In developing countries, Diseases related to inadequate water, sanitation, and hygiene are a huge burden. It is estimated that 88% of diarrheal disease is caused by unsafe water supply and inadequate sanitation and hygiene. The future generation of a nation spends most of its time in schools, and since the status of the WASH component in school is strongly linked to Learning and health. Therefore, Objectives of the study was to assess the status of availability, accessibility, functionality, usability, and quality of WASH standards in secondary schools located in a Municipal corporation area of Saurashtra region. Methods: The study was carried out in 34 secondary schools in the study city for a period of 18 months. Data was collected using a pre-validated, standard tool in the form of a questionnaire prepared by WHO and UNICEF and analysed. Results: Out of 34 schools, the majority (24) of the schools had piped water supply as their primary source of drinking water, 70.59% had hand washing stations available, but the availability of both soap and water was observed only in 3 government and 11 non-government schools. Menstrual hygiene management like Covered bins facilities were found only in 18 schools, with a higher proportion in non-government schools; 73.52% of schools had adequate distribution of students per toilet, but the norms for girls per toilet were only met in non-government schools. A wide gap was found between the availability of toilet facilities, usability, and functionality. Conclusions: While the availability of the structural component of WASH was satisfactory in most of the schools (with a better proportion in non-government ones), its functionality, usability, and quality were not uniform among schools.

Background: Background: Enhanced iron levels in patients afflicted with \(\beta\)-thalassemia induces oxidative stress, which restrains the secretion of gonadal and pituitary hormones. The associated severity level based on several hormones and oxidative stress biomarkers is not been demonstrated so far.
Method: The present study encompasses the employment of hierarchical clustering and different classifiers for determining the severity of the disease based on the analyzed clinical parameters in the study population. Furthermore, the hormonal parameters along with ferritin levels were used as input parameters for the prediction of the oxidative stress biomarkers ([Malondialdehyde (MDA) and protein carbonyl] through neural networks.
Result: A Significant negative correlation was observed between the oxidative stress biomarkers and the hormonal levels in both the female and male datasets of the case group. The clustering results depicted that the datasets corresponding to high oxidative stress biomarkers with very low gonadal hormones represented severe levels of the disease. Support vector machine outperformed the other classifiers in the case of the male dataset. The neural network efficiently predicted female and male models’ MDA and protein carbonyl values. High Fisher’s F-value (2042.035 to 6353.659) and low p-value (<0.001) established the significance of each model.
Conclusion: The proposed framework can be used as a real-life decision tool for medical professionals to diagnose and treat \(\beta\)-thalassemia from a proper classification of the severity of the disease. Furthermore, the passive determination of some critical blood parameters may avoid the complex analytical procedure and its high cost.

Background and Aim: Bilateral superficial cervical plexus block provides adequate analgesia in the neck region for thyroid surgery. Intermediate cervical plexus block can block all four cutaneous branches of the cervical plexus and sensory/ motor branches of the cervical plexus supplying the sternocleidomastoid muscle simultaneously so that provides adequate analgesia and anesthesia for neck surgeries that involve manipulation or resection of the sternocleidomastoid muscle. Along with general anesthesia, bilateral superficial cervical plexus block with intermediate cervical plexus block was given to reduce intraoperative opioid requirement and increase the duration of postoperative analgesia.
Material and Methods: A total of 56 patients aged between 18 to 65 years of either sex, ASA I and II, undergoing elective thyroid surgery were randomly allocated in two groups. Group S receives bilateral superficial and intermediate cervical plexus block with Inj. Ropivacaine 0.375% before induction of general anesthesia, and Group C receives no block. In both groups, intraoperative opioid requirement, intraoperative hemodynamics, time of rescue analgesia, total no. of rescue analgesic in 24 hours, total duration of analgesia, and complications were noted.
Results: Group S (\(25\pm0\) micrograms) had less mean fentanyl requirement intraoperatively than group C (\(35\pm14.43\) micrograms). Intraoperative hemodynamics were better in Group S compared to Group C. Total duration of analgesia was prolonged in group S (\(24.57\pm4.72\) hours) than in Group C (\(4.57\pm2.10\) hours). Total no. of rescue analgesic was reduced in group S (8 patients (28.57%)- 1 dose and 20 patients (71.42%)- no analgesic) as compared to group C (7 patients (25%)- 3 doses, 20 patients (71.42%)- 2 doses, one patient (3.57%)- one dose).
Conclusion: Combination of bilateral superficial cervical plexus block with intermediate cervical plexus block reduces intraoperative opioid requirement and increases postoperative analgesia with better intraoperative hemodynamic variables and fewer side effects.

Before taking the dimension, the persons were positioned such that the hips and knees were in extension, the quadriceps muscles were relaxed, and the legs and ankles were neutral. Following mark¬ing, one of the arms of the manual goniometric was placed such that the ASIS and the patellar middle point were combined, and the other arm was placed so that the tuberose as tibia and the patellar centre were collective. The dimension value was recorded after the manual goniometry was positioned. \textbf{Aim and Objective:} The objective of the study is to find out the bilateral variation in the mean Q- angle (Quadriceps angle) values in both male and female. This study is to determine the correlation between Q- angle (quadriceps angle) values, Bicondylar distance and body height measurement. Material and Method: The present study was done on 500 adult human subjects (300 male and 200 female) of north Indian origin. The Q angle is precise with a full circle universal manual goniometry which is made of clear steel with the subject standing in the upright weight-bearing position. Result: The dimension of Quadriceps angle values in males from right side (mean 13.25) and from left side (mean 13.41) , the Q- angle values in females from right side (mean 16.97) and from left side (mean 16.35) (P<0.0001). The effect shows that the Q- angle was more prominent in females than in males. The difference of Q-angle with dominant side revealed that left side of Q- angle value (both males and females) was more often higher than right side. Conclusion and Discussion: The Quadriceps angle values of both males and females decreases with increases in body height which shows a positive correlation with body height and condylar distance. Positive correlation exists between Quadriceps angle and Body height.