Background: Nonunion fracture of the neck of the femur remains an unsolved issue owing to peculiar vascular anatomy and the relationship of weight transmission to fracture pattern stability. Salvaging the viable biological head is more preferable than replacement to avoid revision surgeries, especially in young adults. Objective: This study was designed to evaluate the outcome of old fractured necks of femur patients who underwent osteosynthesis through valgus osteotomy. Materials and Methods: We did a retrospective cohort study and collected the data for old fracture neck of the femur from 2010 to 19 from hospital records who underwent valgus osteotomy (McMurray's and Pauwel's osteotomy) and followed them for complications. The Student's t-test was used to compare the results of the two methods, i.e., McMurray's and Pauwel's. Results: About 83.3% of cases were of Pauwel's Type II and III groups. In cases that underwent McMurray's osteotomy, the mean shortening was 0.9 cm. Forty percentage had a full range of movements (ROM), 60% had occasional pain, 20% had complications such as screw back out, trochanteric bursitis, and 10% had avascular necrosis of the head femur. In cases that underwent Pauwel's osteotomy had a mean shortening of 1.5 cm, 20.83% had full ROM, 62.5% had limping, 45.5% had pain, 25% had screw back out, and infection in 25. Two cases underwent trans-fracture abduction osteotomy, so results are not discussed. Conclusions: We found that valgus osteotomy showed promising results and was comparable with the results of acceptable literature. Hence, it is suggested that osteosynthesis rather than arthroplasty should be the preferred method of treatment for old fractures of the neck of the femur.

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Background: In December 2019, patients with viral pneumonia-like illnesses were found to be infected with the coronavirus. The spread of COVID-19 infection continues unabated even after vaccination has begun. A study done on health-care workers who were vaccinated reported mild symptomatic breakthrough infection. Studies on breakthrough infections, their severity, and outcome have not been widely done in India. Objectives: This study estimates the COVID-19 test positivity rate among patients reporting to the flu corner of a tertiary care center, their contact history, vaccination status, and the rate of breakthrough infection among the cases. Methodology: A prospective longitudinal study was done on people who presented to the flu corner of McGANN Teaching District Hospital, Shivamogga, in June 2021. Preliminary data were collected through direct interviews. Later positive cases of COVID-19 were followed up till a documented clinical outcome. Responses were made into a database and descriptive statistics were done. Results: The test positivity rate of COVID-19 is 25%. Around 16% of the people who tested positive were asymptomatic. One out of four of the participants was vaccinated with at least one dose of the COVID-19 vaccine. Around 15% of the vaccinated people tested positive. Conclusion: Our study found that the test positivity rate at our tertiary hospital is higher than the district average. A single dose of COVID-19 vaccination does not seem to be protective against contracting COVID-19 infections. These findings need to be verified through studies in different settings.

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Background: The globe has faced a number of challenges in recent years from viral epidemics brought on by newly developing zoonotic diseases, particularly the coronavirus family of viruses. Patients with COVID-19 disease are more likely to experience a more severe course and progression of the disease if they also have comorbid conditions such as hypertension or diabetes mellitus. Hence, the present study was carried out to study the clinical characteristics of COVID-19 patients and the association between COVID-19-related morbidities and mortality in a tertiary care center. Objectives: The objective of this study was to study the clinical profile of COVID-19 patients and the relationship between COVID-19-related morbidities and death at a tertiary care facility. Methodology: The present study was a cross-sectional study which was carried out in the tertiary care hospital of Central India from March 2020 to August 2021 on 11,201 patients. Results: Among the 11,201 study subjects, 6755 (60.31%) were males and 4446 (39.69%) were females. The majority of the study subjects, 2428 (21.68%), were between the age group of 51–60 years. Cough was the major presenting complaint found in 5243 (46.81%) study subjects. Hypertension was the main morbid condition in 2249 (20.08%) study subjects. Among the 11,201 admitted patients, 8763 (78.23%) were discharged, and in 2438 (21.77%) study subjects, the outcome was death. Conclusions: Since morbid conditions such as diabetes and hypertension were more prevalent and it affects more in COVID-19 disease mortality.

