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Increase in the prevalence of hysterectomy among low-and middle-income countries (LMICs) such as India has become a significant concern. Reports based on either a particular group or region show an increasing trend in hysterectomy, but there is a dearth of national-level data in this domain. Hence, there seems to be an urgent need to garner evidence on the prevalence and determinants of hysterectomy, which could pave the way for future programs and policies. We aimed to estimate the prevalence of hysterectomy and assess its determinants using a nationally representative sample. An observational analysis was conducted using data from Longitudinal Aging Study in India (LASI), 2017–2018. 38,154 women aged > 18 years were included. A multivariable logistic regression, presented as an adjusted odds ratio (AOR) with a 95% confidence interval (CI), was used to predict the association between various socio-demographic characteristics and hysterectomy. A separate multivariable logistic regression model was executed to determine the association between selected non-communicable diseases (NCDs) and hysterectomy. Survey weights compensated the complex study design. The overall prevalence of hysterectomy was around 11.35%. Excessive menstrual bleeding followed by fibroids emerged as the leading causes of hysterectomy. The various determinants of hysterectomy were urban residents [AOR: 1.54 (1.21–1.96)], other backward class [AOR: 2.19 (1.72–2.78], working women [AOR: 1.19(1–1.42)] and the most affluent (rich) group [AOR: 2.06 (1.62–2.63)]. Hysterectomy was associated with cancer [AOR: 4.83 (2.51–9.29)], diabetes [AOR: 1.79 (1.25–2.57)], hypertension [AOR: 1.48 (1.27–1.71)] and joint diseases [AOR: 1.43 (1.09–1.88)]. Hysterectomy is considerably prevalent in India, which cannot be overlooked. Health promotion regarding hysterectomy and its implications is needed especially among urban residents, affluent groups and those with a higher body mass index. Health programmes aimed at women should follow a life course approach by prioritizing health and overall well-being even after reproductive years. [ABSTRACT FROM AUTHOR]

Increase in the prevalence of hysterectomy among low-and middle-income countries (LMICs) such as India has become a significant concern. Reports based on either a particular group or region show an increasing trend in hysterectomy, but there is a dearth of national-level data in this domain. Hence, there seems to be an urgent need to garner evidence on the prevalence and determinants of hysterectomy, which could pave the way for future programs and policies. We aimed to estimate the prevalence of hysterectomy and assess its determinants using a nationally representative sample. An observational analysis was conducted using data from Longitudinal Aging Study in India (LASI), 2017–2018. 38,154 women aged > 18 years were included. A multivariable logistic regression, presented as an adjusted odds ratio (AOR) with a 95% confidence interval (CI), was used to predict the association between various socio-demographic characteristics and hysterectomy. A separate multivariable logistic regression model was executed to determine the association between selected non-communicable diseases (NCDs) and hysterectomy. Survey weights compensated the complex study design. The overall prevalence of hysterectomy was around 11.35%. Excessive menstrual bleeding followed by fibroids emerged as the leading causes of hysterectomy. The various determinants of hysterectomy were urban residents [AOR: 1.54 (1.21–1.96)], other backward class [AOR: 2.19 (1.72–2.78], working women [AOR: 1.19(1–1.42)] and the most affluent (rich) group [AOR: 2.06 (1.62–2.63)]. Hysterectomy was associated with cancer [AOR: 4.83 (2.51–9.29)], diabetes [AOR: 1.79 (1.25–2.57)], hypertension [AOR: 1.48 (1.27–1.71)] and joint diseases [AOR: 1.43 (1.09–1.88)]. Hysterectomy is considerably prevalent in India, which cannot be overlooked. Health promotion regarding hysterectomy and its implications is needed especially among urban residents, affluent groups and those with a higher body mass index. Health programmes aimed at women should follow a life course approach by prioritizing health and overall well-being even after reproductive years. [ABSTRACT FROM AUTHOR]

This paper presents a novel nonlinear guidance law for an autonomous unmanned aerial vehicle (UAV) that enables it to track any predefined path while taking into account wind effects. The approach involves treating the desired path as the trajectory of the virtual target, which the UAV tracks without relying on knowledge of the path's curvature. This makes the design applicable to paths with varying levels of complexity and smooth curvatures. Additionally, the proposed method draws inspiration from pursuit guidance, known for its simplicity and ease of implementation. Theoretical analysis ensures that the UAV will converge to the intended path within a fixed time, irrespective of its initial configuration relative to the path. Simulations demonstrate the effectiveness of the proposed method, showcasing the UAV's ability to accurately follow diverse curvilinear paths. [ABSTRACT FROM AUTHOR]

