Introduction: Pregnancy constitutes a period of increased emotional and psychological demands, during which women may experience varying levels of stress that can affect maternal and fetal outcomes. Social support plays an important role in enhancing coping and promoting maternal well-being; however, evidence from local healthcare settings remains limited. This study aimed to examine the relationship between perceived social support (PSS) and perceived stress (PS) among pregnant women in Malappuram district, Kerala. Methodology: A hospital-based cross-sectional study was conducted among 200 pregnant women attending antenatal clinics between March and June 2025. Data were collected using a structured questionnaire incorporating MSPSS and PSS scales and analysed using SPSS version 26. Associations were assessed using chi-square test and binary logistic regression, with p < 0.05 considered statistically significant. Results: Of the participants, 48% reported moderate perceived social support, while 62% had moderate stress levels. A statistically significant association was observed between perceived social support and perceived stress (?² = 24.52, p < 0.001). Higher PSS was significantly associated with occasional social interactions (OR = 3.12; 95% CI: 1.29–7.52) and presence of a caregiver (OR = 2.54; 95% CI: 1.21–5.32). Higher PS was significantly associated with support from family members (OR = 2.41; 95% CI: 1.10–5.25) and friends/others (OR = 2.86; 95% CI: 1.02–8.01), as well as rare social interactions (OR = 3.85; 95% CI: 1.45–10.19). Conclusion: PSS was significantly associated with PS among pregnant women. Incorporating routine psychosocial assessment and strengthening partner and family support within antenatal care services may help reduce stress and improve maternal well-being.
ntroduction: Oral health is a vital component of overall health and well-being, yet it remains one of the most neglected aspects of preventive healthcare in India. Poor oral hygiene practices contribute significantly to dental caries, periodontal disease, and systemic health risks. This study aims to evaluate oral health status, oral hygiene practices, and oral health awareness among undergraduate healthcare trainees in Rajnandgaon, Chhattisgarh. Results: Among 386 participants, 98.96% recognized the link between oral and systemic health, and 85.23% demonstrated a positive oral health attitude (OHVS score >36). Overall, 67.1% brushed twice daily, 73.1% used soft-bristled toothbrushes, 73.3% used fluoride toothpaste, and 94.8% practiced daily tongue cleaning. However, 34.9% never flossed, 31.9% did not use any interdental cleaning aid, and 33.9% had never visited a dentist. B.Sc. Nursing students exhibited significantly better oral hygiene practices than MBBS students across most practice indicators. Female students demonstrated superior oral hygiene behaviors, including twice-daily brushing (72.4% vs. 46.2%) and use of soft toothbrushes (77.3% vs. 56.4%), whereas tobacco use (6.4% vs. 1.0%) and alcohol consumption (9.0% vs. 0.6%) were significantly higher among males (p<0.05). Conclusion: Undergraduate medical and nursing students in Rajnandgaon showed satisfactory oral health knowledge and predominantly positive attitudes (85.23% positive OHVS score), with favorable practices including twice-daily brushing (67.1%), near-universal toothbrush use (98.96%), and regular tongue cleaning (94.82%). However, key gaps persisted: 34.97% never flossed, only 14.8% used interdental aids, 17.88% were unsure of their toothpaste's fluoride content, and 33.94% had never visited a dentist. B.Sc. Nursing students outperformed MBBS students on nine of ten practice variables, and females outperformed males across all domains, while males showed higher tobacco (6.4% vs. 1.0%) and alcohol use (9.0% vs. 0.6%). These findings highlight the need for structured, skills-based oral health education and routine dental screening within undergraduate curricula to close the knowledge-practice gap and prepare future providers as effective preventive health advocates.
