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A novel Corona virus disease 2019 (COVID-19) outbreak is declared as the international public health emergency concern by the World Health Organization in the month of March 2020. This viral disease invented from China in the month of December 2019 has previously caused havoc around the world, including India. In this paper, efficient mathematical models using Gustafson–Kessel fuzzy clustering approach for the transmission of the COVID-19 are developed by considering the actual reported cases in the state of Tamil Nadu, India. The results proved a good concord between the reported data and the estimated data given by the proposed models. Moreover, the developed models are also capable to predict the requirements of beds in hospitals on the month of August 2020 in Tamil Nadu, India. Also, this work suggests strictly implementing/extending the complete lockdown for at least 21 days in the month of August 2020 and immediate separation of infected cases are the positive steps to reduce the spread of novel corona virus in Tamil Nadu state, India. [ABSTRACT FROM AUTHOR]

Background: Increased occurrence of mucormycosis during the second wave of COVID-19 pandemic in early 2021 in India prompted us to undertake a multi-site case-control investigation. The objectives were to examine the monthly trend of COVID-19 Associated Mucormycosis (CAM) cases among in-patients and to identify factors associated with development of CAM.Methods: Eleven study sites were involved across India; archived records since 1st January 2021 till 30th September 2021 were used for trend analysis. The cases and controls were enrolled during 15th June 2021 to 30th September 2021. Data were collected using a semi-structured questionnaire. Among 1211 enrolled participants, 336 were CAM cases and 875 were COVID-19 positive non-mucormycosis controls.Results: CAM-case admissions reached their peak in May 2021 like a satellite epidemic after a month of in-patient admission peak recorded due to COVID-19. The odds of developing CAM increased with the history of working in a dusty environment (adjusted odds ratio; aOR 3.24, 95% CI 1.34, 7.82), diabetes mellitus (aOR: 31.83, 95% CI 13.96, 72.63), longer duration of hospital stay (aOR: 1.06, 95% CI 1.02, 1.11) and use of methylprednisolone (aOR: 2.71, 95% CI 1.37, 5.37) following adjustment for age, gender, occupation, education, type of houses used for living, requirement of ventilatory support and route of steroid administration. Higher proportion of CAM cases required supplemental oxygen compared to the controls; use of non-rebreather mask (NRBM) was associated as a protective factor against mucormycosis compared to face masks (aOR: 0.18, 95% CI 0.08, 0.41). Genomic sequencing of archived respiratory samples revealed similar occurrences of Delta and Delta derivates of SARS-CoV-2 infection in both cases and controls.Conclusions: Appropriate management of hyperglycemia, judicious use of steroids and use of NRBM during oxygen supplementation among COVID-19 patients have the potential to reduce the risk of occurrence of mucormycosis. Avoiding exposure to dusty environment would add to such prevention efforts. [ABSTRACT FROM AUTHOR]

COVID-19, a novel coronavirus, is currently a major worldwide threat. It has infected more than a million people globally leading to hundred-thousands of deaths. In such grave circumstances, it is very important to predict future scenario to support prevention and recurrence of the disease, aid in healthcare service preparation and help in decision making process. Following that notion, a model has been developed for forecasting future COVID-19 cases in India. The time series analysis indicates that the cases will keep on increasing in India in the coming month as the peak has not been attained until now. A statistical analysis based on the effect of reopening of schools has also been performed. It is revealed that there will be a minor increase in the active cases when pre-/primary schools are opened. The present prediction models will assist the government and medical personnel in gaining insight and planning for forthcoming conditions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has recently become a threat all across the globe with the rising cases every day and many countries experiencing its outbreak. According to the WHO, the virus is capable of spreading at an exponential rate across countries, and India is now one of the worst-affected country in the world. Researchers all around the world are racing to come up with a cure or treatment for COVID-19, and this is creating extreme pressure on the policy makers and epidemiologists. However, in India the recovery rate has been far better than in other countries, and is steadily improving. Still in such a difficult situation with no effective medicine, it is essential to know if a patient with the COVID-19 is going to recover or die. To meet this end, a model has been developed in this article to estimate the probability of a recovery of a patient based on the demographic characteristics. The study used data published by the Ministry of Health and Family Welfare of India for the empirical analysis. [ABSTRACT FROM AUTHOR]

Background: There have been sporadic and periodic large‑scale epidemics of hand, foot, and mouth disease (HFMD) with cases at risk for significant morbidity and mortality particularly in Southeast Asia since 1997 and in India since early 2003. Method: We retrospectively studied 403 cases recorded from 2009 to 2019 and reviewed relevant Indian literature published between 2004 and 2019 to understand clinical, epidemiological, and virological attributes of this long‑lasting Indian epidemic. Result: There were 96.8% children and adolescents (M:F 1.6:1) aged 2 months to 18 years and 84% were aged <5 years. Adult family contacts comprised 3.2%. Only 12 sporadic cases occurred during 2009‑2011 followed by increased number from 2012 to 2015 peaking with 30.8% cases in 2013 and declining slowly until the year 2019 with small resurge in 2018. The major peaks occurred during summers with small peaks in autumns. Literature review showed 3332 cases presenting between 2004 and 2019 across Indian states with similar epidemiological trends whereas serotyping identified Coxsackievirus A16 (CV A16) in 83%, Coxsackievirus A6 (CV A6) in 17%, Enterovirus 71 in 4.1%, and multiple strains in 11.7% samples, respectively. Conclusion: The overall features of this long‑lasting HFMD epidemic; affecting children aged <5 years more often than adults, none or minimum neurological or pulmonary complications in few patients, peaks occurring during summer and autumn months, and identity of the pathogenic virus coincide with global trends. However, the continuous spread of the disease across the country appears in sync with pre‑epidemic periods of China and Taiwan. It calls for a continuous surveillance and making HFMD a notifiable disease in India. [ABSTRACT FROM AUTHOR]

