Background: Chronic Obstructive Pulmonary Disease (COPD) is a severe lung disease and a major cause of mortality and morbidity worldwide. Because COPD is associated with systemic inflammation, which initiates or aggravates comorbid diseases, cardiovascular disease and arrhythmia risks have been reported to be associated with COPD. In previous studies, supraventricular arrhythmia, particularly atrial fibrillation, was the most common cardiac arrhythmia in patients with COPD.  However, in patients with acute COPD exacerbation, the most common arrhythmia was reported to be ventricular premature beats. Aim: The aim of this study is to determine the risk and prevalence of arrhythmia among COPD patient. Methods and Materials: This prospective cross sectional study carried out in the Azadi Teaching Hospital/Kirkuk general hospital in Kirkuk between November 2021 to March 2022. Patients who had been diagnosed with COPD depending on clinical features and admitted to hospital for exacerbation of COPD. Each patient has ECG on admission and 24-48 hours Holter monitoring. Results: There were 82 patients with acute exacerbation of COPD have been included in this study. The mean age of patients was 65.8±7.9 years (range 55-90 years). Majority of patients (80.5%) were males. Regarding medical history for HTN, DM and IHD, there were 47 (57.3%), 43 (52.4%) and 28 (34.1%) patients had HTN, DM and IHD respectively. For smoking, all patients were a smoker with mean pack per year was 36.8±8.5 pack-years. The ECG finding at the time of COPD exacerbation showed that, 40 (48.7%) patients had abnormal ECG finding and 42 (51.2%) patients had normal ECG finding. The most common abnormal ECG finding was Ectopic beats that presented in 10 (12.2%) of patients, followed by AF which was presented in 8 (9.8%) patients. The Holter finding showed that, 47 (57.3%) patients had abnormal Holter finding and 35 (42.6%) patients had normal Holter finding. The most common abnormal Holter finding was Ectopic beats that presented in 29 (35.4%) of patients, followed by AF in 8 (9.8%) patients, RBBB was presented in 5 (6.1%) patients. No significant associations have been found with abnormal ECG or Holter finding for demographic characteristics. Spo2 and PR showed significant association with abnormal ECG or Holter finding. Conclusion: The prevalence of arrhythmia in patients with exacerbation of COPD was 48.7% by ECG and increased to 57.3% with 24-48 hours Holter monitoring. Only Spo2 and PR showed significant association with abnormal ECG or Holter finding.

Labour induction and observation are a vital aspect of obstetric care with an aim of ensuring maternal and fetal outcomes optimisation. There are clinical induction methods of labour, whether pharmacological or mechanical, with indications, advantages and risks of each. Complications can be identified in time and thus interventions can be taken through effective monitoring of labour by continuous or intermittent fetal and maternal assessment. This review will compile the existing evidence related to the methods, guidelines and outcomes related to induction and monitoring of labour, best practices and difficulties in clinical practice. The focus is on the balancing of the benefits of intervention and maternal and neonatal safety. These approaches are vital and clinicians need to understand them to make evidence-based and informed decisions and enhance perinatal outcomes.

Background: Stroke is one of the leading causes of death and long-term disability worldwide, and India is experiencing a growing burden due to lifestyle changes, aging populations, and poor awareness. Punjab, with its high prevalence of non-communicable diseases, substance use, and sedentary lifestyles, is at particular risk. Despite this, limited data exist on public awareness of stroke in the region. This study was conducted to assess awareness of stroke risk factors, warning signs, and immediate management among the general public of Punjab, while identifying socio-demographic determinants influencing knowledge levels. Materials and Methods: A descriptive cross-sectional survey was conducted among 400 adults aged ≥18 years across urban and rural Punjab. Data were collected through a structured, validated questionnaire designed on Google Forms, covering socio-demographics, awareness of stroke risk factors, and recognition of warning signs. Each correct response was scored as 1, with total knowledge scores categorized as excellent (16–20), good (12–15), fair (8–11), and poor (0–7). Data were analyzed using descriptive statistics and Chi-square tests to explore associations between knowledge levels and socio-demographic variables. Results: Of 400 participants, the majority were aged 30–44 years (34.0%), males (52.5%), and urban residents (56.0%). Hypertension (69.0%) and diabetes (62.0%) were the most widely recognized stroke risk factors, whereas awareness of lifestyle contributors such as physical inactivity (41.0%), excess salt intake (43.5%), and stress (46.5%) was limited. Only 32.0% recognized family history and 34.5% increasing age as risk factors. Among warning signs, slurred speech (73.0%) and sudden weakness (69.0%) were well identified, but recognition of vision loss (51.0%), confusion (49.0%), imbalance (47.0%), and severe headache (44.5%) was poor. Only 41.0% were aware of the FAST test, though 75.5% correctly emphasized the need for immediate hospital referral. Overall, 17.0% demonstrated excellent knowledge, 30.5% good, 34.5% fair, and 18.0% poor. Education, occupation, and residence were significantly associated with knowledge levels, while age and gender were not. Conclusion: The study reveals moderate stroke awareness in Punjab, with critical gaps in understanding lifestyle and hereditary risk factors, recognition of non-classical symptoms, and emergency response strategies. Targeted community-based health education, integration of stroke literacy into existing NCD programs, and greater outreach in rural and less educated populations are urgently needed to improve early recognition, timely intervention, and reduce stroke-related morbidity and mortality.

Background: Breast cancer continues to be the most commonly diagnosed cancer and a major cause of cancer-related deaths among women worldwide. In India, and particularly in geographically challenging states like Himachal Pradesh, limited awareness, socio-cultural taboos, and misconceptions often delay early diagnosis and treatment. Given the critical role of early detection in improving outcomes, it is essential to assess public awareness, especially in underserved and rural populations. Materials and Methods: A cross-sectional, descriptive study was conducted over three months in 2025 to assess knowledge, awareness, and misconceptions about breast cancer among residents of Himachal Pradesh. A bilingual (English and Hindi) structured questionnaire comprising 20 awareness questions and socio-demographic variables was disseminated through a Google Form using convenience sampling. A total of 400 participants (aged 18 years and above) responded. Knowledge scores were calculated, categorized into four levels (Very Good, Good, Fair, Poor), and analyzed using SPSS. Chi-square tests assessed associations between knowledge levels and socio-demographic factors, with p < 0.05 considered statistically significant. Results: Among the 400 participants, 70% were female, 56.5% resided in rural areas, and 33% were undergraduates. Awareness levels were relatively encouraging, with 78% recognizing the importance of early detection, 77.8% acknowledging breast self-examination, and 74.5% aware that men can also develop breast cancer. However, misconceptions persisted—only 59.5% correctly denied the myth that tight bras cause cancer, and just 58% understood that not all cases require mastectomy. Knowledge scores revealed that 31.5% of participants had very good knowledge, 36% had good, 20.5% fair, and 12% poor. Statistically significant associations were observed between knowledge levels and education (p<0.001), age (p = 0.014), gender (p = 0.047), and residence (p = 0.026). Conclusion: While awareness of breast cancer in Himachal Pradesh shows promising trends, particularly among younger, educated, and urban populations, significant gaps remain—especially among rural and less-educated groups. Persistent myths and limited knowledge about screening access underline the urgent need for culturally sensitive, community-based educational campaigns. Strengthening grassroots awareness initiatives and integrating breast cancer education into public health programs could greatly enhance early detection and reduce mortality in this Himalayan region.