Introduction Coronary Artery Disease (CAD) in less than 45 years of age is termed as young onset CAD. There is an alarming increase in young-onset CAD in Low- and Middle-Income countries, especially in the Asian Subcontinent. Aim and Objectives The study aimed to estimate the clinical profile, risk factors, and post-angiography outcome at six months among young-onset CAD patients. Method A prospective study was conducted at a national, tertiary care, government referral hospital in North India, from October 2022 to November 2023. All patients undergoing coronary angiography following CAD and less than 45 years of age were enrolled after obtaining informed consent. Data was collected using a structured pilot-tested interviewer-administered questionnaire and review of medical records and analysed using R version 4.2.3. Results The study included 55 patients with a mean age of 39.2 years and majority being males. The common risk factors observed were smoking (36.3%) and dyslipidemia (9%). Most of the participants presented with dyspnea and chest pain together (30.9%). The NYHA class at presentation was class III (73%). 5.5% had thrombocytopenia, transaminitis was in 14.5% and 36.7% had dyslipidemia. CRP was increased in 52.7% and abnormal cardiac markers in (63.6%). The ECG showed ST depression, T Inversion (51%), ST elevation (29%), left ventricle hypertrophy in 3.7%. Chest x-ray showed cardiomegaly in 16.4%. Coronary angiography showed that among total patients 60% had single vessel disease, 21.8% had double vessel disease and 18.2% had triple vessel disease. Further 32.7% were diagnosed NSTEMI, 29.1% with STEMI and 16.4% each had stable and unstable angina respectively. 20% had EF 45%- 55%, 11% had EF <45%+ hypokinesia, 5.5% had EF <45%, 3.6% each had EF 45%- 55%+ hypokinesia and EF <45%+ Hypokinesia+ Valvular insufficiency respectively and 1.8% had EF <45%+ valvular insufficiency. Angioplasty was done in 81.8% and CABG in 14.5%. At the 6th month of follow up NYHA grading was class I in 56.6% and class II in 37.8% and class III in 5.6%. The mortality rate was 3.6% (2 deaths) because of cardiac failure. Conclusion The study concludes that six month survival for the diagnosis was 96.4%. Modifiable risk factors (such as smoking, dyslipidemia, obesity) and non modifiable risk factors (sex and family history) both are directly associated with early Coronary artery disease. Majority of the patients presented with chest pain and dyspnea. The common biochemical derangements found were elevated CRP and cardiac biomarkers. In non invasive tests ECG and 2D Echocardiography were found to be good tools for evaluation of CAD as ECG changes such as ST elevation, T wave inversion, ST depression etc and 2D Echo findings like Reduced ejection fraction and regional wall motion abnormalities have been recorded in most of the patients. Angioplasty was done and after performing angioplasty patients showed improvement. At 6 months follow up NYHA score significantly improved i. e. Class 1 and class 2, and the patients were asymptomatic. During study among 55 patients 2 deaths were reported mainly because of cardiac failure.

Introduction: As per the 2023 National Acquired Immunodeficiency Syndrome Control Programme report, there are 8.5 lakh intravenous drug users (IDUs) in India, although the figures have varied greatly from the year 2009 to 2023. The IDU size population in Punjab is about 2600 to 18,000 as per the year 2008 survey reports. In the 2008 survey, the majority of such patients belonged to the age group of 18 to 30 years and most of them were employed, and the mean duration of IDU was 3 to 7 years. The total number of patients receiving in-patient treatment during the past 6-month period was only 15 clients per month. IDUs with HCV infections are more likely to have hepatitis B and HIV infections. Aim and Objectives: 1. To study the sociodemographic factors of HCV-infected IDUs admitted in the psychiatry ward of Sri Guru Ram Das (SGRD) Medical College, Vallah, Amritsar. 2. To study the clinical features, psychiatric profile, hepatitis B surface antigen (HBsAg), and HIV status of HCV-infected IDUs. Methodology: This was a hospital-based, observational, cross-sectional study conducted in the Department of Psychiatry at SGRD Medical College, Vallah, Amritsar. The data were collected from the year 2019 to 2023 consisting of the sociodemographic profile, IDU status, HCV status, and psychiatric history of all the opioid-dependent patients admitted during this time. The HBsAg and HIV status of the same patients were also collected. Results: In our study, the mean age group was 25 ± 5 years. All were males (100%). The majority of the patients were educated up to higher secondary level. The majority of cases started using intravenous drugs out of curiosity (52.5%). Most of them were using heroin from 0 to 5 years (56.7%). Most of them had tried to quit substances 2 or more times in the form of deaddiction treatment (49%) and had relapsed due to craving. Most patients were still IDU positive or relapsed to be IDU positive again despite being HCV reactive (66.7%) because of craving (44.5%) and stress and comorbid psychiatric disorders (30%). Bipolar disorder (46.7%), schizophrenia (33.3%), and personality disorders (6.7%) were common psychiatric illnesses seen in the studied cases. Most of them had a positive family history for substance use (60%). Conclusion: The opioid-dependent and HCV-infected IDUs having psychiatric illness are likely to have coinfections such as hepatitis B and HIV. All such patients need to be comprehensively evaluated for such coinfections.

