Search

Introduction: In India, even with planned health services, it is difficult to reach the health goals without community participation. While Community needs assessment approach (CNAA) tools like Focussed group Discussion (FGD), Village mapping and matrix ranking have been effective in quickly gathering information, surveys have been conventionally preferred. Aim & Objective: The present study compares qualitative and quantitative methods t o understand feasibility of using CNAA tools in place of survey as an alternative tool Methodology: Mixed Method research employing Survey and CNAA methods of FGD, Village Mapping, transect walk and Matrix ranking score was carried out as a part of academic activity of National Service Scheme(NSS). Data was represented in form of percentages and frequency tables. Association was measured using Chi Square using Epi Info TM version 7.2.1software. Results: Using quantitative survey, we found that 71% used piped supply and 93.1% of the households used toilets. But 6.9% of them still preferred open fields for defecation. Amongst the participants of FGD, it was found that 90% participants preferred going to government hospitals. Comparable data found for variables like Maternal and child health indicators, Sanitation practices and burden of Non communicable diseases. Partially comparable results were found for burden of communicable diseases. Conclusion: CNAA research tools demonstrated comparability with survey in most areas of health concern and reduced the time required for conducting research without compromising the quality of results [ABSTRACT FROM AUTHOR]

Background: Anxiety disorders are common in children and contribute to adverse developmental outcomes. Although etiological models of child anxiety have identified various environmental factors, very few studies in India have examined these factors in children presenting with anxiety disorders. Therefore, the present study was designed to examine parenting styles, parental personality, and child temperament in children with anxiety disorders in an Indian outpatient setting. Methods: In total, 42 children with anxiety disorders and 42 typically developing children, matched on age and gender, were screened using Child Behavior Checklist, Color Progressive Matrices, and Screen for Child Anxiety Related Emotional Disorders Parent version. Their parents were screened using Mini International Neuropsychiatric Interview 5.0, following which they filled the questionnaires for parenting styles, parent personality, and child temperament. Results: There were significant differences between the two groups on parenting style, parent personality, and child temperament. Anxiety disorder was positively associated with the father's permissiveness and negatively with the mother's authoritativeness and child's sociability. A combination of parenting styles and child temperament explained 69% of the variances in child anxiety disorders. There were significant associations between parental personality, child temperament, and parenting style. Parent and child characteristics explained 14%–46% of the variances in parenting styles. Conclusion: Results of this study are generally consistent with Western studies outlining the influence of child temperament and parenting styles on child outcome and have important implications for clinical management of anxiety disorders. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is a major global public health issue. In India, access to medicines is poorly regulated and therefore antibiotics in dairy cattle are commonly used by farmers without consulting with veterinarians. This study was conducted to understand practices and knowledge related to antibiotic use and AMR among dairy farmers and veterinary professionals in selected urban and peri-urban areas of India. A total of 28 focus group discussions with farmers and 53 interviews with veterinary professionals were carried out. Mastitiswas identified as the main animal health challenge. Antibiotic consultation behavior of farmers depended on the availability of veterinarians. Except in Bangalore, farmers were found to often treat animals on their own. They were found unaware of the concept of AMR, but knew the importance of vaccination. Veterinarians included in the study had a good understanding of antibiotics, AMR, and zoonotic diseases. The knowledge level and practices observed in the study related to the use/abuse of antibiotics can potentially increase the risk of development of AMR and its transfer in the community. Our findings can help support AMR – mitigation efforts in the country, including the design of better policies on antibiotic use in dairy. [ABSTRACT FROM AUTHOR]

