Preventive health care remains underutilized in India despite its proven benefits in reducing morbidity, mortality, and healthcare costs. With rising chronic diseases such as diabetes and cardiovascular conditions, the urgency for proactive health management has never been higher. Yet, societal apathy, lack of awareness, infrastructural gaps, and low perceived value hinder its adoption. Many prefer curative over preventive care, viewing regular checkups as unnecessary unless symptomatic. The undervaluation of Preventive and Social Medicine (PSM) (Syn. Community Medicine) within medical education and society further compounds the issue, discouraging future healthcare professionals from pursuing this specialty. Complex health systems, cost concerns, and limited motivation also prevent timely screenings and lifestyle modifications. A shift toward preventive-focused public policies, stronger health insurance integration, better public awareness, and greater recognition of PSM professionals is imperative. India must reorient its healthcare paradigm – valuing prevention as much as cure – to safeguard public health and ensure sustainable outcomes.

Background: Mistreatment in healthcare is widespread in low- and middle-income countries (LMICs) especially as obstetric violence in and around motherhood amid paucity of evidence. Respectful maternity care is a woman-centered care by discharge of soft skills from the healthcare workers (HCWs) that befriends and allays anxiety among mothers regarding their unborn child. Objective: To assess the perception of mothers on their care during childbirth by feedback analysis. Methods: This hospital-based study was conducted in a teaching rural institute from January 15 to July 14, 2024. The predesigned pretested semi-structured questionnaire collected feedback of mothers who delivered their children in the past 1 year containing 26 questions in 5 domains, namely, Friendly care (9), Non-confidential and non-dignified care (11), Negative experience (2), Neglect (2), and Discrimination (2). Results: An array of untold truths on ‘Obstetric violence’ was elicited by candid feedback from 58 respondent mothers on their positive and negative, subjective and objective internalization discharged by the HCWs. Mothers appreciated positively on the care received ranging from 58 (100) to 22 (37.93%) on different issues. Conclusions: Overall, our mothers felt positive on service provision during childbirth at our center. Disrespect and abuse, though infrequent findings, underscore the need for continuing education on holistic maternity care. This paper will significantly impact on Family Medicine and Primary Care on LMICs including India to boost respectful maternity care.

Background: Surgical wound infection (Syn. Surgical site infection SSI) remains major chunk of hospital acquired infection despite robust advancements of science and technology in asepsis research. Objective: This Prospective, observational longitudinal study was designed to assess whether aqueous alcohol-based surgical hand rubbing (SHR) can effectively replace traditional surgical hand scrubbing (SHS) without increasing incidence of SSIs amid additional benefits of enhanced compliance and saving of real time, and saving water in the operation rooms. Methods: The study was conducted to assess outcomes of gastrointestinal (GI) surgeries from 1st January 2025 to 1st March 2025 on 83 patients with comparable demographic and procedural profiles scheduled for elective open and laparoscopic uncomplicated cases. Two groups of surgeons with comparable skills in two units were primed into two arms by randomly assigning to carry out either surgical hand scrubbing (SHS n=37) and surgical hand rubbing (SHR n=46) groups to compare post-operative SSI rates. Results: 62 laparoscopic cholecystectomies (n=34 SHS, n=28 SHR) were performed; 21 other gastrointestinal surgical procedures were done. Our study recorded nil SSI in both groups at both the 7-day and 31-day postoperative follow-up. Average sanitization times were noted in SHS 3.48 and SHR 1.56 minutes respectively; a difference of nearly 2 minutes. Mean water utilized per SHS was 3.8L, SHR consumed no water beyond initial rinse. Conclusions: Initial results of our original research work suggest that alcohol-based hand rubs may offer a comparable alternative to traditional scrubbing, with added practical benefits of summary findings on ‘saving water by Surgical Hand rubbing’.

