The use of mobile Internet devices (MIDs), smartphones, and proprietary software applications (also known as "apps" in short) can improve communication among medical caregivers. The utilization of these mobile technologies has further transformed health care, communications, commerce, education, and entertainment, among other fields. Newer technologies have the potential to be adapted for improvement in health care and medical education in general. Mobile technology is one of the latest strings of technological innovations that can be integrated into medical education. M-learning (the use of mobile technologies in teaching/training) has been used as a complimentary resource for interaction between students and instructors for motivation and learning. The main uses described for mobile devices in medical education can be divided into (a) information management (IM), (b) communication, and (c) time management. The field of mobile technology in health-care services and medical education is quite new and throws open ample opportunities for researchers to conduct further studies. Educators in medicine, dermatology, and public health as well as practicing physicians and surgeons need to embrace this new technology, study its further adoption, and assist in the responsible integration of these devices into the art and practice of medicine.

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Background: Nutritional status especially that of preschool children is a sensitive indicator of health and nutritional status of a community. Aim: To estimate the prevalence of undernutrition among tribal preschool children and to assess the factors associated with variation in nutritional status. Methods: A cross-sectional survey was conducted among 438 tribal preschool children in 10 clusters of Wayanad district of Kerala. Height, weight, mid-arm circumference and hemoglobin level were measured. Children more than two standard deviations (SDs) below the standard median of World Health Organization Multi Centric Growth Reference Study were considered underweight (weight-for-age), stunted (height-for-age) and wasted (weight-for-height) respectively. Qualitative variables such as prevalence of underweight, stunting and wasting were summarized using percentages. Mean (SD) was used, to summarize, quantitative variables such as height and weight. Generalized estimating equation models were constructed to assess associations. Adjusted models included social factors and child morbidities. Results: More than half of the children say 58.7% (257/438) had deficits in at least one of the three anthropometric indicators. The prevalence of underweight, stunting and wasting was 39% (171/438), 38% (167/438) and 20.5% (90/438) respectively. The prevalence of anemia was 95.7% (419/438). Bivariate analysis showed significant associations between undernutrition and educational status of parents, tribe to which the child belonged, diarrheal episode and low birth weight. In adjusted analysis, lower educational status of mother (adjusted odds ratio 1.9, 95% confidence intervals 1.2-3) and an episode of diarrhea (1.8, 1.03-3.2) independently predicted undernutrition in a tribal preschool child. Conclusion: Undernutrition in the form of stunting, wasting and underweight is very high among the tribal preschool children. There is an urgent need to improve health care services to the tribal population and tribal children.

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Background: In India, overall prevalence of blindness is 1.1%, the principal cause being cataract (62.6%) affecting over 9 million people. Aim: The present study was carried out to find the prevalence, barriers and facilitating factors related to cataract health services in a rural community of Tamil Nadu. Methods: The study was carried out in four villages in sub-center Kondur, under Primary Health Centre (PHC) Kondur, Villupuram district, Tamil Nadu, during November-December 2010. All adults of more than 50 years (n = 331) residing in the sub-center Kondur, were examined for lenticular opacity and visual acuity. A structured proforma was used to assess the awareness, barriers and facilitating factors related to available cataract health services. Results: The prevalence of cataract among the population studied was 62.8% (95% confidence interval [CI]: 57.5-67.9%). There was a significant increase in cataract with increase in age (P < 0.001). Only 13% (95% CI: 9.6-16.3%) of the persons with cataract were operated at the time of interview. The major barriers were no one to accompany (25.5%) and absence of felt need (22.6%). Less than one-fifth (17.8%) reported the awareness of cataract as a condition affecting eye. The facilitating factors were free surgery in camps (83.7%), self-decision due to defective vision (69.7%) and quality of service provided (65.1%). More than one-half (56.7%) of subjects diagnosed for cataract during the survey were willing to be operated. Conclusion: Prevalence of cataract was high in Kondur PHC area. It is vital to increase the level of awareness regarding the need and availability of cataract health services.

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Background: Since there is a high mortality due to malaria, there is a need of a parameter to identify patients at risk of developing complications, whereby intensive care is given to those patients who are at higher risk for complications and mortality. Aims: This study was undertaken to estimate serum lactate levels in patients with Plasmodium vivax, Plasmodium falciparum, and mixed malaria, and also to correlate it with various clinical and biochemical parameters and with the severity and prognosis of malaria. Methods: This was a cross-sectional, analytical, and observational study, which was conducted on 100 patients diagnosed with malaria and older than 14 years of age. Diagnosis of malaria was made by the gold standard method of peripheral blood smear examination and rapid tests. The blood sample for plasma lactate levels on admission was collected from a stasis free vein. The Student's t-test for continuous normally distributed variables was used. For categorical data, the chi-square test was used and for the small numbers, Fisher's exact test was used for small numbers. P < 0.05 was considered as a statistical significance at 95% confidence intervals. Results: In this study, there were 90% survivors and 10% of patients succumbed. Out of 90 survivors, 43 patients (47.7%) had some form of complicated malaria, whereas all patients who succumbed (10) had complicated malaria. All the patients who had jaundice, severe thrombocytopenia, renal failure, severe anemia, or hypotension (hypotension was confirmed clinically, but the remainder were confirmed by biochemical parameters such as liver functions, renal functions, platelet count, and hemogram) had hyperlactatemia in this study. All patients who died had a serum lactate level of >2 mmol/l. Conclusions: Hyperlactatemia had significant associations with complications of malaria. Raised serum lactate levels were significantly associated with mortality (P < 0.05).