ABSTRACT Background: Hoarseness of voice is a common symptom in otolaryngology, ranging from benign to serious causes. The American Academy of Otolaryngology–Head and Neck Surgery reports that nearly one-third of people experience voice problems, with 1 in 13 adults affected annually. While often due to vocal strain or infections, persistent hoarseness beyond two weeks may indicate malignancy. Aim: To analyze the clinical presentation of patients with hoarseness, focusing on prevalent benign etiologies and associated predisposing conditions. Methods: This cross-sectional and longitudinal study was conducted over 18 months (January 2024–July 2025). Patients presenting with hoarseness underwent detailed clinical evaluation and diagnostic investigations. Data were analyzed using frequency and percentage distributions, supported by SPSS (version 23) and Microsoft Office. Results: A total of 117 patients were enrolled. Middle-aged groups (31–40 and 51–60 years) showed the highest prevalence. Males (58.97%) outnumbered females (41.03%), yielding a ratio of 1.43:1. Chronic laryngitis was the most frequent cause (26.49%), followed by vocal cord nodules (21.36%) and polyps (13.67%). Less common etiologies included tuberculosis, cysts, and functional voice disorders. Conclusion: Hoarseness arises from diverse conditions, from mild inflammation to malignancy. Careful history, examination, and appropriate investigations are essential for timely diagnosis and management.
Introduction: The Indian healthcare sector has witnessed rapid growth in medical tourism, driven by cost-effectiveness and high-quality services. Concurrently, there is a global paradigm shift toward holistic health, positioning India’s traditional systems of medicine—Ayurveda, Yoga, Unani, Siddha, and Homeopathy (AYUSH)—as pivotal components of this industry. Objective: This study aims to analyze the integration of AYUSH and wellness programs within the Indian medical tourism sector, assess their economic impact ( Direct employment, Direct revenue contributing to GDP ( Gross Domestic Product ) of India) and evaluate the management strategies driving this growth. Materials and Methods: A descriptive research design was employed utilizing secondary data sources including government reports, market analyses, and budget allocations over a period of eight weeks. A PESTEL framework ( a strategic managerial tool covering political, economical, social ,technological, environmental and legal factors for assessing viabilities, risks and opportunities in medical tourism ) was applied to analyze the macro-environmental factors influencing the sector. Results: The AYUSH manufacturing sector grew at a CAGR exceeding 30% between 2014-2020, with the industry valuation reaching approximately US$ 24 billion by 2024. Wellness services are anticipated to hold a dominant industry share of 61.50% of the medical tourism market in 2024. Government support is evident through consistent budgetary increases, reaching Rs. 3647.50 Crores in 2023-24. Conclusion: The integration of AYUSH with conventional medical tourism creates a unique value proposition for India. However, management challenges regarding insurance coverage and standardization remain. Strengthening regulatory frameworks and promoting evidence-based integrative practices are recommended.
ABSTRACT Background: Laboratory technicians are routinely exposed to a wide range of occupational health risks, including biological, chemical, physical, ergonomic, and psychosocial hazards. Inadequate awareness and suboptimal adherence to occupational health and safety (OHS) measures increase the risk of laboratory-acquired infections, injuries, and work-related illnesses. Evidence from district-level health facilities in India remains limited. Objectives: To assess the occupational health risks and the level of awareness regarding occupational safety measures and preventive practices among laboratory technicians in Rajnandgaon district, Chhattisgarh. Methods: An institutional-based cross-sectional study was conducted among laboratory technicians working in government medical colleges, district hospitals, community health centres, and primary health centres in Rajnandgaon district, Chhattisgarh. Data were collected using a pre-tested interviewer-administered questionnaire and an observational checklist assessing general awareness and biological, chemical, physical, and psychosocial hazards. Data were analysed using Microsoft excel spreadsheet and the chi-square test; p < 0.05 was considered statistically significant. Results: A total of 66 laboratory technicians participated in the study. Most participants were male (71.2%) and had more than five years of work experience (68.2%). While awareness of incident reporting procedures (95.5%) and emergency response plans (93.9%) was high, only 27.3% knew where to access OHS regulations or had reviewed the OHS hazards and controls handbook. Consistent use of personal protective equipment was reported by 68.2% participants. Chemical safety awareness was poor, with only 37.9% having received chemical safety training and 4.5% knowing the location of MSDS/SDS. Significant associations were observed between PPE use and chemical spill response training (p = 0.002), educational status and chemical safety training (p = 0.008), and years of experience with safe autoclave use (p = 0.014). Conclusion: Technicians with more experience showed better awareness of emergencies, ergonomic risks, and safe equipment use. Those with higher education levels demonstrated stronger understanding of safety procedures and chemical handling. Spill-response training had the greatest impact, improving PPE use, disinfectant preparation, and knowledge of OHS rules and rights. Trained technicians were also far more likely to review safety documents and undergo respirator fit-testing. Hence experience, education, and targeted training are key to improving occupational health and safety among laboratory staff.
