Disaster incidents leading to massive obliterations often bring to the forefront the inadequacies of the systems, infrastructure as well as personages. In healthcare settings, these imperfections are usually exhibited specifically during fire disasters. This case report details a true fire incident that erupted in a patient bed-head panel of an emergency complex room and describes the real-life challenges encountered by the emergency staff in preserving both life and property. Bed-head units encompass both electrical and medical gases: a structural component quite common in modern hospitals. Precautionary measures should be implemented to mitigate such incidents, as well as specific attention, should be made during the designing and installation of these bed-head panels. Better coordination, scheduled training, and fire drills can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby, making a safer healthcare environment for every worker and patient.

Background: Organ transplantation is a life-saving treatment for patients with end-stage organ failure all over the world, and the demand for organs has increased as a result. Organ donation involves legal, psychological, and ethical considerations. Many countries around the world have reported that people's attitudes toward organ donation are influenced by various factors such as knowledge, education, and religion. The existing study sought to explore the awareness, attitude, and willingness of organ donation among adult population in Western Rajasthan. Materials and Methods: A cross-sectional hospital-based survey was conducted with 445 adult populations who were visiting the hospital. Self-Structured Awareness Assessment Scale for Organ Donation and Attitude Assessment Scale for Organ Donation were used. Data analysis was done using the SPSS software 22.0 version. Results: 74.61% of participants were aware about organ donation. Statistically (P < 0.001) higher odds for organ donation willingness was found among participants who were aware that organ such as eye (odd ratio [OR]: 10.34, 95% confidence interval [CI]: 4.40–24.25, P < 0.001), heart (OR: 4.71.95% CI: 2.68–8.25), P ≤ 0.001), intestine (OR: 2.26, 95% CI: 1.41–3.6, P = 0.001), skin OR: 2.93, 95% CI: 1.83–4.70) P ≤ 0.001), extremities (Lower and upper) (OR: 2.46,95% CI: 1.53–3.95, P ≤ 0.001) can be donated or transplanted. 40.6% of the participants disagree that it is better to die than to receive an organ from another person. Interestingly, 35.28% of the participants agreed that organ donation is a true donation and a real service to mankind. Conclusions: This study not only echoes low awareness of organ donation among the adult population in Western Rajasthan, India but also reflects low and neutral level of positive attitude and willingness for organ donation.

Diabetic patients need to take multiple insulin injections in a day to achieve efficient glycemic control. However, repeated injections can cause pain and discomfort for patients. Therefore, we have developed an amphiphilic double-brush polymer-based hydrogel (DBP-hydrogel) that can encapsulate insulin and can be injected subcutaneously. Additionally, we have demonstrated the robust nature of DBP-hydrogel by encapsulating small molecular drugs and large biological agents. Using a streptozotocin-induced type 1 diabetic mouse model, we have demonstrated that a single injection of the insulin-loaded hydrogel can efficiently control hyperglycemia for 24 hours, whereas 5 repeated injections of free-insulin (commercial formulations) are required to achieve a similar level of glycemic control. This novel DBP-hydrogel can stabilize encapsulated insulin without losing its activity for at least 90 days, which may have a huge impact in avoiding cold chain supply. Furthermore, a series of in vitro and in vivo experiments suggest that newly developed DBP-hydrogel is highly biocompatible and does not cause immune response and inflammation.

For the general public, healthcare facilities are always a safe and secure place for treatment. Generally, healthcare institutions are equipped to deal with exterior interruptions, but circumstances brought on by internal risks are more serious and frequently require an emergency evacuation of the facility. An incident happened at the radiodiagnostic setup of a tertiary care institute in North India. This fire incident created panic among staff and patients. At the place of casualty, there were around 150 persons, including staff, patients, and their attendants. Immediately after the confirmation of the fire incident, the fire department and security department took action in the form of fire control and smoke evacuation. Though six fire handling staff required minor emergency services for asphyxia due to smoke inhalation and were cured by oxygen support only, none of the patients was affected due to timely smoke evacuation. Most often, smoke management techniques implemented are compartmentation, pressurization, dilution, ventilation, buoyancy, and airflow. So, we concluded that the step of timely smoke evacuation and preventing the spread of smoke by various methods help to reduce fatality due to smoke. The training programs and mock drills give stakeholders the needed knowledge, skills, and practice they need to safeguard patients and employees.

