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Background: With a call to action from the health-care industry and the Indian government, there are significant gaps in health-care professionals’ uptake and utilization of artificial intelligence (AI)-based tools. This study attempts to explore the current perceptions and readiness for AI among health-care workers. Methods: A web-based questionnaire comprising seven sections on descriptive educational and occupational data, AI familiarity level, role-specific training benefits, training advantages, implementation issues, driving factors, and perceived risks was designed from a literature search. Two additional domains of perception on professional impact and preparedness for AI in health care were estimated using a prevalidated Shinners AI Perception tool. Results: Of the 402 study participants, 192 (47.9%) were doctors from diverse specializations, and the remaining 209 (52.1%) were undergraduate medical and nursing students and affiliated health professionals. Although 79.8% of participants had never attended a course on AI, 82% agreed on the need for training in AI to explore new opportunities in their respective fields. 72.1% of participants agreed that data privacy and confidentiality posed the most significant challenge to AI implementation among the studied factors. Conclusion: This survey reveals awareness regarding AI, which is attributable to a lack of formal training received by health-care professionals. Most participants believed that AI could improve population health outcomes, and collective efforts are needed to make this belief a reality.

Coronavirus disease 2019 (COVID-19) is a respiratory illness caused by SARS-CoV-2. Dengue is one of the most common tropical diseases in India caused by dengue virus (DENV). COVID-19 and tropical diseases such as dengue and leptospirosis have a similar spectrum of clinical manifestations; therefore, it becomes very difficult to diagnosis. The present study describes five cases of coinfection of COVID-19 and dengue. A case series of patients reported to the flu clinic with fever and myalgia were tested, and diagnosed with SARS-CoV-2 and DENV as well as epidemiological and entomological investigations were also done for the identification of the source of infection. Laboratory reports were obtained from hospital laboratory data. Data were analyzed using Microsoft Excel. All patients were younger adult age group and were found to be residents of the same locality. The most common symptom found was fever associated with myalgia. Every patient had a history of contact with laboratory-confirmed COVID-19 cases and was fully vaccinated. Thrombocytopenia was seen in two patients. However, only one patient found immunoglobulin M or immunoglobulin G positive for DENV after discharge. No systemic complications were observed throughout the course of illness in patients. We described a case series of five patients with COVID-19 breakthrough and cases of dengue. Clinicians should have a suspicion of multiple infections while managing the cases.

Introduction: Environmental factors such as temperature, precipitation, and various other pollutants in the air like nitrogen dioxide (NO2), CO2, etc., have been studied for sustenance and transmission of Coronavirus disease-19 (COVID-19). Studies from India are lacking about the distribution of COVID-19 cases according to air pollutants and meteorological factors. Hence, the present study was conducted to study the relationship between COVID-19 and environmental factors with the objectives of Cluster mapping of the COVID-19 cases district-wise for the state of Maharashtra. Methodology: The air pollution variables NO2 column density (mol/m2), sulfur dioxide column density (mol/m2), Aerosol absorbing index (Ai), Carbon monoxide (CO) column density (mol/m2), and Ozone column density (mol/m2) were extracted from Sentinel-5P datasets available in Google Earth Engine (GEE) (https://code.earthengine.google.com/). The meteorological variables precipitation (m), temperature (t), and humidity (k) were extracted from the European Environmental Agency 5-Land reanalysis dataset in GEE, which provides data at a resolution of 1113.2 m. The preprocessing and retrieval of data were carried out in GEE. These values were correlated with daily cases, density, and other demographic factors. Results: The study identified a cluster of cases in few districts of Maharashtra. These districts were Pune, Ahmednagar, Mumbai, Nashik, and Nagpur. Population density and NO2 were important factors in most of the monthly data. Conclusion: The present study used data available on public platforms to assess the association between COVID-19 and environmental factors. The study found that various environmental factors such as NO2, CO, and Ai may be associated with increase cases of COVID-19 in the district. However, ecological bias may be kept in mind.

Background: During the first wave of the pandemic, health-care workers (HCWs) experienced high levels of stress, depression, and anxiety. These frontline workers remained a vulnerable group with the second wave of the pandemic being more severe than the first wave across the globe. There is a need to assess the psychological impact of the second wave of COVID-19 on HCWs and identify risk factors associated with higher morbidity. This will be beneficial in planning appropriate prevention and remedial measures. Materials and Methods: Consecutive 1275 HCWs (between the age group of 18 and 60 years) responded to the online survey. After the collection of sociodemographic data, participants were administered the Impact of Event Scale-Revised, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 Scale. Results: Moderate-to-severe stress, depression, and anxiety were reported by 40%, 31.7%, and 24.3% of participants, respectively. Regression analysis revealed that female gender, nurses, high COVID-19 exposure, history of COVID-19, chronic medical illness, and work experience between 10 and 20 years were risk factors for increased psychological morbidity. Conclusions: This study demonstrates that stress, anxiety, and depressive symptoms remained high among HCWs during the second wave of COVID-19. Certain risk factors predicted higher mental health morbidity. There is a need to develop appropriate interventions targeting these groups.

Introduction: Oesophageal cancer is the seventh most common cancer worldwide and the sixth highest cause of cancer-related mortality. Radiation plays an important role in the multimodality treatment of carcinoma of the oesophagus. Aim: To compare locoregional control and toxicity of two External Beam Radiation Therapy (EBRT) fractionation schedules of concurrent chemoradiotherapy and high-dose intraluminal brachytherapy in patients with oesophageal carcinoma at a single institute. Materials and Methods: The present study was a pilot study including a total of 33 participants with histologically confirmed oesophageal cancer. Patients were prospectively randomised into two groups. Arm I: EBRT with a total dose of 46 Gy delivered in 23 fractions at a rate of 2 Gy per fraction over 4.3 weeks, along with Concurrent Injection of Cisplatin (CDDP) 100 mg/m2 on days 1 and 22, followed by Intraluminal Radiation Therapy (ILRT) with 6 Gy per session weekly. Arm II: EBRT with a total dose of 30 Gy delivered in 10 fractions at a rate of 3 Gy per fraction over two weeks and CDDP 100 mg/m2 on day 1 only. The primary endpoint of this study was to compare the locoregional response and toxicities (both acute and late) in the two arms at the end of radiotherapy and six months. Results: At the end of the two-month follow-up, no statistically significant difference was found in the response between the two arms (p-value=0.2697). Dysphagia relief was comparable in both arms; however, this difference was not statistically significant (p-value=0.9235). Conclusion: The responses in both arms were comparable, and further randomised trials with larger sample sizes should be encouraged.

