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   Table of Contents - Current issue
January-June 2021
Volume 6 | Issue 1
Page Nos. 1-110

Online since Thursday, April 8, 2021

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Extranodal non-Hodgkin's lymphoma of the sinonasal tract: A review Highly accessed article p. 1
Santosh Kumar Swain, Satyabrata Acharya
Lymphoma is classified into Hodgkin's lymphoma (HL) or non-HL (NHL). NHL is more commonly found in the head-and-neck region. Majority of the extra-nodal location for NHL is the Waldeyer's ring. These NHLs are rarely found in the sinonasal tract. The clinical presentations of the extra-nodal sinonasal NHL are usually nonspecific. Computed tomography scan of the head-and-neck region usually reveals the extent of the neoplasm. However, the confirmatory diagnosis is done by the tissue biopsy and study of the immunohistochemistry. The treatment modality is controversial in regards to the best therapeutic option. Chemotherapy or concomitant chemoradiation is an important treatment option. Surgery has a limited role for the treatment of the sinonasal NHL. The increasing prevalence and the significant morbidity of the sinonasal NHL are often critical to do early diagnosis and treatment. Early diagnosis along with continuous monitoring and close follow-up are recommended for the early diagnosis and effective treatment. Clinicians should have knowledge regarding the clinical presentations of the extranodal NHL. Correct and timely diagnosis is helpful for effective treatment of the sinonasal NHL. The aim of this review article is to discuss about the etiopathology, clinical presentations, investigations, and current treatment of the sinonasal NHL.
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Obesity and chronic leptin resistance foster insulin resistance: An analytical overview p. 7
Sananda Dey, Nensina Murmu, Mayukh Bose, Shilpi Ghosh, Biplab Giri
Leptin is secreted from adipose tissue, maintains energy balance in our body, and regulates appetite via arcuate nucleus of the hypothalamus. It binds with its receptor (LepR) to kick-start multiple reaction cascades such as Janus kinase 2/signal transducer and activator of transcription 3, suppressor of cytokine signaling-3, insulin receptor substrate 1, phosphatidyl inositol 3-kinase, and protein kinase B-Akt. Insulin increases the uptake of fatty acids and enhances cellular glucose uptake and utilization. Insulin's metabolic effects are mediated by a number of tissue-specific pathways, some of which crosstalk leptin-mediated signaling. Studies showed that leptin resistance is instigated due to the excess release of leptin from adipocytes. It causes a lack of sensitivity toward leptin, for which the body fails to attain satiety and results in more food intake which in turn induces more obesity and aggravates further leptin resistance. Emphasizing on obesity, this review directs toward a possibility of chronic leptin resistance being responsible for insulin resistance. The above statement has been elicited by delineating the point of convergence between insulin and leptin signaling pathways.
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Role of ureterolysis in the management of retroperitoneal fibrosis: A systematic review p. 22
Rami Boulma, Akil Mestiri, Hassen Khouni, Bilel Saidani, Adnen Chouchen
The purpose of the present study is to assess the outcome of ureterolysis in the management of ureteral entrapment secondary to retroperitoneal fibrosis (RPF). A literature search of online database PubMed for studies about ureterolysis was performed. The keywords used for this literature review were: “Retroperitoneal fibrosis” and “Ureterolysis.” Articles in English published between 1980 and 2019 were included. Articles published in non-English language, without full text or lacking of relevant data, were excluded. Clinical perioperative and outcome data were collected, analyzed, and compared between open, laparoscopic, and robotic ureterolysis subgroups. Postoperative complications were recorded according to the Clavien classification. One hundred and six articles were initially collected. After analysis, 37 articles were finally selected for the review. The number of patients was 402. The number of renal units was 554. The median age of our population was 54.55 years (36.5–71). The male/female ratio was 1.71. RPF was idiopathic in 312 patients (77.61%). Ureterolysis was bilateral in 131 cases. The mean success rate in open ureterolysis was 90.45% (77%–100%), the mean success rate in laparoscopic ureterolysis was 93.72% (77.8%–100%), and the success rate in robot-assisted ureterolysis was 100%. Most complications were Clavien I and II. Clavien V was noted in four patients. Ureterolysis is an effective treatment in the management of ureteral entrapment in RPF. It is a safe procedure with possible but manageable complications. It can be proposed in cases of medical therapy failure.