Background: The sudden surge of mucormycosis cases which happened during the second wave of COVID‐19 pandemic was a significant public health problem in India. Objectives: The aim of this study was to analyse the clinico‐epidemicological characteristics of the mucormycosis cases to determine the changes that had occurred due to COVID‐19 pandemic. Methodology: A retrospective cross‐sectional study was conducted at the Department of Otolaryngology Head and Neck Surgery, PGIMER, Chandigarh, India. Patients diagnosed with rhino‐orbital mucormycosis were categorised into the following groups: Pre‐pandemic(May 2019 to April 2020), Pandemic Pre‐epidemic (May 2020 to April 2021) and Epidemic (1 May 2021 to 12 July 2021). The epidemiological, clinical and surgical data of all the patients were retrieved from the hospital records and analysed. Results: The epidemic period had 370 cases, compared with 65 during pandemic period and 42 in the pre‐pandemic period. Diabetes mellitus was seen in 87% of cases during epidemic period, 92.9% in the pre‐pandemic period and 90.8% in the pre‐pandemic pre‐epidemic period. The proportion of patients suffering from vision loss, restricted extra‐ocular movements, palatal ulcer and nasal obstruction was higher in the pre‐epidemic groups, and the difference was significant (p, <.01). There was no history of oxygen use in 85.9% of patients and no steroid use in 76.5%. The death rates were the lowest during epidemic (10%). Conclusion: COVID‐19 has caused a statistically significant increase in the number of mucormycosis infections. The mortality and morbidity which showed an increase during the first wave of COVID‐19 decreased significantly during the epidemic period. [ABSTRACT FROM AUTHOR]

Novel Coronavirus (COVID-19) has become one of the deadliest pandemics that has affected almost all the nations in the world. Lockdown and systematic re-opening of shopping malls, offices, etc. is still one of the major weapons against this virus. However, the government and medical agencies take long time to reopen the places due to risks involved in this deadly virus. The delay to reopen places has resulted in sharp decline in the growth of economy. In this paper a current context aware framework is proposed which uses multiple inputs for a specific region to decide whether to open it or not. The proposed framework used series of deep neural network models to generate recommendations specific to a particular region. Most of the inputs are real-time and readily available with the government. The main aim is to develop framework which can be used in any kind of pandemic even in small region to easily contain it. However, it has been tested using opensource data available for COVID-19. Data was crawled from web for 22 districts of Haryana state of India. Experimental result proved the efficiency of proposed framework. [ABSTRACT FROM AUTHOR]

The outbreak of the SARS CoV2 virus, commonly referred to as the COVID‐19 pandemic, has impacted the social, economic, political, and cultural lives of citizens around the world. The sudden outbreak of the pandemic has exposed the legal preparedness, or lack thereof, of governments to reduce and contain its drastic impact. Strong legislative measures play a crucial role in any epidemic or pandemic situation. In this situation, the Indian Government has requested all state governments to invoke the Epidemic Disease Act (EDA) of 1897 to address the COVID‐19 emergency. The Central Government has also used the powers provided in the Disaster Management Act (DMA) of 2005. As the country is facing its first major health emergency since independence, the existing legislative measures to deal with a COVID‐19 like situation are lacking and require certain amendments to address such situations in the future. This paper aims to present the current constitutional and legislative response to health emergencies in India and attempts to identify gray areas in the statutory provisions. Based on the analysis, this paper suggests several recommendations for amending current legislation and suggests the promulgation of comprehensive public health law. This paper is largely based on primary sources such as the EDA and the DMA, regulations, guidelines, rules issued by the public authorities and court cases related to health and health emergencies along with secondary resources such as newspaper articles and published papers. [ABSTRACT FROM AUTHOR]

Purpose This work aimed at demonstrating India's scientific contribution on Covid-19 research and analyzes the emerging research pattern using various bibliometric parameters. Design/methodology/approach Indian publications data on Covid-19 research were retrieved from SCOPUS database using structured query. VOSviewer & CiteSpace data visualization tools are used to generate citation, co-citation map and keyword clusters for better understanding of the research pattern. The leading institutions, most productive journal, prominent researchers are identified and analyzed further to reflect the collaborative nature. Key Findings Between January to September, 2020, a total of 3465 research documents were published pertaining to Covid-19. A larger share of the documents published in domain of Medicine 2185 (67.44%) followed by Biochemistry, Genetics and Molecular Biology 532(16.42%) and Pharmacology, Toxicology and Pharmaceutics 232(7.16%). The 'Diabetes and Metabolic Syndrome Clinical Research and Reviews' publish maximum research document 102(2.94%). Dr. V Wiwanitkit found to be the most prolific contributor while AIIMS, New Delhi has become the leading institution in producing the maximum research 266(7.68%). The USA, England & China are found to be the most favored countries for research collaboration Originality/value This study provides significant findings of Covid-19 research carried out by Indian scientists. The results are beneficial for researcher and practitioner in India and worldwide for understanding the pattern of research on Covid-19 and identifying the potential collaborator. [ABSTRACT FROM AUTHOR]

The microbial oomycete pathogen Phytophthora infestans causes severe epidemics of potato late blight in crops globally. Disease management benefits from an understanding of the diversity of pathogen populations. In this study, we explore the dynamics of P. infestans populations in the late blight-potato agro-ecosystem across the Indian subcontinent. Investigations of the macroecological observations at the field level and microbial ecological principles provided insights into future pathogen behavior. We use a comprehensive simple sequence repeat allele dataset to demonstrate that an invasive clonal lineage called EU&#95;13&#95;A2 has dominated populations over 14 years across India, Bangladesh, and Pakistan. Increasing levels of subclonal variation were tracked over time and space, and, for the first time, populations in Asia were also compared with the source populations from Europe. Within India, a regional pathogen population structure was observed with evidence for local migration, cross-border movement between surrounding countries, and introductions via imports. There was also evidence of genetic drift and between-season transmission of more strongly pathogenic subclones with a complete displacement of some subclonal types. The limited introduction of novel genotypes and the use of resistant potato cultivars could contribute to the dominance of the 13&#95;A2 lineage. The insights will contribute to the management of the pathogen in these key global potato production regions., Competing Interests: The author(s) declare no conflict of interest.