Introduction: Head and Neck Cancers (HNCs) in India account for 30% of all cancers, out of which 60-80% of patients present with advanced disease, leaving the patients with limited survival and poor Quality of Life (QoL). Poor nutritional conditions, advanced disease presentation, limited tolerance, and socio-economic constraints necessitate the development of appropriate and effective palliative treatment options that are also easily available. One such palliative approach has been explored, and its relevance and applicability are discussed here. Aim: To study the role of weekly intramuscular injection Methotrexate (MTX) along with oral Tablet Gefitinib in advanced unresectable, recurrent, or residual HNCs. Materials and Methods: A retrospective analysis of 50 patients was carried out in the Department of Radiation Oncology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India. All patients included had advanced HNC and were ineligible for curative treatment. All received weekly intramuscular injection MTX 40 mg/m2 and Tablet Gefitinib administered orally in a dose of 250 mg once daily. These patients were assessed for tumour response, acute toxicities, symptomatic relief, and median survival. All the data were recorded in Microsoft Excel and analysed using Statistical Package for Social Sciences (SPSS) software version 28.0. Results: This study included 50 patients (45 males, 5 females) with a mean±SD age of 49±8.8 years, all diagnosed with histologically confirmed squamous cell carcinoma, predominantly at stage 3 (six patients) and stage 4 (44 patients). Median survival was 5.9 months. According to RECIST (Response Evaluation Criteria in Solid Tumours) criteria, no complete responses were observed; 18 (36%) had a partial response, 21 (42%) had stable disease, and 11 (22%) had progressive disease. The treatment was well-tolerated, providing notable relief in pain and dysphagia symptoms. In terms of toxicity, grade-3 mucositis was observed in 10 patients, and none had grade-4. Grade-3-4 neutropenia and anaemia were seen in six and eight patients, respectively. Conclusion: The use of MTX and gefitinib combination in advanced HNCs has the potential to substantially alleviate pain, provide symptomatic relief concerning dysphagia and speech, and hence improve the overall QoL.

Background: Hepatitis C virus (HCV) infection is a major public health concern. Persons living with HCV infection are at risk of developing liver cirrhosis and progressing to end-stage liver disease and liver cancer (hepatocellular carcinoma). The present study was undertaken to assess the prevalence of HCV infection in patients admitted as well as outpatient department services of a Zonal Hospital. Methods: The present study was cross-sectional, observational study, conducted in patients >18 years of age, clinically suspected acute infectious hepatitis or admitted to the intensive care unit, and willing to participate in the study. Results: In the present study, 472 patients were studied for hepatitis C infection. Majority of cases were from 51 to 60 years age group (34.5%), followed by 61–70 years age group (26.7%). Female cases were (51.3%) slightly more than male (48.7%). Rapid method and enzyme-linked immunosorbent assay (ELISA) methods detected HCV prevalence as 5.7% and 12.5%, respectively. After HCV genotype testing, the prevalence was 12.1%. Majority had 3A genotype (69.49%), followed by 1A genotype (16.95%), 1B genotype (8.47%), 3B genotype (3.39%), and 4 genotypes (1.69%). ELISA testing was significantly correlated with HCV genotype testing (P = 0.017) while the rapid method was not correlated with HCV genotype testing (P = 0.937). Conclusion: There is a high prevalence of HCV among the suspected, genotype 3 being the most common.

Background: The outbreak of pneumonia among young healthy recruits in military training establishments during winter months is well documented. Rapid gathering of recruits from all parts of the country in crowded living conditions exposes them to a variety of pathogens. The objective of the present investigation was to identify causes, establish diagnosis, imply control measures, and develop future strategies after the occurrence of pneumonia outbreak during winter. Methods: The outbreak was investigated using standard epidemiological methods and medical case sheets, X-ray findings, laboratory findings, etc., to describe the epidemiology and guide the control efforts. Results: Over 3 months, 67 cases of pneumonia occurred among recruits with an attack rate of 11.1/1000 recruits/month. Radiological positivity in the form of consolidation in chest X-ray was found in 100% of cases with complications like pleural effusion in seven cases, of which intercostal chest tube drainage was required in two cases. The outbreak responded rapidly following mass chemoprophylaxis with tablet azithromycin 500 mg in five doses. Conclusion: The outbreak of pneumonia occurred among young healthy recruits (age – 17–23 years) residing in an overcrowded dwelling. Mass chemoprophylaxis was a suitable strategy along with conventional remedial measures such as health advisories, health education, hand hygiene/respiratory hygiene etiquettes, and segregations of affected squads to control the outbreak.

Introduction: Acute on chronic liver failure (ACLF) has been a difficult entity to define. The use of the hepatic venous pressure gradient (HVPG) for the measurement of portal pressure is well established in chronic liver disease. This is based on data showing that improvements in the HVPG are associated with improvements in clinical outcomes. Methods: The study was a prospective observational study conducted in the department of gastroenterology of a tertiary care center in Northern India for 2 years. Thirty cases each of ACLF (Group I), compensated cirrhosis (Group II), and decompensated cirrhosis (Group III) were enrolled. We evaluated the role of HVPG values and complications in patients with liver disease. Results: The mean age of the cohort was 44.2 ± 7.3 years. The most common etiology of ACLF noted in the study was alcohol (54.4%), followed by infections by hepatotropic viruses (22.2%). ACLF has high short-term mortality compared to compensated and decompensated cirrhotics. Compensated cirrhosis is associated with the lower risk of bleed. The model for end-stage liver disease score was higher among the patients of ACLF (25.2 ± 3.1) and decompensated cirrhosis (23.93 ± 2.8) than compensated cirrhotics (9.7 ± 1.8). The mean HVPG was 12.3 ± 7.5 mmHg, which was significantly higher than the normal gradient. It was also noted that the HVPG was significantly higher in the ACLF and decompensated cirrhotics. Conclusions: HVPG monitoring is recommended in ACLF and decompensated liver disease at admission to stratify the risk of early mortality.

Global warming is causing industrial development to increase greenhouse gas emissions, impact power provider economies, and potentially pose a solution through renewable energy. In order to solve these issues, the research offers a dual strategic auction difficulty for renewable energy market clear prices (MCPs) to maximize supplier and buyer revenues while mitigating rival unpredictability and renewable vacillation power supply sources. The study uses scenario reduction techniques, including Beta and Weibull distribution of probability, forward-reduction technique, and underestimation and overestimation of the cost function to manage uncertainties in renewable energy. The Gravitation Search algorithm and a hybrid approach ordered weighted average distance (OWAD) combined, with Topsis operational gravitational search algorithm TOGSA (OWAD-TOGSA), are used to solve the multi-objective issue. The study evaluates the performance of IEEE standard 30-bus and 57-bus test systems and an Indian 75-bus operational system to solve a problem involving wind and sun energy in spite of its volatility. The proposed bidding approach is feasible and could increase revenue by nearly 10 %, potentially improving efficiency for electric energy-producing utilities and consumers, and its findings will be beneficial for similar research using optimization techniques.

Despite consensus on universal screening of women at 24–28 weeks for a diagnosis of gestational diabetes, controversy remains on an appropriate criterion. The study is aimed to find out the sensitivity and specificity of Diabetes in Pregnancy Study Group India (DIPSI) criteria compared to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria for diagnosis of Gestational Diabetes Mellitus (GDM). A meta-analysis of studies comparing DIPSI as an index test to IADPSG as the reference test for diagnosing GDM was carried out. A total of 8 comparative studies were included. Pooled analysis showed a sensitivity of 0.44 [0.29 to 0.60] and specificity of 0.97 [0.94 to 0.98], which means the index test DIPSI will correctly identify only 44% of the subjects who have the disease (GDM positive) but it will also fail to identify 56% of the GDM positive subjects. Derek's funnel graph revealed fewerchances of publication bias. Though convenient, DIPSI criteria was not found to be sensitive enough for a diagnosis of GDM and missed an opportunity to improve pregnancy and subsequent long-term outcomes for a substantial number of women. Further studies should focus on comparing pregnancy outcomes for the two criteria, so that decision to adopt any criteria is more evidence-based.