Introduction: Drug addiction among children and adolescents is spreading very fast. The age of initiation of substance use is falling progressively. Aims and Methods: The aim of the study was to know about the socio demographic profile of children and adolescents diagnosed with substance dependence and to assess the pattern of drug dependence. So we conducted a retrospective study in Swami Vivekananda Drug De addiction centre at Amritsar in Punjab. The diagnosis of substance dependence was made by a consultant psychiatrist after direct interview with the patient and the relatives according to International Classification of Diseases (ICD-10). Results: The study comprised 446 children and adolescents who reported for de addiction during the study period. Majority were in the age group 16-19(95.73%), 49.5% were from urban areas and 50.5% patients were from rural areas. Out of these 36.09% were employed, 24.43% were unemployed and 39.46% were students. Our results showed more involvement of male as compared to females. As far as education status is concerned, 47.53% studied up to matric, 23.99% up to Secondary school, 12.78% up to middle, 6.95% up to primary and 5.38% were illiterate. Opioids and polysubstance use are common among them. Conclusion: The need of the hour is to educate and counsel young children and adolescents and create awareness among the public regarding drug addiction.

Background: Injecting drug use is a major route of hepatitis C virus(HCV) infection in north India especially Punjab with very high rates of substance abuse. The present study was attempted to study the prevalence of hepatitis C among the injectable drug users, which is more important in a country like India where viral hepatitis is estimated to be among the top ten causes of deaths. Methods and findings: A study was conducted in 2014-2015(FEB-FEB).The subjects included were 1162 IDUs who were opioid dependent as diagnosed by ICD-10 and confirmed for opioid in urine with help of Instant-View opiates (300) urine cassette test and IDU status was confirmed by observing injection marks on body parts. After that every patient was subjected to blood sampling for anti HCV antibodies using immunoassay technique and opioid dependent IDUs positive for anti HCV antibodies were interviewed regarding demographics, injecting and sexual behaviours. Seroprevalence of HCV was found to be 38.12 % (443 positives). Out of 443 positives about 98.6% were males, 63% were of rural background, 60% were married and 43% unemployed. Majority was between the age group of 25-30 years age (58%). Conclusion: Our study shows a high seroprevalence of HCV in IDUs. The study helps us to evaluate various aspects associated with Hepatitis C infection in Punjab. The need of the hour is to increase awareness about HCV among the public and practicing physicians.

Background: The epidemic of substance abuse in the present generation has assumed alarming dimensions in the state of Punjab. The success story of Punjab’s economy has seemingly come to an end. District Amritsar being close to border is deeply influenced. Maximum cases were registered under the NDPS Act in the year 2012 in Punjab, with the nationally highest drug-related crime rate of 51.6%, against the national average of 2.8% . The present study aims to identify the emerging trends and prevalence of drug abuse among the patients enrolling at Swami Vivekananda drug de-addiction and treatment centre, Amritsar. Methods and findings: In the year 2014 and 2015, consecutive patients on outpatient basis from the month of January 2014 till august 2015 were enrolled. Urine toxicology was done for the drugs abused with rapid immune-chromatographic assay kits available in the centre. A total of 10,568 patients were screened for urine toxicology. Out of 10,568 enrolled patients 9815 patients were found positive for morphine and out of 9815 patients addicted to morphine 5785(54.74%) of patients were abusing heroin in one or other form, which was concluded from the personal interview and general physical examination for scar marks of injectable drug users of heroin. Rest of the substances abused includes other opioids, alcohol, sedatives, cannabis, cocaine, amphetamines and tobacco. The dose of heroin used by the patients varied from person to person but on average most of patients abuse heroin from 500mg up to 2grams on daily basis either in the form of snorting, sniffing or as injectable. Conclusion: High numbers of heroin abusers indicate its high addiction potential. Due to its high cost majority of addicts are not able to procure it and get involved in illegal activities. This publication helps to provide the figure of current alarming rise of heroin abuse among the study population. Immediate steps like demand reduction via proper education of youth and proper treatment of addicts with individual or group counselling are required curtailing the current drug menace in Punjab. Increasing trends of heroin abuse among population is shattering the youth of Punjab. Such a drastic deviation towards heroin abuse can be attributed to its high addiction potential, easy availability, unemployment and socio-occupational pressure faced by youth of Punjab. Awareness regarding the side effects of drugs and their addictive potential should be focused and campaigns in the rural population regarding the preventive measures and treatment options available for addiction should be encouraged.