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A corkscrew-shaped spirochaete named Leptospira interrogans causes the infectious disease called leptospirosis. Leptospirosis, a growing public health concern worldwide, from subclinical infections to potentially lethal pulmonary hemorrhage. The disease caused by the pathogenic Leptospira, poses a threat to both humans and animals, and its transmission occurs through contact with infected animals, contaminated water, and soil. The prevalence of leptospirosis is influenced by various factors, including climate, urban development, and animal-rearing practices. It can manifest with severe symptoms in humans, making early diagnosis crucial. Diagnostic methods like microscopic agglutination test (MAT) and enzyme-linked immunoassay (ELISA) are widely used for the screening of leptospira infection. Molecular technique like PCR and qPCR offering higher sensitivity and rapidity. This paper meta-analyses the incidence of leptospirosis in various animals based on the literature published from 2005 to 2023 and provides prevalence of the disease in various animal including humans. Results suggest the significance prevalence of the disease in humans and various animal species, namely buffalo, rodents, and dogs. Coastal regions in India were particularly vulnerable to the disease. Efforts to control leptospirosis include surveillance programs and public health initiatives. Understanding the epidemiology and prevalence of leptospirosis, as highlighted in this paper, is essential for implementing effective preventive measures. Finally, a continued research, diagnostic advancements, public awareness campaigns and addressing research gaps in epidemiology of the disease are critical in mitigating the impact on human and animal health. This review provides important data for public health authorities, veterinarians, scientists and for the public, in general. [ABSTRACT FROM AUTHOR]

Oral cavity cancers contribute to a majority of cancers in India. Clinical examination alone cannot determine the deeper extent of the disease; therefore, need for cross-sectional imaging including computed tomography and magnetic resonance imaging becomes indispensable for pre-treatment evaluation to decide optimal plan of management. Oral cavity squamous cell cancers (OSCC) can be treated with surgery alone, whereas deep muscle, neurovascular, osseous, or nodal involvement on imaging suggests advanced disease that requires a combination of surgery, radiation, and/or chemotherapy. Because of the complex anatomy of the oral cavity and its surrounding structures, imaging is crucial for locoregional staging and early detection of distant metastases. Imaging plays indispensable role not only in diagnosis but also in planning the management. An optimal guideline paper for developing countries like India is lacking that not only helps standardize the management but will also assist oncologists make reasonable decisions and reduce the unnecessary imaging. This imaging guideline paper will discuss the optimal imaging in diagnosis and management OSCC for Indian subcontinent. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is frequently misdiagnosed during pregnancy. There is an abundance of evidence, but little is known regarding the regional prevalence estimates of GDM in India. This systematic review and meta-analysis aims to provide valuable insights into the national and regional prevalence of GDM among pregnant women in India. Methods: We conducted an initial article search on PubMed, Scopus, Google Scholar, and ShodhGanga searches to identify quantitative research papers (database inception till 15th June,2022). This review included prevalence studies that estimated the occurrence of GDM across different states in India. Results: Two independent reviewers completed the screening of 2393 articles, resulting in the identification of 110 articles that met the inclusion criteria, which collectively provided 117 prevalence estimates. Using a pooled estimate calculation (with an Inverse square heterogeneity model), the pooled prevalence of GDM in pregnant women was estimated to be 13%, with a 95% confidence interval (CI) ranging from 9 to 16%.. In India, Diabetes in Pregnancy Study of India (DIPSI) was the most common diagnostic criteria used, followed by International Association of Diabetes and Pregnancy Study Groups (IADPSG) and World Health Organization (WHO) 1999. It was observed that the rural population has slightly less prevalence of GDM at 10.0% [6.0–13.0%, I2=96%] when compared to the urban population where the prevalence of GDM was 12.0% [9.0–16.0%, I2 = 99%]. Conclusions: This review emphasizes the lack of consensus in screening and diagnosing gestational diabetes mellitus (GDM), leading to varied prevalence rates across Indian states. It thoroughly examines the controversies regarding GDM screening by analyzing population characteristics, geographic variations, diagnostic criteria agreement, screening timing, fasting vs. non-fasting approaches, cost-effectiveness, and feasibility, offering valuable recommendations for policy makers. By fostering the implementation of state-wise screening programs, it can contribute to improving maternal and neonatal outcomes and promoting healthier pregnancies across the country. [ABSTRACT FROM AUTHOR]

India continues to grapple with a significant burden of HIV infections. Despite notable progress in prevention and treatment efforts, multiple challenges, such as high-risk populations, inadequate testing facilities, and limited access to healthcare in remote areas, persist. Though the Government of India offers HIV-1 plasma viral load testing at various medical centers, aiding treatment decisions and monitoring antiretroviral therapy effectiveness, enhancing care for individuals living with HIV under the National AIDS Control Program (NACP), the nation's large population and diverse demographics further complicate its outreach and response. Hence, strategic interventions and alternative methods of testing remain crucial to curbing HIV transmission and improving the quality of life for those affected. Dried blood spot (DBS) sampling has emerged as a convenient and cost-effective alternative for HIV-1 viral load testing, revolutionizing the landscape of diagnostic and monitoring strategies for HIV infection. Though the plasma-based viral load remains the gold standard for monitoring HIV-1, DBS-based HIV-1 viral load testing holds immense promise for improving access to care, particularly in resource-limited settings where traditional plasma-based methods may be logistically challenging. DBS entails the collection of a small volume of blood onto filter paper, followed by drying and storage. This approach offers numerous advantages, including simplified sample collection, transportation, and storage, reducing the need for cold-chain logistics. Recent studies have demonstrated the feasibility and accuracy of DBS-based HIV-1 viral load testing, revealing a strong correlation between DBS and plasma measurements. Its implementation can enhance the early detection of treatment failure, guide therapeutic decisions, and ultimately contribute to better clinical outcomes for HIV-infected individuals. Hence, this review explores the principles, advancements, feasibility, and implications of DBS-based HIV-1 viral load testing. [ABSTRACT FROM AUTHOR]

