Background: In Himachal Pradesh, a few studies have been done to determine how well the general public understands the risk factors and preventative measures for getting diabetes (DM). This study's goal was to gauge how much of the general Shimla city populace knew about it. Material and Methods: This cross-sectional survey was conducted from October 2022 to   December 2022 using Google forms among the people residing in the Shimla city of Himachal Pradesh. The questionnaire was circulated among both rural and urban residents of the city for responses using online modes like e-mail and social media platforms like WhatsApp groups, Facebook, Instagram and LinkedIn till the 400 responses were collected.  Information regarding their socio-demographic characteristics and knowledge, regarding risk and preventive factors for Diabetes Mellitus were obtained. Data was analyzed using Epi info v7 software using appropriate statistical tests. Results: A total of 400 respondents including 165(41.25%) were from urban area and 235(58.75%) were from rural area were participated in the study. Among the participants of the majority 262(65.5%) were males, 174(43.5%) were between 18-30 years, 159(39.75%) were Graduate, 259 (64.75%) were employee, 248(62.0%) were married and 384 (96.0%) were Hindu In the present study 59(14.75%)  study participants had very good knowledge (9-10 marks) towards risk factors for Diabetes, 221(55.25%) had good knowledge  (7-8 marks), 71(17.75%) had fair knowledge  (4-6 marks) and 49(12.25%) had poor knowledge  (<4 marks) towards risk factors for Diabetes. Similarly, 42(10.5%) study participants had very good knowledge (9-10 marks) towards preventive measures about Diabetes, 249(62.25%) had good knowledge (7-8 marks), 64(16%) had fair knowledge (4-6 marks) and 45 (11.25%) had poor knowledge (<4 marks) towards preventive measures about Diabetes. Conclusion: Many survey respondents said that they were still unsure about the risk and preventive factors for diabetes mellitus. Initiatives to promote community health education about DM risk factors and defences are necessary.

Graves’ disease (GD) and type 1 diabetes mellitus (T1DM) are auto-immune conditions that are frequently encountered independently in the practice of endocrinology. Both endocrinopathies can however be encountered in the same patient. In children, T1DM has been severally reported to develop first with onset of GD after many years. We report the case of a 9-year-old girl with GD who developed T1DM shortly afterwards.

Motor neuron disease (MND) is an uncommon neurodegenerative disease that affects the brain and nerves. It causes weakness that gets worse over time. There's no cure for MND, but there are treatments to help reduce the impact it has on a person's daily life.

Hepatitis A virus (HAV) infection is common in developing countries, including India. It can be accompanied by extra-hepatic complications such as renal failure, arthritis, and vasculitis. Pleural effusion is a very rare complication of HAV infection, which has been reported usually in children, and has benign clinical courses. Here we report a case of pleural effusion with ascites which occurred in an adult hepatitis A patient. A 26-year-old-man presented with generalized myalgia and fever and was diagnosed as acute hepatitis A. Despite of the improvement of laboratory findings, fever and cough persisted. Pleural effusion newly appeared on the serial chest radiologic images. After the fever settled down, the pleural effusion resolved spontaneously at 2nd week of admission.

Although the novel pandemic COVID-19 a primary respiratory tract infection, it is a multi-systemic illness, and has an important impact on the haemopoietic cells. The purposes of this study is to concentrate on the possibility of utilizing the hemocytometry results in predicting the infected cases during epidemic periods. Methods: A total 220 cases included in this study, (118 males, 102 females), divided into 3 groups, 1^st group represent those of second wave of pandemic COVID-19 in Iraq, 2^nd group during period of third wave, and 3d group includes post vaccine infection. Using the 5 diff Sysmex autoanalyzer for complete blood count as a rapid, informative, cheap test. Results: About 1/3d of group 1 and 2 (37%, 33%) respectively are presented with leukocytosis while no one of vaccinated group, in opposite to leucopenia, more common in 3d group (25%), while in group 1and 2only few (8%, 11%) cases respectively. Thrombocytopenia is infrequent in all three groups. The differential white blood cell count is symmetrical in 1^st and 2^nd group, all patients presented with eosinopenia followed by high N/L ratio (84%, 92%) -whether due to neutrophilia and/or lymphopenia, or both within normal range-, this is not the finding in post-vaccinated group, eosinopenia presented in 25%, of cases and neutropenia is the most common finding 31% in 3d group, while lymphopenia is rare in third group.