Introduction: Lymphatic filariasis (LF) is a debilitating and disabling parasitic disease of immense public health concern in India with more than 650 million people at risk. Mass drug administration (MDA) is the recommended preventive chemotherapy strategy to eliminate LF. But, its coverage and compliance has been a mixed success. There is an urgent need of evidence to strengthen the program further, which can be done by exploring and understanding implementer as well as beneficiary perspectives. Objective: To systematically review the facilitators and barriers experienced during the coverage and compliance of MDA for LF elimination in India from both beneficiary and provider’s (health system) perspective. Methods and Analysis: We will search at Medline database through PubMed and Embase, along with ProQuest and Google Scholar to retrieve literature. Original qualitative observational studies exploring challenges and enablers in MDA program will be screened by two independent reviewers systematically based on title and abstract followed by full text. The risk of bias will be assessed through critical appraisal skills program checklist for each included article. Data will be extracted in a pre‑designed proforma with study characteristics, demographic features, and texts and quotes of qualitative data. Data will be analyzed through thematic analysis and motivation‑opportunity‑ability‑behavior framework using MAXQDA software. Ethics and Dissemination: This is a literature‑based review with minimal privacy concerns. The findings of this study will be published in a peer‑reviewed journal and disseminated through policy brief to program implementers. [ABSTRACT FROM AUTHOR]

Background: Smokeless Tobacco (SLT) use is culturally rooted and more acceptable among women in India. SLT is a significant risk for oral cancers and has other adverse health outcomes on women's general as well as reproductive health. This study aimed to estimate and compare the prevalence and correlates of SLT among adult females in India using Global Adult Tobacco Survey (GATS), 2009-2010 (GATS 1) and 2016-2017 (GATS 2).Methods: Data from a nationally representative cross-sectional study GATS 1 (n = 35,529) and GATS 2 (n = 40,265) were analysed for adult female smokeless tobacco users. Correlates of SLT exposure were assessed separately using binary logistic regression. Multivariable logistic regression analysis was done for the variables which computed p < 0.1. The association was expressed as Adjusted Odds ratio with 95% confidence intervals.Results: There was a reduction in prevalence of SLT use among women in India between GATS 1 (18.4%) and GATS 2 (12.8%). SLT use was highest among the North-Eastern women in both rounds [AOR: 4.567 (3.942-5.292) during GATS-1 and 9.149 (7.722-10.839) during GATS-2]. Odisha had highest prevalence of 56.53% while Himachal Pradesh had lowest 0.14% during the recent GATS 2 survey. 33.3% vs. 34.80% of the participants were willing to quit tobacco in Central region across both rounds of survey.Conclusions: Although, smokeless tobacco prevalence among females has reduced between 2009 and 2016 in India, yet tobacco control strategies need further pace. Hence, more focused gender-based tobacco control programs and policies are the need of time. [ABSTRACT FROM AUTHOR]

This article proposes a leader–follower cooperative salvo guidance strategy to intercept nonmaneuvering targets by exploiting the advantages of supertwisting sliding mode control. An improved estimate of time-to-go, that does not assume interceptor's small heading angle, is used in the guidance design. This allows the guidance strategy to remain effective even for large initial heading of the interceptor. Under the action of supertwisting control, the error in impact time settles precisely to zero in finite time. The proposed guidance strategy provides robustness against uncertainties and a smooth control signal, along with finite-time convergence of error. The guidance performance has been shown for one-to-one engagement, and in a cooperative framework, to achieve a salvo in a predetermined time. Numerical simulations are presented for various engagement scenarios to aid the analysis, and illustrate the efficacy of the proposed guidance scheme, even under noisy environment. [ABSTRACT FROM AUTHOR]

Continuous Stirred Tank Reactors (CSTR) are the most important and central equipment in many chemical and biochemical industries, that exhibit second order complex nonlinear dynamics. The nonlinear dynamics of CSTR poses many design and control challenges. The proposed controller guarantees a stable closed loop behavior over multiple operating points even in the presence of perturbations and parametric anomalies. An event driven sliding mode control is presented in this work to regulate the temperature and concentration states very close to the equilibrium points of a CSTR. The control is executed only when a predefined condition gets violated and hence, the controller is relaxed when the system is operating under tolerable limits of closed loop performance. A novel dynamic event triggering rule is presented to maintain desired performance with minimum computational cost. The inter event execution time is shown to be lower bounded by a finite positive quantity to exclude Zeno behavior. Sliding mode control (SMC) combined with event triggering scheme retains the inherent robustness of traditional SMC and aids in reducing computational load on the controller involved. Simulation results validate the efficiency of the proposed controller. [ABSTRACT FROM AUTHOR]

