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Context: Children with human immunodeficiency virus (HIV) infection frequently present with opportunistic infections of the lung that may be associated with high mortality rate. There is no study, to the best of our knowledge, correlating specific radiographic patterns of chest infections with CD4 levels of immunity in HIV-infected children of Indian subcontinent (where prevalence of respiratory tuberculosis is very high). Aims: To study the radiological patterns of chest infections in HIV-infected children, and to correlate these radiological findings with CD4 cell count and final diagnosis. Methods: Forty-five HIV-infected children (1–18 years of age) with suspected chest infections were included in the study. The baseline and the most recent CD4 counts were recorded for each patient. Chest X-ray (CXR) was obtained in all the patients, and multi-detector computed tomography (MDCT) chest was done in 27 patients having clinical suspicion of infection with normal or equivocal findings on CXR. Chest radiographs and MDCT chest were analyzed for different radiological patterns of chest infections. Imaging findings were correlated with CD4 count range for disease spectrum. The final etiopathological diagnosis was achieved in combination with clinico-radiological findings, laboratory data, cytohistopathology and follow-up imaging. Results: Out of 45 children confirmed to be HIV-infected, 27 (60%) had bacterial infection, 14 (31.11%) had tuberculosis, and four (8.89%) had fungal infection. Consolidation on CXR/CT strongly suggested bacterial etiology (P < 0.05). Mediastinal/hilar lymphadenopathy (with or without necrosis) strongly suggested tubercular etiology (P value < 0.05). Diffuse GGO/haziness on CXR/CT strongly suggested fungal etiology (P value < 0.05). On correlation with CD4 count (cells/mm3), the bacterial infections occurred at early stages of HIV infection when immune status was relatively preserved, and most of the patients with tubercular infection had moderate immunosuppression. On the other hand, all patients of fungal infection showed severe immunosuppression. Conclusion: A wide spectrum of pulmonary disease encountered in HIV-infected children warrants an integrated approach of image interpretation. Familiarity with the imaging patterns, combined with relevant clinical/laboratory details, may greatly help to improve the diagnostic confidence and to reach to a more meaningful differential diagnosis. [ABSTRACT FROM AUTHOR]

Enhancing the productivity of seed potato production systems by improving the size of the tubers is a primary concern. Punjab, a state located in the northwest region of India, meets 60% of the country's seed requirements. In order to optimize the morpho‐physiological aspects, root structure, and overall yield of seed‐sized tubers, research trials were carried out at Punjab Agricultural University, Ludhiana over two consecutive years. The trial consisted of 11 different treatments and was conducted using a randomized complete block design with three replications. The application of Gibberellic acid at a concentration of 200 ppm, at 45 and 60 days after sowing (DAS), resulted in significantly higher yields of seed‐sized tubers measuring <4.5 cm. This treatment also exhibited superior root architecture parameters and accumulation of dry matter, outperforming all other growth regulation treatments. Compared to the untreated control group, the Gibberellic acid application led to a remarkable increase of 45.9% and 39.8% in seed‐sized tuber yields. Furthermore, it significantly boosted the protein, starch, antioxidant (total phenols), sugar (total and reducing), and mineral content (nitrogen, phosphorus, and potassium) in the tubers, surpassing the effects of all other growth regulation treatments. These results suggested that the exogenous use of gibberellic acid (200 ppm) at 45 and 60 DAS substantially improved the physiology, root architecture, and yield of seed‐sized tubers. [ABSTRACT FROM AUTHOR]

Background: Contact screening was conducted under ICMR (REFERENCE ID: 2019-07811) programme in villages near SGT hospital, Gurugram. Objective: To evaluate risk factors, extent of spread of tuberculosis among household contacts of tuberculosis cases and to create awareness. Methods and Material: Address of TB cases were taken from RNTCP register at DOTS clinic, SGT medical college. Then all household contacts of positive cases were screened, counselled and advised to approach ASHA Workers if such symptoms appear. Data was analysed using appropriate statistical methods. Results:21 Index cases along with 94 household contacts were screened. 61.90% families still use chullahs for cooking. 76.1% families have overcrowding. 3) 61.90% families had inadequate ventilation 4) 19.05%families were aware about the spread of this disease. 5)Only 23.80% families practised adequate sanitation methods and precautions6) 42.8% Index cases had a history of smoking. 7) 44.4% 4 continue to smoke with infection. The association of adequate sanitation with presence of awareness was found to be statistically significant. (p-value<0.05). Other factors were not significantly associated with level of awareness regarding prevention of tuberculosis spread among study participants. Conclusions: Contact screening is an effective tool and it gives the real-time picture of TB in India. [ABSTRACT FROM AUTHOR]

• TB patients have lower IFN-γR1 and IFN-γR2 expression. • There is sex-dependent modulation of IFN-γR1 and IFN-γR2 expression in TB patients. • IFN-γR1 mRNA and its surface expression shows significant positive correlation in HCs. Interferon-γ (IFN-γ) is an essential pro-inflammatory cytokine against tuberculosis (TB). To initiate immune response, IFN-γ binds to its receptor complex which consists of two subunits IFN-γ receptor 1 (IFN-γR1) and IFN-γ receptor 2 (IFN-γR2). The deficiency in either receptor subunit can alter IFN-γ signalling thus influencing host susceptibility to TB. In the present study IFN-γ receptor expression at transcriptional and translational level was analysed in pulmonary TB patients from North India. A total of 46 pulmonary TB patients (at 0 day of anti-tuberculosis therapy) and 48 healthy controls (HCs) were recruited. It was found that the mRNA expression of IFN-γR1 was decreased in male TB patients (p = 0.003). The surface expression of IFN-γR1 (p = 0.0005) and IFN-γR2 (p = 0.024) was also found to be decreased in male TB patients. In conclusion, we found sex-dependent regulation of IFN-γR1 and IFN-γR2 expression in pulmonary TB patients of studied population. [ABSTRACT FROM AUTHOR]

Study was conducted utilizing a confirmed medication adherence scale to measure the socio-demographic profile, self-care, and medication adherence among Type-2 Diabetes Mellitus (T2DM) patients. The Fisher exact test was used to calculate the level of significance (P) using SPSS (Statistical Package for Social Sciences) Version 21.0. The research presented in this paper uses statistical evidence to assess the numerous aspects that may be linked to medication adherence. A prospective observational study was undertaken on participants visiting the outpatient department for 6 months at a North Indian tertiary care hospital to investigate the pattern and quality of life associated with T2DM. The study examined those who had T2DM for more than 2 years. At the time of the visit, subjects were interviewed using socio demographic information and a structured verified questionnaire. Fisher exact test was used to identify the parameters that were linked to medication adherence, with P0.05 being regarded statistically significant. A total of 350 T2DM outpatients were followed up on, with a male-to-female ratio of 1:0.95. A 13-item medication adherence scale was created and tested, revealing that approximately 32% of participants demonstrated high adherence to anti-diabetic drugs (score = 13). The P value was obtained using Fisher exact test for educational status, occupation, marital status, and the quantity and kind of anti-diabetic drugs was found to be 0.05. Only 32% of the respondents took their diabetes medication as prescribed, indicating the need to improve adherence among T2DM patients. The quantity and kind of anti-diabetic drugs, as well as the patients' educational status, occupation, and marital status, all demonstrated a statistically significant relationship with medication adherence. [ABSTRACT FROM AUTHOR]

