Background: There is changing health care, ground reality remaining naturally same, some needing services, others entrusted to deliver. Objectives: Search literature about happenings, possibilities for reforms in health professionals education systems, health care systems to share for sensitization for change. Methodology: Literature was searched with various search engines to find information in relation to objectives adding personal, shared experiences. Results: Literature reveals lot needs change in training of health professionals, health systems. Causes of illnesses emphasized during health professionals' training, are biochemical, infectious, genetic, trauma, not influences of mind, environments. In health care spirituality, humanities, self-healing are not emphasized. There is disconnect between education, health systems with health professionals appropriate training in short supply. What is learned outside formal academics, ‘hidden curriculum’ observed behaviour, interactions, training environments which are extremely powerful in shaping values, attitudes are forgotten. This results in mismatch between delivered care / quality care even by those highly dedicated to doing good job. At places there are awakened users, however influenced by commercialized managed systems, at others, many health seekers are ignorant, lack resources, struggle for two square meals. Inequality, gaps continue. Conclusion: Change needs realization, instructional, institutional reforms for training with coordination in systems for competent, compassionate, courageous service providers for efficient, effective integrated health delivery. For appropriate health delivery, clinicians need training to coordinate care in integrated way across systems, teams, in settings, time frames, responding to patients' expectations, which reaffirms importance of relationship between health providers whole person care. Health delivery has to be steered by ethical commitments, social accountability, ‘professionalism’.

Health promotion strategies have been successfully integrated in services of emergency departments of hospitals of many developed nations. The aim of this commentary is to highlight the health promoting orientation of emergency department in a tertiary health care hospital in India and suggest how Bensberg's model of ‘Strategies for Health Promotion’ can be applied in relation to health promoting emergency care in India

The importance of written examination in medical schools is implied from its wide spread acceptance in our country, and its use over several decades, not only as a tool for evaluation but also sometimes as tool for learning and for gettin a feedback on the classroom and bed-side teaching that had taken place sometime in the past. Though this form of summative or formative assessment is plagued with serious drawbacks like lacking objectivity, reliability, relevance and validity, but still it has survived the test of time, since it is easy to administer and suitable for a large group. However by improving the quality of the question paper with adequate analysis and preparation, these known weaknesses can be minimised if not totally eliminated.

Background: Adolescence is a period of physical, psychological, emotional and personality change, which can be affected by stress, and emotional and behavioral problems. Hence this study was conducted to estimate the prevalence of mental health problem among adolescent studying in secondary school of district Patna by using of SDQ Questionnaire. Method: A cross-sectional study was conducted on the assessment of mental health status of children of 12-16 years. This study was conducted at 15 schools in the rural area and 20 schools in urban area of Patna district from August 2013 to January 2015 using of SDQ Questionnaire. Result: Conduct problems as well as peer problem were the highest (10.3%) with mean score of 5.59±0.84 and 6.40±0.67 respectively, followed by emotional problem (7.6%) with mean score7.88±1.00. The Conduct problems were significantly higher in males than females (p=0.025). The abnormal score of all domain of the mental problem were more common in the children of urban area except prosocial problem. 20.4% children had definite difficulties in daily life and 11.4% had severe difficulties in daily life. The difficulties had interfered in 64.6% of children by different impact factor. Conclusion: Mental health problems are common among the general adolescent population in India. Early detection and effective intervention will result in better development of the futures citizens of our country

Background: Global population is ageing; the proportion of older persons has been rising steadily, from 7% in 1950 to 11% in 2007, with an expected rise to reach 22% in 2050. In India, It has been projected that by the year 2050, the number of elderly people would rise to about 324 million. India has thus acquired the label of “an ageing nation”. With the advancing age, the physical as well as psychosocial morbidity rises. Though the elderly have increased in number, the welfare plans including health and other social services for elderly are minimal. This study was carried out to study health problems in geriatric population of hilly & plain regions in Uttarakhand. Methods: The study was conducted from July 2010 to May 2011 in villages of Tehri district of Uttarakhand among 400 participants that were selected by purposive method of sampling. Results: Out of 400 participants, 220 (55%) participants belonged to the nuclear families, 136 (34%) participants were belonging to below poverty line families. Addiction was present in 130/200 (65%) of men and 88/200 (44%) of women. Most common psychosocial morbidity was lack of monetary support and financial insecurity that was seen in almost half (185/400, 46.3%) of participants. In men, the psychosocial morbidities that were present in higher percentages in plain areas were social insecurity, loneliness, depression and in hilly areas were monetary insecurity, irritability, depression. In case of women also similar findings were reported. In physical morbidity, eye was the most common organ to be affected i.e. in 224/400 (56%). Among men, the physical morbidities which were present in higher percentages in plain areas were of eye, bones, gastro-intestinal tract, psychological, generalized weakness and in hilly areas were of eye, bones, respiratory, skin, generalized weakness. In case of women also similar findings were reported. Conclusion: There is a growing need for good quality geriatric health care services at the primary level and it should be based on the “felt needs”. Focus on national health programs and policies that are initiated for geriatric age group needs to be implemented right away in all health institutions and health centers without further delay.

