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Introduction: Nonavailability of quality healthcare in mountainous, isolated, inaccessible sparsely populated regions is a universal problem. In this project, remote virtual healthcare was provided at Keylong and Kaza in Himachal Pradesh (HP) in North India. This innovative public-private partnership (PPP) provides 24/7 affordable healthcare to an alpine community where people commute 20-50 km for primary and 250 km for secondary healthcare services. Following a need assessment study, an MoU was signed by Apollo Hospitals in January 2015 with the National Health Mission. The government paid for all services delivered, Capital Expenditure (CAPEX) and Operating Expenditure (OPEX). Noncompliance to auditable weekly and monthly program MIS would result in penalties., Methods: Apollo Telehealth Services customized a turnkey solution, end-to-end, on a program management approach with measurable milestones and monthly reports. Key health issues in the region were identified. Very Small Aperture Terminals were installed amidst landslides and subzero temperatures. In February and March 2015, staff recruited from the community and local government staff were trained in Chennai. A major cultural transformation had to be effected. Urban teleconsultants were sensitized for community interaction, while deploying cutting- edge technology., Results: Case records were audited. In the first 42 weeks, 2,213 teleconsults were provided, including 171 emergencies. Telelaboratory services and telehealth education programs have also been added., Conclusions: Evaluation confirms that delivering remote healthcare in inhospitable terrains in a PPP mode is effective.

Diagnosis of canine babesiosis, caused by Babesia gibsoni is difficult, especially in chronically infected dogs. A loop mediated isothermal amplification (LAMP) assay was developed and standardized by using four oligonucleotide primers targeting the hypervariable region of 18S rRNA gene (GenBank Acc. no. KC461261). The primers specifically amplified B. gibsoni DNA, while no amplification was detected with DNA from non-infected dogs as well as from dogs infected with Babesia canis vogeli, Hepatozoon canis, Ehrlichia canis and Trypanosoma evansi. The assay could detect 1.35 × 10(-7) parasitaemia and 10(-4) dilution of recombinant plasmid, equivalent to 12 pg of target DNA. All the samples were tested by nested PCR as well as LAMP assay. LAMP was found to be 10 times more sensitive than nested PCR targeting the same gene. Out of 75 suspected field samples, collected from different parts of the country, LAMP could detect B. gibsoni in 43 samples, while nested PCR and microscopy could detect 37 and 23 samples, respectively. High sensitivity, specificity and rapidity of LAMP assay may be exploited for screening large number of samples in a field setting., (Copyright © 2015 Elsevier B.V. All rights reserved.)