There is a growing body of evidence from rigorous evaluations demonstrating the effectiveness of education entertainment – ‘edutainment’– interventions in achieving development outcomes. Building on this research, this study presents the results of a pioneering quasi-experimental evaluation of Navrangi Re, a 26-episode television drama aired in India in 2019. The show was the first ever edutainment broadcast on commercial television in India. It aimed to influence sanitation behaviours through changing knowledge and attitudes, increasing risk perception, stimulating conversations, building collective efficacy, and creating social disapproval against poor faecal sludge management practices. The evaluation compared changes in outcomes of those exposed to the TV show with those unexposed, applying differences-in-differences estimation to a panel of 2,959 respondents. Baseline balance tests show high comparability between exposed and unexposed respondents. It found exposure to the drama led to significant changes in most outcomes with 37% of those who watched at least one episode showing behavioural intent to act, rising to 78% of those who had watched at least seven episodes. The show reached 59.6 million unique viewers, confirming drama as an effective, low cost and scalable tool to engage people around faecal sludge management – a critical and hard to address issue. [ABSTRACT FROM AUTHOR]

Background: Anemia is a major nutritional health problem in developing countries like India because of poor dietary habits and malnutrition. The prevalence of anemia is inordinately higher among adolescents as they are signalized by marked physical activity and rapid growth spurt; therefore they need additional nutritional supplements and are at utmost risk of developing nutritional anemia. Materials and Methods: A quantitative research approach with descriptive Research design was adopted for the study. A total of 86 adolescent girls studying in Vinay public school, Gurugram, Haryana who met the inclusion criteria were selected using total enumerative sampling technique. The tools consists of demographic variables, knowledge questionnaire and Sahli's hemoglobinometer to assess the knowledge and prevalence regarding anemia. Reliability of the tool was established by Cronbach's alpha method and it was found to be 0.84Ethical permission was obtained from ethical committee SGT University and the written informed consent was taken from each participant before administering the tool. Results: Findings of the present study revealed that majority 81% adolescent girls have poor level of knowledge followed by 19% adolescent girls have moderate level of knowledge regarding anemia. Overall prevalence and knowledge regarding anemia has range value varied from of 3-16 with mean 9.8 and standard deviation 2.88. The area of residence had significant difference on knowledge score regarding anemia in adolescent girls when P value is = 0.05. Conclusion:Knowledge level affects the prevalence rate of anemia in adolescent girls. Majority of adolescent girls have poor level of knowledge. Most of adolescent girls fall under moderate category of anemia. [ABSTRACT FROM AUTHOR]

As the surface water in northern India is the main water resource for regional economic and also supply for drinking and irrigation purposes. However, deficiency of water quality leads to serious water pollution in the Pandoh river basin (PRB). Therefore, the main objective of the present study is to evaluate the quality of surface water. With this objective, surface water samples were collected from the PRB of northern India, and analyzed for pH, EC, turbidity, alkalinity, total dissolved solids, and total hardness. Moreover, geographical information system (GIS) tools were used to prepare the geology, drainage pattern, and location maps of the study region. Surface water quality observed from the PRB has an alkaline nature with a moderately hard type. Further studies are encouraged to better understand the water quality in northern India. [ABSTRACT FROM AUTHOR]

To understand the similarities and dissimilarities of a breed structure among different buffalo breeds of North India, it is essential to capture their morphometric variation, genetic diversity, and effective population size. In the present study, diversity among three important breeds, namely, Murrah, Nili-Ravi and Gojri were studied using a parallel approach of morphometric characterization and molecular diversity. Morphology was characterized using 13 biometric traits, and molecular diversity through a panel of 22 microsatellite DNA markers recommended by FAO, Advisory Group on Animal Genetic Diversity, for diversity studies in buffaloes. Canonical discriminate analysis of biometric traits revealed different clusters suggesting distinct genetic entities among the three studied populations. Analysis of molecular variance revealed 81.8% of genetic variance was found within breeds, while 18.2% of the genetic variation was found between breeds. Effective population sizes estimated based on linkage disequilibrium were 142, 75 and 556 in Gojri, Nili-Ravi and Murrah populations, respectively, indicated the presence of sufficient genetic variation and absence of intense selection among three breeds. The Bayesian approach of STRUCTURE analysis (at K = 3) assigned all populations into three clusters with a degree of genetic admixture in the Murrah and Nili-Ravi buffalo populations. Admixture analysis reveals introgression among Murrah and Nili-Ravi breeds while identified the Gojri as unique buffalo germplasm, indicating that there might be a common origin of Murrah and Nili-Ravi buffaloes. The study provides important insights on buffalo breeds of North India that could be utilized in designing an effective breeding strategy, with an appropriate choice of breeds for upgrading local non-descript buffaloes along with conservation of unique germplasm. [ABSTRACT FROM AUTHOR]

Seasonal dynamics in macro and micronutrient concentrations were evaluated in leaves, peel and pulp of four grapefruit varieties viz. Marsh Seedless, Flame, Rio Red and Red blush, grown at Punjab Agricultural University, Fruit Research Station -- Jallowal, Jalandhar, Punjab, India. Significant variations in nutrient concentrations at specific growth and development stages were observed in different grapefruit varieties. Leaves of grapefruit varieties recorded higher concentration of nutrients followed by peel, while pulp contained minimum nutrient accumulation. With the progression of season, most of the nutrient elements were observed to increase in leaves of grapefruit varieties. N and P were observed to be higher in fruit peel while K, Ca, Mg and micronutrients were found to be higher in fruit pulp. [ABSTRACT FROM AUTHOR]

The Government of India has developed a National Strategic Plan for tuberculosis (TB) elimination by 2025, five years ahead of the global target set by the World Health Organization (WHO). For achieving these targets there has been a paradigm shift in the diagnostic and treatment strategies of TB at all ages. This update summarizes the specific changes in pediatric TB management in light of the guidelines developed by National Tuberculosis Elimination Program and Indian of Academy of Pediatrics. [ABSTRACT FROM AUTHOR]