Background: Implant for fixation of neglected fracture lateral condyle humerus remains an issue of controversy. This study compares the clinical and radiological outcome of fixation with Kirschner wire (K-wire) and with cancellous screw (CS) in neglected fracture lateral condyle humerus Materials and Methods: 42 patients of neglected lateral condyle humerus fracture, treated either by open reduction and internal fixation (ORIF) with K-wire or ORIF with CS were included in study. The comparisons were made in term of slab immobilization time, union time, improved range of motion (ROM), final achieved carrying angle, and functional outcome measured by Liverpool Elbow Score (LES) Results: There were 22 patients in Group I with mean age 7.8 years and 20 patients in Group II with mean age 7.3 years. Mean delay in presentation was 12.9 versus 15.6 weeks (P > 0.05). Mean followup was 26.9 versus 26.7 months. Mean duration of immobilization was 11.6 versus 9.4 weeks (P < 0.001). Improved carrying angle was 6.8° versus 9.7° (P < 0.05). Mean gain in ROM was 17.7° versus 27.5° (P < 0.05). Mean LES was 8.15 versus 8.18 (P > 0.05). Premature closure of physis was observed in two patients. Pin tract infection was seen in three of Group I (P > 0.05) Conclusion: There was no difference in LES, irrespective of implant used. Screw was better in terms of duration of slab, improvement in carrying angle and ROM [ABSTRACT FROM AUTHOR]

Background: Implant for fixation of neglected fracture lateral condyle humerus remains an issue of controversy. This study compares the clinical and radiological outcome of fixation with Kirschner wire (K-wire) and with cancellous screw (CS) in neglected fracture lateral condyle humerus. Materials and Methods: 42 patients of neglected lateral condyle humerus fracture, treated either by open reduction and internal fixation (ORIF) with K-wire or ORIF with CS were included in study. The comparisons were made in term of slab immobilization time, union time, improved range of motion (ROM), final achieved carrying angle, and functional outcome measured by Liverpool Elbow Score (LES). Results: There were 22 patients in Group I with mean age 7.8 years and 20 patients in Group II with mean age 7.3 years. Mean delay in presentation was 12.9 versus 15.6 weeks (P > 0.05). Mean followup was 26.9 versus 26.7 months. Mean duration of immobilization was 11.6 versus 9.4 weeks (P < 0.001). Improved carrying angle was 6.8° versus 9.7° (P < 0.05). Mean gain in ROM was 17.7° versus 27.5° (P < 0.05). Mean LES was 8.15 versus 8.18 (P > 0.05). Premature closure of physis was observed in two patients. Pin tract infection was seen in three of Group I (P > 0.05). Conclusion: There was no difference in LES, irrespective of implant used. Screw was better in terms of duration of slab, improvement in carrying angle and ROM. [ABSTRACT FROM AUTHOR]

Background: Gentle passive manipulation and casting by the Ponseti method have become the preferred method of treatment of clubfoot presenting at an early age. However, very few studies are available in literature on the use of Ponseti method in older children. We conducted this study to find the efficacy of Ponseti method in treating neglected clubfoot, which is a major disabler of children in developing countries. Materials and Methods: 41 clubfeet in 30 patients, presenting after the walking age were evaluated to determine whether the Ponseti method is effective in treating neglected clubfoot. This is a prospective study. Pirani and Dimeglio scoring were done for all the feet before each casting to monitor the correction of deformity. Quantitative variables were expressed as mean ± standard deviation and compared between preoperative and postoperative followup using the paired t-test. Also, the relation between the Pirani and Dimeglio score, and age at presentation with the number of casts required was evaluated using Pearson's correlation coefficient. No improvement in Dimeglio or Ponseti score after 3 successive cast was regarded as failure of conservative management in our study. Results: The mean age at presentation was 3.02 years (range 1.1 - 10.3 years). The mean followup was 2.6 years (range 2-3.9 years). The mean number of casts applied to achieve final correction were 12.8 casts (range 8-18 casts). The mean time of immobilization in cast was 3.6 months. The mean Dimeglio score before treatment was 15.9 and after treatment were 2.07. The mean Pirani score was 5.41 before treatment and 0.12 after treatment. All feet (100%) achieved painless plantigrade feet without any extensive soft tissue surgery. 7 feet (17%) recurred in our average followup of 2.6 years. Conclusions: Painless, supple, plantigrade, and cosmetically acceptable feet were achieved in neglected clubfeet without any extensive surgery. A fair trial of conservative Ponseti method should be tried before resorting to extensive soft tissue procedure. [ABSTRACT FROM AUTHOR]