Background-Human immunodeficiency virus (HIV) infection is a global pandemic with varying prevalence in Indian states. Since 2010, north-eastern states have seen an increase in infections, and by March 2023, 1.68 million individuals were on antiretroviral therapy (ART). Routine evaluations of haematological and biochemical markers are carried out, but there is a need for more research on substitute markers related to HIV pathogenesis, patient vulnerability, and treatment responses, particularly focusing on affordable biochemical variables as alternative prognostic indicators in developing countries like India. Methods- This observational and cross-sectional study was conducted at the Sir J.J. Group of Hospitals, Grant Government Medical College, Mumbai, in the Department of Biochemistry. This study involved 150 HIV-positive participants and 50 controls, totalling 200 subjects. The HIV-positive participants were categorized based on CD4 counts into three stages: Stage I (?500 cells/?l), Stage II (201-499 cells/?l), and Stage III (?200 cells/?l) having 50 subjects each. Blood samples were collected for serum total protein and other investigations, and were stored at -20 °C for analysis using autoanalyzer. Results- In our study we noted that biochemical markers such as serum total protein, A/G ratio, and haemoglobin showed statistically significant alterations in HIV group as compare to control group. In progressive stages based on CD4 count modifications with striking significant correlation were observed between CD4 count and serum total protein and haemoglobin. Conclusion-In rural areas, government health systems struggle with CD4 count and viral load assays for HIV. There is an urgent need for low-cost alternative indicators to monitor HIV progression. Indicators such as serum total protein and haemoglobin could serve as inexpensive substitutes when CD4 count is under 499 cells/?l in stage II. Regular monitoring of these biochemical markers may be suggested to improve prognosis, manage co-morbidities, and lower mortality rates.
Background Adolescence involves changes that heighten vulnerability to mental health disorders. This study assessed the prevalence and severity of depression, anxiety, and stress among in-school adolescents in Indore city. Methodology This cross-sectional study was conducted from January 2020 to June 2021 among 130 students from classes 11th and 12th. Data were collected using a semi-structured questionnaire, which included the Depression Anxiety Stress Scales (DASS-21) and questions on psychosocial factors. Statistical analysis was performed using IBM SPSS Version 26.0. Qualitative variables were described using frequency and percentage. Inferential analysis was conducted using the chi-square. A p-value of <0.05 was considered significant. Results The mean age of the participants was 18.05 (±0.50) years. Most participants were from the 11th class, and the vast majority resided in urban areas. The study found that 40% of participants experienced depression, 44.6% anxiety, and 48.5% stress. Higher rates of these conditions were observed among older students and those in higher classes. Females reported significantly higher levels of anxiety and stress compared to males. Depression was significantly associated with family conflicts, perceived financial difficulties, parental alcohol consumption, and experiences of bullying. Elevated levels of stress were particularly evident among students who had experienced the loss of a parent. Conclusions The study revealed a high prevalence of depression, anxiety, and stress among school-going adolescents. There is a need for mental health programs in schools that focus on psychological well-being, especially for female students and those facing adverse social circumstances.