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Combined effect of Kinesio taping and exercises on pain and function in individuals having patellofemoral pain syndrome with different grades of obesity p. 31
Divya M Gohil, Pranita Khose, Chinmaya Patra, Gaurang Baxi, Tushar J Palekar
BACKGROUND: Obesity causes an excess amount of weight on the knee joint and promotes abnormal functioning of the joint. Correction with Kinesio taping allows forces to act in the correct direction. This study was conducted to see the combined effectiveness of Kinesio taping and exercises among different grades of obese population with anterior knee pain. METHODOLOGY: This study was conducted on obese individuals with anterior knee pain. Thirty-six participants were divided into three groups as per three grades of obesity. All the groups received the same treatment, Kinesio taping, and exercises. Participants received treatment three times a week for 4 weeks. The Visual Analog Scale and Kujala Scale were taken as outcome measures. RESULTS: Data were analyzed using Primer statistical software. A paired t-test was applied for within-group analysis, and one-way ANOVA was applied to compare data between the groups. All the groups showed a significant reduction in the pain score and improvement in function (P < 0.005). However, no statistically significant difference was seen for both outcome measures when comparing the three groups. CONCLUSION: The findings suggest that exercising and Kinesio taping are together effective in the treatment of anterior knee pain. This combined protocol was effective in restoring the knee function and reducing knee pain in all the three groups.
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Evaluation of impact of ambient air pollution on respiratory health of traffic police in Kolkata p. 35
Arindam Dey, Tanusree Mishra, Subhashis Sahu, Atanu Saha
BACKGROUND: Air pollution is associated with a broad spectrum of an environmental health problem, caused by increased urbanization and population, globally. Emission of pollutants was strongly implicated in acute morbidity and mortality associated with severe pollution. Traffic cops are most vulnerable due to the nature of their job, continuously exposed to toxic pollutants. AIM OF STUDY: The study aimed to assess the physical and respiratory morbidities of traffic cops due to the effect of environmental pollutants. METHODOLOGY: Air quality data were collected by the Central Pollution Control Board. Traffic cops were selected from three traffic zones of the city. Anthropometric data were collected by anthropometric instruments. Health assessment was performed via the questionnaire method. Pulmonary function parameters were recorded via digital spirometer. STATISTICAL ANALYSIS: Collected data were analyzed statistically via SPSS (V-16.0). RESULTS: Particulate matter 2.5 (PM 2.5) and PM 10 found to be dominant pollutants in three zones of Kolkata. Air Quality Index values are high in winter. Any type of respiratory symptom is highest in the north, followed by the south and central zones. In the central zone, forced expiratory volume in 1 second and forced expiratory flow from 25% to 75% values significantly changed with work exposure. The habit of smoking also showed a significant effect on pulmonary function test (PFT) parameters. The difference of the change in PFT among the three zones was found significant. CONCLUSION: The result of the study indicates that outdoor environmental exposure creates detrimental effects on lung function parameters of traffic cops among the three zones of Kolkata. Use of mask, healthy food intake, performing exercise, and regular medical check are suggested to prevent respiratory damages of police personnel.