Healthcare fires have always been one of the major internal hazards and an oxygen-rich environment further aggravates these threats. The present case study reports such a fire incident in an Advanced Trauma Centre of a tertiary care hospital in North India wherein a tiny spark generated while handling an oxygen cylinder a health care worker got caught in a fire blaze. Fortunately, the flare was controlled within no time due to prompt action by a fellow HCW, and a major unexpected incident was averted. A formal investigation conducted by a team of experts ascertained that oxygen enrichment from leaking equipment, improper handling, and repeated striking of cylinder regulator by the spanner which attained the required threshold temperature was the probable cause for the onset of a flare. Henceforth, to mitigate such incidents users shall follow manufacturer recommendations, and ensure only safe and suitable components are used as part of a compressed oxygen system. Maintenance of cylinders, valves, and regulators should be done periodically to mitigate the risks of such incidents. All hospitals shall carry out risk-assessment exercises and provide oxygen safety training to all healthcare staff.

Background:: Strokes of the undetermined cause or cryptogenic strokes (CS) account for 30-40% of ischemic strokes. Paradoxical embolism secondary to patent foramen ovale (PFO) may be associated with CS. Transcranial Doppler (TCD) with bubble contrast is a noninvasive bedside tool for diagnosis of right-to-left shunt (RLS) with high sensitivity and specificity. Data on the prevalence of PFO in CS in India are lacking. We determined the prevalence of RLS likely secondary to PFO in cryptogenic young strokes of the north Indian population using TCD with bubble contrast. Patients and Methods:: In this hospital-based prospective cross-sectional study, TCD with bubble contrast was performed in 57 young (age 15 > 45 years) CS and 50 healthy controls for the detection of RLS. The risk of paradoxical embolism (RoPE) score was calculated from various variables such as age, presence of cortical stroke on neuroimaging, and absence of vascular risk factors. Results:: 57 young CS and 50 healthy controls were recruited. TCD with bubble contrast was positive in 31% cases vs 6% in controls (P = 0.001). All patients with TCD positive for RLS had superficial cortical infarcts (P = 0.03). The median RoPE score of our patients was 9 (range: 7-10). Conclusions:: There is a high prevalence of RLS likely secondary to PFO in cryptogenic young strokes in north India. TCD with bubble contrast is an excellent bedside tool for the detection of RLS.

Background: Since the time of use of blood and blood products in medical and surgical interventions, its utilization is a point of debate. Over demanding of blood from blood bank services may lead to aging of blood and wastage of blood units. It also negatively impacts on the services of blood bank. There are various indices to estimate the utilization of blood services in a healthcare institute. Methods: In this study we have analysed 4 months blood bank data for CTVS interventions. Total 252 patients were involved. We have analysed the utilization of PRBC for the cardiac surgeries. Also, we have formulated MSBOS from the available data. Results:Results of this study shows, total 1006 units of PRBC were demanded for the surgeries, 784 units were issued by the blood -bank of the hospital and out of which 60 % (472 units) were transfused to the patients.C/T ratio was less than 2.5 in majority of the surgeries, T% was more than 30% in all the cases, and TI was greater than 0.5 in all surgeries.These figures show the significant requirement of blood in cardiac surgeries.Further, there was optimal utilization of blood in the institute.

Background Peripheral artery disease (PAD) may be a useful tool to predict coronary artery disease (CAD) in patients undergoing coronary angiography. If proven that PAD can be a good predictor of CAD, it can help in early and cost-effective diagnosis of CAD. Methodology This observational study was conducted from January 2020 to February 2021 in the cardiology unit of a tertiary care hospital. Participants older than 40 years, with a history of uncontrolled hypertension and unstable angina, who warranted the need of angiography were enrolled in study. After enrollment and recording history, these cases were assessed for the presence of PAD based on ankle brachial index (ABI). ABI values less than 0.9 were labelled as participants with PAD. Then these cases underwent coronary angiography at the same institute, and the presence of greater than 50% stenosis of any coronary vessel on angiography was taken as positive CAD. Results In this study, PAD was identified in 152 (62.8%) participants. A total of 165 (68.1%) participants had greater than 50% stenosis on angiography. Out of 152 participants with ABI less than 0.9, 140 had greater than 50% stenosis on angiography. In total, 90 participants had ABI more than 0.9, of which 35 participants had greater than 50% stenosis. Sensitivity of PAD in predicting coronary artery stenosis was 80.0% (95% confidence interval [CI]: 73.30%-85.66%), specificity was 82.09% (95% CI: 70.80%-90.39%), and accuracy was 80.58% (95% CI: 75.02%-85.37%). Conclusions Our study demonstrated that the sensitivity, specificity, and accuracy of PAD in predicting coronary artery stenosis were significant. Hence, we conclude that PAD can be an excellent predictor of CAD by helping in early and cost-effective diagnosis of CAD.