Global healthcare system faces an urgent need to tackle surgical errors amid downstream issues caused by resource constraints and burgeoning demands for science and technology. Studies are needed to find tailor-made improvements in particular settings viz. surgical timeouts and verification of surgery site amid infrastructural changes embracing advances in science and technology. This review provides a conceptual and contextual framework to locate surgical errors and consequences to innovate ways to improve patient safety. Search of databases viz. PubMed, Scopus, Google Scholar, and ResearchGate was conducted from among published literatures that included definition, classification, and categorization of surgical adverse event and errors, checklist, and safety issues across surgical disciplines in their pre-, intra-, and post-operative phases, further allowing and including references of literature sourced as potentially relevant studies. From 22 published literatures, we reported outcomes including adverse events, complications, and errors. Variations of a reported scale of a surgical error stemmed from the absence of universally accepted definition, categorization, classification, and research method. In orthopedics, risk factors for the wrong-site surgery mostly occur among other surgical errors. The WHO-promoted checklist has been globally tried in array of settings as a promising tool to mitigate errors. Ongoing studies to improve the paradigm of quality of perioperative care is identifying potential hazards to reduce complications, suggested capacity building, and improved communication among operating room personnel as key to patient safety. Ethical practice of care should be a mainstay to optimize patient safety by improvised checklists in different set-ups for optimum clinical outcomes. Significant upgrading in outcomes can be attained by scrutinizing a total surgical work corridor by rigorous adherence to safety protocols before, during, and after operation as majority errors transpire outside operating table.

Background: Medication Errors (ME) are a major global health concern across all health systems and can negatively impact patient safety, health expenditure, and health system efficiency, especially in Low- and Middle-Income Countries (LMICs). Aim and Objectives: Assessing the risks associated with medications and the acting risk mitigation interventions, as well as the building of research capacity at all levels, health care systems and disciplines. Methods: All relevant disciplines within the health care system and mitigation plans were examined, using all available databases and search engines to identify and query relevant literature. Results: Complications, secondary adverse outcomes and a summary of the influenced impact of errors were retrieved and compiled from 23 scattered published articles among the health databases. These errors and adverse outcomes lead to a considerable amount of death, morbidity, higher length of stay in health institutions, and higher costs of health care. The outcomes illustrate the necessity of overcoming these knowledge gaps and the need to employ integrative approaches to mitigate MEs, and improve the patient safety of the health care system and overall. The gaps in the estimated magnitudes of data errors are due to gaps in definitions, typologies, and methods of analysis. Conclusions: In the pursuit of safety improvement across disciplines in diverse fields and work environments, utmost compliance with instructions, restructuring of checklists, and adherence with ethics are the main pillars of mitigating errors and achieving a healthy system with improved care. Focus should be on health impact assessment, MEs, healthcare, healthcare safety, and healthcare checklists. There is a need for more in-depth research to understand risks and strengthen safety protocols. This can be achieved by tailoring practices to the specific features of LMICs. Investment is overdue to understand the risks, build systems and strengthen communication during a safety paradigm shift. The research team focuses on tailoring healthcare systems to optimize safety and quality while minimizing MEs to design a safety and quality reporting system.

Background: There is need to collate the evidences on the prevalence of diagnostic errors and their influence on hazardous outcomes to affect efficiency, cost and safety in healthcare delivery. Objectives: This review addressed diagnostic errors in terms of epidemiology, hazards, impacts, challenges to suggest holistic recommendations to all the stakeholders, researchers and administrators. Methods: Electronic public domains viz. PubMed, SCOPUS, GoogleScholar, ResearchGate. and manual search on diagnostic errors and interventions implemented by clinician in clinical environment, searched for literatures published between January 2005 and June 2025 for common errors concerning the diagnosis in the practice directed towards the patient, direct and indirect repercussions on health and financial and operational aspects of healthcare, challenges, research and interventions to improve patient safety by checklists using PRISMA reporting guidelines. Results: A total of 291 articles were screened of which 28 studies met inclusion criteria of our review. Data extraction was done by two groups, each group comprising two independent investigators from Review (n=20), Cohort study (n=2), Cross-sectional, (n=3), Controlled intervention (n=2), Invited Commentary (n=1). WHO check list, digitalization and AI are showing potential solution for error reduction amid ethical, legal, quality assurance issues. Conclusions: Our analyses revealed evidence on prevalence, risk correlates and interventions to limit DEs being feasible in clinical settings across High Income Countries (HICs) and Low and Middle Income Countries (LMICs). A comprehensive approach is needed to ensure safety by quality of care at every patient interface, capacity building and systems approach to enhance accuracy and ensure updating.

