Directorate of Health

The increasing integration of smartphones into daily life has given rise to partner phubbing – being ignored in favor of a partner phone use – which may impact mental health and family dynamics. Although phubbing has been explored in various relational contexts, empirical evidence on its association with depression and family functioning in primary care populations remains limited. This cross-sectional study was conducted among 222 married individuals aged 18 and above who visited a university-affiliated Family Health Center in Turkey between July and September 2024. Participants completed validated measures including the Phubbing Exposure Scale, Patient Health Questionnaire-2 and -9 (PHQ-2 and PHQ-9), and the Family Adaptability, Partnership, Growth, Affection, Resolve Scale. Statistical analyses included Mann–Whitney U, Kruskal–Wallis, chi-square, and correlation tests, with significance set at P < .05. Phubbing exposure was significantly higher among participants with positive PHQ-2 screenings for depressive symptoms (P < .01) and those with a history of psychiatric medication use (P < .01). Although PHQ-9 scores were not significantly associated with phubbing, early depressive symptoms measured by PHQ-2 were. Women reported higher phubbing exposure than men, and younger participants had higher perceived phubbing levels. Interestingly, individuals with low family functioning reported lower Phubbing Exposure Scale scores compared to those with moderate or high family functioning (P < .01), suggesting possible perceptual or relational dynamics in digitally neglected households. Partner phubbing appears to be linked with early depressive symptoms and various psychosocial characteristics, including gender, age, and psychiatric history. These findings highlight the relevance of digital neglect in clinical assessments and underscore the importance of integrating phubbing awareness into mental health and family care practices. Future research should explore longitudinal effects and develop interventions targeting smartphone-related disruptions in couple dynamics.

Hyperandrogenism in Polycystic ovary syndrome (PCOS) negatively affects health-related quality of life (HRQOL). Anti-androgens may improve both biochemical and patient-related outcomes. To evaluate the impact of combined finasteride and spironolactone on HRQOL in married and unmarried women with PCOS using PCOSQOL-47 and PCOSQOL-42, respectively. A total of 263 married and 236 unmarried women with PCOS were enrolled from two tertiary centers. All received finasteride (5mg) and spironolactone (100mg) daily and were followed every four months over a year. HRQOL was assessed using PCOSQOL-47 for married and PCOSQOL-42 for unmarried women, alongside evaluating their biochemical and clinical hyperandrogenism. After one year, significant reductions were observed in total and free testosterone, dehydroepiandrosterone sulfate, body mass index (BMI), and a decrease in modified Ferriman-Gallwey (mFG) scores. Both groups showed marked HRQOL improvement, greater in unmarried women. In PCOSQOL-47, psychological and emotional domains improved most, while fertility and sexual domains improved least. In PCOSQOL-42, menstrual and fertility domains had the highest gains, while coping improved least. Both groups had a 25% reduction in mFG score and 5% reduction in BMI. This is the first study to evaluate combined finasteride and spironolactone on HRQOL domains in PCOS using PCOSQOL-47 and PCOSQOL-42. Prior studies assessing anti- androgens used other tools, without distinction between married and unmarried women. Combined finasteride and spironolactone significantly improved all HRQOL scales and reduced hyperandrogenism within the first four months in women with PCOS, supporting its role alongside lifestyle measures.

Aims: The present study aimed to investigate the effects of various smoking methods (cigarettes, electronic cigarettes, hookah and their combination) on plaque accumulation and gingivitis among (20-40) years old in males and females in Mosul city. Material and Methods: To attain this purpose, 400 males and females aged 20-40 years participated in the study. The sample was divided into 8 groups of 50 participants each one, as follows: nonsmokers, cigarette smokers, electronic cigarette smokers, hookah smokers, cigarette smokers with hookah, electronic cigarette smokers with hookah, males, and a group who smoke hookah, and a group of nonsmoking females. (Silness and Loe, 1964) and (Silness and Loe, 1963) indices were recorded in the clinical examination. Results: The findings revealed that the plaque index in males using cigarettes and electronic cigarettes was significantly higher from those using hookah alone and nonsmokers. The plaque index is significantly higher in female hookah smokers compared to nonsmoking females. The plaque index does not differ significantly between female and male hookah smokers. The effect on the gingival index was higher in male smokers of cigarettes and electronic cigarettes compared to non-smoking males. Gingival index was higher in females smoking hookah compared to non-smokers, and both males and females smoking hookah had similar readings. When comparing tooth brushing behavior among male smokers, cigarette smokers had the highest percentage of "no" responses. Conclusion: The study found that smoking cigarettes and electronic cigarettes with or without hookah has a deleterious impact on the oral health of males and females, which is manifested by increasing plaque accumulation and associated gingivitis.