Background: The Indian Systems of Medicine and Homoeopathy (ISM&H) has an age-old acceptance in India bur experiences suggest that AYUSH doctors are still not fully utilized to provide holistic care at primary level. Present qualitative research was planned with an objective of studying the working pattern, intended functions, challenges at work and expectations of AYUSH practitioners in one of the districts of Odisha. Method: A face-to-face opportunistic group discussion (GD) was conducted among 14 willing AYUSH practitioners during a pre-planned district level meeting in one of the northern district headquarters of Odisha. Key areas of the discussion were their duties and responsibilities, type of in-service trainings, usefulness of those trainings in day to day work related practices, Challenges and difficulties faced by them while working in the system. Content analysis was carried out by coding the relevant responses and developing categories and themes based on the findings. Result: Members of the focus group had expressed the view that many of the activities suitable for allopathic system of medicine are imposed up on them; as a result skills of their own system of medicine are underutilized. Other than these, problems related to lack of hands on training, poor job satisfaction were also highlighted by the members. Conclusion: India is a country where medical pluralisms is officially recognized and encouraged. If the existing difficulties faced by the AYUSH practitioners were not properly addressed, the original purpose of mainstreaming the AYUSH will be a distant goal in the future also.

Background: Oral cancer being sixth most common cancer in world and more so in developing countries, particularly in people addicted to tobacco and alcohol. Patients usually present in advanced stages when the treatment offered is not much helpful. An early diagnosis is therefore required for improving the results in these patients. Methods: Patients attending ENT OPD with problems of sore throat and sore mouth with the history of smoking were examined in detail and after basic investigations, a pinch biopsy of the oral mucosa was taken under local infiltration anaesthesia in outdoors and was sent for histopathological examination. The patients already diagnosed with oral cancers or with premalignant lesions were excluded from the study. Result: Hyperplasia was the most common finding in all (100%) cases. The next significant finding found in 96.7% of the sample was chronic inflammatory infiltrate. Dysplasia was also seen in 16.66% of the cases, bearing a direct relationship with the smoking duration. Keratinization and acanthosis was observed in 3.33% and 6.66% of the samples respectively. Conclusion: Smoking definitely causes changes in the oral mucosa which can progress to frank malignancy if smoking is continued. Pinch biopsy can be a simple economical method to monitor the progress of disease in smokers.

Background: Giving birth to a child is not only a strain for the body, but it also puts the woman's health at risk. Globally, nearly 300,000 thousand women die each year as a result of pregnancy related complications. India, with a population of more than 1.21 billion, has the highest maternal mortality in the world (estimated to be 56000 in 2010). Addressing the maternity care needs of women may have considerable ramifications for achieving the Millennium Development Goal (MDG)–5. The proportion of births attended by skilled health personnel (safe delivery) is one of the main indicators used to monitor progress in reaching MDG 5. Objective: The main objective of this paper is the traces the changes in utilization patterns and determinants of safe delivery care services by women in India, during last one and half decade, 1990-2006. Methods: Data from three round of the Demographic and Health Survey (DHS), known as the National Family Health Survey (NFHS) in India were analyzed. Bivariate and multivariate-pooled logistic regression model were applied to assessing the trends and determinants of safe delivery care services utilization, over one and half decade, 1990-2006 and also fit models stratified by survey periods and with interactions among key socioeconomic predictors to show the extent of disparity in the utilization of safe delivery care services among women belonging to different socioeconomic strata. Results: The results from analysis indicate that the coverage of safe delivery has increased from 34 percent to 50 percent during the last one and half decade. Overall, it can be said that, there was an improvement in the level of safe deliveries over the period of time. This improvement was somewhere very marginal, but somewhere very pronounced too. The results shows that women's education, husband's education, religion, caste, mass media exposure, birth order and interval, wealth quintile and region of residence were found to be statistically significant determinants inthe utilization of safe delivery care services. Women from the Southern region utilizing the highest safe delivery care services compared to other regions. Conclusion: The region specific inequalities, which were greater than the socioeconomic inequalities, may be reduced by expanding outreach health programs to bring services closer to the disadvantaged. Promoting the use of family planning, female education, targeting vulnerable groups such as poor, illiterate, high parity women, involving media and grass root level workers and collaboration between community leaders and health care system could be some important policy level interventions to address the unmet need of safe delivery care services among women. Maternity programmes should be designed keeping in mind the socioeconomic and geographically context, especially women who belongs to EAG states, India.

