Interesting case report on Chiari network

The Chiari network is a congenital remnant that is typically found in the right atrium and is generally not associated with significant pathophysiological implications. Usually, this is detected on general routine health checkup screening or casual examination. But, occasionally in certain cases, it is possible for this condition to results in diagnostic ambiguity when assessing right atrial disorders. Additionally, it has potential to contribute to the development of thromboembolism by inducing flow blockage. The Chiari network can be accurately diagnosed by echocardiography. This network appear as a highly mobile, highly reflectant echo target at many regions in the right atrium during transthoracic and transesophageal echocardiography. In this study, we provide a case involving an 18 year old male students studying cardiac technology who was diagnosed incidentally during echocardiography practical classes with Chiari network, mild TR and mild PR. The value and precision of echocardiography are becoming more widely recognized and being used more frequently. The potential for finding normal anatomical variations and their potential incorrect interpretation as pathological states coincides with the wider implementation of this imaging method.

Spinal anaesthesia for emergency cesarean section in neurofibromatosis for an antepartum haemorrhage: a case report

Neurofibromatosis 1 (NF1) is an autosomal dominant disease and is usually diagnosed during childhood. Neurofibromatosis are group of genetic disorders that cause tumors to form, which can develop anywhere in the nervous system including brain, spinal cord and nerves. It poses a great challenge to the anaesthesiologist as it may have difficult airway, fibrosis in lungs and neuromas in spinal cord. Due to the involvement of CNS, regional anaesthesia in type 2 neurofibromatosis without careful preoperative examination can be extremely dangerous. Regional anaesthesia on the other hand could be useful in type 1 neurofibromatosis because CNS involvement is rare. This was a case report of management in a 24-year-old pregnant female with undiagnosed neurofibromatosis for an emergency cesarean section for antepartum haemorrhage and IUD under spinal anaesthesia. Although general anaesthesia is the safer option in neurofibromatosis patients, spinal anaesthesia can be a safe procedure in neurofibromatosis patients but special precautions should be taken to avoid neurological injury and uneventful anaesthesia.

Perception of breast cancer and self-breast examination practices among women in Lucknow, north India

Background: Breast cancer is the leading cause of mortality and morbidity among women worldwide. It is one of the prime health issues in developed and developing countries because of the high prevalence of known risk factors. In the present study, we assess the knowledge of breast cancer and breast self-examination (BSE) screening practices among women in the capital city, Lucknow, Uttar Pradesh, North India. Methods: This cross-sectional study was conducted in urban and rural areas of Lucknow. The period of study was one year, starting from December 2020 to November 2021. Data were obtained from 400 adult women (212 rural and 193 urban) using a pretested, self-administered questionnaire. Participants aged >20 years were randomly selected from two rural and two urban community health centres (CHCs). The questionnaire assessed respondents’ socio-demographic characteristics, risk factors, signs and symptoms, early detection methods, and knowledge and practices related to self-breast examination among women in Lucknow. Results: Out of 400 respondents, only 33.5% (rural) and 55.96% (urban) women had heard of breast cancer. 17.55% (rural) and 13.47% (urban) women had heard about BSE. 4.72% (rural) and 8.81% (urban) women practice BSE occasionally. Knowledge about breast cancer, its symptoms, risk factors, and screening methods was similarly poor in women of Lucknow. Conclusions: This finding correlated significantly with older age, higher levels of education, and occupation. There is a low level of awareness of breast cancer in Lucknow's urban and rural areas. BSE is hardly practiced, though the willingness to learn it is high.

A rare combination of ileal duplication cyst with mesenteric cyst in 8 months old child: a case report

Enteric duplication cysts are rare congenital lesions that can develop anywhere along the alimentary tract and vary greatly in presentation, size, location and symptoms. Duplications most commonly arise from the mesenteric border of the intestine and are frequently single. These are classified as cystic or tubular. Mesenteric cysts are rare intra-abdominal lesions occurring during childhood period, which may vary in presentation and can be asymptomatic or can present as obstruction, perforation or bleeding. The diagnosis of duplication cyst is difficult due to absence of obvious pathognomic signs. Abdominal ultrasound and computed tomography may aid in diagnosis. Radiological imaging may not be sufficient and high index of suspicion is needed to diagnose such cases. We herein are presenting the rare case of combination of mesenteric cyst with enteric duplication cyst in 8 months old child who reported to surgical emergency with complaints of bleeding per rectum. Ileal duplication cysts are rare anomalies which are often underreported because of their vague symptomatology and radiological features are often not diagnostic. A high index of suspicion is always needed to pick up the diagnosis based on history, examination and radiological findings.