Objectives The objective of this study was to compare the effectiveness of fluoride, essential oil ( EO) and chlorhexidine ( CHX)-containing mouth rinses on dental plaque and gingivitis and to compare their relative efficacy in patients with and without dental caries. Material and methods A randomized, controlled, double- blind, crossover clinical trial was conducted for a period of 8 weeks. Thiry-six qualifying subjects, aged 12-44 years, were included in the study. Subjects were divided into caries and caries-free groups and were randomly assigned to one of the following mouth rinse groups: fluoride; EO; CHX and saline as negative control. Subjects used their respective mouth rinse for a period of 7-days each with 1-week wash-out periods. Primary efficacy variables were Quigley-Hein plaque index ( PI) and Loe and Silness gingival index. Results Fluoride and CHX mouth rinses showed significant reduction in plaque after use of mouth rinses ( P < 0.05). However, no significant differences were observed with respect to each other in reducing gingivitis ( P > 0.05). Further significant differences were found in reducing plaque and gingivitis in caries-free subjects in comparison to those with caries ( P < 0.05). Conclusion All the three mouth rinses significantly reduced plaque accumulation and gingivitis especially in caries-free subjects in comparison to those with caries, and amongst the three, fluoride and CHX proved to be more effective than EO mouth rinse. [ABSTRACT FROM AUTHOR]

Purpose: To identify and report the perceived barriers to the provision of low vision services among ophthalmologists in India.Methods: Seventy nine ophthalmologists responded to a structured self-administered questionnaire. Information was collected to understand the level of awareness and barriers/constraints to provision of low vision services. Significant factors associated with each barrier/constraint and perceptions on providing low vision care were investigated.Results: Lack of training/knowledge [65 (82.3%)], lack of awareness [59 (74.7%)] and non-availability of low vision devices [57 (72.2%)] were perceived as the major constraints / barriers to providing low vision care. At least one significant factor was found for each of the above constraints/barriers in providing low vision care. The perception of lack of awareness as being one of the constraints/barriers was significantly higher [OR 3.97 (95% CI, 1.02 - 7.8)] among ophthalmologists from organisations providing low vision services. The perception of lack of motivation as constraint/barrier was significantly higher [OR 3.62 (95% CI, 1.3 - 10.3)] among ophthalmologists from organisations providing low vision services and/or those involved in VISION 2020: The Right to Sight programmes [OR 3.83 (95% CI, 1.4 - 10.4)]. The likelihood of responding that low vision care is time consuming was greater for those belonging to a teaching institute [OR 7.19 (95% CI, 2.0 - 26.1)], those involved in low vision services [OR 5.45 (95% CI, 1.8 - 16.5)] and those who knew that low vision is a priority in VISION 2020 [OR 15.1, 95% CI, 1.5 -155.4].Conclusion: Ophthalmologists need more education about the benefits of low vision care in order to increase their level of awareness and knowledge. [ABSTRACT FROM AUTHOR]

aimed to be an effective antibiotic on Gram-negative bacteria (GNBs) causing urinary tract infections (UTIs) in Pondicherry in Southern India. Monotherapy of fosfomycin is not recommended due to chances for development of resistance during therapy is a serious concern2 therefore the authors suggested using fosfomycin with amoxyclav and nitrofurantoin.1 Researchers reported fosfomycin as the most effective antibiotic inhibiting 100% E. coli, 70% Klebsiella sp., and 50% Pseudomonas sp. and 40% Enterobacter sp. isolates from UTIs. Fosfomycin was also effective against extended-spectrum β-lactamases (ESBL), carbapenemase and AmpC1 producers. A recent report from Bareilly3, Northern India indicated E. coli as the most common bacteria associated with UTI infections both in humans and animals similar to the report from Pondicherry.1 However, the report from Northern India reported only that only 12.9% and 33.3% isolates of GNBs associated with UTIs in humans and animals were susceptible to fosfomycin. The study3 reported that only8.3% and 25% of E. coli isolates from UTI cases were susceptible to fosfomycin. The two studies1,3 concurred (Table 1) each other concerning the efficacy of meropenem and nitrofurantoin but contradicted each other for the susceptibility of E. coli isolates (Table 1) and other GNBs from UTIs to other antibiotics. View the original paper by Gopichand and colleagues A Response to Letter has been published for this article [ABSTRACT FROM AUTHOR]

Highly pathogenic avian influenza (HPAI) outbreaks have repeatedly occurred in two districts of Kerala state, India, over the last few years. The outbreaks in the wetland areas coincided with the arrival of migratory birds. At the time, the factors responsible for local transmission in ducks were not known. This study aimed to identify the socio-economic factors responsible for spatial variation in the occurrence of HPAI outbreaks in the two districts using Bayesian network modelling (BNM) and Stochastic Partial Differential Equation (SPDE) model. Further, information was collected on the duck rearing practices in rice paddy fields to identify the risk factors for local - spread of the outbreaks. We found that the SPDE model without covariates explained variation in occurrence of outbreaks. The number of rice paddy fields used by the duck farmers was identified as risk factor. We concluded based on BNM and SPDE that the infected migratory birds were the source of infection for the first few duck farms in the wetland areas and subsequent transmission was driven by shifting of ducks from one rice paddy field to other fields. There is a probability of persistent and recurrent infections in the ducks and possible spill over to humans. Hence, it is important to have surveillance in ducks to prevent recurrent outbreaks in the region.