A well-structured digital database is essential for any national priority project as it can provide real-time data analysis and facilitate quick decision making. In recent times, particularly after the COVID-19 pandemic, invasive fungal infections (IFIs) have emerged as a significant public health challenge in India, affecting vulnerable population, including immunocompromised individuals. The lack of comprehensive and well-structured data on IFIs has hindered efforts to understand their true burden and optimize patient care. To address this critical knowledge gap, the ICMR has undertaken a Pan-India pioneer initiative to develop a network of Advanced Mycology Diagnostic research centres in different geographical zones of the country (ICMR-MycoNet). Under the aegis of this project, a clinical registry on IFIs in the ICUs is initiated. This process paper presents a detailed account of the steps involved in the establishment of a web-based data entering and monitoring platform to capture data electronically, ensuring robust and secure data collection and management. This system not only allows participating ICMR-MycoNet centres to enter patient information directly into the database using standardized Case Report Form (CRF) but also includes data validation checks to ensure the accuracy and completeness of entered data. It is complemented by a real-time, web-based, and adaptable data visualization platform. This registry aims to provide crucial epidemiological insights, promote evidence-based hospital infection control programs, and ultimately improve patient outcomes in the face of this formidable healthcare challenge. [ABSTRACT FROM AUTHOR]

The health organisation has suffered from the lack of diagnosis support systems and physicians in India. Further, the physicians are struggling to treat many patients, and the hospitals also have the lack of a radiologist especially in rural areas; thus, almost all cases are handled by a single physician, leading to many misdiagnoses. Computer aided diagnostic systems are being developed to address this problem. The current study aimed to review the different methods to detect pneumonia using neural networks and compare their approach and results. For the best comparisons, only papers with the same data set ChestXray14 are studied. [ABSTRACT FROM AUTHOR]

Private primary care providers are usually the first site where afflictions come under institutional view. In the context of poverty, the relationship between illness and care is more complex than a simple division of responsibilities between various actors--with care given by kin, and diagnosis and treatment being the purview of providers. Since patients would often visit the provider with family members, providers are attuned to the patients' web of kinship. Providers would take patients' kinship arrangements into account when prescribing diagnostic tests and treatments. This paper terms this aspect of the clinical encounter as 'kin testing' to refer to situations/clinical encounters when providers take into consideration that care provided by kin was conditional. 'Kin testing' allowed providers to manage the episode of illness that had brought the patient to the clinic by relying on clinical judgment rather than confirmed laboratory tests. Furthermore, since complaints of poor health also were an idiom to communicate kin neglect, providers had to also discern how to negotiate diagnoses and treatments. Kinship determined whether the afflicted bodies brought to the clinics were diagnosed, whether medicines reached the body, and adherence maintained. The providers' actions make visible the difference that kinship made in how health is imagined in the clinic and in standardized protocols. Focusing on primary care clinics in Patna, India, we contribute to research that shows that kinship determines care and management of illnesses at home by showing that relatedness of patients gets folded in the clinic by providers as well. [ABSTRACT FROM AUTHOR]

Background and Objectives: Rheumatoid Arthritis (RA) is an auto-immune disease in which the body mistakenly considers some parts of its own system as pathogens and attacks them. Prevalence is approximately 0.75% in India. About 40% of the diseased become work disabled within 5 years from the onset of symptoms. The objective of this paper is to assess the sign/symptoms, joints' involvement, difficulties in daily activities and screening accuracy of serology tests of clinically suspected RA patients. Material and Methods: A cross-sectional cohort study design was conducted on two hundred ninety clinically suspected subjects who were referred by different OPDs of hospitals for screening. The profiles of study subjects were carried through a semi-structured, pre-tested schedule method. About 2 mL of blood samples were collected in a plain vial from each patient and tested for diagnostic tests RF, CRP and AntiCCP by using RF-Latex, CRP Latex and ELISA method, respectively, by the laboratory persons. Results: Joint pain shows to be a leading problem in RA as compared to other signs and symptoms. The majority of the study subjects suffer from knee problems (62%). Approximately equal numbers of RA-positive cases were screened by RF and AntiCCP tests. The CRP test screened about one-third of cases. CRP+ AntiCCP, RF+ AntiCCP and RF + CRP all have good sensitivity, and RF+ AntiCCP + CRP has a very high sensitivity for diagnosing RA. Conclusions: This study found that a substantiation of a major proportion of clinically suspected RA patients were suffering from knee pain. Predication of AntiCCP increased the possibility for the diagnosis of RA. However, RF was also moderately related to the diagnosis of RA, and the combination of both tests was more valuable. [ABSTRACT FROM AUTHOR]

