February 2022

Introduction: Swine Flu is a respiratory tract infection from the hogs. This infection is a worldwide virus outbreak which can kill the human race. It has affected nearly 42,592 people and claimed over 2,990 lives in India. Methodology: An experimental study with Pre-test, Post-test Control group design was conducted to evaluate effectiveness of structured teaching programme (STP) on knowledge and attitude regarding prevention and control of swine flu (H1N1) among school students at selected school of Rajasthan. Simple Random Sampling technique was used to select 60samples through lottery method to receive STP. Structured knowledge questionnaire and Attitude Scale were the tools. Result: Study found a statistically significant (P 0.00003) increase in Post-test knowledge score 18.46,±2.04 of the experimental group from pre-test knowledge scores of 10.2, ±2.21.The mean post-test knowledge score of experimental group (18.46, ±2.04) was statistically significantly (P 0.0145) higher than the mean post-test knowledge scores of control group (18.46, ±2.04). In experimental group, mean post-test attitude score (57.16, ±6.69) increased statistically significant (P 0.0068) from mean pre-test attitude scores (46.36, ±5.69). Similarly the mean difference (10.1) between mean post-test attitude scores (57.16, ±6.69) of experimental group and control group (47.06, ±5.63) was statistically significant (P 0.0186). Correlation (r = 0.67) between post-test Knowledge and attitude scores of school students in experimental group were statistically significant (P 0.000051). Post test knowledge and attitude score was independent of demographic variables. Conclusion: The structured teaching programme was found effective to improve the knowledge and attitude of school students regarding prevention and control of swine flu. This suggests the importance of adopting health education strategies through various mass media regarding swine flu.

The concept of Teacher Performance Appraisal and Development (TPAD) policy was officially operational zed in Kenya in 2016 with the main aim of improving the performance of teachers and consequently, academic achievement of pupils. Despite the good intentions of TPAD, pupils’ performance in Kenya certificate of primary education in Ndhiwa Sub County has been low despite the operationalization of TPAD in 2016 with mean scores of 241.66 in 2016, 238.93 in 2017, and 238.65 in 2018 and 238.92 in 2019. This necessitated the current study which explored the perspectives on the effect of TPAD on teachers` performance. The objective of the study was to determine perspectives on the effect of TPAD on professional knowledge application in public primary schools in Ndhiwa Sub County. The study established that Teacher Performance Appraisal and development policy had moderate effect on teacher professional knowledge application. This is because it enhanced the following aspects of knowledge application. This included: maintenance and use of schemes of work in teaching, maintenance and use of lesson plans that guide teachers in effectively managing lessons during lesson presentations, teachers’ ability to set examinations for pupils which is undertaken regularly, preparation and use of marking schemes by teachers to the expected standards, teachers’ commitment to timely marking of pupils formative examinations which are regularly administered to learners, teachers’ commitment to giving timely feedback to pupils on their academic performance in terms of weaknesses and strengths, maintenance and use of record of work covered, maintenance and use of pupils’ progress records, teachers’ commitment to regularly updating of lesson notes relevant to teaching, teachers’ organization of individualized education programmes for pupils, teachers’ effectiveness in invigilating formative and summative examinations, teachers’ ability in identification of weak learners in time and assisting them in improving academically. These findings are important to stakeholders in education particularly, the Ministry of Education, Kenya Institute of Curriculum Development, Teachers Service Commission, Kenya National Examination Council and Boards of Management in informing policy formulation relating to teacher professional knowledge application which is always at the centre of curriculum development and implementation.

Physical punishment and mental harassment as methods of managing pupil discipline in primary schools are currently unlawful in line with the Basic Education Act, 2013. However, despite the ban, by the year 2015 the status in Vihiga county was such that Emuhaya Sub-County had a higher rate of indiscipline cases where there were 833(53%) cases compared to 644(43%) in Vihiga Sub-County and 543(37%) in Hamisi Sub county. The objective of the study was to determine the extent of implementation of ban of physical punishment in Vihiga county. A conceptual framework consisting of implementation of ban of physical punishment as the independent variable and pupil discipline as the dependent variable were used. The results showed that the overall mean rating on extent of implementation of ban of physical punishment was rated 2.89, which translated to moderate ban in terms of implementation. The study concluded that the ban of physical punishment in Vihiga County and by extension in Kenya was only partially being implemented. The study recommended that ban of physical punishment be fully implemented in primary schools. The study findings are significant in informing the stakeholders in education, for example the Ministry of Education, Teachers Service Commission, learners, teachers, policy makers and members of school management boards that the ban on physical punishment and mental harassment is indeed being implemented and improving pupil discipline in public primary schools, and should be implemented fully.