Background: The perception of caregivers on immunization is of paramount importance to combat -childhood morbidity, mortality and disability. Objective: This study was conducted to find knowledge, attitude and practice (KAP) of caregivers on immunization of under-5 aged children of rural Bihar. Method: A mixed-methods study was conducted at the outpatients departments of rural medical college from November 2023 to October 2024 among 384 caregivers of under-5 children using a pretested questionnaire to evaluate KAP on immunization. The data were analyzed using descriptive statistics and presented with categorical variables. Results: Significant proportion (94.8%) of caregivers showed a positive mindset regarding immunization as safe and essential for kids. Important challenges to complete immunization included lack of awareness, remoteness to healthcare facilities, and false belief about adverse effects following immunization; majority of caregivers were literate (79.2%) and homemakers (85.9%). Majority (89.1%) of the children received all mandatory childhood vaccines, while 9.4percent were partially immunized. Discrepancies in knowledge were noticeable; typically (90.1%) caregivers were unaware of disease prevented by BCG vaccine. ASHA workers and Anganwadi centers served as the primary sources of immunization information to caregivers. Sociodemographic factors, viz., literacy and socioeconomic status, were found to be significant determinants of immunization coverage. Conclusions: Our study noted that caregivers mostly had positive standpoint amid limitation of knowledge on advantages of immunization from poverty and illiteracy. These findings will definitely be beneficial for Practitioners of Family Medicine and Primary care givers.

Introduction: Pain is the most unpleasant subjective feeling comprising of innumerable emotional and psychological components that require medical advice for relief, regardless of the cause. Transversus Abdominis Plane (TAP) block and Erector Spinae Plane (ESP) block are effectively studied blocks that provide adequate pain control. Aim: To compare postoperative analgesic efficacy in pregnant women undergoing caesarean section under spinal anaesthesia with Ultrasound (USG)-guided TAP block and USG-guided ESP block. Materials and Methods: In this institution-based interventional randomised clinical study, two categories comprising 30 subjects in group I with USG-guided bilateral TAP block and group II with USG-guided bilateral ESP block using Ropivacaine were involved. Visual Analogue Scale (VAS) was used to compare analgesic efficacy. Other parameters for analysis included time of first rescue analgesia, total number of administrations of rescue analgesia within 24 hours, together with Adverse Drug Reactions (ADRs). Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 21.0. Student’s t-test and Chi-square test were used for data analysis. Results: Subjects in group I had a mean age of 24.9±4.66 years while those in group II were 25.5±3.99 years. The VAS score at 24 hours in group I was 7.22±0.89 and in group II was 6.8±0.83, which was statistically significant with a p-value of 0.0241. USG-guided ESP block was superior to USG-guided TAP block, providing analgesia for 24 hours. Following the first dose, there was a significant delay in rescue analgesia and a reduction in the total administration of rescue analgesia within 24 hours. The first rescue analgesia in group I was at 10.66±2.32 hours and in group II was at 16.66±2.53 hours, with a p-value of 0.0001 indicating a statistically significant difference. No ADRs were reported in either group of participants. Conclusion: ESP block provided a prolonged duration of analgesia, as shown by a decrease in the total VAS score. There was also a significant reduction in the total number of administrations of rescue analgesia within 24 hours when compared to TAP block, suggesting that ESP block provides superior analgesia. Hence, for pain relief in postcaesarean section individuals, ESP block can be regarded as a novel potent option.