Background: Academic stress is a psychological and physiological response that arises when academic demands exceed a student's perceived ability to cope. Assessment of the burden of academic stress, identification of stress- associated symptoms and understanding the coping mechanisms are vital to making impactful targeted interventions. Methodology: A descriptive study was conducted among 317 medical undergraduates from various medical colleges. The perceived stress levels were measured using the PSS-10 scale score. The most common self-reported stressors, symptoms, and coping mechanisms were taken into account from the responses filled out by the participants. Results: The mean age of the study participants was 21.03 ± 1.62 years, and females predominated (72.6%). A moderate level of stress was found in 99.1% of the study participants. High syllabus load 200 (63.1%), long college hours 195(61.5%) and inability to manage time efficiently 187(59%), were the most common stressors identified. Sleep disturbance (50.8%) was the most prevalent stress-related symptom, and increased caffeine/ energy drinks intake (75.1/ %) was the most frequent change in personal habits. The social support strategy most frequently used was talking with family and friends (41%). Only 4.7% sought professional counselling. Conclusion: Medical undergraduates experienced moderate stress and preferred informal coping mechanisms. Further research should examine the future of informal mechanisms for effectively managing moderate stress.
Background Vatarakta, a classical Ayurvedic condition arising from mutual obstruction of Vata Dosha and Rakta Dhatu, shares clinical parallels with gout — an inflammatory arthropathy driven by monosodium urate crystal deposition. While Raktamokshana (therapeutic bloodletting) is a cornerstone treatment in Ayurvedic surgery, objective documentation of its outcomes in such conditions remains sparse. Case Presentation A 27-year-old male presented with acute pain, swelling, and restricted mobility of the right first metatarsophalangeal (MTP) joint for one week. Laboratory findings revealed elevated serum uric acid (>7 mg/dL), mildly raised ESR, and a mildly elevated RA factor. The clinical presentation was consistent with acute podagra, clinically suspected as Uttana Vatarakta. Management and Outcome Siravedhana (therapeutic venesection) was performed in two sittings (Day 0 and Day 7) at the dorsal venous arch of the right foot, proximal to Kshipra Marma (the vital point located in the web space between the first and second metatarsals). Approximately 60–70 mL of blood was withdrawn per sitting using a 20-gauge sterile needle. Pain assessed by Visual Analogue Scale (VAS) decreased from 7/10 to 3/10 (57% reduction). Goniometric assessment of the first MTP joint showed flexion improvement from 25° to 45° (80% increase) and extension from 5° to 15° (200% increase). Conclusion Siravedhana demonstrated clinically meaningful improvement in pain and joint mobility within 7 days. However, as acute gout episodes can self-resolve within a similar timeframe, the contribution of treatment versus natural disease resolution cannot be confirmed from a single uncontrolled case. Controlled trials with objective inflammatory biomarkers are warranted.
ABSTRACT Background Mosquito-borne diseases (MBDs) remain a public health challenge in rural India. Assessing Gaps in knowledge, attitudes, and practices (KAP) among school children can inform targeted interventions. Methods An institution-based cross-sectional study was conducted from September to December 2025 among 215 secondary school children from one randomly selected rural secondary school in West Godavari District, Andhra Pradesh (selected by simple random sampling using the lottery method after line-listing all rural secondary schools). A pre-tested questionnaire assessed sociodemographics, knowledge, attitudes, and practices. Data were analyzed using SPSS 20 with chi-square tests (p<0.05). Results About 99.1% of the study subjects were aware that mosquito bites cause sickness, but specific knowledge was limited (e.g., only 18.6% knew dengue mosquito breeding sites). Teachers were the primary source of information (63.3%). Attitudes were positive (89.3% believed mosquito control is possible). Preventive practices showed notable gaps (e.g., only 19.1% used daytime bed nets). Significant associations were observed between gender, parental education, attitudes, and key KAP variables (p<0.05). Conclusions Majority of the students had basic awareness and positive attitudes were noticed, but critical gaps in specific knowledge and preventive practices remain. School-based education is recommended to address both knowledge depth and behavioural barriers to translate awareness into sustained action.