Teenagers’ food consumption patterns during the COVID-19 pandemic are very important, to keep the body healthy and avoid infectious diseases such as Covid-19. This study aims to analyze the consumption behavior of balanced nutrition that still needs attention from the students of SMK Kesehatan Binatama so that it can be used to produce health promotion programs for students. This research is a qualitative descriptive study. Secondary data from the results of previous studies. Both closed behavior (such as knowledge, attitudes) and open behavior of students in consuming balanced nutrition, where students' understanding still answered incorrectly, or their attitude negative. It is presented and concluded. The results showed that the knowledge, attitudes, and roles of teachers towards students regarding balanced nutrition during the covid 19 pandemic were mostly good, only in terms of behavior that required attention, namely about the lack of action in terms of 1) maintaining regular weight gain during the covid-19 pandemic for normal weight (54 out of 84); 2) eat fruit at least 2 times a day during the covid-19 pandemic (47 out of 84); 3). reducing consumption of sweet, salty and fatty foods during the covid-19 pandemic (52 out of 84); and 4). do physical activity/sports for at least 30 minutes a day during the covid-19 pandemic (59 out of 84). Then the role of parents is mostly good, the only thing that needs attention is regarding excessive consumption of snacks during the COVID-19 pandemic has not received the attention of parents (43 out of 84).

Background: Present study was done to evaluate the Mechanical ventilation and its association with Ocular Surface Disorders among Patients admitted in Adult Intensive Care Unit. Material and Methods:It was a prospective observational study carried in AICU over period of one year by Department of Ophthalmology, Dr. RPGMC Kangra at Tanda. All the patients who were admitted in AICU greater than 48 hours between ages of 18-65 years were included and evaluated for socio-demographic information like age, gender, Mechanical ventilation etc. Thorough ophthalmic examination was also done for ocular surface disorders and analyzed using epi info v7 software. Results: A total of 126 patients were included in the study. Mean age of the study participants was 41.8 years.  Maximum patients, 23.8% of the patients were in age group of 51 and 60 years followed by 23% between 21 and 30 years and 41 and 50 years each. 64.3% of the patients were males while 35.7% were females. 74 (58.7%) of the patients had ocular surface disorders. In the present study, 66.7% of the patients were on mechanical ventilation at 48 hours. At the end of first week, 63% patients were on mechanical ventilation while at the end of second week, 54.5% patients were on mechanical ventilation. At the end of fourth and fifth week, none of the patients was on mechanical ventilation. In the present study, the association between presence of mechanical ventilation and ocular surface disorders was statistically significant. Conclusion: The present study concluded that the patients who were on mechanical ventilation had significantly higher number of ocular surface disorders.

Anaemia is the most common nutritional disorder worldwide. Anaemia accounts for a majority of the nutritional problem across the globe and it is principally engendered by deficiency of iron. The World Health Organization (WHO) estimates anaemia as a major public health problem with almost 2 billion people having anaemia below normal values. One of the most common causes of anaemia is due to inadequate supply of nutrients. Poor eating habits play a major role in the development of iron deficiency anaemia that is an important indicator of poor health status. According to national family health survey (NFHS-4) conducted in the year 2015-2016, the prevalence of anaemia, among women aged 15-49 years is 53%. Anaemia results from one or more of the following process: defective red cell production, increased red cell destruction or blood loss. Women are the most vulnerable group of population due to different reasons. The present study was carried out to get a clear idea of the different degree of anaemia among the women adult females between the age group 18-50.The standard method for diagnosing anaemia is to measure the level of haemoglobin (Hb) in a person’s blood, low Hb levels indicate anaemia. Anaemia is a major public health problem among women. The prevalence was high among girls who were between 20-30 years of age. haemoglobin was estimated and the severity of anaemia i.e. mild, moderate, severe and absent were classified. Mild degree of anaemia was prevalent among the age group 20- 30 compared to the moderate and severe condition of anaemia.