Background: The current severity assessment measures for nomophobia have issues related to clinical applicability, which makes them difficult to be consistently applied in the Indian context. We aimed to develop a valid and reliable instrument for the assessment of severity of Nomophobia., Methods: This study was a two-phase, exploratory sequential mixed method design conducted across three centres in India. The development of the questionnaire included identification of the domains and items, inputs from experts and refining the questionnaire. EFA was carried out to check the internal consistency among items. CFA was carried out to test the factor structure of ISAN. Concurrent validity with NMP-Q was ascertained. Convergent and discriminant validity were tested using bivariate correlation analysis., Results: The qualitative findings from the initial exploration were developed into 27-item ISAN reviewed by experts for content validity. EFA showed that the questionnaire has good internal consistency (Cronbach's alpha reliability coefficient = 0.934) with a five-factor pattern matrix. CFA explained five-factor structure (Digital compulsion, Digital Intensement, Digital Obsession, Digital Detachment Distress and Digital Engagement) was deemed to be the most tenable comprising of 21 items. ISAN fits good on all indices (CMIN/df = 2.44, CFI = 0.93, RMSEA = 0.05, TLI = 0.92, IFI = 0.93) for the five-factor structure. Concurrent validity with NMP-Q was good (r = 0.695). Good to moderate associations were noted for the convergent (r = 0.985) and discriminant validity (r = -0.560) respectively., Conclusion: ISAN (Indian Scale for Assessment of Nomophobia) is an accurate and reliable instrument that can measure nomophobia in the Indian youth population., Competing Interests: Declaration of competing interest I, hereby, submit a manuscript for full length article section titled “Factor structure, Reliability and Validity of an Indian Scale for Assessment of Nomophobia (ISAN) among College Students: A Multicentre Indian Study”. All the authors have contributed substantially in the work and there is no conflict of interest in reporting this study. This paper has not been published or simultaneously submitted or already accepted for publication elsewhere. We hope that the manuscript meets the scope and interest of the journal., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Despite the large number of children in India, there is little information on the impact of children's disability on school enrolment, and how this differs by population. We estimated the prevalence of childhood disability in two sites in Tamil Nadu, southern India, and the effect of functional difficulty on school enrolment. We used a parent-reported survey containing the UNICEF-Washington Group questions to identify children aged 5 to 17 years with functional difficulty during a census conducted for an ongoing trial. We estimated pooled- and gender-specific prevalence of functional difficulty among 29,044 children. We fitted regression models to identify subgroups with higher rates of functional difficulty and the effect of functional difficulty on reported school enrolment. We estimated the modification of the effect of functional difficulty by age, gender, socioeconomic status, household education, and sub-site, on additive and multiplicative scales. We found of 29,044 children, 299 (1.0%) had any functional difficulty, equal among boys and girls. Being understood (0.5%) and walking (0.4%) were the most common difficulties. Functional difficulty was strongly associated with non-enrolment in school (Prevalence ratio [PR] 4.59, 95% CI: 3.87, 5.43) after adjusting for age, gender, and site. We show scale-dependent differences between age and socioeconomic groups in the effect of functional difficulty on enrolment. This study shows that at least one in a hundred children in this region have severe functional difficulties and nearly half of these children are not enrolled in school, highlighting the need for further efforts and evidence-based interventions to increase school enrolment among these groups., Competing Interests: Declarations. Ethics Approval and Consent to Participate: The DeWorm3 Project was reviewed and approved by the Institutional Review Board at Christian Medical College, Vellore, India, The London School of Hygiene and Tropical Medicine, and the Human Subjects Division at the University of Washington. The trial is registered at ClinicalTrials.gov (NCT03014167). The functional difficulty assessment was approved as a protocol amendment by the Institutional Review Board at Christian Medical College, Vellore, India and The London School of Hygiene and Tropical Medicine. Written informed consent was sought from the household head for households’ participation in the census and functional impairment assessment. The purpose of the survey and use of the data were explained and informed consent to participate was ascertained before collecting any further information. Consent for Publication: All participants included in this study were informed that their data may be used as part of publications in anonymised form, to which they gave consent. Competing Interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Drug-resistant tuberculosis (DR-TB) is one of the challenging forms of TB to treat, not only in adults but also in children and adolescents. Further, there is a void in the treatment strategy exclusively for children due to various reasons, including paucity of pharmacokinetic (PK) data on anti-TB drugs across the globe. In this context, the present study aimed at assessing the PK of some of the anti-TB drugs used in DR-TB treatment regimens., Method: A multicentre observational study was conducted among DR-TB children and adolescents (n = 200) aged 1-18 years (median: 12 years; IQR: 9-14) treated under programmatic settings in India. Steady-state PK (intensive: n = 89; and sparse: n = 111) evaluation of moxifloxacin, levofloxacin, cycloserine, ethionamide, rifampicin, isoniazid and pyrazinamide was carried out by measuring plasma levels using HPLC methods., Results: In the study population, the frequency of achieving peak plasma concentrations ranged between 13% (for rifampicin) to 82% (for pyrazinamide), whereas the frequency of suboptimal peak concentration for pyrazinamide, cycloserine, moxifloxacin, levofloxacin and rifampicin was 15%, 19%, 29%, 41% and 74%, respectively. Further, the frequency of supratherapeutic levels among patients varied between 3% for pyrazinamide and 60% for isoniazid. In the below-12 years age category, the median plasma maximum concentration and 12 h exposure of moxifloxacin were significantly lower than that of the above-12 years category despite similar weight-adjusted dosing., Conclusions: Age significantly impacted the plasma concentration and exposure of moxifloxacin. The observed frequencies of suboptimal and supratherapeutic concentrations underscore the necessity for dose optimization and therapeutic drug monitoring in children and adolescents undergoing DR-TB treatment., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Prior vaccination is often studied for its impact on individuals' post-infection prognosis. Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) medicines, advised by the Government of India as prophylaxis during the first wave of the coronavirus disease 2019 (COVID-19) pandemic, were consumed by the masses in 2020. A study was therefore undertaken to observe any association between the prior usage of AYUSH prophylactic medicines and post-infection severity as reported by recovered COVID-19 individuals., Methods: This was a retrospective, multi-centre, cohort study conducted in 21 cities of India from 5th August to 30th November 2020. Data from recovered COVID-19 patients, of either sex or any age, captured information about AYUSH prophylactic medicines intake prior to infection, disease severity, symptomatology, duration of complaints, etc. The study participants were grouped into AYUSH intake and non-intake. Primary composite outcome was the disease clinical course. Secondary clinical outcomes were the rate of and time to clinical recovery., Results: Data of 5,023 persons were analysed. Ayurveda or homeopathic prophylactic medicines were consumed by more than half of the study participants: that is, 56.85% ( n  = 1,556) and 56.81% ( n  = 1,555) respectively. The overall adjusted protective effect (PE) of AYUSH prophylactic intake against moderate/severe forms of COVID-19 disease was 56.7% (95% confidence interval [CI], 48.7 to 63.50; p  < 0.001). Adjusted PE for homeopathy and Siddha was 52.9% (95% CI, 42.30 to 61.50; p  < 0.001) and 59.8% (95% CI, 37.80 to 74.10; p  < 0.001), respectively. A statistically significant association was found between AYUSH prophylactic medicine intake and clinical recovery more frequently by the 3rd day of illness (χ 2  = 9.01; p  = 0.002). Time to resolution of symptoms in the AYUSH intake group was on average 0.3 days earlier than in the non-intake group ( p  = 0.002)., Conclusion: AYUSH prophylactics were associated with statistically significant levels of protection against COVID-19 disease severity. Amongst these, previous intake of homeopathy or Siddha medicines was associated with some protection against moderate/severe illness and with a somewhat quicker clinical recovery. Prospective studies with experimental research design are needed to validate the findings of this study., Study Registration: Clinical Trials Registry-India (CTRI/2020/08/027000)., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Objectives: Assessment of diabetes-specific knowledge among children with type 1 diabetes (T1D) and their caregivers using a validated diabetes knowledge test (DKT) and to determine the factors associated with DKT score., Methods: A cross-sectional study was conducted in a tertiary care hospital, New Delhi (India). Children 5-18 years with T1D and caregivers were evaluated using a validated DKT tool to assess knowledge in basic and advance domains. The factors associated with DKT scores were studied., Results: A total of 110 T1D children with mean (SD) age 12.2 (3.3) years and duration 5.3 (2.7) years were assessed. The mean (SD) composite DKT score (%) was 58.0 (11.1) while in basic and advance domains were 66.4 (9.5) and 50.4(1.5), respectively. Maternal education (≥graduate), socio-economic strata (≥upper middle), annual per capita income (>Rs 50,000/700 USD), urban setting and HbA 1c <8.5 % were significantly associated with higher odds of DKT score>50 %. HbA 1c <8.5 % and urban setting were significant predictors of the DKT score on multivariate logistic regression analysis (p<0.001)., Conclusions: DKT can identify individual challenges in specific (basic or advance) domains related to diabetes self-management skills. Higher maternal education significantly impacted achieving a high DKT score and improved glycemic control., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Malignant catarrhal fever (MCF) presents a sporadic yet significant threat to livestock and wildlife. A comprehensive investigation in Karnataka, India into the prevalence and transmission patterns of sheep-associated MCF (SA-MCF) was conducted. A total of 507 sheep peripheral blood leukocyte samples from 13 districts along with 27 cows and 10 buffalo samples from various regions in Karnataka were tested for SA-MCF infection i.e. Ovine gammaherpesvirus 2 (OvHV-2) using heminested PCR. Furthermore, serum samples collected from 73 cows and 15 buffalo suspected of MCF were tested using a commercially available ELISA kit. Additionally, histopathological examinations of affected tissues and phylogenetic analysis of viral tegument protein sequences were conducted. Our findings indicated a 20.11%, 33.33% and 20% positivity for OvHV-2 in sheep, cows and buffalo respectively by PCR. Statistical analysis revealed a significant association between the age of sheep and the detection of OvHV-2. Seven cows and one buffalo serum samples tested positive for ELISA. Clinical findings in bovids were consistent with typical MCF signs, and histopathological results revealed multi-organ involvement characterised by necrotising vasculitis and lymphoid hyperplasia. The nucleotide pairwise identity matrix revealed 99.5% identity between the sequences obtained in the study with sequences from other states. The phylogenetic analysis of partial tegument protein sequences from bovid and sheep samples suggested a close genetic relationship between the local OvHV-2 strains and those from various global regions. Crucially, this study underscores the widespread presence of SA-MCF in Karnataka, with significant implications for both livestock management and wildlife conservation., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Introduction: There is sparse data from India on indications, technical success, safety and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) using standard adult duodenoscope in the pediatric population., Methods: Retrospective analysis of prospectively maintained electronic endoscopy and clinical database was performed to identify pediatric patients (age ≤ 18 years) who underwent ERCP between January 2017 and December 2022. Demographics and procedural details including indications, cholangio-pancreatogram findings, endotherapy type performed, technical and clinical success and complications were noted., Results: As many as 150 pediatric patients were included of whom 88 had pancreatic (mean age-13.7 years) and 62 had biliary disease (mean age- 14.9 years). Common pancreatic ERCP indications were chronic pancreatitis (n = 45 [51.1%]), pancreatic duct disruption fistula (n = 21 [23.9%]) and recurrent acute pancreatitis (n = 16 [18.2%]). Among biliary indications were choledocholithiasis (n = 29 [46.8%]), benign bile duct strictures (n = 13 [21%]), bile duct injury/leak and biliary stent removal (n = 7 [11.3%]) , choledochal cyst (n = 5  [8.1%]) and pancreatic mass causing biliary compression (n = 1 [1.6%]). Technical success in pancreatic and biliary ERCP was 94.3% and 95.2%, respectively, and clinical success was 84.1% and 93.5%, respectively. Most common complications following pancreatic ERCPs were acute pancreatitis (n = 9 [10.2%]) (mild = 5, moderate = 4) patients and post sphincterotomy bleed in one (1.1%). Among biliary ERCPs, post ERCP pancreatitis was seen in (n = 3 [4.8%]) (mild = 2, moderate = 1)., Conclusion: ERCP can be safely and effectively performed in children using standard duodenoscope. Chronic pancreatitis, choledocholithiasis and pancreatic divisum are common pediatric ERCP indications., (© 2024. Indian Society of Gastroenterology.)