We propose predefined-time consensus-based cooperative guidance laws for a swarm of interceptors to simultaneously capture a target capable of executing various kinds of motions. Unlike leader-follower cooperative guidance techniques, the swarm of interceptors has no leader and each interceptor executes its own guidance command in a distributive fashion, thus obviating the residency of the mission over a single interceptor. We first design cooperative guidance commands subject to target's mobility, followed by the same when the target is stationary, and also account for interceptors' changing topologies. We further show through rigorous analysis that the proposed cooperative guidance laws guarantee consensus in the interceptors' time-to-go values within a predefined-time. The proposed design allows a feasible time of consensus in time-to-go to be set arbitrarily at will during the design regardless of the interceptors' initial time-to-go values, thereby ensuring a simultaneous target interception. We also demonstrate the efficacy of the proposed design via simulations for interceptors connected over static and dynamic networks. [ABSTRACT FROM AUTHOR]

Background: Currently, inequality in life expectancy across gender makes women outlive men. Adult women transit towards menopause around midlife accompanied by a series of natural physiological changes leading to several conditions such as osteoporosis, depression, and urinary incontinence, which puts them at a higher risk of having multimorbidity. Multimorbidity is often associated with poorer quality of life, leading to deteriorated work productivity and associated economic loss in midlife. Hence, this study aimed to determine the magnitude and correlates of early onset of multimorbidity and explore its linkages with health-related quality of life (HRQoL) among middle-aged women in India.Methods: We have utilized data from the first round of the Longitudinal Ageing Study in India, 2017-19. We included women aged 45-65 years (n = 23,951) for analysis. Descriptive data were presented. An ordered logistic regression was conducted and proportional odds were reported to identify the correlates of multimorbidity. To explore the linkages between multimorbidity and selected indicators of HRQoL, an array of regression models were executed.Results: Multimorbidity was reported amongst 29.8% of women in midlife. Chandigarh (PR-54.8 PER 100 women) and Punjab (PR-52.8 per 100 women) reported the highest prevalence of multimorbidity. Women with multimorbidity reported compromised HRQoL indicators such as self-rated health, work-limiting health conditions, mobility, and activities of daily living.Conclusions: Multimorbidity is increasingly prevalent in midlife women associated with inferior quality of life. The reproductive health programs for women should consist of midlife women focusing on multimorbidity and overall well-being. [ABSTRACT FROM AUTHOR]

Commitment to and completion of sexual development are essential for malaria parasites (protists of the genus Plasmodium) to be transmitted through mosquitoes. The molecular mechanism(s) responsible for commitment have been hitherto unknown. Here we show that PbAP2-G, a conserved member of the apicomplexan AP2 (ApiAP2) family of DNA-binding proteins, is essential for the commitment of asexually replicating forms to sexual development in Plasmodium berghei, a malaria parasite of rodents. PbAP2-G was identified from mutations in its encoding gene, PBANKA_143750, which account for the loss of sexual development frequently observed in parasites transmitted artificially by blood passage. Systematic gene deletion of conserved ApiAP2 genes in Plasmodium confirmed the role of PbAP2-G and revealed a second ApiAP2 member (PBANKA_103430, here termed PbAP2-G2) that significantly modulates but does not abolish gametocytogenesis, indicating that a cascade of ApiAP2 proteins are involved in commitment to the production and maturation of gametocytes. The data suggest a mechanism of commitment to gametocytogenesis in Plasmodium consistent with a positive feedback loop involving PbAP2-G that could be exploited to prevent the transmission of this pernicious parasite. [ABSTRACT FROM AUTHOR]

This work proposes two different cooperative integrated guidance and control schemes for a group of interceptors, each steered by combined effects of canard and tail aerodynamic surfaces, aiming a simultaneous interception of a non-maneuvering target. The first approach is based on a leader-follower framework, in which the time of interception can be prescribed before homing, while the second approach is of a leaderless framework, in which the time of interception is decided during engagement. The proposed integrated guidance and control design for multi-body engagement is carried out under nonlinear settings, with time-to-go formulations that relax the restrictive assumption of interceptors' small heading angles. This facilitates wide applicability of the proposed design in scenarios necessitating large terminal time requirements. In addition to the nonlinearity in kinematics of engagement and interceptors' dynamics, effect of actuators are also considered, making the design suitable for practical implementation. Since canard and tail aerodynamic surfaces have different capabilities, a weighted effort allocation scheme is devised to apportion the total effort in both control surfaces in a suitable manner. Finally, various engagement scenarios have been considered in simulations to substantiate the efficacy of the proposed schemes. [ABSTRACT FROM AUTHOR]