Primary paratesticular tumors are a rare group of tumors that present as a painless mass in the scrotum. Generally, due to the rarity and decreased awareness of their presence, they appear as an incidental finding on the operating table or in the postoperative pathology. Despite the fact that these tumors can be benign or malignant, they are entitled to be handled without preoperative biopsy. The presence of these tumors in younger individuals complicates management, and strong evidence is needed to justify orchidectomy in these cases. There has been a vast improvement in the literature regarding paratesticular tumors and their management strategies over the past few years which are a boon to the clinicians. We discuss here one such rare case of paratesticular tumor in an adolescent male and share our experience in its management.

Background and purpose: High tibial osteotomy (HTO) is a widely performed procedure to treat medial knee arthritis. Two basic HTO techniques are performed commonly, a lateral closing-wedge HTO and a medial opening-wedge HTO. Previous studies have not consistently demonstrated either technique to offer more clinical advantage than the other. Material and methodology: From 2019 to 2020, one hundred patients were randomized to receive either a closing-wedge or an opening-wedge high tibial osteotomy. The clinical outcome and radiographic results were examined preoperatively, at 2, 6 and 18 months postoperatively. Main demographic variables such as age, gender, body mass index (BMI) and previous non-surgical treatment data were collected and reviewed. The outcomes that we reviewed include maintenance of the achieved correction (pre- and postoperative wight bearing line, medial proximal tibial angle), progression of osteoarthritis (based on the Kellgren and Lawrence classification), severity of pain and quality of life (as assessed with an Oxford and a Lysholm knee score), knee function (pre- and postoperative knee range of motion), surgical duration and complications. Data analysis calculated by using Stata 13.0. Results: The mean age of study participants was 51±6 and 10 percent of those were men. The 51 percent of the total subjects underwent the lateral closing-wedge high tibial osteotomy and remained 49% received the medial opening-wedge technique. At 18 months, percent of weight bearing line increased to 57.1±4.2 in lateral closing-wedge osteotomy group and 58.8±4.0 in medial opening-wedge osteotomy group. The mean medial proximal tibial angle was 92.8±2.7 in lateral closing-wedge osteotomy group and 92.8±3.0 in medial opening-wedge osteotomy. The Oxford knee score and Lysholm knee score significantly increased at 6 months and 18 months follow-up in both study groups compared to pre-operation assessment (p < 0.0001). At 2 months follow-up period, participants in both groups obtained significantly lower score in the Oxford and Lysholm knee scale compared to both pre-operation and final assessment. Conclusion: Both method of tibial osteotomy, medial opening wedge and lateral closing wedge, depicted satisfactory result in our study. However, medial opening wedge technique may provide surgeons better possibility to correct weight bearing line more accurately than lateral closing wedge method.

A febre reumática (FR) e a cardiopatia reumática crônica (CRC) são complicações não supurativas da faringoamigdalite causada pelo estreptococo beta-hemolítico do grupo A e decorrem de resposta imune tardia a esta infecção em populações geneticamente predispostas. Essa é uma doença que está frequentemente associada à pobreza e às más condições de vida. Assim, apesar da reconhecida redução da incidência da FR nas últimas décadas nos países desenvolvidos, com consequente redução na prevalência da CRC, a FR permanece como um grande problema de saúde pública, principalmente nos países em desenvolvimento” (Diretriz brasileira Febre Reumática, 2009, p. 4). Neste relato de caso, buscamos evidenciar as características desse achado em que o acometimento cardíaco agudo e grave, evidenciou uma patologia de alta morbimortalidade, associada a endocardite não-infecciosa em uma criança com autismo.

