Revisiting the Inner Self in Times of Debilitating Distress: Gateways for Wellness Through Spiritual Tourism

The COVID-19 pandemic has had devastating effects on our bodies, minds and souls. Having suffered it for more than a year now we know how crucial it is to tackle the pandemic at physical, psychological and spiritual levels. We have well-established Standard Operating Procedures alongside vaccines to deal with it at physical level, but equally crucial are mental and spiritual problems caused by COVID-19 (Chopra, 2020). This paper seeks to explore certain gateways and possibilities of dealing with distress, despair, anxiety, angst, trauma and disruption caused by the COVID-19 pandemic in diverse arenas of human activities to ascertain how crucial a role spiritual tourism plays in coping with the challenges we face today. It will also take into account mystical, sufic, yogic, ayurvedic and other meditational practices that represent the richly diverse cultural and spiritual heritage of India. These practices have substantial bearing on the tourism industry by connecting tourists with their deeper, inner selves and thus providing much required spiritual solace. The inclusive and integrative aspect of spiritual and other meditational practices in India will also be underscored to demonstrate how these have been influencing and benefiting the tourism industry in India. Besides enriching the lives of tourists from different countries of the world by providing inner peace and harmony, the tourism industry also equips them with coping strategies to effectively negotiate despair and inner conflicts

Clinical profile of scrub typhus patients in a tertiary care centre in Himachal Pradesh, India

Background: Scrub typhus a zoonotic disease caused by gram negative bacteria O. tsutsugamushi, is endemic in Himachal Pradesh. This illness occurs mainly in monsoon and post monsoon season. study design of  this study was conducted in a tertiary care centre in Himachal Pradesh between July 2015 and June 2016. All the indoor patients with age above 18 years with a diagnosis of scrub typhus were included in this study.Results: Out of total 180 patients, 130 were female patients. Most patients were in the age group 21-30 (23.3%). All the patients presented with history of fever, but 54 patients presented with high grade fever. Other Most common symptom was chills and rigours (81%), followed by vomiting and headache each 32%, cough 31%. On examination 21% patients had eschar,14% patients had lymphadenopathy. Most number of patients presented in the month of September (51.6%), followed by August (33.3%).Conclusion: Scrub typhus being an important differential of acute undifferentiated fever in this region, should not be missed by primary care physicians, as once multi organ dysfunction sets in, mortality rate starts rising. So, there is a high need of sensitization of doctors and people about this illness so that early diagnosis and early treatment can be ensured

Frequency of peripheral neuropathy in pre diabetics in sub Himalayan region: a cross sectional observational study

Background: Peripheral neuropathy in pre diabetics has been studied in various studies till now. Many are in support and many against. No data was available in any study using all three criteria i.e. impaired fasting glucose, impaired glucose tolerance and HbA1C. Aim was to study the frequency of peripheral neuropathy in pre diabetics in a tertiary health care centre in sub Himalayan region.Methods: A 50 patients of prediabetes were enrolled for this study; preformed proforma was used to collect the information, data on examination and investigations. Then these patients were subjected to nerve conduction studies.Results: Out of total 50 pre diabetic patients 9(18%) were diagnosed having peripheral neuropathy. Maximum number of pre diabetic patients were (26) in the age group 46-55 years with mean age of 44.49 years ±7.01 (S.D.). 28 (56%) were males with a female to male ratio of 1:1.27. 20% patients had complaint of polyuria, 12% presented with polydipsia, 14% of total pre diabetic patients had paresthesia on history. 6% patients had impaired vibration and position sense on clinical examination. Out of total 9 patients having evidence of Peripheral Neuropathy 6 (66.66%) were meeting all three criteria for Prediabetes while 8 (88.88%) had IFG, 7 patients had IGT. 42% of the patients were fulfilling the criteria of metabolic syndrome. 28 had raised TGs and out of them 5 (17.8%) had peripheral neuropathy. Out of 24 obese patients, 4 (16.6%) had peripheral neuropathy. Out of 9 patients with peripheral neuropathy 66.66% patients were considered to be suffering with peripheral neuropathy on the basis of sensory symptoms and 33.33% were considered on the basis of impaired vibration and position sense on examination, one patient diagnosed on the basis of nerve conduction studies. 38% were in high risk group of developing T2DM in future as per Indian diabetes risk score. Mean compound motor action potential (CMAP) and nerve conduction velocity (NCV) were less in patients with peripheral neuropathy in comparison to patients without peripheral neuropathy.Conclusions: Peripheral neuropathy can occur in prediabetes though it is difficult to confirm it. Most common is small fiber neuropathy which can be diagnosed on the basis of history and examination. But by diagnosing it early in the course of prediabetes, morbidity and mortality secondary to neuropathy can be prevented

Feasibility of implementing public-private mix approach for tuberculosis case management in Pokhara Metropolitan City of western Nepal: a qualitative study