Despite the fact that the hepatitis B virus (HBV) is the most common cause of hepatitis, the hepatitis C virus (HCV) is quickly becoming a serious infection that must be addressed. 1Hepatitis C virus (HCV) is a leading cause of acute and chronic liver disease. The purpose of this study was to determine the frequency of hepatitis B and C patients, as well as to determine whether elevated serum AFP levels were associated with hepatitis B and C infection. From the 19^th of March 2021 to the 29^th of June 2021, a cross-sectional study was carried out in the city of Kirkuk. There were 86 hepatitis B patients and 24 hepatitis C patients in the understudy for hepatitis. These patients were referred to the Hepatology and Gastroenterology centers in Kirkuk for treatment five milliliters of blood drawn through a vein puncture for determination of AFP, liver function tests, Hepatitis B surface Antigen (HBsAg), and hepatitis C antibody investigations were performed using blood samples. According to the results of the study, the mean AFP level in the study patients was 359 9.9 ng/mL, while the mean level in the controls was 1.93 0.24 ng/mL. When comparing the mean aspartate amino transferase activity to the mean control value, the difference was 145 1.8 u/L and 10.8 1.2 u/L, respectively. When measuring the activities of alanine amino transferase and alkaline phosphatase in the experimental subjects, the mean values were 75.51 and 176.1u/L and 171.6u/L, respectively, whereas in the control subjects, the mean values were 8.6 1.2u/L and 294.2u/L, respectively. The mean total bilirubin and mean direct bilirubin in the study subjects were 68.7 6.8 mol/L and 26.0 4.1 mol/L, respectively, whereas the mean total bilirubin and mean direct bilirubin in the control subjects were 10.6 1.2 mol/L and 4.2 1.0 mol/L, respectively. The mean total protein, albumin, and globulin concentrations were 50.6 3.6 g/L, 29.6 1.9 g/L, and 20.6 2.8 g/L, respectively, while the mean control values were 65.2 1.1 g/L, 42.1 1.1 g/L, and 21.9 1.2 g/L, respectively, in the same study. According to the findings, the mean AFP level in the 36 subjects who tested positive for HBsAg was 279 20 ng/mL, whereas the mean AFP level in CLD patients who tested positive for Hepatitis C antibody was 849 23 ng/mL, and the mean AFP level in those who tested negative for Hepatitis C virus was 16.3 3.6 ng/mL. The mean AFP level was highest (P 0.001) in CLD patients who had HCV infection, followed by those who had HBsAg positivity and those who did not have hepatitis infections. Conclusions: Serum AFP level was highest in CLD patients with HCV antibody positive compared to HBsAg positive CLD and hepatitis negative patients.

Objective: The aim of this study is to investigate the contribution of social support systems to the bio-psycho-social and economic problems of patients waiting for lung transplantation in the Covid-19 pandemic. Methods: Qualitative research was conducted with one-on-one interviews with 21 patients. Results: 61% of the patients were male, 47.6% were married, and the mean age was 36.67±14.023 (Median: 39, Min: 18, Max: 61). 85.7% of the patients were not working in any job. The patients were waiting for lung transplantation due to boron ectasia, COPD, pulmonary hypertension, interstitial lung disease, cystic fibrosis, idiopathic pulmonary fibrosis. It has been determined that there are more fear, anxiety and panic in patients waiting for transplant due to the decrease in organ transplants during the Covid-19 pandemic and the Covid-19 disease affecting the lungs. While transplant candidates benefited less from formal support systems during the Covid-19 pandemic process, they benefited more from informal support systems. All of the candidates stated that the family is a very important structure and stated that they would not be able to continue their lives if they did not have a family. Conclusion: More comprehensive formal and informal support systems including vulnerable groups should be planned in disasters.

