Division Of Medicine Research Articles

Prospective study on the prevalence of HCV infection in consecutive adult inpatients in a hospital division of Internal Medicine in Tuscany

Prospective study on the prevalence of HCV infection in consecutive adult inpatients in a hospital division of Internal Medicine in Tuscany

Sleep Neurology: Is It a Ready for Prime Time Player?

Division of Sleep Neurology, Mayo Center for Sleep Medicine, Division of Pulmonary and Critical Care Medicine, Departments of Medicine and Neurology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, U.S.A. The author has no funding or conflicts of interest to disclose.

Patient characteristics and testing over COVID-19 waves 1 and 2 from the first German COVID-19 testing unit in Munich, Germany

BackgroundIn Munich, the first German case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected on 27 January 2020 at the Division of Infectious Diseases and Tropical Medicine of the University Hospital LMU Munich (DIDTM), and consecutively the Covid Testing Unit was established. Germany advocated several public health measures to control the outbreak. This study investigates the effects of measures on health service utilization in the public, which in turn can alter case numbers and test positivity rates.MethodOur retrospective observational study was conducted to determine the effects of public health measures on the utilization of a testing facility and positivity rates from the first operational COVID-19 testing facility in Munich for waves 1 and 2 over a period of 14 months. This was accomplished by comparing trends in client characteristics including age, gender, symptoms, and socio-demographic aspects over time to non-pharmaceutical measures in Germany. To depict trend changes in testing numbers over time, we developed a negative binomial model with multiple breakpoints.ResultsIn total 9861 tests were conducted on 6989 clients. The clients were mostly young (median age: 34), female (60.58%), and asymptomatic (67.89%). Among those who tested positive for SARS-CoV-2, 67.72% were symptomatic while the percentage was 29.06% among those who tested negative. There are other risk factors, but a SARS-CoV-2-positive colleague at work is the most prominent factor. Trend changes in the clients’ testing numbers could be attributed to the implementation of various public health measures, testing strategies, and attitudes of individuals toward the pandemic. However, test positivity rates did not change substantially during the second wave of the pandemic.ConclusionWe could show that implementation or changes in public health measures have a strong effect on the utilization of testing facilities by the general public, which independently of the true epidemiological background situation can result in changing test numbers.

Approach to New-Onset Psychosis in Pediatrics: A Review of Current Practice and an Interdisciplinary Consensus-Driven Clinical Pathway at a Single-Center Institution.

New-onset psychosis in the pediatric population poses many diagnostic challenges. Given the diversity of underlying causes, which fall under the purview of multiple medical specialties, a timely, targeted, yet thorough workup requires a systematic and coordinated approach. A committee of expert pediatric physicians from the divisions of emergency medicine, psychiatry, neurology, hospitalist medicine, and radiology convened to create and implement a novel clinical pathway and approach to the pediatric patient presenting with new-onset psychosis. Here we provide background and review the evidence supporting the investigations recommended in our pathway to screen for a comprehensive range of etiologies of pediatric psychosis.

Be kind. Use systems. Improve care.

