Background: Pregnancy-induced hypertension is one of the major health problems leading to maternal mortality. Globally, one woman dies every 7 min due to hypertensive disorders of pregnancy (HDOP). Pre-eclampsia and eclampsia contribute majority of maternal, perinatal morbidity and mortality. The objective of this meta-analysis was to estimate the pooled prevalence of pregnancy-induced hypertension in India. Methods: A systematic search was done through PubMed, Google Scholar, MEDLINE, EMBASE and Scopus for studies conducted on HDOP. All studies that met inclusion criteria published till January 2020 were included and analysed. The analysis was done using STATA 20.0 software (STATA Version 20.0 is sufficient). The pooled prevalence of hypertension in pregnancy was estimated using both mixed-effects and random-effects models. Results: A total of 18 studies with 92,220 study participants (pregnant women) were included in this review. The estimated overall pooled prevalence of HDOP in India was found to be 11% (95% confidence interval, 5%–17%). Most of the included studies were cross sectional and from the southern zone of India. Conclusions: The overall pooled estimate shows high prevalence, i.e., 1 out of 11 women suffers from pregnancy-induced hypertension. High prevalence of hypertension in the study population demands the attention of policymakers and healthcare professionals. Better implementation of early screening of hypertension during pregnancy should be undertaken.

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Coronavirus disease-19 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in massive health and economic burden. There has been substantial morbidities and mortalities owing to its high transmission rate. Therefore, effective strategies for treatment and prevention are crucial. Vaccines offer a ray of hope for the prevention and controlling the spread. Various new technological platforms have been utilised for vaccine production. The current review provides a brief description of these platforms for vaccine production and an update on the available and upcoming COVID-19 vaccines, discussing their results and outcomes from different trial phases. We have also focused on COVID-19 vaccination drive in India, emergency use authorisation, other candidate vaccines in Indian landscape, and issues involved with their clinical use and current recommendations.

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Gallbladder duplication is a rare congenital anomaly. Knowledge of its various types is important since it can complicate cholecystectomy. Many varieties of gall bladder duplication and its classification are reported in the literature. Pre-operative diagnosis plays a crucial role in the planning of surgery and preventing possible injuries or re-operation if the accessory gallbladder has been overlooked during the initial surgery. Gallbladder duplication though rare requires special attention to pre-operative anatomy and its variation. The operative challenge is more than the usual laparoscopic cholecystectomy and should be done by fundus first approach by an experienced laparoscopic surgeon. We report a case of a 44-year-old -male who presented with biliary colic. His pre-operative imaging confirmed the diagnosis of the duplicated gall bladder, and he underwent successful laparoscopic cholecystectomy.

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Background: The abuse and neglect of older people in the family context are emerging as a significant social, as well as a public health concern that is affecting the overall quality of life (QOL) of the elderly. Aims: The main objective of this paper was to study the experience of abuse and its relation with QOL of older people in rural Nepal. Methods: This is a cross-sectional, community-based survey carried out in the Kailali district of Nepal. The total sample size for this study was 547 people aged 60 years and older selected randomly. QOL was measured using the World Health Organization QOL scale popularly known as WHOQOL-BREF. Elderly abuse was measured by asking questions related to elderly abuse in the last 1 month. The descriptive technique is used to analyse the data. Descriptive, chi-square tests and F-test was used to analyze the data. Results: The findings show that about one-sixth of males (15.6%) and one in every seven females (14.3%) have faced any type of abuse in the last 1 month. This study found that overall QOL score of the Nepalese elderly was moderate (12.92 ± 1.75). The mean scores of the overall QOL index of people experiencing abuse were observed significantly low (12.28 ± 1.74) compared to those who did not experience any abuse (13.04 ± 1.73). Conclusions: Elderly experiencing abuse have significantly low QOL compared to not abused elderly in Nepal. The experience of abuse was elicited in the last 1 month. This study was carried out in specific rural area and cannot be generalised to all Nepali older people. Local activities and awareness to discourage older person's abuse should be encouraged that may help to enhance the QOL of older people.

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Background: North India has a very high incidence of Carcinoma gallbladder (GBC). The aim of the study was to identify the hotspot regions and relationship of gallstones to GBC in two northern states of India. Materials and Methods: It was a retrospective, observational, hospital-based cohort study. The data of patients with locally advanced (LA) or metastatic GBC from January 2019 to December 2019 were evaluated for geographical distribution of cases, and their clinical spectrum was compared with the presence or absence of associated cholelithiasis. Statistical analysis was performed using R Statistical software version 3.6.2. Results: Forty-two patients were enrolled in our study. A high burden of GBC was observed from Western Uttar Pradesh (District Bijnor 12(29%) and Muzaffarnagar 7(17%)) and Uttarakhand (District Haridwar 7(17%), whereas the remaining 16(38%) patients were residents of other districts of Uttarakhand (UK) and Western Uttar Pradesh (UP). In our study, only 17(40.5%) patients had associated cholelithiasis. Metastatic disease at presentation was seen in nearly 59% of patients with cholelithiasis and 52% of patients without cholelithiasis. Jaundice was the most common presentation in 12(70.6%) patients, followed by pain in 9(nearly 53%) patients with GBC associated with gallstones. Whereas in patients with GBC without gallstones, loss of appetite and loss of weight was the most common presentation in 16(64%) followed by jaundice in 13(52%). Conclusion: Most cases with LA or metastatic GBC in the present study were not associated with cholelithiasis. Clinical spectrum of either LA or metastatic GBC is similar, irrespective of presence or absence of gallstones.