Introduction: Although several studies point out that cancer therapy can contribute to problems in sexual function, more research is needed to better understand the concerns and information of cancer patients about the sexual life. This study aimed to identify the sexual life importance and the quality of communication with oncologists on this topic in patients with reproductive cancers. Methodology: A total of 251 cancer patients from the oncological department completed a self-reported questionnaire along with two oncological consultations (T0 and T12 after 12 months). Chi-square analysis and T-test methods were used to compare the sexual life importance and quality communication of these patients according to gender, age and education. Results: The data of our study showed that male patients considered more important their sex life than female patients at the first consultation (T0). At the second consultation, (T12), a general increase of sexual life importance resulted for both sexes, along with a slight decrease of the difference between male and female patients. Regarding communication about sexual life, we observed at T0 that the female patients were more embarrassed to talk about their sexual life with their oncologist in respect to male patients. After one year (T12), there was a general increase of quality communication, accompanied by a moderate reduction of the difference between sexes. Conclusions. The importance of sexual life and the related quality of communication with the oncologists/ healthcare professionals (HCPs)/oncological nurses (ONs) tend to significantly increase during the treatment. Implications for Practice: This study is limited in that specific sexual life concerns were determined with self-report measures. All health professionals did not always recognize emotional cues than those related to physiological complaints. It follows that the issue of sexuality must be incorporate in interventions offered in the context of care for these women and men.

Background: Benefits for use of Clipless Laparoscopic Cholecystectomy (CLLC) technique using Absorbable suture material and Single Clip Laparoscopic Cholecystectomy (SCLC) using harmonic scalpel are Less operative time, Less bleeding, Early postoperative recovery, Less spillage of stones, Less chances of converting into open cholecystectomy, Less pain post operatively and Less amount of CO₂ used. This study was undertaken to compare the advantages of Single clip laparoscopic cholecystectomy (SCLC) and Clipless Laparoscopic Cholecystectomy (CLLC). Material and Methods: This prospective randomized study was conducted in the Department of Surgery IGMC, Shimla over a period of 1 year starting from 1st july 2019 to 30^th june 2020. In this study 100 consecutive patients of symptomatic cholelithiasis confirmed by USG reporting were participated and randomized into 2 groups of 50 each. Group 1 patients underwent SCLC and Group 2 patients underwent CLLC. Outcomes were measured in terms of operative time, intra operative stone spillage, intra operative blood loss, amount of CO₂ used, post-operative pain, conversion into open cholecystectomy and post-operative complications. Results: Among the total 100 patients, 24 were males and 76 were females. Among them, 10 males and 40 females underwent single clip laparoscopic cholecystectomy (SCLC) while 14 males and 36 females underwent Clipless laparoscopic cholecystectomy (CLLC). In between two groups, mean age of males were 48.50±14.49 and females were 46.73±16.16 in SCLC group while mean age of males were 53.07±18.96 and females were 44.44±15.41 in clipless laparoscopic cholecystectomy group. Present study showed that there was significant more Operative Time and more Mean CO2 used in CLLC group as compared to SCLC group. In the study although there was more Approx. Blood Loss, more Intra Op. Stone spillage and more Use of Drain, more Average Length of hospital stay, more Post Op. Complications but less Average pain score at 6 and 24 hours in CLLC group as compared to SCLC group but this difference was not statistically significant.  Similarly, in both groups equal number of patients Converted to Open Cholecystectomy. Conclusion: Study concluded that there was no statistically significant difference among both groups except for Operative Time and Mean CO2 used which was significantly more in CLLC group as compared to SCLC group.

Background: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of gallstone disease.This study was undertaken to compare the advantages of two clips laparoscopic cholecystectomy (TCLC) and Clipless Laparoscopic Cholecystectomy (CLLC). Material and Methods: This prospective randomized study was conducted in the Department of Surgery IGMC, Shimla over a period of 1 year starting from 1st july 2019 to 30^th june 2020. In this study, 100 consecutive patients of symptomatic cholelithiasis confirmed by USG reporting were participated and randomized into 2 groups of 50 each. Group-1 patients underwent TCLC and Group-2 patients underwent CLLC. Outcomes were measured in terms of operative time, intra operative stone spillage, intra operative blood loss, amount of CO₂ used, post-operative pain, conversion into open cholecystectomy and post-operative complications. Results: Among the total 100 patients, 28 were males and 72 were females. Among them, 14 males and 36 females underwent TCLC while 14 males and 36 females underwent CLLC. In between two groups, mean age of males were 45.36±14.53 and females were 45.25±15.97 in TCLC group-while mean age of males were 53.07±18.96 and females were 44.44±15.41 in CLLC group. Present study showed that there was significant more Operative Time and more Mean CO2 used in CLLC group-as compared to TCLC group. In the study although there was more Approx. Blood Loss, more Intra Op. Stone spillage and more Use of Drain, more Average Length of hospital stay, more Post Op. Complications, more Average pain score at 6 but less Average pain score at 24 hours in CLLC group-as compared to TCLC group-but this difference was not statistically significant. Similarly, in both groups equal number of patients Converted to Open Cholecystectomy. Conclusion: Study concluded that there was no statistically significant difference among both groups except for Operative Time and Mean CO2 used which was significantly more in CLLC group-as compared to TCLC group.

