Government of Sikkim

This chapter explores how physical exercise acts as a transformative force in reshaping the brain and enhancing psychological resilience. It highlights the mechanisms of exercise-induced neuroplasticity at molecular, cellular, and systemic levels that contribute to improved memory, attention, and executive function. The discussion emphasizes the close relationship between physical activity and mental health, showing how exercise strengthens cognitive performance and emotional stability through the regulation of neurotrophic factors, neurotransmitters, and stress response systems. It also examines the comparative effects of aerobic, resistance, and mind-body exercises, explaining their unique and complementary influences on cognition and resilience. The chapter concludes that regular physical activity is a powerful non-pharmacological strategy for improving brain function, emotional well-being, and lifelong adaptability.

Opportunistic screening for diabetes mellitus (DM) is a key component of India's noncommunicable disease programme, yet its coverage remains poorly assessed. We conducted a cross-sectional study in ten primary healthcare facilities in West Sikkim over 7 weeks using register reviews and staff interviews. Among 4323 outpatient department attendees aged ≥30 years, 1515 (35%) were screened and 175 (12%) were newly diagnosed. Screening coverage ranged from 9% to 100% and yield from 0% to 36%. Fishbone analysis identified staff shortages, inadequate supplies, and low provider motivation. Targeted quality improvement strategies are recommended to improve screening and DM management.

This paper examines the effectiveness of the rehabilitation centre situated in Rangpo, Pakyong District, Sikkim, which helps the drug addict patients to detox themselves through yoga, meditation, group counselling e.t.c. In this study, a patient is considered detoxified if he/she stayed at least 90 days as duration of each detoxification programme is at least 90 days. Those who left the programme before 90 days were treated as censored (2). Censored patients are discarded from the study assuming that they are not detoxified. Real-life data of admitted patients were collected from the centre over two years,2023 and 2024. Since the exact pattern of recovery times are not known, Histograms are used to assess the recovery times of the patients who completed the programme. The objective of this study is to classify the detoxified patients according to the age bracket. An exploratory data analysis is performed by calculating the mean, median, and variance of their ages to get an overall view of the age distribution of the patients. To determine that there is a significant difference between the median ages of patients over two years MannWhitney U test is applied, as the two population found to be non-parametric. This test is used to evaluate the centre’s performance over time.

Introduction and importance:Cerebral myiasis is a rare neurosurgical condition with only 21 cases reported globally. Post-traumatic forms are common in low- to middle-income countries, often arising from neglected wounds. We report the first documented case in Ghana, highlighting systemic barriers to timely neurotrauma care.Case presentation:A 7-year-old boy sustained an open comminuted skull fracture as an unhelmeted pillion rider in a tricycle collision. After a 3-day delay in wound care at a peripheral facility, he presented with a foul-smelling, sand-contaminated wound. Neurologic assessment revealed GCS 4/15, anisocoria, flaccid paralysis of all limbs, and absent plantar reflexes. The 12 × 8 cm wound overlaid the right frontal lobe with exposed brain tissue and several maggots were observed around the wound. Ten larvae were removed from wound, extensive debridement was performed, and broad-spectrum antibiotics were initiated. Despite intensive multidisciplinary care, the patient died on day 5 of admission.Clinical Discussion:While head injury of such severity requires immediate multidisciplinary care in an intensive unit, there was a lag in assessing referral centers. This was compounded by a lack of expertise in wound management and the absence of appropriate remote guidance from experts. This case highlights challenges in neurotrauma care in Ghana amidst limited and highly centralized specialist facilities.Conclusion:Post-traumatic cerebral myiasis within a hospital is a testament to weak trauma care. It emphasizes the urgent need to implement measures, such as telemedicine support for peripheral centers, improved trauma referral pathways, and capacity building in emergency stabilization.