Background: Many studies have shown the beneficial effect of prophylactic lidocaine or esmolol on hemodynamic response during laryngoscopic intubation. Although many studies observed a better effect of esmolol over lidocaine, some studies have drawn an impression of equal efficacy or even no benefit with the use of either of the drugs. Aims and Objectives: The study aimed to compare the heart rate (HR) at 1 min after intubation between the patients receiving lidocaine and esmolol. Other outcome measures were to compare HR at 3 and 5 min post-intubation and to compare the mean arterial pressure at 1, 3, and 5 min after intubation. In addition, the adverse events, if any, were noted. Materials and Methods: Fifty patients, 30–45 years, either sex, Mallampati grade 1–2, of the American Society of Anesthesiologists physical status I-II, posted for elective abdominal surgery requiring direct laryngoscopic endotracheal intubation were included. Patients were randomly allocated into two groups to receive esmolol 2 mg/kg (Group E, n=25) or 2% lidocaine 2 mg/kg (Group L, n=25), intravenously. HR and mean arterial blood pressure (MAP) were recorded at 1-, 3-, and 5-min interval post-intubation. Results: The mean HR at 1-min post-intubation was considerably lower using esmolol in comparison with lidocaine (91.7±9.7 vs. 107.7±5.1, P≤0.0001). The mean HR and MAP at 3-min and 5-min post-intubation were considerably lower with the use of esmolol compared with lidocaine. Conclusion: Esmolol is better than lidocaine in attenuating the hemodynamic response of intubation.

Background:The role of caregivers in grooming the neuro-developmental outcome of high-risk newborns and developmental challenges in children needs to be explored. Objectives:To find the knowledge and perception among parents regarding the neuro-developmental outcome of high-risk newborns, methods adopted to address these problems, and to identify areas on which awareness generation needs to focus. Materials and Methods:A questionnaire-based awareness survey was conducted to understand the knowledge, attitude, and practices of families of children with developmental challenges. Results:The study revealed that more than 70 percent of families lack information about child development, developmental challenges, and means to deal with them. They are unaware of the available health care services and other resources. One in three families has misconceptions on developmental disabilities; consider them as curse or jinx and consequently neglected. Female children with developmental problems are further ostracized due to gender inequity in families. About 10 percent of families have shown great openness toward acquiring new skills and knowledge for handling their children with developmental delays. Conclusions:This study is based on the précis research findings of our grass-root level fieldwork conducted in remote rural Bengal areas. The observation will be of interest and learning materials for general primary care practitioners, family physicians, and stakeholders to initiate appropriate intervention strategies for properly rehabilitating children with developmental delay at grass-root levels of primary health care.

Background: Early childhood development (ECD) is the foundation of future life starting from conception and depends on biological and environmental factors. Seventy-four percent of these children reside in villages; many are underserved and marginalized. Enabling young children to achieve their full developmental potential is a requisite for sustainable development, but globally, 43% of children are still at risk to do so. The problem of ECD is grave for underprivileged rural population in India. Objectives: The objective of the present study was to identify the key risk factors that are prevalent in a marginalized rural community in West Bengal and to observe the impact of these impeding factors on ECD, thereby helping in priority setting in service delivery to optimize ECD promotion. Methods: In this community-based cross-sectional observational study, a random sample survey of 609 households with children 0–6 years was conducted in Purulia district, West Bengal, India, using a Multiple Indicator Cluster Survey III-based questionnaire followed by data analysis. Results: Lack of stimulatory home environment, poor learning opportunities, and inadequate responsive parental care were major hindrances. The cumulative effect of multiple other health and hygiene factors was also hindering ECD. Most factors were strongly influenced by poor maternal education. Conclusion: Education of caregivers, especially parents by dedicated health workers on early learning opportunities, showed the path of applied sciences in pediatric clinical practice. To modulate socioeconomic adversities with responsive parental care, ECD can be fostered.