Background: Globally, hypertension is the leading risk factor for men and women and the largest contributor to premature deaths and diseases in India. Health literacy (HL) and health-care access are important determinants for self-care management of hypertension. Objectives: The purpose of this study was to estimate the prevalence of HL, health-care access, and their importance in the self-care management of hypertension. Materials and Methods: A community-based cross-sectional study was conducted among 104 known hypertensive patients for 2 months from May to June 2022. Data were collected by face-to-face interviews using a pretested, preformed, and validated questionnaire, and tabulated and analyzed using Microsoft Excel and SPSS version 20 software. Results: Most of the participants (80, 76.9%) have low levels of HL. However, more than half of the (62, 59.6%) participants were satisfied with their access to primary health care. The age of the participants ranged from 38 to 80 years, and half of them (54, 51.9%) were middle-aged adults. The majority (66, 63.5%) of the patients belonged to lower-middle socioeconomic status, and 15.4% (16) were living alone. We found poor HL, and primary health-care access is statistically significantly associated with poor self-care management. Conclusion: Our findings confirm that HL and access to primary health care are crucial factors in the self-care management of hypertension in hypertensive patients.

Introduction: Musculoskeletal injuries sustained during training are not only the major cause of loss of training hours but also lead to attrition of precious workforce. Detailed knowledge of the pattern, type, mechanism of musculoskeletal injury, etc., helps in designing prevention strategies. Hence, the study was conducted to study the epidemiology of injuries sustained by trainees while undergoing training at an institutional training. Materials and Methods: The study is a record-based observational study. The data relating to training-related injuries sustained over 5 years (April 2014 to March 2019) were obtained from the record maintained in the medical facility of the training institute in India. The data were extracted using a case record form. The injury data (date of injury, unique identification number, trainee name, diagnosis, and type of treatment taken) were obtained from the medical record register maintained in the medical facility of the training institute. Anthropometric data (height and weight) were obtained from the record of initial medical screening done routinely on the day of joining the training institute. The descriptive analysis of the collected data was done. Results: A total of (n = 2946) trainees comprising 2584 male trainees and 362 female trainees underwent training during the period of the study. The total number of visits to the medical facility related to injury during the 5-year study period was 13,579. Most of the injuries are occurring in the 5th–20th week in the first half of training period and 29–44 week in the second half of training period. Among male trainees, the lower limb injuries alone accounted for 72.8% of total injuries, followed by trunk and back injuries (11.97%) and upper limb injuries (11.95%). Among female trainees although lower limb injuries still account for the majority (79.66%) of injuries, among them, hip and groin injuries accounted for the highest percentage of injuries as compared to leg and knee injuries in male trainees. The twisting injuries of the knee, stress fractures, and acute traumatic fractures accounted for the majority (78.34%) of the injuries leading to repetition of the training by 24 weeks. The twisting injuries of the knee, acute traumatic fractures, traumatic shoulder instability, and head injuries accounted for the majority (83.2%) of the injuries leading to dropout from training institution (withdrawal). Conclusion: The analysis related to the injuries sustained by trainees during the 5 years found out the timings, severity, and location of injuries. The findings may be important for the formulation of preventive program in an institutional training institute.

Aim and Objective: This study aimed to assess the knowledge, attitude, and practices of individuals residing in the rural part of Bihar toward COVID-19. Methods: We conducted a cross-sectional study from September 10, 2020, to September 29, 2020, with the help of a prevalidated questionnaire. The questionnaire was distributed to individuals living in the different rural parts of the Patna district in Bihar. People from the age group of 16 years and above were included in the study. Health-care workers, Anganwadi workers, and Accredited Social Health Activists (ASHA) were excluded from the study. Results: Out of 385 study participants, 58.7% were males. The majority of the respondents belonged to the age group of 26–35 years (39.2%). 64.9% of the study participants were working in the private sector, and 5.5% were unemployed. The majority of the participants (98.44%) agreed regarding the seriousness of the COVID-19 pandemic and had adequate knowledge about symptoms of COVID-19. The female knowledge score was slightly more than males, but the difference was not statistically significant (P > 0.5). Furthermore, 97.4% of the study participants were aware that there is no specific cure for the disease. Higher income was associated with higher knowledge, attitude, and practice. Conclusion: The participants had significant knowledge about COVID-19 and acceptable practices toward its protective measures. However, there was continuing movement of participants to meet relatives and friends.

Introduction: During COVID-19 pandemic to cater for increase number of cases, the government set up various COVID-19 hospital. Herein, we describe the challenges in establishing and operationalising COVID hospitals from public health professionals' point of view. Methods: The article describes the different type of infrastructure available at different site. Since there was different type of settings, there were different types of public health problems associated with all of these. Problems were analysed in an narrative manner in the article. Results: The public health problem were described under infection prevention and control, Bio Medical waste, Solid waste management, Mosquito menace, water and sewage system, Mortuary services, manpower management and training, and monitoring mechanism. Conclusion: The possible issues which could have created major health were anticipated and corrective action were taken well in time. Continued risk communication and training is of paramount importance in controlling not just COVID-19 but any communicable disease.

Introduction: COVID-19 pandemic has affected all sections of society; this study was conducted with the aim to assess the behavioral and economic impact of the COVID-19 lockdown among people living in an urban slum in Pune city, Maharashtra. Materials and Methods: A descriptive cross-sectional study was conducted among people living in an urban slum of the southeastern Pune region using a semistructured questionnaire by house-to-house interviews of residents. Participants were asked about knowledge and practice of COVID-appropriate behavior and change in income and expenditure patterns to assess economic impact. Results: A total of 130 households with one adult member from each household were included in the study with a mean age of 46 years with a standard deviation of 15. On inquiring about the COVID appropriate behavior, 94.6% agree that face mask is essential and 93% of the respondents agree that hand washing is essential for the prevention of COVID-19 infection. Out of 130 respondents, 49% were unemployed at the time of the study and 39% had monthly household income < Rs. 10,000 per month. A notable decrease in the monthly household income after the lockdown period was reported by 76.2% of the study participants while 46% of the study participants reported a decrease in monthly expenditure on food. About 24% of the study participants gave a history of selling personal belongings to meet monthly expenses during the lockdown period. Conclusion: COVID-appropriate behavior was adequately practiced by the study participants during COVID restrictions. A significant decrease in household income coupled with a change in trends of monthly expenditure affected the slum population. These transitions need to be further deliberated to understand the shift in administrative and economic policies needed to combat the effects of the pandemic.

Background: Fast-food culture is an uprising trend among the younger age groups. Stressful life due to increased study load, staying away from home, peculiar working hours, etc., negatively influences the food choices of medical students. Hence, this study was conducted to describe the prevalence, pattern, and preferences of fast-food consumption and also to determine the relationship of frequency of fast food with body mass index (BMI) of students of a medical college in Western Maharashtra. Methods: A cross-sectional study was done among 398 students of a medical college in Pune for 6 months. The data collection was done using a self-administered pretested structured questionnaire and analyzed using Microsoft Excel and SPSS version 20 software. Results: Three hundred and ninety-eight medical students responded. We found a 100% prevalence of fast-food consumption with different frequencies. 13.8% of the students were found to be overweight. Pizza was the most frequently consumed fast food. The taste factor was the most common reason to consume fast food among both sexes. The majority of the study participants (98.5%) were aware that fast foods are hazardous to health. A statistically significant association was found between the frequency of consumption of fast food with the type of diet (P = 0.008) and BMI (P = 0.023). Conclusion: High prevalence and preference for fast-food consumption can result in various noncommunicable diseases among students of the medical profession and is a major concern. Thus, there is a need for educating the students regarding nutritional information and counseling to bridge the gap between their knowledge and practice about healthy eating behavior.