Abstract Introduction Globally, the proportion of older persons is steadily increasing. In India, 8% of the population is above 60 years of age, rising to 12.6% in Kerala, the highest among all states. To address the growing health needs of this demographic, the Ministry of Health and Family Welfare launched the National Programme for Health Care of the Elderly (NPHCE) in 2010–2011. This study evaluates the implementation and impact of NPHCE across five districts in Kerala—Kozhikode, Thrissur, Pathanamthitta, Alappuzha, and Idukki—and examines its key achievements and challenges. Methods A cross-sectional, concurrent mixed-method design was used. Quantitative data were collected through structured questionnaires and observation checklists, while qualitative insights were obtained from Key Informant and In-Depth Interviews. Results The quantitative findings show that NPHCE has expanded from five pilot districts to all fourteen, establishing geriatric wards, outpatient clinics, and elderly-friendly infrastructure. However, implementation remains uneven, with disparities in staffing, infrastructure quality, and service utilisation across districts, indicating inconsistencies in accessibility and care delivery. Qualitative findings reveal that while accessibility and comfort for older adults have improved, persistent challenges remain due to workforce shortages, limited funding, and inadequate transport facilities. Beneficiaries also reported social isolation, economic vulnerability, and barriers to essential healthcare. Strengthening human resources, interdepartmental coordination, and community participation were emphasised to enhance programme effectiveness. Conclusion Kerala’s decentralised healthcare model provides a strong foundation for elderly care. However, addressing political, financial, and operational challenges remains critical to improving the quality of life for the state’s ageing population.

Sinonasal tumours are rare entities presenting with non-specific symptoms, therefore being often misinterpreted. The present study aimed to evaluate if the 13-gene DNA Methylation assay for early cancer detection already assessed in the oral cavity, was also useful in nasal cavity tumours. The case series consisted of 93 patients (63 males/30 females), 49 with malignant tumours, 14 with benign/borderline tumours, 34 as control series with 33 inflammatory polyps and one fungus ball. We collected one flocked swab from the lesion and one from the contralateral nasal cavity. All sinonasal cancer cases were evaluated by bisulfite next generation DNA sequencing, investigating the following genes: ZAP70, ITGA4, KIF1A, PARP15, EPHX3, NTM, LRRTM1, FLI1, MIR193, LINC00599, MIR296, TERT, GP1BB. To evaluate the performance of the methylation assay, a specific methylation score was calculated for each sample using linear discriminant analysis, with a predefined positivity threshold of 1.0615547. The association between diagnosis and methylation score positivity was evaluated through Fisher's exact test and calculation of risk ratios with 95% confidence intervals. Additionally, dimensionality reduction techniques were employed to explore the structure of the dataset and assess the ability of methylation profiles to distinguish between different pathological conditions. The 13-gene DNA Methylation scored positive in 42/49 malignant tumours; We included also 14 benign/borderline tumours of which 11 scored positive. Among 33 inflammatory polyps, 24 scored negative, as well as 64/70 normal contralateral mucosa and one fungus ball. Therefore, excluding benign/borderline tumours, the detected sensitivity was 85.7% and specificity 85.6% (AUC: 0.878).

Aim: Microplastics contamination is an escalating environmental threat in Northeast India, critically impacting its fragile ecosystems, agriculture, and public health. The region, recognized as a global biodiversity hotspot, faces growing microplastics pollution from diverse sources such as domestic waste, agriculture, industrial activities, and aquaculture. This study explores the comprehensive understanding that can guide future research, governance, and regional mitigation strategies. Objective: This review aims to synthesize existing research on microplastics contamination in Northeast India, assess their sources and environmental pathways, evaluate ecological and agricultural impacts, identify critical knowledge gaps, and highlight policy and community-level interventions required for effective management. This review uniquely integrates freshwater–soil linkages, monsoon-driven transport mechanisms, and region-specific policy challenges within the Eastern Himalayan context. Methodology: The review compiles and analyzes available scientific literature, government reports, and regional environmental assessments related to microplastics contamination in Northeast India. A comprehensive search was conducted from 2020 to 2025 using major scientific databases, including Web of Science, Scopus, Google Scholar, and PubMed. Studies focusing on freshwater ecosystems, soils, biodiversity impacts, and regional waste-management practices were systematically evaluated. Results: Microplastics are commonly found in freshwater systems and agricultural soils, highlighting widespread contamination. Freshwater ecosystems often contain higher levels of microplastics, with significant biological uptake in fish and other aquatic organisms, suggesting potential for trophic transfer and bioaccumulation. In agricultural soils, contamination is linked to practices like plastic mulching, irrigation infrastructure, and land use. Despite these growing concerns, research efforts remain limited and inconsistent, with a lack of standardized methodologies and long-term monitoring. Significance: This review highlights the urgent need for comprehensive monitoring, standardized assessment techniques, and targeted policy action to address microplastics contamination in Northeast India.