Wildlife and natural resources constitute an integral part of the ecosystem, whereas human interventions dismantled the living conditions of the wildlife. This is testified in the Dalma Wildlife Sanctuary (DWS) where the habitats of Asian elephants have changed due to human intervention and deforestation over the decades. The present study aimed to assess the elephant habitat suitability in the DWS of Jharkhand state (India) using the geospatial parameters such as forest density, degree of slope, proximity to water bodies, land use land cover, proximity to agricultural land, built-up density, and road density. The analytical hierarchical process technique was utilized to determine habitat preference and selection of relevant factors to categorize criteria. The study revealed that about 6.7% (26.74 km 2 ) of the area is very highly suitable for elephant habitat, while 52.26% (208.49 km 2 ) of the forest area was found highly suitable. The most suitable habitat was identified in the core parts of the forest, while the least suitable areas were found in the southern part, where the presence of roads, built-up, and agricultural land was prominent. It was also observed that most human-elephant conflicts were exhibited in the low and very low suitable areas, while 90% of the elephant movement was witnessed in the high and very high suitable areas. Among the four identified corridors, three are inactive, and their location corresponds with low to very low suitable habitats. The study identified the migratory corridor routes inside the sanctuary where effective management is required for the conservation of elephant habitats and minimizing conflicts., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Adoption provides a unique opportunity to establish stable family relationships and enhance the social safety net. In India, adoptions are governed by the Hindu Adoption and Maintenance Act, 1956, and the Juvenile Justice (Care and Protection of Children) Act, 2015, each with distinct eligibility criteria. Currently, approximately 33,870 Indian couples are registered as prospective adoptive parents (PAPs), and this number is rising. The Central Adoption Resource Authority (CARA) website lists 2,140 children available for adoption, with 731 being categorized as normal and 1,409 as special needs. CARA, under the Ministry of Women and Child Development, oversees both domestic and international adoptions of legally free orphaned, abandoned, and surrendered children. The scope of adoption has expanded from primarily young infants to include older children, children with special needs, and foster care, in line with the National Child Policy. Pediatricians play a crucial role in the adoption process, understanding medical aspects within the legislative framework and acting in the child's best interests. This involves collaborating with multiple stakeholders, conducting comprehensive pre-adoption medical examinations, and providing ongoing medical and behavioral support post-adoption. This review emphasizes recent changes in adoption practices in India and highlights the evolving role of pediatricians as champions for these children and their adoptive families.