Introduction: Medical colleges in India are opening gradually for resumption of medical education. Assessment of learning behavior and perspectives of students toward COVID-19 pandemic is essential for effective medical education as well as to assess their role in pandemic if need arises. Hence, the present study aims to assess learning behavior and perspective of medical students on COVID-19 pandemic. Materials and Methods: A descriptive cross-sectional study was conducted from September to December 2020 among 392 medical students at various medical colleges of the country. An online self-administered questionnaire was designed to assess learning behavior of medical students about infection prevention and control practices in COVID-19 adopted during the course of pandemic. Snowball sampling method was used for data collection. Results: On assessment of 392 medical students about preventive measures during COVID-19 pandemic, more than 80% of medical students were aware of the importance of facemask, social distancing, frequent hand washing, and use of digital tools such as Aarogya Setu app in surveillance. Majority of students were aware of the symptoms, testing, and treatment protocols along with importance of self-reporting. Most of the students were aware of various sources of getting scientific and relevant information about pandemic. While majority of students were aware of rationale of quarantine, appropriate waste management technique, and post-COVID precautions, there was a lack of knowledge about appropriate disinfection measures. Conclusions: Medical students are an asset to health care; learning behaviors adopted by them can certainly help to assist health-care system in COVID times.

Introduction: Insulin is one of the most effective agents in reducing hyperglycemia when used in appropriate doses. However, insulin may have risks if used inappropriately. Insufficient knowledge of insulin self-injection can result in complication, adverse patient outcomes, and invariably poor glycemic control. Methods: A cross-sectional observational study was conducted among patients with diabetes mellitus attending the outpatient department of the hospital in western Maharashtra. Data on sociodemographic factors and knowledge and attitude with insulin syringes were collected. Results: A total of 93 participated in the study. The mean age of the participant was 55.5 years, and most were male (52, 55.9%). Seventy-five (80.7%, 95% confidence interval [CI]: 71.1–88.1) were having adequate knowledge. Higher education was associated with adequate knowledge. The attitude was adequate in 24 (25.8%, 95% CI: 17.2–35.9) participants. Higher duration of illness of diabetes mellitus was associated with good attitude. Conclusion: The study found that there are gaps in knowledge and attitude for the use of insulin syringes. Opportunistic or one-to-one health education may be taken to improve knowledge and attitude regarding insulin syringes.

Background: There is a need to study the performance, validity, and accuracy of cartridge-based nucleic acid amplification test (CB-NAAT) for accessing drug resistance among pulmonary tuberculosis (TB) compared with the solid culture drug susceptibility test (DST). Methods: Patients with symptoms of cough for more than 2 weeks with anyone symptoms such as night sweats, fever, and unintentional weight loss were studied. Cases with previously diagnosed drug-resistant pulmonary TB by sputum CB-NAAT having constitutional symptoms but not on any ATT for a minimum of 2 months were also included in the study. The patient's information, including age, immune surveillance status, clinical features, and chest X-rays, were recorded. Each sputum sample was divided into three aliquots and tested for smear microscopy, liquid culture (LC), and genotypic DST. Results of all three diagnostic modalities were compared with CB-NAAT reports. Results: Of 236 patients with sputum-positive CB-NAAT (n = 236), 49.4% (n = 117) were rifampicin resistant, while 50. 4% (n = 119) were rifampicin sensitive. The genotypic DST assays carried out of all enrolled patients showed that 76.3% (n = 181) patients were resistant to one or more first-line antitubercular drugs (FL ATTs) or second-line (SL) ATTs, while 23.7% (n = 55) patients were sensitive to all ATTs. Among all the study participants, 56.4% (n = 133) of patients had sputum smear-positive by ZN stain, while 88.6% (n = 209) showed growth on LC (BACTEC) media. On concordant analysis of CB-NAAT with DST assays, we found that among 119 CB-NAAT rifampicin-sensitive patients, 66 patients were drug-resistant (DR) TB to any of the FL or SL ATTs. The sensitivity, specificity, positive predictive value, and negative predictive value of CB-NAAT for detecting rifampicin resistance on sputum for pulmonary TB when compared with the gold-standard DST assays were 97.67%, 76.67%, 70.59%, and 98.29%, respectively. Conclusions: This study found that the use of rapid molecular technique (CB-NAAT) in screening DRTB at the community level is suboptimal compared to the gold-standard solid culture method. Although CB-NAAT's sensitivity in detecting DR pulmonary TB is significantly higher, the specificity is lower in that population who have received ATT earlier.

Introduction: The present study was conducted to explore the awareness and perception of the coronavirus disease 2019 (COVID-19) vaccine among pregnant women. Material and Methods: A descriptive cross-sectional study was conducted from September 01, 2021, to September 28, 2021, among 301 pregnant women aged 18–35 years at antenatal care outpatient department in a tertiary care hospital of Western Maharashtra. Results: On assessing the knowledge and awareness score, the mean score (± standard deviation) was 7.83 ± 1.2 out of 16. A total of 176 (58.5%) had good scores (≥8). There was no statistically significant association between knowledge and awareness scores and the level of education, type of residence, and age or with weeks of gestation. Although the overall awareness of study participants was satisfactory, 177 (58.8%) felt that COVID-19 vaccines should be avoided during the first trimester. Interestingly, 45 (15.3%) felt that vaccines should not be given during menstruation. There were misconceptions about perceived contraindication, with 81(26.9%), 50(16.6%) and 43(14.4%) responding that diabetes, hypertension and heart disease are contradicts respectively. Interestingly, a total of 52 (17.3%) responded as likely when enquired whether the present vaccine can cause infertility. Similarly, about 62% of study participants felt that the vaccine might alter the DNA. Conclusion: The present study revealed good overall knowledge and awareness about the COVID-19 vaccine among pregnant with certain misconceptions. The findings suggest that immediate health education programs, risk communication, and correct information should be disseminated by respective health authorities.

Introduction To critically analyze the functional and radiological improvement in patients of cervical spondylotic myelopathy (CSM) who underwent surgical decompression by an anterior or posterior approach. Materials and Methods A retrospective study was conducted in a tertiary-level Armed Forces Hospital from June 2015 to December 2019. Preoperative assessment included a thorough clinical examination and functional and radiological assessment. The surgical decompression was done by an anterior or a posterior approach with instrumented fusion. Anterior approach was taken for single or two-level involvement and posterior approach for three or more cervical levels. The pre and postoperative neurological outcome was assessed by Nurick and modified Japanese Orthopaedic Association (mJOA) score along with measurement of canal diameter and cross-sectional area. Results A total of 120 patients of CSM who underwent surgical decompression were analyzed. Both the groups were comparable and had male predominance. A total of 59 patients underwent surgical decompression by an anterior approach and the remaining 61 patients by the posterior approach. Out of the 59 patients operated by the anterior approach, 30 (50.85%) underwent anterior cervical discectomy and fusion (ACDF); remaining 29 (49.15%) underwent anterior cervical corpectomy and fusion (ACCF). In the posterior group (n = 61), 26 (42.6%) patients underwent laminoplasty and the remaining 35 (57.4%) underwent laminectomy with or without instrument fusion. Sixteen patients out of these underwent lateral mass fixation and the remaining 19 underwent laminectomy. There was functional improvement (mJOA and Nurick grade) and radiological improvement in both subgroups, which were statistically significant (p < 0.0001). Conclusion A prompt surgical intervention in moderate-to-severe cases of CSM either by the anterior or the posterior approach is essential for good outcome.