Background: India continues to share a colossal count of the global tuberculosis load, with a perturbing 19% spring in the reported cases in 2021. With the National Tuberculosis Elimination Program (NTEP) consolidated to bring this epidemic to an end by 2025, the rapidly growing mobile health technologies can be utilized to offer promising results. Even though the implementation of this novel strategy is escalating around the globe, its triumph is still sub optimal in India. Objectives: This scoping review intends to explore the available mobile health (mHealth) technologies and analyse the effectiveness of the same for tuberculosis management in India. Methods: An elaborate search in electronic databases, such as PubMed and Google scholar, using the key terms and focussing from the year 2015, provided very broad results focussing on mHealth interventions and their utilisation in TB management in India. Further selection of the inclusive publications was carried out based upon the eligibility requirements as formulated for this review, pertaining to the objective of this study. Results: The collaborate search yielded a total of 858 scientific research papers. After the filtering of the obtained results, a total of 45 articles were selected to be analysed for this review. Published manuscripts, articles in peer review and abstracts from reliable databases were included to obtain vast range of information. Conclusion: The extensive literature search showed a preponderance of mHealth intervention studies focusing on TB treatment and drug monitoring. There exists a paucity of mHealth applications targeted to educate the public and intercept this infectious disease. The scientific articles reviewed and analysed in this scoping review strongly recommend the demployment of mHealth applications to achieve the target of eradicating TB by 2025 in India. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is the main cause of diabetic retinopathy, the most common cause of blindness worldwide. In order to slow down or prevent vision loss and degeneration, early detection and treatment are essential. For the purpose of detecting and classifying diabetic retinopathy on fundus retina images, numerous artificial intelligence-based algorithms have been put forth by the scientific community. Due to its real-time relevance to everyone's lives, smart healthcare is attracting a lot of interest. With the convergence of IoT, this attention has increased. The leading cause of blindness among persons in their working years is diabetic eye disease. Millions of people live in the most populous Asian nations, including China and India, and the number of diabetics among them is on the rise. To provide medical screening and diagnosis for this rising population of diabetes patients, skilled clinicians faced significant challenges. Our objective is to use deep learning techniques to automatically detect blind spots in eyes and determine how serious they may be. We suggest an enhanced convolutional neural network (ECNN) utilizing a genetic algorithm in this paper. The ECNN technique's accuracy results are compared to those of existing approaches like the K-nearest neighbor approach, convolutional neural network, and support vector machine with the genetic algorithm. [ABSTRACT FROM AUTHOR]

Crop disease in the plant is a significant issue in the agriculture sector, and it is currently very difficult to detect these illnesses in crop leaves. The foundation of the global economy is agriculture. India ranks second in the production of tomatoes worldwide. The tomato crop is affected by various diseases which lead to a reduction in product quality and quantity. The advancement in computer vision and deep learning opens up the door for predicting diseases that appear in the crops. The aim of this paper is classification among 10 different categories of tomato plant leaves using the proposed novel TomConv model which deploys an improved Convolutional Neural Network (CNN). For this purpose, the publicly available dataset called PlantVillage comprising of more than 16000 images of tomato leaves, both diseased and healthy was used for the experimentation purpose. The proposed model is the simplest model among all the available state-of-the-art models. The tomato leaf images were preprocessed for reducing the size in 150 × 150 dimension. The model constitutes four layered CNN followed by a max pooling layer. The model splits the corpus into training and validation datasets in 80:20 ratio, is trained under 105 epochs for tomato leaf images, and achieved an accuracy of 98.19%. The proposed model is compared with existing models under different parameters such as no. of classes, no. of layers, and accuracy. The results are promising as they outperform all the available state-of-the-art models. [ABSTRACT FROM AUTHOR]

A new species of the genus Thermobia (Zygentoma: Lepismatidae), Thermobia smithi sp. nov., found in a library and store rooms from Kerala, India, is described and diagnosed. This is the second species in the genus Thermobia reported from India. The report presents morphological, meristic and molecular details of the species and discusses its differences with related species of the genus. [ABSTRACT FROM AUTHOR]

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Background. Dance as therapy is gaining attention as an adjuvant option for Parkinson's disease (PD). Assessing culturally popular dance forms is crucial for promoting the acceptance of dance therapy in a culturally sensitive context. Objectives. The pilot study evaluated the efficacy of Garba dance for alleviating motor symptoms, nonmotor symptoms, cognitive functions, and mood. Furthermore, this pilot study also assessed the tolerability and safety of this dance form using fatigue severity scale and assessing falls, respectively. Methods. Eligible participants with mild‐to‐moderate PD (H&Y stage 1 to 2.5) were sequentially randomized into the dance therapy, physical therapy, or control groups. Motor symptoms, nonmotor symptoms, cognitive functions, and mood were assessed using standard scales at baseline, week 6, and week 12. Tolerability was measured using the Fatigue Severity Scale, and safety was assessed by monitoring falls. Results. In the Garba dance group, significant improvements in UPDRS scores were observed at week 6 (p = 0.002) and week 12 (p < 0.001) compared to baseline. At week 12, UPDRS scores were better in the Garba dance group as compared to the control and physical therapy groups. Freezing of gait significantly improved at week 6 (p < 0.001) and week 12 (p < 0.001) in the Garba dance group. Garba dance also led to significant improvements in mood and sleep. Tolerability was favorable, with significantly better fatigue severity scores in the Garba dance group at week 12 compared to controls and physical therapy. About 6 patients in Garba dance group experienced near falls. Conclusion. Underscoring a cautious optimism, results of the current study indicate that Garba dance may be an effective, safe, and well‐tolerated intervention for Indian patients with mild‐to‐moderate PD (H&Y stage 1 to 2.5). [ABSTRACT FROM AUTHOR]

In comparison to the worldwide burden of asthma, although India contributes to 13% of the total asthma prevalence, it has a threefold higher mortality rate and more than twofold higher DALYs, indicating a substantial gap in asthma diagnosis and treatment. Asthma causes significant suffering, affecting people's quality of life and draining the country's resources; therefore, we must devise ways and means to fill these gaps. The most successful and cost-efficient strategy to battle asthma is to form strong partnerships between patients, the general public, the government, the pharmaceutical industry and non-governmental organisations. This necessitates a comprehensive approach that involves raising awareness, developing universally applicable recommendations, increasing access to high-quality asthma care, and other measures. The purpose of this article was to review the existing scenario of asthma management in India and the factors that contribute to it and devise unique and all-encompassing strategies to fill these gaps. [ABSTRACT FROM AUTHOR]