This paper presents a functional Arduino based platform for real time undergoing cable fault detection for enhancing the reliability and efficiency of the electrical distribution system. Conventional fault detection methods typically need lengthy diagnosis processes and manual inspections resulting in extended outages and high maintenance cost. An Arduino microcontroller system monitors real time cable voltage and current signals, detecting faults by analyzing resistance and voltage variations along the cable. The system accurately locates cable faults, connecting <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$100 \Omega$</tex> resistors arranged in series to simulate cable resistance. It activates a relay for isolating the faulty phase while simultaneously displaying real-time fault details and phase identification on an LCD screen. This study utilizes Proteus VSM software for detailed system simulation, ensuring operational success before actual deployment. The integration of real-time monitoring technology with digital signal processing provides a cost-effective, scalable, and reliable solution for detecting underground cable faults. These enhancements ensure rapid responsiveness and automated fault detection, significantly improving the efficiency and reliability of the cable network.

The Himalayan region is facing a pressing environmental crisis marked by the rapid expansion of glacial lakes. This surge, primarily fueled by climate change and compounded by seismic activity and landslides, presents a severe threat to communities downstream. This chapter delves into the issue of glacial lake expansion, focusing particularly on glacial lake outburst floods (GLOFs). Through a case study of the 2023 South Lhonak GLOF, which caused significant casualties and damage, the study extracts crucial insights for policy formulation. It emphasizes the need for a collaborative policy approach to tackle the expanding glacial lake problem. Drawing from past disasters, we underscore the increasing frequency and severity of GLOFs, supported by recent empirical studies, and examine the impact of the South Lhonak Lake GLOF on the Teesta River valley. This event underscores the urgency for policymakers to reassess existing risk assessment and disaster management frameworks. The chapter identifies the shortcomings in current glacial lake monitoring in the Himalayas and the lack of robust early warning systems as critical deficiencies that demand immediate attention. The primary objective of this chapter is to guide policy decisions aimed at reducing the vulnerability of Himalayan communities to GLOF incidents and fostering resilience in the face of environmental change.

Sikkim state is located in the eastern Himalayas, stands as a unique northeastern state of India, in terms of diverse geological and natural resources, sharing its borders with Bhutan to the east, Nepal to the west, and the Indian states of West Bengal to the south and Assam to the northeast. The region boasts a diverse topography, characterized by mountainous terrain and a wide range of altitudes (300–8598 m), encompassing subtropical regions, alpine zones, and glacial areas. The management of water resources in Sikkim, particularly the wetlands (lakes) and springs, poses significant challenges due to its complex topography and distribution disparities. The majority of lakes, particularly in South, East, and West Sikkim, have transitioned from perennial to seasonal. The population of Sikkim heavily relies on spring water for various purposes, including domestic, agricultural, and industrial needs. Notably, water scarcity is more pronounced in the districts of South and West Sikkim compared to East and North Sikkim. Adding to these challenges are the seismic factors, as South, East, and West Sikkim are classified as very high to high seismic hazard zones. Microtremors and minor earthquakes are common occurrences, leading to an increased density of subsurface fractures, causing water seepage in lakes. Given that tourism is a major economic driver in Sikkim, the drying up of lakes, and significant tourist attractions, becomes a concern that requires urgent attention. Geophysical investigations, employing vertical electrical sounding and profiling, have revealed subsurface fractures in many lakes in South, West, and East Sikkim, potentially contributing to seepage. Treating such fractures is necessary for the revival of the lakes. Another pressing issue is the diminishing discharge of springs, affecting water availability. To mitigate this, recharge pits have been strategically excavated on hilltops to collect and naturally infiltrate rainwater. Recognizing the importance of water resources for local livelihoods and the tourism sector, efforts have been made to create small ponds (Amrit Sarovar) near habitations. While these initiatives, including the excavation of recharge pits and the creation of ponds, aim to enhance water security, a comprehensive assessment of their effectiveness is still pending. Balancing the ecological resilience of Sikkim's water resources with socioeconomic demands emerges as a critical imperative for sustainable development. It calls for integrated approaches that prioritize conservation while addressing the needs of communities and the tourism sector. Only through concerted efforts, supported by scientific research and community participation, Sikkim state water challenges can be addressed.