Background: Musculoskeletal Disorders (MSDs) are prevalent across the globe and are one of the commonest causes of long-term pain and disability, affecting millions of people all over the globe. Objective: To review the literature on studies conducted in India regarding prevalence of Musculoskeletal disorders and its associated factors in adult population in India. Methods: The review of literature was done using various online sites such as PubMed and Google Scholar. The National Medical Library was also searched and relevant papers from different journals were selected. Key words used in search included: Musculoskeletal disorders or pain, General population, Rural area, India.Result:The prevalence of MSD’s among the adult population was found to range between 6.92% - 76.8%. The studies have shown rural- urban difference in the prevalence as well as the health seeking behaviour for MSD’s. There is hardly any screening program existed. The review also shows that factors such as female gender,middle age, lower education status, performing moderate work and repetitive hand movements at work were significantly associated with musculoskeletal pain.Conclusion: A large proportion of the adult population who suffers from various MSD’s goes unrecognized either due to poor understanding of the various factors associated with it or due to less efficient screening and treatment opportunities. Therefore, a clear understanding of the various factors is must to identify these disorders in their earlier course and suitable treatment options to be provided along with the follow-up care.

Introduction: Acute Encephalitis Syndrome (AES) is a disease characterized by fever and mental confusion, disorientation, delirium, or coma. It could be due to various causes such as viruses, bacteria, fungus, parasites, spirochetes, chemical and toxins.Objective: Epidemiological investigation of acute encephalitis syndrome occurred in Muzaffarpur, Bihar in 2011. Methods: This epidemiological investigation was done by a team consisting of experts from various disciplines. The team visited Muzaffarpur, from 14th to 20th July 2011 and reviewed the situation of deaths among children due to AES, as directed by the Authorities. Results: A total of 147 cases of fever with altered sensorium were admitted between 11th June to 18th July 2011 in a private hospital and a Medical College Hospital of Muzaffarpur. Out of these, 54 patients died indicating case fatality rate of 36.73%. Evidences suggest that there were increased chances of contacts between cases and wild rats during the period of occurrence of outbreak. Etiological agent could not be identified by laboratory tests. Conclusion:Clinico-epidemiological and environmental evidence supports the diagnosis of Acute Encephalitis Syndrome which has significant mortality, affecting predominantly rural population with poor sanitation and presence of wild rats.

Background: Multi-Drug Resistant Tuberculosis (MDR-TB) besides increasing cost and duration of treatment also increases the mortality and morbidity. Less awareness in the community and diagnostic constraints for MDR-TB at patient level is a major cause of delay in diagnosis.Objective: To find out the delay in diagnosis of MDR-TB and factors affecting this delay among MDR-TB patients attending tertiary care hospital, PGIMS Rohtak, Haryana, India.Material and Methods: It is a hospital based cross-sectional studycarried out in the department of Respiratory Medicine, PGIMS Rohtak, Haryana from March 2018 to February 2019 among 125 admitted patients of MDR-TB in tertiary care hospital, PGIMS Rohtak. A pre-designed, pre-tested, semi-structured interview schedule was used and data were analysed using SPSS version 20.0 and Chi square test was applied.Result: The mean and median patient delaywas found to be 31.11 days and 21 days, respectively. Extent of patient delay was significantly associated with socio-demographic factors like age, sex, literacy status, occupation, addiction and past history of TB in patients.Conclusion: In this study, it was concluded that there was significant delay in the diagnosis as well as seeking treatment at patient level which was associated with socio-demographic factors. Thus, there is urgent need to boost up the Information, Education and Communication(IEC) activities to increase awareness among general public about the importance of early diagnosis and treatment of MDR-TB.

Introduction: Preeclampsia remains to be an important cause of maternal morbidity and mortality in both the developing and developed world. It is imperative to devise preventive strategies to reduce the burden of this disease. Vitamin D deficiency has emerged as an important inflammatory mediator in its pathogenesis. Objective: To find an association between the severity of preeclampsia and vitamin D deficiency amongst women attending a tertiary hospital in northern India. Material & Methods: this was a prospective comparative observational study. 125 women of preeclampsia and 125 controls were enrolled in the study after due written consent. The women of preelampsia were further divided into preeclampsia with or without severe features. After history, examination and relevant routine investigations, both groups underwent testing for vitamin D. Statistical analysis was conducted with the statistical package for the social science software version SPSS 20.0. The comparison of normally distributed continuous variables between the two groups was performed using Student’s t test and for more than two groups comparison done through ANOVA test. For all statistical tests, a p value less than 0.05 was taken to indicate a significant difference/ association. Result: 80% subjects of study group were significantly more vitamin D deficient as compared to 68% of controls (p-value=0.03). Patients with preeclampsia with severe features had significantly lower levels of Vitamin D as compared to controls indicating that increased vitamin D deficiency was associated with increased severity of preeclampsia. None of the cases with severe preeclampsia had normal levels of Vitamin D. This was statistically significant (p-value=0.046). Conclusion: Severe pre-eclampsia was significantly associated with Vit D deficiency. Prevention of Vitamin D deficiency could be beneficial to prevent pre-eclampsia but community intervention studies are required.