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Background: Young people are most vulnerable to sexually transmitted diseases (STDs) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in Bangladesh. Lack of knowledge about reproductive health issues is also common in this group. Aims: This study aimed to assess the knowledge and perceptions of STDs, HIV/AIDS, and reproductive health of young female university students (19-27 years) in Dhaka, Bangladesh. Methods: A cross-sectional study was carried out among 402 female students from seven universities in Dhaka, Bangladesh. Data were collected through face-to-face interviews using a structured questionnaire on sociodemographic information, knowledge, and perceptions of STDs, HIV/AIDS, and reproductive health. Descriptive analysis was used, and data were presented as frequencies and percentages. Results: The majority of the participants were young, unmarried, undergraduate students. Most of the participants reported that they knew about STDs (79%) and HIV/AIDS (66%). However, knowledge about the modes of transmission and prevention of the diseases was poor. HIV/AIDS was considered by 90% participants as a public health threat to Bangladesh, mostly due to illiteracy (76%), increased mortality (20%), existence of risky sexual behavior (18%), and aggression of Western culture (31%). About 65% of the participants mentioned that AIDS can be prevented by safe sexual practice, 55% mentioned prevention through upholding religious values and moral education, and 59% mentioned that education about AIDS would help prevent transmission. Conclusions: Although a majority of young Bangladeshi female students reported knowing about HIV/AIDS, their knowledge regarding transmission and prevention of the diseases was poor. Strategies for creating reproductive health education targeted at young female students are essential for the prevention of STDs and HIV/AIDS.

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Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has become one of the significant public health problems in the world. Research regarding HIV/AIDS among nursing professionals is limited from India. Aim: The aim was to assess nursing student's knowledge and attitude toward people living with HIV/AIDS. Methods: A descriptive cross-sectional design was adopted among conveniently selected under graduate nursing students (n = 172) using self-reported questionnaires. Results: The overall mean knowledge (38.05 ± 4.91) and attitude score (51.26 ± 6.2) indicate that majority of the students have good knowledge (77.6%) and moderately favorable attitudes (67.4%) toward HIV/AIDS patients. However, statistically significant differences were observed between age (P < 0.001, P < 0.019) education (P < 0.34, P < 0.01) and experience in taking care of HIV/AIDS patients (P < 0.01, P< 0.01) with knowledge and attitude. Conclusion: Though, a majority of nursing students had adequate knowledge, few students hold discriminatory attitudes toward people with HIV/AIDS. These findings indicate that there is an urgent need to improve the level of knowledge and attitudes among nursing students toward HIV/AIDS as they have a key role in prevention, care and treatment in their future career as nurses.

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Background: Snakebite is a frequently encountered medical emergency faced mainly by rural populations. It is a significant public health problem in many parts of the world, especially in South Asian countries. Aims: This study aimed to analyze the epidemiological aspects of snakebite among human snakebite victims admitted to the emergency ward of a tertiary care teaching hospital between 2010 and 2012 in rural Haryana. Additional objectives were to study other factors that have a bearing on the outcome of snakebite. Methods: In this cross-sectional study, lists of addresses and contact numbers were prepared for all the snakebite cases admitted to the emergency ward of Maharishi Markandeshwar Institute of Medical Science & Research (MMIMSR), Mullana, Haryana, between June 2010 and May 2012. The subjects eligible for the study were then interviewed to gather epidemiological information. Necessary clinical data were obtained from records. Results: The majority or 49.4% of the victims were in the age group of 31-45 years, followed by 32.91% in the age group of 16-30 years. Of the victims, 20.3% were illiterates. A majority (48.1%) of the victims were manual laborers and farmers. The foot was the most commonly (62.03%) involved part of the body. Most (48.10%) of the snakebite incidents occurred while the victims were doing agricultural work. Further, 64.56% cases were reported during the monsoon season and 41.77% victims were bitten in the bush. Among the subjects, 60.76% received first aid at the site of incident, and 20.25% of them sought hospital care after consulting the traditional healers (ozhas). Time lapsed for seeking hospital treatment was less than 4 h in 55.69% of the cases. The overwhelming majority (83.54%) of snakebite victims recovered after the treatment. Conclusion: This study highlights the need for improving community education, prompt transport of bitten patients to medical care, capacity-building of medical staff at all levels, and availability of anti-snake venom in rural health facilities to reduce snakebite deaths.