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Background: The absence of proper waste management, lack of awareness about the health hazards from biomedical wastes, insufficient financial and human resources, and poor control of waste disposal are the most critical problems connected with biomedical waste management (BMWM). Objectives: The objectives of this study were to assess the infrastructure available for BMWM in primary health-care facilities in Murshidabad district of West Bengal and to find out the gaps in the management. Materials and Methods: This descriptive, observational, facility-based mixed method study with cross-sectional design was conducted in primary health-care facilities selected by multistage random sampling technique. In-depth interview was done with important stakeholders related to BMWM at block, subdivision, and district level. Results: The gaps were identified related to infrastructure, logistic supply, and workforce resources in the studied primary health-care facilities. Segregation at source and disposal of biomedical waste were improper. Training on BMWM and posttraining evaluation were also seen deficient. Information, education, and communication materials and proper record keeping were seen to be absent with lack of supervision. Conclusion: Logistics supply with emphasis on the supply chain with proper allocation of the fund at the primary health-care level should be ensured. Filling up of the vacancies of the Group D staff is essential. Training of health workers with supervision and monitoring by block and district officials needs to be strengthened for efficient BMWM.

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Background: Anemia is responsible directly or indirectly for 40%–60% of maternal deaths from cardiac failure, hemorrhage, infection, and preeclampsia. It also increases perinatal mortality and morbidity rates consequent to preterm deliveries, intrauterine growth restriction, low iron stores, iron-deficiency anemia, and cognitive and affective dysfunction in the infant. Objective: The objective of this study is to study the efficacy of intravenous iron sucrose in terms of hemoglobin rise and side effects. Materials and Methods: Single-center, hospital-based comparative prospective study was conducted among 60 patients admitted with anemia in pregnancy with a hemoglobin concentration of 7.5–9 g/dl. Blood samples were sent for evaluation of hemoglobin, packed cell volume (PCV), and serum ferritin levels at baseline, at 4, and 8 weeks. Results: Mean age was 29.08 ± 5.74 years. About 51.7% belonged to the middle social class. Most were gravida III (36.7%). About 46.7% had 20–24 weeks of gestations. Seventy-five percent had microcytic hypochromic anemia. Hemoglobin improved significantly (P < 0.05) from 8.76 ± 0.54 g% at baseline to 11.47 ± 0.85 g% at 4 weeks, and to 12.68 ± 1.04 g% at 8 weeks; PCV also improved significantly (P < 0.05) from 26.78 ± 3.11% to 34.64 ± 3.73% at 4 weeks and again improved to 42.50 ± 4.67% at 8 weeks; serum ferritin also improved significantly (P < 0.05) from 23.06 ± 7.96 μg/l to 28.86 ± 9.79 μg/l at 4 weeks and again improved to 36.31 ± 12.53 at 8 weeks after parenteral iron sucrose therapy. Only one pregnant woman complained of vomiting and only four women complained of pain at the site of injection after giving parenteral iron sucrose therapy. About 91.6% of the women had no complaints. Conclusion: Parenteral iron sucrose therapy in pregnant women with a gestational age of 20–34 weeks with iron-deficiency anemia was found effective in improving the hemoglobin, PCV, and serum ferritin with negligible side effects.

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Artificial sweeteners are widely used as a substitute for sugar due to their low-calorie content. They are deemed safe for consumption by regulatory bodies and can be useful in controlling blood sugar levels and promoting weight loss when consumed in moderation. However, there is still some debate about their efficacy for diabetes control, and consuming large amounts of artificial sweeteners may have negative effects on blood sugar control and weight management. This article provides an overview of the role of artificial sweeteners in diabetes management, highlighting the benefits and potential risks of their use.