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Phytochemical and high-performance thin-layer chromatography analysis of Ashawattha (Ficus religiosa Linn.) Kaanda Twaka (outer portion of stem bark) Churna (powder) p. 43
Pravin Jawanjal, Prashant Bedarkar, Biswajit Patgiri, VJ Shukla
AIM: The aim of this study was to evaluate phytochemical constituent and high-performance thin-layer chromatography (HPTLC) analysis of Ashawattha Kandatwaka (the outer portion of stem bark) Churna (powder). INTRODUCTION: Ashawattha Kandatwaka Churna is a major constituent of numerous ayurvedic formulations. The plant has possessed their various pharmacological activities such as antifungal, anthelmintic, hypoglycemic, antibacterial, antioxidant, anticonvulsant, hypolipidemic, immunomodulatory, and wound healing activities. MATERIALS AND METHODS: Experiments were performed on authenticated plant materials following standard procedures. The methanol extract of stem bark of Ficus religiosa Linn. was used for the HPTLC study. Toluene (9 ml) and ethyl acetate (1 ml) were used for stem bark of F. religiosa Linn. as a mobile phase. RESULTS: Identification of alkaloids, steroids, and amino acids was confirmed through the phytochemical parameter. In the HPTLC study, the Rf values obtained at 254 nm were 0.02 and at 366 nm were 0.01, 0.17, and 0.53, respectively. CONCLUSION: Physiochemical analysis including HPTLC of Ashawattha Kaanda Twaka Churna will help in further standardization.
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Effect of performance level on the longitudinal electromyographic activity of vastus medialis and vastus lateralis muscles after induced extreme fatigue with a workload of 30 repetition maximum p. 49
Dhananjoy Shaw, Deepak Singh, Manvinder Kaur, Umesh Kr. Ahlawat, Dinesh Bhatia
CONTEXT: The study of longitudinal electromyographic (EMG) activity of the muscles under extreme fatigue conditions has been an inadequately explored area in muscle fatigue research. AIMS: The aim of this study was to assess the effect of performance level on the longitudinal EMG activity of the vastus medialis (VM) and vastus lateralis (VL) after induced extreme fatigue with a workload of 30 repetition maximum (RM). DESIGN: This was a cross-sectional study. MATERIALS AND METHODS: Eighteen healthy intercollegiate level male sportspersons (age: 19.84 ± 2.1 years, height: 171.38 ± 8.48 cm, and weight: 69.72 ± 13.85 kg) were randomly selected as participants. As fatigue protocol, 30 repetitions of leg extension exercise with 30 RM load were performed. Isometric contraction of VM and VL muscles at an angle of 0°–10° with 30 RM load was performed until failure as the postfatigue or extreme fatigue protocol. Both protocols were performed in Cybex VR1 leg curl exercise device. EMG activity was recorded from VL and VM during the postfatigue protocol. EMG data were acquired using a 4-Channel Wireless EMG BIOPAC Inc. MP150 system. A criterion called relative impulse (RI) was developed. Based on the magnitude of RI of participants, nine participants were enlisted and equally divided into high-performance (HP) group, mid-performance (MP) group, and low-performance (LP) group. The raw EMG signals were quantified through MATLAB to derive root mean square (RMS) and median frequency (MDF). STATISTICAL ANALYSIS USED: One-way ANOVA and least significant difference (at P < 0.05) were used to assess the influence of performance level, and independent two-tailed t-test (at P < 0.05) was applied to compare the EMG activities of VM and VL in regard to performance level. RESULTS: All the groups displayed a constant linear trend in regard to MDF and RMS except for the HP group in the VL and LP groups in VM. The EMG activities of all the groups were not significantly different from each other under extreme fatigue. However, muscle activation of VM and VL was significantly different from each other in the MP and LP groups. CONCLUSIONS: Findings are useful for further understanding muscle fatigue.