The characteristics of the vegetation fire (VF) regime are strongly influenced by geographical variables such as regional physiographic settings, location, and climate. Understanding the VF regime is extremely important for managing and mitigating the impacts of fires on ecosystems, communities, and human activities in forest fire-prone regions. The present study thereby aimed to explore the potential effects of the confounding factors on VF in India to offer actionable and achievable solutions for mitigating this concurring environmental issue sustainably. A global burn area (250 m) data (Fire-CCIv5.1) and fire radiative power (FRP) were used to investigate the dynamics of VF across seven different divisions in India. The study also used the maximum and minimum temperatures, precipitation, population density, and intensity of human modification to model forest burn areas (including grassland). The Coupled Model Intercomparison Project-6 (CMIP6) was used to predict the burn area for 2030 and 2050 future climate scenarios. The present study accounted for a sizable increasing trend of VF during 2001-2019 period. The highest increasing trend was found in central India (513 and 343 km 2  year -1 in the forest and crop fire, respectively), followed by southern India (364 km 2  year -1 in forest fire), and upper Indo-Gangetic plain (128 km 2  year -1 in crop fire). The FRP has varied significantly across the divisions, with the north-eastern Himalayas exhibiting the highest FRP hotspot. The maximum and minimum temperatures have the greatest influence on forest fires, according to Random Forest (RF) modeling. The estimated pre-monsoonal burn area for 2050 and 2050 future scenarios suggested a more frequent forest fire occurrence across India, particularly in southern and central India. A comprehensive forest fire control policy is therefore essential to safeguard and conserve forest cover in the regions, affected by forest fire periodically., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Leptospirosis and dengue are two significant public health concerns in tropical and subtropical regions, often resulting in severe forms of disease and fatality. This study addresses the pressing public health issues of leptospirosis and dengue in the Dakshina Kannada district of Karnataka, India. Both diseases pose significant health risks and are relatively understudied in this region, making it essential to investigate their prevalence and clinical presentations for targeted healthcare planning., Aim: The primary aim is to determine the frequency of leptospirosis and dengue among febrile illness cases to understand the epidemiological patterns and assess co-infection rates in Dakshina Kannada., Method: Between 2020 and 2021, serum samples suspected of leptospirosis were tested using IgM ELISA (n = 1629) and the Microscopic Agglutination Test (MAT) (n = 92) for leptospirosis, while dengue was tested using NS1Ag and IgM antibodies ELISA (n = 1415). Data were collected through medical records and patient interviews. Seasonal trends, gender, and age distributions were analyzed., Result: The study found a significant prevalence of leptospirosis (21 %) and dengue (10 %) among febrile illness cases in the study area, with a 1.3 % co-infection rate. Clinically, fever was common to both diseases, but leptospirosis also frequently exhibited symptoms such as abdominal pain, myalgia, and jaundice. MAT screening revealed a predominance of anti-leptospiral antibodies against the Djasiman, Pyrogenes, Hurstbridge, Hebdomadis, and Grippotyphosa serogroups in Dakshina Kannada., Conclusion: The study highlights the urgent need for focused public health interventions, improved diagnostic tools, and targeted epidemiological studies to manage these diseases. The findings underscore the necessity of enhancing diagnostic capabilities and public health awareness, particularly considering the significant health risks posed by leptospirosis and dengue in the region., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.)

Introduction: One of the most vexing challenges to public health today is the menace of tobacco. Despite the large body of evidence indicating the vast scale of health hazards, tobacco use continues to be a major cause of preventable death. This study was conducted with the objective of quantifying the progress and challenges of the tobacco control policy of India., Methods: The Tobacco Control Scale (TCS) was used, which has a maximum score of 100 and assesses nine components including, price of cigarettes, smoke-free public and work places, spending on public information campaigns, comprehensive bans on advertising and promotion, large pictorial health warning labels, treatment to help smokers stop, illicit tobacco trade, tobacco industry interference and ratification of the WHO FCTC. The components of the TCS for India were scored based on data obtained from the WHO, Report on The Global Tobacco Epidemic, 2021 and the Cigarettes and Other Tobacco Products Act 2003 and their amendments and the Tobacco India 2023 country profile., Results: The total score for the tobacco control scale placed India at 65 points, scoring highest with respect to 'large pictorial health warning labels', and lower with respect to 'spending on public information campaigns', 'illicit tobacco trade' and 'price of cigarettes'., Conclusions: Strong tobacco control legislation and its equally robust implementation is an affirmative step in achieving the vision of the WHO-FCTC and empowering the world towards being tobacco free.

Objective: To study the association between altered vitamin D profiles and different indices as well as clinical features of polycystic ovary syndrome (PCOS), including antimüllerian hormone (AMH) levels, phenotypes (A [hyperandrogenism {HA} + ovulatory dysfunction {OD} + polycystic ovarian morphology {PCOM}], B [HA + OD], C [HA + PCOM], and D [OD + PCOM]), insulin resistance, oligomenorrhea, hyperandrogenism, obesity indices, and stress biomarkers in the ethnic population of West Bengal., Design: Case-control observational study., Setting: Outpatient department of gynecology and obstetrics and environing., Participants (patients and Control): Sample size: case group (PCOS, n = 160), age: 16-38 years, and their gender, age, as well as ethnicity-matched healthy control (n = 160)., Intervention(s): In this observational study, a structured questionnaire for menstrual status and to determine the scores of cutaneous manifestations, a bioelectrical impedance analyzer for measurement of anthropometric indices, relevant biochemical assessments (vitamin D, AMH, insulin, glucose, and other associated hormonal profiles), statistical software for the social sciences, and Microsoft Office Excel were used to evaluate as well as analyze different indices., Main Outcome Measure(s): Study of the association of vitamin D deficiency with differential manifestations of PCOS such as phenotypes of the syndrome, altered AMH levels, and risk of insulin resistance. An attempt has been made to determine the cutoff value of AMH of the patients with PCOS belonging to the ethnic population of West Bengal using receiver operating characteristic (ROC)., Result(s): Vitamin D deficiency was found to be directly correlated with AMH level in