Cette étude vise à une meilleure connaissance des perceptions socio-anthropologiques de l’évolution du climat. Le caractère sacré de l’évolution du climat découle du lien existant entre les composantes du milieu physique et les us et coutumes des groupes socio-culturels. Les données climatologiquesde la série 1985-2015 (station de Bohicon) ont permis d’analyser les tendances climatiques. L’accent a été mis sur l’analyse des perceptions populaires basées sur les croyances recueillies à partir des données d’enquête de terrain auprès de 312 producteurs agricoles. Les investigations attestent que 85,5 % des populations enquêtées perçoivent les fluctuations climatiques comme attribuables aux divinités ‘’vôdoun’’ du sud-Bénin. Dans les aires socioculturelles mahi et fon du sud-est, la croyance religieuse lie les événements climatiques extrêmes à un signe de colère ou de vengeance des divinités (65 %), par suite d’une négligence, d’une promesse non tenue (67 %), d’une offense ou d’une privation de cultes rituels (75 %). Bien que ces considérations religieuses tendent à disparaître dans les milieux urbains, elles continuent de régir la gestion des ressources dans les milieux ruraux. Le respect de l’inviolabilité des lieux sacrés constitue une attitude positive qui favorise la stabilité climatique (87 % des populations enquêtées). C’est pourquoi, des propositions des mesures de conservation basées sur la sacralisation des lieux (forêts d’Agbogbozoun, la rivière fétiche Hlan de Gbénou-hlanhonou ainsi que les forêts appelées « Lozounkan »)ont été faites.

According to official data from the Ministry of Health, at the same time, the number of cases and deaths increased worldwide. Since then, several initiatives have been developed in order to contain the contagion, prioritizing people considered to be at risk, such as the elderly. In view of this, isolation was adopted by several sectors. In view of this, the elderly had the eagerness to communicate with the family, the outside environment, promoted new attitudes in favor of information, contacts, news activities, that is, means that allowed solving of daily living. In this way, the elderly who had some kind of knowledge about technology, they could have access to several opportunities to reduce the effects of social isolation, whether for a video call, as well as conducting online searches in search of movies, or even for virtual mall. This article aims to study the use of Digital Technologies in Education and Health Promotion in the face of COVID 19 in institutionalized elderly. The research is an integrative literature review. The selection took place through reading titles, abstracts and, when necessary, the full reading of texts as a way of selecting them according to the inclusion and exclusion criteria. During this phase, the researchers critically and independently evaluated the full articles and made the appropriate selections. It was concluded that resources are present in the life of all technological possibilities increasingly within reach, and the positive impact they can cause to the elderly is impressive, because from them isolation can become less aggressive. However, the elderly are the age group with the lowest participation in the digital world. The results in relation to technology users were positive in the cases mentioned in the survey. Technology helps seniors to stay mentally active, which can bring a sense of well-being, such as talking to other people, reading, playing games, staying informed.

Cowpea (Vigna unguiculata L.) is a legume whose seeds and leaves are used for human consumption. However, many insects cause damage to inflorescences, fruits and / or leaves. The objective of the work was to take an inventory of insects, identify pests, describe their damage and assess the damage caused by pests in order to select resistant varieties. To carry out this study, 16 varieties were cultivated. The test was conducted using a three-block arrangement. A method was used to quantify the insects physical capture using the hay net. The visual method was used to quantify the damage by a simple count. The data collected indicate that the insects most harmful to cowpea belong to four orders: Lepidoptera, Heteroptera, Coleoptera and Orthoptera. The damage caused by insects on each variety is different. This damage is proportional to the number of pests. In conclusion the varieties N11BBoBp, N8BRcp, N18ZR, N21DR and N10BBrp would be the most resistant to pests. These results indicate a new approach to the dynamics of cowpea insect pests.

