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Introduction: Telemedicine has emerged as a crucial healthcare tool, especially during the COVID-19 pandemic, offering risk-free contactless communication between physicians and patients. In India, the introduction of official guidelines in 2019 and initiatives like the “e-Sanjeevani” national teleconsultation portal have accelerated telemedicine’s adoption. However, the utilization and satisfaction levels of telemedicine services in Institutes of National Importance (INI) remain underexplored. OBJECTIVE: This mixed-method study aims to describe the utilization of telemedicine services at the All India Institute of Medical Sciences (AIIMS), Rajkot, an INI in western India, and assess patients’ satisfaction with these services. Methods: Data was collected from patients availing telemedicine services through the e-Sanjeevani portal at AIIMS Rajkot between February and December 2022. Quantitative analysis included patient demographics, specialty attended, location, call duration, and wrong call rates. Qualitative analysis involved interviews with patients to assess their experiences and satisfaction levels. Statistical analyses were performed using SPSS for quantitative data and Atlas Ti for qualitative data. Results: A total of 12,442 doctor-to-doctor and 7,876 patient-to-doctor consultations were recorded, with a diverse age distribution (21-40 years, 45.4%). Most patients were from medical specialties, with general medicine, Pulmonary Medicine, and Dermatology being the highest. The data revealed a wide geographic distribution, with over 70% of cases from more than 200 kilometers away. Despite some challenges, including a 38.2% wrong call rate, the telemedicine services were well-received, with 96% of respondents reporting overall satisfaction. Conclusion: Telemedicine services at AIIMS Rajkot have shown high user satisfaction and accessibility, highlighting their potential in improving healthcare delivery and access, particularly in remote areas. However, efforts to enhance digital literacy and address challenges are necessary for further optimization of telemedicine services.

Objectives We verified subnational (state/union territory (UT)/district) claims of achievements in reducing tuberculosis (TB) incidence in 2020 compared with 2015, in India.Design A community-based survey, analysis of programme data and anti-TB drug sales and utilisation data.Setting National TB Elimination Program and private TB treatment settings in 73 districts that had filed a claim to the Central TB Division of India for progress towards TB-free status.Participants Each district was divided into survey units (SU) and one village/ward was randomly selected from each SU. All household members in the selected village were interviewed. Sputum from participants with a history of anti-TB therapy (ATT), those currently experiencing chest symptoms or on ATT were tested using Xpert/Rif/TrueNat. The survey continued until 30 Mycobacterium tuberculosis cases were identified in a district.Outcome measures We calculated a direct estimate of TB incidence based on incident cases identified in the survey. We calculated an under-reporting factor by matching these cases within the TB notification system. The TB notification adjusted for this factor was the estimate by the indirect method. We also calculated TB incidence from drug sale data in the private sector and drug utilisation data in the public sector. We compared the three estimates of TB incidence in 2020 with TB incidence in 2015.Results The estimated direct incidence ranged from 19 (Purba Medinipur, West Bengal) to 1457 (Jaintia Hills, Meghalaya) per 100 000 population. Indirect estimates of incidence ranged between 19 (Diu, Dadra and Nagar Haveli) and 788 (Dumka, Jharkhand) per 100 000 population. The incidence using drug sale data ranged from 19 per 100 000 population in Diu, Dadra and Nagar Haveli to 651 per 100 000 population in Centenary, Maharashtra.Conclusion TB incidence in 1 state, 2 UTs and 35 districts had declined by at least 20% since 2015. Two districts in India were declared TB free in 2020.

Introduction: All 26 antiretroviral treatment (ART) centers of Gujarat were monitored by Gujarat State AIDS Control Society under the National AIDS Control Program. A comprehensive tool is needed to identify gap in service delivery and to prioritize monitoring visits. Objectives: To supplement the existing monitoring system, identify strengths/weakness of ART centers, and give recommendations. Methodology: Scorecard was developed in spreadsheet format with 17 scoring indicators on monthly base from March 2014 onward. The centers were classified in three color zones: green (score ≥80%), yellow (score

Introduction: In preparation for future waves of H1N1 influenza, determining the correlates of the severity of disease may be very important. Methodology: A retrospective, descriptive study was carried out at the Civil Hospital, Gandhinagar which included all the deceased patients of Influenza A H1N1 from 1st January 2015 till 31st March 2015. The admission history and their medical records including certified cause of death of all deceased H1N1 patients were collected and assessed for clinico-epidemiological details. Result: Mean age of fatal cases was 51.4 years, male to female ratio was 1:0.9 and 68% resided in Gandhinagar rural area. Majority (68%) were referred from private hospital. Almost 50% of the deceased had some form of comorbid conditions. Fever (78.9%), breathlessness (73%) and dry cough (73.7%) were reported mainly among the deaths due to H1N1. Median time, from onset of symptoms to date of admission was 4 days; whereas that from admission to death was 2 days. Conclusion: Adult age, residing in rural area, delayed referral from private practitioner, presence of comorbid conditions were found to the few reasons associated with deaths due to H1N1.