Health Services ResearchVolume 58, Issue 2 p. 247-249 COMMENTARY Be kind. Use systems. Improve care Taressa K. Fraze PhD, Corresponding Author Taressa K. Fraze PhD [email protected] orcid.org/0000-0002-8346-6425 Family and Community Medicine, Healthforce Center, University of California San Francisco, San Francisco, California, USA Correspondence Taressa K. Fraze, Family and Community Medicine, Healthforce Center, University of California San Francisco, San Francisco, CA, USA. Email: [email protected]Search for more papers by this authorSunita Mutha MD, Sunita Mutha MD orcid.org/0000-0001-6618-7240 Division of General Internal Medicine, Healthforce Center, University of California San Francisco, San Francisco, California, USASearch for more papers by this author Taressa K. Fraze PhD, Corresponding Author Taressa K. Fraze PhD [email protected] orcid.org/0000-0002-8346-6425 Family and Community Medicine, Healthforce Center, University of California San Francisco, San Francisco, California, USA Correspondence Taressa K. Fraze, Family and Community Medicine, Healthforce Center, University of California San Francisco, San Francisco, CA, USA. Email: [email protected]Search for more papers by this authorSunita Mutha MD, Sunita Mutha MD orcid.org/0000-0001-6618-7240 Division of General Internal Medicine, Healthforce Center, University of California San Francisco, San Francisco, California, USASearch for more papers by this author First published: 26 January 2023 https://doi.org/10.1111/1475-6773.14135 Commentary on ‘A systematic review of research on empathy in health care’ by Nembhard et al., https://doi.org/10.1111/1475-6773.14016. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume58, Issue2April 2023Pages 247-249 RelatedInformation

Cardiometabolic HFpEF: NASH of the Heart.

HomeCirculationVol. 147, No. 6Cardiometabolic HFpEF: NASH of the Heart No AccessArticle CommentaryRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toNo AccessArticle CommentaryRequest AccessFull TextCardiometabolic HFpEF: NASH of the Heart Federico Capone, MD, Roberto Vettor, MD and Gabriele G. Schiattarella, MD, PhD Federico CaponeFederico Capone Translational Approaches in Heart Failure and Cardiometabolic Disease, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (F.C., G.G.S.). Division of Internal Medicine, Department of Medicine, University of Padua, Italy (F.C., R.V.). Search for more papers by this author , Roberto VettorRoberto Vettor Division of Internal Medicine, Department of Medicine, University of Padua, Italy (F.C., R.V.). Search for more papers by this author and Gabriele G. SchiattarellaGabriele G. Schiattarella Correspondence to: Gabriele G. Schiattarella, MD, PhD, Max Rubner Center for Cardiovascular Metabolic Renal Research, Charité - Universitätsmedizin Berlin, Berlin, Germany. Email E-mail Address: [email protected] https://orcid.org/0000-0002-7582-7171 Translational Approaches in Heart Failure and Cardiometabolic Disease, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (F.C., G.G.S.). Max Rubner Center for Cardiovascular Metabolic Renal Research, Charité - Universitätsmedizin Berlin, Germany (G.G.S.). German Center for Cardiovascular Research, Partner Site Berlin, Germany (G.G.S.). Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (G.G.S.). Search for more papers by this author Originally published6 Feb 2023https://doi.org/10.1161/CIRCULATIONAHA.122.062874Circulation. 2023;147:451–453FootnotesThe opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.For Sources of Funding and Disclosures, see page 453.Circulation is available at www.ahajournals.org/journal/circCorrespondence to: Gabriele G. Schiattarella, MD, PhD, Max Rubner Center for Cardiovascular Metabolic Renal Research, Charité - Universitätsmedizin Berlin, Berlin, Germany. Email gabriele.[email protected]de

Accuracy Is Anti-Racism.

Sarahn M. Wheeler is from the Duke University School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Durham, NC; email: [email protected]. Financial Disclosure The authors did not report any potential conflicts of interest. The author thanks Dr. Allison Bryant and Dr. R. Phillips Heine for their editorial contributions to this work.

Chronic viral coinfections differentially affect the likelihood of developing long COVID.