Diagnosing extrapulmonary tuberculosis (EPTB) is challenging. Immunohistochemistry or immunocytochemistry has been used to diagnose tuberculosis (TB) by detection of MPT64 antigen from various extrapulmonary specimens and has shown good diagnostic performance in our previous studies. The test can distinguish between disease caused by Mycobacterium tuberculosis (Mtb) complex and nontuberculous mycobacteria and can be applied on formalin‐fixed paraffin‐embedded tissue. As the antibodies previously used were in limited supply, a new batch of polyclonal antibodies was developed for scale‐up and evaluated for the first time in this study. Our aim was to assess the diagnostic accuracy of the MPT64 test with reproduced antibodies in the high burden settings of Pakistan and India. Patients were enrolled prospectively. Samples from suspected sites of infection were collected and subjected to histopathologic and/or cytologic evaluation, routine TB diagnostics, GeneXpert MTB/RIF (Xpert), and the MPT64 antigen detection test. Patients were followed until the end of treatment. Based on a composite reference standard (CRS), 556 patients were categorized as TB cases and 175 as non‐TB cases. The MPT64 test performed well on biopsies with a sensitivity and specificity of 94% and 75%, respectively, against a CRS. For cytology samples, the sensitivity was low (36%), whereas the specificity was 81%. Overall, the MPT64 test showed higher sensitivity (73%) than Xpert (38%) and Mtb culture (33%). The test performed equally well in adults and children. We found an additive diagnostic value of the MPT64 test in conjunction with histology and molecular tests, increasing the yield for EPTB. In conclusion, immunochemical staining with MPT64 antibodies improves the diagnosis of EPTB in high burden settings and could be a valuable addition to routine diagnostics. [ABSTRACT FROM AUTHOR]

Introduction: Numerous studies have previously estimated the dementia prevalence in India. However, as these estimates use different methodologies and sampling strategies, generating definitive prevalence estimates can be difficult. Methods: A Delphi process involving eight clinical and academic experts provided prevalence estimates of dementia within India, split by sex and age. The experts were also asked to estimate the number of people potentially living at different stages of the condition. A priori criteria were used to ascertain the point in which consensus was achieved. Results: Our consensus estimates generated a dementia prevalence of 2.8% (95% CI = 1.9 to 3.6) for those aged 60 years and above in India. Consensus was achieved across age and sex prevalence estimates, with the exception of one (females aged 60–64). Our experts estimated that 42.9% of people living with dementia in India had a mild severity. Conclusions: The findings indicate that there could be approximately 3.9 million people living with dementia in India, of which 1.7 million could be living with dementia of mild severity. Such estimates can better help researchers and policy makers to estimate the true cost and impact of dementia in India and can inform resource allocation decisions. [ABSTRACT FROM AUTHOR]

Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a unique autosomal recessive disorder characterized by mitochondrial changes resulting from mutations in the TYMP gene, responsible for encoding thymidine phosphorylase. Despite its genetic origin, the study indicates that the manifestation of MNGIE does not strictly adhere to a hereditary pattern. The investigation focused on a family from the Ernakulam district of Kerala, India, involving three members. The proband began experiencing gait difficulties at the age of 4, leading to a confirmed diagnosis of MNGIE at 17. Subsequent clinical assessments confirmed MNGIE in the two younger siblings, while the youngest remained unaffected. Common symptoms across all three included ptosis, limited eye movements, generalized muscle atrophy, and the absence of tendon reflexes. Elevated lactate levels were observed in both venous blood and cerebrospinal fluid, and magnetic resonance imaging scans revealed diffuse leukoencephalopathy. Emphasizing the importance of early identification of MNGIE patients, the study underscores the emerging therapeutic options that can positively impact survival and overall health outcomes. The findings highlight that prompt diagnosis and intervention contribute to improved prognosis and well-being in affected individuals. [ABSTRACT FROM AUTHOR]

A rare species of masked bee Hylaeus strenuus (Cameron, 1897) is reported for the first time from south India. Diagnosis of the species together with the illustrations of morphological characters is presented. Images of the trap nest and nest parameters are provided. A revised checklist of all the known species of the genus Hylaeus from south India along with species distribution map is also provided. © 2023 Association for Advancement of Entomology. [ABSTRACT FROM AUTHOR]

The COVID-19 infection caused by the new SARS-CoV-2 virus has been linked to a broad spectrum of symptoms, from a mild cough to life-threatening pneumonia. As we learn more about this unusual COVID-19 epidemic, new issues are emerging and being reported daily. Mucormycosis, also known as zygomycosis or phycomycosis, causes severe fungal illness to individuals with a weakened immune system. It is a devastating fungal infection, and the most frequent kind is the rhino cerebral type. As a devastating second wave of COVID-19 sweeps India, doctors report several instances involving a strange illness—sometimes known as the "black fungus"—among returning and recovered COVID-19 patients. This paper analyzes the existing statistical data to address the severity of prevalence and further notes the nano-based diagnostic parameters, clinical presentations, its connection with other conditions like diabetes, hypertension, and GI disorders, and the importance of anti-fungal therapy in treating the same. Anti-fungal therapies, as well as surgical interventions, are currently used for the treatment of the disease. Proper and timely diagnosis is necessary, along with the reduction in the spread of COVID-19. From the review, it was found that timely pharmacologic interventions and early diagnosis by using a nano-based diagnostic kit can help control the disease. Additionally, this paper provides novel information about the nanotechnology approaches such as fungal detection biosensors, nucleic acids-based testing, point-of-care tests, and galactomannans detection, in the diagnosis of mucormycosis, and thereby reinforces the need for further research on the topic. [ABSTRACT FROM AUTHOR]

Globally and in India, lung cancer is one of the leading malignancies in terms of incidence and mortality. Smoking and environmental pollution are the common risk factors for developing lung cancer. Traditionally, lung cancer is divided into small cell and nonsmall cell types, with nonsmall cell carcinomas including squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. In this review article, we describe the imaging recommendations and findings in the diagnosis, staging, and management of lung cancer, including the imaging of treatment-related complications. [ABSTRACT FROM AUTHOR]

