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Background: Japanese encephalitis (JE), a vector-borne viral disease, caused by a group B arbovirus (Flavivirus) and transmitted by Culicine mosquito. Acute Encephalitis Syndrome (AES) is most widely caused by Japanese Encephalitis (JE) virus. Bihar stands third in the reporting of JE cases in India and still there is a deficiency of the data coming from locales in the state. The current study was carried out to assess the status and trends of AES and JE in Bihar state and to know the status of districts in the disease, so to come up with the recommendations for its prevention and control. Methods & Materials: Epidemiological data on the monthly basis for AES and JE in over the past 6 years (2009-2014) was collected as reported by State Health Authorities with prior necessary permission. Results: The total numbers of 4400 cases (733 cases/year) with an average Case Fatality Rate (CFR) of 30% in aggregate of AES for the entire study period. A total 396 JE cases reported approximately 14% CFR. The peaks are shown in start and end of the monsoon months i.e. May-June and September -October for AES and JE respectively. District such as Patna, Nalanda, Jehenabad, Nawada, Gaya, Aurangabad, Vaishali, Muzaffarpur, Sheohar, East Champaran have annual incidence rate ranging from 4.7 to 25.0 per lakh population, which falls in highest incidence reporting for AES while Patna, Jehenabad, Nawada, Gaya, Lakhisarai, Gopalganj, Siwan, East Champaran and West Champaran have annual incidence rate ranging from 0.546 to 1.78 per lakh for JE. Study shows the incidence of AES and JE in Bihar is keep increasing since 2009. Conclusion: AES and JE is an endemic problem in Bihar state with now all district reporting cases of AES and JE. Reporting and surveillance mechanism needs to be strengthened at local level also. Confidence among the private practitioners needs to be developed for reporting of AES cases which are participating less in surveillance activities. Intense IEC activities concentrate efforts for prevention and control strategy must be operationalized at sub district level and village level to increase the participation from community so that passive surveillance increase. [ABSTRACT FROM AUTHOR]

Background: Indiscriminate antibiotic prescribing is cause for the global increase in antibiotic resistance. Hospitals are major antibiotics users and thus substantially contribute in the development of resistant bacterial strains. The situation is highly under-estimated due to the paucity of studies from major antibiotic consumer countries like India. Aim of the present study was to describe and compare antibiotic prescribing among in-patients diagnosed for non-bacterial infections, at the medicine departments of two private sector hospitals, a teaching (TH) and a non-teaching (NTH), in Madhya Pradesh, India. Methods & Materials: The data was collected manually for all in-patients for 3 years between 2008 and 2011. Patients were grouped using International Classification of Diseases-10 system for the recorded diagnoses. Patients having bacterial infections were excluded from analysis. Prescribed antibiotics were classified based on WHO anatomical therapeutic chemical (ATC) classification system and Defined daily doses (DDDs) per 1000 patients were calculated. Type and class of prescribed antibiotics and adherence to the generic name prescribing and National list of essential medicines of India (NLEMI) were analyzed. Results: Overall, 20303 patients were admitted in the medicine departments of two hospitals, of which 66% were prescribed antibiotics. Malaria or viral fever was diagnosed in 693 patients in the TH and 1177 in the NTH. Of these, 82% patients at the TH and 71% at the NTH (71%, p<0.001) were prescribed antibiotics. Prescriptions made at the TH show more adherence both towards the use of generic names and the NLEMI, compared with theNTH(p<0.001). Most commonly prescribed antibiotic classes at the TH were fluoroquinolones (48%) and third generation cephalosporins (21%) and at theNTHwere third generation cephalosporins (47%), and fixed dose combinations (19%). The most prescribed antibiotic substances at the TH was ciprofloxacin (1940 DDD/1000 patients), and at the NTH was ceftriaxone (1052 DDD/1000 patients). Conclusion: Frequent and unnecessary antibiotic prescribing practices at both hospitals were observed. Significantly high percentage of patients in non-bacterial infection groups i.e. malaria and viral fever, were prescribed antibiotics which is a point of concern. An urgent need is felt to develop and implement relevant antibiotic stewardship program to rationalize the antibiotic prescribing in the settings. [ABSTRACT FROM AUTHOR]