Introduction: Omega-3 fatty acids have for long been shown to reduce the incidence of cardiovascular (CV) diseases.Omega-3 fatty acids mainly exist in the form of eicosapentaenoic acid (EPA) and docosahexaenoic acid in fish oils.Cod liver oil is found to have a high concentration of these omega-3 fatty acids.This study aims to explore the benefits of using cod liver oil in reducing the incidence of myocardial infarction (MI) among at-risk patients.Method: This open-label placebo-controlled two-arm interventional study was conducted in the internal medicine and cardiology unit of tertiary care hospital between January 2018 to January 2021.During this period, 870 patients at risk of CV events were enrolled in the study after obtaining informed consent.The study group received 415 mg cod liver oil daily, in addition to their current treatment, in a bottle without label and the control group received no additional treatment to their standard treatment.Patients were followed up for 12 months or till the development of MI.Result: Patients treated with cod liver oil had comparatively fewer incidences of MI; however, the difference was not significant (p-value: 0.09).Furthermore, the difference was non-significant for both fatal and nonfatal MI.The relative risk for total MI incidence was 0.70 (0.44-1.10).Conclusion: According to our study, adding cod liver oil to the diet does not play a major role in reducing the risk of MI.Further large-scale studies are needed to understand the role of cod liver oil in reducing the risk of CV events, including MI.

Atomic Layer Deposition (ALD) is employed for the growth of nanometric conformal layers on distinct substrates. In the present work, we demonstrated the attainable consequences on the examination of optical and structural peculiarities of pristine and SHI (swift heavy ions) irradiated ultrathin multilayer samples of Al2O3-ZnO fabricated on glass and silicon substrates using the technique based on ALD. Multilayer Al2O3-ZnO specimens were irradiated with 100 MeV SHI in the fluence range of 1E12 to 5E13 ions/cm(2). For a better conception of the impact of ion beam irradiation with high energy on structural parameters like strain, dislocation density, crystallite size was demonstrated by X-Ray Diffraction (XRD). The coefficient of absorption was used to demonstrate the changes that occur in optical bandgap, urbach energy, skin depth and optical density with the function of ion fluence. Photoluminescence (PL) spectra were investigated at room temperature to comprehend the mechanism of changes in peak shifting and intensity of broad and strong emission luminescence spectra at excitation wavelengths of 300 nm were noteworthy. To evaluate the thickness, crystalline quality and quantitative composition of the elements Rutherford Backscattering Spectroscopy (RBS) employing utilizing the He2+ with high energy was used and reported. Regulation of optical peculiarities through swift heavy ion beam irradiation explores extensive opportunities for Al2O3-ZnO multilayer nanofabrication in optoelectronics domain.

Aim: COVID-19 has emerged as a serious global health problem in the 21st century Due to its rapid spread across the nations, the World Health Organization declared it as a Public Health Emergency of International Concern (PHEIC), and efforts are being made worldwide to find a permanent solution This disease outbreak has also shown certain gender-based impacts and has shown gender differences in vulnerability and mortality toward COVID-19 Materials and methods: A 3-month cross-sectional study aimed to study the gender differentiation among COVID-19-positive patients was conducted in one of the premier tertiary-care multispecialty hospital of North India The data pertaining to all the screened, tested, and reported positive for COVID-19 patients admitted in the "COVID hospital" of the institute was taken into analysis

Healthcare workers (HCW) are always prone to risk of acquiring COVID-19 infections duringpatient management activities. The present case report is aimed to address clinical outcome of exposed HCWin relation to trainings and PPE usage. Since the reporting of first suspect, a total of 4373 suspected patientswere screened, 315 tested and 149 were reported COVID-19 positive. In initial month, although all HCWswere wearing prescribed PPEs, but they were not well versed with these measures. And, there was a panic forperforming COVID-19 related duty assignments. Later, emphases were laid on donning and doffing, handhygiene, respiratory etiquettes, social distancing, and mask usage protocols for the safety of HCW. Moraleboosting, counselling sessions, regular supervisions, strict implementation and compliance to guidelines wereensured. Henceforth, authors acknowledge that appropriate usage of PPE, capacity building, and strictimplementation of guidelines significantly reduced the risk of transmitting infection to HCW.