Indian medicinal plants are referred to as the "nectar of life" owing to their phytochemicals and bioactive complexes that are beneficial in treating diseases. Coronavirus disease 2019 (COVID-19) is a global health issue without any proper medication. The indigenous plants of India can be exploited to control the precise signs of SARS-CoV-2. The Ministry of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) has advised routine usage of medicinal plants for COVID-19. Medicinal plants like Zingiber officinalis, Azadirachta indica, Ocimum sanctum, Nigella sativa, Withania somnifera, Curcuma longa, Piper nigrum, Allium sativum, Tinospora cordifolia, etc. have immunity-boosting, antiviral, antibacterial, antioxidant and anti-inflammatory actions that can suppress and treat symptoms of COVID-19. In vitro, in vivo as well as in silico validation, these phytochemicals can help us to manage and treat COVID-19 disease. This integration of traditional knowledge in the prophylaxis of corona infection and current skills validating it for the development of precise and powerful therapeutic approaches will more efficiently resolve different clinical aspects of COVID-19. The review focuses on both traditional and emergent methods to prevent and treat COVID-19 with various Indian medicinal plants along with their phytochemicals. [ABSTRACT FROM AUTHOR]

Paediatric extra-cranial solid tumours are one of the common causes for paediatric malignancies. Lack of appropriate imaging at presentation, staging and for follow-up is a major challenge for paediatric solid tumours. We have reviewed the paediatric solid tumour imaging protocols suggested by the major oncological societies/groups around the world (mainly the SIOP – Society International Pediatric Oncology, and the COG – Children's Oncology Group). We have adapted some of those protocols to develop imaging recommendations for the diagnosis, staging and management of extra-cranial solid tumours based on the treatment protocols followed in India. [ABSTRACT FROM AUTHOR]

Autism Spectrum Disorder is a complex syndrome that consists of a set of developmental and behavioral features. Not only children with Autism face different challenges in the family as well as society but it also challenges the people in the background such as parents and family members. Autism affects 18 million people in India and raising awareness can help patients overcome stigma and improve the daily routines for the people with ASD as well as the relationships around them. This article focuses on the possible interventions for Autism and strategies on how to better control sensory and perceptual problems. This also serves as a guide to parents on how to tackle kids with ASD and simultaneously not losing a focus on themselves as well. The main areas of concern in ASD are communication, social interaction and sensory integration so the interventions are also focused on these areas such as Hanen Program, Floortime Model and Individualized Education Program (EIP). Autism is spoken of generally as a jigsaw with a missing piece, instead, it is a bucket full of several different jigsaws in it (Chapter 1-A Bucket Full of Jigsaws, Autism an inside out approach.) Figuring out the different pieces of the jigsaw and making sense out of them is the main task while handling ASD. [ABSTRACT FROM AUTHOR]

: Socio-behavioral disorders(SBD), a subtype of neurodevelopmental disorders (NDDs) characterized by social and behavioral abnormalities, is a significant mental health concern requiring immediate attention. Phenotypic knowledge, biological understanding and the tools developed are all from western countries. Numerous researches have been conducted that have scrutinized the performance accuracy of traditional-based SBD tools developed in western culture. However, very little information is available for low or middle-income countries. In middle-income countries like India, there is a shortage of resources, trained professionals and a lack of knowledge regarding which tools are effective for a particular target group owing to which most of the cases go undetected and undiagnosed until adolescence. Motivated by the earlier discussion, this study's objective is to consider all the pathways from traditional to Artificial Intelligence (AI) tools developed for diagnosing SBD in the Indian population. This research work expounds on the systematic study and analysis of various conventional and fuzzy-based expert systems introduced between 1925–2021. PRISMA guidelines were used to select the articles published on the web of science, SCOPUS, and EMBASE to identify relevant Indian studies. A total of 148 papers are considered impactful for SBD prediction using traditional or fuzzy-based techniques. This survey deliberated the work done by the different researchers, highlighting the limitations in the existing literature and the performance comparison of tools based on various parameters such as accuracy, sensitivity, specificity, target audience, along with their pros and cons. Some investigations have been designed, and the solutions to those were explored. : Results of this study indicated that most validated SBD tools present many barriers to use in the Indian population. Thus, to overcome these implications, an Artificial Intelligence(AI) framework, MRI M M TL, based on MRI multimodality transfer learning techniques(TL), is proposed to be implemented for the early detection of SBD subjects. • SBD diagnosis concerning Indian Perspective. • Covering all the pathways from traditional to Artificial Intelligence based SBD Diagnosis in India. • Study and analysis of all the traditional (SBD screening and diagnostic procedures) introduced between 1925 and 2022 used in Indian population. • Analysis of existing fuzzy tools covering a time frame of 2010–2022 to complement the traditional clinical practices and their existing implications to deploy in natural clinical settings. • An intelligent multimodal framework MRI M M TL using MRI & transfer learning techniques is suggested for early & effective SBD diagnosis. [ABSTRACT FROM AUTHOR]