Background: Artificial intelligence (AI) is increasingly gaining importance in modern medicine. Yet, there is a dearth of knowledge on what the anesthesiologists know and think about AI in context. The objective of the study was to find conceptual, contextual, and translational aspects of AI among current practitioners of anesthesiology. Methods: This investigator-initiated, open-label, analytical, cross-sectional, noninterventional study was conducted from February 15, 2024, to March 21, 2024, with personal pursuance on consenting practitioners of anesthesiology using pretested partially open-ended questionnaire from across India. Results: Among 102 respondent anesthesiologists from diverse domains of anesthesiology and wide spectrum of experience and expertise, the majority were in the fifth decade of life, male and qualified professionals; the minority were faculty members and had a decade of practicing experience. Their concepts on techniques, applications, and safety of AI including levels and potentials of use were significant so far as predictive algorithms, assessing vital parameters and perioperative care were concerned. Their attitude on techniques and applications of AI was overall positive on innovation, integration, and employment of algorithms to reduce adverse events and on the incorporation of capacity building as a doable entity. The intended practice was overall significant on techniques and putting into effect an update and institutional practices of AI including predicting problems in real-life practice. However, the majority was apprehensive on the use of AI aligning it with a machine and expressed ethical concerns. Conclusion: The respondents felt that innovation, integration, and implementation of AI in anesthesia can heighten precision and safety in rural and remote areas of all surgical specialties.

Background: Frontline healthcare workers, a vital workforce in developing countries is often out of mainstream vision and their challenges and coping behaviors under stressful conditions remain unclear to stakeholders. This study was undertaken with the objective to explore the challenges faced by community surveillance workers and their coping strategies during COVID-19 pandemic. Methods: A qualitative descriptive study with constructivism paradigm was undertaken for a period of one year by conducting eight focus group discussions and eight in-depth interviews among the health workers undertaking COVID-19 surveillance selected purposively from eight wards within three Boroughs of a Municipal Corporation using interview guide. Thematic analysis was used to compare and contrast the codes to generate themes inductively under two constructs. Results: The first construct, factors influencing work related stress was categorized into four themes related to- work environment, community’s response towards pandemic surveillance, organizational support and personal factors. Main predisposing factors of work place stress were risk of self-infection, concern for family safety, inadequate training, shortage of manpower and protective equipment etc. While a strong commitment towards work, assistance from local community influencers, administrative appreciation and supportive supervision were protective factors against stress. Second construct on coping strategies was categorized into managing stress by problem-focused strategies like adapting with experience, gathering information and sharing experiences, adopting self-care practices; while emotion-based coping strategies included denial, venting out, or turning to religion etc. Conclusion: Community surveillance workers faced considerable and variable stress during pandemics due to various underlying work stressors, managed innovatively, using self-coping strategies.

Background: Adverse drug reactions (ADRs) have national and international monitoring and are part of teaching–learning of undergraduate medical course and curriculum. Objectives: To find the knowledge and perception of ADRs among undergraduate medical students in a tertiary care teaching institute in eastern India. Materials and Methods: This was an observational cross-sectional study conducted among the MBBS medical students by administration of pre-designed, pre-tested, semi-structured questionnaires. The data on their knowledge and candid reflections on ADRs were analyzed question by question using software and compared with peers. Results: The responses from the participants on knowledge and perception of ADRs varied widely. Final-year students had the most precise response on classification, filing an ADR report, national reporting centers, and the first step in monitoring ADRs; the majority accepted their first- hand experience and legal and professional responsibilities on ADRs. Third-year students responded well on objectives, methods, and scope of patients on direct reporting or drug overdose and monitoring; respect patient confidentiality while reporting; and expect feedback from monitoring centers, with special training on ADR. Second-year students responded well on definitions, pharmacovigilance programs in India, alertness of banned drugs because of ADR, and related capacity building. Conclusions: The awareness and insight on ADRs of the undergraduate medical students were quite reasonable. However, further reinforcement is needed in future to be updated to relevant issues to their practice as primary care physicians.