BACKGROUNDThe presence and reactivation of chronic viral infections, such as EBV, CMV, and HIV, have been proposed as potential contributors to long COVID (LC), but studies in well-characterized postacute cohorts of individuals with COVID-19 over a longer time course consistent with current case definitions of LC are limited.METHODSIn a cohort of 280 adults with prior SARS-CoV-2 infection, we assessed the presence and types of LC symptoms and prior medical history (including COVID-19 history and HIV status) and performed serological testing for EBV and CMV using a commercial laboratory. We used covariate-adjusted binary logistic regression models to identify independent associations between variables and LC symptoms.RESULTSWe observed that LC symptoms, such as fatigue and neurocognitive dysfunction, at a median of 4 months following initial diagnosis were independently associated with serological evidence suggesting recent EBV reactivation (early antigen-diffuse IgG positivity) or high nuclear antigen (EBNA) IgG levels but not with ongoing EBV viremia. Serological evidence suggesting recent EBV reactivation (early antigen-diffuse IgG positivity) was most strongly associated with fatigue (OR = 2.12). Underlying HIV infection was also independently associated with neurocognitive LC (OR = 2.5). Interestingly, participants who had serologic evidence of prior CMV infection were less likely to develop neurocognitive LC (OR = 0.52).CONCLUSIONOverall, these findings suggest differential effects of chronic viral coinfections on the likelihood of developing LC and association with distinct syndromic patterns. Further assessment during the acute phase of COVID-19 is warranted.TRIAL REGISTRATIONLong-term Impact of Infection with Novel Coronavirus; ClinicalTrials.gov NCT04362150.FUNDINGThis work was supported by NIH/National Institute of Allergy and Infectious Diseases grants (3R01AI141003-03S1, R01AI158013, and K24AI145806); the Zuckerberg San Francisco General Hospital Department of Medicine and Division of HIV, Infectious Diseases, and Global Medicine; and the UCSF-Bay Area Center for AIDS Research (P30-AI027763).

Integrating Infectious Diseases and Preventive Medicine Specialties Into 1 Division: Experience of an Academic Medical Center

Throughout the coronavirus disease 2019 (COVID-19) pandemic, clinicians and researchers with appointments in separate divisions of infectious diseases (ID) and preventive medicine (PM) subspecialties collaborated on multiple projects, programmatic activities, and large-scale interventions at a tertiary academic medical center in the US Midwest. This collaboration was one of the reasons that prompted the integration of these groups into 1 unified academic division. Although this integrated structure is uncommon in the United States, the rationale, circumstances, and culture leading to this realignment may be common to other academic health systems.

Editorial introductions.

Current Opinion in Endocrinology and Diabetes was launched in 1994, with Obesity added to the title in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of endocrinology and diabetes are divided into 9 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Editor and Section Editors for this issue. EDITOR IN CHIEF David M. HarlanDavid M. HarlanDr David M. Harlan is a graduate of the University of Michigan (Bachelor of Science) and the Duke University School of Medicine, USA. He completed his internal medicine internship and residency at the Duke University Medical Center. This was before serving for 4 years as a staff internist at the Navy Hospital, San Diego, CA, USA. He then returned to Duke for his fellowship training in diabetes, endocrinology, and metabolism. In 1991 he established his laboratory at the Navy Medical Research Institute, USA, where he rose to become the Director of Combat Casualty Care. He was then appointed to the faculty of the Uniformed Services University of the Health Sciences. In 1999, he moved his laboratory to the National Institutes of Health, where he became the Diabetes Branch Chief within the National Institute of Diabetes, Digestive, and Kidney Diseases. In 2010, he moved to the University of Massachusetts School of Medicine, USA, where he is the William and Doris Krupp Professor of Medicine and Diabetes Division Chief. Dr Harlan also co-directs the UMass Diabetes Center of Excellence. His research interests all relate to diabetes and include the immunopathogenesis underlying type 1 diabetes and improved care delivery models for the disease. SECTION EDITORS Matthew FreebyMatthew FreebyMatthew Freeby, MD, is Health Sciences Associate Clinical Professor of Medicine in the Division of Endocrinology, Diabetes, and Hypertension, David Geffen School of Medicine at the University of California Los Angeles, USA. Dr Freeby received his MD from Virginia Commonwealth University, USA and completed his internal medicine internship and residency training at the University of California San Diego. He subsequently completed training in an endocrinology fellowship at Columbia University Medical Center in New York, USA. Dr Freeby is involved in community leadership for the American Diabetes Association and serves on planning committees for the Endocrine Society's annual meetings. His research has focused on a number of diabetes related topics including non-invasive in vivo measurement of beta cell mass as well as the evaluation of general care and complications. He has also collaborated with researchers evaluating iPS as a method for beta cell replacement in type 1 and other rare forms of diabetes. Lynne L. LevitskyLynne L. LevitskyDr Lynne L. Levitsky is a graduate of Bryn Mawr College and Yale Medical School, USA. She received her pediatric training at the Albert Einstein College of Medicine in New York, USA, and at the Children's Hospital of Philadelphia, USA. She was trained in pediatric endocrinology at the University of Maryland in Baltimore, USA. She was a Pediatric Endocrinologist and Professor of Pediatrics at the Pritzker School of Medicine, University of Chicago, USA, until 1990. She then came to Massachusetts General Hospital, USA, as Chief of the Pediatric Endocrine Unit and Associate Professor of Pediatrics at Harvard Medical School. She is now Emeritus Chief and co-director of the Turner Syndrome Wellness Center, USA. Her research interests in carbohydrate metabolism span laboratory studies of transcriptional control of beta cell function, and a role as an investigator in the NIH-sponsored TODAY treatment study of type 2 diabetes in the young. She is a past President of the Pediatric Endocrine Society and was the first head of the Education Council for that organization.