The emergence of various diseases during the COVID-19 pandemic made health workers more attentive, and one of the new pathogens is the black fungus (mucormycosis). As a result, millions of lives have already been lost. As a result of the mutation, the virus is constantly changing its traits, including the rate of disease transmission, virulence, pathogenesis, and clinical signs. A recent analysis revealed that some COVID-19 patients were also coinfected with a fungal disease called mucormycosis (black fungus). India has already categorized the COVID-19 patient black fungus outbreak as an epidemic. Only a few reports are observed in other countries. The immune system is weakened by COVID-19 medication, rendering it more prone to illnesses like black fungus (mucormycosis). COVID-19, which is caused by a B.1.617 strain of the SARS-CoV-2 virus, has been circulating in India since April 2021. Mucormycosis is a rare fungal infection induced by exposure to a fungus called mucormycete. The most typically implicated genera are Mucorrhyzuprhizopusdia and Cunninghamella. Mucormycosis is also known as zygomycosis. The main causes of infection are soil, dumping sites, ancient building walls, and other sources of infection (reservoir words "mucormycosis" and "zygomycosis" are occasionally interchanged). Zygomycota, on the other hand, has been identified as polyphyletic and is not currently included in fungal classification systems; also, zygomycosis includes Entomophthorales, but mucormycosis does not. This current review will be focused on the etiology and virulence factors of COVID-19/mucormycosis coinfections in COVID-19-associated mucormycosis patients, as well as their prevalence, diagnosis, and treatment. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a serious and important public health issue to be addressed in India. Timely diagnosis of the drug resistance in tuberculosis is essential to ensure and initiate appropriate therapy. The detection of drug resistant Mycobacterium tuberculosis (MTB) in cases of smear-negative and clinical diagnosed pulmonary TB. A prospective case-control study was conducted on 473 pulmonary samples received at the tertiary care center from January 2019 to December 2019. All specimens were processed for microscopy and culture. CBNAAT-Gene Xpert and LPA Genotype MTBDRplus (VER 2.0) was used to confirm in smear-negative samples. Among the pulmonary samples, 52% smear-positive, and 48% smear-negative, 183 (43%) were found to be culture-positive by Lowenstein Jensen medium (LJ) and MGIT 960, 267 (63%) were positive CBNAAT and LPA n= 216 (51%) samples positive for the TUB band. The use of CBNAAT-Gene Xpert, Line Probe Assay Genotype MTBDR plus(VER 2.0) can be done from the samples directly and the diagnostic performance are more specific for detecting MTB in smear-negative specimens. This study suggests that LPA also helps in the diagnosis of MDR rapidly and in initiation of earlier treatment. [ABSTRACT FROM AUTHOR]

A resistant and hypervirulent dermatophyte from India has been described as a taxonomic novelty, Trichophyton indotineae, a species of the Trichophyton mentagrophytes complex. Rapid detection and correct identification of closely similar dermatophytes with different predilections are essential for efficient clinical management. We evaluated the efficacy of rapid diagnostic methods clinical and environmental strains in the T. mentagrophytes complex. The methods included Real-time-PCR, DermaGenius, LAMP, and MALDI-ToF MS, using rDNA ITS sequences as taxonomic standard. The results show that only MALDI-ToF MS can distinguish 96.97% T. indotineae from other closely related species. The complex comprises numerous clones which may differ in anonymous markers but with similar evolutionary behavior. Therefore, we recommend to distinguish species only when they show an appreciable degree of adaptation and thus are clinically significant. The distinction of remaining clonal diversity is an epidemiological query and can be solved by haplotype numbering. [ABSTRACT FROM AUTHOR]

Justification: In India, there is a lack of uniformity of treatment strategies for aplastic anemia (AA), and many children are managed only with supportive care due to non-availability of hematopoietic stem cell transplantation (HSCT). Process: Eminent national faculty members were invited to participate in the process of forming a consensus statement in Hyderabad in July, 2016. Draft guidelines were circulated to all members, and comments received in a online meeting in October, 2020 were incorporated into the final draft. These were approved by all experts. Objective: To facilitate appropriate management of children with acquired aplastic anemia. Recommendations: Key recommendations are: i) A bone marrow biopsy is must to make a diagnosis of AA; ii) Rule out inherited bone marrow failure syndromes (IBMFS), connective tissue disorders, viral infections, paroxysmal nocturnal hemoglobinuria (PNH), drug or heavy metal induced marrow suppression in all cases of AA; iii) Conservative approach to transfusions should be followed, with a target to keep hemoglobin >6 g/dL in children with no co-morbidities; iv) HLA-matched sibling donor HSCT is the preferred choice of treatment for newly diagnosed very severe/severe AA; v) In absence of HLA-matched family donor, a matched unrelated donor (MUD) transplant or immunosuppressive therapy (IST) should be considered as alternate choice based on physician expertise; vi) Fludarabine, cyclophosphamide and anti-thymocyte globulin (ATG) based conditioning with cyclosporine and methotrexate as graft versus host disease (GvHD) prophylaxis is the preferred regimen; vii) Horse ATG and cyclosporine are the recommended drugs for IST. One should wait for 3–6 months for the response assessment and consideration of next line therapy. [ABSTRACT FROM AUTHOR]

There is an urgent need to have reliable technologies to diagnose post-coronavirus disease syndrome (PCS), as the number of people affected by COVID-19 and related complications is increasing worldwide. Considering the amount of risks associated with the two chronic lung diseases, asthma and chronic obstructive pulmonary disease (COPD), there is an immediate requirement for a screening method for PCS, which also produce symptoms similar to these conditions, especially since very often, many COVID-19 cases remain undetected because a good share of such patients is asymptomatic. Breath analysis techniques are getting attention since they are highly non-invasive methods for disease diagnosis, can be implemented easily for point-of-care applications even in primary health care centres. Electronic (E-) nose technology is coming up with better reliability, ease of operation, and affordability to all, and it can generate signatures of volatile organic compounds (VOCs) in exhaled breath as markers of diseases. The present report is an outcome of a pilot study using an E-nose device on breath samples of cohorts of PCS, asthma, and normal (control) subjects. Match/no-match and k-NN analysis tests have been carried out to confirm the diagnosis of PCS. The prediction model has given 100% sensitivity and specificity. Receiver operating characteristics (ROC) has been plotted for the prediction model, and the area under the curve (AUC) is obtained as 1. The E-nose technique is found to be working well for PCS diagnosis. Our study suggests that the breath analysis using E-nose can be used as a point-of-care diagnosis of PCS. Trial registration Breath samples were collected from the Kasturba Hospital, Manipal. Ethical clearance was obtained from the Institutional Ethics Committee, Kasturba Medical College, Manipal (IEC 60/2021, 13/01/2021) and Indian Council of Medical Research (ICMR) (CTRI/2021/02/031357, 06/02/2021) Government of India; trials were prospectively registered. [ABSTRACT FROM AUTHOR]

