World Health Organization (WHO) recommends prohibition of advertisements, promotion and sponsorship of tobacco to reverse tobacco epidemic. Tobacco advertising, promotion and sponsorship (TAPS) is also banned under India's Cigarettes and Other Tobacco Products Act, 2003, with few exceptions. Despite the Act and increasing evidence of advertising linked with smoking behaviours, tobacco companies indulge in it brazenly to neutralise tobacco control efforts and normalize its use, making it seem like any other consumer product. The companies aim at creating a brand franchise for their product through advertisements. Point of sale promotion account for more than three-fourth of marketing spends by tobacco companies. Although India has been a frontrunner in tobacco control, it faced huge legal challenge from the tobacco industry. There is a need to regulate tobacco business by compulsory registration and licensing of tobacco vendors and also effective implementation of Indian Act. Besides, the gap in current research from developing countries on how restrictions on advertising impact tobacco use and its associated behaviour, monitor tobacco industry activity, map vendors and access of products, and economic impact of restrictions on tobacco promotions at POS needs to be fulfilled. Without these measures it will be challenging to counter nefarious, cash-rich and truant tobacco industry.

Insurance refers to a promise of compensation for any potential future losses. Health insurance is a form of insurance that compensates for medical expenses related to sickness and treatment. Huge portion of Indian population are vulnerable to economic burden in accessing health care. Equity in accessing healthcare is also of great concern in India. In the present scenario, vulnerable population of our country can be protected from impoverishment and catastrophic health expenditure through a model of health insurance that encompasses the entire population. However, health insurance is still in a developing condition in India. In this article we have discussed the challenges and opportunities for both the public and private insurance system in India. Presently there are important challenges in the public sector as well as private sector insurance in India in terms of monitoring, data capturing, administration and oversight. It is also important to gauge the financial sustainability of the insurance programme and develop early warning systems for identification of signs of collapse. Ensuring adequate focus on the primary and secondary level of care including preventive aspects is another area where insurance programmes have to work since majority presently focus only on tertiary care.

Mental Health is an indispensable dimension for human development. It deals with human thoughts and emotions, and provides a pathway for healthy minds and contributes to a healthy living. Absence of healthy mind poses a great burden to the economic, political, and social functioning of human beings, society and nation. Mental health in India is a neglected paradigm with the shortage of trained staff and inadequate infrastructure. Mental illness has been veiled in stigma, ignorance and superstition since a long time in India. Lack of political and administrative leadership, financial commitments and human resources, are missing in the national and expanded district programmes. Efforts have been put in recent times by the government to oversee the disease burden and provide remedial measures. Draft national health policy formulated in 2015 had thrown a light of hope in this scenario. The gap in the provision of efficient health care to the needy was the building block of this draft formulation.The hassles in the existing system should be identified and efforts to cut down the over-burdened system should be made to cater to the actual needs of the community.

There is a strong association between stillbirth and fetal growth restriction. Early detection and management of IUGR can lead to reduced related morbidity and mortality. In this paper we have reviewed effectiveness of Doppler velocimetry for the detection and surveillance of high risk pregnancies. Serial fundal height measurement plotted on customized charts is a useful screening tool, whereas fetal biometry and Doppler flow are the mainstay for investigation and diagnosis of IUGR. Among high-risk pregnancies with suspected IUGR, the use of umbilical arterial Doppler assessment significantly decreases the likelihood of labour induction, caesarean delivery, and perinatal deaths. Ante partum surveillance with Doppler of the umbilical artery should be started when the fetus is viable and IUGR is suspected.

Background: For health of populations, teaching / training of public health with clinical medicine is essential. Also health providers, educators need to remain sensitive, while training public health, clinical medicine about things beyond. We have collected information about teaching training of public health with clinical medicine and concepts beyond. Methods: Information was collected by simple review with help of different search engines. Results: There is void of guidance on practice-based teaching for personal health with public health. Socio-environmental determinants of health strongly interact with demands of everybody's life. For all medical conditions indicated, treatments are prescribed, but many unanswered questions remain. Answers are searched in gadgets, forgetting that, in medicine there is much room for judgments which help in re-adaptation to demands of life. Also many barriers exist in achieving practice-based teaching with public health for social justice. Conclusion: Public health teachers need to provide linkage of public health issues of disease to symptoms, signs, prevention, cure. Clinical teachers need to link the same to public health issues of disease. Public health education needs to be a shared enterprise with clinical teaching in health professionals' schools, who have mission of teaching, service, research for populations. In addition to caring for those who seek services, gaps between academia, practice, public health need bridges so that personal health as well as public health are ensured for healthy communities. Amalgamated teaching training of clinical medicine, public health, concept of social justice, accountability, and vision beyond for health wellness, needs to be mission of medical schools.