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Evaluation of knowledge, attitude, and comfort concerning human immunodeficiency virus/acquired immunodeficiency syndrome field education understanding among Kanpur Dehat, Indian rural school educators: A questionnaire analysis p. 56
Rohan Sachdev, Kriti Garg, Garima Singh, Kriti Nigam, Akash Srivastava
CONTEXT: Countries were left ravaged as the fastest increasing path of acquired immunodeficiency syndrome (AIDS) infection, hence the epidemic misconceptions surrounding the path of human immunodeficiency virus (HIV) infection in the populations. According to the latest national AIDS management organization survey on HIV/AIDS, North central India is regarded as low awareness and low prevalence area. AIMS: This study aims to evaluate the knowledge, attitude, and comfort regarding HIV/AIDS among Kanpur Dehat rural school educators. SETTINGS AND DESIGN: A cross-sectional descriptive survey was carried out on a total of 110 rural school educators of government and private schools. SUBJECTS AND METHODS: A pretested, self-structured, close-ended questionnaire was administered that consisted of 30 questions. STATISTICAL ANALYSIS USED: The information gathered was incorporated in a foundational way and t-test was applied and P value was determined. RESULTS: Among 110 school educators, females were more in number (56.36%). Private school educators scored more mean (standard deviation) in terms of knowledge (68 ± 5.83), attitude (50 ± 5.82), and comfort (49 ± 6.60) when compared to government school educators. Government school educators were uncertain about methods of transmitting AIDS. Maximum school educators were unaware of the different myths concerning AIDS. CONCLUSIONS: The knowledge, attitude, and comfort of rural school educators among the government school teachers were found to be unsatisfactory. Information is an effort to improve the high-risk conduct of every illness and to build an understanding of HIV/AIDS. We will seek to increase awareness among educators of rural schools by holding workshops at regular intervals and enhancing their comprehension.
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Online dental education during coronavirus pandemic-challenges and future ahead: An observational study p. 61
Malvika Singh
CONTEXT: The spread of coronavirus infection and its declaration of pandemic by the World Health Organization took us all by surprise and left us unprepared. Sudden lockdown declared by the Government of India confined the studies to be taken up through online mode. AIMS: The aim of this study was to assess the problems faced by the students and faculty members while conducting online lectures during pandemic. SETTINGS AND DESIGN: The study was conducted in our institute. SUBJECTS AND METHODS: A total of 336 students and 52 faculty members enrolled in various professional years of Bachelors of Dental Surgery were selected for the study. STATISTICAL ANALYSIS USED: Standard deviation, mean, and mode. RESULTS: Majority of students and faculty members suffered from various forms of connectivity issues while their other issues were completely different. CONCLUSIONS: Both students and faculty members suffered from different issues but minimizing these issues though cooperation and seemed to be a way out for online mode of teaching during coronavirus times.
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Assessment of visual and mental fatigue of young smartphone users of Kolkata p. 65
Subhankar Banerjee, Somnath Gangopadhyay
CONTEXT: According to multiple studies, the use of smartphone leads to several deleterious implications such as visual fatigue, mental fatigue, and altered mental alertness level. AIM: The purpose of this study is to determine whether there is any instance of visual fatigue, mental fatigue, and changes in alertness. METHODOLOGY: A light meter has been used to detect the level of illumination of the experimental room. Critical flicker fusion frequency (CFFF) test is used to identify the occurrence of visual fatigue, mental fatigue, and changes in alertness. Student's t-test was performed to investigate the differences in the CFFFs of pre- and post-experimental conditions in both illuminated and dark situations. RESULTS: A reduction of posttask CFFF has occurred after the completion of the task in both cases. There were significant differences of means in between pre- and post-experimental conditions in both illuminated and dark conditions. Posttask mean CFFF values in the dark condition are lesser than the illuminated condition. CONCLUSIONS: It can be suggested from the present study that the use of smartphone with video features for 30 min or more can cause visual fatigue, mental fatigue, and reduced mental alertness among young (22 ± 2.1 years) smartphone users. The use of smartphone in the presence of illumination causes less deleterious effects than dark conditions.