Dielectric ceramic capacitors are highly regarded for their rapid charge–discharge, high power density, and cyclability in various advanced applications. However, their relatively low energy storage density has prompted intensive research aiming at developing materials with a higher energy density. To enhance energy storage properties, research has focused on modifying ferroelectric materials to induce relaxor ferroelectricity. The present study aims to induce a superparaelectric (SPE) state in relaxor ferroelectrics near room temperature by altering BaTiO3 ferroelectric ceramics using the (Sr,Bi)TiO3-Bi(Mg0.5Ti0.5)O3 system ((1−x)BT-x(SBT-BMT)). X-ray diffraction and Raman spectroscopy analysis demonstrated a shift in the crystal structure from tetragonal to cubic with an increasing x content. Notably, the compositions (except x = 0.1) satisfied the criteria for the SPE state manifestation near room temperature. The x = 0.2 specimen displayed characteristics at the boundary between the relaxor ferroelectric and SPE phases, while x ≥ 0.3 specimens exhibited increased SPE state fractions. Despite reduced maximum polarization, x ≥ 0.3 specimens showcased impressive energy storage capabilities, attributed to the enhanced SPE state, especially for x = 0.3, with impressive characteristics: a recoverable energy density (Wrec) of ~1.12 J/cm3 and efficiency (η) of ~94% at 170 kV/cm applied field. The good stability after the charge–discharge cycles reinforces the significance of the SPE phase in augmenting energy storage in relaxor ferroelectric materials, suggesting potential applications in high-energy density storage devices.

The Assisted Reproductive Technology (Regulation) Act, 2021, was passed on December 20, 2021 by an act of Parliament to regulate the functioning of assisted reproductive technology (ART) clinics and ART banks in the country. Since the dawn of in vitro fertilization (IVF), there has been a mushrooming of ART clinics in the country. There was need to supervise and regulate the functioning of these clinics and to safeguard the rights of women undergoing fertility treatment at these centers. The passing of this Act will go a long way in the better supervision, regulation, licensing, and smooth functioning of ART clinics and ART banks. The Act also brings into its ambit the controversial treatment of surrogacy and hence ensures protection of the rights of surrogate mothers. Moreover, strict implementation of the act will guarantee the success of the treatment within the legal and ethical framework.

Human papillomavirus (HPV) is implicated in over 90% of cervical cancer cases, with factors like regional variability, HPV genotype, the population studied, HPV vaccination status, and anatomical sample collection location influencing the prevalence and pathology of HPV-induced cancer. HPV-16 and -18 are mainly responsible for the progression of several cancers, including cervix, anus, vagina, penis, vulva, and oropharynx. The oncogenic ability of HPV is not only sufficient for the progression of malignancy, but also for other tumor-generating steps required for the production of invasive cancer, such as coinfection with other viruses, lifestyle factors such as high parity, smoking, tobacco chewing, use of contraceptives for a long time, and immune responses such as stimulation of chronic stromal inflammation and immune deviation in the tumor microenvironment. Viral evasion from immunosurveillance also supports viral persistence, and virus-like particle-based prophylactic vaccines have been licensed, which are effective against high-risk HPV types. In addition, vaccination awareness programs and preventive strategies could help reduce the rate and incidence of HPV infection. In this review, we emphasize HPV infection and its role in cancer progression, molecular and immunopathogenesis, host immune response, immune evasion by HPV, vaccination, and preventive schemes battling HPV infection and HPV-related cancers.

Introduction: Contact tracing can identify potentially infected individuals before severe symptoms emerge, and if conducted sufficiently quickly can prevent onward transmission from secondary cases. This study has been conducted to find challenges and mitigation strategies in contact tracing during the COVID-19 pandemic. Methodology: A cross-sectional descriptive study was conducted among health care professionals involved in contact tracing using an online questionnaire. The participants were asked about challenges faced during contact tracing and the usefulness of mitigation strategies. Results: A total of 302 health care professionals with a mean age of 34.69 ± 5 years participated in the study. Various strategies employed by agencies during contact tracing included measures to reduce stigma, community participation, and the use of digital tools and technology. Among the most common challenges faced by the study participants, 68% felt contacts being unreachable a major challenge, while 54.3% found difficulty in contact identification. Approximately 39% of doctors, 26% of nurses, and 17% of paramedical staff faced language/communication problems. Conclusion: Training health care professionals on the key aspects of contact tracing, the use of the latest technology, mitigation of stigma by health education may help in overcoming challenges during contact tracing in the COVID-19 pandemic.

With the advent of the World Wide Web, there are numerous online platforms that generate huge amounts of textual material, including social networks, online blogs, magazines, etc. This textual content contains useful information that can be used to advance humanity. Text summarization has been a significant area of research in natural language processing (NLP). With the expansion of the internet, the amount of data in the world has exploded. Large volumes of data make locating the required and best information time-consuming. It is impractical to manually summarize petabytes of data; hence, computerized text summarization is rising in popularity. This study presents a comprehensive overview of the current status of text summarizing approaches, techniques, standard datasets, assessment criteria, and future research directions. The summarizing approaches are assessed based on several characteristics, including approach-based, document-number-based, Summarization domain-based, document-language-based, output summary nature, etc. This study concludes with a discussion of many obstacles and research opportunities linked to text summarizing research that may be relevant for future researchers in this field.

Background: On March 30, 2020, coronavirus disease 19 was declared pandemic and many countries of the world started working on the development of vaccine soon after China released the genetic structure of severe acute respiratory syndrome coronavirus 2. Drugs Controller General of India on January 3, 2021, accorded emergency use authorization to Oxford-AstraZeneca's ChAdOx1 nCoV-19 vaccine and vaccination drive commenced in India on January 16, 2021. The present study was conducted to determine the incidence adverse event following immunization (AEFI) among recipients of the first and second dose of the vaccine. Materials and Methods: A longitudinal descriptive study was conducted among 2529 vaccine beneficiaries who were asked about the side effects at 24 and 72 h after the first dose and second dose of vaccination with ChAdOx1 nCoV-19 vaccine. Passive surveillance was also done for 4 months. Results: AEFI was reported in 27.59%, 38.4%, and 19.96% of vaccines after both doses, first dose, and second dose, respectively. 14% did not report any AEFI with either dose of vaccine. Younger people had higher rates of AEFIs with both the doses. Pain at injection site and fever

Objectives: The objective of the study was to assess impact of quarantine on lifestyle behavior and the psychological state of persons during the COVID-19 pandemic. Study Design: This study was a cross-sectional study. Methods: A questionnaire-based cross-sectional study was conducted among 216 persons quarantined during the COVID-19 pandemic at home or in selected facilities set up by various tertiary care hospitals and administrative authorities in various parts of India. The questionnaire was distributed among participants using electronic media. Psychological state during quarantine was assessed using the DASS 21 questionnaire. Results: Out of 57.4% of responders who gave a history of physical exercise before quarantine, 52.7% reported a reduction in physical activity. 18.5% of study participants brought about dietary changes towards healthy diet during quarantine, while 24.5% took up some new activities or hobbies. 62.9% of respondents reported any degree of psychological stress (depression, stress, or anxiety) during the quarantine. Conclusions: Quarantine impacted psychological state of individuals and brought about changes in lifestyle with both positive attributes such as dietary modification toward healthy diet or negative attributes such as reduction in physical activity. IEC activities have a positive impact in terms of reducing negative attributes and increasing the compliance toward quarantine.

