Aim: Concentration of formaldehyde (FA) which is used to preserve cadavers for dissection in medical colleges was monitored in indoor air including at the breathing level in dissection classes during a 2-week study in a gross anatomy laboratory and also in the cadaver storage room in a Medical College in India in 2012. Materials and Methods: Air samples were collected for 30 min and 3 h to commensurate with World Health Organization (WHO) standard (short-term exposure limit) value of FA (30-min) and dissection class of 3 h duration respectively. Results: FA concentration ranged from 0.11 to 1.07 mg/m 3 in the cadaver storage room and 0.06-1.12 mg/m 3 in the gross anatomy laboratory. In samples taken at 5 ft height at the breathing level, FA concentration ranged from 0.32 to 0.86 mg/m 3. Conclusions: Most of the observed FA levels were found to be above the prescribed FA guideline values laid down by organizations such as OSHA, ACGIH, WHO, Japan Ministry of Health, Labor, and Welfare and, therefore, could be considered as harmful for students' and teachers' health. FA concentrations reported from a few medical facilities in other countries are comparable, implying that some uniform management and control strategies for FA could be contemplated to reduce risks of FA exposure to students and teachers which are discussed in this paper.

BACKGROUND: Pediatric nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, hypertension, metabolic syndrome, cardiovascular problems, and increased risk of chronic liver disease and Type II diabetes mellitus. The aim of the study was to assess the metabolic profiles and associated risk factors of NAFLD in obese children. MATERIALS AND METHODS: Children with a body mass index (BMI) of >27 kg/m 2 an adult equivalent cutoff (Indian Academy of Paediatrics, 2015 guidelines) aged 5–18 years presenting to the pediatric outpatient unit of PGIMER Satellite Centre, Sangrur, India, were retrospectively recruited over a 1-year period. Anthropometry, lipid profile, thyroid levels, liver function test, fasting blood sugar, and blood pressure were measured. Ultrasonography was used to diagnose NAFLD. Logistic regression was used to assess the risk factors. RESULTS: A total of 100 children participated in the study. The mean age was 10.6 ± 2.6 years and the mean BMI-Z score was 2.6 ± 0.5. The prevalence of NAFLD was 62%. Alanine transaminase (ALT) was significantly elevated in all the children with NAFLD. Lipid levels and BMI Z-score were similar in both groups. Unadjusted odds ratio shows statistically significant association of ALT (2.058 [1.11–1.01]) and waist circumference (1.089 [1.19–0.99]) with NAFLD. With adjusted odds ratio only, ALT (1.12 [1.24–1.01]) was found to be significantly associated with NAFLD. CONCLUSION: There is quite a high prevalence of nonalcoholic fatty liver in obese Indian children. All children with raised liver enzymes should undergo sonography to rule out NAFLD.

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Introduction: COVID-19 has emerged as a major health care problem during 2020. The risk of infection and transmission led to imposition of a severe lockdown by the government. The diversion of health care machinery towards the control of transmission, treatment of the infected individuals led to a compromise in delivery of care towards non-COVID ailments. This is truer in rural and unapproachable areas where the health facilities were already in jeopardy. Study Design: A prospective observational study was conducted from May 2020 to November 2020 at PGIMER satellite center, Sangrur. Methods: Standard operating procedures (SOP) were instituted for physical consultation during the COVID-19 pandemic at PGIMER satellite center, Sangrur, a branch of PGIMER, Chandigarh. These were approved by the committee constituted for this purpose. The effectiveness of these SOPs was reported as percentage of healthcare workers who contracted infection for non-COVID OPD. Results: A total of 9963 patients attended the Out Patient Department (OPD). Male to female ratio of the patients was 1.2:1. Maximum (6141) consultations were sought for general physician followed by ophthalmologist (1464). Majority of the consultation were for benign non-communicable disorders. Seventy patients who visited the OPD were referred for COVID-19 testing as they had symptoms of infection. A total of 5 (3.8%) incidents of COVID-19 infection were reported among the healthcare workers at the center. Conclusions: The SOPs proved effective in the delivery of physical care with low occupational hazard to the healthcare workers (HCW).

The Six Sigma is a global management methodology that empowers clinical laboratories by better understanding of the quality in their laboratories and helps in improving quality and subsequently reducing laboratory costs. The objective of this prospective study was to practically apply Six Sigma on pre-analytical quality indicators i.e. pre-analytical phase errors of “Total Testing Process” in laboratory at PGIMER Satellite Centre, Sangrur (Punjab). In this study Six Sigma DMAIC ( Dene, Measure, Analyse, Improvement and Control) methodology was applied on routine Outpatient Department (OPD) samples received in hematology and biochemistry laboratory from May, 2020 to July, 2020 after institutional ethical committee permission. Pre-analytical phase errors were taken as pre-analytical quality indicators and were broadly classied in to requisition form and sampling errors. Sigma values and frequencies were calculated using Westgard formula present online at (www. westgard.com > six sigma calculators) for pre-analytical phase errors. After that Improvement phase of DMAIC methodology was done by training of laboratory technicians or personell involved in pre-analytical phase by audio-visual aids. Six Sigma values were calculated again after improvement phase. A total of 787 requisition forms and 1105 samples were studied before improvement phase and 889 requisition forms and 1400 samples were studied after improvement phase. Before improvement phase, overall requisition form errors were working at 2.9 sigma and sampling process was working at 3.1 sigma but after improvement phase, requisition form errors were working at 3.3 sigma and sampling process was working at 3.5 sigma. Before and after improvement phase the sample rejection rate in laboratory improved from 1.90% to 0.93% highlighting the benecial concept of six sigma in laboratory in pre-analytical phase leading to increased clinicians and patients'satisfaction and prevents unusual delaying of reports.