The Government of India has developed a National Strategic Plan for tuberculosis (TB) elimination by 2025, five years ahead of the global target set by the World Health Organization (WHO). For achieving these targets there has been a paradigm shift in the diagnostic and treatment strategies of TB at all ages. This update summarizes the specific changes in pediatric TB management in light of the guidelines developed by National Tuberculosis Elimination Program and Indian of Academy of Pediatrics. [ABSTRACT FROM AUTHOR]

Evaluation of mental health in chronic lung diseases like interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD) has always been neglected and underrated. The aim of the study was to determine the psychological morbidity in patients of ILD and to determine its various socio-clinical and psychological correlates. A cross-sectional clinic based descriptive study with 50 ILD patients, 30 COPD patients and 30 healthy controls was undertaken. Psychological distress was assessed using different psychological scales, like General Health Questionnaire-12 (GHQ-12), Patient Distress Thermometer (PDT), Coping Strategy Checklist (CSCL), WHO Quality of Life- Brief-26 (WHOQOL-Bref-26) and Depression Anxiety Stress Scale (DASS). The patients with a GHQ-12 score of =3 were considered as experiencing psychological distress and additionally referred to consultant psychiatrist for further detailed evaluation and management. Fifty-eight percent of ILD patients and 60% of COPD patients experienced psychological distress after screening with GHQ-12; 40% of all the ILD and COPD patients were ultimately diagnosed with a psychiatric disorder, after evaluation by the psychiatrist. Patients of ILD and COPD had significantly higher scores on GHQ-12, CSCL and DASS, and significantly lower scores on WHOQOL-Bref-26 when compared with healthy controls. However, these scores, including PDT did not differ significantly between ILD and COPD patients. The scores on all these scales in the patients of ILD and COPD who were experiencing psychological distress (GHQ =3) were significantly poorer than those without psychological distress (GHQ<3). GHQ-12 emerged as an excellent predictor of psychological morbidity. Various other psychological scales correlated with GHQ-12 and amongst each other in both the groups experiencing psychological distress. GHQ-12 and other different scales also significantly correlated with the different clinical indicators in ILD as well as COPD patients having psychological distress. Psychological distress and poorer quality of life was present in a significant percentage of ILD patients, and was comparable to that seen in COPD. Mental health evaluation should be incorporated in the routine management of these patients. Simple, easy and brief screening tools like GHQ-12 can be of immense help. [ABSTRACT FROM AUTHOR]

Background: Diagnosis of TB in pediatric population poses several challenges. A novel initiative was implemented in several major cities of India aimed at providing upfront access to free-of-cost Xpert MTB/RIF to presumptive pediatric TB cases. This paper aims to describe the experience of implementing this large initiative and assess feasibility of the intervention in high TB burden settings. Methods: Data were drawn from the pediatric TB project implemented in 10 major cities of India between April 2014 and March 2018. In each city, providers, both public and private, were engaged and linked with a high throughput Xpert MTB/RIF lab (established in that city) through rapid specimen transportation and electronic reporting system. Rates and proportions were estimated to describe the characteristics of this cohort. Results: Of the total 94,415 presumptive pediatric TB cases tested in the project, 6,270 were diagnosed positive for MTB (6.6%) on Xpert MTB/RIF (vs 2% on smear microscopy). Among MTB positives, 545 cases were rifampicin resistant (8.7%). The median duration between collection of specimens and reporting of results was 0 days (same day) and >89% cases were initiated on treatment. Approximately 50% of the specimens tested were non-sputum. The number of providers/facilities engaged under the project increased >10-fold (from 124 in Q2'14 to 1416 in Q1'18). Conclusion: This project, which was one of the largest initiatives globally among pediatric population, demonstrated the feasibility of sustaining rapid and upfront access to free-of-cost Xpert MTB/RIF testing. The project underscores the efficiency of this rapid diagnostic assay in tackling several challenges in pediatric TB diagnosis, identifies opportunities for further interventions as well as brings to light scope for effective engagement with healthcare providers. The findings have facilitated a policy decision by National TB Programme mandating the use of Xpert MTB/RIF as a primary diagnostic tool for TB diagnosis in children, which is being scaled-up. [ABSTRACT FROM AUTHOR]

Background: Himachal Pradesh is a hill state in North India in the Western Himalayas. β-thalassemia is a genetic disorder of hemoglobin inherited in an autosomal recessive manner that results in defective globin production leading to the early destruction of red blood cells. β-thalassemia has long been neglected in Himachal Pradesh due to popular belief that it runs along "Lahore-Gujarat-Punjab" belt in India. Therefore, there is no β-thalassemia testing facility currently in the state. Methods: To estimate the prevalence of β-thalassemia carriers, we calculated the sample size based on probability proportional to size self-weighing design. In each of 20 selected colleges, 111 students having an age of 18–25 were tested for high-performance liquid chromatography (HPLC) and complete blood count. Some were further tested for the mutations. We computed sensitivity, specificity, positive predictive value (PPV) and negative predictive value, and receiver operating characteristic curve for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) red cell parameters. Results: Of the 2220 students, 57 were found to be β-thalassemia carrier by HPLC. The overall prevalence rate was 2.6% which translates to probable 180,000 β-thalassemia carriers in Himachal Pradesh. Six districts bordering highly endemic Punjab had a higher prevalence. Hemoglobin D-Punjab, Heterozygous-Iran Trait, and raised fetal hemoglobin were found. Thalassemia major and sickle cell disease were not found. Anemic status or MCV/MCH parameters were not found to be reliable predictors of thalassemia carrier status among the healthy populations of HP. The predominant mutation found was IVS 1–5 G > C. Conclusion: Popular ongoing strategy for screening with MCV and MCH has low-PPV and can miss upto 37% of true thalassemia carriers. HPLC is better strategy for screening carriers and reduces further spread of thalassemia. [ABSTRACT FROM AUTHOR]