Understanding among dialysis therapist and technologist about prevention protocols of COVID-19 in north-west zone of India: a questionnaire-based survey

Background: All over the world human community fighting with COVID-19. It affected a large number of population. Our immune system helps fighting with COVID-19, CKD patients which are on MHD are more prone to COVID-19 infection. MHD patient required twice or thrice a week dialysis. During dialysis, a therapist plays a major role in COVID-19 HD procedure of CKD patients. Dialysis therapist works like a frontline warrior. Aim was to observe the understanding of dialysis therapist/technologist about COVID-19 protocols for prevention of COVID-19 infection. Methods: A total 122 responder from northwest zone of India attended question-based survey form on the understanding of the infection prevention procedure of COVID-19 maintenance hemodialysis patients. Question set was based on union health ministry of Indian government guideline for dialysis unit set up for COVID-19 patients, Dialysis therapist and patents care taker. Data collection was done by online sampling method. Results: Study observed dialysis therapist of northwest India about understanding of COVID-19 prevention protocols. Approximate- 122 participants include in this study. But major case of COVID-19 treating in government sector hospitals. This study observed that mostly participants have good understanding about COVID-19 infection prevention protocols. Conclusions: Required a regular education training program for all government and private sector health workers for infection control practices of COVID-19. Dialysis therapist and other health workers are doing work like a frontline warrior, their safety is a major concern so we can avoid the risk of transmission of disease to dialysis therapist.

Correlates of substance misuse among college-going male students in Chandigarh

Background: The World Health Organization (WHO) defines substance misuse as “consistent or occasional use of a drug inconsistent with or unrelated to acceptable medical practice”. The implementation of evidence-based policies, rules, and interventions targeted at preventing substance abuse and promoting healthier campus settings can result from an understanding of the specific issues associated with substance mis-use among children, particularly college students. Methods: A cross-sectional study was conducted among 256 college students in Chandigarh, selected through stratified multi-stage random sampling. A self-administered, semi-structured, and validated questionnaire was used for collecting data. The data was analyzed using SPSS-26.0. Results: Out of 256 respondents, 157 (61.3%) reported not using any substance. The prevalence of substance use among them was found 38.7%. Among substance users, smoking was the most commonly used (82.8%) followed by drinking (75.7%) and chewing (26.2%). Inhaling was also emerging as substance misuse (4.0%). Prevalence rates among different disciplines varied significantly, law students (100.0%) followed by arts (40.0%), commerce (36.4%), medical (34.9%), and engineering (32.3%). Students irrespective of socio-demographic factors were at equal risk of substance misuse based on the logistic regression. Conclusions: Based on the study’s findings in demographics, it was determined that age, discipline, mother’s educational level, and current living situation have a significant association with substance misuse.

Prevalence and risk factor of diabetes and hypertension in northeastern and south Indian region in India: insights from large scale survey data

Background: Hypertension and diabetes, two of the major global risks for mortality are on a rapid rise in developing nations and leading risk factors for a hero sclerosis and its complications, including heart attacks and strokes. It is predicted that by 2030, India’s diabetes burden will be almost 87 million people. This study aimed to estimate the prevalence and risk factor of diabetes and hypertension in northeastern and south Indian region in India. Methods: This study utilised the fourth wave of the national family health survey (2015-16). Bivariate, multivariable logistic regression analyses were done to meet the aim of the paper. Results: Analysis shows that the highest prevalence of prehypertension is higher in Sikkim state whereas the prevalence of hypertension men is higher in also Sikkim state. Prevalence of women is prehypertension in Sikkim state and hypertensive women is higher prevalence in Nagaland and Assam state. Conclusions: Diabetes is developing with multi-morbidity like hypertension. Thus, there is need to provide the health education to diabetic people by public and private health care services and increase the health awareness in the society at grass root level. The main reason behind diabetes is heredity, less physical activity, higher body mass index, and increased cholesterol level in that group of south India and northeastern region. There is need that people should change their lifestyle and government should build the structure of city with health perspective.

