Challenges and advantages of modern rural surgery: an experience of two secondary care centres of rural India

Background: Rural surgery refers to the practice of surgery in rural communities and geographically remote areas, facing multiple challenges like limitation of resources and manpower, poverty, multiple co-morbidities and superstitions. Assam has geographical and population diversity with more than 85 percent of rural population. This study was done to analyse the various challenges and advantages faced during surgical practice in two secondary care centres of rural Assam. Methods: This is a retrospective study done from 228 cases which were operated in Teok First Referral Unit and Titabor Sub-Divisional Civil Hospital, both secondary care centres of rural Assam, India between July 2022 to August 2023 by a single surgeon. Inclusion criteria were all patients who were operated following written and informed consent. Patients who opted not to operate and pregnant women were excluded from the study. Data collected were placed in charts and tables and statistical analysis done using IBM statistical package for the social sciences (SPSS) statistics version 2.0. Results: Study population has 46 percent adult male, 51 percent adult female and 3 percent children. 1.3 percent (3 patients) were operated under general anaesthesia, 14.5 under regional anaesthesia and 73.2 percent under local anaesthesia. 11 percent (25 patients) opted not to operate. Challenges were lack of manpower, lack of resources, infection control, fatigue, trust issues and socio-political pressure. Advantages are financial relief, homely environment, better diet and care, community support, avoiding unnecessary referral and better follow-up. Conclusions: Rural surgery can be a boon to modern healthcare if available resources and manpower are properly managed and challenges are overcome.

Prevalence and predictors of iron deficiency anaemia in adolescent girls in India

Background: In India, iron deficiency anaemia is highly prevalent, particularly among women of reproductive age group. Following early childhood, during adolescence, the risk of iron deficiency and anaemia reappears for both boys and girls, but remains more susceptible to girls because of menstrual loss. The aim of this study was to find the prevalence and predictors of iron deficiency anaemia in adolescent girls in India. Methods: This study was a descriptive form of review of literature on data from comprehensive national nutrition survey (CNNS 2016-2018). CNNS was conducted to collect data on the nutritional status of Indian children from 0-19 years of age. The data collection period was from 26 February 2016 to 24 October 2018 and data was collected using individual and household questionnaires. Results: In the study, prevalence of various levels of anaemia (mild, moderate and severe) was higher in adolescent girls as compared to adolescent boys. Adolescent girls had 31.3% iron deficiency whereas adolescent boys had 11.5% iron deficiency. Anaemia prevalence was also higher in the age group 15-19 years as compared to 10-14 years. Conclusions: It was concluded that iron deficiency anaemia was more prevalent in adolescent girls than boys. Inadequate intake of iron rich foods and vitamin C, less knowledge about anaemia, low socio economic conditions along with poor hygiene and sanitation practices are the major factors that contribute to iron deficiency anaemia.

Distribution of ABO and Rh blood groups among people visiting tertiary hospital of Dibrugarh district of Assam, India

Background: Clinical application of blood grouping are many. Blood grouping are needed for blood transfusion, in preventing hemolytic disease, paternity dispute, medico legal cases, in knowing susceptibility to disease, and also necessary for genetic research. This study was carried out with an objective to provide data regarding distribution of ABO and Rh blood groups among people visiting various department of tertiary hospital of Dibrugarh district of Assam, India. Methods: Data of 200 subjects were collected and analyzed regarding ABO and Rh blood groups from 01 August 2021 to 31 July 2022 and reported in simple numbers and percentage. ABO and Rh blood group type is determined by glass slide method. Results: The most common blood group among the subject was O (33%), B (33%), A (23%) and AB (22%). Rh positivity among the subject was 93% and Rh negativity is 7%. Conclusions: The most common blood group among the subject was O positive and B positive and least common was AB negative.

Virtual Gaming as A Contemporary Research Trend for Mental Health Professionals

As technology continues to be a part of our life, online gaming has claimed the hearts of millions of people as a favourite leisure activity. Among them online role-playing game provides people the opportunity to play a de-sired role, be it a king, princess or warrior. This article aimed to provide an insight into what role-playing game is, and why it has become so popular in recent years, with the help of existing literature. This article also attempted to point out the need to research more in the field of gaming as the existing literature is not suffi-cient to cover the vastness of the topic. The digitalization of games from physical form to online form has changed the way games has been viewed, played, and understood. Due to the popularity of online games, there is a significant change in the research around online games, especially role-playing games. There is still more research needed in Indian context about online games as it has become a popular source of entertain-ment throughout all the ages and also become a huge source of economy.