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Background: Online Registration System (ORS) is latest method of appointment in various hospital, which is very easy method and ultimately shorter queues of hospital. No research has been conducted which shows any challenges faced by patients during online registration in hospitals. Aims: The main aim of this study was to investigate challenges faced by patients during online registration in tertiary level hospital, Uttarakhand. Patients and Methods: A cross-sectional descriptive study using non-probability sampling techniques was conducted on 400 patients visiting outpatient department (OPD) using self-structured questionnaire. Results: Majority (99.5%) of participants were familiarised how to operation of smartphone or electronic devices for online registration. Majority (71%) participants were knowing that online OPD registration system is a method of registration in hospital, but only few (26%) were doing it. Main barrier faced by participants that they do not know how to do online registration process, that why they did not do online registration of their patients. Conclusion: The study concludes that online registration process should be simpler so that people can be easily use. More awareness campaign by mass media communication also required, so that people should know how to effectively use ORS.

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Background: Considering the impending crisis of COVID-19 and hospitals across India and the world gearing up to manage such cases, an online survey to assess the baseline psychological symptoms in health-care workers (HCWs) of a single tertiary care hospital was designed. The survey was cleared by the institutional ethics committee. Materials and Methods: An online self-reported survey was designed on the Google Survey portal, COVID: A survey of stress (SOS COVID) and posted on various closed WhatsApp group of employees. A snowball sampling method was adopted. We collected self-reported data on socio-demographics and data in relation to COVID-19 patient care, depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), insomnia (Insomnia Severity Index) and perceived stress (Perceived Stress Scale-10). Results: Two hundred and twenty-seven participants responded to the online survey. The mean age was 28.77 years, 64% were female, mostly (74.9%) resided outside the campus and approximately half (46.7%) were frontline worker. On average, participants had low scores on all the scales, but approximately 23% scored above the cut-off for either moderate to severe depression, anxiety or insomnia. Those scoring higher (lower) in one scale also scored similarly on other scales. The chances of scoring above cut-off were significantly higher in females (P = 0.022), postgraduate educated (P = 0.018), physicians (P = 0.006) and residents of the campus (P = 0.011), though being a female and a physician persisted as significant predictors on logistic regression analysis. Conclusions: The COVID-19 pandemic created considerable anxiety and stress among the HCWs. The most vulnerable HCWs are women and physicians who may require special support services to address the extra burden of psychological distress.

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The purpose of this article is to summarise the major features of the National Nursing and Midwifery Commission (NNMC) Bill, as well as the opportunities and challenges that the proposed legislation presents. We look forward to improved professional standards, title protection, higher quality education, precise scope of practice guidelines and standardisation of nursing and midwifery registration as the Indian Nursing Council gets replaced by the National Nursing and Midwifery Council. We are hopeful for a rapid start and expansion of advanced nurse practitioner programmes, which will allow for increased participation in the country's health system and the advancement of health-care goals.

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Socio-economic status is the key parameter for understanding the affordability of the community of health services and their purchasing capacity. Kuppuswamy's socio-economic scale based on educational, occupational status of head of the family and overall aggregate income of the whole family measures the socio-economic status of urban areas. The scale changes with the updated values of consumer-price index and base year.

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This article reviews the ongoing initiatives to prevent and control cardiovascular diseases (CVDs) and non-communicable diseases (NCDs) in India and analyses the role of primary health care (PHC) system. The authors note that in last 2 decades, there has been increasing policy recognition of the challenges posed by CVDs and NCDs in India. The review of ongoing government health program in India indicate that while the interventions to tackle CVDs and NCD have also been launched and scaled up, a majority of these initiatives continue to be delivered through district or sub-district levels. Though, there has been plans, the scale up through PHC system is at early stage only. There is sufficient scientific evidence that the effective prevention and control of CVDs need accessible health services and a series of public health interventions through strengthened PHC system. There are learnings from COVID-19 pandemic response in India (in areas such as private sector engagement, effective enforcement of health regulation, community engagement and the use of tele-consultations), which can be useful. The authors conclude that a strengthened and well-functioning PHC system can ensure increased access to CVD and NCD services. As India plans to scale up ongoing health programs and launch a few new initiatives, the learnings from the past, documented in this paper, could be useful. These steps would help India to accelerate progress towards universal health coverage.

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An ideal medical college not only delivers medical education but also introduces new trends in medicine. There are numerous elements of an ideal medical college. In this article, a comprehensive list of some of the elements is given, which are often ignored by medical students and medical institutions. The list includes acceptance to change, medical research, technical advancements in medicine, communication skills, public health, some structural changes in medical education, teaching methods and assessment of students, burnout and mental health issues among students. However, this list is not exhaustive, and only continuous feedback can help a medical establishment to reach the epitome of idealism.

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