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Tuberculosis (TB) is a communicable disease of great public health importance. Nurses play an important role in treatment adherence, caring with counseling of patients and their family members and can also guide in early detection of side effects produced by anti-TB drugs. So knowledge, attitude, and practices (KAPs) of nurses will have a tremendous role in the delivery of various treatment modalities to TB patients. Present study was carried out to assess the level of KAP regarding TB among nursing staff. This cross sectional study was conducted in a tertiary care teaching hospital in Hyderabad among 115 nurses. Data collection tool was a questionnaire having 11 questions on knowledge, 4 on attitude and 4 on practical aspects of TB. One hundred and fifteen (100%) nurses could tell about the side effects of anti-TB drugs, while 81 (70.4%) told that 6 months is the minimum duration for treatment of new sputum positive TB cases. 96.5% nurses knew about the sample required for diagnosing TB patients while 98.2% felt compassionate toward TB patients and none of the nurses were equipped in wearing N95 masks while treating TB patients. We conclude that nurses had adequate knowledge, good attitude, and satisfactory practical aspects about TB infection though none of them had undergone NTEP training.

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Introduction: The government of India has launched large-scale health education and vaccination campaigns to combat pandemic COVID-19. However, their effects on changing behavior and practices of the very vulnerable tribal communities remain largely unexplored. Materials and Methods: A cross-sectional study was conducted to obtain COVID-19 knowledge and practice data from 390 households of 10 representative tea gardens of Darjeeling district, chose by cluster random sampling. Heads of each household were interviewed using a questionnaire containing 19 knowledge-related questions and 9 practice-related questions, marked on a 3-point Likert scale. A multivariable linear regression model was fitted to ascertain any association between sociodemographic parameters and participants' knowledge with COVID appropriate behavioral practice. Results: Most households were led by men and had a per capita monthly income of >INR 3000. The mean age of the respondents was 52.15 ± 10.14 years, with most being employed and having secondary-level education and above. The mean knowledge score was 30.16 ± 2.97, and practice score was 5.68 ± 1.54. The most common source of knowledge was from government and health-care campaigns. While most of the participants followed COVID-appropriate behaviors such as wearing masks and getting vaccine, hand hygiene (33.82%) and social distancing practices (32.05%) were found to be poor. Employment (P = 0.005) and knowledge about COVID-19 (P = 0.016) were significantly associated with a higher practice score. Conclusions: Among the tribal people assessed, good knowledge about COVID-19 was observed, owing to government efforts. However, while some COVID-appropriate behavior was widely adopted, hand hygiene, and social distancing were not.

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We are presenting the case of a 49-year-old man, a heavy smoker, who had weakness and wasting of the lower limbs along with neuropathic pain for several months for which no medical care was sought. Presentation to the emergency was prompted by a sudden development of pain in the buttocks and cyanosis of the lower limbs. Investigations revealed total atherosclerotic occlusion of the infrarenal abdominal aorta with collateral circulation that was responsible for the delayed presentation. Anticoagulation with heparin was initiated but the patient refused to undergo any invasive procedure. This case highlights that atherosclerotic disease of the aortoiliac region or distal abdominal aorta can present with long-standing symptoms apparently of a neurologic disorder with muscle weakness and wasting rather than an occlusive vascular disease. The symptoms of lower limb claudication and pain may be ignored until a catastrophic complete occlusion supervenes manifesting as acute ischemia as in our case.

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Pyrethroids are widely used as insecticides at home, as part of mass anti-mosquito strategies, and in agricultural fields for control of insects. A 24-year-old female presented with a history of IV injections of around 2–3 ml of mosquito-repellent fluid (pyrethroid compounds) 2 days back. The patient complained of breathing difficulty and had normal vitals with slight derangement of laboratory parameters. On day 5 of admission, the patient complained of increased breathing difficulty with respiratory failure. The patient condition improved with oxygen and supportive care over next 5 days. The current case was unique in its route of administration being intravenous (IV), leading to more bio-exposure with less quantity of poison. No similar reports were found in the literature. There is scope for further research to throw light on the effects and toxicity of pyrethroids in plausible scenarios.

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