Background: Extrapulmonary tuberculosis (EPTB) represents a significant and increasingly recognized component of the tuberculosis burden in India. Its heterogeneous clinical presentation and paucibacillary nature often result in diagnostic delays. Data from South Indian tertiary care settings remain limited. Objectives: To study the clinical profile and treatment outcomes of patients diagnosed with EPTB. Methods: This prospective observational study was conducted over 18 months in a tertiary care centre in South India. Fifty newly diagnosed EPTB patients were enrolled. Diagnosis was based on clinical, radiological, histopathological, and microbiological methods including CBNAAT. Patients were treated as per National Tuberculosis Elimination Programme (NTEP) guidelines and followed until treatment completion. Results: Females constituted 54% of cases, and 56% were aged 18–45 years. Diabetes mellitus was the most common comorbidity (57%), with poor glycaemic control (mean HbA1c 9.92 ± 1.75). Lymph node TB (44%) and pleural TB (22%) were the most common forms. Clinical diagnosis was made in 66% of cases, while microbiological confirmation was achieved in 34%, with CBNAAT outperforming smear microscopy. Treatment completion rate was 86%, with 8% lost to follow-up. Nearly 48% of patients had persistent symptoms despite therapy. Conclusion: EPTB predominantly affects younger adults and females, with a strong association with diabetes. Despite good treatment completion rates, residual morbidity is common. Early diagnosis, optimal comorbidity management, and extended follow-up are essential.
Background: Primary dysmenorrhoea is a common gynaecological problem among young women, often affecting daily functioning and academic performance. Data on its prevalence and management practices in rural hilly settings remain limited. Objectives: To determine the prevalence and severity of primary dysmenorrhoea among nursing students and to assess their self-medication practices. Methods: A cross-sectional study was conducted among 224 nursing students in a rural hilly area. Data were collected using a pre-validated, self-administered questionnaire that captured sociodemographic details, severity of dysmenorrhoea using the WaLIDD scoring system, and self-medication or other management practices. Descriptive statistics including percentage, mean, standard deviation and Chi Square test were used for analysis. Results: The prevalence of primary dysmenorrhoea was 83.9% (188), with a considerable proportion experiencing severe pain (WaLIDD score ?8). The lower abdomen (80.4%) and lower back (78.6%) were the most common pain sites. Many students (128 or 68.1%) preferred non-pharmacological remedies such as rest, hot water application, and herbal drinks. However, 73.3% reported self-medicating, primarily with over-the-counter NSAIDs (mefenamic acid or others), often without professional consultation. Conclusion: Primary dysmenorrhoea is highly prevalent among nursing students in rural hilly settings. The widespread use of self-medication and reliance on traditional remedies point to the need for menstrual health education and improved healthcare access. Implementing evidence-based management strategies and enhancing awareness could reduce the burden and promote safe practices, ultimately improving the well-being of young women in underserved regions.
