Background: Increasing prevalence of screen time-related disorders such as obesity, sleep disorders, and mental health disorders calls for comprehensive and cost-effective educative measures. A comprehensive review that focuses on understanding the potential hypotheses for these associations is lacking. Published practical strategies to curb excessive screen time are scarce. Aims: We aimed to synthesize existing data on the behavioral science that underlies wireless mobile device (WMD) overuse, and its adverse health outcomes and suggest practical strategies to achieve life-technology balance. Methods: Comprehensive search of databases was performed for smartphone, screentime, and phone addiction. Articles across all ages, genders, and countries were included. Results: Repeated exposure to potentially addictive stimuli (i.e., notifications) can cause persistent brain changes in the prefrontal cortex. The hyperreactive dopamine system could drive this compulsive behavior in the form of a habit-loop of cue, craving, response, and reward. Screentime-associated increase in body mass index was independent of physical activity and likely due to food marketing, distracted eating, and reduced satiety. Interactive WMD use at bedtime promoted sleep procrastination, unconscious late-night snacking, disrupted sleep, daytime tiredness, and depression. Only 5% of the US adolescents met the sleep, physical activity, and screen time recommendations concurrently, with screen time being the main impediment. Adverse psychological well-being, life and job dissatisfaction, and low self-esteem were noted secondary to irrational comparisons on social media platforms. Practical strategies to curb WMD overuse included WMD triage and uncluttering, eliminating redundant cues to check WMD, and modifying the digital environment at home and office. Conclusions: While it would be irrational to suggest complete avoidance of all WMDs, moderation, balance, and real-life engagement, together with the strategies discussed here, will be critical components of any intervention plan.

Introduction: The prevalence of renal stones is increasing globally. While surgical techniques have improved dramatically, there is no emphasis on preventing renal stone formation based on the metabolic abnormalities present in individual patients. There is no data from South India regarding the prevalence of metabolic abnormalities in patients with a high risk of stone recurrence. Materials and Methods: The study was conducted on 59 patients who underwent a metabolic evaluation to detect risk factors for recurrent renal stones. Detailed history followed by fasting blood samples were taken for total serum calcium, phosphorous, albumin, creatinine, alkaline phosphatase, parathyroid hormone, uric acid, and venous blood gas. A 24-h urine collection was done for evaluation of metabolic abnormality with proper precautions. A urine acidification test was done in selected patients based on baseline abnormalities. Results: The mean age of the patients was 41.03 ± 15.97 years. The majority were males, 35 (59.32%), of which 7 (11.86%) patients were in the pediatric age group. Eleven (18.64%) patients had a family history of renal stones. Metabolic abnormalities detected were high salt consumption resulting in high 24-h urine sodium in 50 (84.75%) patients, hyperoxaluria in 23 (38.98%) patients, hypocitraturia 1 (1.69%) patient, hypercalciuria 9 (15.25%) patients, and hyperuricosuria 5 (8.47%). Five (8.47%) patients did not have any metabolic abnormality. Conclusion: There is an increased prevalence of metabolic abnormalities in patients at high risk of recurrent renal stone formation. This information can be of value in the prevention of recurrence and for individualizing medical therapy.

Background: The study aimed to delineate clinical profile of rhinocerebral mucormycosis and its associated factors to enhance understanding of this newly emerging disease. Materials and Methods: The case series study design with total enumerative sampling method was used to enroll 40 patients admitted with mucormycosis in a leading tertiary care hospital. Patients aged >18 years and admitted to the hospital within 3 days of confirmed or probable diagnosis of mucormycosis were included in the study. KOH mount of the nasal discharge was used to diagnose 45% of the subjects and rest 55% of subjects were diagnosed by radiological investigations. Results: Forty mucormycosis patients (median age 46.5 years, 67.5% male) were included in this observational study. 87.5% were symptomatic at the time of coronavirus disease (COVID) infection with maximum 59.5% having mild COVID-19 infection. The most common risk factors found for mucormycosis include use of steroids (77.5%) as treatment during COVID-19 and diabetes (65%), with 82.5% admitting to the hospital with high blood sugar at the time of mucormycosis infection. All 100% of subjects required ventilation support with 97.5% having noninvasive high-frequency oxygen support and 2.5% having invasive ventilation. Maximum 57.5% were discharged from hospital following recovery, 17.5% died during the course of disease, and 25% opted for leave against medical advice. Conclusion: COVID-19 patients with diabetes as comorbidity and use of steroid therapy increase susceptibility of patients for mucormycosis.