Background: With the universality of internet, the problems with its overuse and abuse have been increasing in recent times. Methods: This cross sectional study was conducted among all the students on rolls of MKCG medical college, Berhampur using the young's internet addiction test for assessment of internet addiction. Results: Mobile phones were the primary source of internet in 73.9% subjects. Average online time was 3.59 hours per day. Prevalence of mild or moderate internet addiction was 26.3% with no significant difference between males and females. Significant positive correlation was found between the BMI of the subjects and duration of internet use in the last 24 hours. The mean amount of money spent by the students to purchase internet connection per month is Rs.290.30. There was significant negative linear correlation between the estimated daily time spent on the internet (μ=3.59, SD=3.51) and time spent on studies (μ=4.38, SD=2.5) (r = -0.107, p=0.016); and time of continuous night sleep (μ=7.07, SD=1.39) (r= -0.237, p<0.01). The most frequent cause for internet access overall was social networking followed by educational uses. Average duration of internet usage in a typical day, internet usage in the past 24 hours, the amount of money spent per month on internet services, and duration since internet use commenced showed significant positive correlation as predictors of internet addiction (Adjusted R²=0.089, p<0.01). Conclusion: The findings of this study imply that internet addiction is a rising public health problem with multiple contributing factors

Background: In some instances health related out of pocket expenditure can be catastrophic thus compelling individuals to raise money through unusual means. Such a situation becomes unavoidable if, there are either too many illnesses or shortage of money. We carried out this study to assess the proportion of elderly who availed distressed financing while availing health care and whether or not they avoided any health care need due to shortage of money. Methods: This was a community-based cross-sectional study. The present study was conducted on a total of 404 elderly residing in both the urban and rural parts of Lucknow district. Participants were selected from the community using multistage random sampling. Data was collected with the help of a pretested questionnaire, it collected information related to health care utilization, health care financing and health care need deferred due to shortage of money. Results: Overall the children were the most common source for healthcare financing and 16.8 % study participants faced financial hardship while availing health care. Most common reason for seeking distressed financing was for buying medicine (58.8%). Conclusion: Use of distressed financing was not uncommon. Families need to be protected from catastrophic health expenditure through an effective social insurance to prevent financial hardship.

Background: Nearly 360 million people in the world have disabling hearing loss, out of which 32 million are children. In India, total number of person with deafness were 63 million of which 26.4 million is contributed by school aged children. Chronic Suppurative Otitis Media (CSOM) is the commonest cause of persistent mild to moderate hearing impairment in children. Methods: The study was done among 5-14 years old children residing at Kalyanpuri, a resettlement colony of East Delhi. A convenient sample of 1398 children were studied and out of them 102 children were found to have hearing impairment on screening by tuning fork. Screen positive children were subjected to pure tone audiometry to confirm deafness. Results: Out of total 1398 children studied, 744 (53.2%) were boys and 654 (46.8%) girls. Prevalence of hearing loss was 3%. The main causes of hearing loss found were CSOM (48.8%). Hearing loss was significantly associated with unsafe ear cleaning practices. Conclusion: It is evident from the present study that causes of hearing loss in children is mostly preventable. Raising awareness of community for early diagnosis of ear problems is important to bring down the burden of hearing loss and deafness.

Background: Migration has led to development of slums. Slum area improvement and clearance act, 1956, slums have been defined as mainly those residential areas where dwellings are in any respect unfit for human habitation by reasons of dilapidation, overcrowding, faulty arrangements or lack of ventilation, light, sanitation or combination of these factors which are detrimental to safety, health and morals, thereby compromising health of people leading to morbidity and mortality. About 22 % of the total population reside in slums. Methods: 10% of total families residing in the slums were selected by systematic random sampling. First family was selected randomly and subsequently every 10th family was included in the study sample Results: 13.2% population was under 5 years of age, out of which 2.7% were infants and 3.5% of the population was above the age of 60 years. 60% of the children <5 years of age who were examined were undernourished as per weight for age. 70% of adult females and 75% of children aged <5 years were anaemic. Conclusion: The study found a large number of respondents living in overcrowded and insanitary conditions, basic amenities were not available in majority of the households and families. Antenatal care and immunization status of the beneficiaries were lacking.

Background: Considering the limitations of validity and predictive values as stand-alone indicators of evaluating a screening/diagnostic test, this study assesses a composite index - Clinical Utility Index- of Body Mass Index (BMI) for assessment of obesity. Methods: The secondary data of bus drivers of an urban transportation facility regarding weight, height, age and body fat percentage collected during a health camp were used to calculate the validity, predictive values and clinical utility indices for different cut off values of BMI. Positive Clinical Utility Index (+CUI) was calculated by multiplying sensitivity and posited predictive value. Negative Clinical Utility Index (-CUI) was calculated by multiplying specificity and negative predictive value. Results: A BMI cut off value of 25kg/m² had the maximum positive clinical utility(+CUI=0.75) and 26 kg/m² had the highest negative clinical utility (-CUI=0.82). The BMI cut off of 25kg/m² had good clinical utility across all age groups. Conclusions: BMI cut off value of 25kg/m² has good clinical utility to diagnose obesity and BMI cut off of 26 kg/m² has excellent utility for ruling out obesity in this high prevalent setting.