Artificial intelligence (AI) has rapidly emerged as a transformative technology in dermatology, a specialty inherently suited for image-based analysis. The increasing availability of large dermatological image datasets, advances in deep learning algorithms, and improvements in computational power have enabled the development of automated systems capable of diagnosing skin diseases with high accuracy. This systematic review aims to evaluate the current applications, diagnostic performance, limitations, and future potential of AI in dermatology. A systematic literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar databases following PRISMA guidelines. Studies evaluating AI algorithms in dermatologic diagnosis, disease severity assessment, dermatopathology, teledermatology, and treatment prediction were included. Evidence suggests that deep learning models, particularly convolutional neural networks (CNNs), demonstrate diagnostic accuracy comparable to dermatologists in certain tasks, such as melanoma detection and lesion classification. AI applications also extend to dermatopathology image analysis, psoriasis severity scoring, acne grading, and teledermatology triage systems. Despite its significant potential, the clinical implementation of artificial intelligence (AI) in dermatology faces several important challenges, including algorithmic bias due to underrepresentation of darker skin phototypes, limited external validation, ethical concerns regarding patient privacy, and regulatory barriers. In this systematic review, 78 eligible studies were analyzed to evaluate the current evidence regarding AI applications in dermatology. The reviewed studies collectively demonstrate that AI-based systems, particularly deep learning models, show promising diagnostic performance in skin cancer detection, dermatopathology, disease severity assessment, and teledermatology. However, considerable heterogeneity exists among studies with respect to datasets, methodologies, validation techniques, and clinical applicability. While AI technologies have the potential to improve diagnostic efficiency and expand access to dermatologic care, current evidence suggests that these systems should be considered supportive clinical tools rather than replacements for dermatologists. Further large-scale, multicenter studies with diverse patient populations and standardized validation protocols are required before widespread clinical integration can be achieved
Background: Cervical cancer (CC) caused by the human papillomavirus (HPV) can be prevented or managed with the help of healthcare professionals, particularly young medical students. However, it is frequently noted that medical students, who provide front-line patient care, have little knowledge about CC and HPV. Aim & Objective: The study aims to evaluate the knowledge, attitude, and practice regarding the Human Papillomavirus (HPV) vaccine among undergraduate medical students at Government Medical College, Rajnandgaon, Chhattisgarh, while also assessing their knowledge about cervical cancer to identify gaps. Materials and Methods This was a descriptive cross-sectional and institutional-based study conducted at BRLSABVMMC, Rajnandgaon (C.G.), from July to October 2025. Convenience sampling was used. The sample size was 341 students, from all Phase i.e. Phase I, II, III and IV. Data was collected using a validated semi-structured questionnaire distributed via Google Form. Data was analysed using MS-Excel 2007. Results The study was conducted among 341 students. Approximately 53.7% of participants were females and 46.3% were males. The majority of students (58%) belong to (21-25 years age group). About 33.7% belong to Phase III. About 92.1% were Hindu. More than 80% of students had sufficient knowledge about the HPV vaccine. In comparison, knowledge regarding cervical cancer and HPV vaccine was poorer in MBBS Phase-I & II students than Phase III & IV students. Only 5.7% student were vaccinated in Govt. Medical College, Rajnandgaon, Chhattisgarh. Conclusion Students reported a good knowledge about Cervical cancer as well as HPV Vaccine but the uptake was very poor i.e. only 5.7%. More work is required to raise medical undergraduates' knowledge of HPV and encourage them to be vaccinated. To have a significant beneficial impact on their acceptance of vaccination as well as their desire to advocate it in the future, targeted health education activities are necessary.
Background: Diarrhoeal disease remains a major contributor to morbidity and mortality among children under five years, particularly in rural and resource-limited settings. Timely home-based management using oral rehydration salts (ORS), zinc supplementation, continued feeding, and hygienic practices can significantly reduce diarrhoea-related deaths; however, caregiver-level gaps persist. Objectives: To assess the knowledge, attitudes, and practices (KAP) regarding diarrhoeal management among mothers of under-five children in rural Gautam Buddh Nagar, Uttar Pradesh, and to identify associated socio-demographic factors. Methods: A community-based cross-sectional study was conducted from 19–27 November 2022 in three randomly selected villages under the Rural Health Training Centre of Sharda University. A total of 223 mothers of under-five children were interviewed using a semi-structured questionnaire assessing KAP related to diarrhoea management. Data were analysed using SPSS version 20. Descriptive statistics were used, and associations were tested using the Chi-square test. Results: While 66.4% of mothers were aware of diarrhoea, only 37.2% knew its causes and 33.2% knew the correct preparation of ORS. Although 87.4% recognised exclusive breastfeeding as a preventive measure, awareness regarding vaccination (34.1%) and sanitation (45.3%) was limited. In practice, 41.7% of mothers used ORS and only 16.6% administered zinc during diarrhoeal episodes. Maternal education and socioeconomic status were significantly associated with better knowledge and practices (p < 0.05). Conclusion: Despite the availability of effective interventions, important gaps in maternal knowledge and practices persist. Strengthening community-based health education and improving ORS and zinc utilisation through frontline health workers are essential to reduce preventable diarrhoeal morbidity and mortality.