Introduction: Dyslexia is the most common learning disability in children and persists throughout life. Children who repeatedly experience failure in reading may become demoralized. This influences their self-esteem. This decrease in self-esteem is also accompanied by an increase in tension, apprehension and anxiety. A dyslexic person may react differently to social situations, because of their social immaturity, causing embarrassment to others. Present study was carried out to explore the risk factors for dyslexia and to find out the role of literacy environment at home in dyslexic children. Materials and Methods: In the present case control study 3 to 7 years children with and without dyslexia were enrolled. The data was collected on sociodemographic profile of children, types of dyslexia, regularity in attending school from the caregivers of children. Statistical analysis: was done with proportions and 95% confidence limits. Results: 75 cases and 76 controls participated in the study.

Background: Flu has been a major cause of concern in recent times. It creates fear and panic among common people. Government of India has been making concerted efforts to increase the awareness regarding flu through various mass media approaches. The idea is to empower the population to take preventive actions and ensure appropriate action if it strikes. Keeping this in mind, the present study was designed to assess awareness of general public regarding various aspects of flu in a rural population of Jammu. Methods: 393 participants aged 15 years and above were interviewed using pre-tested semi-structured questionnaire. The interviewers collected information about various aspects of flu by subjecting the respondents to an array of closed and open ended questions and recorded relevant socio-demographic characteristics of the population. Results: Study population comprised of 186 males and 207 females. 40.9%respondents were in the age group 21-40 years. Nearly half (47.3%) of the respondents had studied Higher Secondary Certificate (HSC) and above. Majority of respondents (93.6%) had heard of flu. Mass media was credited as a source of information by 72.3% respondents. Majority (80.4%) was aware of Flu presenting as fever. Cough and cold were correctly reported as presenting symptoms by almost two thirds (65.4%) of respondents. 52.1% knew correct route of transmission. Hand washing and use of face mask as a mode of prevention was known to15.4% and 55.4% respectively. 5.4% respondents were unaware of any preventive measures. Only about half of the respondents were aware of diagnostic tests, treatment and vaccine for flu. Conclusion: Persistent efforts are needed to enhance awareness about various aspects of Flu. Mass media initiatives need to be supplemented by focused health education sessions regarding prevention and management of flu among general public.

Introduction: Dengue is a viral disease caused by an arbovirus of genus flavivirus. In India several dengue epidemics have been took place. In absence of any study from Southern Rajasthan, present study is focussing light on trend of disease in this area. Method: This is a retrospective analysis of all Dengue cases during year 2011, 2012 and 2013. IgM capture ELISA positive cases were considered Dengue positive. Results: Male to female sex ratio of cases was1.5:1. Maximum cases were from 16 to 45 Age Group. Cases begin to increase form August and peaks during September, October and November months. Discussion: Gradual increase in toll of dengue cases every year indicates ineffective control measures in the area and is a threat for coming years. Association of post-monsoon season (September, October and November) and dengue is clearly evident. So the dengue control measures should come into full action towards the end of monsoon season.

Background: Delhi's per-capita income grew at the rate of seven percent per annum during the seven year period 2005-06 to 2012-13, enabling the capital state to become the richest in India. Still the proportion of underweight among under-five children in urban slum of Delhi still was high (35.3 %) as reported by National Family Health Survey (NFHS) 2005-2006. The present study was conducted to estimate the prevalence and associated risk factors of underweight among 0-5 year children in an urbanized village of east Delhi Methods: The present cross sectional, community based study was conducted in Ghazipur, an urbanized village of East Delhi where 422 children aged 0-5 years were studied using a random sampling method. Bivariate and multivariate analysis was done to find out the risk factors associated with underweight status. Results: In all, 422 children were studied and the prevalence of underweight as well as severe underweight was found to be very high i.e. 39.34% and 12.09% respectively. In bivariate analysis, the risk factors found associated with underweight were a higher birth order, lesser previous birth interval, lower maternal education, lower occupation level of father and history of diarrhea in the last two weeks, whereas for severely underweight children, lower occupation level of father was found to be a significant risk factor. Lower level of occupation of father and non-availment of the supplementary nutrition benefit from anganwadi centres were independent risk factors of severe underweight. Conclusions: Delhi, even being the capital state of India and having the highest per capita income in the country has certain geographical pockets where undernutrition among children is very high and most of the risk factors are modifiable.