This study aimed to analyze the importance of National Competency Based Teacher Standard Model in reducing the impact of pandemic in the attainment of an effective teaching. The core in every reaction to mediation rests in the utilization of National Competency Based Teachers Standard (NCBTS) instructional processes, the main basis in proposing it. Appraisal survey is being used in descriptive research like this study. The respondents were comprised of two hundred seventy-six (276) purposely selected overseas Filipino teachers/faculty members. Factual rankings centered on five-point level were used together with illustrative figures employing rate of recurrence allocation, ratio, standard, regular variation and averaging while Regression Analysis was used for inferential statistics. Results of the Regression run reveal that the occurrence of pandemic has significant effect on effective teaching related to curricular and extra-curricular activities. The positive coefficient (.000b) indicates incremental effects on the point of curricular and extra-curricular activities of students and their variables can be considered significant predictors on the level of effect of the occurrence of pandemic. It is therefore necessary to carefully examine the possible impact of our actions in the future through the study of various alternatives and be more motivated and directed after knowing the relevant effect of our actions in providing instructional interventions.

The binding energy and dissociation energy of fourteen first and second row diatomic molecules (twelve hydride molecules and two hydrogen halide molecules) have been computed using Börn-Mayer, Gaussian, Woodcock and Logarithmic (L_5) potential models. The Woodcock and Logarithmic models are also used to compute the electron affinity of halogen atoms and hydrogen atom. The estimated values are compared with the experimental findings. The Logarithmic (L_5) and Woodcock models provide the better results in comparison to other proposed models.

Background and Objectives: The annual incidence of diabetic foot ulcer in diabetic patients is known to be about 2% to 5% and the lifetime risk ranges from 15% to 20%. The main objective of this studyis to determine the most prevalent pathogens involved in diabetic foot ulcers and its antibiotic susceptibility. The predominant organism related to the different Wagner grades were also assessed as part of this study. Methods: The present study was a hospital-based descriptive study conducted on patients admitted with diabetic foot in the department of General Surgery at Government Medical College, Kozhikode, Kerala during the period from August 2019 to July 2020. Tissue or swab culture was taken from the ulcer and the antibiotic sensitivity was tested by Kirby-Bauer Disk Diffusion Susceptibility Test. Results: At the time of presentation more than 50% of ulcers were of Wagner’s grade II and III. The predominant organism isolated from diabetic foot infections were Klebsiella (32.98%) followed by Pseudomonas (24.47%). Multi-drug resistance was seen in 12 out of 62 samples that yielded Klebsiella, 2 out of 46 samples that yielded Pseudomonas, 4 out of 22 samples that yielded E. Coli and MRSA was seen in 8 out of 22 samples that yielded Staph. Aureus. Discussion and Conclusions: The predominant organisms isolated were Klebsiella and Pseudomonas species and were mostly sensitive to Piperacillin/Tazobactam, Meropenem, Ciprofloxacin and Amikacin. Hence it is advisable to start patients on empirical therapy with these drugs for better outcome. Proper assessment of ulcer and targeted antibiotics against these organisms can aid in early healing and avoidance of diabetic foot related complications.

Background: Breast cancer (BC) has many risk factors that lead to its diagnosis in premenopause and more common in postmenopause; most of these factors are modifiable; including anthropometric factors and reproductive factors. Objectives: To assess knowledge and its associated factors among physicians in primary healthcare settings in Makkah city about the modifiable risk factors of breast cancer. Subjects and methods: A cross-sectional study was conducted in Makkah Al-Mukarmah city, western area of Saudi Arabia among a sample of primary healthcare physicians working at the PHC centers, belonging to the internal PHC sectors inside the city. A self-administered questionnaire was utilized in the present study. It includes two main sections; background information of the physicians and assessing the knowledge of the participants regarding modifiable risk factors for breast cancer (Contraceptive history, obesity/physical activity, smoking and diet). Results: A total of 150 primary healthcare physicians have participated in the study. More than half of them (58.7%) aged between 20 and 30 years, and 56% were females. The knowledge score ranged between 16 and 30 with a mean±SD of 23.71±3.16. Almost two-thirds of the physicians (68%) had high level of knowledge. Among studied sociodemographic factors, only the degree of job of the participants was significantly associated with knowledge level about BC as the highest score was observed among residents (25.46±1.98) and the lowest among general practitioners (22.27±3.39), p<0.001. Conclusion: most of primary healthcare physicians in Makkah had good level of knowledge regarding breast cancer modifiable risk factors, resident physicians. Their main source of information was the Internet, followed by books and guidelines.