Influence Of Digital Gaming on Relationship and Social Health

The transition from the stone age to the digital era has radically altered our way of life. No matter their socioeconomic status, everyone around us currently has a mobile device. Immediately, we want to speak with someone, and within a second, we do. Facebook, Instagram, and online games simplify our daily lives, leaving little room for interpersonal relationships. This paper will examine how digitization has af-fected our interpersonal connections and also changed the way we view relationships from a so-cial/mental health viewpoint. Since technology has lessened the necessity for social interaction, does this imply that we have all become digital natives? To gain a deeper understanding of the topic, this paper proposes a novel perspective supported by prior research. Since this problem has not been substantially investigated, more targeted research is required in the Indian setting

A comparative study on sociodemographic and clinical profile of patients undergoing admission and readmission in a mental health institute

Aims: Psychiatric patients have a high rate of readmission. So, we need to understand what kind of patients are more likely to be readmitted, to predict the clinical and social factors that place them at risk, and to identify potential limitations in existing healthcare delivery systems. Objective of the study was to find out and compare sociodemographic and clinical profiles of patients getting first admission and readmission. Methods: It was a retrospective, record-based observational study from computerised database of the institute and the case record files of patients for one year. Variables like age, sex, religion, marital status, locality, education, occupation, and diagnosis were studied. Analysis was done by chi-square test using the Statistical Package for the Social Sciences (SPSS) version 16.0. Results: The total number of admissions during this period was 876, among which 463 had been admitted previously in the institute and 60 had been admitted more than once in the time period. Among new admissions and readmissions, majority were unemployed, unmarried, Hindu males, 16-30 years of age, and had schizophrenia and related spectrum diagnosis (F20-F29). No significant difference in readmission rates were found for sex, marital status, religion, educational status, or locality. Readmission rates among housewives were seen less than expected. There were significant differences among different diagnoses in terms of readmission (p<0.001), with F30-F39 showing more than expected readmissions and F10-F19 showing more than expected first admission with less than expected readmissions. Conclusions: Current study reviews the scenario of mental healthcare utilisation. Decreased readmission rates of women and of patients with substance abuse disorders warrants further community-based research.

Profile of distress callers and service utilisation of tele-counselling among the population of Assam, India: an exploratory study during COVID-19

Background: The coronavirus disease 2019 (COVID-19) pandemic has affected people globally by causing psychological, social, and economic chaos. The Assam Police, India started telephone helplines to address the psychological issues. Aims: To evaluate the sociodemographic profile of the distress callers, their psychosocial concerns, the interventions provided by the service provider, and whether the service users were satisfied with the intervention(s) or not. Method: It was a cross-sectional study done during the period of lockdown (7-24 April 2020). All the callers who called the helpline were screened for anxiety, depression, suicidal thoughts (when required), and the psychosocial issues which they were facing were explored. They were provided the psychological intervention(s) at the appropriate time, and they were asked to rate their experience at the end. Results: A total of 239 callers used the tele-counselling services. The majority of callers were male (79.1%). Most of the callers were between 19-35 years of age group (66.5%), married (52.5%), and graduates (31%). Two-thirds of the callers called to seek guidance for their own issues and one-third for their relatives or friends. Callers had anxiety (46%), depressive disorder (8.3%), and depressive symptoms not qualifying for depressive disorder (14%), and suicidal thoughts (5.44%). The commonest intervention provided to the callers was supportive (77.8%), followed by psychoeducation (30.5%), cognitive behaviour therapy (24.7%), relaxation (23.6%) and behaviour therapy (13.4%). Most of the callers utilised more than one type of therapy. Overall, most of the callers were satisfied and appreciated the tele-counselling services. Conclusion: The findings could help in formulating psychological interventions to improve the mental health of vulnerable groups in the post-COVID-19 period to reduce psychiatric morbidity and mortality.

In vitro regeneration of Hypericum patulum Thunb.--a medicinal plant.

A protocol was developed for high frequency plant regeneration in H. patulum by shoot-tip culture. H. patulum plants were collected from a wild source growing at high altitude in the eastern Himalayas. Multiple buds were initiated from shoot-tips cultured on Murashige and Skoog's medium supplemented with BAP, kinetin. Addition of thiamin HCI, Ca-pantothenate and biotin enhanced multiple shoot formation. Upon transfer to phytohormone free liquid medium following a brief exposure to auxin, root formation occurred from the micro shoots . Rooted plants were hardened and transferred to soil. Regeneration potentiality was found to be constant throughout the year in long term cultures.

Batista procedure as a bridge to cardiac transplantation.

A 37-year-old male patient with dilated cardiomyopathy and end-stage heart failure underwent Batista procedure. After 6 months, he underwent orthotopic heart transplantation. Though he did not survive the procedure, we conclude that Batista procedure may serve as a cost-effective biological bridge to cardiac transplantation.