[Display omitted] • The genotype 'TT' of rs2234711 is increasing susceptibility to TB. • Haplotypes 'C-C-C' and 'T-C-C' of IFNGR1 are associated with TB. • Genotype 'TT' of rs2234711 is associated with lower surface expression of IFNGR1. Interferon-gamma (IFN-γ) is a pro-inflammatory cytokine playing essential role in immunity against tuberculosis (TB). IFN-γ performs function by binding to its receptor complex, consisting of two polypeptide chains viz. IFN-γ receptor 1 (IFN-γR1) and IFN-γ receptor 2 (IFN-γR2). Structural and functional deficiencies in IFN-γR1 can make individual vulnerable to even weak mycobacterial infections. Studies from different populations of the world have reported the association of single nucleotide polymorphisms (SNPs) present in IFNGR1 gene with TB, however, there are no such studies from India. Thus, the present study was designed to analyse the association of rs2234711 (C/T), rs7749390 (C/T) and rs1327475 (C/T) SNPs of IFNGR1 with TB in the population of North India. For the present study, 263 TB patients (at zero day of anti-tuberculosis therapy) and 256 healthy controls (HCs) were recruited. The genotyping of selected SNPs was done by high-resolution melting (HRM) curve analysis. The mRNA and surface expression data of IFNGR1 was extracted from our previous study and was grouped according to the genotypes of studied SNPs. The genotype 'TT' and 'T' allele of SNP rs2234711 (C/T) were found to be associated with TB in studied population ['T' vs 'C': OR (CI) = 1.79 (1.39–2.29); p-value < 0.0001]. The haplotypes 'C-C-C' of rs2234711-rs7749390-rs1327475 confers protection, while haplotype 'T-C-C' is a risk factor for TB in studied population. It was also found that 'TT' genotype of rs2234711 in HCs is associated with lower surface expression of IFNGR1 (p-value = 0.0078). In conclusion, 'TT' genotype is associated with lower surface expression of IFNGR1 and is increasing the susceptibility to TB in North Indian population. [ABSTRACT FROM AUTHOR]

Punjab with just 1.53 per cent of the geographical area of the country accounted for about 40-45 per cent of wheat and about 25-30 per cent of rice procured for the central pool of food grains during the last 50years or so. The State agriculture, which was growing fast earlier, has now reached a sort of plateau in terms of productivity and production. In the wake declining land - man ratio, it is not able to generate gainful employment and sufficient income for the growing population. There is almost stagnation in the net farm income. The farming alone is not able to generate sufficient income for small and marginal farmers. Due to economic distress, 6926 farmers and agricultural labourers had committed suicides between 2000 and 2010. At present, the farm indebtedness is to the extent of about Rs.80,000, which work out at Rs.7.60 lakh per farming household. Unless the state make rational use of its irrigation resources, it would be difficult to maintain even the present type of cropping pattern in the long run. In the overall interest of rural economy, the employment opportunities in the non-farm sector may be created for the unemployed/ under-employed youth. Future of the state is in the hands of present young generation. [ABSTRACT FROM AUTHOR]

Background:Drug susceptibility testing (DST) of Mycobacterium tuberculosis (Mtb) isolates is crucial for the effective treatment of tuberculosis. Data on DST patterns in Mtb isolates in childhood tuberculosis are scanty. Aims:To determine drug resistance patterns in Mtb isolates from a paediatric TB cohort in North India. Methods:403 children aged 6 months to14 year with probable intrathoracic tuberculosis were enrolled prospectively. All were treatment-naïve. 802 ambulatory-induced sputa (IS) and 787 gastric aspirate (GA) samples were cultured in BACTEC-MGIT960 system, and DST of the Mtb isolates was undertaken using the automated BACTEC-MGIT960 SIRE kit. Results:Of the 403 children, 147 (36.4%) were culture-confirmed: 132 (89.8%) isolates were Mtb and 15 (10.2%) non-tuberculous mycobacteria (NTM). Five Mtb isolates were contaminated and the remaining 127 were subjected to in-vitro drug susceptibility testing against streptomycin, isoniazid, rifampicin and ethambutol. Twenty-six (20.47%) isolates were resistant to one or more drugs, seven (5.5%) were resistant to rifampicin singly or in combination, and 11 (8.7%) were resistant to isoniazid singly or in combination. Mono-resistance to isoniazid, rifampicin, streptomycin and ethambutol was detected in four (3.1%), one (0.8%), four (3.1%) and two (1.6%), respectively. Five children (3.9%) had MDR-TB; 101 (79.9%) children had Mtb isolates which were sensitive to all four drugs. Conclusions:The rifampicin and isoniazid resistance rates were much higher than those in the adult TB population in India. [ABSTRACT FROM AUTHOR]

This study aims to investigate the consumer perceptions and purchase determinants of imported fruits in an emerging economy such as India. A consumer survey was conducted in one of the major urban cities of India. Item measures were related to consumer perceptions, purchase determinants, and consumer-reported willingness to pay price premiums. The data analysis was undertaken using techniques like exploratory factor analysis, logistic regression, and analysis of variance. Consumers associate imported fruits with health, safety, taste, and free from chemicals, whereas extrinsic factors such as storage conditions, store image, appearance, label, country of origin, and price also influence the willingness to purchase imported fruits. The demographic factors having the most impact on consumers’ attribute ratings for imported fruits are age, gender, income, and education. This study highlights the significant purchase determinants that can help marketers of imported fruits to gain higher share in Indian markets. [ABSTRACT FROM AUTHOR]

Background: Micronutrients play an important role in immune function. To our knowledge, there have been no comprehensive studies on the role of micronutrient supplementation in children with tuberculosis. Objective: We assessed the effect of micronutrient supplementation in children treated with antituberculosis therapy (ATT). Design: A randomized, double-blind, placebo-controlled trial that used a 2 X 2 factorial design was undertaken at 2 teaching hospitals in Delhi. Children with newly diagnosed intrathoracic tuberculosis were enrolled, and they received ATT together with daily supplementation for 6 mo with either zinc alone, micronutrients without zinc, micro-nutrients in combination with zinc, or a placebo. Main outcomes were weight gain and an improvement in a chest X-ray (CXR) lesion assessed at 6 mo of treatment. Results: A total of 403 children were enrolled and randomly assigned. A microbiological diagnosis of tuberculosis was confirmed in 179 children (44.4%). The median (95% CI) increase in weight-for-age z score at 6 mo was not significantly different between subjects who received micronutrients [0.75 (0.66, 0.84)] and those who did not receive micronutrients [0.76 (0.67, 0.85)] and between subjects who received zinc [0.76 (0.68, 0.85)] and those who did not receive zinc [0.75 (0.66, 0.83)]. An improvement in CXR was observed in 285 children, but there was no difference between those receiving zinc and no zinc or between those receiving micronutrients and no micronutrients after 6 mo of ATT. However, children who received micronutrients had a faster gain in height over 6 mo than did those who did not receive micronutrients (height-for-age z score Δ = 0.08; P = 0.014). Conclusions: Micronutrient supplementation did not modify the weight gain or clearance of lesions on CXR in children with intrathoracic tuberculosis. However, micronutrient supplementation during treatment may improve height gain in children with intrathoracic tuberculosis. This trial was registered at clinicaltrials.gov as NCT00801606. [ABSTRACT FROM AUTHOR]