Introduction: Queuing is an event that is often encountered in everyday life. The purposes of conducting this research are to analyze the effectiveness of the queuing system that occurs during the service of ambulatory patient care and to examine whether the one-way queuing model (M/M/1) is still an affective model when serving ambulatory patient at the RSUD Dr. M.M Dunda Limboto, Gorontalo. The data used in this research is secondary data of ambulatory patients at the RSUD Dr. M.M Dunda Limboto, Gorontalo on February 2nd until 17th 2021 (during work days). Methods: An unobtrusive (non-reactive) analysis using the secondary data of ambulatory patients at RSUD Dr. M.M Dunda Limboto, Gorontalo. Results: The waiting time for ambulatory patient is 0.05 hour and the queue length formed is 3 patients, so there is no queue that significantly detrimental the patients at RSUD Dr. M.M Dunda Limboto, Gorontalo and the queuing system that applies at RSUD Dr. M.M Dunda Limboto, Gorontalo for ambulatory patients is an effective queuing system, where the server can serve all patients every day in a fairly short time using only one server. So, the M/M/1 system can still be used by RSUD Dr. M.M Dunda Limboto, Gorontalo.

Teenage pregnancy continues to be one of the social barriers to the human resource development of Sierra Leone. It limits the educational progress of the girl child. The situation was a national concern in the year 2015 immediately after the Ebola Virus Disease (EVD) out-break as teenage pregnancy of school going children reached its record highest in Sierra Leone, and demanded a change in the Education policy to encourage their class attendance and sitting to public examinations. This research was, therefore, conducted in one worst-hit community in the Bombali District, the Masuba community which has a Government supported Maternal and Child Health Center that could recount better for the mishap so that useful information to support Government to respond to the menace would be generated. To ensure this, the research employed a desk research in which information contained in the records of the Masuba Health Center, which was the only functioning health facility in the Masuba Community that responded to the affairs of pregnant and lactating mothers was collected. The research sought to ascertain the surge in teenage pregnancies, number delivering at the health facility complications at their deliveries, Government’s intervention on family planning in the health facility occasioned by the EVD outbreak in the Masuba community. The research found out that there was a marked increase in the number of teenage pregnancies in the Masuba community, with such reduced complications in the middle period of the outbreak; teenage mother deliveries were overwhelmingly safe with only a few referrals; Government Family Planning interventions during the EVD outbreak were the non-injectables, non-invasive, and sensitization, while that the pre and post-EVD outbreak period were counseling, pregnancy test, alongside with the injectable, pills, condoms, and invasive methods.

Introduction: Non-communicable diseases (NCDs) kill 41 million people each year, equivalent to 71% of all deaths globally. Each year, 15 million people die from a NCD between the ages of 30 and 69 years; over 85% of these "premature" deaths occur in low- and middle-income countries. Objective: The objective of this study was to assess the profile of clients attending NCD Clinic of a tertiary care institute. Methodology: Opportunistic screening of patients and attendants above 30 years of age attending different clinics of the department of community medicine for various risk factors of NCDs including Obesity, smoking and physical activity. Blood pressure and blood sugar measurements were also taken. A total of 148 people were screened. All those screened received counseling on healthy lifestyle and prevention of NCDs. Results: 89.2% had a sedentary lifestyle and 7.4% were current smokers and 12.8% were obese. 2.7% has raised blood pressure and 4.1% had raised blood sugar at the time of screening and were referred for further investigations. Out of the 148 people screened 20 were known hypertensives, 10 were diabetics and 4 had both hypertension and diabetes and 2 had other comorbidities. Conclusion: A considerable proportion of people screened were found to be at risk of NCDs. Proper counseling at the appropriate time would help in preventing NCDs among such people. Also many of the people screened were found to have high blood pressure or raised blood sugars and needed to be referred for further management.

