patients not consuming alcohol and no extra salt intake and ones with no junk food preference. Also, complications were significantly higher among non adherent patients (82.8%) as compared to ones who took their medication regularly (45.2%). Among reasons for non-adherence to treatment, the most frequent reasons were discontinuation of medication when feeling well followed by forgetfulness and financial issues amongst others. Conclusions Hypertension is becoming a global health issue and is yet a preventable disease if timely and adequately treated. Non-adherence to drug therapy among anti-hypertensives is a matter worth concern. Improving adherence will not only reduce complications and mortality among patients but also improve their quality of life and reduce financial burden. Hence, certain interventions in this regard like health education and behaviour change communication are utmost essential at community level.

Aim: The aim of this study was to evaluate the factors affecting adherence to antidiabetic medication among diabetic patients in India. Setting and Design: A qualitative study was conducted among 40 diabetic patients aged >30 years, on treatment for more than a year without any complications in the Urban Health Centre of Dayanand Medical College and Hospital, Ludhiana, Punjab, India. Materials and Methods: A semistructured questionnaire was harnessed to congregate data by interviewing the patients for 30–40 min in person. The interviews were recorded in the form of audios by acquiring informed consent and transcribed verbatim. The factors were then divided into barriers and enablers which were further subdivided into themes and subthemes as a result of which four major themes were built including individual, social, organizational, and community levels. These major themes were further categorized into several subthemes to assess the nonadherence to antidiabetic medications. Results: The results of the interviews depicted that the lack of knowledge, financial problems, familial issues, misconceptions regarding the disease, and side effects of taking medications daily were the major altruist for nonadherence, whereas on the other hand, positive perception about the disease, family support, and getting medications on affordable prices by some health-care institutes played an important role in enabling medication adherence as about 50% patients were adherent to the medications. Moreover, various interventions were used to escort the patients regarding medication compliance and blood glucose level monitoring such as lifestyle modifications (diet and exercise), use of reminders for medication intake on time, encouraging them to visit health-care centers, or hospitals on time for regular check-ups and by educating them regarding the long-term effects of diabetes and its prevention.

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.

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.

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 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.

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.

Introduction: In India, little is known about the reproductive behavior during earlier years of married life of women, when they are more vulnerable to reproductive ill health and early child bearing with very few interventions available. Objective: The objective of this study is to follow a cohort of newly married women immediately after marriage until their first pregnancy outcome to gain an insight into their reproductive behavior so that important opportunities could be identified for intervention. Subjects and Methods: A community-based longitudinal study was carried out in 15 villages of Ludhiana District under the Rural Health Training Centre of Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab. All marriages of the male residents that took place in these villages from January 1, 2013, to December 31, 2013 were enrolled. Thus, a cohort of 195 newly married women was identified over a period of 1 year and followed every month till first pregnancy outcome. The analysis was performed using SPSS version 20 statistical software. Results: Mean age at marriage for newly married women was 22.9 ± 3.0 years. Majority of them conceived within 1st year of marriage (79.5%) while 10.8% of women did not conceive till the end of follow-up period. Mean age at first pregnancy was 23.4 ± 3.1 years with mean interval between marriage and first pregnancy of 5.4 ± 6.1 months. Nearly, three-fourth of pregnancies resulted in live births while adverse pregnancy outcome including still births and abortions was seen in 15.9% of the study cohort. Conclusions: Overall findings indicate optimistic picture for married young women, but critical opportunities should be utilized to promote health of these women in a journey toward safe motherhood.

Introduction: In India, due to some barriers, the parents are not willing to vaccinate their children which lead to 3.2 million of chil- dren still not being vaccinated. Materials and Methods: A descriptive study was conducted on 200 mothers of under-five children residing in filed practice area of UHTC, Shimlapuri. Structured interview questionnaire was ap- plied on mothers to explore the knowledge on immunization & perceived barriers related to it. Results: The study revealed that 50.5% of mothers of under-five children were having below average level of knowledge on child immunization. Child illness and low importance of vaccination were most occurring perceived barriers among mothers. There were other barriers like lack of accompany to go to center for im- munization, and confusion about what age immunization has to be given, etc. Conclusion: Current study necessitates the need to to provide IEC (information, education and communication) sessions programs. This can be achieved by organizing health education campaigns in community. Parents and families need to be sensitized regarding importance of immunization to overcome the perceived barriers.

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: Neurological disorders are ranked as the leading cause of DALYs in 2015, most prevalent being tension-type headache, migraine, medication overuse headache, Alzheimer's disease and other dementias. Therefore, this community based cross sectional study was planned to determine the prevalence and disability due to migraine in the Urban Field Practice Area of Department of Community Medicine, DMCH, Ludhiana. Methodology: A total of 465 adults (> =18 years) from a population of 11,179 were interviewed by house to house visits. The questionnaire to measure disability among diagnosed patients was prepared based on the diagnostic criteria of migraine by International Headache Society and Migraine Disability Assessment Test (MIDAS). Results: Out of 465 adults, 104 (22.4%) were found to have migraine, out of which 21 had migraine with aura. The prevalence was found to be greater in females (26.1%) than males (10.6%). After applying MIDAS, it was found that 70.2% were facing moderate disability whereas severe disability was seen in 24.0 %. Only 12 out of 104 study subjects had prior knowledge regarding their migraine status. Conclusion: This study not only puts light on the proportion and disability due to migraine but also on the need to make people aware about their health condition.

Introduction: Birth weight is a strong predictor for ensuring healthy life of a newborn and is affected by various maternal and social determinants. The study was planned to analyze the pattern of birth weight of newborns and to identify possible factors affecting birth weight. Materials and Methods: A community based retrospective cohort study was conducted by identifying a birth cohort of 332 live born between 1st January 2014 to 31st December, 2014 under Rural Health Training Centre, Department of Community Medicine, Dayanand Medical College & Hospital, Ludhiana, Punjab. Data on birth weight and socio-demographic characteristics was collected from the records maintained at the centre by health workers through regular house to house visits. Results: Mean birth weight was 2.69±0.57kg. Lower mean birth weight was significantly associated with younger maternal age, lower socio-economic status, lower maternal height and pre-pregnancy underweight mothers. The incidence of low birth weight (