• The 'T' alleles of rs1861494 and rs2069718 SNPs are increasing TB susceptibility. • SNP rs2069718 (C/T) shows sex dependent association with TB. • Haplotype C -T-A-T and T-T- G -T of IFN-γ are increasing risk to TB. • Genotype 'AA' of SNP rs1861493 is associated with high plasma levels of IFN-γ. Interferon-gamma (IFN-γ) plays an integral role in the host immunity against tuberculosis (TB). The gene encoding IFN-γ is polymorphic and several studies have reported the association of its genetic polymorphisms with TB in different populations of the world. The present study investigated the association of rs2069705 (C/T), rs1861494 (C/T), rs1861493 (A/G) and rs2069718 (C/T) single nucleotide polymorphisms (SNPs) of IFN-γ with pulmonary TB in a population of Himachal Pradesh, India. For present study, 210 pulmonary TB patients and 205 healthy controls (HCs) were recruited. The selected SNPs of IFN-γ were genotyped by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) and plasma IFN-γ levels were measured by ELISA. The 'T' allele of rs1861494 SNP was found to increase susceptibility to TB in the studied population (OR = 2.18, 95%CI = 1.57–3.03; p < 0.001). After stratifying the subjects on basis of sex, males with 'T' allele of rs2069718 SNP were found to be at higher risk to TB (OR = 1.55, 95%CI = 1.07–2.25; p = 0.02). We also found moderate linkage disequilibrium among the studied SNPs. The haplotypes C -T-A-T and T-T- G -T of rs2069705-rs1861494-rs1861493-rs2069718 were overrepresented in TB patients and found to increase susceptibility to TB (p = 0.012). The plasma IFN-γ levels in TB patients were around seven times higher in comparison to HCs (p < 0.0001). The HCs with genotype 'AA' of SNP rs1861493 were found with higher plasma IFN-γ levels than 'AG/GG' genotype (p = 0.023). In conclusion, the results suggest the association of rs1861494 (C/T) and rs2069718 (C/T) SNPs of IFN-γ with TB and genotype 'AA' of rs1861493 is associated with higher plasma IFN-γ levels in the population of Himachal Pradesh, India. [ABSTRACT FROM AUTHOR]

The article presents an updated national guidelnes for pediatric tuberculosis in India. It provides an overview on the prevalence of the disease in the nation. It offers information on the national consultation on diagnosis and management of childhood tuberculosis with details including drug dosages, drug formulation and TB preventive therapy.

Abstract: Although reinforced concrete structures are designed as per codes/standards but enough care is not always taken during construction process. As a result, the structures start showing signs of distress, some times less than 10 years of service life, requiring early repair and rehabilitation work. In this paper, a case study of 3 no. (G+8) multi-storeyed buildings badly damaged due to corrosion and Bhuj (India) earthquake of 2001, rehabilitated in 2003 has been presented. Repair strategy involved removal of delaminated carbonated concrete cover, application of rust remover, anti-corrosion coating, polymer bond coat, polymer modified mortar, injection of low viscosity epoxy grout to beam-column junctions and cracks, repair of masonry cracks with polymer modified mortar & grouting with SBR modified cement grout and jacketing of columns at the ground floor. Extensive material testing was carried out and specifications for acrylic and SBR polymer modified mortar were selected for durable repairs. Strict quality control and assurance both in material and workmanship was adopted. After nine years of successful rehabilitation and functioning, some signs of distress in the form of cracks and spalls due to rebar corrosion have been noted at some locations, requiring rehabilitation again. Some recommendations/conclusions have been given for durable concrete constructions and rehabilitation work. [Copyright &y& Elsevier]

The Punjab agriculture which was growing fast earlier has now reached a sort of plateau in terms of productivity and production. In the wake of a declining land man ratio, it is not able to generate gainful employment and sufficient income for the growing population. Farm profitability has witnessed a decline in the recent years due to cost price squeeze. There is almost stagnation in farm income. Farming alone is not able to generate sufficient income for small and marginal farmers. Due to economic distress, 2116 farmers had committed suicides during the last 15 years in the State. At present, the rural indebtedness is to the extent of about Rs 35000 crore which work out to be about Rs 3.50 lakh per household. The Punjab farmers are in deep economic crisis. For sustainable agricultural development, non-farm employment opportunities for rural youth may be created in the rural areas of the state. It is need of the hour in the overall interest of Punjab and the country. [ABSTRACT FROM AUTHOR]

Ascochyta rabiei isolates were characterised for their variability using a set of host differentials following cloth chamber screening technique. Sixty chickpea genotypes were evaluated against the characterised 10 individual pathotypes separately to identify genotypes with stable resistance during 2007–2008. Twenty four genotypes showed resistance to all the pathotypes; whereas 18 genotypes were resistant to moderately resistant to these pathotypes. The above genotypes can be considered good sources of stable resistance and recommended as donors or for direct cultivation in north western plain zone of India. [ABSTRACT FROM PUBLISHER]

Background: Childhood tuberculosis (TB) patients under India's Revised National TB Control Programme (RNTCP) are managed using diagnostic algorithms and directly observed treatment with intermittent thrice-weekly short-course treatment regimens for 6-8 months. The assignment into pre-treatment weight bands leads to drug doses (milligram per kilogram) that are lower than current World Health Organization (WHO) guidelines for some patients. Objectives: The main aim of our study was to describe the baseline characteristics and treatment outcomes reported under RNTCP for registered childhood (age <15 years) TB patients in Delhi. Additionally, we compared the reported programmatic treatment completion rates between children treated as per WHO recommended anti-TB drug doses with those children treated with anti-TB drug doses below that recommended in WHO guidelines. Methods: For this cross-sectional retrospective study, we reviewed programme records of all 1089 TB patients aged <15 years registered for TB treatment from January to June, 2008 in 6 randomly selected districts of Delhi. WHO disease classification and treatment outcome definitions are used by RNTCP, and these were extracted as reported in programme records. Results and Conclusions: Among 1074 patients with records available, 651 (61%) were females, 122 (11%) were <5 years of age, 1000 (93%) were new cases, and 680 (63%) had extra-pulmonary TB (EP-TB)—most commonly peripheral lymph node disease [310 (46%)]. Among 394 pulmonary TB (PTB) cases, 165 (42%) were sputum smear-positive. The overall reported treatment completion rate was 95%. Similar reported treatment completion rates were found in all subgroups assessed, including those patients whose drug dosages were lower than that currently recommended by WHO. Further studies are needed to assess the reasons for the low proportion of under-5 years of age TB case notifications, address challenges in reaching all childhood TB patients by RNTCP, the accuracy of diagnosis, and the clinical validity of reported programme defined treatment completion. [ABSTRACT FROM AUTHOR]

Objectives: To compare the clinical efficacy, pharmacokinetic profiles and safety of once-daily dosing (ODD) and multiple daily dosing (MDD) of gentamicin in hospitalized Indian children. [ABSTRACT FROM PUBLISHER]

A response from the authors of the article "Updated National Guidelines for Pediatric Tuberculosis in India, 2012" in the 2013 issue is presented.