Objectives: COVID-19 outbreak has surfaced as an imminent threat for the public health. Because India is a populous country, it is important for Indians to be aware of the basic modes of prevention that can diminish the spread of the coronavirus disease 2019 (COVID-19) infection. Aim: The present questionnaire study was carried out among the undergraduate students to assess the awareness regarding the spread and control of COVID-19. Methods: The questionnaire was circulated among the undergraduate students as a Google form. Results: The study included responses of 868 undergraduate students belonging to 2 university colleges. The majority of the participants were females (63%; n = 547) in the age range of 18-23 y. Approximately 98.3% (853) had awareness regarding COVID-19. Approximately 94.7% (822) were washing their hands after visiting public places, out of which only 90.6% (786) were aware of proper steps to be followed in hand washing. It was concluded that it is required to create awareness among 20.8% (181) of our study participants regarding the importance of hand washing to control COVID-19. Conclusions: Awareness regarding COVID-19 among study participants was good. However, a small part of the study population is required to be educated on proper steps to be followed in hand washing. [ABSTRACT FROM AUTHOR]

The severe acute respiratory syndrome coronavirus 2 from the family of Coronaviridae is causing coronavirus disease. This is a zoonotic disease and identified first in the Hubei Province of China. In early 2020, this disease was announced as a global pandemic. The pandemic hit the nations undiscriminating their economic and development status. Tamil Nadu, a state of India is one of the most affected in the country. In spite of various precautionary measures in controlling the pandemic, the state recorded active cases of 18,881 as of 13th June 2020. With no defined treatment to cure the disease till date, the healthcare workers along with the collective support of various departments of the state are handling the situation with an aim to end the epidemic. Almost all the sectors such as finance, business, education, etc. were affected by the pandemic. This article discusses the current countermeasures for the infection, the impact on the state and suggests a few strategies to control the spread. [ABSTRACT FROM AUTHOR]

The concept of 'one health' recognizes that there is an inextricable link between the health of people, animals, and the shared environment. With the rapid growth in population and the destruction of natural habitats, humans are coming into closer contact with wild and domesticated animals. This, in turn, creates ripe conditions for the movement of viruses and diseases between animals and people. The world is seeing frequent occurrences of epidemics caused by new pathogens, to which humans have little immunity, owing to this phenomenon. 'One Health' assumes global significance today when the world is in the grip of the COVID-19 pandemic. The response of the state of Kerala to the COVID-19 crisis is guided by its prior experience with curbing the Nipah virus epidemic in 2018. The same core philosophy of 'one health' that was at the heart of the campaign to rein in the Nipah outbreak has spearheaded the state response to the COVID-19 pandemic. A review of available literature in Pubmed/Medline & Google scholar databases was carried out to study the impact of 'one health' on the epidemic response of Kerala state to the Nipah virus, and how it has been extrapolated in managing the current COVID-19 pandemic. The articles obtained were screened by title, abstract and full text to obtain the most relevant papers. Recommendations have also been proposed regarding the incorporation of 'one health' in public health strategy. [ABSTRACT FROM AUTHOR]

Introduction: RTA is the public health issue and cost a lot to individuals, families, communities and nations as injuries and deaths due to road traffic accidents (RTA) are a major public health problem in developing countries. Objectives: The present study was carried out with the objective to find out the profile of RTA cases in a tertiary care hospital in South India in one year. Methods: A retrospective analytical content based analysis was made on 549 RTA cases recorded in a tertiary care hospital in South India in one year from June 1st 2017 to May 31st 2018 and the results were tabulated. Results: Of the 549 cases, 409 cases were males and 140 were females of which head injury with 182 cases (29.50%) forms the majority of the injury followed by orthopaedic injuries with163 cases (26.04%). Conclusion: This study thus analyses various aspects of RTA with head injury being the most common and and its various confounding factors which shows that there is clearly a need for road safety education particularly targeting student community. [ABSTRACT FROM AUTHOR]

Objective: The coronavirus disease (COVID-19) pandemic is a disaster of unprecedented proportions with global repercussions. Psychological preparedness, the primed cognitive awareness and anticipation of dealing with emotional responses in an adverse situation, has assumed a compelling relevance during a health disaster of this magnitude. Methods: An anonymized eSurvey was conducted in India to assess psychological preparedness toward the ongoing pandemic with a focus on knowledge, management of own and others' emotional response, and anticipatory coping mechanisms among the survey population. An adapted version of the qualitative Psychological Preparedness for Natural Disaster Scale validated by the World Health Organization was widely circulated over the Internet and various social media platforms for assessment. Results are expressed as median ± standard deviation. Descriptive statistics were used and figures downloaded from surveymonkey.com. Results: Of the 1120 respondents (M:F 1.7:1, age 35 years ±14.1), most expressed a high level of perceived knowledge and confidence of managing COVID-19, such as awareness of the symptoms of the illness (95.1%), actions needed (94.4%), hospital to report to (88.9%), and emergency contact number (89.1%). A majority (95%) monitored regularly the news bulletins and scientific journals regarding COVID-19. However, nearly one-third (29.2%) could not assess their likelihood of developing COVID-19, and 17.5% were unaware of the difference between a mild and severe infection. Twenty-three percent (23.3%) were unfamiliar with the materials needed in an acute illness situation. Conclusion: Psychological disaster preparedness is reasonable, although lacking in specific domains. Timely but focused interventions can be a cost-efficient administrative exercise, which federal agencies may prioritize working on. [ABSTRACT FROM AUTHOR]