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Coronavirus transmission mitigation behaviors: The first-line intervention against COVID-19 p. 70
Khundrakpam Devananda Singh
BACKGROUND AND OBJECTIVE: The spread of COVID-19 across the globe develops psychological disturbance to the population. People are always trying to protect themselves from this pandemic through transmission mitigation behavioral (TMBs) practices. The understanding and practice of the exemplary coronavirus TMBs will help the population to fight the disease effectively and efficiently. This study draws the exemplary coronavirus TMBs among the Indian population and constructs a viable model to study these behaviors. METHODS: Data collected from 238 valid respondents through online were the sample of this study. TMB items were collected from the publications of the Ministry of Health and Family Welfare, Government of India, and World Health Organization, Regional Office for Europe. AMOS, SPSS, and Microsoft Excel were used for statistical calculations. Confirmatory Factor Analysis (CFA), Bartlett's Test of sphericity and Keiser–Meyer Olkin (KMO) test, Cronbach's alpha, Principal Component Analysis (PCA), Average Variance Extracted (AVE), and composite reliability (CR) were calculated for the analysis of data. RESULTS, INTERPRETATION, AND CONCLUSIONS: Based on the existing literature, three out of 14 TMB items was dropped, and CFA was run for the remaining 11 items. The result of CFA identified a 5-component structure. Bartlett's test of sphericity was significant at P < 0.001, and KMO measure was acceptable at 0.83. The model fit indices (λ2/df = 1.43, goodness of fit index = 0.953, adjusted goodness of fit index = 0.925, normed fit index = 0.914, Tucker-Lewis Index = 0.962, comparative fit index = 0.972, and root mean square error of approximation = 0.043) and convergent validity (AVE = 0.41 and CR = 0.88) were acceptable. Based on the statistical results, the hypothesized model is fit to examine the 11 TMB items. The 3-factor model with 11 TMB items can be adopted for further replication study, and effective practice of these items is the first-line intervention to fight the spread of coronavirus.
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Awareness, attitude, and action about COVID-19 among Rural Elders: A cross-sectional rapid pilot survey p. 75
Devajana Chinnappa Nanjunda, Jyothi S Lakshmi
BACKGROUND: The China origin coronavirus has spread across the globe including India. As per the epidemiology, the corona is targeting the elderly people more. Hence more aged people are being infected in India and losing their lives as well. The government has taken all the efforts to prevent the effects of this pandemic on the citizens. OBJECTIVE: The major aim of the current study is to find out the perception and opinions of COVID-19 among the rural elderly people. METHODS: The current study has been conducted in the Mysore district, Karnataka State, using a snowball technique through local health workers. Moreover, local sources have been used to collect the data by using survey questionnaires, and descriptive data were collected over the telephone with the respondents (because of lockdown). RESULTS: The majority of respondents are well aware of the pandemic and have expressed serious concern and have taken required precautionary methods However, but they lack more precise information in practice. CONCLUSION: The specific and concrete knowledge about the corona pandemic is very crucial while evaluating a proper plan to prevent spreading the disease and evidence-based clinic awareness. Frequent communication between health workers, media, and other sources is very vital and of higher concern interpreted into more compliance with cautionary endorsements.
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Complementary medicine utilization and practices of self-medication in the field practice areas of a medical college of district Dakshina Kannada, Karnataka, India p. 82
Saurabh Kumar, Achal Shetty, Sowmya Bhat, Sudhir Prabhu, Oliver Dsouza, K Nishanth Krishna, Moira Dsouza, V Narayana
INTRODUCTION: Complementary modalities have been established globally but lack of sufficient data on their utilization patterns hinders the mainstreaming with the existing health care delivery system. The concerning issues are especially of self-medication and usage of complementary medicines with or without the usage of allopathic drugs. AIM: The study aims to find out the prevalence of complementary medicine utilization and prevalence of self-medication amongst the people in the field practice areas of the medical college. MATERIALS AND METHODS: Community-based cross-sectional study was conducted from November 2018 to January 2019. The International questionnaire for the use of Complementary and alternative systems of Medicine was used to interview the 451 study participants. The results were expressed in percentages and proportions. Chi-square test was used to find out the association of sociodemographic variables with the use of complementary medicine and self-medication practices. RESULTS: Overall prevalence of utilizing the complementary medicine services were found to be 17.7%. About 14.6% and 2.9% of the study participants visited ayurvedic and homeopathic practitioners, respectively for the past 12 months. A significantly higher proportion of the rural population was utilizing the services of the complementary system of medical practitioners. Other sociodemographic variables were not found to be associated with the utilization of complementary medicine services. The prevalence of self-medication practices was found to be 25.9%. CONCLUSION: The prevalence of complementary medicine utilization was lower than the prevalence of self-medication practices. Rural area study participants accessed more services of a complementary system of medical practitioners.