Fungal infections commonly present with myriad symptoms that mimic other clinical entities, notable amongst which is tuberculosis. Besides histoplasmosis and chronic pulmonary aspergillosis, which can mimic TB, this review has identified several other fungal infections which also do. A total of 80 individual cases misdiagnosed as TB are highlighted: aspergillosis (n = 18, 22.5%), histoplasmosis (n = 16, 20%), blastomycosis (n = 14, 17.5%), cryptococcosis (n = 11, 13.8%), talaromycosis (n = 7, 8.8%), coccidioidomycosis (n = 5, 6.3%), mucormycosis (n = 4, 5%), sporotrichosis (n = 3, 3.8%), phaeohyphomycosis (n = 1, 1.3%) and chromoblastomycosis (n = 1, 1.3%). Case series from India and Pakistan reported over 100 cases of chronic and allergic bronchopulmonary aspergillosis had received anti-TB therapy before the correct diagnosis was made. Forty-five cases (56.3%) had favorable outcomes, and 25 (33.8%) died, outcome was unclear in the remainder. Seventeen (21.3%) cases were infected with human immunodeficiency virus (HIV). Diagnostic modalities were histopathology (n = 46, 57.5%), culture (n = 42, 52.5%), serology (n = 18, 22.5%), cytology (n = 2, 2.5%), gene sequencing (n = 5, 6.3%) and microscopy (n = 10, 12.5%) including Gram stain, India ink preparation, bone marrow smear and KOH mount. We conclude that the above fungal infections should always be considered or ruled out whenever a patient presents with symptoms suggestive of tuberculosis which is unconfirmed thereby reducing prolonged hospital stay and mortalities associated with a delayed or incorrect diagnosis of fungal infections. [ABSTRACT FROM AUTHOR]

Mucormycosis is a potentially fatal infection that presents in different clinical forms and occurs in patients with various risk factors. Recently, the COVID-19 epidemic has been responsible for an increase in the incidence of mucormycosis, particularly in India. As with other invasive filamentous fungal infections, there are no specific clinical or radiological signs, and we have fewer diagnostic tools available than for other invasive fungal infections. Therefore, the diagnosis of Mucormycosis remains difficult. Nevertheless, for optimal management, early and accurate diagnosis is important. According to the latest recommendations, diagnosis is based on direct examination of clinical specimens, and/or histopathology, and culture. There are also molecular tools for direct detection from clinical specimens, but these techniques are moderately recommended. The main problems with these molecular techniques are that, until now, they were not very well standardized; there was a great heterogeneity of DNA targets and methods, which resulted in variable sensitivity. It is in this field that most advances have been made in the last two years. Indeed, recent studies have evaluated the performance and kinetics of Mucorales qPCR in serum and have shown good sensitivity and specificity. Large inter-laboratory evaluations of qPCR in serum have also been performed and have demonstrated good qualitative and quantitative reproducibility. These new results suggest the use of Mucorales qPCR as part of the diagnostic strategy for mucormycosis. One way to achieve better reproducibility could be to use commercial methods. Currently, there are at least three commercial qPCRs for Mucorales (MucorGenius from PathoNostics, MycoGenie from Ademtech, and Fungiplex from Bruker) that can be used to test serum, respiratory samples, or biopsies. However, to date, there has been little evaluation of these methods. Overall, Mucorales PCR in tissue samples, in respiratory samples, and in serum is promising and its addition as a diagnostic tool in the definitions of invasive mucormycosis should be discussed. [ABSTRACT FROM AUTHOR]

Timely recognition of autism in children is integral to improve developmental outcomes. This study used mixed-methods (84 case-registers and 20 in-depth interviews with caregivers of children with a diagnosis of autism) to explore the extent to which the nature of parental concerns and prior knowledge of developmental disorders impact the time between symptom recognition and autism diagnosis, and the contextual family, societal and health-system related factors that impede the autism help-seeking pathway. Lack of awareness of age-appropriate child developmental milestones, apparent amongst the community and health professionals, contributed to a 1.5-year delay between parental concerns and autism diagnosis. Recommendations to shorten this help-seeking pathway include harnessing the potential of non-specialist workers to increase awareness and enable developmental monitoring of young children through scalable tools. [ABSTRACT FROM AUTHOR]

Introduction: Cryptococcosis is a potentially fatal fungal disease affecting both immunocompromised and immunocompetent individuals. Hence, a Point Of Care Test (POCT) is required with higher sensitivity and specificity (100%), for the rapid detection of cryptococcosis which will be life saving for the patient. Aim: To evaluate the usefulness of Lateral Flow Assay (LFA) for rapid detection of Cryptococcal Antigen (CrAg) from Cerebrospinal Fluid (CSF) sample. Materials and Methods: This diagnostic study was conducted in Mycology Laboratory, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India, over a period of six months (June 2019-November 2019). The CSF samples (n=37) from patients with suspected meningitis were considered for the study. Direct microscopy with gram stain, negative stain and histopathological stains was performed for all the CSF samples. Culture was done on basal medium, enriched media and special media. Cryptococcus genus specific Polymerase Chain Reaction (PCR) was also performed to confirm the isolates grown on the culture. Serological tests like Latex Agglutination Test (LAT) and LFA were also performed on all the samples. The LFA results were compared with microscopy, culture and LAT. Results: Among the 37 suspected meningitis patients, three grew Cryptococcus in culture which was considered as the gold standard in the diagnosis of Cryptococcal Meningitis (CM). Direct microscopic techniques had 100% specificity however their sensitivity was less i.e., 67%. LAT had a sensitivity of 100% and specificity of 94%. However, LFA in present study had a very good sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) (100%). Conclusion: LFA for the detection of CM is considered to be an effective method when compared to the other conventional and serological methods with higher sensitivity and specificity. Hence, in present study authors evaluated the use of LFA in diagnosis of CM and found that this assay when used as a POCT, can give the results in short duration. Considering this as a pilot study, further studies including higher number of samples are essential to confirm the effectiveness of the findings. [ABSTRACT FROM AUTHOR]