Saving life and limb.

Academic Emergency MedicineEarly View REFLECTION Saving life and limb Folafoluwa O. Odetola MB ChB, MPH, Corresponding Author Folafoluwa O. Odetola MB ChB, MPH [email protected] orcid.org/0000-0001-8001-9630 Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI, USA Correspondence Folafoluwa O. Odetola, Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan Health System, G030W, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Email: [email protected]Search for more papers by this author Folafoluwa O. Odetola MB ChB, MPH, Corresponding Author Folafoluwa O. Odetola MB ChB, MPH [email protected] orcid.org/0000-0001-8001-9630 Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI, USA Correspondence Folafoluwa O. Odetola, Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan Health System, G030W, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Email: [email protected]mich.eduSearch for more papers by this author First published: 06 January 2023 https://doi.org/10.1111/acem.14657 Funding information: None. Supervising Editor: Dr. Brian Zink. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

Editorial Commentary.

No AccessUrology Practicethe Specialty1 Mar 2023Editorial CommentaryThis article comments on the following:Advanced Urology Boot Camp: A Simulation-based Curriculum to Enhance Fourth-year Medical Student Procedural Competency Alexandra L. Tabakin and Sammy E. Elsamra Alexandra L. TabakinAlexandra L. Tabakin * E-mail Address: [email protected] Division of Female Pelvic Medicine and Reconstructive Surgery, Donald and Barbara Zucker School of Medicine and Hofstra/Northwell, Great Neck, New York More articles by this author and Sammy E. ElsamraSammy E. Elsamra Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey More articles by this author View All Author Informationhttps://doi.org/10.1097/UPJ.0000000000000379.01AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Editorial Commentary." Urology Practice, 10(2), p. 201

Deaf Ears, Blind Eyes, and Driverless Cars.

Both authors: Division of Pediatric Critical Care Medicine, UH Rainbow Babies and Children’s Hospital, Cleveland, OH *See also p. 112. The authors have disclosed that they do not have any potential conflicts of interest.