COVID-19 is one of the very contagious diseases from the family Coronaviridae and spreading at a faster rate in the community. In December 2019, the first case of COVID-19 was reported in Wuhan, China. An epidemic outbreak of COVID-19 was seen in India from March 2020. Epidemiological data of COVID-19 cases of the world and India have been analyzed in our study. We have utilized publicly available two databases from data repository by Johns Hopkins CSSE and covid19india.org. COVID-19 cases and case fatality rate (CFR) of the world have been summarized and compared with India from January 22, 2020 to April 15, 2020. Indian cases were analyzed among states of India and also compared with age and gender by performing statistical approaches such as central tendency, standard deviation and interquartile range. By April 15, 2020, Indian has reported 12,322 confirmed cases, 1,498 recovered cases and 405 death cases of COVID-19. In spite of India being a diverse country with the second-highest population, the deadly side of COVID-19 was comparatively far less as compared to the other countries. India has taken preemptive measures at an early stage to prevent transmission of COVID-19 outbreak and it is reviewed from our study by comparing India with other countries. Our study also summarizes that age also plays a vital role in the intervention of COVID-19 cases. [ABSTRACT FROM AUTHOR]

Background: A visceral leishmaniasis outbreak was reported from a village in a low-endemic district of Bihar, India.Methods: Outbreak investigation with house-to-house search and rapid test of kala-azar suspects and contacts was carried out. Sandfly collection and cone bio-assay was done as part of entomological study.Results: A spatially and temporally clustered kala-azar outbreak was found at Kosra village in Sheikhpura district with 70 cases reported till December 2018. Delay of more than a year was found between diagnosis and treatment of the index case. The southern hamlet with socio-economically disadvantaged migrant population was several times more affected than rest of the village (attack rate of 19.0% vs 0.5% respectively, ORMH = 39.2, 95% CI 18.2-84.4). The median durations between onset of fever to first contact with any health services, onset to kala-azar diagnosis, diagnosis to treatment were 10 days (IQR 4-18), 30 days (IQR 17-73) and 1 day (IQR 0.5 to 3), respectively, for 50 kala-azar cases assessed till June 2017. Three-fourths of these kala-azar cases had out-of-pocket medical expenditure for their condition. Known risk factors for kala-azar such as illiteracy, poverty, belonging to socially disadvantaged community, migration, residing in kutcha houses, sleeping in rooms with unplastered walls and non-use of mosquito nets were present in majority of these cases. Only half the dwellings of the kala-azar cases were fully sprayed. Fully gravid female P. argentipes collected post indoor residual spraying (IRS) and low sandfly mortality on cone-bioassay indicated poor effectiveness of vector control.Conclusions: There is need to focus on low-endemic areas of kala-azar. The elimination programme should implement a routine framework for kala-azar outbreak response. Complete case-finding, use of quality-compliant insecticide and coverage of all sprayable surfaces in IRS could help interrupt transmission during outbreaks. [ABSTRACT FROM AUTHOR]

Background: India suffers from a huge burden of substance abuse and associated morbidity and mortality. Among all substance use, tobacco consumption is the most common and yet the most widely accepted one. This study aimed to estimate the prevalence of tobacco consumption, to find out the type of tobacco products used and to assess the factors influencing tobacco consumption in the slums of Shillong city. Materials and Methods: A cross-sectional, community-based study was carried out in 330 respondents aged 15 and above. Chi-square test was used to compare proportions, and Student's t-test was used to compare groups for continuous variables. Results: The prevalence of current tobacco consumption was found to be 73.9%, and the rate of quitting was found to be 4.3%. The prevalence of tobacco consumption was observed to be higher in males (52.4%) compared to 21.5% in females. Highly significant statistical association was observed between tobacco consumption and age, gender, and occupation. The statistical association between tobacco consumption and religion and education was found to be statistically significant. Ever use of tobacco in any form as well as smokeless form peaked in 24–34 years, while smoking was more prevalent among 15–24 year olds. The prevalence of smokeless tobacco was higher (47.5%) as compared to the prevalence of smoking (28.2%), closely followed by dual use (24.3%). The most popular smoked and smokeless forms were found to be cigarettes and khaini, respectively. Conclusions: Tobacco consumption was found to be highly prevalent and was much higher than the national average hinting toward its association with higher incidence of various malignancies in the region and calling for immediate action toward propelling its prevention and control by all stakeholders. [ABSTRACT FROM AUTHOR]

Objective: We conducted a study to find a relationship between main weather parameters with admission of positive dengue cases in a tertiary hospital.Methods: Retrospective analysis was undertaken to identify epidemiological trend of dengue in 2016 from paediatric wards of a tertiary hospital in New Delhi. Data were collected on patient particulars and daily weather from January to December 2016.Results: A total of 266 confirmed cases of dengue were considered. Relative humidity (RH) was associated with burden of positive dengue cases. On week-wise analysis, each surge of dengue admission was preceded by heavy rain 4-6 weeks earlier. Monthly averaged daily temperature range and RH were noted to have strong correlations with dengue burden, keeping an interval of 2 months in between.Conclusions: Weather parameters seem to influence magnitude of dengue epidemic, particularly in dengue season. There is need to have an in-depth study about developing a prediction model for dengue epidemic. [ABSTRACT FROM AUTHOR]

Medical missions formed an important part of British colonial policy in the Northeast India. This study will trace the evolution of colonial medical policy from the early decades of twentieth century in Arunachal Pradesh. Considered to be on the fringe of the British Empire which was based in the Brahmaputra Valley, and thus outside the administrative limits of the colony, this study will provide a fresh vista to re-assess British frontier policy in the erstwhile tribal areas of Assam. Medicine, so far, has not been seen or understood to have been part of these colonial interventions in Arunachal Pradesh. The findings and the arguments of this study is primarily based on archival records. [ABSTRACT FROM AUTHOR]

The clinical presentations of dengue fever range from mild viral fever to life-threatening manifestations that may be typical or atypical. With the World Health Organization recommending new guidelines for the diagnosis of dengue, it becomes necessary to document clinical spectrum for classification and setting priorities. Therefore, a study was undertaken to document clinical and biochemical profile and outcome in denguepositive pediatric patients. Records were retrieved from August to November 2015 in a tertiary care hospital in Delhi. Out of 188 dengue-positive patients enrolled, 61.1% were males. Mortality rate was 1%. Apart from the classic triad of fever, vomiting and abdominal pain, there were some atypical presentations, including febrile seizure (5.8%) and acute respiratory distress syndrome (3%). Myalgia was rare in the severe form of the disease. On laboratory investigation, anemia (75%) and thrombocytopenia (73%) were most common findings. Platelet counts were significantly lower in severe dengue than in other types. [ABSTRACT FROM AUTHOR]