Introduction: Malaria continues to be a great health problem in some of the most populated areas of the world & continues to cause significant morbidity and mortality worldwide. The hematological abnormalities that have been reported to consistently with malaria are anemia, thrombocytopenia, atypical lymphocytosis and infrequently disseminated intravascular coagulation. Methodology: This cross sectional study was conducted in central hospital laboratory of a tertiary care hospital of Surat, Gujarat. The laboratory confirmed cases of malaria from August to October, 2012 were included in the study. Hematological profile of different spices of malaria was compared. Results: The difference in mean platelet count according to severity of infection was highly statistically significant according to ANOVA test both for P.Vivax and P.Falciparum. Platelet counts show decreasing trend according to severity of infection. Difference in the mean haemoglobin level and mean platelet counts of P.Vivax cases and P.Falciparum cases was also statistically significant. Conclusion: The low level of platelet can be used as predictor of severity of the infection. And thus, prediction of the hematological changes enables the clinician to establish an effective and early therapeutic intervention in order to prevent the occurrence of major complications.

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Introduction: Sigmoid volulus is by far the most common type of volvulus, accounting for 75 to 90 % of all volvulus. Most common presenting symptom is abdominal pain and constipation. . It may be initially managed by sigmoidoscopy or rectal tube insertion but where fear of compromised vascular supply of the sigmoid colon is associated, immediate laparotomy after resuscitation must be undertaken to avoid gangrene and septic shock. The primary objective of the study is to demonstrate the most suitable procedure for management of patients with sigmoid volvulus needing emergency surgery. Methodology: All patients presenting with volvulus and needing emergency operative intervention during 1 years duration from January 2010 to December 2011 were included in this study. Total 41 patients were included in the study of which 25 presented with gangrenous sigmoid colon on laparotomy and viable sigmoid colon was present in the remaining 16 cases. Comparison is done with respect to mortality and early morbidity associated with different operative procedures. Results: Highest mortality i.e. 33.3% observed among patients who underwent primary resection and anastomosis without proximal colostomy. Wound infection was more common following all forms of stoma procedure. Conclusion: Hartmann’s procedure goes a long way in decreasing mortality due to sigmoid volvulus in the emergency setting.

Background: Biomedical waste consists of solids, liquids, sharps, and laboratory waste that are potentially infectious or dangerous and are considered biomedical waste. It must be properly managed and safely disposed. Methodology: Cross-sectional study design, consisting of participant observation and interviews, among 20 health centres of Surat Municipal Corporation area. Results: Our study shows number of bags having inappropriate content was maximum in red bags (50.0%). Among the medical officers and nurse, knowledge regarding proper bag for collection of cotton gauze pieces and empty box is better than all other article. Conclusion: Healthcare waste management should be supported through appropriate education, training and the commitment of the healthcare staff, management and healthcare managers.

Background: Thyroid is an endocrine gland located below the larynx. The principal thyroid hormones are thyroxine (T4), tri-iodothyroxine (T3). The current study was carried out to investigate the impact of age, gender and seasons on the level of Thyroxine (T4), Triiodothyronine (T3) and Thyroid Stimulating Hormone in individuals free of thyroid diseases. Methods: - Serum levels of T3, T4 and TSH in 198 individuals attending Dhiraj General Hospital in different seasons were examined. Hormonal assay was done by using AIA 360 immunoassay. Results: - Levels of T3, T4 and TSH ranged from 0.98-4.8ng/dl, 0.56-3-25ng/dl and 0.01-5.3μIU/L. There is significant change in thyroid hormone levels in both genders of different age group in different seasons. Conclusion:- It is concluded that the age, gender and seasons have an appreciable effects on the levels T3, T4 and TSH.

Background: Vitamin B12 is a biologically active corrinoid, a group of cobalt containing compounds with macrocyclic pyrrol rings. Vitamin B12 deficiency is characterized by megaloblastic anemia, fatigue, weakness, constipation, loss of appetite, and weight loss. Neurological changes, such as numbness and tingling in the hands and feet, can also occur. Materials and Methods: Records of the patients who tested for vitamin B12 during April 2011 to September 2011 were analyzed. Secondary data on vitamin B12 level, age, sex, referring unit, religion and dietary history of these patients were obtain from hospital records. Results: Gender did not appear to contribute towards the B12 deficiency according to our study. Vegetarian dietary habit was found to be a substantial risk factor for B12 deficiency

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HIV infection and AIDS is more prevalent in India and occurs in all states.2 Today, there are around 2.5 million people living with HIV/AIDS in India.1 Surat city in the western state of Gujarat attracts a very large migrant population. As most of them belong to sexually active age group, their exposure to sex workers or having multiple sexual partnerships is very high. The aim of this study was to explore the sexual behavior among textile factory workers in Surat and assess the knowledge and awareness about mode of transmission of HIV. This cross-sectional study of 250 textile workers reveals that 76.4% worker know that HIV can be transmitted by unsafe sexual route while 43.2% of workers does not know that HIV can be spread through reused injections. 43 workers currently had extra marital or premarital sexual relations and among them 48.8% had used condom during last such intercourse.