Synchronousmultiplecolorectal cancers are defined as multiple malignant tumors of the colon and rectum, occur simultaneously, are distant from each other and are not a result of metastasis. We present a case of a 76 years old male who was admitted to our hospital complaining of diffuse, mild abdominal pain started a month ago, associated with diarrhea, fatigue and body weight loss. Computer tomography revealed a mass at the splenic flexure. Colonoscopy confirmed the finding of the tumor at the splenic flexure obstructing the lumen of the colon, not allowing the examination to be completed. Furthermore, a second tumor was found at the boundary between descending and sigmoid colon, narrowing the lumen at approximately 75%. Virtual colonography under CT reconstruction illustrated the previous two lesions and revealed an additionally mass at the hepatic flexure. The patient underwent an exploratory laparotomy the day after and all the above findings were confirmed intraoperatively for which he received a successful extended colectomy.

Drug abuse is becoming increasingly problematic in Kenya. Studies done outside Vihiga and Sabatia Sub-counties have shown that students abuse drugs. The foremost concern was the number of these students that would form an addiction to serious substances, jeopardizing their own health and safety and creating difficulties for their families and the public at large. Preliminary survey in five schools revealed that students in Vihiga and Sabatia sub-counties were abusing drugs. In Vihiga and Sabatia sub-counties, cases of indiscipline had been experienced. For instance, 4(80%) were found doing examination under the influence of alcohol, 4(80%) stealing and 5(100%) students fighting. It was alleged that most of these incidences involved students who abused drugs. What was not known was the influence of drug abuse on student discipline in secondary schools in Vihiga county. The objective of the study was to establish the influence of drug abuse on student sexual harassment in secondary schools in Vihiga county. A conceptual framework showing influence of drug abuse on student sexual harassment in secondary schools was used to guide the study. The study established that with regard to influence of drug abuse on student sexual harassment principals' rating was moderate (M =3.04) while Guidanceand Counselling teachers' was high (M = 3.61). The findings of this study are useful to the managers of schools in Kenya in understanding the issues related to substance abuse among students in their schools and to come up with strategies to be used in addressing substance abuse related issues.

The right to education for Persons With Disabilities (PWDs) is globally acknowledged as a basic human right. Education is regarded as the means by which economically and socially marginalized persons can break vicious cycle of poverty. In Kenya, the right to education is provided for in article 53(b) of Kenya Constitution, which advocates for the right to free and compulsory basic education for every child. Article 54 of the Constitution of Kenya emphasizes the need to enhance education for persons with disabilities. The Government of Kenya recognizes the importance of Special Needs Education as a crucial sub sector for accelerating the attainment of Education For All, Millennium Development Goals and Sustainable Development Goals. The objective of the study was to establish learner based opportunities and challenges influencing education for the mentally challenged learners. The study established that learner-based opportunities are learners’ attitude and existence of mentally challenged learners. The learner-based challenges are; learners’ attitude, drop out and enrollment. It was concluded that learners are accorded various opportunities to participate in learning but there are challenges too. The study recommended that school management and the Ministry of Education should establish strategies to ensure that learners and teachers are motivated and facilitated to foster quality education for the mentally challenged. These findings are valuable in formulation of policies that facilitate promotion of special education in Kenya.

The article is intended for people interested in research in such areas as physics (engines for interplanetary travels, interplanetary flights, torsion field, quantum correlation, cavity structures). This article does not contain many complex mathematical formulas and technical terms, because it is very difficult to describe the state of the Physical Vacuum and the behavior of virtual particles. Roger Penrose, Nobel Prize laureate , points out that this new, as yet absent theory, must be "uncomputable". It is believed that quantum particles are objects in much the same way as classical ones. This similarity provides an important continuity between classical and quantum physics. We believe that there is value in making research accessible to specialists in various fields - which is really the point of our publication. It is intended for readers with a college degree.