Due to lack of facilities and expensive medicines most of the patients in developing courtiers do not get adequate treatment for HIV/AIDS. Hence it was an immediate requirement that the developed countries and the developing countries walk hand in hand on the path of defeating this epidemic monster. President's Emergency Plan for AIDS Relief is the largest global health initiative dedicated for the cure of a single disease by United States Government. The review article provides the information about the condition of the world before the implementation of PEPFAR program, history and political framework of the organisation, the goals of PEPFAR, the funding sources and its partnership with different countries including India. [ABSTRACT FROM AUTHOR]

An outbreak of Hand, Foot and Mouth Disease (HFMD) was reported in Navi Mumbai in July-October 2018. Of 15 HFMD cases, two had recurrences within a month while three had lesions extending to trunk. Coxsackie virus A6 and A16 were detected from 13 cases (CV-A6 from 10 cases and CV-A16 from 3 cases) indicating co-circulation of these viruses.. The present study highlights an urgent need of HFMD surveillance. [ABSTRACT FROM AUTHOR]

Introduction: Dengue fever (DF) is an arboviral infection transmitted to humans through the bite of an infected Aedes mosquito. It causes a wide spectrum of illness from mild asymptomatic illness to severe fatal dengue haemorrhagic fever (DHF) & dengue shock syndrome (DSS). In India, dengue is endemic / hyperendemic with prevalence of all four serotypes of dengue circulating in population. There is almost two-fold rise in dengue cases in India from 2015 to 2017. With this background, present study was conducted to study trend & pattern of dengue patients attending a tertiary care hospital of Himmatnagar, Gujarat. Material & Method: Patients attending hospital from January 2017 to December 2018 with suspected dengue infection were included in this study. ELISA kits were used for detection of dengue NS1 antigen & dengue IgM antibody. Result & Discussion: The present study shows that there is increased number of dengue cases as well as positivity rate in 2018 (n=141, 34.2%) as compared to previous year 2017 (n=24, 12.1%). We found that most of the cases were seen during September to December period with peak during October. Very few cases occurred during the period January to July in the study. Trend of dengue in our study correlated well with other studies. Conclusion: Community awareness, early diagnosis and management and vector control measures need to be strengthened in order to reduce the increasing number of dengue cases. [ABSTRACT FROM AUTHOR]

Introduction: the association of Tuberculosis and Diabetes Mellitus is a cause of concern for the health sector. The coexistence of these two highly prevalent diseases has made the already existing treatments very complex. This issue is of particular significance to developing countries like India that bear a significant burden of these two diseases. Methods: retrospective analysis of 1000 consecutively admitted patients in a tertiary care hospital were analyzed for the coexistence of Tuberculosis and Diabetes Mellitus. Results: the study found that a significant proportion of diabetic patients had coexistent tuberculosis (65.5%). Rural population was predominantly affected in both the genders. The study observed that the coexistence of these two conditions increased with advanced age. Conclusion: the coexistence of Diabetes Mellitus with Tuberculosis needs to identified early and adequately addressed. The rural population needs to be educated about these two conditions and seek timely medical care. [ABSTRACT FROM AUTHOR]

The first cases of HIV infection in India were detected in 1986 among female sex workers in Chennai. A rapid increase followed in many states. The current national prevalence is about 0.26% compared with a global average of 0.2%, but the figure in most high-risk groups including female sex workers is much higher (up to 7%). New HIV infections reached a peak in 1998 and have since declined by 60%, although the total number of HIV-positive persons remains stable at 2.1 million, largely probably due to the increased life expectancy following antiretroviral therapy. The Indian epidemic is characterized by low levels in the general population and elevated concentrations among high-risk groups. Transmission is mainly heterosexually driven, with differential burdens across the states. The four main drivers of HIV infection in India differ in order from those elsewhere in the world and are commercial sex work, general heterosexual intercourse, injecting drug use and unprotected anal sex between men who have sex with men. There are distinct differences from state to state in the prevalence of HIV, with some around the national norm of 0.21% but others with over 1% infected. India has embarked on a targeted HIV prevention strategy in recent years which is strongly associated with a fall in infection rate in both low- and high-risk groups. [ABSTRACT FROM AUTHOR]

Background: Remarkable and groundbreaking performances of scientists all over the globe have led to the evolution of COVID-19 vaccines, which are extensively viewed as means to control the epidemic. The primary purpose of this research work was to discover the major side effects of the vaccines, mainly in Homo sapiens., Methods: An online survey was conducted in various cities of Haryana, India, using a trial version of QualtricsCoreXM software to prototype 20 questionnaires., Results: In the survey, 200 candidates participated, among which 83.5% had received Covishield and 16.5% had been vaccinated with Covaxin. Overall 65% of respondents have reported side effects. The major side effects reported were fever, tiredness, myalgia, diarrhea, headache, etc. Conclusion: Succeeding the survey related to the effects of COVID-19 vaccine on non-identical Homo sapiens, generally with respect to their perspective regarding the symptoms of vaccine, both the vaccines were found to have mild side effects which could be easily managed., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Pneumocystis jiroveci pneumonia (PJP) is an important opportunistic infection in immunosuppressed hosts. At our center, nine transplant recipients developed PJP over a 4-month period. The median time from transplant was 56 months and none of them was on cotrimoxazole prophylaxis at the time of developing the infection. Over half had been admitted to the renal transplant ward for unrelated indications and contracted the infection in‑hospital. Diagnosis was based on microbiological demonstration of P. jiroveci in sputum and/or bronchoalveolar lavage in symptomatic patients. Atypical clinical and radiological signs were common with poor correlation of symptoms to computed tomography findings. Cotrimoxazole therapy was effective; however, patients with pre‑existing graft dysfunction developed hyperkalemia commonly (50%). Alternative treatment with clindamycin and primaquine combination was equally effective. Early diagnosis and prompt treatment resulted in low mortality rate (11%). The outbreak was halted after universal use of cotrimoxazole prophylaxis to all patients admitted to the renal transplant ward. We report the first ever outbreak of PJP in Indian renal transplant recipients with possible inter‑human transmission of infection in admitted patients. [ABSTRACT FROM AUTHOR]