Background: The modern era is full of competition. Students face a wide variety of stresses such as academic, parental, peer pressure, socioeconomic status, and many others. Stress is seen as a negative, cognitive, emotional, behavioral, and physiological process that occurs, as a person attempts to deal with stressors. To date, there is no tool designed to measure the level of stress present in a person. The objective of our study is to identify and assess the level of stress among 12^th-standard students and the outcome generated by that stress. Materials and Methods: A cross-sectional study was done in 6 higher secondary schools among 303 students from each stream (Science, Arts, and Commerce) by considering gender equality. The Educational Stress Scale for Adolescents (ESSA), the Patient Health Questionnaire-9 (PHQ-9), and the Rosenberg Self-Esteem Scale (RSE) were used to assess stress among students. Results: Analysis was done by using SPSS 15.0 software. 45.2%, 25.0%, and 29.8% were under high stress, respectively, from Science, Arts, and Commerce streams. There is a strong association between perceived stress and students' academic performance among students in the Science stream. Based on PHQ-9 for assessment of depression, 38.0% of students showed minimal depressive symptoms, 21.5% showed major depression with mild severity, 4.3% of students had major depression with moderate severity, and 0.7% had major depression with severe severity. Whereas 21 students of the Arts stream perceived high stress, 76.2% lived in urban areas (Cronbach's alpha = 0.774 and 0.734 for ESSA and RSE, respectively). Conclusions: Students of the Science stream perceived the most stress; reasons are pressure from study, worry about grades, workload, and despondency. Students of the Arts stream belonging to urban areas face more stress. As the stress level increases, there is an increase in depressive symptoms as well as a decrease in self-esteem seen.

Trial registration: CTRI/2018/03/012571; UTN: U1111-1210-7895. Background: Uterine fibroids are the most common benign tumors in women of reproductive age. New fibroids can form with any conservative management and preexisting small or undetected fibroids can grow significantly. This necessitates the use of noninvasive and complementary treatments, including homeopathy. This study investigated the effectiveness of the homeopathic medicine Aurum muriaticum natronatum (AMN) against individualized homeopathic medicines (IHMs) in 62 women with uterine fibroids. Materials and Methods: A 6-month, open-label, randomized (1:1), two parallel arms trial was conducted at the outpatient departments of the National Institute of Homoeopathy, West Bengal. Patients were randomized to receive either AMN (n = 31) or IHMs (n = 31). The outcome measures were the Uterine Fibroid Symptom Quality of Life questionnaire (UFS-QOL, primary) total and subscale scores, and pelvic ultrasound findings – number and size of fibroids (secondary); all were measured at baseline, and after 3 and 6 months. After adjustment for the baseline differences using analysis of covariance models, the intention-to-treat sample was analyzed to detect group differences by unpaired t-tests at different time points individually and by two-way repeated-measure analysis of variance overall. Results: Adjusted analysis revealed a statistically significant difference between the two groups after 6 months of intervention for UFS-QOL total score favoring IHMs against AMN (mean difference: 23.9, 95% confidence interval 15.832.1, F_1,60 = 14.062, P < 0.001). Most of the UFS-QOL subscale scores also revealed similar significant differences in favor of IHMs. However, for the secondary outcomes, no statistically significant difference was observed between the two groups (numbers of fibroids: P = 0.640; sizes of fibroids: P = 0.588). The most frequently prescribed medicines in the IHMs group were Natrum muriaticum, Pulsatilla nigricans, Calcarea carbonica, Ignatia amara, and Thuja occidentalis. Conclusion: Overall, IHMs performed better than AMN in the treatment of uterine fibroids. Efficacy trials of both interventions are necessary.

Introduction: With the whole world turning digital in this era, healthcare is no exception. Digital tools such as electronic medical records (EMR), cloud data concepts, telemedicine services, artificial intelligence systems, and clinical decision support systems are redefining the classical healthcare delivery processes. Although these technologies were proven to enhance the care delivery and accessibility processes, research shows a gap in their acceptance due to various factors. Therefore, the current study was undertaken to identify the physician's readiness in accepting EMR services. Objectives: The objectives of the current study are to identify the factors that act as barriers for the adoption of EMR by physicians and to suggest the management on the mechanisms to overcome those barriers. Materials and Methods: The study was conducted for a period of 3 months at a tertiary care teaching hospital. A questionnaire for assessing barriers of EMR acceptance was prepared with eight components namely finance, technical, time, psychological, social, legal, organizational, change process; administered over 150 doctors of various departments. The data was analysed using MS-Excel for computation of percentages. Results: Most of the physicians agreed about the advantages of EMR as a cost saver in the long-run and improving patient-provider relationship. They also felt the need for strong leadership in the implementation of EMR in the hospital. Conclusion: Despite many advantages of EMR, unfortunately, it has not gained the same level of acceptance by physicians across places due to several reasons. Studies of this kind will help to identify the underlying factors that hamper EMR implementation. Thus, necessary actions can be initiated by the management to promote EMR acceptance.

There has been a surge in the prevalence of ocular and visual issues across the globe following the COVID-19 pandemic. An 11-year-old student reported with a sudden onset of intermittent diplopia at near, noticed after continuous online classes. He was diagnosed with decompensated exophoria associated with excessive near visual demands and was prescribed prisms as an initial management option followed by vision therapy. He responded well to vision therapy with resolution of symptoms and improvements in clinical parameters. This report emphasizes the importance of awareness regarding binocular vision anomalies that could get exacerbated or decompensated due to excessive near visual demands.