Background: The COVID-19 pandemic has affected almost 100 million people worldwide. Although the disease spectrum has still not been fully understood, there have been the reports of the persistence of symptoms well beyond the acute stage or after discharge from the hospital. Therefore, there is a need to document the persistence of symptoms to identify and provide physical as well as psychosocial support for ensuring the complete recovery of COVID-19 survivors. The present study examines the postacute stage persistence of symptoms in severe acute respiratory syndrome-coronavirus-2 patients. Materials and Methods: A longitudinal follow-up study was conducted on 1170 patients discharged from COVID hospital. All the study participants were contacted after discharge and at 7-day intervals for 42 days, and details of the persistence of symptoms were sought from them. Results: It was found that 43.8% of patients had persistence of symptoms, and 12.4% had symptoms even after 30 days of discharge from the hospital. Among symptoms, the most common persisting symptom was found to be fatigue (26%) followed by respiratory difficulty. The presence of comorbidity (odds ratio 1.61, 95% confidence interval 1.56–2.25, P < 0.01) and moderate/severe disease were found to be independent risk factors for the persistence of COVID-related symptoms. Conclusion: The findings of the study indicate that a large number of COVID-19 survivors continue to suffer from COVID-19 symptoms well after the recovery from the acute stage (discharge from hospital). Therefore, there is a genuine need for instituting measures for the monitoring of patients postdischarge and if required providing treatment to those having persistent symptoms of COVID-19.

Kasurdi Health and Demographic Surveillance System (Kasurdi HDSS) was established at Rural Health Training Center Kasurdi on February 16, 2018. Kasurdi HDSS has been established to increase the research potential of medical colleges and develop real-time data for research purposes to study the changes in population demography, health, and health-care utilization. Kasurdi HDSS currently follows 2755 individuals living in 549 households. The system collects the data from the population through annual rounds conducted by postgraduate residents of the department of community medicine. The data are collected in the digital format with the help of android-based tablets. HDSS has collected demographic data, reproductive data, data on diseases such as tuberculosis and noncommunicable diseases, and socioeconomic data. The HDSS is in the process to upgrade its data management system to a more integrated platform, coordinated and guided by national/international standards, and data sharing policy.

Background: Coronavirus disease-2019 (COVID-19) has protean clinical presentation, influencing almost every organ. The number of COVID-19 patients with acute kidney injury (AKI) is expanding, and the incidence of kidney injury in COVID-19 patients with severe disease is higher than in patients with mild disease. Objectives: The objective of the study is to find out the association of AKI with COVID-19 deaths. Methods: A case–control study was designed with a total of 172 patients. This included 92 death cases and 80 discharged cases in a dedicated COVID-19 hospital, critical care and fully intensive care unit equipped, in the peak of the second wave of COVID pandemic. Various biochemical parameters and inflammatory markers were studied to find out the mortality indicators in these severe COVID-19 cases. Results: Significantly elevated AKI markers such as urea (mean 58.5 vs. 37.1, P < 0.05), uric acid (mean 5.67 vs. 4.18, P < 0.05), and blood urea nitrogen (mean 26.9 vs. 17.3, P < 0.05) were detected in the death group compared to discharge group. This was accompanied by significantly elevated markers of inflammation such as total leukocyte count (TLC) (mean 16082 vs. 12100, P < 0.05), interleukin (IL-6) (mean 194.9 vs. 58.7, P < 0.05), C-reactive protein (mean 28.45 vs. 9.73, P < 0.05), and ferritin (mean 761.4 vs. 608.2, P < 0.05) in the death group. Conclusion: Significant AKI was noticed in the death group and AKI was further positively correlated with inflammatory markers C-reactive protein, ferritin, IL-6, d-dimer, and TLC levels.

Introduction: Contact tracing is an essential public health response to infectious disease outbreaks, principally in the early stages of an outbreak when specific treatments are limited. Importation of novel coronavirus (SARS CoV-2) from Hubei province China and elsewhere into the world highlights the need to recognize the power of contact tracing as a preventive measure. This study was performed to estimate the SARS CoV-2 transmission among the contacts of confirmed cases of coronavirus disease-19 (COVID-19). Methods: The present study included data from contact tracing performed on confirmed COVID-19 cases admitted in the tertiary care hospital of western Maharashtra. Contacts were categorized into high-risk and low-risk contacts. Contacts were quarantined in home or institute, and reverse transcription–polymerase chain reaction (RT-PCR) was done as per the COVID-19 testing strategy. Contacts were admitted once they were RT-PCR-confirmed COVID-19 positive. Results: Out of 471 COVID-19 cases, 104 (22.08%) were females and 367 (77.92%) were males. A total of 2617 contacts were traced with the mean (standard deviation) of 5.56 (8.52). Of these 2617 contacts, 289 (11.04%) contacts became RT-PCR-confirmed positive COVID-19 cases. Out of 471 COVID-19 cases, 271 (46.7) were the contacts of RT-PCR-confirmed COVID-19 cases, and from them, 92 (42.4%) were asymptomatic at the time of admission. Conclusion: The contact tracing strategy in India helped to identify a sufficient proportion of infected individuals, and due to that, subsequent spread of the disease could be prevented. However, the complete achievement will depend on the rapid detection of cases and isolation of contacts. With the increasingly large number of cases globally once in between the null period, this strategy can be effectively utilized to contain the spread of disease.

Background: Awareness of dog bite-related rabies in rural population of developing countries, including India, can lead to reduction in mortality from dog bite. The present study was conducted to know the general awareness pertaining to dog bite and rabies, antirabies vaccines, and health services utilization in a rural community. Also, to ascertain the first-aid measures adopted after dog bite and to know the opinion regarding control of dog population. Methods: The study was conducted as a community-based cross-sectional study in the rural field practice area of a Medical College in Western Maharashtra among the age group of 30–40 years using pretested questionnaire. Results: A total of 108 respondents participated in the study. Of the study participants, 37 (34.3%, 95% confidence interval [CI]: 25.3%–44%) participant were aware of rabies. Only 19 (17.59%, 95% CI: 11%–26.1%) participants were aware of the symptoms of rabies. Only 20 (18.5%, 95% CI: 11.7%–27.1%) participants would like to apply first-aid measure and 85 (78.7%, 95% CI: 69.8%–86%) participants will visit to doctor, and rest responded as doing nothing. Of the participants, 66 (61.11%, 95% CI: 51.3%–70.3%) were aware of antirabies vaccine and 77 (71.1%, 95% CI: 61.8%–79.6%) responded that dogs should be caught and taken away from locality, whereas the rest responded that dogs should be sterilized as a control measure. Conclusions: The gaps in knowledge, attitude, and practice with respect to prevention and control of rabies need to be addressed by educating the rural population. The present study reflects the need for making the rural population aware about the disease, vaccination, and first aid.