Background & objectives: Successive outbreaks of acute watery diarrhoea occurred in Talikoti and Harnal, located in Bijapur District of the southern Indian State of Karnataka, in July and August 2012, respectively. These outbreaks were investigated to identify the aetiology and epidemiology. Methods: Information was collected from the local population and health centres. Stool and water samples were collected from the admitted patients and their drinking water sources. Standard microbiological and PCR techniques were employed for isolation and characterization of the pathogen. Results: While 101 people (0.38%) were affected in Talikoti, 200 (20.94%) were affected in Harnal which is a small remote village. All age groups were affected but no death occurred. While the outbreak was smaller, longer and apparently spread by person to person contact in Talikoti, it occurred as a single source lash outbreak at Harnal. A single clone of toxigenic Vibrio cholerae O1 Ogawa biotype El Tor was isolated from the two stool samples obtained from Talikoti and subsequently from three of five stool samples obtained from Harnal indicating village to village spread of the aetiological agent. Striking similarity in antibiotic resistance profiles of these isolates with a particular strain isolated from the city of Belgaum, 250 km away, in 2010, prompted tracking the lineage of the V. cholerae isolates by DNA fingerprinting. Random amplified polymorphic DNA (RAPD) fingerprinting assay helped confirm the origin of the incriminating strain to Belgaum. Interpretation & conclusions: Our study reported the first twin outbreak of cholera in two remote areas of Bijapur district, Karnataka, south India. It also indicated the need for immediate preparedness to deal with such emergencies. [ABSTRACT FROM AUTHOR]

Health and education is an important mainstay for all individual in today's world and serves as the basis of economic productivity. The state of the epidemic of tobacco use in India was comprehensively described in the recently completed Global Adult Tobacco Survey (GATS). Tobacco use in India is more varied than in most countries. India is the world's third largest tobacco-growing country. Anti tobacco counseling is best suited for Indian scenario because it is inexpensive and effective. Dental practice in the 21st century should ideally move from a restorative orientation to one of broader promotion of health and well being and it would be unconscionable not to include aggressive tobacco intervention in that paradigm. [ABSTRACT FROM AUTHOR]

Postsecond wave of COVID-19 pandemic in the year 2021, rhino-orbital mucormycosis (ROM) was seen as an epidemic in the Indian community. Severe ROM disease has poor prognosis and requires a multidisciplinary approach for treatment. Hence, its prevention is better than cure. Studies done during the epidemic assessed predisposing factors, but this was a novel study which focused on assessing risk factors for severe disease of ROM. Ninety-four consecutive patients of ROM admitted at our designated nodal tertiary hospital of North India were enrolled, and data were collected and analyzed. Facial edema was the most common presenting complaint. Subclinical and mild COVID-19 infection was associated with severe ROM. Uncontrolled diabetes mellitus and prophylactic zinc supplementation were other significant risk factors for severe ROM. Public awareness among the general population for the above risk factors can prevent a debilitating disease like severe ROM.

Objective: To describe the epidemiology and clinical features of cases in an outbreak of Hand, Foot and Mouth Disease (HFMD). Design: Descriptive epidemiological study. Setting: Hospitals and community in urban areas of Bhubaneswar city, Odisha. Methods: Upon clinical suspicion of the first case as HFMD, local pediatricians and dermatologists were sensitized for case referral to Dermatology department of Institute of Medical Science and SUM hospital (IMS&SH) for evaluation and follow up. Community survey was undertaken by household visit by the team from Regional Medical Research Centre, Bhubaneswar in an outbreak area through hospital case tracing. Blood samples were tested for hematological counts and RT PCR assay done in a subset of samples for confirmation. Results: Seventy eight cases of HFMD were detected between September 7 and November 6, 2009. Mean age (SD) was 5.13 (4.94) years (range 4 mo-31 yrs) and both sexes were equally affected. Fever and rash were the most common presenting symptoms with the rash distributed mostly over buttocks (83.3%), knees (77.5%), both surfaces of hands and oral mucosa (78.2%). Lesions healed in Mean (SD) 8.6 (1.5) days (range 7-15 d). Recovery was complete with minimal supportive treatment but, nail shedding was noted in three children within 4-5 weeks. CA16 was confirmed as the viral agent. Conclusion: Children (5-14 yrs) were majorly affected and complete recovery without neurological complications were noted. The characteristic clinical features described will be useful for early clinical diagnosis where laboratory confirmation is not feasible. [ABSTRACT FROM AUTHOR]

Background & objectives: Dengue virus (DV) infection has emerged as a major health problem in north India. Here, we report the annual trend of dengue virus infection as seen in Lucknow, Uttar Pradesh, during 2008-2010. Methods: Blood samples from clinically suspected cases of dengue virus infection were collected and history was taken on structured clinical data sheet. All samples were tested for dengue IgM by antibody capture ELISA. Selected samples were tested by conventional RT-PCR for dengue virus RNA. Weather information was continuously recorded from website of world weather information service. Results: There was a gradual increase in number of dengue fever cases with increased occurrence in 2010. Cases referred in January - December 2008 were 398 (54.5% anti DV IgM positive), in January - December 2009 were 599 (51.9% anti DV IgM positive) and in January - December 2010 were 1602 (64.9% anti DV IgM positive). Serotypes circulating in years 2008, 2009 and 2010 were DV-2 & DV-3, DV -1, 2 & 3 and DV-1 and DV-2 respectively. There is no statistical significant correlation between weather data and increasing dengue positive cases. Interpretation & conclusions: Increased cases of dengue fever were seen in 2010, which was not correlated with any change in environmental factors. A change in circulating serotypes was noted. [ABSTRACT FROM AUTHOR]