PCOS phenotype A (67%), oligomenorrhea, and PCOM, along with a substantial agonistic relationship with insulin resistance in the PCOS population under study. In the PCOS phenotype B, the AMH level was highest, with a cutoff value of 5.27 ng/mL (asymptotic sig. = 0.000, 95% confidence interval: 8.37-9.95, derived by ROC analysis, with area under the ROC curve- area under the curve value = 0.949, sensitivity=0.882, and specificity = 0.880). Oligomenorrhic women with PCOS possess significantly higher values of AMH levels (8.70 ± 3.66 > 3.09 ± 1.86 ng/mL) level than the regular menstrual rhythm within the same group. Patients with PCOS had significantly less skeletal muscle mass and greater subcutaneous fat content than the control group., Conclusion(s): 25-hydroxy-vitamin D might be intermeshed with the underlying pathophysiology and severity of PCOS, as well as associated metabolic disorders like insulin resistance. The AMH level is finely tuned by most of the plausible effectors of PCOS and contends to be a promising biomarker for the diagnosis as well as prognosis of PCOS., Competing Interests: Declaration of Interests S.C. has nothing to disclose. T.K.N. has nothing to disclose. B.R.B. has nothing to disclose., (Copyright © 2024 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Leptospirosis is a significant zoonotic disease affecting livestock, leading to reproductive issues and economic losses. Despite its endemic status in India, research has predominantly focused on coastal regions, leaving the North Eastern Region (NER) underexplored. This study aims to investigate the seroprevalence and serogroup distribution of leptospirosis in livestock across Assam, a major state in the North Eastern Region (NER) of India. Serum samples (n=811) from cattle, buffalo, sheep, goats, and pigs were collected between 2016 and 2019 and screened using the Microscopic Agglutination Test (MAT) for 24 serogroups. The overall seroprevalence was 22.9 % (186/811), with highest prevalence in cattle (26.2 %) and buffalo (25 %), followed by small ruminants (19.8 %) and pigs (18.6 %) . Notably, uncommon serovars such as Mini (28.8 %), Manhao (12.4 %), and Cynopteri (7.5 %) were identified, indicating a unique epidemiological pattern in Assam. High seroprevalence was observed in districts like Bongaigaon (66.7 %), Kamrup Metropolitan (50.0 %), and Nalbari (40.0 %), emphasizing the need for targeted intervention strategies. The presence of these uncommon serogroups, typically found in neighbouring countries and other regions, suggests potential transboundary transmission from these countries. This study provides valuable insights into the seroprevalence and serogroup distribution of leptospirosis in Assam's livestock, highlighting the need for region-specific surveillance and control measures. These findings underscore the importance of understanding the local epidemiological landscape to develop effective disease management and prevention strategies, ultimately reducing the impact of leptospirosis in the NER of India., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Natural radioactivity measurement, radiation monitoring of the region, dose assessment and interpretation of radiological-related parameters are crucial aspects from the public awareness and environmental safety point of view. The ionising radiations (gamma-rays) emitted from radionuclides such as 226Ra, 232Th and 40K present in environmental materials contributes significantly to the external radiation dose received by the public. High-efficiency gamma spectrometry based on a 4″ × 4″ NaI (Tl) detector was employed for estimating activity concentrations of the gamma-emitting radioelements. The spectra from the detector were recorded using a PC-based 1k multichannel analyser system (WinTMCA 32). Each sample spectrum was acquired for a counting period of 60 000 s (16.67 hr). Assuming the daughter products of 226Ra and 232Th in equilibrium, the activity concentration of these radionuclides were estimated by using the prominent gamma photo peaks of daughter products. Using the same technique, dose-related radiological parameters were calculated for all the samples. The activity concentrations of the radionuclides and the dose-related parameters for the samples were found to be comparable with the global literature values. The data generated from our study will contribute to the baseline radiological data of the region., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Radionuclide activity of the selected radionuclides 238U, 232Th and 40K was measured in surface soil samples collected from 40 villages of the western part of Yadgir district of Karnataka. A 4″ × 4″ NaI (Tl) detector based on a gamma spectrometer is used for the estimation of radionuclides. The major type of soil in this region is sandy and red. The 222Rn activity concentrations in drinking water were determined by the Emanometry method. The 222Rn activity in ground water is found to vary from 1.73 to 155.6 Bql-1. The total annual effective doses because of 222Rn inhalation and ingestion range from 4.72 to 424.84 μSv y-1 with an average value of 108.8 μSv y-1, respectively. Among the sampling stations, Shahapur and Shorapur soil samples show higher activity values than the Kembhavi and Hunasagi sampling stations soil samples., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

The activity concentrations of 238U, 232Th and 40K were found using high-resolution gamma-ray spectrometry on depth profile samples collected from the Kalaburagi districts. This study aims to ascertain the radioactivity Changes concerning the depth profile. With values of 51.64 ± 0.50 Bq kg-1 for 238U, 58.77 ± 0.23 for 232Th and 313.92 ± 3.57 for 40K, respectively, the depth profile samples of Jayanagar in the Kalaburagi region exhibit significant activity concentrations among the measured values. Moreover, estimates of the K/Th and K/U ratios have been made, based on surface-level collected samples, which may have values that differ from the samples under study., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Summary: A cross-sectional, web-based survey was conducted to assess the health-care professionals (HCPs)' perception toward existing medical device postmarket surveillance (PMS) practices in India. A total of 1756 responses (medical practitioners [19.8%], nurses [22.5%], pharmacists [21.4%], and biomedical engineers [13.8%]) were recorded and analyzed. About 71.2% of participants were aware about the ongoing PMS program, 87.5% were aware that medical devices are under regulation in India, and 83.3% were aware about who can report medical device adverse event (MDAE). About 56.3% of participants agreed that they take regular feedback from patients after using high-risk medical device. Majority of participants (69.4%) were aware about tools for reporting MDAE and the online reporting form is the most preferable tool among users. About 76.2% of participants were agreeing that reporting of MDAE is their professional/ethical responsibility. This study reveals that Indian HCPs show a good understanding of PMS practices and a positive perception toward MDAE reporting. However, underreporting still remains a challenge in India., (Copyright © 2024 Copyright: © 2024 Indian Journal of Public Health.)