Introduction: Hepatitis B infection remains a major global public health concern, particularly among healthcare workers and trainees who are at risk of occupational exposure. Despite this risk, limited data are available regarding the level of awareness and preventive practices among medical students in our institution. This study was therefore conducted to assess their knowledge, attitudes, and preventive practices related to hepatitis B infection. Materials and Methods: A cross-sectional descriptive study was carried out among 212 medical students. Data were collected using a pre-tested, semi-structured questionnaire designed to evaluate knowledge and attitudes regarding hepatitis B infection and its prevention. Descriptive statistics were used to summarize participant characteristics, and Pearson’s correlation test was applied to explore associations between variables. Results: A total of 212 students participated in the study. Less than half of the participants demonstrated adequate knowledge regarding the risk of acquiring hepatitis B infection in hospital or other high-risk settings. In contrast, a large proportion of students recognized the importance of hepatitis B vaccination for healthcare workers. However, gaps were observed in knowledge related to modes of transmission, clinical features, and complications of the disease. Conclusion: Although medical students showed a generally positive attitude toward hepatitis B prevention, their overall knowledge remains suboptimal. Strengthening educational initiatives, including targeted training and awareness programs, is essential to improve understanding and promote safe practices among future healthcare providers.
Background Group A Streptococcal (GAS) pharyngitis management requires clinical expertise to differentiate viral from bacterial aetiology, and also balancing antibiotic stewardship with prevention of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Jamaica maintains an active ARF and RHD control programme, yet antibiotic overuse remains problematic. This study evaluates the cost-utility of implementing clinical decision rules (CDR) with rapid antigen detection tests (RADT) compared to current pharyngitis management practices. Methods We conducted cross-sectional surveys at 22 public health centres and two insurance companies in Kingston and St Andrew to determine 2018 pharyngitis incidence, and at five regional hospitals to calculate direct RF and RHD costs. Data were incorporated into a Markov model comparing four strategies: no treatment, current empirical practice, universal antibiotic treatment, and CDR-guided management with RADT. The model adopted a healthcare system perspective with an 81-year time horizon. Costs were expressed in 2018 US dollar value. Deterministic and probabilistic sensitivity analyses examined parameter uncertainty. Findings The CDR strategy dominated all alternatives in both discounted and undiscounted analyses, demonstrating lowest lifetime costs ($7.92 per patient) and highest Disability-adjusted Life Years (DALYs) averted. Compared to current practice, CDR implementation would save $21.84 per person while improving health outcomes. At 15.7% of Jamaica’s 2018 weekly minimum wage, the intervention represents highly acceptable expenditure. Probabilistic sensitivity analysis confirmed CDR dominance with 99% probability of cost-effectiveness at a willingness-to-pay threshold of three GDPs per capita. Interpretation Despite implementation costs, including clinician training, protocol development, and RADT procurement, CDR-guided pharyngitis management offers superior clinical outcomes and cost savings compared to current practice in Jamaica. These findings support WHO recommendations for improved GAS pharyngitis diagnostics in RF and RHD prevention programmes and provide actionable evidence for health policy makers in Jamaica and similar resource-limited settings.
Vaccination is a very important step in reducing the spread of COVID-19 by way of herd immunity. Vaccine hesitancy among pregnant women is particularly high despite professional bodies strongly endorsing the vaccine. Many pregnant women are not willing to be vaccinated due to safety concerns despite the reassurance that vaccines are safe during pregnancy without any additional complication during pregnancy. Our study aims at identifying the attitudes towards COVID-19 vaccine acceptance as well as non-acceptance in pregnant and lactating women. A cross sectional study was conducted on 454 pregnant and post natal mothers of Father Muller Medical College. Data was collected from a face-to- face questionnaire which included demographic characteristics of study participants and a set of questions to test the Knowledge and Attitude towards COVID-19 vaccination in pregnancy. All participants were aware about the vaccine’s availability; however, 80.93% were uncertain about its benefits. The primary reasons for hesitancy included familial influence (82.6%) and safety concerns (87% believed the vaccine might cause infection, 81.05% feared fetal harm). Only 17.62% of the study participants believed in the vaccine's efficacy. Participants showed limited understanding of COVID-19's impact on pregnancy, underscoring the need for improved health education.