The article discusses the age and gender distributions among flu patients in Delhi, India from 2009 to 2010. A research study showed that most of the Indians (32.83 percent) infected by the influenza A virus were aged 21 to 45 years, while 64.45 percent of the total pH1N1 flu patients were men. The increase in humidity and drop of temperature in areas across India contributed to the increase of the flu virus infections.

A response from the authors of the article "Updated National Guidelines for Pediatric Tuberculosis in India, 2012" in the 2013 issue is presented.

The article suggests that the manuscript by Varinder Jain on agricultural and rural reforms in China and India be added in the list of citations in the journal.

Summary: With the increasing globalisation, immigration and travel there are increasing opportunities for the exotic diseases to be seen in different settings. This paper highlights pulmonary diseases seen in the Indian subcontinent. It discusses briefly the clinical features and management of Tropical Pulmonary Eosinophilia, Hydatid disease of the lungs, Malarial lung pathology. In addition, the low cost medical innovations evolved to use the newer medical technologies, in an affordable fashion, in a developing countries context have been detailed. [Copyright &y& Elsevier]

The pollutants released from pharmaceutical, steel, paper, and battery industries into water cause stress on the natural ecosystems, may mix with soil and water, enter into human food chain, and hence cause irreparable damage to the biotic system. Hence, the appropriate monitoring of water along with determination of heavy metals is very important for human beings. In present paper, total reflection X‐ray fluorescence (TXRF) spectrometry technique is employed to determine the level of different contaminants in the water samples gathered from the various sites of an identified industrial area. Experimentation is carried out at Raja Ramanna Centre for Advanced Technology (RRCAT), Indore‐India by using TXRF, which is one the advance techniques of element determination up to ppb levels. The elemental concentration of Cl, K, Ca, Fe, Cu, Zn, Ga, Br, Sr, As, Pb, and Ni is quantified and compared with the limits established by the WHO (World Health Organization) and BIS (Bureau of Indian Standard) guidelines regarding drinking water use. The levels of the Pb, Fe, As, Ni, Cr, Co, and Mn exceeded the values suggested by WHO and BIS at some locations/sites. To better understand the situation, water quality parameters such as Water Quality Index (WQI), Heavy metal Pollution Index (HPI), Contamination Index (CI), Metal Enrichment Index (MEI), and Heavy Metal Evaluation Index (HEI) have also been assessed for all the sites close to industrial hub. Among all sites except at A3 and A6, WQI is found to be much greater than WHO and BIS established limit. Level of arsenic in the water at A1 location was found 73 ppb. However, lead metal in water was found to be very high at all the six studied locations, and at A1 location, it is found extremely high 2613 ppb. Therefore, water at A1 and A2 sites is found to be unfit for drinking. Practitioner Points: Total reflection X‐ray fluorescence (TXRF) spectrometry technique is employed to determine the level of different contaminants in the water samplesThe elemental concentration of Cl, K, Ca, Fe, Cu, Zn, Ga, Br, Sr, As, Pb, and Ni is quantified and compared with the limits prescribed by the WHOWater Quality Index (WQI), Heavy metal Pollution Index (HPI), Contamination Index (CI), Metal Enrichment Index (MEI), and Heavy Metal Enrichment Index (MEI) have also been assessed for all the sitesWater at some sites is found unfit for drinking purpose. Based on the observations, some remedial measures are suggested to reduce the level of water contaminants up to desired levels. [ABSTRACT FROM AUTHOR]

Objectives: India has the highest prevalence of severe acute malnutrition (SAM). Severe anemia is one of the comorbidities responsible for increased mortality in severely malnourished children, yet it has not received the attention it should. The aim of the present study was to determine the prevalence and type of anemia and to evaluate the possible etiologies for severe anemia, in these children. Methods: A cross-sectional study of patients with SAM in a tertiary care hospital in northern India over a period of 12 mo from Sept. 1, 2010 to Aug. 31, 2011 was conducted. We observed the prevalence of severe anemia (hemoglobin < 7 g/dL), morphologic type of anemia, number of patients requiring blood transfusion, hematologic profile of mothers, nature of feeding, duration of exclusive breastfeeding, and the demographic profile of these patients. Results: Included in the study were 131 cases of SAM. The age group varied between 6 and to 59 mo. Of patients with SAM, 67.3% had severe anemia; 13.8% had moderate anemia. Of these patients, 25% required packed red blood cell transfusion. The most common type of anemia was microcytic (38.6%) followed by megaloblastic (30.5%). Conclusions: A high incidence of severe anemia in SAM with a large proportion (25%) requiring blood transfusion is a pointer toward nutritional anemia being a very common comorbidity of SAM requiring hospital admission. Because megaloblastic anemia closely followed microcytic anemia, supplementation with vitamin B12 in addition to iron and folic acid would be recommended. [ABSTRACT FROM AUTHOR]

Background: Mycobacterium tuberculosis (MTB) is the causative organism of tuberculosis. Cholesterol is a crucial carbon source required for the survival of MTB in host cells. Transcription factor NR1H3 along with its important target genes ABCA1 and ApoE play important role in removal of extra cholesterol from cells. Changes in the gene expression of NR1H3, ABCA1 and ApoE can affect cholesterol homeostasis and thus the survival of MTB in host cells.Therefore, the present study was designed to analyze the mRNA expression of NR1H3, ABCA1 and ApoE in pulmonary TB (PTB) patients from the population of Punjab, India., Methods and Results: In this study, mRNA expression of the transcription factor NR1H3 and its target genes ABCA1 and ApoE was analyzed in 89 subjects, including 41 PTB patients and 48 healthy controls (HCs) by real-time quantitative PCR. It was found that the mRNA expression of both NR1H3 and ABCA1 genes was significantly lower in TB patients than in HCs (p < 0.001). Even after sex-wise stratification of the subjects, mRNA expression of NR1H3 and ABCA1 was found to be down-regulated in both male and female TB patients. No significant difference was observed in expression of ApoE (p = 0.98)., Conclusions: The present study found that the mRNA expression of NR1H3 and ABCA1 is down-regulated in TB patients from Punjab state of India., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Objectives: To evaluate the incidence of laboratory-confirmed pertussis (LCP) among infants hospitalized with acute respiratory infections (ARIs) and meeting the Centers for Disease Control and Prevention (CDC)-recommended clinical case definition., Methods: An investigator-initiated active surveillance for clinically suspected cases (CSCs) of pertussis screened infants aged ≤6 mo hospitalized with ARIs during January 2020-April 2022 at seven centers across India. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect Bordetella pertussis in nasopharyngeal swabs. Infants were classified as having 'LCP' or 'probable pertussis' (PP)., Results: Among 1102 screened infants, 400 participants met the CDC-2020 clinical case definition for pertussis. Of these, 34/400 (8.5%) had LCP and 46/400 (11.5%) had PP. The proportion of participants with LCP and PP was similar among infants aged 0-3 and 4-6 mo [LCP: 0-3 mo, 21/248 (~9%); 4-6 mo, 13/152 (~9%); PP: 0-3 mo, 30/248 (~12%); 4-6 mo, 16/152 (~11%)]. Cough illness lasted ≥2 wk in 3/34 (~9%) and 34/46 (~74%) participants with LCP and PP, respectively. Notably, 80% CSCs had neither LCP nor PP, and a respiratory pathogen apart from B. pertussis was detected in ~32%. Ventilation was required in 12 participants with LCP/PP., Conclusions: In this first study from India based on revised CDC guidelines, the incidence of LCP was 8.5%; cough illness was not a predominant feature. Infants below the age appropriate for vaccination are prone to pertussis-related hospital admissions, ICU care, and ventilation. Maternal immunization may be evaluated for neonatal protection, in addition to other strategies, to decrease disease burden in this highly vulnerable group., Clinical Trial Registration Number: CTRI/2019/12/022449., (© 2023. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation.)