The reasons for high morbidity and mortality with Corona virus disease (COVID-19) disease remain unanswered with extremes of manifestation and uncertainty of modes of transmission for which biomarkers are urgently needed for early prediction of severity and prompt treatment. We have reviewed publications from PubMed (years 2019–2021) analysing the biochemical, immune-inflammatory, nucleic acid, and cellular biomarkers that predict infection, disease progression in COVID-19 with emphasis on organ-specific damage. Our analysis of 65 biomarkers assessing the impact of SCoV-2 infection on five organs (lung, liver, cardiac, kidney, and neural) reported that increased levels of CRP, TNF-α, ferritin, IL-6, D-dimer, Procalcitonin, Fibrinogen to Albumin Ratio (FAR), and decrease platelet count (PC), lymphocyte count, leukocyte count, and CD4+/CD8+ ratio shows promising association in the early diagnosis, prediction of prognosis and severity disease and also correlates with cytokine storm a cardinal feature of COVID-19 progression. In the above scenario, this review has put forth the most promising biomarkers for COVID diagnosis and prognosis based on the reported literature. In recent year's chemically synthesized antibody-like biomolecules, aptamers were also used in the diagnosis of COVID-19 which could be preferably used for diagnosis over antibodies. Biomarkers including increase in free DNA and Fibrinogen-to-Albumin Ratio, CRP, PCT, and Ferritin along with a consequential decrease of CD3+ T, CD4+ T, CD8+ T, NK cells with corresponding increase in CD4+/CD8+ ratio following SARS CoV-2 infection has been consistently correlated with disease severity. Despite the two waves of COVID-19 pandemic, currently there is no standard clinical practice guideline for evaluating the severity of the devastating pandemic of COVID-19, hence these biomarkers will have immense relevance for the third and subsequent wave of COVID-19 and related pandemic.

Background Adverse events after immunization are an integral part of meningococcal polysaccharide vaccine that need to be minimized by a holistic approach from production to administration. This study aimed to characterize serious adverse events in meningococcal vaccine recipients. Methods A search was carried out following a strategy Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using PubMed, EMBASE, EBSCO, and SCOPUS databases till May 2020. A series of cases, observational prospective and retrospective cohort, case and control, randomized control trials, and patients of any age vaccinated against meningococcus were included. Results A total of 8 selected studies included 7,213,663 children and adults, immunized with meningococcal vaccines. Adverse events in the neurological system are shown (4 studies); the most important are seizures, respiratory system (dyspnea and bronchospasm) and dermatological reactions (angioedema), anaphylaxis, and infectious processes. Conclusions Vaccination is adequate protection against meningococcal infections, with reported minimal adverse effects after immunization that do not constitute absolute contraindications to vaccination except allergic or anaphylactic reaction that needs further evaluation.

The ongoing global spread of SARS-CoV-2 infection and the resulting COVID-19 pandemic had led to health care requirements which are labour and resource intensive to manage. This has led to acute shortage of medical essentials, in almost all countries of the world with increased demand for healthcare supplies at a time when there is a simultaneous disruption in the supply chain. The pandemic has shown beyond doubt that none of the countries in the world from high income to low- and middle-income countries had ready mitigation strategies to handle such a pandemic, with overwhelming shortages leading to loss of hundreds of thousands of lives. New practices and procedures have been created by making modifications within the existing framework of procurement norms, with extraordinary emergency powers to facilitate emergency purchases. There is a continuous and ongoing urgent requirement to procure various essential items, all within a short time frame, which may not be available with the regular or a single vendor. This has to be balanced and judicious, being carried out under extremely tight deadlines, and pose major challenges to maintain inventory control of critical goods required to keep the required humanitarian services up and running.