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Ischemic necrosis of gastric tube due to intercostal drainage tube causing delayed gastropleural fistula – Rare case report p. 87
Prriya Eshpuniyani, Ramakant Deshpande, Shravan Shetty, Keyur Sheth
Gastropleural fistula is a rare complication of a number of disease processes, much less as a reported complication of pressure necrosis of a drainage tube. We present a patient of carcinoma esophagus having developed such a posttransthoracic esophagectomy complication with cervical esophagogastric anastomosis due to the ischemic pressure necrosis due to the tip of the normally place intercostal drainage tube on the gaseous distended stomach tube.
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The WRITE physiology: Thinking and inking p. 90
Hwee-Ming Cheng, See-Ziau Hoe
Writing Physiology well is much more than a fine motor skill. The capacity to simplify mechanisms, use choice, meaningful words, and construct them in accurate sentences to explain an aspect of Physiology strengthens learning. Writing focuses the mind and sharpens the students' ability to define and describe Physiology. Medical faculties should not be tempted to lessen the role of writing tests even though evaluation is less time-consuming. The enjoyment of writing Physiology can be expanded to include creative activity like composing Physiology songs, rhymes, and comic dialogs.
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Teaching disability competencies to medical graduates: Need of the hour p. 96
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
Disabled individuals are more often than not subjected to a wide range of barriers, including physical which significantly affects their access and utilization of quality-assured preventive and healthcare services. Acknowledging the problems encountered by the disabled individuals, it is of utmost importance to train the medical students to respond to the special needs of these people and to ensure the provision of optimal healthcare. With the introduction of new competency-based medical education for undergraduation, a set of disability competencies have been defined for medical students for the very first time in the foundation course document. A wide range of teaching–learning methods and assessment methods can be employed to assess the learning. In conclusion, considering the problems faced by the disabled individuals, the need of the hour is to address the disability competencies expected of a medical graduate; to accomplish the same, curriculum planning has to be done and the medical students have to be trained in a phase-wise manner.
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Identifying the path and the areas of focus to accomplish malaria eradication: World Health Organization p. 98
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
Malaria is a life-threatening infectious disease presenting an enormous burden on the health care delivery system, in terms of cases and the attributed deaths. The epidemiological analysis of the trends of the disease and the mortality rates since 2015, it has been reported that we have not succeeded in reducing them. However, the encouraging fact is that since 2010, 8 nations have succeeded in eliminating the disease. Obviously, we are aiming for the global eradication of the disease in the long run, as it won't only play a role in saving human lives, but also in strengthening of the national economy. On a bright note, we have succeeded in developing new tools for diagnosis, medications, passive immunization and even the first malarial vaccine. In conclusion, the time has come to rise to the challenge of malaria eradication and it will essentially require sustained political commitment, financial support and adoption of new tools & a strategic approach.
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Envisaging patient safety in health-care settings: Need of the hour p. 100
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
The concept of patient safety came into existence owing to the complexity attributed to the health systems and the rising incidence of patient harms in health care facilities. It won't be wrong to say that patient harm in healthcare is intolerable, especially the ones resulting because of the error in the diagnosis, prescription or the use of medicines. The need of the hour is to establish a culture that fosters linkage with patients, boosts reporting and learning from mistakes and establishes a safe environment wherein health professionals are empowered and well-trained to minimize their errors. In conclusion, patient safety during health care delivery is an essential prerequisite to accomplish health system strengthening and move forward towards the attainment of universal health coverage. The time has come when patient safety has to be regarded as one of the global health priorities and focused actions are taken to achieve improved health outcomes.
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Targeting the sexual and reproductive health and rights of women: United Nations population fund p. 102
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
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Joining hands to eliminate viral hepatitis worldwide: An appeal to stakeholders p. 104
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
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A three-point triage system to enhance hospital preparedness during the COVID-19 pandemic p. 106
Varun Suresh
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Patient possessiveness among doctors: A unique Indian phenomenon p. 109
B Sadananda Naik, Sangram Biradar
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