Models for Evidence Generation During the COVID-19 Pandemic: New Opportunities for Clinical Trials in Cardiovascular Medicine

HomeCirculationVol. 147, No. 3Models for Evidence Generation During the COVID-19 Pandemic: New Opportunities for Clinical Trials in Cardiovascular Medicine No AccessArticle CommentaryRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toNo AccessArticle CommentaryRequest AccessFull TextModels for Evidence Generation During the COVID-19 Pandemic: New Opportunities for Clinical Trials in Cardiovascular Medicine Patrick R. Lawler, MD, MPH Patrick R. LawlerPatrick R. Lawler Correspondence to: Patrick R. Lawler, MD, MPH, Peter Munk Cardiac Center, Toronto General Hospital, RFE3-410, 190 Elizabeth St, Toronto, ON, Canada M5G 2C4. Email: E-mail Address: [email protected] https://orcid.org/0000-0001-5155-5071 Peter Munk Cardiac Centre, Toronto General Hospital; and Division of Cardiology and Interdepartmental Division of Critical Care Medicine, University of Toronto, Canada. Search for more papers by this author Originally published17 Jan 2023https://doi.org/10.1161/CIRCULATIONAHA.122.061231Circulation. 2023;147:187–189FootnotesThe opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.Circulation is available at www.ahajournals.org/journal/circFor Sources of Funding and Disclosures, see page 189.Correspondence to: Patrick R. Lawler, MD, MPH, Peter Munk Cardiac Center, Toronto General Hospital, RFE3-410, 190 Elizabeth St, Toronto, ON, Canada M5G 2C4. Email: patrick.[email protected]ca

National Academy of Medicine: "National Plan for Health Workforce Wellbeing".

Vanderbilt Occupational Health Clinic, Vanderbilt Health & Wellness, Vanderbilt Medical Center, Nashville, TN Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN Correspondence: Lori A. Rolando, MD, MPH, Vanderbilt Health & Wellness 1211 21st Avenue South Suite 640 Medical Arts Building Nashville, TN 27212 Funding Sources: NA Conflicts of Interest: None Declared Address for reprints: same as above Sources of Support: NA Ethical Considerations (e.g., IRB #): NA

Immediate or Delayed Pushing After Complete Cervical Dilation.

Marlene M. Corton is from the Department of Obstetrics and Gynecology in the Division of Female Pelvic Medicine and Reconstructive Surgery at the University of Texas Southwestern Medical Center, Dallas, Texas; email: [email protected]. Financial Disclosure The author did not report any potential conflicts of interest.

Integrative Oncology's 30-Year Anniversary: What Have We Achieved? A North American Naturopathic Oncology Perspective.

In 1991 the U.S. Congress mandated that the National Institutes of Health (NIH) form the Office of Alternative Medicine to study alternative medical therapies, especially in oncology care. Shortly after, the National Cancer Institute (NCI) created its own division of complementary and alternative medicine (Office of Complementary and Alternative Medicine). At the genesis of the field 30 years ago, what were we hoping to see accomplished by now? In this article we take a look back at milestones, shortfalls and future directions. Exciting opportunities exist to direct our established subspeciality's future directions and we have made valuable advances the field of integrative oncology over the last 30 years: 1, IV high dose ascorbate has clinical research-based applications when used concurrently with some chemotherapeutic agents. 2. Whole body, extracorporeal and locoregional hyperthermia are being applied in treating solid tumors, including brain tumors. 3. PDL-1 tumor microenvironment testing and PDL-1 inhibitor immunotherapies have surprisingly excellent outcomes in a subgroup of cancer patients. 4. Tumor DNA sequencing (resected tumor and circulating tumor DNA in blood) has led to personalized precision targeted treatments. 5. Glucose metabolism's role in cancer progression is better understood and better therapies are available (e.g., intermittent fasting, metformin). 6. Medical cannabis has a larger role in treating chemotherapy-related side effects and shows promise for anti-proliferative effects. 8. Greater understanding has been gained of the interdependence and mutual regulation of processes in psychoneuroendocrinoimmunology (PNEI). The burgeoning field of PNEI has exponentially expanded the discussion of tumorigenesis, apoptosis, and introduced to the field the investigation of more holistic approaches to immune regulation and cancer care. 8. Psychedelic-assisted psychotherapy is gaining traction especially for cancer patients facing demoralization, existential and spiritual distress, anxiety, depression and trauma related to the diagnosis and treatment of their cancer. 9. Spiritual health of cancer patients is more commonly addressed and measurable with an NIH validated scale. 10. Mind-Body therapies are efficacious for reducing cancer-related distress and are included in many cancer care programs.