Background: Road traffic accidents are common cause of head injuries followed by fall and combat injuries nearly 20 percent of traumatic brain injury patients develop seizures ,which may be early onset or late onset. Materials & Methods: Retrospective comparison of role of antiepileptics to control seizures in traumatic brain injury in a tertiary care centre the effectiveness to control seizures in traumatic brain injury patients admitted in rajiv Gandhi government general hospital either prophylactically or treatment is analysed. Results and Principle Conclusion: Phenytoin is drug of choice for early onset seizures in traumatic brain injury patients levetiracetam is a viable alternative, carbamazepine and sodium valproate are used as second line drugs.

Background and Objective: Objective of this study was to identify the risk factors for corneal graft failure and isolate microrganisms associated with graft infections after penetrating keratoplasty . The present study was conducted in the Department of Ophthalmology at tertiary care centre in central India. Methods: The present study was a case control study conducted in the Department of Ophthalmology at tertiary eye care from November 2018 to October 2020. Patients operated for optical penetrating keratoplasty attending eye OPD were examined. Results: Preoperative risk factors- adjusted risk associated with donor’s age > 60 years was 8.798 with p-value 0.001, indicating significantly higher risk of graft failure as compared to donor’s age < 60 years. Presence of corneal vascularity had a significantly increased adjusted risk i.e. 7.542 with a p-value 0.002, as compared to those without corneal vascularity . Perioperative risk factors: the graft size > 8.5mm has significantly higher adjusted risk of graft failure with estimate of 15.296 with a p-value of 0.013, as compared to the reference category 8.0 – 8.5mm. Postoperative risk factors: The presence of raised IOP had significantly higher adjusted risk of graft failure with estimate 10.26 with a p-value 0.011, as compared to those with normal IOP. Adjusted risk estimate corresponding to epithelial defects was 8.464 with a p-value 0.014, suggesting increased risk as compared to those without the defect. The likelihood of graft failure corresponding to graft rejection was also significantly higher as indicated by adjusted estimate of 5.688 (95% CI: 1.048 – 30.869) with a p-value 0.044, compared to those with no graft rejection. Interpretation and conclusion: Pre-operative risk factors for graft failure: 2 or more quadrant corneal vascularisation, peripheral anterior synechiae and older donor age (>60 years). Peri-operative risk factors: repeat keratoplasty and larger donor graft size >8.5mm. Post operative risk factors: elevated IOP, suture problem, epithelial defect, graft rejection, post penetrating keratoplasty infection were postoperative risk factors for graft failure. As per multiple logistic regression Pre-operative risk factors were Corneal vascularization and Donor age of >60 years Peri-operative risk factors were Graft size of >8.5mm Post operative risk factors were raised IOP, epithelial defect, graft rejection. Although other factors indicated increased risk in univariate analysis, evidence was statistically insignificant in multivariate analysis.

Background: Menopausal women are an increasing population that needs more attention and care. Providing counseling and management of menopausal symptoms effectively are one of the roles of primary healthcare (PHC) doctors. Thus, they need to be up to date in menopause management. Objectives: To explore the knowledge, attitude, and practices of family medicine residents towards the management of postmenopausal symptoms. Subjects and methods: Analytic cross-sectional study was performed among all family medicine residents registered at the joint program of family medicine in Makkah Al-Mukarramah city, 2021. A self- administered online questionnaire including questions about sociodemographic data, knowledge, attitude and practice of menopausal management among the participants was applied for data collection. Results: The study included 118 Family Medicine resident physicians. Majority (94.9%) aged <30 years and females represented 51.7% of them. History of ever attending courses or workshops about menopause and its management was mentioned by 18.6% of the respondents. Overall, sufficient knowledge was reported among 44.9% of them. Attending training courses was borderline insignificantly associated with knowledge level, p=0.050. Majority of the physicians (97.5%) expressed positive attitude towards menopause and its management, however, only 33.1% had good practice, with no difference between the participants according to sociodemographic characteristics and history of attending training courses. The most frequently reported barriers facing family medicine resident physicians in managing menopausal symptoms were lack of training in the management of menopause (58.5%), lack of knowledge about menopausal management (48.3%), unaware of existing guidelines (42.4%) , lack of skills (24.6%) and lack of effective referral system (24.6%). Conclusion: Insufficient knowledge and poor practice of menopause management were noticed among family medicine residents. However, positive attitude was expressed by majority of them towards menopause and its management.