Background & Objectives: Studies assessing the spatial and temporal association of ambient air pollution with emergency room visits of patients having acute respiratory symptoms in Delhi are lacking. Therefore, the present study explored the relationship between spatio-temporal variation of particulate matter (PM) 2.5 concentrations and air quality index (AQI) with emergency room (ER) visits of patients having acute respiratory symptoms in Delhi using the geographic information system (GIS) approach., Methods: The daily number of ER visits of patients having acute respiratory symptoms (less than or equal to two weeks) was recorded from the ER of four hospitals of Delhi from March 2018 to February 2019. Daily outdoor PM 2.5 concentrations and air quality index (AQI) were obtained from the Delhi Pollution Control Committee. Spatial distribution of patients with acute respiratory symptoms visiting ER, PM 2.5 concentrations and AQI were mapped for three seasons of Delhi using ArcGIS software., Results: Of the 70,594 patients screened from ER, 18,063 eligible patients were enrolled in the study. Winter days had poor AQI compared to moderate and satisfactory AQI during summer and monsoon days, respectively. None of the days reported good AQI (<50). During winters, an increase in acute respiratory ER visits of patients was associated with higher PM 2.5 concentrations in the highly polluted northwest region of Delhi. In contrast, a lower number of acute respiratory ER visits of patients were seen from the 'moderately polluted' south-west region of Delhi with relatively lower PM 2.5 concentrations., Interpretation & Conclusions: Acute respiratory ER visits of patients were related to regional PM 2.5 concentrations and AQI that differed during the three seasons of Delhi. The present study provides support for identifying the hotspots and implementation of focused, intensive decentralized strategies to control ambient air pollution in worst-affected areas, in addition to the general city-wise strategies.

The present study was carried out to determine the physico-chemical characteristics and heavy metal contents in roadside soil samples collected during 2 sampling periods (September 2018 and April 2019) from 8 different roadside sites lying parallel to the Buddha Nullah, an old rivulet, flowing through Ludhiana, (Punjab) India. The contents (mg/kg) of seven metals (cadmium, chromium, cobalt, copper, lead, nickel and zinc) were estimated using a flame atomic absorption spectrophotometer. Among the metals analyzed, the contents of Cd, Co, Cu, Pb and Zn were found above the permissible limits. The results of the index of geoaccumulation (Igeo), contamination factor (CF), contamination degree (Cdeg), modified contamination degree (mCdeg), the Nemerow pollution index (PI) and pollution load index (PLI) indicate a moderate to high heavy metal contamination of the analyzed soil samples. The results of the potential ecological risk factor (ERi) and potential ecological risk index (RI) indicate a low to moderate risk of heavy metals in the studied soil samples. The Pearson correlation analysis revealed that most of the variables exhibited a statistically significant correlation with one or more variables during the two samplings. Multivariate analysis demonstrates that contents of heavy metals in the study area are influenced by anthropogenic and geogenic factors.

The present study explored the association between daily ambient air pollution and daily emergency room (ER) visits due to acute respiratory symptoms in children of Delhi. The daily counts of ER visits (ERV) of children (≤15 years) having acute respiratory symptoms were obtained from two hospitals of Delhi for 21 months. Simultaneously, data on daily concentrations of particulate matter (PM 10 and PM 2.5 ), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), carbon monoxide (CO), and ozone (O 3 ) and weather variables were provided by the Delhi Pollution Control Committee. K-means clustering with time-series approach and multi-pollutant generalized additive models with Poisson link function was used to estimate the 0-6-day lagged change in daily ER visits with the change in multiple pollutants levels. Out of 1,32,029 children screened, 19,120 eligible children having acute respiratory symptoms for ≤2 weeks and residing in Delhi for the past 4 weeks were enrolled. There was a 29% and 21% increase in ERVs among children on high and moderate level pollution cluster days, respectively, compared to low pollution cluster days on the same day and previous 1-6 days of exposure to air pollutants. There was percentage increase (95% CI) 1.50% (0.76, 2.25) in ERVs for acute respiratory symptoms for 10 μg/m 3 increase of NO 2 on previous day 1, 46.78% (21.01, 78.05) for 10 μg/m 3 of CO on previous day 3, and 13.15% (9.95, 16.45) for 10 μg/m 3 of SO 2 on same day of exposure. An increase in the daily ER visits of children for acute respiratory symptoms was observed after increase in daily ambient air pollution levels in Delhi., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study is the maiden attempt for genetic characterization of the Purnathadi, a phenotypically distinct buffalo population of the western Vidarbha region of Maharashtra and to explore genetic diversity using STR markers. A total of 48 unrelated Purnathadi buffaloes from the entire native tract were genotyped using a battery of 25 heterologous microsatellite markers. 5' end of forward primer of each microsatellite marker was labeled with one of the fluorescent dyes, viz., FAM (Blue), VIC (Green), NED (Yellow) or PET (Red) to assess the fragment length of genotyped PCR product with automated DNA sequencer (ABI 3100). 23 microsatellite loci (except ETH003 and ILSTS030) amplified successfully and adequately high allelic diversity (observed: 0.615 ± 0.043 and expected: 0.655 ± 0.037) was reported with 162 distinct microsatellite alleles. Sufficiently high Shannon index and PIC indicated the suitability of markers to evaluate genetic diversity in Purnathadi buffaloes. Within-population inbreeding estimates ( F IS ) for Purnathadi buffalo ranged between -0.171 and 0.495 with global F IS average of 5.9%. The outcome for IAM, TPM and test for mode shift revealed the absence of any recent bottleneck in Purnathadi buffalo. Pairwise F ST (genetic differentiation) and gene flow between Purnathadi, Nagpuri and Marathwadi buffaloes were estimated using genotype data of 19 microsatellite markers. Lowest F ST (0.031) was observed between Nagpuri and Purnathadi buffaloes with highest gene flow of 7.91% and highest F ST (0.094) was between Purnathadi and Marathwadi populations. Present findings will definitely support in designing breeding plan for genetic improvement, as well as for developing conservation strategies of Purnathadi buffalo population. The comparative molecular study with other breeds of the regions is needed.