Background: Plasmodium falciparum is usually asynchronous during in vitro culture. Although various synchronization methods are available, they are not able to narrow the range of ages of parasites. A newly developed method is described that allows synchronization of parasites to produce cultures with an age range as low as 30 minutes. Methods: Trophozoites and schizonts are enriched using Plasmion. The enriched late stage parasites are immobilized as a monolayer onto plastic Petri dishes using concanavalin A. Uninfected erythrocytes are placed onto the monolayer for a limited time period, during which time schizonts on the monolayer rupture and the released merozoites invade the fresh erythrocytes. The overlay is then taken off into a culture flask, resulting in a highly synchronized population of parasites. Results: Plasmion treatment results in a 10- to 13-fold enrichment of late stage parasites. The monolayer method results in highly synchronized cultures of parasites where invasion has occurred within a very limited time window, which can be as low as 30 minutes. The method is simple, requiring no specialized equipment and relatively cheap reagents. Conclusions: The new method for parasite synchronization results in highly synchronized populations of parasites, which will be useful for studies of the parasite asexual cell cycle. [ABSTRACT FROM AUTHOR]

This paper proposes integrated guidance and control design to intercept a target, which may execute various motions, at a pre-specified time of interception. The problem is addressed considering nonlinear engagement kinematics and the interceptor is steered using the combined effects of canard as well as tail configurations (dual-controlled interceptors). Different formulations of time-to-go, without the restrictive assumption of interceptor's small heading angle, have been used in deriving the guidance commands, allowing the proposed strategy to remain effective over a wide range of impact time values. A weighted effort allocation scheme, in canard and tail deflections, has been proposed to generate the required lateral acceleration. The overall design uses sliding mode control owing to its simplicity of design, while a nonlinear finite-time disturbance observer is used to estimate the target's maneuver. Finally, simulations are presented for various target motions, and time-constrained interception with an impaired actuator is also shown, vindicating the efficacy of the proposed technique. [ABSTRACT FROM AUTHOR]

This paper deals with nonsingular guidance and control design for an interceptor, using a decoupled approach, steered by the combined effects of both canard and tail, to intercept a moving but non-maneuvering target at a time specified a priori. First, interceptor's desired lateral acceleration, consisting of nominal and corrective components, is derived using deviated pursuit guidance. While the nominal component is the pursuit guidance law, the corrective component drives the time-to-go error to zero within a finite-time in an optimal manner. Using a desired error dynamics and a meaningful performance index, the lateral acceleration demand is minimized during the transient phase. With exact knowledge of time-to-go and the consideration of nonlinear kinematic model, the proposed design circumvents the errors arising out of any approximations. Interceptor's canard and tail deflection commands are derived using predefined-time convergent sliding mode control, which allows the autopilot to precisely track the commanded lateral acceleration within a time specified during design. Finally, simulations are presented for various cases to demonstrate the efficacy of the proposed design. [ABSTRACT FROM AUTHOR]

Malaria has inflicted serious morbidity and mortality across the globe. The major brunt of the disease has been on African, South-East Asian and South American countries. Proportionally, malaria has attracted global research priorities and this is evident from the number of publications related to malaria from across the globe, irrespective of its endemicity. However, formal and exhaustive analyses of these 'malaria publications' are rarely reported. The systematic review and secondary data analyses were done to retrieve information on what has been published on malaria, where is it published, and which countries are major contributors to malaria research. The study presents malaria publications from 1945 to 2020 retrieved using three databases: Web of Science™, Embase® and Scopus®. Exported data were examined to determine the number of publications over time, their subject areas, contributions from various countries/organizations, and top publishing journals. The total number of published records on malaria ranged from 90,282 to 112,698 (due to three different databases). Based on the number of publications, USA, UK, France, and India were identified as the top four countries. Malaria Journal, American Journal of Tropical Medicine & Hygiene, and PLoS One were the most preferred journals, whereas the University of London (Institutions other than LSHTM), the National Institute of Health, the London School of Hygiene and Tropical Medicine, and the University of Oxford appeared to be the top contributing organization. A disproportional contribution to malaria research was observed with non-malaria endemic countries making the largest contribution. Databases differed in their output format and needed standardization to make the outputs comparable across databases. [ABSTRACT FROM AUTHOR]

The article presents the etymology of the term Falciparum, the parasite that causes malignant tertian malaria in humans.