Effect of Levels of Nitrogen and Phosphorus on Growth, Yield and Economics of Lentil (Lens culinaris L.)

The present investigation was carried out in Rabi (winter) season 2022-23 at Agronomy Research Farm of Chandra Bhanu Gupta Post Graduate College, Bakshi ka Talab, Lucknow (U.P). The treatments comprised of four nitrogen levels viz., 0, 15, 30 and 45 kg N ha-1 with four phosphorus levels viz., 0, 20, 40 and 60 kg P2O5 were tried in Factorial Randomized Block Design. The soil was silty-loam texture with slightly alkaline pH 8.1, organic carbon 0.70 %, available nitrogen 270.00 kg ha-1, available phosphorus 27.0 kg ha-1, and available potash 262.0 kg ha-1 during 2022- 2023. The rainfall received during the crop period was 0.00 and 0.02 mm, respectively. The relative humidity was recorded maximum during month of December study while, the sunshine ranged from 2.3 to 9.1 during crop period. Increasing levels of nitrogen and phosphorus significantly increased most of the growth and yield attributing characters viz., plant height, number of branches, dry matter accumulation and yield attributes viz., number of pods plant-1, number of grains pod-1, grain weight and test weight were significantly higher with 45 kg N ha-1 and 60 kg P2O5 ha-1 and superior to other doses of nitrogen and phosphorus. Yield studies viz., Grain yield, straw yield and biological yield were significantly higher with 45 kg N ha-1 and 60 kg P2O5 ha-1 and superior to other doses of nitrogen and phosphorus. The N and P content % and uptake increased with increasing levels of nitrogen and phosphorus. The highest nutrient content and uptake were recorded with 45 kg N ha-1 with 60 kg P2O5 ha-1. Economics analysis viz., gross return, net return and benefit cost ratio was recorded highest with 45 kg N ha-1 + 60 kg P2O5 while lowest with control. Thus for obtaining better yield and profit apply 45 kg N ha-1 in combination with 60 kg P2O5 ha-1 for lentil.

Growth, Yield and Economics of Wheat (Triticum aestivum L.) as Influenced by Different Seed Rates and Weed Control Methods

An experiment was conducted at Shradhay Bhagwati Singh Agriculture Research Farm (Hajipur), Chandra Bhanu Gupta krishi Snatakottar Mahavidyalaya, B.K.T., Lucknow (Uttar Pradesh) during the rabi season of 2021-22. The experiment consisted of 12 treatment combinations comprised of 3 seed rates and 4 weed management practices, tested in factorial randomize block design with three replications. The results indicated that different seed rates and weed management practices significantly influenced the growth, yield and nutrient uptake of wheat. The soil of experimental site was silty loam soils having medium organic carbon (0.70%) and nitrogen (270 kg ha-1), phosphorus (27 kg ha-1) and potassium (262 kg ha-1). Crop sown with seed rate, S3 (120 kg ha-1) recorded highest plant height, number of tillers m-2, leaf area index, dry matter accumulation, number of effective tillers, grain yield, straw yield, biological yield and nutrient uptake. However, higher number of grains spike-1, grain weight spike-1, length of spike and test weight was recorded with crop sown with 100 kg ha-1 seed rate. Weed free upto 60 DAS (W1) resulted in significantly higher growth and yield attributes and yields over rest of the weed control treatment. Post emergence spray of Clodinafop + Metsulfuron (60 + 4) g ha-1 recorded significantly higher values of all growth, yield attributes and yield over sulfosulfuron @ 25g a.i ha-1. Weed free upto 60 DAS had highest weed control efficiency followed by Clodinafop + Metsulfuron 60 + 4 g ha-1 (49.78%). However, the highest weed index was noticed in weedy check and lowest with herbicide mixture. The highest net returns (Rs. 69036) and B:C (1.73) were obtained with combination of 120 kg seed rate ha-1 + Clodinafop+ Metsulfuron @ 60g ha-1 +4g ha-1 (PoE) at 30-35 DAS.