Hunger strike is a protest where an informed person refuses essential nourishment with the intention of accomplishing a specific goal. Hunger strikes conflict with medical, ethical, humanitarian and legal values. A multidisciplinary approach is important when dealing with hunger strike patients. On one hand, there is the wish to preserve life, and on the other to respect the strikers' autonomy and their wishes, values and advanced directives (or living will). Most hunger strikes are short-lived, but in complex and prolonged circumstances, legal advice must be sought from health service solicitors and a doctor's medical indemnity organisation. There is an emergent need to have defined guidelines for the management of these hunger strikes to be followed.

BACKGROUND: Pediatric nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, hypertension, metabolic syndrome, cardiovascular problems, and increased risk of chronic liver disease and Type II diabetes mellitus. The aim of the study was to assess the metabolic profiles and associated risk factors of NAFLD in obese children. MATERIALS AND METHODS: Children with a body mass index (BMI) of >27 kg/m2 an adult equivalent cutoff (Indian Academy of Paediatrics, 2015 guidelines) aged 5–18 years presenting to the pediatric outpatient unit of PGIMER Satellite Centre, Sangrur, India, were retrospectively recruited over a 1-year period. Anthropometry, lipid profile, thyroid levels, liver function test, fasting blood sugar, and blood pressure were measured. Ultrasonography was used to diagnose NAFLD. Logistic regression was used to assess the risk factors. RESULTS: A total of 100 children participated in the study. The mean age was 10.6 ± 2.6 years and the mean BMI-Z score was 2.6 ± 0.5. The prevalence of NAFLD was 62%. Alanine transaminase (ALT) was significantly elevated in all the children with NAFLD. Lipid levels and BMI Z-score were similar in both groups. Unadjusted odds ratio shows statistically significant association of ALT (2.058 [1.11–1.01]) and waist circumference (1.089 [1.19–0.99]) with NAFLD. With adjusted odds ratio only, ALT (1.12 [1.24–1.01]) was found to be significantly associated with NAFLD. CONCLUSION: There is quite a high prevalence of nonalcoholic fatty liver in obese Indian children. All children with raised liver enzymes should undergo sonography to rule out NAFLD.

ABSTRACTHealth care facilities are always seen as places of haven and protection for managing external incidents, but situations become difficult and challenging when such facilities themselves are affected by internal hazards. Such incidents are arguably more disruptive than external incidents, because patients are dependent on supportive measures and are neither in position to respond to such crisis situation nor do they know how to respond. Operating room fires are rare but potentially catastrophic, involving loss of costly resources and possibly lives. This case report details a true operating room fire incident in an emergency operating room and details the real-life challenges encountered by operating room staff in preserving both life and property. As a result of this work, precautionary measures may be implemented to mitigate such incidents. Careful coordination, continuous training, and fire drill exercises can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby making a safer health care environment for every worker and patient.

In wireless communication era, we need the antennas with low profile, light weight, planar but can meet the characteristics of non-planar structures, with ease of fabrication, flexibility in terms of electromagnetic parameters like radiation pattern, gain, impedance, polarization etc. Microstrip patch antennas, which come at low cost, size, good performance, ease of installation and easy integration to circuits, high efficiency, are suitable in that context. The Principle of slot is used on the patch which decreases the radius of the circular patch antenna, so as to reduce the size. In this work various Ircular microstrip patch antenna arrays are intended for the application of WLAN and Wi-Max at 2.4GHz for the improvement of gain. Single microstrip patch antenna and planar arrays of 1x2 and 2x2 ircular microstrip patch antennas are designed using strip line feeding technique and simulated on FR4 substrate. The planar antenna arrays are simulated using the High Frequency Structure Simulator (HFSS) software version v17.2 and the parameters like gain, return loss, Bandwidth and VSWR are evaluated at 2.4GHz frequency and the same are presented.