Background: COVID-19 has become a great public health concern in the world and has been declared a pandemic. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS CoV 2 is a positive-sense single-stranded RNA virus. COVID 19 pandemic has posed a major challenge to the health- care systems across the world. During this acute phase of the pandemic, health care workers have been working day and night to meet the need of the hour and fulfil the requirements of the covid patients and they have been facing various challenges during this pandemic. A study was done to find out the various difficulties faced by nurses anf the possible ways to cope up with the problems. Methods: A descriptive research design was used to identify the challenges faced by Indian nurses by using an electronic web-based questionnaire for data collection by using Google forms, with a consent form appended to it. The questionnaire was available to the participants through social media (Whats App, Facebook and Instagram). Study participants included 100 nursing officers of India working in the hospitals dedicated to the admission and hospitalization of COVID-19 patients. Results: Findings revealed that 42 nursing officers faced severe challenges while caring for covid-19 patients followed by moderate challenges by 34 nursing officers and mild challenges by 24 nursing officers. Conclusion: The study concluded that maximum nursing staff faced severe challenges while serving Covid-19 patients.

Background & objectives: The main objective of this study was to determine microbiological profile and its association with visual outcome. The present study was conducted in the department of ophthalmology at tertiary eye care centre in central India. Methods: The present study was a hospital based prospective observational and Interventional study conducted in the department of ophthalmology at tertiary eye care centre during the period from November 2018 to Octomber 2020. After collection of aqueous or vitreous sample from all patients they received intravitreal antibiotics with or without vitrectomy and the management was based on microbiological analysis of the vitreous fluid. Results: Post operative endopthalmitis was found in 35 (45.5%) cases, post-traumatic endophthalmitis was in 31 (40.3%) cases and 11 (14.3%) cases of endogenous endophthalmitis. Males were predominant in all three types of endophthalmitis. There were 22 patients with only culture positive findings and 10 cases with both smear and culture positive finding. 24 culture samples were positive for bacteria and 8 were positive for fungi. Postoperative endopthalmitis was most common among all types. All Gram-positive bacteria were susceptible to vancomycin and all gram negative bacteria were Susceptibile to ceftazidime. Visual outcome of fungal endophthalmitis cases was poorer compared to bacterial endophthalmitis. Post-interventionv Best corrected visual acuity (BCVA) was better when the vitreous samples was negative in culture. Interpretation & conclusions: The outcome of infectious endophthalmitis and spectrum of infection in central India was similar to other parts of the country. Compared to bacterial endophthalmitis, the visual outcome of fungal endophthalmitis cases was poorer. Empirical use of standard intravitreal therapy is recommended while emphasizing on vitreous biopsy for culture and sensitivity whenever possible.

Background: Infected aortic aneurysm is one of the major clinical challenges vascular surgeons are facing, with high incidence of morbidity and mortality. In this study we present the advantages of endovascular treatment in patients with infected aortic aneurysms and clarify the factors that determine favorable outcome of these patients. Material and Methods: A comprehensive systematic retrospective study (PubMed, Medline, Embase, Google Scholar and Scopus) according to the recommendations of the PRISMA statement for administrative dataset registries reporting outcomes after patients treated endovascularly for infected aortic aneurysm and a thorough evaluation of references. Results: Endovascular treatment of infected aortic aneurysms may reduce the early and mid-term mortality. Prolonged fever, fatigue, aortic rupture, aortoenteric, aortobronchial and aortoesophageal fistulas greatly increase the rates of reintervention, morbidity, and mortality. Survival rates in patients without fistulae even reached 94% at 2 years. Conclusion: In treatment of infected aortic aneurysms, the use of endovascular aortic graft provides an alternative, to open repair method, and simplifies the management of patients who are in this critical condition. Endovascular treatment of infected aortic aneurysms is feasible both as a temporary measure and the preferred definitive treatment in selected patients.

