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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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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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Medication-related osteonecrosis of the jaw (MRONJ) is one of the most challenging condition that clinicians come across owing to its varied degree of presentation defined in literature. In rheumatoid arthritis (RA), individuals are under the influence of varied medications which might impact the bone turnover. Hence, this narrative review has been undertaken to specifically discuss development of MRONJ in RA, to study the associated risk factors, to highlight the importance of oral health care and to revisit the concepts of medications related to the above said condition. PubMed and Cochrane database search was done in English language literature using the term “Medication-related osteonecrosis of jaw and rheumatoid arthritis” and “bisphosphonate induced osteonecrosis of jaw and rheumatoid arthritis”, which resulted in 45 articles. It was concluded that MRONJ is a multifactorial condition, seen concomitantly with various medical co morbidities like thromphophilia, hypertension, kidney disorders, osteoporotic conditions, arthritis, and various medications like steroids, bisphosphonates and other drugs affecting metabolism of bone. Literature has often tried to prove the association of RA in MRONJ causation, however there is no uniform agreement on the same. Though various risk factors have been delineated, but multiple evidences suggest that RA may prove to be a major risk factor. Present review supports the same and also highlights the growing evidence on the role of emerging new drugs in MRONJ development. Also utmost dental care, appropriate patient education, reduction of infective foci prior to initiation of medical therapy, patient compliance and regular follow up is required for reduction of number of patients presenting with MRONJ.

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Background: Handwritten language is one of the key learned expertises of the human brain and preferred modes for long-distance communication. The dexterity and hand dominance in written language are well-known phenomenon. Normally, we are accustomed to writing with one hand only. Literature suggests that the dual task of attention interferes with the performance of one task and/or the other, as these tasks use the same attentional resources. Aim: The aim of this study was to investigate the quantitative electroencephalographic (EEG) correlates of non-dominant handwriting (NDHW) as an attentionally demanding task. Materials and Methods: We conducted a study on 35 male native Hindi speakers, well accustomed to reading and writing. The intervention consisted of 5-min writing with the DHW and NDHW with concurrent EEG recording. The EEG electrodes were applied according to the 10–20 international system of electrode placement. EEG signals were analysed offline. The outcome measures were fast Fourier transform transformed absolute power in delta (1–4 Hz), theta (4–8 Hz), alpha (8–14 Hz), beta (14–30 Hz) and gamma (30–50 Hz) frequency bands at 19 electrode positions. Medians of 10 epochs from artefact-free regions of EEG during NDHW and DHW were statistically analysed. Results: The task of NDHW was associated with decreased absolute powers in frontal and occipital leads mainly in delta and theta frequency bands and at frontocentral leads in the alpha band. Absolute powers in the beta frequency band were increased mainly at frontal and decreased posteriorly, while there was a generalised increase in gamma-band power. Conclusions: NDHW task as compared to the DHW task has distinct EEG correlates suggestive of a stressed attentive mental state.

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In Eastern, philosophy meditation is considered part of a yogic lifestyle. Meditation is increasingly being popular amongst the masses and routinely practiced for well-being and as a means to alleviate stress and related disorders. There are various types of meditation practices prevalent across the world and with a boom in social media and communication technology we are widely exposed to many types of meditation practices. Still, the selection of meditation is mainly based on common intuition or layman recommendations. However, there are large variations in personality, temperament, and external circumstances of an individual. With the progress of scientific research in the meditation field, all kinds of meditation can be broadly classified into major three types: focussed attention (FA), open monitoring (OM) and automatic transcendence (AT). The neurophysiology of meditation has given insight into selective functional brain networks activation such as executive control network (ECN) in FA type and default mode network (DMN) in AT type of meditation. ECN provides substratum for the focussed attention and DMN for the mind-wandering state. One fundamental question is what factors lead to oscillations of the brain between two states. Here, we are proposing that oscillations of the brain in these two states are chiefly determined by the daily life challenges and a nice way to group daily life challenges is by Maslow's hierarchy of needs. The individuals lower in this hierarchy are required to execute more of ECN for the successful survival. In this paper, we are hypothesising the detailed intricacies of the selection of meditation based on the position of an individual in the pyramid of needs and their predominant functional brain states.

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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 SARS-CoV-2 viral load may have importance in assessing COVID-19's pathogenesis, clinical presentation, diagnosis, treatment, prognosis and infectivity. The severity of the disease has been attributed to the dysregulated immune mechanisms, but studies have suggested a correlation between disease severity and viral loads although evidence is not strong enough in justifying the same. Viraemia is shown to be keenly related to the disease progression. Viraemia has an association with increased Interleukin-6 levels and poorer prognosis. In terms of symptomatology, any definite correlations are not yet deduced, with no difference in viral loads among symptomatic and asymptomatic individuals. Reduction of viral load may be used as a marker of treatment success. Cycle threshold (Ct) values correlate with the SARS-CoV-2 viral loads. Ct values have shown a correlation with viral cultures and sub-genomic RNA values, both of which are considered the gold standard for determining infectivity but are expensive. Thereby, Ct value titres form an economical basis for deciding the de-isolation of the patients, which has implications in better resource management. Various limitations of viral load testing, especially of Ct values including human and laboratory factors are also discussed.

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