Background: The COVID-19 pandemic commenced in China in December 2019 and has since become a major public health problem. India, as a country, faced many challenges in preparing for the coronavirus pandemic. Due to the novelty of the disease, high infectivity rates, and constant risk of health-care workers (HCWs) getting infected, the training of the first responder, including primary care physicians, in the management of COVID-19 is paramount importance. This study analyses the benefits of a short training session imparted to HCWs involved in a makeshift COVID-19 hospital. Methodology: A structured training program consisting of lectures and workshops was formed for the HCWs detailed for the COVID-19 hospital. A questionnaire was prepared and administered to HCWs pre- and post-training sessions. Paired t-test was used to determine the mean difference, and P < 0.05 was taken as statistically significant. Results: A total of 260 HCWs participated in the study. The doctors gained the most in the critical care aspect, especially in oxygen requirement for the patient and knowledge of oxygen delivery by various apparatuses. The nurses showed a significant improvement in knowledge regarding recommended drugs for severe COVID cases (P < 0.05). Conclusion: HCWs are required to man the COVID facility at very short notice. The article showed the utility of short, structured, and quick training for HCWs. Regular training sessions are important in this regard, and there is a requirement for standardization of the training program and curriculum.

Aim: The aim of the study was to correlate environmental changes with coronavirus disease 2019 (COVID-19) cases in four metropolitan cities. Methodology: Data on monthly cumulative new cases, monthly average temperatures, humidity, precipitation, and average monthly air quality index (AQI) levels for the four Indian cities – Chennai, New Delhi, Mumbai, and Kolkata, and biomedical waste (BMW) quantity at national level were abstracted for the period from March 2020 to December 2020. Results: An inverse correlation was observed between temperature and transmission of the disease in New Delhi and Kolkata which was of fair degree for New Delhi (r = 0.299, P = 0.402) and poor for Kolkata (r = 0.200, P value = 0.579). Positive correlation of fair and poor degrees was observed between temperature and transmission of the disease in Mumbai (r = 0.272, P = 0.448) and Chennai (r = 0.196, P = 0.588), respectively. A positive correlation was observed between the transmission of the disease and humidity in New Delhi, Mumbai, and Kolkata, which was of moderate-to-good degree for Mumbai (r = 0.729, P = 0.017) and poor for New Delhi (r = 0.242, P = 0.501) and Kolkata (r = 0.123, P = 0.735). A significant positive correlation was observed between the rise in COVID-19 cases and the quantity of BMW generated (r = 0.88, P = 0.009). Furthermore, significant improvement in air quality AQI in four metros and water quality biological oxygen demand/chemical oxygen demand of Yamuna river was observed. Conclusions: Understanding of the interplay of environmental meteorological factors on COVID-19 disease transmission and vice versa is necessary for better informed policy framing and future research.

Introduction: The present study was conducted for vaccine effectiveness in the prevention of mortality among moderate to severe COVID-19 cases. Methods: The study was conducted in a dedicated COVID-19 hospital in Northern India from April 2021 to June 2021. Only moderate and severe COVID-19 cases were admitted to the hospital. All patients with the outcome (recovery or mortality) till 30 June 2021 constitute the study population for the study. The study is designed as a case-control study. The outcome was mortality due to COVID-19. The control group was cases who have recovered. The exposure was vaccination status. The data about the age, sex, and vaccination status including the type of vaccine was collected from the case sheets. Results: A total of 735 participants were recruited, out of which 409 patients survived and 326 patients died due to COVID-19 in the hospital. The mean age was 52.80 years (SD = 14.1 years) in the cases group and 60.92 years (SD = 14.97 years) in control group (P = 0.001). 137 (33.50%) were female and 272 (66.50%) were male in the control group while in cases 134 (41.10%) were female and 192 (58.90%) were male (P = 0.03). A total of 473 (64.35%) patients were unvaccinated, 199 (27.07%) were partially vaccinated, and 63 (8.57%) were fully vaccinated. Among the patients who survived, 101 (24.69%) were partially vaccinated and 28 (6.85%) were fully vaccinated; in the cases group, 98 (30.06%) people were partially vaccinated and 35 (10.74%) were fully vaccinated. On multiple regression analysis, there was no association between vaccination status and mortality among moderate and severe cases. Conclusion: The present study brought out that there is no association between vaccination and mortality among moderate to severe COVID-19 cases admitted to the makeshift hospital in Delhi.

Background: Despite the low level of clinical evidence in hydroxychloroquine (HCQ) favor, it was prescribed for pre- and post-exposure prophylaxis in India and worldwide. In absence of a large randomized control trial, the evidence needs to be generated through observation study, hence the study was conducted to find the evidence for prophylaxis of HCQ. Materials and Methods: A multi-centric cross-sectional study involving government hospitals was chosen for serosurvey conducted from August 21, 2020, to November 20, 2020. Questionnaire was adopted from WHO. Data about chloroquine (CQ) use among health-care workers (HCWs) were added and the duration of CQ intake was also noted. Results: A total of 2,224 HCWs were recruited. The mean duration of time of taking HCQ was 7.1 weeks (standard deviation ± 6.1 weeks, median = 4 weeks with IQR, 3–10 weeks). Training on personal protective equipment (PPE), knowledge of handwashing, direct care to the patient, availability of alcohol hand rub, close contact with the patient, duration of contact, and usage of PPE were associated with HCQ intake. The antibody formation in group taking HCQ was 16.9% compared to 19.8% not taking it (P = 0.08). The Chi-square for linear trend for weeks of HCQ intake and antibody formation. However, the same was not statistically significant (Chi-square = 3.61, P = 0.06). Conclusion: Our study did not find a statistically significant association in the large multicentric study. The absolute difference of 2.9% in the two groups may not be sufficient to warrant its widespread use for prophylaxis.

Background: The coronavirus disease-2019 (COVID-19) pandemic has introduced new ethical challenges in the care of patients and people who may have been exposed to severe acute respiratory syndrome coronavirus-2 or have mild to moderate COVID-19. Refusal to get tested for COVID-19 and having poor adherence to infection prevention protocols are the areas of concern for the ongoing pandemic. Such situations increase the risk of infection to other patients and staff. The factors affecting testing refusal were studied with the help of the Google questionnaire. Methodology: The cross-sectional survey tool was developed and distributed after pilot testing. The study population was selected using mix sampling method, snowball, and random sampling using the mobile number of the participants. All the participants were informed about the purpose of the study and included after taking consent. Results: Of the 176 study participants, the majority were male (112, 63.6%), with a mean age of 37.2 years (standard deviation 10.4). Forty-one (23.3%) were health-care workers and 74 (42.1%) were private company employees. Seventy-one (40.3%) refused to get tested for COVID-19 when asked whether they will get tested in the presence of any COVID-19 symptoms and 81 (46.8%) refused to get tested in the absence of any symptoms. Conclusion: Health policy-makers should utilize the study results to formulate the policy regarding any future pandemic to reduce the level of stigma associated with an unknown disease. These clarifications and excuses asked to the study participants are meant to provide a deeper understanding to address the pandemic better.