The selection of the appropriate adhesive and filler is always an important issue in conservation of wooden artifacts of Cultural Heritage. A poor adhesive can cause further and sometimes irreversible damage, both aesthetically and mechanically to an already deteriorated object. Hence, before selecting a potential adhesive, its performance is assessed by several criteria including i) long term stability ii) reversibility iii) characteristics after curing such as colour, hardness, brittleness and sensitivity to relative humidity (RH) and temperature (T) iv) bond strength v) physical characteristics such as open and closed time, viscosity, concentration vi) health and safety issues and vii) cost and ease of application11-14. The functional requirements of gap-filling adhesive for use in the structural conservation of Dharumavantha Rasgefaanu Mosque impose considerable constraints on the choice of material for this purpose. Some degree of flexibility in the adhesive is considered an important material characteristic. Adhesive types considered include natural and synthetic, water based materials such as acrylic and polyvinyl acetate. The paper presents an evaluation, based on accumulated personal experience from the practice of wood conservation and performance of a range of adhesive systems for gap-filling application.

It is estimated that 50% of Indian women are 15 to 49 years old. India has been struggling with malnutrition and undernutrition for many years. Poor nutritional and dietary habits, low spending capacity, and inability to afford a good quality diet. Central and state governments have taken many initiatives to improve the status. Hemoglobin is a very crucial parameter for pregnant ladies. Pregnancy is a significant face in women's life. One of the fundamental problems pregnant women faces is Iron deficiency anemia. Anemia may cause premature birth of babies, low birth weight, and maternal mortality. NITI Aayog and National Institute for Transforming India have indicated a strong focus on essential nutritionfor pregnant and lactating women and children during the first 1000 days of a child's life. A mother's diet is the primary source of the overall well-being of the mother and infant. Iron deficiency anemia is widespread in pregnancy. Iron and folic acid are essential minerals before and during pregnancy. Red cell mass will increase in the pregnancy. Many factors will cause the condition of anemia.To deal with anemia during pregnancy Andhra Pradesh Government implemented Integrated Child Development Services Scheme (ICDS), a universal scheme is being implemented to deliver Nutrition, Health Care through the sampoornaposhana scheme.The present study evaluates the scheme's benefits and its impact on improving the hemoglobin level in pregnant ladies in three trimesters.

It has been reported that, hyperglycaemia is more common in patients with coronavirus disease 2019 (COVID-19). COVID-19, which triggered by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), can cause extrapulmonary symptoms such as diabetes mellitus (DM) and hyperglycaemia, which both indicate a poor prognosis and a higher chance of death.SARS-CoV-2 infects the pancreas through angiotensin-converting enzyme 2 (ACE2), which is abundantly expressed in the pancreas relative to other organs, causing pancreatic damage, insulin secretion impairment, and hyperglycemia in non-DM patients. Thus, the present study provides an overview of the potential association or relation or linkage between COVID-19 and hyperglycemia as a risk factor for the development of diabetes mellitus in relation to diabetes pharmacotherapy.

Introduction: Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. The American Pain Society (APS) has officially declared pain as the fifth vital signs. Intramuscular (IM) injection is a common procedure that nurses frequently carry out and observe pain and distress to the recipient. The aim of the study was to compare the effectiveness of ice cube and vapocoolant spray as an anesthetic pre-treatment for IM injection among patients in selected hospital, East Sikkim. Method: A quantitative factorial design study was conducted on patients, receiving intramuscular tetanus toxoid injection at Central Referral Hospital, Gangtok, East Sikkim. Total 50 participants were selected using simple random sampling technique. The demographic data of the patients were collected using structured questionnaire and a Standardized Numerical Pain Rating Scale was used to assess the pain level after the administration of intramuscular tetanus toxoid injection using ice cube and vapocoolant spray as an anesthetic treatment. Result: The study findings highlights that the mean and SD for intensity of pain in ice cube group was 1.84±1.313 and in vapocoolant group was 2.92±1.470 with mean difference was 0.157 and (t=2.740 and p=0.009) and p<0.05 level of significance which was statistically significant and indicates that ice cube was more effective than vapocoolant in reducing the intensity of pain among patients as an anesthetic pre-treatment for IM injection. The findings also revealed that there is no association between the level of pain with selected demographic variables. Conclusion: The study found that ice cube was more effective than vapocoolant spray to reduce the level of pain while administering IM injection. The study intervention would help the health care professionals mainly the staff nurses to execute the practice of using ice cube before IM injection to reduce pain.