Effect of Age of Seedling and Plant Spacing on Yield and Economics of Transplanted Rice (Oryza sativa L.)

An experiment was conducted at Shradhay Bhagwati Singh Agriculture Research Farm (Hajipur), Chandra Bhanu Gupta Krishi Snatakottar Mahavidyalaya, B.K.T., Lucknow (Uttar Pradesh) during the Kharif season of 2022. The experiment was laid out in split plot design with three replications keeping three ages of seedlings viz., 21 days of the age of old seedlings, 28 days of the age of old seedlings and 35 days of the age of old seedlings in main plots and three plants spacing 20 cm x 10 cm, 25 cm x 10 cm and 15 cm x 15 cm in subplots. Results revealed that there was significant variation among different times of transplanting with respect to growth. Growth parameters were higher in paddy transplanted at 21 days of age of old seedlings as compared to the rest of the age of seedlings. The yield attributes as effective tillers m-2, panicle length (cm.), numbers of grains panicle-1, grains weight panicle-1 (g.), panicle weight (g.) and 1000 grain weight were significantly superior in paddy transplanted in 21 days of age of old seedlings. 21 days of age of old seedlings proved significantly superior in terms of grain, straw, total biological yield and harvest index when compared to the rest of the age of seedlings. The maximum N – content (%) was significantly superior in paddy transplanted in 35 days of the age of seedling in grain and straw. The N – Uptake (kg/ha.) was significantly superior in paddy transplanted in 21 days of age of seedling in grain and straw. The protein content (%) was significantly superior over in paddy transplanted at 35 days of the age of seedlings in grain and straw. The Protein – production (kg/ha.) were significantly superior in paddy transplanted at 21 days of age of seedling in grain and straw. Growth parameters such as plant height (cm.), dry matter accumulation (gm-2) and leaf area index were higher in paddy transplanted with 20 cm x 10 cm but a number of tillers (m-2) higher with 25 cm x 10 cm as compared to rest of the plant spacing. Plant spacing of 25 cm x 10 cm produced significantly more yield attributes and yield of rice. The maximum N – content (%) were significantly superior in paddy transplanted with 15 cm x 15 cm in grain and straw. The maximum N – Uptake (kg/ha.) was significantly superior in paddy transplanted with 25 cm x 10 cm in grain and straw as compared to the rest of the plant spacing. The maximum protein content (%) were significantly superior over in paddy transplanted with 15 cm x 15 cm in grain and straw. The Protein – production (kg/ha.) was significantly superior in paddy transplanted with 25 cm x 10 cm in grain and straw. Transplanting of paddy 28 days of age of old seedlings with 25 cm x 10 cm plant spacing had higher gross return, net return, and B:C ratio of rice crop.

Mucormycosis and COVID-19- black threat of the pandemic

Background: Cases of mucormycosis in people with COVID-19 have been increasingly reported world-wide, particular from India. Globally, the prevalence varied from 0.005 to 1.7 per million population. The aim of the study was to determine the effect of mucormycosis in COVID-19 patients. Methods: A retrospective study was conducted on 30 patients with biopsy-proven mucormycosis with RT-PCR-confirmed COVID-19 from May 21 to April 2022. Clinical and paraclinical data including demography, underlying diseases, clinical features, corticosteroid use, sites of infection, co-infections, the time between COVID-19 and mucormycosis, clinical management were recorded. Results: Data from a total of 30 patients post covid mucormycosis was analyzed. The majority of patients were male 70%, age group 30-55 years and were immunocompromised. All of them were diabetic. 80% patients had severe COVID-19 illness. 20% had mild-moderate infection. The average interval between COVID-19 infection and mucormycosis was 15-35 days. The most common was rhinorbital cerebral infection followed by pulmonary involvement. 2 patients had cutaneous mucormycosis. Systemic antifungals were used in all the patients. 12 out of 20 patients with rhinorbital cerebral mucormycosis underwent reconstructive surgery. Debridement was done in 2 patients with mucormycosis. Conclusions: Our study concludes that CAM (COVID-19 associated mucormycosis) is associated with high mortality and morbidity. Systemic steroids are helpful in people with severe COVID-19 infection but they can also predispose them to secondary fungal diseases. Timely diagnosis and management are challenging but can be helpful if there is an early diagnosis of infection and control of comorbid conditions.