Diverse genotoxic agents, entering the aquatic environment through natural and anthropogenic events, pose serious threats to its biotic components. The present study involves the monitoring of water quality by assessing the genotoxic effects and physico-chemical parameters including heavy metals of 10 surface water samples collected from different locations of Buddha Nullah, a tributary of Sutlej flowing through Ludhiana, Punjab (India). Genotoxicity was evaluated following Allium cepa root chromosomal aberration assay and DNA nicking assay using plasmid (pBR322) whilst the metal (cadmium, chromium, cobalt, copper, lead, nickel and zinc) analysis was conducted using atomic absorption spectrophotometer. All water samples collected from the study area had cobalt and lead content more than the permissible limits (0.04 and 0.01, respectively) recommended by the Bureau of Indian Standards and the World Health Organization. The samples also induced genotoxicity following both bioassays. The water samples collected from Gaunspur (GP), a site approx. 75.53 km upstream of the Sutlej-Buddha Nullah joining point, has shown the maximum genotoxic effect, i.e. 38.62% in terms of per cent total aberrant cells during A. cepa assay and 100% DNA damage during DNA nicking assay. The Pearson correlation indicated that genotoxicity had a significant positive correlation with the content of cobalt (at p ≤ 0.5). During cluster analysis, the samples from 10 sites formed four statistically significant clusters based on the level of pollution that was dependent on two factors like similarity in physico-chemical characteristics and source of pollution at a specific site., (© 2020. Springer Nature B.V.)

Background/aims: The association between tuberculosis (TB) and female reproductive health issues usually remains unaddressed. TB is considered as one of the major causes of infertility in India. Because of the associated stigma, the suffering females do not discuss the problems they are facing. This may lead to disturbances in serum hormone levels also. Hence, a study was planned to find abnormalities in menstrual patterns and fertility in women in childbearing age, who were suffering from TB, and evaluate disturbances in serum hormone levels of LH, FSH, Prolactin and testosterone, if any. It also aimed to evaluate if hormone levels, or some early disturbances in menstrual cycle, can serve as a predictor for infertility in future lives., Materials and Methods: 25 female patients each of child bearing age group from OPD/IPD: of pulmonary TB (PTB), extra pulmonary non genital TB (EPTB), extra pulmonary genital TB (GTB) and healthy controls were enrolled. Thus, a total of 75 patients with TB and 25 healthy controls were taken into the study. Patients were questioned for any abnormalities of menstrual cycle. If married, fertility status, total number of live children, abortions etc and previous history of any reproductive health issues was asked. Serum FSH, LH, Prolactin and testosterone levels on the 3rd day of the menstrual cycle were done. Data so obtained was tabulated and statistically analyzed., Results: TB patients (75/100) and healthy controls (25/100) were matched with respect to age, marital status and rural/urban background. Menstrual abnormalities, infertility and adverse events related to pregnancy were higher in patients with TB than healthy controls (p = 0.176, 0.571 and 0.005 respectively). TB patients had significantly higher levels of Testosterone and significantly lower levels of Prolactin than healthy controls (p=<0.001). Levels of FSH and LH were lower in TB patients than healthy controls (p = 0.428 and 0.274 respectively). On categorization into different types of TB, the sub-groups were matched with respect to rural/urban background. GTB was significantly higher in patients who were married (p = 0.020). Significantly higher GTB patients (10/25) reported menstrual abnormalities (p < 0.001). All the 3 infertile patients reported in the study belonged to GTB sub-group (p = 0.044). GTB had higher number of adverse events related to pregnancy followed by EPTB and PTB. Levels of FSH, LH, Testosterone and Prolactin in the three sub-groups of TB patients did not show any significant difference (p = 0.683, 0.817, 0.781, and 0.187). Since the total number of infertile patients in our study was only 3, relationship of menstrual abnormalities or serum hormone levels as a predictor of infertility could not be assessed., Conclusion: Females suffering from TB experience significantly higher adverse events related to pregnancy than healthy controls. Menstrual abnormalities, infertility and adverse events related to pregnancy were more pronounced in females suffering from GTB than PTB/EPTB. Female patients suffering from any form of TB need to be comprehensively managed. Because of highly sensitive issues related to infertility and reproductive health in today's era, it is imperative that any future complications of the same are kept into consideration in female patients with TB., (Copyright © 2020 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)

Childhood tuberculosis does not get the attention it deserves, both in the general child health services and the TB specific services. The difficulty in identification of the organism due to lack of proper sample as well as lower sensitivity of the smear, made it harder to detect cases with ease in the community. Newer diagnostic methods like cartridge based nucleic acid amplification tests (CBNAAT) and line probe assays (LPA) have the capacity to rapidly identify Mycobacterium tuberculosis with an improved sensitivity over the smear testing and have been employed under Revised National Tuberculosis Control Programme (RNTCP) across the country. As the symptoms suggestive of TB are very common and overlapping, the final yield of TB testing is better if the microbiological confirmation is done on good quality specimen from cases suspected of TB based on clinical and radiological abnormalities. Newer tests also provide simultaneous detection of much critical Rifampicin resistance. A Rifampicin resistant case is not only unlikely to respond to first-line standard therapy but such a treatment can result in further amplification of resistance to other companion drugs. Prevention of spread of the drug resistant disease thus requires that the treatment is guided by universal drug sensitivity testing (U-DST) of all TB cases. Furthermore, several changes have come up in the treatment of TB and are discussed. The dosages of anti TB drugs have been revised upwardly for optimal drug levels and now the fixed drug combinations are used under RNTCP. With the awareness about high initial Isoniazid (INH) resistance and its contribution to failure of retreatment regime, a companion third drug (Ethambutol) has been added to the continuation phase of the first-line therapy. The standard retreatment regime, better known as category II therapy, has been replaced by specific therapy as per the resistance pattern detected. The TB control activities have thus evolved a lot and the present article discusses the evolution and the current status of diagnostics and therapy of TB in children.