Introduction: This highly contagious zoonotic corona virus (SARS-CoV-2) spread to most parts of the world (200 countries) and created a public health emergency. Due to its novel nature and indistinctness, different sources of information and suggestions were developed to guide the individuals about its transmission and prevent its infection. Responses to the active intervention efforts have posed some relevant questions on population understanding and attitudes toward COVID-19. The present study is aims to assess the COVID-19 related knowledge, attitude, and practices (KAP) in a heterogeneous Indian population. Material and methods: 501 respondents across India participated in a questionnaire-based online survey from April 2020 to May 2020. The questionnaire incorporated 56 questions about demographic characteristics and KAP dimensions. The mixed (quantitative and qualitative) methods were employed to evaluate KAP dimensions. Descriptive analysis was estimated as means, SD, and proportion. The bivariate (χ2), correlation, and regression analysis were utilized for the response analysis. In addition, qualitative analysis, including content and thematic analysis were done for open-ended questions. Result: High knowledge and positive attitude were reported in more than half of the study population, with a proportion of 58.6% and 62.1%, respectively. Education shows a significant difference in the knowledge and attitude dimensions. The good practice (50.5% of the total population) reported a significant difference in age and gender categories with the test of independence (χ2). Prevention (56.89%) in knowledge domain and risk (17.56%), information-seeking (45.51%), prevention (51.50%), and treatment-seeking (54.29%) in attitude domains recorded low proportion. KAP variables were found in association in Pearson correlation analysis. In logistic regression analysis, knowledge was the strongest predictor for the positive attitude, whereas attitude was reported as the best predictor for good practice outcome. Conclusion: The study presents a moderate level of covid related knowledge, Attitudes, and Practices in Indian population. [ABSTRACT FROM AUTHOR]

Background: Evidence on tobacco use among indigenous communities is scarce with available literature based either on a specific region or a particular tribe. Considering the large tribal population in India, it is pertinent to generate evidence on tobacco use among this community. Using nationally representative data, we aimed to estimate the prevalence of tobacco use and assess its determinants and regional variations among older tribal adults in India. Methods: We analysed data from Longitudinal Ageing Study in India (LASI), wave-1 conducted in 2017–18. A sample of 11,365 tribal individuals aged ≥ 45 years was included in this study. Descriptive statistics was used to assess the prevalence of smokeless tobacco (SLT), smoking, and any form of tobacco use. Separate multivariable regression models were executed to assess the association of various socio-demographic variables with different forms of tobacco use, reported as adjusted odds ratio (AOR) with 95% confidence interval. Results: The overall prevalence of tobacco use was around 46%, with 19% of smokers and nearly 32% smokeless tobacco (SLT) users. Participants from the lowest MPCE quintile group had a significantly higher risk of consuming (SLT) [AOR: 1.41 (95% CI: 1.04–1.92)]. Alcohol was found to be associated with both smoking [AOR: 2.09 (95% CI: 1.69–2.58)] and (SLT) [AOR: 3.05 (95% CI: 2.54–3.66)]. Relatively higher odds of consuming (SLT) were associated with the eastern region [AOR: 6.21 (95% CI: 3.91–9.88)]. Conclusion: This study highlights the high burden of tobacco use and its social determinants among the tribal population in India, which can help tailor anti-tobacco messages for this vulnerable population to make tobacco control programs more effective. [ABSTRACT FROM AUTHOR]

Background Telelactation, a virtual lactation support platform, is a convenient and effective way of providing virtual breastfeeding support services and communicating proper breastfeeding techniques to new mothers to address any breastfeeding challenges and boost overall maternal breastfeeding confidence all from the comfort of their homes. This Ontario Health Insurance Plan (OHIP) covered service benefits more mothers in the remote areas where in-person LC service is not easily accessible. Objective The objective of this cross-sectional survey study is to explore the feasibility, potential benefits, and challenges, and level of patient satisfaction in virtual lactation consultation services along with virtual paediatrician consultation available in Ontario, Canada. Method Patient satisfaction was assessed using a structured online survey as a part of a cross-sectional observational study that asked questions relevant to several independent demographic variables as well as specific Likert type scale questions to gauge patient satisfaction with virtual lactation consultation. Results Data were analyzed from 177 survey responses (n=177), of which study revealed that 86.44% (153/177) were satisfied with the virtual lactation services they received. Patient satisfaction was found to be higher in the first-time mothers with high school or undergraduate education between the age group of 26 to 35 years living in the Greater Toronto Area (GTA). In terms of connectivity, participants from the GTA had a better experience overall compared those living outside the GTA. Conclusion OHIP covered telelactation with a paediatrician consultation is an innovative and feasible health care delivery platform for providing remote professional breastfeeding support to mothers of all socio-economic strata with great potential to further improve both patient experience and efficiency in patient care. [ABSTRACT FROM AUTHOR]