Obesity in Adolescents: Prevalence and Association with Sociodemographic and Lifestyle Factors

Introduction: Overweight and obesity has become a worldwide epidemic and is a growing public health concern. The increase in prevalence and severity of obesity among children and adolescents has been attributed largely to behavioral factors such as changing eating habits and sedentary lifestyles. Objective: To determine prevalence of obesity and abdominal obesity among adolescents and its association with sociodemographic factors and lifestyle. Methods: Present cross-sectional study was conducted in the urban field practice area under the Community Medicine Department of LLRM Medical College, Meerut, among 872 adolescents. All localities in the field area were covered and house to house survey was done. Questions were asked about eating patterns, physical activity and sedentary lifestyle. Data was collected and analyzed using appropriate statistical tests. Results: The prevalence of overweight and obesity was 17.43, 6.88%, respectively. Obesity was significantly higher among females, those who indulged in unhealthy eating habits were physically inactive, watched television for a longer duration and ate junk while watching television. Conclusion: In the present study, we found that high junk food consumption and a sedentary lifestyle were found to be significantly associated with childhood overweight/obesity. As a result, timely interventions should be taken to improve awareness about healthy lifestyle behavior to prevent obesity and its complications among adolescents.

Outcomes of usage of polypropylene mesh in TAPP hernia repair

Background: Repair of hernia has seen a paradigm shift from open technique to laparoscopic technique. Laparoscopic transabdominal preperitoneal mesh hernioplasty is the latest technique with several advantages over open repair. Polypropylene (PP) mesh is the most frequently preferred product, as are easily and cheaply available, provide enough strength for the technique with good biocompatibility and less tissue reaction. Objective was to study the outcome of usage of polypropylene mesh in TAPP hernia repair. Methods: It was a prospective study on patients with diagnosis of inguinal hernia and underwent TAPP hernia repair with polypropylene mesh. Results: Total of 60 patients were included. Majority of the patients (18; 30%) were in age groups of 46-55 years and 56-65 years. 67% cases of inguinal hernia were of indirect type, 30% direct type and 3% both direct and indirect. Right-sided inguinal hernia (57%) was more frequent, followed by left sided (23%) and bilateral (20%). Average time taken was 72 to 98 minutes with a mean of 81.33 minutes in the surgery for unilateral repair and 90 to 103 minutes with a mean of 97.66 minutes for bilateral repair. 40 (67%) patients returned to work within 2 weeks of surgery. Conclusions: Inguinal hernia repair is a common surgical procedure performed on daily basis around the world. Delay in treatment can lead to complications. Laparoscopic approach has shown clear advantages regarding less postoperative pain, numbness, fast return to normal activities and decrease in the incidence of wound infection and hematoma. Polypropylene has proven physical, chemical and biological properties and is currently the most widely used allograft in laparoscopic inguinal hernias.

Outcomes of usage of polypropylene mesh in TAPP hernia repair

Background: Repair of hernia has seen a paradigm shift from open technique to laparoscopic technique. Laparoscopic transabdominal preperitoneal mesh hernioplasty is the latest technique with several advantages over open repair. Polypropylene (PP) mesh is the most frequently preferred product, as are easily and cheaply available, provide enough strength for the technique with good biocompatibility and less tissue reaction. Objective was to study the outcome of usage of polypropylene mesh in TAPP hernia repair. Methods: It was a prospective study on patients with diagnosis of inguinal hernia and underwent TAPP hernia repair with polypropylene mesh. Results: Total of 60 patients were included. Majority of the patients (18; 30%) were in age groups of 46-55 years and 56-65 years. 67% cases of inguinal hernia were of indirect type, 30% direct type and 3% both direct and indirect. Right-sided inguinal hernia (57%) was more frequent, followed by left sided (23%) and bilateral (20%). Average time taken was 72 to 98 minutes with a mean of 81.33 minutes in the surgery for unilateral repair and 90 to 103 minutes with a mean of 97.66 minutes for bilateral repair. 40 (67%) patients returned to work within 2 weeks of surgery. Conclusions: Inguinal hernia repair is a common surgical procedure performed on daily basis around the world. Delay in treatment can lead to complications. Laparoscopic approach has shown clear advantages regarding less postoperative pain, numbness, fast return to normal activities and decrease in the incidence of wound infection and hematoma. Polypropylene has proven physical, chemical and biological properties and is currently the most widely used allograft in laparoscopic inguinal hernias.