Background: Breast cancer is a malignancy that develops from breast tissue that arises in the lining cells (epithelium) of the ducts or lobules. Breast cancer is one of the burdens of non-communicable diseases globally, increasing every year. Breast cancer is one of the most common cancers globally with 2,089 million new cases. One of the preventions of breast cancer that every woman can do is Breast Self-Examination (BSE). The objective of this study was to determine the effect of Whatsapp Group-based health promotion on the knowledge, attitudes, and behavior of early detection of breast cancer in health students in Badung Regency. Method: This study uses a cross-sectional research design with a total sample of 54 respondents. The study was conducted in one of the private universities in Badung Regency. Data were analyzed using SPSS, including univariate and bivariate analysis with the Wilcoxon signed-rank test. Result: The results found that the Whatsapp Group-based health promotion affected health students’ knowledge, attitudes, and behavior in Breast Self-Examination (BSE). This can be seen from the p-value of each variable, including knowledge (<0.001), attitude (<0.001), and behavior (<0.001). Conclusion: Counseling about BSE with health promotion media through Whatsapp Group is useful in increasing the knowledge, attitudes and behavior of health students.

Introduction: Dengue fever is a common arthropod borne viral fever presenting with thrombocytopenia. There are number of study on thrombocytopenia and its correlation with severity of dengue fever, but results are conflicting. We want to study level of platelet count and its correlation with various complications of dengue like bleeding, DIC, hepatitis, shock etc. We would also like to evaluate platelet trends (increasing or decreasing) with various complication and outcome. Methods: It was prospective observational study over the period of one year. 90 Indoor patients with dengue with thrombocytopenia were studied after inclusion and exclusion criteria. Data entry and analysis was done in Microsoft excel through Descriptive statistic,’t’ test and chi-square tests. Results: In uncomplicated cases the mean platelet count was 54077±42277 and in complicated cases the mean platelet count was 29500±23197. This signifies platelet count were low in complicated dengue fever. This suggests that platelet count is surrogate marker of severity of dengue fever. With improving platelet count, most of patients survived, while patients with decreasing trend suggested poor outcome (p<0.01) with 53 time higher chances of expiring as compared to patient with increasing trend of platelet (odd ratio: 53.64). Severe thrombocytopenia was related with high mortality rate. Conclusion: From this study, we recommend that absolute platelet count & more specifically change in platelet count trend (increasing or decreasing) should be monitored closely as it can be used as a predictor of severity of dengue fever.

Tuberculosis is a lethal disease, which is caused by bacteria Mycobacterium tuberculosis complex, is one of the oldest diseases known to affect humans and a major cause of death worldwide. Tuberculosis continues to be a huge burden of disease against the human population and it is a major killer of the human population after HIV/AIDS. Tuberculosis is highly prevalent among the low socioeconomic section of the population and marginalized sections of the community. Through this article we wish to review the factors responsible for the delay in diagnosing and seeking medical care in patients affected with tuberculosis.

Introduction: Globally, Tuberculosis (TB) remains a major public health problem. It is one of the top 10 causes of death worldwide. According to World Health Organization (WHO) TB report 2019, globally, an estimated 10 million people fell ill with TB in 2018. Material and Methods: A cross-sectional study was conducted among the patients of tuberculosis diagnosed at I.G.M.C. Shimla to assess the profile of T.B patients and assess the knowledge levels and stigma among the patients. Results: Among all the participants enrolled for study (52.38%) were males. Only 19 % were educated up to university level. Among all the participants, 47.6% were unemployed. Among all the patients included in the study, extra pulmonary tuberculosis was diagnosed in 54.3% patients visited I.G.M.C Shimla.27.6% of participants were exposed to TB patients at home or workplace. Conclusion: There is high proportion of extra pulmonary tuberculosis among study participants. Diabetes mellitus, HIV and COPD were detected as co-morbidities in participants. Social stigma was present in study participants for seeking treatment.