„Allah nie zesłał żadnej choroby, jak tylko z lekarstwem, a więc leczcie się” – o historii medycyny świata islamu na przełomie VII–XIII wieku

This article concerns the medicine of the Arab world during its heyday from the Prophet Muhammad to the beginning of the 13th century and the emergence of European research centers. During the golden age of Islam, the medicine of this period developed rapidly. At that time, many therapies and drugs were created, used in a slightly changed form to this day. Without them, there would not be many discoveries in diseases, epidemics, surgeries, anatomy, dietetics, ophthalmology, or therapies. The article aims to show a cross-sectional division of medicine in the Islamic world from the 7th to the 13th century, outlining the most important achievements in this field.

Red cell requisition and utilization pattern in a tertiary care hospital of South India.

The equilibrium between supply and demand for red blood cells is increasing unpredictably in many countries. An understanding of trends in blood usage profile and current usage can help predict future trends in demand and to put efforts to reduce use in particular areas. This study helps in analyzing the pattern of red blood cell utilization in a tertiary care hospital. This retrospective study was conducted in a blood bank, tertiary care hospital over a period of 6 months. All the requests coming to blood bank with information regarding patient's demographic details, diagnosis and indication for transfusion, type of request, blood transfused or returned were collected and reviewed. Crossmatch transfusion (CT) ratio, transfusion index (TI), and transfusion probability were also calculated. A total of 10,364 patients (20,399 requests) utilized total 32,608 units of blood and its components, out of those 14,195 units of packed red cells units were utilized. March month had maximum number of requests and utilization. Most of the requests for blood were from the inpatients (wards) and were requested and utilized in the age group of 21-30 years with male predominance. Patients in the division of medicine utilized most blood. Although the division of surgery requested most of the blood, on an average, they utilized only one-third of the requested product. Overall, anemia was the most common indication for red cell utilization. In surgical group, spine surgery had a maximum CT ratio. Neurosurgery and hand surgery had the lowest TI in all specialties. Hand surgery and spine surgery had a lowest transfusion probability. Overall, utilization rate in our study was 59.8%. A regular review of blood unit's usage is very important to estimate the blood utilization pattern in any hospital. Profile of blood utilization will act as indicator for quality management of blood bank.

Public Health Management a Curative Tool for the Public Health Related Problems

Health always remains a core component in the life of human beings and considered as a major instrument of overall socio-economic development. Concept of health has been defined and understood in different ways by different cultures. The two major division of medicine namely curative and preventive medicine came into light at the close of 19th century. Although origin of Medicine and Public health goes back to ancient Greek mythology, Asclepius was the Greek god of Healing. He was the son of Apollo and the Coronis. Asclepius was married to Epione, with whom he had five daughters: Hygieia, Panacea, Aceso, Iaso, and Aglaea. Hygieia was the goddess of health, cleanliness and hygiene. Follower of panacea practiced curative medicine and were called healer and followers of Hygieia were called as Hygienist or Public Health experts (1). Concept of Public Health came from this hygienist category of healthcare personals. The Constitution of the World Health Organization, which came into force on April 7, 1948, defines health “as a state of complete physical, mental and social well-being.”(2) In today’s world more emphasis is given on physical health and most of the resources are diverted for the care of physical health especially for the medical treatment. Other domains of health care remain neglected. Public health applies to the holistic approach for the care of health. Physical health is best taken care by the judicious mix of public health and medical domain of health. The evolution of concepts of public health tries to address new challenges of population health like non communicable diseases, cancers, accidents, injuries, inequities, increasing cost of care, poor quality of care, and poor patient satisfaction etc.