Spousal violence among consanguineous marriage in India: a social-ecological analysis using nationally representative cross-sectional study

Background: Marriage is a second most event after birth. Wikipedia states consanguinity marriage as the property of being from the same kinship as another India is a socially and culturally diverse country, which is also reflected in considerable variation in the prevalence of IPV across regions. The aim of study to identify the prevalence and the factors influencing the spousal violence among consanguineous marriage in India. Methods: The present study utilised the fourth wave of the National family health survey (2015-16), the Indian version of the demographic and health survey. Descriptive, bivariate with Chi-square tests and multivariable multilevel logistic regression analyses were done to determine the extent of association between spousal violence and various predicter variables. Results: The study established the prevalence of spousal violence among consanguineous marriage were higher (33.0%) compared with spousal violence among non-consanguineous marriage (26.0%). Women those who get married with any blood relation experienced more physical violence (16.6%), emotional (27.7%), sexual (7.6%) compared with women those who get marriage with non-blood relation, physical violence (11.0%), emotional (22.4%), sexual (5.5%) respectively. Conclusions: The finding is expected to contribute to formulating an appropriate policy to combat Spouse violence in consanguineous marriage among women at the national level of India. The study also showed a significant association between consanguinity and experience more emotional as compared to physical and sexual violence. The results argue for manipulating contextual factors to empower women to challenge gender-related equations and investing in education for gender sensitization at the higher-level social ecologies.

Occupational stress among armed forces and police personnel: a review

In today’s world, stress is a word which is hard to avoid. If someone asks people about their stress and specifically how they know it exists- two general types were described. First, there are experiences of mental distress, - often accompanied by feelings of not being able to cope, that things are falling apart, that the person is not in control of themselves and their situation or is just a general case that without specific reasons that all is not well. Secondly, the physiological manifestations of less appetite, sleeplessness, sweating, ulcers and physical illness of various degrees. Different people have different views about it from various, sources. Occupational stress can be explained as the physiological and emotional responses that originate when personnels feel an imbalance between their work demands and their capability and response to meet these demands. Purpose of this paper is to provide a general review on “occupational stress among armed forces and police personnel of India” with the help of available literature. The home ministry commissioned conducted a study to look into the reasons for premature retirements of paramilitary forces. The findings of the study revealed that lack of sleep, manpower crunch, no leaves and lack of motivation were some of the reasons responsible for people quitting the jobs. However, to the best of my knowledge, no specific research study has been carried-out in India till date to assess the rate and reason of suicides among armed forces and even the home ministry’s official statement revealed that, in most of the cases of suicides, the reasons are more personnel than work related.

Development and use of open-source algorithms for space-time emerging hotspot analysis of routine dengue NVBDCP data in Punjab, India

Background: Understanding spatiotemporal epidemiology using open-source and reproducible algorithms add value to routine health information systems. Objectives were to estimate spatial clustering, identify spatial clusters and space-time hotspots of dengue. Methods: Queen’s contiguity neighborhood matrix and row-standardized spatial weights were used. Spatial clustering was estimated using Moran’s I. Local Moran’s I with sensitivity analysis at 0.01, 0.05, and 0.1 significance levels were performed. The space-time cube model was developed. Gi* statistic and seasonal Mann Kendal test identified persistent and intensifying, persistent, persistent and diminishing, emerging, oscillating, new, historical, and sporadic hotspot sub-districts. Analysis was carried out using R version 4.1.0. Results: The expected Moran’s value was -0.00671. Significant spatial clustering was observed annually in 2016-2018 (p<0.01, <0.01, and 0.04, respectively) and was most common in August, followed by July and November. High-high, high-low, low-low, and low-high sub-district clusters were identified between Aug-Dec from 2015-19. Sensitivity analysis highlighted the core and spread of spatial clusters. Faridkot and Muktsar blocks/ sub-districts were persistent and intensifying hotspots. Conclusions: Spatial clusters were dynamic in space and time. The development of open-source algorithms provides a reproducible and scalable platform for future research and evidence for informed decision-making by public health managers.