Introduction: The world is enveloped with the coronavirus disease 2019 (COVID-19) Pandemic with modern medicine and public health facing their most significant challenges ever posed. As the number of COVID-19 cases increased worldwide, an important issue of concern was the continuation of routine immunization services for children. This study has been conceptualized to assess the effect of the COVID-19 pandemic on infant Immunization. Materials and Methods: This study was a descriptive study conducted in an urban community amongst healthy children

Background: Healthy adulthood thrives on the foundation of a healthy childhood. Earlier studies show different morbidity patterns and prevalence of under-nutrition in children studying in Government primary schools. The present study was undertaken to explore the morbidity pattern and nutritional status of children studying in a government primary school in the field practice area of Rural Health Training Centre of a medical college in Pune, Western Maharashtra. Methodology: A cross-sectional study was done in a Government Primary School during January–February 2019. A total of 134 school children studying in classes 1st to 7th underwent anthropometric measurements, medical examination, dental examination, and haemoglobin estimation to bring out the common morbidities present in children of school-going age. School records of the past 6 months of the academic year 2018–19 were used to know the prevalence of absenteeism among the subjects studied, and an attempt was made to find any association between absenteeism and under-nutrition among school children. Results: Out of 134 children, 26 (19.4%) were stunted, 51 (38.64%) were underweight, and 2 (1.49%) were found to be obese. Dental caries was found in 73 (54.48%) pupils, and it was the commonest morbidity found. Eighty-six (64.18%) of the examined school children were anemic. Thirty-five (26.12%) had ear problems, skin problems were found in 35 (26.12%), 6 (4.48%) had refractive errors, and 2 (1.49%) were having Tachycardia. An association was found between abesentism and underweight (P = 0.02). Conclusions: The present study found that under-nutrition is present among children studying in a rural Government school despite the mid-day meal programme being implemented in the school. Targeted interventions may be planned for undernourished children to improve their nutritional status, and more studies are required to assess their health needs and problems.

Besides being limited in quantity, conventional energy sources also emit toxic gases. The Photovoltaic (PV) Solar System is one of the most energizing green energy sources. Around the globe, solar panels are being installed on barren land as well as on the roofs of buildings to generate electricity. An education institute in northern India recently took a step in this direction by installing a grid-tied 100 kWp solar power plant. The installed PV panels are tilted at an angle of 30° and mounted on the roof of the building. The actual PV plant system’s performance differs from the performance under laboratory conditions. Hence, performance evaluation of real outdoor plants becomes essential, especially when the plant is commissioned in different situations, such as roof-mounted systems. Many softwares can estimate the plant’s performance evaluation, but their reliability is not yet proven. This paper examines the performance evaluation of grid-tied PV plants between January 2019 and December 2019 in accordance with the IEC 61724 standard. Moreover, the results of the actual plant have also been compared with the results from the PV*Syst software that simulates the real-time behavior of the plant. Further, in order to evaluate the power plant’s performance, this paper analyzes the various parameters of the PV plant, including reference yield, final yield, and performance ratio of the PV plant. An evaluation of the module’s performance indicates that it has produced 101.57 MWh of energy over 1 year, with a performance ratio of 0.60. It is evident from the comparative analysis that rooftop solar panels are an economically viable and technologically feasible means of providing electricity in the northern parts of India. By taking such measures, the institutes or offices can protect the environment and save money by becoming microgrids. The proposed project provides a roadmap for installing rooftop photovoltaic plants in populated cities without occupying additional land.

Introduction: Demographic indices known as the age-heaping indexes were used to explore the patterns of age misreporting in a multicentric survey. Methods: The data of 3252 individuals were analyzed, and measurement of errors in age for the sampled data has been evaluated by Whipple's Index (WI), Myer's Blended Index, and United Nations Age–Sex Accuracy Score which comprises Sex Ratio Score, Male Age Ratio Score (ARS), and Female ARS. Results: Out of total 3252 participants, 828 (25.5%) were female. The mean statistical division age of our population was 34 (8.5) years and ranged from 15 to 65 years. The percentage of female ages ending with digits 0 or 5 is 23.55% and percentage of male ages ending with digits 0 or 5 is 23.28%. The calculated WI was 117.75 and 116.34 for males and females, respectively. The calculated Myer's Index for females and males is 10.53 and 25, respectively. Conclusion: The study provides evidence that probably age-heaping bias is less of problem in the conducted study.

Abstract Background Intussusception is the one of the commonest causes of intestinal obstruction requiring urgent attention in early childhood. There is no gold standard of non-operative reduction. We report our 6 years’ experience in non-operative reduction using our “RIGHT” (Reduction of Intussusception under General anesthesia using Hydrostatic Technique) technique, emphasizing the need to perform the procedure in the operating room (OR) under general anesthesia. This prospective observational study covering the period from July 2014 till May 2020 included patients diagnosed with intussusception. Hydrostatic reduction was performed in the OR under general anesthesia by infusing a saline enema and the reduction was confirmed by ultrasound. Results Forty-eight patients underwent reduction using the RIGHT technique. Successful reduction was achieved in 44 (91.6%) patients. Four (8.3%) patients needed surgery, three (6.2%) due to failed reduction and one (2.0%) due to perforation. One (2.2%) patient developed a recurrence. Conclusions The “RIGHT” technique is a combination of the best available techniques of reduction of intussusception. It ensures patient safety by being performed in the OR, being pain free, avoiding radiation, avoiding the risk of aspiration associated with sedation, and also being able to immediately address a failure of reduction or a complication by surgical exploration.

Abstract Background The Santhal tribe in Assam, India use the roots of Asparagus racemosus (Asparagaceae) as a deworming remedy. The study aimed to investigate the anthelmintic credentials of this plant, using two representative groups of helminth parasites. Methods The in vitro testing was conducted against Hymenolepis diminuta (cestode) and Syphacia obvelata (nematode). Parasites were exposed to 10, 20 and 30 mg/ml concentrations of plant extract, and efficacy was adjudged on the basis of parasites paralysis and mortality. In vivo efficacy was examined using H. diminuta-rat and S. obvelata-mice models where animals were administered 125, 250 and 500 mg/kg doses of extract. Results In vitro assay, against H. diminuta revealed that at 30 mg/ml concentration the extract showed almost a comparable efficacy with that of reference drug praziquantel (PZQ) (1 mg/ml). The in vitro efficacy of extract against S. obvelata was however lower than H. diminuta. In vivo studies against H. diminuta at 500 mg/kg revealed 53.88 and 24 % reduction in eggs per gram (EPG) and worm counts respectively. Against S. obvelata the extract showed 26.61 and 30.93 % reduction for the same. Conclusions The findings of this study present suggest that the roots of A. racemosus are effective against intestinal helminthic infections and justifies its use as an anthelmintic in the traditional medicine of the Santhals.

Abstract Background Betulinic acid (BA) and ursolic acid (UA) are two major phytoconstituents of Houttuynia cordata Thunb., (Saururaceae) which is used as an anthelmintic in the traditional medicine system of the Nagas in Nagaland, India. This study evaluates their toxic potentials using rodent models (Swiss albino mice and Wistar rats) according to the OECD (Organization for Economic Cooperation and Development) guidelines. Acute and 28-day sub-acute oral toxicity studies were conducted, and evaluations were made based on biochemical, hematological, and histopathological observations. Results Acute oral toxicity study revealed the oral LD50 of both the test compounds to be > 2000 mg/kg in mice. Sub-acute administration of BA at 10 mg/kg body weight (b.w.) revealed a significant increase in serum glutamic oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP), urea concentrations and eosinophil and lymphocyte counts in rats. Animals administered with 10 mg/kg b.w. UA revealed elevated neutrophil count, SGOT, ALP, and urea concentrations, whereas white blood cells (WBC), lymphocyte, and platelet counts were found to be low. Histopathological examinations of body organs revealed alterations in the architecture of the liver, kidney, and spleen tissues. Notably, all these alterations were recoverable as evident in the satellite group, indicating a recovering pattern from the toxic effects caused by the oral administration of these phytocompounds. Conclusion Although UA and BA possess several therapeutic properties, their long-term usage can cause mild toxicity in their users. This study also paves way for evaluating the optimum effective and safe dose of these phytocompounds.