Introduction: Ocular morbidity is among the most under-reported public health problems in the developing world. The estimated number of visually impaired people in the world is around 1.3 billion. India has around 8 million blind and 62 million visually impaired individuals. There are several published studies describing the profile of ocular morbidities in rural areas across India, however such studies on ocular morbidities in rural Goa are rare. The present study was undertaken to generate evidence on this important public health problem.Materials and Methods: The present study was conducted between March to August 2018, after Institutional Ethics Committee approval. The study population included patients from the villages of Ponda Taluka, Goa; who reported to outreach camps. Informed consent was obtained. The data so obtained was entered into structured proformas. The data included socio-demographic details, history regarding any ocular complaints and a detailed ophthalmic examination.The data was entered in Microsoft Excel 2010 version and statistical analysis was performed using Simple percentages and proportions.Result: out of the 120 patients that were studied, 51.67% were aged between 60-80 years, 70% were males, and 61.67% were illiterate. 78.33% participants had refractive errors, 45.33% had cataract, 5.83% had glaucoma, 3.34% had retinal affection and 3.33% had corneal opacities. Conclusion: Refractive errors were noted in majority of our study participants; followed by cataract, glaucoma, corneal opacities and others. A high percentage of patients with cataract and corneal opacities were probably due to low socio-economic background, illiteracy leading to a lack of awareness about common ocular problems and their treatable nature.

Background: Musculoskeletal Disorders (MSDs) are prevalent across the globe and are one of the commonest causes of long-term pain and disability, affecting millions of people all over the globe. Objective: To review the literature on studies conducted in India regarding prevalence of Musculoskeletal disorders and its associated factors in adult population in India. Methods: The review of literature was done using various online sites such as PubMed and Google Scholar. The National Medical Library was also searched and relevant papers from different journals were selected. Key words used in search included: Musculoskeletal disorders or pain, General population, Rural area, India.Result:The prevalence of MSD’s among the adult population was found to range between 6.92% - 76.8%. The studies have shown rural- urban difference in the prevalence as well as the health seeking behaviour for MSD’s. There is hardly any screening program existed. The review also shows that factors such as female gender,middle age, lower education status, performing moderate work and repetitive hand movements at work were significantly associated with musculoskeletal pain.Conclusion: A large proportion of the adult population who suffers from various MSD’s goes unrecognized either due to poor understanding of the various factors associated with it or due to less efficient screening and treatment opportunities. Therefore, a clear understanding of the various factors is must to identify these disorders in their earlier course and suitable treatment options to be provided along with the follow-up care.

Background:Vehicular emissions degrade the ambient air quality posing a major public health problem in cities across the world. Being stuck in traffic for long hours has been attributed with increased incidence of road rage, back pain, cramps, anxiety and depression. Objectives:To find out the magnitude of health problems among daily commuters in traffic; To assess the effects of traffic on health of daily commuters. Methods: A descriptive cross-sectional exploratory study was done in urban Bengaluru in the first half of 2018. The sample size was 506. The subjects should have been a resident of Bengaluru for a minimum period of one year, should have commuted with either one or more than one mode of transport within the city on a daily basis. Results:Out of a total of 506 study subjects, 253 (50.0%) were males and 253 (50.0%) were females. The median (IQR) age of the subjects was 21 (20, 23) and age range was between 16-60 years. The overall burden of one or more than one health problems observed due to traffic was 376 (74.3%). The health problems attributed to traffic was 289 (57.11%) subjects complained of body pain, 205 (40.5%) mentioned physical exhaustion/ dehydration, 144 (28.5%) allergies and 159 (31.4%) respiratory problems. Conclusion: One or more than one health problems was observed in more three forth of the subject due to commute in traffic. Body pain and physical exhaustion/ dehydration were the commonest health problems observed.