The influenza epidemic of 1918 was the single worst outbreak of this disease known in history. This article examines an area of western India that was affected very badly—that of a tract inhabited by impoverished indigenous peoples, who are known in India as adivasis. The reasons for this are discussed. Some oral accounts help to bring out the enduring memory of that terrible time. The general health of the adivasis and the existing medical facilities in this area are examined. Attempts to check and treat the disease by the colonial government and its doctors, as well as missionary doctors and other non-governmental agencies, are considered to see why they had so little overall impact. Some comparisons are made with the fate of indigenous people in other parts of the world during the epidemic, in particular with the Inuits of Alaska. [ABSTRACT FROM PUBLISHER]

This article is an attempt to present and elaborate the HIV/AIDS scenario in Jharkhand state of India, services available, key issues, challenges, and concerns at various levels to mitigate the epidemic. It also examines the role of different stakeholders and agencies in halting and reversing the epidemic. The findings show that there are various challenges that need immediate attention. The article critically examines these issues in detail and suggests the approach to address the epidemic. [ABSTRACT FROM AUTHOR]

This article reviews and discusses the problems, responses, and concerns of orphans and vulnerable children in India. The article shows that HIV/AIDS programs and interventions are vital for survival and welfare of orphan and vulnerable children, but they have reached only to a small fraction of the most vulnerable children. The article suggests a number of measures that government and civil society could take to address the problems and emphasizes the need to learn from other countries' experience and initiatives in developing appropriate policy and programmes for orphan and vulnerable children. [ABSTRACT FROM PUBLISHER]

Abstract: Diffusion of new technology is an important driver of economic growth. In this paper, diffusion of mobile telephony in India is studied. There is a vast diffusion potential in this country which needs to be exploited efficiently and in a rational way. This paper investigates the social, technological, economical and political (STEP) factors that have influenced the diffusion process of mobile telephony especially the diffusion speed. The epidemic model, which is widely employed in the diffusion studies of mobile telephony, is used for the study. The data is fitted into logistic, gompertz, and bass models by nonlinear least squares and it is found that gompertz model best describes the diffusion process of mobile telephony in India. The study reveals that competition and government intervention played a significant role in accelerating the diffusion speed of mobile telephony by making the technology affordable. It is found that mobile telephony is a substitute for fixed line telephony in India. The findings will be useful in taking managerial decisions with respect to factors in forecasting and controlling the diffusion process of emerging technologies. [Copyright &y& Elsevier]

Background: The association of the present Chikungunya pandemic with a mutation in the Chik virus is already established in many parts of the world, including Kerala. Kerala was one of the worst-affected states of India in the Chikungunya epidemic of 2006–2007. It is important to discuss the clinical features of patients affected by Chikungunya fever in the context of this change in the epidemiology of the disease. Aim: This study tries to analyze the clinical picture of the Chikungunya patients in Kerala during the epidemic of 2007. Setting and Design: A cross-sectional survey was carried out in five of the most affected districts in Kerala, India. Materials and Methods: A two-stage cluster sampling technique was used to collect the information. Ten clusters each were selected from all the five districts, and the size of the clusters were 18 houses each. A structured interview schedule was used for data collection. Diagnosis based on clinical signs and symptoms was the major case-finding strategy. Results and Conclusion: Of the 3623 residents in the surveyed households, 1913 (52.8%) had Chikungunya clinically. Most of the affected were in the adult age group (73.4%). Swelling of the joints was seen in 69.9% of the patients, followed by headache (64.1%) and itching (50.3%). The knee joint was the most common joint affected (52%). The number of patients with persistence of any of the symptoms even after 1 month of illness was 1388 (72.6%). Taking bed rest till the relief of joint pain was found to be a protective factor for the persistence of the symptoms. Recurrence of symptoms with a period of disease-free interval was complained by 669 (35.0%) people. Older age (>40 years), a presentation of high-grade fever with shivering, involvement of the small joints of the hand, presence of rashes or joint swelling during the first week of fever and fever lasting for more than 1 week were the significant risk factors for recurrence of symptoms predicted by a binary logistic regression model. In conclusion, we found that there is substantial acute and chronic morbidity associated with the Chikungunya epidemic of 2007. [ABSTRACT FROM AUTHOR]

India has the second-largest population living with HIV/AIDS in the world. Although the exact number of HIV positive people is contested, it is predicted that the current numbers are likely to grow at a rapid rate in the next decade if the epidemic goes unchecked. This paper explores the HIV/AIDS epidemic in India through the perspective of two non-governmental organisations (NGOs) whose roles have become critical in the fight against the disease. Specifically, it identifies the challenges faced by these NGOs such as lack of government responsiveness, funding-related problems, corruption, donor accountability, and cultural attitudes to HIV/AIDS, while exploring the theoretical implications of NGOs playing a greater role in providing programming and services to those living with, and affected by, the epidemic. [ABSTRACT FROM AUTHOR]

Background & objectives: A large number of cases of undiagnosed fever and joint pain were reported from different parts of the State of Orissa since February 2006. Epidemiological and laboratory investigation were carried out to confirm the cause of emerging illness, which was provisionally suspected as Chikungunya (CHIK) fever. Methods: Upon getting the reports of suspected CHIK like illness in different parts of the State, epidemic investigations were carried out in the outbreak affected villages. Case history was recorded, clinical examination undertaken and blood samples collected for seroconfirmation for CHIK IgM antibody using ELISA based kit. Simultaneously vector survey was also carried out. Results: With no previous record of CHIK infection in the State, the first outbreak was confirmed during February 2006. Subsequently, the infection spread to 13 of 30 districts in different episodes covering 79 villages till November 2007. Attack rate was 9-43 per cent in the different outbreaks with average seropositivity of 24 per cent to CHIK specific IgM. Morbidity was high though no deaths were recorded. Aedes aegypti and Ae. albopictus were identified as the possible vectors for transmission. Interpretation & conclusions: The report confirmed emergence of CHIK infection in the State of Orissa, India, and its spread to a larger geographic zone in a short period which warrants public health measures to control further spread. [ABSTRACT FROM AUTHOR]