Objectives: Upper limb motor impairment causes limited activities of daily living in stroke survivors. Bimanual therapy is based on Bimanual movement that facilitates cortical balancing by simultaneous movement of paretic and non-paretic arms while performing a task. Studies aimed at exploring the effects of resisted Bimanual therapy with rhythmic auditory cues on arm function, balance, and endurance in stroke survivors. Methods: A pilot study was commenced after the institutional ethical committee approval. Twenty stroke survivors were randomly allocated into two treatment groups; Group A received conventional therapy along with resisted bimanual therapy with rhythmic auditory cues and group B received only conventional therapy. All patients received 14 treatment sessions within three weeks. Each session lasted for 45-60 minutes. The outcome measures used to assess hand function, trunk function, balance, gait, and endurance were Wolf Motor Function (WMFT), Trunk Impact Scale (TIS), Berg's Balance Scale (BBS), Dynamic Gait Index (DGI), and Six Minute Walk Test (6MWT), respectively. Results: Pre-post-analysis in resisted bimanual therapy with rhythmic auditory cues showed statistically significant difference in WMFT (P=0.005), TIS (P=0.005), BBS (P=0.005), DGI (P=0.008), and 6MWT (P=0.003). Pre-post-analysis in conventional therapy showed statistically significant difference in WMFT (P=0.005), TIS (P=0.016), and BBS (P=0.014). Inter-group analysis of mean difference between resisted bimanual therapy with rhythmic auditory cues and conventional showed statistically significance difference in WMFT (P=0.037), TIS (P=0.003), BBS (P=0.0001), and DGI (P=0.004). Discussion: Although both groups showed improvement individually in arm function, balance, and functional capacity among stroke survivors, resisted bimanual therapy with rhythmic auditory cues showed better improvement than conventional therapy in all three components: arm function, balance, and functional capacity in stroke survivors. [ABSTRACT FROM AUTHOR]

Graham's posthumous publication (Cat. Pl. Bombay, 1839) was completed by Joseph Nimmo, in addition to contributing several new species in it. Croton gibsonianus Nimmo and C. lawianus Nimmo (Euphorbiaceae) were part of this addition, and both were described based on Gibson's collection from adjoining localities in the Western India. As the diagnosis of the latter species was scant, it was subsequently interpreted in different genera viz. Dimorphocalyx, Trigonostemon and Tritaxis. Due to misinterpretation of the protologue and Gibson's Croton collection housed at K, the name C. lawianus was wrongly applied to C. gibsonianus by subsequent authors. This inadvertent application of name is corrected here and referred to the hitherto undescribed new species C. chakrabartyi. Our recent collection of C. gibsonianus has turned out to be a rediscovery after 170 years. The nomenclature, description, photographs, and distribution of C. gibsonianus are provided to avoid further taxonomic ambiguity. [ABSTRACT FROM AUTHOR]

Ficus religiosa is a large tree, native to India, and considered to have religious significance and found invariably in Buddhist shrines. The manuscript reports a new foliar disease, named as 'Diaporthe leaf disease' (DLD) in F. religiosa. DLD was first observed in a Buddhist temple in Colombo, Sri Lanka, in 2012 and now spread over some other parts of the island. Causal organism was identified as Diaporthe acutispora, based on combined ITS, TUB and TEF phylogenetic analysis. Koch's postulates were fulfilled, confirming that D. acutispora was the pathogen, producing symptoms originally observed in F. religiosa leaves. Initial infections occur in younger but fully expanded leaves, producing darkened, 1.0-1.5 cm segments of the mid-rib or primary/secondary veins. Peripheral tissues around the darkened mid-rib/vein became necrotic with large, circular and chlorotic zones. The most striking symptom was the appearance of clusters of numerous, shiny, blackish and spherical to irregular conidiomata (pycnidial) over the leaf surface and along the affected mid-rib/veins of senescing leaves. Infected leaves, younger or mature, tended to roll upwards showing desiccation probably due to blockage of water movement through infected mid-rib/veins. Considering the potentially devastative nature of the DLD, and that the disease has already spread over to parts of the country, findings in the present work will be significant in terms of disease diagnosis and management. Accurate identification of the pathogen is a prerequisite to determine the epidemiology and, effective disease management strategies. This is the first report of DLD in F. religiosa anywhere in the world. [ABSTRACT FROM AUTHOR]

Isothermal techniques with lateral flow detection have emerged as a point of care (POC) technique for malaria, a major parasitic disease in tropical countries such as India. Plasmodium falciparum and Plasmodium vivax are the two most prevalent malaria species found in the country. An advanced multiplex loop-mediated isothermal amplification (mLAMP) combined with a lateral flow dipstick (LFD) technique was developed for the swift and accurate detection of P. falciparum and P. vivax, overcoming the challenges of the existing RDTs (rapid diagnostic tests). A single set of LAMP primers with a biotinylated backward inner primer (BIP primer) was used for DNA amplification of both malaria species in a single tube. The amplified DNA was hybridized with fluorescein isothiocyanate (FITC) and digoxigenin-labelled DNA probes, having a complemented sequence for the P. falciparum and P. vivax genomes, respectively. A colour band appeared on two separate LFDs for P. falciparum and P. vivax upon running the hybridized solution over them. In total, 39 clinical samples were collected from ICMR-NIMR, New Delhi. Melting curve analysis, with cross primers for both species, was used to ascertain specificity, and the sensitivity was equated with a polymerase chain reaction (PCR). The results were visualized on the LFD for both species within 60 min. We found 100% sensitivity and specificity, when compared with a traditional PCR. Melting curve analysis of mLAMP revealed the lowest detection limit of 0.15 pg/μL from sample genomic DNA. The mLAMP-LFD assays could be a potential point of care (POC) tool for early diagnosis in non-laboratory conditions, with the convenience of a reduced assay time and the simple interpretation of results. [ABSTRACT FROM AUTHOR]