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Objective: This study compared the clinical efficacy and cost-effectiveness of parenteral iron, using intravenous iron sucrose (IVIS) therapy against the standard regimen of oral iron (OI) therapy for managing iron-deficiency anemia (IDA) among pregnant women in a natural primary care setting in Gujarat. Design: A prospective cost-effectiveness study was conducted in natural programme setting wherein 188 pregnant women in their 14 to 18 weeks with moderate and severe anemia women enrolled from two districts of Gujarat, and 142 were followed up until the post-partum phase. The intervention group comprised of 82 participants who were administered IVIS, while the comparison group comprised of 106 participants who were put on OI therapy. Hemoglobin (Hb) levels were measured at periodic intervals, first during enrollment and then during each month of pregnancy period and finally on the 42nd day of the post-natal period. Outcome measures: Change in mean Hb level from baseline was the primary outcome, while the incidence of morbidity and mortality was a secondary outcome measure. Results: The intervention group showed a significant incremental mean change in Hb level from 8.2 g/dl to 11.45 g/dl at the fourth follow-up, while the control group's mean Hb level reduced from 9.99 g/dl to 9.55 g/dl. The discounted cost per beneficiary for IVIS was US$ 87, while that for OI was US$ 49. The incremental cost-effectiveness ratio (ICER) was US$ 9.84, which is 0.049% of India's per capita GDP. Conclusion: IVIS therapy was more clinically effective and cost-effective than OI therapy among pregnant women for management of moderate and severe anemia. [ABSTRACT FROM AUTHOR]

Information on people living with HIV (PLHIV) and current COVID-19 pandemic is still scarce in Indian setting. This case series of PLHIV with COVID-19 describes clinical characteristics and outcome in this special group of patients. This case series included 11 confirmed cases of COVID-19 among PLHIV admitted at a tertiary care hospital in Gujarat, India during April–December 2020. This retrospective study was conducted by doing secondary data analysis from case records of patients for various variables including demographic, clinical characteristics, HIV-related parameters, and outcome (discharged/death). The mean age of patients was 39.2 years ranging from 20 to 55 years. Nearly, 18% (2/11) of patients had major comorbidities like diabetes and hypertension. All were taking antiretroviral therapy drugs with >95% drug adherence and had CD4 count ranging from 79/cu.mm. to 1189/cu.mm. Majority (91%) of patients recovered and were discharged while only one patient (9%) died during course of COVID-19 treatment. COVID-19 showed a similar clinical and epidemiological profile among PLHIV like other group of people. Further studies with large-sample size are recommended to find risks of COVID-19 among PLHIV and its impact on treatment outcomes. [ABSTRACT FROM AUTHOR]

Background and Aims: Water Sanitation and Hygiene (WASH) within the context of Sustainable Development Goal (SDG) is well debated; however, WASH in health care sector is still in nascent phase, especially for maternity units. Although there are studies on WASH in maternity units, least are focused towards the microbiological safety. The objective of present study is to compare the visual assessment with microbiological assessment of selected maternity units of Gujarat (India) and to document microbiological contamination and drug resistance. Methods: A cross-sectional study was carried out in 10 selected maternity units of Sabarkantha and Gandhinagar district of Gujarat, India, during Feb-March 2018. Two steps of Tool Box Plus were used for documentation: visual and microbiological assessment. Antimicrobial Resistance (AMR) patterns amongst positive microorganisms were also documented. Results: Although the majority of the studied maternity units were visually clean, the microbiological findings contraindicated the same. The overall visual score across all facilities was close to 50% indicating good visual cleanliness. Out of 195 samples collected, 18% (35) samples were positive for pathogenic organisms and the majority were identified from mops and labour table. 1/3rd of organisms were resistant to > 5 antibiotics. Pathogenic organism identified includes Acitenobacter, Klebsilla, MR CONS, E coli, Psudomonas Aeruginosa and Pseudomonas species. Conclusions: Visual assessment alone which is currently used for assessment of hygiene is not a proxy for safety. It should be validated by the microbiological method. Microbiology surveillance should be explored to get valuable insights on the effectiveness of cleaning practices of the maternity units. [ABSTRACT FROM AUTHOR]