Abstract: India contributes greatly to the global incidence of malaria. The factors influencing malaria in India are highly diverse and vary greatly from the epidemiological setting of any other country. Central India is the most vulnerable area to malaria in India. This study was carried out in three community health centres in Dindori District, Madhya Pradesh (Central India). Dindori District is mesoendemic for malaria, with both Plasmodium falciparum and P. vivax being present in all age groups. Anopheles culicifacies and A. fluviatilis are highly efficient vectors of malaria. In this study, an epidemic of malaria among indigenous ethnic group Baigas was investigated to determine the causes of the epidemic and the population involved in order to aid in disease containment. The existence of sporozoite-positive A. culicifacies and A. fluviatilis indicates either that spraying had not been done properly or the presence of insecticide resistance. A combination of factors propagated the epidemic. Evidence suggests that the non-availability of artemisinin-based combination therapy and rapid diagnostic tests along with an immunogenically vulnerable population each played an important role. As the global prevalence of malaria decreases owing to initiatives to control or eliminate the disease, more areas will become mesoendemic or hypoendemic for malaria. Detection and control of epidemics requires greater attention, and mechanisms to ensure the quality of interventions are essential. [Copyright &y& Elsevier]

Introduction: Even after 20 years of UIP diphtheria is still prevalent showing up and down trends in India. India contributes about 19 to 84% of total burden worldwide and many of time it is unidentified and notified. Present study is aimed to study Diphtheria cases in a tertiary care hospital Ahmedabad from January 2012 to December 2015. Methodology: Total 74 confirm throat swab smear or culture for C Diphtheria positive patients were included in study. Their age, immunisation status, response to treatment in form of throat swab clearance of bacilli, complications and mortality was noted and analysed. Results: 38(51.35%) were from 5-10 years age groups. Inappropriate booster doses and waning immunity in older age is responsible for shifting of age pattern. 9% of cases were fully immunised and had very milder form of disease. 56.65% were unimmunised had more severe form, complications, delayed clearance of throat bacilli and mortality. 90% patients throat swab cleared within 72 hours of starting treatment showing sensitivity of bacilli to slandered treatment. 12(18.9%) patients were expired mostly due to cardiac complications. Conclusion: Thus strengthening of routine immunisation, early identification and timely intervention can definitely overcome the resurgence of disease. [ABSTRACT FROM AUTHOR]

To determine the incidence of acute hepatitis because of hepatitis E virus (HEV) and the source of the epidemic in Nellore in south India in 2008. Anti-HEV IgM ELISA and RT-PCR for HEV-RNA were carried out on blood and stool samples from patients with acute hepatitis presenting to different hospitals in the city. The city was divided into 33 clusters, and 20 families from each cluster were systematically interviewed to determine the incidence of hepatitis E in the city. The survey was conducted on 2685 residents of 673 households from 24th November to 4th December 2008. The overall incidence of hepatitis was 5.7% (152/2685), i.e. an estimated 23 915 persons in the city were affected. There were two deaths because of acute hepatitis in the population surveyed translating to an estimated 315 deaths. Men had higher attack rates than women (7.8% vs. 3.5%) and young adults compared to children under 5 years (6.9% vs. 2.9%). Families drinking water from the pumping station at Bujjamarevu had the highest attack rate of 54.5% (39.8-69.2%). HEV IgM antibodies were present in 80/100 plasma samples tested. HEV-RNA was detected in 43/100 individuals tested, and isolates were characterized as genotype 1 by sequencing. Sewage draining into the river close to the pumping stations and broken pipelines crossing sewage drains may have triggered this large outbreak. [ABSTRACT FROM AUTHOR]

Summary: Malaria was the major cause of morbidity and a leading cause of mortality in the Andaman Islands Penal Colony from 1858 to 1945. Besides annual malaria incidence peaks coinciding with the arrival of the monsoon, multi-year cycles (administrative in nature) of 10–15 years are also discernable. The size of the previous year''s prisoner intake was associated (r 2 =0.21, n =57) with increased malaria. The positive relationship (r 2 =0.33, n =47) between the total number of Buddhist prisoners and malaria may have been due to prisoners of Burmese ethnicity introducing new malaria strains to the otherwise isolated islands. Well-meaning but ultimately disastrous attempts were made to drain the mangrove swamps around the penal colony. Because of the brackish-water breeding habits of the main vector, Anopheles sundaicus, engineering works along the shoreline often increased malaria. Malaria morbidity approximately trebled from 1928 to 1929 and doubled again in the next year with increases in all-cause mortality from 20/1000 in 1929 to 51/1000 in 1930, coincident with a major dredging operation for a new port. The history of malaria control in the Andaman Islands Penal Colony is a cautionary tale that well-meaning and well-funded efforts can fail spectacularly if local epidemiological reality is not well understood. [Copyright &y& Elsevier]

India is silently witnessing a stroke epidemic. There is an urgent need to develop a national program towards "Fighting Stroke". This program should be specific to our national needs. In order to recommend on who should lead an Indian fight-stroke program, we examined the published opinions of stroke clinicians and the official documents on stroke care training abroad. We identified the resources that already exist in India and can be utilized to develop a national fight-stroke program. Through a review of published literature, we noted different opinions that exist on who would best manage stroke. We found that because stroke is a cardiovascular disorder of the central nervous system, its management requires a multi-disciplinary approach involving clinicians with background not limited to neurology. India has very few neurologists trained in stroke medicine and they cannot care for all stroke patients of the country. We propose a mechanism that would quickly put in place a stroke care model relevant in Indian context. We recommend for tapping the clinical expertise available from existing pool of non-neurologist physicians who can be trained and certified in stroke medicine (Strokology). We have discussed an approach towards developing a national network for training and research in Strokology hoping that our recommendations would initiate discussion amongst stroke academicians and motivate the national policy makers to quickly develop an "Indian Fight Stroke Program." [ABSTRACT FROM AUTHOR]