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Dyke-Davidoff-Masson syndrome (DDMS) is characterized by cerebral hemiatrophy, contralateral hemiplegia, skull and facial asymmetries, seizures, and mental retardation. We present a case of acquired DDMS following meningoencephalitis. The patient experienced recurrent seizures, had profound sensorineural deafness, aphasia, mental retardation, and severe behavioral abnormalities. The neuroimaging showed classical features of DDMS.

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Background: Tobacco use is a public health issue throughout the world. Research related to information about tobacco control and cessation among nursing students is limited from India. Aim: To assess nursing students' knowledge, attitudes and perceptions of health professionals' role regarding tobacco control and cessation. Methods: A cross-sectional descriptive design was adopted among purposively selected (N = 178) undergraduate nursing students. Data was collected using self-reported questionnaires. Results: Our findings revealed that students' knowledge related to tobacco diseases was adequate as mean score of this domain was (M ± SD) 18.0 ± 1.48. Almost all participants agreed to support strict legislation (92.1%): Ban on "public use of tobacco" (91.6%), "tobacco sales to children and adolescents" (95.5%), and "advertising of tobacco products" (93.9%). Almost the entire sample felt that health professionals should serve as "role models" for their patients and the public (97.2%). However, curriculum related to smoking cessation techniques (51.6%) reasons why people smoke (48.8%) and nicotine replacement therapies were the areas found to be inadequate. Conclusion: There is an urgent need to sensitize nurse educators and nurse administrators involved in curriculum preparation to incorporate specific education modules related to tobacco control and cessation at an undergraduate level.

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Splenic abscess is a rare clinical entity with poor prognosis. But owing to imaging technique, diagnosis and prognosis have improved nowadays. Most patients who are presented with splenic abscess are immunocompromised due to predisposing risk factors like diabetes mellitus, intravenous drug abuse, trauma, bacterial endocarditis, human immunodeficiency virus (HIV), chemotherapy, or steroids. Here, we are presenting a rarer case of multiple splenic abscesses with its complication in an immunocompetent healthy adult male without any risk factor.

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Background: Performance assessment of health services provided to maternal and child population is an important area of concern especially in developing countries including India. Aim: This study was conducted to assess the performance of Junior Public Health Nurses (JPHN) on services provided to maternal and child health at sub-centers in Malappuram district of Kerala, India. Methods: Maternal and child health services were assessed based on record analysis and interviewing JPHN in 30 randomly selected sub-centers using a predesigned questionnaire prepared according to Indian Public Health Standards for sub-centers. The work performed by the JPHNs was graded as excellent, very good, good, satisfactory, and poor based on the standard guidelines. Results: Population covered by the 30 JPHNs at their sub-centers ranges from 5050 to 9869. Services were excellent in all the sub-centers for tetanus toxoid immunization and institutional deliveries. Although antenatal care (ANC) registration was excellent in 70% of the sub-centers, it was poor for the 1 ^st trimester ANC registration in 50% of sub-centers. In the case of referral services and postnatal care (PNC), 27% and 33% of the centers were excellent, respectively. 50% of the centers have had poor performance in PNC. Detection of beneficiaries for immunization by JPHNs was excellent in 60% of the sub-centers. Measles and full immunization coverage was poor in 40% of sub-centers. Around 77% JPHNs attended in-service training, and 90% of them could prepare sub-center annual action-plan. Conclusion: There is a variation in performance of JPHNs at a sub-district level which highlights the importance of further studies to elucidate the factors associated with it.

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From a researcher's perspective, the primary target is to publish their research work so that the scientific community can acknowledge their contribution. However, to accomplish their target they should have an access to indices which can guide them about the quality of a journal. Different scientifically proven indicators have been employed by various journals to assess the quality of a journal. To conclude, in order to ascertain the quality of the journal it is better to employ a combination of different scientific indices instead of over-reliance on a solitary index to avoid limitations of individual indices.

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A 22-year-old primigravida who underwent medical abortion at 45 days of amenorrhea was diagnosed to have choriocarcinoma by histopathological examination after dilatation and curettage (D and C) for persistent bleeding per vaginum. Her serum β human chorionic gonadotropin values were less than 1 lakh and she was treated initially with methotrexate monotherapy elsewhere. She needed 10 units of packed cell transfusion for persistent hemorrhage and she was referred to our Institute because of persistent gestational trophoblastic neoplasia and intractable hemorrhage. She needed multiple transfusions and underwent laparotomy and bilateral internal iliac artery ligation with intrauterine packing as she had a severe bout of bleeding resulting in hemorrhagic shock. Post-operatively she was managed with chemotherapy employing EMACO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine/oncovine) and EMA (etoposide, methotrexate, actinomycin D) and thus her fertility was preserved.

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