Hair loss (alopecia), particularly androgenetic alopecia (AGA), affects a substantial proportion of adults worldwide and is associated with significant psychosocial burden. Although conventional therapies such as topical Minoxidil and oral finasteride remain standard treatments, their variable efficacy and potential adverse effects have motivated the search for alternative or adjunctive therapeutic options. Topical melatonin has gained recent interest due to its antioxidant, anti-inflammatory, and hair follicle–modulating properties. Methods A structured literature search was performed in PubMed, Scopus, and Web of Science for studies published up to 2026. Eligible studies included experimental research, mechanistic investigations, and clinical trials examining the effects of topical melatonin on hair growth or hair loss. Following duplicate removal, titles and abstracts were screened, and full texts of relevant articles were reviewed. Data from included studies were qualitatively synthesized to evaluate the efficacy, mechanisms, and safety of topical melatonin in alopecia management. Results Clinical evidence indicates that topical melatonin formulations (0.0033–0.1%, applied once daily) may increase hair density, prolong the anagen phase of hair growth, and reduce hair shedding, while demonstrating a generally favorable safety profile. Mechanistic studies suggest that melatonin exerts its effects via MT1 and MT2 receptors and through modulation of key intracellular signaling pathways, including Wnt/??catenin and AKT/GSK3?, which are essential for follicular proliferation and survival. Preclinical models further support melatonin’s antioxidant and Cytoprotective actions within the hair follicle microenvironment. Conclusion Topical melatonin appears to be a promising, well?tolerated adjunctive therapy for alopecia management. Nevertheless, the current evidence remains limited by heterogeneity among studies, small sample sizes, and a lack of large-scale randomized controlled trials. Future rigorously designed RCTs with standardized dosing and outcome measures are needed to determine its definitive clinical efficacy and optimal use.
The knee joint is a synovial joint present in lower limb of the body. One of the ways to define the force vectors acting on the knee joint is the Quadriceps Angle (Q-Angle) which is defined as the angle formed between the ligamentum Patellae and the extension of the line formed by the quadriceps femoris muscle with its apex at the patella. Higher the Q angle, more are the risks of patellar dislocation and other knee injuries. The present study was aimed to record and analyze the values of Q-angle in a group of asymptomatic medical, paramedical and nursing students of Agartala. The gender-related difference, bilateral variations in Q-angle was also established. Methodology This study was conducted at Agartala Government Medical College and GBP Hospital in the year 2024 with a sample size of 200 after satisfying inclusion and exclusion criteria. All the students under study were divided into 2 groups, Group A consisted of 100 male students and Group B with 100 female students. Q angle was measured by goniometric method and the collected data was analyzed using Microsoft excel and SPSS 25.0 software. Results It was found that male had a mean Q angle of 11.79 ± 1.68?(SD) and female had 13.79 ± 1.93? (SD). The mean value of right Q angle of male students was 12.03±1.73? (SD). Whereas, that of female students was 14.06 ± 2.13? (SD). The mean value of left Q angle of male students was 11.55 ± 1.66?(SD) and that of female students was 13.53±1.72? (SD). Out of a total of 200 students, 60 % had bilateral variations in Q angle. Among them, 6% had bilateral variation more than 3?, 12 % had a bilateral variation of 3?, 11.5 % of all students had bilateral variation of 2? and rest 39.5 % had a bilateral variation of 1?. Conclusion The findings of the present study are in accordance with the fact that female have a higher Q angle than male. The findings of the study would be very helpful for orthopedic surgeons and sports medicine specialists practicing in this region in preventing as well as treating knee injuries.