BackgroundThe Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public health care providers in the fight against tuberculosis using international health care standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal.MethodsWe conducted key informant interviews with 20 participants, 14 of whom were from private clinics, polyclinics, and hospitals where the PPM approach was used, two from government hospitals, and four from policymakers. All data were audio-recorded, transcribed, and translated into English. The transcripts of the interviews were manually organized, and themes were generated and categorized into 1. TB case detection, 2. patient-related barriers, and 3. health-system-related barriers.ResultsA total of 20 respondents participated in the study. Barriers to PPM were identified into following three themes: (1) Obstacles related to TB case detection, (2) Obstacles related to patients, and (3) Obstacles related to health-care system. PPM implementation was challenged by following sub-themes that included staff turnover, low private sector participation in workshops, a lack of trainings, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies.ConclusionGovernment stakeholders can significantly benefit by applying a proactive role working with the private in monitoring and supervision. The joint efforts with private sector can then enable all stakeholders to follow the government policy, practice and protocols in case finding, holding and other preventive approaches. Future research are essential in exploring how PPM could be optimized

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

Infrared spectroscopic study of zinc doped iron borate glasses

828-832The infrared absorption spectra of xZnO(40-x)Fe2O3.60B2O3 glasses (x = 0, 10, 15, 20 and 30 mol% of ZnO) have been investigated to find out the role played by zinc on the structure of these glasses. ZnO was gradually introduced to replace Fe2O3 in the series of zinc doped iron borate glasses containing 60% B2O3. The structural changes were inferred by monitoring the infrared spectra of these glasses in the range 200-4000 cm-1 by KBr technique. Very small change in absorption bands may occur on addition of ZnO impurity in the series of zinc doped iron borate glasses. No boroxyl ring formation is observed in the structure of these glasses. Similarly, tetrahedral formation of zinc is not observed. The absence of absorption band corresponding to a frequency of 806 cm-1 is attributed to the progressive substitution of boroxol ring by triborate (BO3) and tetraborate (BO4) groups

Characterization of iron bearing minerals from Dagsheri and study of their decomposition behaviour during combustion using ⁵⁷Fe Mossbauer spectroscopy

559-56157Fe Mössbauer spectroscopy has been used to characterize the iron-bearing minerals from Dagsheri (Himachal Pardesh, India). An interesting feature of this sample is, the presence of large amount of haematite and small amount of Jarosite, which decompose into oxide phase, i.e. into haematite, which is likely to have volcanic origin. The decomposition behaviour of these minerals on combustions studied by Mössbauer technique, after heating the samples at different temperatures. The decomposition route is significantly different from that normally observed in coal samples

Can wisdom be fostered: Time to test the model of wisdom

Several psychological theories and models of wisdom have been developed. Despite converging trend from different theories and models in the understanding of wisdom, intervention plans or attempts to facilitate wisdom have been meager. In this study, different components of the MORE Life Experience Model of Wisdom were taken as intervention targets, and these components were targeted through mindfulness training, journal writing, narrative simulation, and case discussion on leadership virtues. The basic purpose was to seek the answer for the possibility of development of wisdom in individuals by testing MORE model and we plan to answer this by fulfilling two aims: first, to find empirical support for the MORE life experience model, we wanted to see whether MORE components predict participants’ self-rated wisdom scores; and second, to use this model as an intervention tool to foster wisdom. Intervention, lasted for 18 weeks, was done among 160 students (age range 19–22 years) enrolled for “leadership” course. Complete data were obtained from 108 participants. Result suggests Habitual Action (β = 0.24, p < 0.05), Personal Mastery (β = 0.24, p < 0.05), and Suppression (β = 0.20, p < 0.05) predicted Cognitive Wisdom; Personal Mastery (β = 0.34, p < 0.001; β = 0.43, p < 0.01) and Mindfulness (β = 0.23, p < 0.05; β = 0.26, p < 0.05) predicted Affective and Reflective Wisdom; and composite wisdom was predicted by Mindfulness (β = 0.33, p < 0.001) and Reappraisal (β = 0.24, p < 0.01). After intervention there were changes in Suppression (d = 0.34) and Habitual Action (d = 0.26). The study concluded with an affirmation to the conviction that wisdom may be amenable to the intervention

Mossbauer spectroscopic study of soils collected from Panipat region

914-916<span style="font-size:14.0pt;line-height: 115%;font-family:" times="" new="" roman";mso-fareast-font-family:"times="" roman";="" color:black;mso-ansi-language:en-in;mso-fareast-language:en-in;mso-bidi-language:="" hi"="" lang="EN-IN">Mossbauer spectroscopy of 57Fe has been used to study some soil samples picked up from regions where the growth of crops is not normal as well as from the fertile part of the land in the Panipat district of Haryana. The ferrous- ferric ratios in these samples were determined. An attempt has also been made to correlate the Fe2+/Fe3+ ratio with pH values of the samples. The importance of these results lies in the necessity of application of suitable micronutrients in the area where the growth of crops is below normal.</span