Clinical practice guideline on anticoagulation is intended to manage patients undergoing neurosurgical procedures for the best possible short and long-term outcomes. In the clinical office practice, anticoagulation is offered to prevent thromboembolism with Warfarin, Heparin, Novel Oral Anticoagulants. The management approach starts with the mitigation plans from a reversal of pre-procedural anticoagulants for impending neurosurgical procedures by estimating procedural bleeding risk on the patients. The haemorrhage criteria and the timing of procedures are best assessed by the proceduralist during and after the intervention, standing on ground situations. Yet, intra- and post-procedure anticoagulant therapy should induct a multidisciplinary consultation paradigm for the best outcome in any emergent scenario. Further, each anticoagulation event should be monitored closely with competence in the optimum reversal process. Different neurosurgical procedures also should be weighed for their inherent hazards along with the probabilities of the bleeding and thromboembolism. The treating team should also concur to suggest a resumption of the pre-procedure anticoagulant therapy which may have been in place for altogether different morbidities. Regarding the anticoagulant agent, there are special conditions and recommendations to bear in mind in the daily medical practice for patient management. In the clinical practice guidelines for neurosurgical procedures, decisions about initiation and continuation of anticoagulants require experience and thorough internalization of the planned procedure, to avoid the risks of inherent risks of bleeding and thromboembolism.

Background: Depression is a hidden pandemic among adolescents with multi-factorial causal risk and risk correlates. Objectives: To find the prevalence of depression and risk factors among school-going adolescents. Methods: A cross-sectional study was conducted among 838 adolescents enrolled in 6th–11th standards (age: 11–19 years) in 15 urban schools in Patna city by using the modified Patient Health Questionnaire-9 (PHQ-9); binary logistic regression was applied to find significant risk correlates. Results: Depression was noted among 51.2% adolescents of our study participants: mild 32.3%, moderate 14.3%, moderately severe 3.9%, severe depression 0.6%; among early adolescents (46.2%; boys-21.2%, girls-78.8%) and among late adolescents (55.3%, boys-34.7%, girls-65.3%). Adolescent depression was significantly associated in our study with female gender, late adolescence, higher classes (9th–11th), vegetarian diet, soft drink consumption, fast foods, screen time, domestic harassment, academic dissatisfaction, parental discord as well as mental illness. Girls had higher risk who were in higher classes, on a vegetarian diet, habitually on soft drink, more screen time (>3 h), face more family nuisance, parents brawling frequently, and suffering from known mental diseases. Conclusion: Depression was noted in more than half of the adolescents, with a higher prevalence in girls, scholastic failure, higher grades, vegetarian diet, more screen time, familial disease, and conflict.

CoVID-19 is the most formidable unequaled global challenge invading 220 countries and territories in this millennium to uncountable saga of mortality, disability as humanity is witnessing devastation of socio-economy with more than 4 million deaths till date. The natural history of CoVID-19 from transmission through varied clinical features to overt complications is still under global research and research groups are on the run to trace its ramifications. This ranges from primary involvement of the pulmonary system to multisystem involvement through web of immunological pathways associated with susceptibility, clinical presentations, and severity of COVID-19. It has been hypothesized that the safe and effective mass vaccination program across the globe can ensure flattening of the pandemic curve to prepandemic normal life. This research group explored the basic and applied researches on molecular and immune mechanisms of SARS COV-2 virus. A sincere attempt has been made in futuristic research vision to find potential strengths, shortfalls, and efficacy of the plant-based immunotherapy, antibodies, and vaccine. Different research groups have hypothesized for the best possible use of these indigenous, stable, secure, efficacious natural products by searching their potential to accomplish emergency demands in this trying time. There is an urgent need to understand the inherent immunological predictors of the natural history of the disease spread over the spectrum from mild to severe forms of the disease and harp on these issues. In the wake of multiple waves with worse situations of evolving clinical features with the “variants of concern” and “variants of interest” and innovative interventions, this research group believes in optimum mix of microbial-derived biologicals with immune modifying drugs will broaden the preventive and curative spectrum.