Foreign bodies of the urethra and bladder are rare clinical entities and are most commonly associated with self-insertion, iatrogenic causes, or migration from adjacent anatomical structures. Individuals who are intoxicated, mentally confused, or sexually curious are at higher risk. Delayed presentation is frequent due to embarrassment and guilt, which may result in complications. We report the case of a 32-year-old unmarried male who presented with acute difficulty in micturition for one day. Physical examination revealed a palpable elongated foreign body extending from the distal penis to the penoscrotal junction. Pelvic X-ray confirmed the presence of an approximately 9–10 cm foreign body lodged in the anterior urethra. The patient had no associated systemic symptoms. Prompt diagnosis was made based on clinical examination and imaging findings. Management of urethral foreign bodies focuses on safe extraction, early recognition of complications, and preservation of erectile function. Endoscopic removal is preferred for foreign bodies located distal to the urogenital diaphragm, as it minimizes trauma and reduces the risk of long-term complications. Invasive surgical procedures are associated with higher morbidity, including infection, urethral stricture, fistula formation, and urinary incontinence. Early diagnosis and appropriate intervention are essential to ensure favorable outcomes.

Pilonidal sinus is a common disease in adults of 15-40 years of age hirsute males, jeep and truck drivers. Limberg flap has been recommended as the first line treatment for primary and recurrent disease. There is reluctance of general surgeons to perform the procedure at secondary health care level. This study was undertaken to check feasibility of flap surgery and compare outcomes at secondary health care level. In our study Limberg flap was done for all patients (total 10) of Pilonidal Sinus from December 2020 to November 2021.One case was associated with flap edema and two cases with persistent discharge from tip which subsided by 3 weeks. All patients were successfully treated and returned to work in 4 weeks. There was no recurrence. Limberg flap for Pilonidal sinus is a simple and easy to perform transposition flap even at district level hospital with a very low complication and recurrence rate.

Background: Tuberculosis remain a worldwide public health problem and is one of the top 10 causes of death globally. Millions of people continue to fall sick with TB each year. We conducted the present study to evaluate the Socio-demographic Profile and treatment outcomes of Tuberculosis Patients Diagnosed in a Government Civil Hospital of Northern India. Material and Methods: This cross-sectional record-based study was conducted at Civil Hospital Jogindernagar of Himachal Pradesh. We collected information using a self-designed, structured questionnaire containing information regarding various sociodemographic and clinical variables. Information was collected from Tuberculosis (TB) notification register kept at DOTS centre. Statistical analysis was done using statistical software Epi Info v7.2.2. Results: There were total 74 patients of tuberculosis were registered from Jan 2020 to June 2020 at DOTS center in Civil Hospital, Jogindernagar, Himachal Pradesh Among the total, 54 27 (73%%) were 21-60 years of age. Mean age of patients were 44.78±17.01 years. Majority of patients, 56 (75.7%) were male and 51 (68.9%) belong to lower middle class. 46 (62.25) were pulmonary TB cases while 28 (37.8%) were extra pulmonary cases. Among the total, 26 (35.1%) cases were clinically diagnosed, 11 (14.9%) cases were Clinically diagnosed  or Diagnosed by FNAC while 37 (50.0%) cases Microbiological confirmed cases. 29 ( 39.2%) cases were Contact of TB/DRTB Cases , 29 (39.2%) were tobacco user while 16 (21.6%) had other risk factors. None of the case Reactive HIV status, 8  (10.8%) had Diabetes while 27 (35.5%) had associated Cervical lymphadenopathy. 71 (95.8%) were cured after completing ATT, 1 (1.4%) were become defaulter, 1 (1.4%) Shifted to MDR Treatment and (1.4%)  was died. Conclusion: Study concluded that most of the patients were males, belonged to lower socioeconomic status, in productive age group and of pulmonary TB. Treatment success rate is good but still need to improve, to make it 100 percent.

India in its fight against COVID-19 pandemic launched its mass vaccination campaign on 16^th January, 2021. Adolescent vaccination for 15-18 year age group was started from 3^rd January 2022 onwards with COVAXIN only. In addition to challenges during adult vaccination of 18+ populations, there were added challenges pertaining to adolescent vaccination. This article briefly describes the planning and execution of adolescent vaccination at a district level in a hilly state of North India. Also enlisted are challenges faced and the facilitating factors those contributed in achievement of near 90% vaccination coverage among targeted group in a time of less than one week.