Introduction. Auricular keloids are pathological scar formations characterized by excessive fibroblast activity and collagen deposition, often triggered by ear piercing or trauma. Surgical excision alone is associated with very high recurrence rates, and adjuvant radiotherapy has emerged as an effective strategy to reduce relapse. However, data from Iraq on combined therapy outcomes remain limited. Objective. To evaluate the effectiveness and safety of combined surgical excision and adjuvant radiotherapy in the management of auricular keloids, and to assess patient satisfaction following treatment. Materials and methods. A prospective study was conducted at Al-Sadr Teaching Hospital from 2018 to 2024. Thirty patients aged ≥15 years with primary or recurrent auricular keloids were enrolled. Surgical excision was performed under local anaesthesia, followed by adjuvant radiotherapy (15 Gy in 3 fractions delivered within 24 hours postoperatively). Patients were followed for 2 years to assess recurrence, complications, and satisfaction using a 5-point Likert scale. Data were analysed using SPSS version 24. Results. Thirty patients with 53 auricular keloids were evaluated; mean age was 32.5±12.1 years, and 96.7% were female. The most common lesion site was the earlobe (52.8%). Sixteen patients (53.3%) had recurrent keloids. All patients completed treatment without complications. No recurrences were observed during the 2-year follow-up period. Patient satisfaction was high: 83.3% were very satisfied, and 16.7% were satisfied. Satisfaction tended to be higher in primary keloids (92.9%) than in recurrent lesions (75.0%), although this difference was not statistically significant (p=0.21). Conclusion. Combined surgical excision and adjuvant radiotherapy is a highly effective and safe treatment for auricular keloids, achieving excellent cosmetic outcomes, complete local control, and high patient satisfaction. Введение. Келоиды ушной раковины – это патологические рубцовые образования, характеризующиеся чрезмерной активностью фибробластов и отложением коллагена, часто возникающие вследствие прокалывания ушей или травмы. Хирургическое иссечение само по себе связано с очень высокой частотой рецидивов, а адъювантная лучевая терапия стала эффективной стратегией для снижения рецидивов. Однако данные по Ираку о результатах комбинированной терапии остаются ограниченными. Цель. Оценить эффективность и безопасность комбинированного хирургического иссечения и адъювантной лучевой терапии при лечении келоидов ушной раковины, а также оценить удовлетворенность пациентов после лечения. Материалы и методы. Проспективное исследование проводилось в клинической больнице Аль-Садр с 2018 по 2024 год. В исследование было включено 30 пациентов в возрасте ≥15 лет с первичными или рецидивирующими келоидами ушной раковины. Хирургическое иссечение проводилось под местной анестезией с последующей адъювантной лучевой терапией (15 Гр в 3 фракции в течение 24 часов после операции). Пациенты наблюдались в течение 2 лет для оценки рецидивов, осложнений и удовлетворенности с использованием 5-балльной шкалы Лайкерта. Данные анализировались с использованием SPSS версии 24. Результаты. Было обследовано 30 пациентов с 53 келоидами ушной раковины; средний возраст составил 32,5±12,1 года, 96,7% были женщинами. Наиболее частой локализацией поражения была мочка уха (52,8%). У 16 пациентов (53,3%) наблюдался рецидив келоидных рубцов. Все пациенты завершили лечение без осложнений. Рецидивов не наблюдалось в течение 2-летнего периода наблюдения. Уровень удовлетворенности пациентов был высоким: 83,3% – очень удовлетворены, 16,7% – удовлетворены. Удовлетворенность, как правило, была выше при первичных келоидах (92,9%), чем при рецидивирующих поражениях (75,0%), хотя эта разница не была статистически значимой (p=0,21). Заключение. Комбинированное хирургическое иссечение и адъювантная лучевая терапия являются высокоэффективным и безопасным методом лечения келоидов ушной раковины, обеспечивающим отличные косметические результаты, полный локальный контроль и высокую степень удовлетворенности пациентов.

The increasing demand for sustainable agriculture requires innovative strategies to enhance nitrogen use efficiency while minimizing environmental losses associated with conventional fertilizers. This study aimed to develop and compare ammonium chloride- and ammonium nitrate-modified nanobiochar as controlled-release nitrogen carriers and to elucidate their effects on nitrogen retention, soil properties, and physiological nitrogen utilization in spinach (Spinacia oleracea L.). Nitrogen-modified nanobiochar was synthesized using ammonium chloride (NB-AC) and ammonium nitrate (NB-AN) at three nitrogen rates (0.03, 0.06, and 0.12 g N g−1 NB) and applied to soil at 1% (w/w). Soil properties, nutrient dynamics, and plant growth and physiological traits were analyzed after 15 and 30 days. Nitrogen modification significantly improved soil nitrogen retention and nutrient availability compared with unmodified nanobiochar. The highest nitrogen loading treatments (NB-AC3 and NB-AN3) notably improved spinach growth, photosynthetic efficiency, pigment content, nitrogen metabolism enzymatic activities, and accumulation of key metabolites (soluble sugars, flavonoids). Nitrogen-release assessments indicated a pronounced controlled-release with reduced nitrogen leaching and greater retention, particularly under NB-AN3. Overall, this study demonstrates that nitrogen-modified nanobiochar functions as an effective nitrogen carrier that enhances nitrogen utilization and growth. These findings provide mechanistic insights into its potential as a sustainable alternative to conventional nitrogen fertilizers.