Chlamydia trachomatis (CT) is the most common curable sexually transmitted non-viral infection, which can cause urethritis, prostatitis, orchitis and epididymitis among males. Toxoplasma gondii, a protozoan causes toxoplasmosis among humans. These infections may lead to decreased fertility. Hence, this study was aimed to estimate the seropositivity of CT and T. gondii infection among the male partners of infertile couples in Odisha, India. In this facility-based cross-sectional study, first void urine, seminal fluid and blood sample were collected from 153 males attending infertility clinics including 74 healthy controls. Urine and seminal fluid were tested through polymerase chain reaction (PCR), and enzyme-linked immunosorbent assay was used to detect immunoglobulin (Ig) G, IgA and IgM anti-Chlamydia and IgM anti-Toxoplasma antibodies through serum. The prevalence of CT was 1.26 per cent (95% CI: 0.03-6.85) as estimated from semen samples using PCR. We detected anti-Chlamydia antibodies IgM-four per cent [95% confidence interval (CI): 0.83-11.24]; IgA-28.16 per cent (95% CI: 18.13-40.09) and IgG-12.5 per cent (95% CI: 5.87-22.4) among participants. Anti-Toxoplasma antibodies IgM were observed in 27.63 per cent (95% CI: 17.98-39.08) of participants. None of the control samples were found positive. Overall seropositivity of CT and Toxoplasma infections is comparable, which suggests that greater attention is required for screening these infections at clinics, especially among infertile couples. [ABSTRACT FROM AUTHOR]

Background & objectives: Serial national level serosurveys in India have provided valuable information regarding the spread of COVID-19 pandemic in the general population, but the impact of the ongoing pandemic on the tribal population in India is not well understood. In this study, we evaluated the seroprevalence of COVID-19 antibodies in the tribal population of Odisha post-second wave (September 2021). Methods: A population-based, age-stratified, cross-sectional study design was adopted for the survey, carried out in seven tribal districts of Odisha from 30th August to 16th September 2021. A multistage random sampling method was used where serum samples were tested for antibodies against the SARS-CoV-2 nucleocapsid (N) protein in each district, and a weighted seroprevalence with 95 per cent confidence interval (CI) was estimated for each district. Results: A total of 2855 study participants were included from the seven tribal districts of Odisha in the final analysis. The overall weighted seroprevalence was 72.8 per cent (95% CI: 70.1-75.3). Serological prevalence was the highest among 18-44 yr (74.4%, 95% CI: 71.3-77.3) and from Sambalpur district [75.90% (66.90-83.10)]. Among participants, 41.93 per cent had received at least one dose of any COVID-19 vaccine. Kandhamal district had the highest number of fully immunized participants (24.78%), and in Sundergarh district, most of the study participants (58.1%) were unimmunized. Interpretation & conclusions: This study found high seroprevalence against SARS-CoV-2 in the tribal population of Odisha. The vaccination coverage is at par with the general population, and efforts to address some knowledge gaps may be needed to improve the coverage in the future. [ABSTRACT FROM AUTHOR]

The fundamental requirement of every gametocytocidal drug screening assay is the sufficient numbers of healthy and viable gametocytes. The number of in vitro gametocytes grossly depends on the genetic capacity of parasites to produce gametocytes and on various environmental factors that are not precisely elucidated. In the present study, we tested multiple environmental factors that are reported, hypothesized, or predicted to influence gametocyte numbers. We observed that hypoxanthine and the use of freshly drawn human blood significantly enhance gametocytemia (p < 0.05) in vitro. However, other tested factors did not significantly affect gametocytemia. The addition of N-acetyl glucosamine to the culture enriched the gametocytes but d-sorbitol (5% v/v) in amounts and duration of incubation tested was unable to do so without negatively affecting the maturity and health of the gametocytes. Although the in vitro gametocyte production depends on the genetic capability of the parasite strain tested, various environmental factors also control the ability of the strain to produce gametocytes up to a certain extent. This is the first study testing the role of various environmental factors that might affect the gametocyte development in a gametocyte producing strain. The results presented herein will help in the optimization of gametocyte production procedures for various gametocytocidal drug screening assays. [ABSTRACT FROM AUTHOR]

Background: Under-nutrition has got serious and lasting impact on health, development, society and economy. It may result in poor growth, development of child and can cause increase mortality, morbidity, health care cost, low productivity and economic growth. Nutritional rehabilitation is one of key intervention to address the under nutrition. It is questionable that nutritional intervention has potential to improve multiple domains. Methods: Follow up study evaluated the multi-domain impact of nutritional interventions on 204 admitted Severe Acute Malnutrition (SAM) children. Data was analyzed with SPSS version 20. Results: Significant positive changes were observed in physical, biochemical, developmental domains. Macnemar, paired t- test, co relation, z test were applied for data analysis. Conclusion: Nutritional intervention was found to be effective in improving selected physical, biochemical and developmental parameters. After discharge rate of improvement in anthropometric parameters was less. Actual quantification of recovery especially in biochemical and developmental parameters due to nutritional intervention is difficult. [ABSTRACT FROM AUTHOR]