STUDY OF BACTERIURIA AMONG PREGNANT WOMEN ATTENDING A TERTIARY CARE HOSPITAL IN PANIPAT DISTRICT, INDIA

Most common population at risk for both symptomatic urinary tract infection (UTI) and asymptomatic bacteriuria, however, is sexually active women. Although asymptomatic infection in this group does not clearly produce serious medical problems, it may be a predictor of future symptomatic infection. Women are more susceptible to infection than men because of the shorter length of the female urethra. Perineal bacterial microbiota that originate in the gastrointestinal tract are the usual pathogens, especially if the bacteria possess factors that facilitate their binding to the uroepithelium. Sexual intercourse facilitates entry of the bacteria into the female urethra. Pregnant women are extra at risk of expand UTIs due to physiological adjustments withinside the urinary tract. UTI constitute severe threats to human health worldwide and hundreds of thousands of the humans affected every year. The aim of this study was to know the prevalence and antimicrobial susceptibility pattern of isolates in pregnant female patients. A total two hundred pregnant and non-pregnant females patients had been included on this study after obtaining the consent. Under strict aseptic precautions midstream urine samples had been taken from all sufferers. All the samples had been processed with the aid of using the usage of standard bacteriological methods i.e. wet mount, inoculation on blood agar and MacConkey's agar after which diagnosed with the aid of using standard biochemical tests, antibiotic sensitivity trying out changed into completed with the aid of using Kirby Bauer's disc diffusion method. In this study 80 out of 200 females patient i.e. 40% were showed UTI of which a most of 20 to 30 years age group had a considerably better occurrence of UTI i.e. 56.25%, while the age group of 60 years and above suggests the lowest contamination rate i.e 2.5% as compared to others. Females belonging to lower socioeconomic status had been extra liable to UTI then others. Pregnant females were more prone to UTI then non-pregnant females i.e. 52.73% and 35.17% respectively. Amongst pregnant females, primigravida and those in the first and second trimesters had been at higher risk. All isolates had been sensitivity to ampicillin+sulbactam, sparfloxacin, and gatifloxacin. Our study mentioned that the prevalence of UTIs was 40%; the pregnant female patients were more prone to UTI than non-pregnant females. The most isolated microorganism had been Escherichia coli which was maximum accountable for UTIs. The sexually active age group 26-30 years was highly at risk of UTI. Females belonging to lower socioeconomic status had been extra liable to contamination. Pregnancy was one in each of the predisposing elements for UTI. All isolates had been confirmed sensitivity to ampicillin+sulbactam, sparfloxacin, and gatifloxacin.

Implementation challenges of Pradhan Mantri Jan Arogya Yojana: A Cross- Sectional study in Meerut, Uttar Pradesh

Background: Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana has been launched to provide financial protection expenditure to nearly 500 million vulnerable Indians. For expanding the coverage under the scheme, it is necessary to understand the perspective of health care service providers involved in the scheme. Aim & Objective: To find out the bottlenecks in implementation of PMJAY scheme using empanelled hospitals’ perspective Settings and Design: Cross sectional study Methods and Material: 8 Public and 23 Private hospitals were selected through Simple Random Sampling from the list of PMJAY empanelled hospitals. The PMJAY Medical Officer co-ordinators in the empanelled hospitals were interviewed using a predesigned and pretested questionnaire. Statistical analysis used: Data was analysed using descriptive statistics in Epiinfo software. Results: Among the 31 empanelled hospitals studied, 93.5% were satisfied with the process for empanelment under PMJAY. 64.5% hospitals were not satisfied with the Health Benefit Packages. 77.4% hospitals perceived the PMJAY to be poorer as compared to private health insurance with reasons being poor grievance reprisal, poor claim processing and settlement, denial of reimbursement of health packages, poor rates of health packages and little information about the scheme. Conclusions: Various hurdles are being faced in the implementation of the scheme. There definitely remains a huge scope for further improvements so as to enhance the insurance coverage in the country.