Introduction: Diabetes is a Global Emergency. One in eleven adults have diabetes and one in two adults are with diabetes un diagnosed in 2015. Objectives: To study the prevalence of diabetes and its factors responsible among the age group of 20 to 60 years in urban area of Mansurabad, in Hyderabad. Methods: Cross Sectional study was conducted using the semi structure schedule and data was collected from 501 individuals on religion, socio-economic status, presence of diabetes, habitual consumption of alcohol, habitual smoking, sleep duration per day, presence of stress at home/ work and also collected data on the components of Indian Diabetic Risk Score (IDRS) and later summed to obtain IDRS score =60 and <60. Logistic regression analyses were performed to determine significant factors influencing diabetes. Result: Mean age of the population was 40.31 (SD+10.24), females comprised 60% (301) and males 40% (200). Socio-economic status score mean was 14.23 (SD+5.75). Eighty-eight (17.56%) individuals reported having diabetes. Four hundred and one (80%) reported they did not have diabetes. Twelve (2.39%) individuals reported they did not know their diabetic status. Approx. 36.52% (183) had IDRS score =60. Habitual consumption of alcohol was noted in 43.71% (219). Habitual smoking was noted in 26.74% (134). The duration of sleep less than 6 hrs per day was reported by 42.11% (211). Stress at work, or home or at both places was reported by 46.9% (235). Logistic regression analyses (adjusted model) indicated being female (odds ratio 2.23; reference ‘male’), IDRS =60 (odds ratio 4.26; reference IDRS <60), habitual alcohol consumption (odds ratio 2.06; reference ‘no’) and sleep duration <6 hrs. per day (odds ratio 2.07; reference ‘sleep duration 6-8 hrs. per day) were significant factors influencing diabetes. Conclusion: Educational measures should aim at encouraging regular physical exercise, refraining from alcohol consumption and maintaining adequate sleep duration of 6-8 hrs per day.

Background: Malnutrition is one of serious public health problem affecting children in developing countries like India. Adequate nutrition during childhood is vital for proper physical and mental development. The purpose of this study was to assess the association of malnutrition with scholastic performance of school going children of rural Rohtak. Methods: This cross-sectional study was conducted among 392 school children of age 5 to 19 years of village Makrauli in Rohtak, Haryana, India. Malnutrition was assessed using anthropometric measurements and school records were used to analyse scholastic performance. Values of height, weight and BMI were recorded and converted into respective Z scores using WHO ANTHRO PLUS software. Z scores were categorized into <-3SD, -2SD to -3SD, Normal and >2SD according to WHO 2007 Z score charts.Result: A total of 392 children across 2 private schools and 1 government school were evaluated. In our study 27.5% children were found to be underweight. Stunting was present in 66 children (16.8%). Wasting was found 23.7%. Significant association between malnutrition and academic performance was observed. Conclusion: Present study established a positive relationship between nutritional status and academic performance. Malnutrition is a major limiting factor for overall development of children.

Background: Surgical site infection is one of the most common complications after any operative procedure.Aim: To determine the incidence of postoperative surgical site infection in Obstetrics and Gynaecology and also to identify the common causative organisms and their susceptibility to antimicrobials.Material & Methods: We have analysed data from all the postoperative patients suffering from Surgical Site Infection (SSI), from December 2018 to November 2019 in Andaman and Nicobar Islands Institute of Medical Sciences (ANIIMS).Result: Overall incidence of SSI was 9.17%. Staphylococcus aureus was the most common organism identified (38%), with a high incidence of Methicillin Resistant Staphylococcus Aureus (MRSA) (42.86%), followed by Pseudomonas (23.91%). Overall gram-negative bacteria were responsible for more than half of the cases. All the staphylococcal isolates including MRSA were susceptible to linezolid and regarding antibiotic susceptibility of gram-negative organisms, imipenem and piperacillin-tazobactam were most effective.Conclusion: There is emergence of drug-resistant strains of different bacteria such as Pseudomonas and coagulase-negative Staphylococcus. Injudicious use of antibiotics is one of the reasons for this and, hence, there is need for a proper antibiotic protocol that should be formulated based on local trends and susceptibility of microorganisms.

Introduction:Cryptogenic Organizing Pneumonia (COP) earlier known as ‘Bronchiolitis Obliterans with Organizing Pneumonia’ (BOOP), is a rare lung condition in which the bronchioles, alveoli and the walls of small bronchi become inflamed and plugged with connective tissue. The condition is called “cryptogenic” because the cause is unknown. Aim: To study clinical and radiological spectrum of cases reported as COP.Materials and Methods: This is an observational study including secondary data analysis. The medical records, clinical and radiological profiles of COP patients, visiting Dr. Hedgewar Hospital, Aurangabad (2016-2019) were analyzed.Result:The Study included 25 cases. The urban: rural ratio was 14:11. Male: Female ratio was 14:11. The presenting symptoms were mainly Progressive dyspnoea (72%) and Dry cough (68%). Co-morbidities were observed in 72% patients and 28% patients required assisted ventilation. The radiological features were bilateral patchy opacities in 36%, unilateral consolidation in 24%, reticulo-nodular opacities in 8% patients. 32% of Chest Xray were reported as normal. HRCT Lung showed Ground Glass Opacities in 44%, Sub pleural And Interstitial Thickening in 23%, Multiple Nodular Enhancements in 14%, Cystic Changes and Traction Bronchiectasis in 15% and Others (Crazy paving, cavitory changes) in 4% patients. Steroids were administered in 48% patients. The mortality was 20%. The survivors (80% patients) showed clinical improvement. Elderly population, co-morbidities, smoking and ventilator support were the high risk factors for the outcome.Conclusion: COP has varied clinico- radiological spectrum. A high index of suspicion will lead to proper diagnosis and management resulting in better outcome. The steroid therapy resulted in better outcome.