Background: Medial close wedge, lateral open wedge, dome and "V" osteotomies are the commonly to correct the genu valgum (GV) deformity. However, the ideal method for the correction of coronal plane deformity is controversial. This prospective study is to evaluate the functional and radiological result of supracodylar "V" osteotomy to correct GV deformity. Materials and Methods: "V" osteotomy was done in all patients with clinically significant GV deformity and was fixed with crossed K-wires. Weight-bearing mobilization was started after radiological union. Patients were evaluated for correction in different clinical and radiological parameters. The function of the knee was assessed by Bostman's score. The subjective score was used to assess the parent's satisfaction after the procedure. Results: 187 limbs with genu valgum deformity (47 males and 71 females) were included in this study. We observed a significant improvement in the mean intermalleolar distance, clinical and radiological tibiofemoral angle and lateral distal femoral angle, from 17.3 to 3.9 cm, 23.8°to–4.5°, 25.6° to 6.1°, 76.6° to 88.4°, respectively. The mean Bostman score improved from 20.6 to 28.1. The parent's satisfaction assessed subjectively was 95.3 points. Conclusion: This osteotomy along with the fixation with K-wires is a safe, effective, reproducible technique with a short learning curve and a procedure requiring no repeat surgery for implant removal, with good functional results, and without major complications. [ABSTRACT FROM AUTHOR]

Highlights • Co-circulation of all four Dengue Virus serotypes in Delhi. • Coinfection of dengue with malaria and chikungunya. • Occurrence of dengue and malaria inversely related. • Post monsoon peak in dengue cases and high vector indices Abstract Objectives To study the epidemiology of dengue with reference to serological, demographic profile, spatio-temporal distribution, vectors, circulating serotypes and coinfections. Methods Demographic data and presenting symptoms of fever cases reporting to the clinic were recorded. Suspected patients were tested for dengue, chikungunya and malaria. Dengue specific RT-PCR was performed to detect circulating DENV serotypes. Vector surveys were carried out to detect Aedes breeding. Results Of the 5536 fever patients tested during 2012 to 2015, 1536 (27.7%) had confirmed dengue. The peak in dengue positivity was observed during September and October. Of the 60 samples analysed, 10 (16.7%) had concurrent infection with multiple dengue serotypes; one of them had all the four serotypes. Coinfection of dengue with malaria and chikungunya was also observed. The occurrence of dengue and malaria was inversely related. Seven percent of the dengue patients required hospitalization. Vector surveys in the draining area revealed Aedes breeding with a high house index. Conclusion Delhi being hyperendemic, the occurrence of concurrent infections with multiple DENV serotypes has become a frequent finding. The study emphasizes the need of epidemiological and entomological surveillance to monitor trends in dengue distribution, seasonal patterns and circulating serotypes to guide dengue control activities. [ABSTRACT FROM AUTHOR]

Background: Malaria remains a global health problem despite availability of effective tools. For malaria elimination, drugs targeting sexual stages of Plasmodium falciparum need to be incorporated in treatment regimen along with schizonticidal drugs to interrupt transmission. Primaquine is recommended as a transmission blocking drug for its effect on mature gametocytes but is not extensively utilized because of associated safety concerns among glucose-6-phosphate dehydrogenase (G6PD) deficient patients. In present work, methylene blue, which is proposed as an alternative to primaquine is investigated for its gametocytocidal activity amongst Indian field isolates. An effort has been made to establish Indian field isolates of P. falciparum as in vitro model for gametocytocidal drugs screening. Methods: Plasmodium falciparum isolates were adapted to in vitro culture and induced to gametocyte production by hypoxanthine and culture was enriched for gametocyte stages using N-acetyl-glucosamine. Gametocytes were incubated with methylene blue for 48 h and stage specific gametocytocidal activity was evaluated by microscopic examination. Results: Plasmodium falciparum field isolates RKL-9 and JDP-8 were able to reproducibly produce gametocytes in high yield and were used to screen gametocytocidal drugs. Methylene blue was found to target gametocytes in a concentration dependent manner by either completely eliminating gametocytes or rendering them morphologically deformed with mean IC50 (early stages) as 424.1 nM and mean IC50 (late stages) as 106.4 nM. These morphologically altered gametocytes appeared highly degenerated having shrinkage, distortions and membrane deformations. Conclusions: Field isolates that produce gametocytes in high yield in vitro can be identified and used to screen gametocytocidal drugs. These isolates should be used for validation of gametocytocidal hits obtained previously by using lab adapted reference strains. Methylene blue was found to target gametocytes produced from Indian field isolates and is proposed to be used as a gametocytocidal adjunct with artemisinin-based combination therapy. Further exploration of methylene blue in clinical studies amongst Indian population, including G6PD deficient patients, is recommended. [ABSTRACT FROM AUTHOR]