Background: Effective Cataract Surgical Coverage (eCSC) is a core outcomes domain indicator to assess accessibility and quality of eye care services with limited available information., Purpose: To generate baseline estimates of eCSC for India., Methods: We performed the analysis of data pooled from Rapid Assessment of Avoidable Blindness surveys conducted in 31 districts of India during 2015-2019 among persons aged 50+ years. eCSC was calculated at various thresholds, the primary being operable cataract at best corrected visual acuity <6/12, good outcome at presenting visual acuity of 6/12., Results: Age-sex standardized and weighed eCSC in India was 36.7% (95% CI: 33.6, 39.9), and cataract surgical coverage (CSC) was 57.3% (95% CI: 53.3, 61.2), a relative quality gap in cataract surgery being 36.0%. eCSC in males was higher at 38.0% than females (35.6%). eCSC increased with education from 31.0% in illiterate participants to 59.7% in class 10 educated. On multivariate analysis, rural setting, increasing age, and residence in eastern or northeastern zones of India continued to be associated with poor/worse eCSC, while female gender was associated with higher eCSC. District-wide variations in eCSC were observed., Conclusion: Developmental factors have an important bearing on eCSC in India. Geographical variations point toward the need for targeted, locally relevant strategies., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Mannheimia haemolytica is recognized as principal pathogen associated with pneumonic pasteurellosis leading to huge economic losses to small ruminant farmers. Even though the disease causes huge economic losses, epidemiology of M. haemolytica is less studied, hindering the formulation of effective control strategies. Current study aimed to highlight molecular characterisation of M. haemolytica strains isolated from ovine pneumonic infection. M. haemolytica 27 isolates with two reference strains were characterised using capsular and virulence gene typing, multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) methods. M. haemolytica serotype A2 recognized as predominant serotype (74%) followed by A6 (11%) and A1 (5%) serotypes. Virulence gene profiling by PCRs showed dominance of all five virulent genes [such as adh and gcp (100% each)] followed by gs60 (88.8%), lktC (85.2%), tbpB (51.9%) and least nmaA gene (14.8%). MLST profiling delineated M. haemolytic isolates into 11 sequence types (STs) with most prevalent being ST37 (27.9%) and ST16 (23%) and nine new STs (ST37, 38, 39, 40, 41, 42, 47, 48, and 49). These new STs did not belong to any of the three clonal complexes (CC4, CC8 and CC28). ST16 was exclusively noted in A1 and A6 serotypes. Amongst 25 isolates, 22 pulsotypes (GD 0.88) recorded indicated variability of the M. haemolytica isolates in PFGE analysis. In conclusion, the study suggested dominance of M. haemolytica serotype A2 harbouring different virulent genes, diverse STs and pulsotypes responsible for pneumonic pasteurellosis frequently encountered in sheep., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Acute nondiarrheal illnesses (NDIs) involve overt or subclinical dehydration, requiring rehydration and electrolyte repletion. Dehydration is frequently under-recognized and under-managed, both in outpatient departments (OPDs) and inpatient departments (IPDs). Postadmission dehydration is associated with longer hospital stays and higher inhospital mortality rates. Recognizing and understanding dehydration in hospitalized patients is necessary due to the adverse outcomes associated with this condition. In this article, we aimed to develop practical consensus recommendations on the role of oral fluid, electrolyte, and energy (FEE) management in hospitalized patients with FEE deficits in NDI. The modified Delphi consensus methodology was utilized to reach a consensus. A scientific committee comprising eight experts from India formed the panel. Relevant clinical questions within three major domains were formulated for presentation and discussion: (1) burden and factors contributing to dehydration in hospitalized patients; (2) assessment of fluid and electrolyte losses and increased energy requirements in hospitalized patients; and (3) management of FEE deficits in hospitalized patients [at admission, during intravenous (IV) therapy, IV to oral de-escalation, and discharge]. The consensus level was classified into agreement (mean score ≥4), no consensus (mean score <4), and exclusion (mean score <4 after the third round of discussion). The questions that lacked agreement were discussed during the virtual meeting. The experts agreed that the most common factors contributing to dehydration in patients with NDI hospitalized in IPDs include decreased oral fluid intake, increased fluid loss due to the illness, insensible fluid loss, and a lack of awareness among doctors about dehydration, which can result in poor fluid intake. Time constraints, discontinuity of care, lack of awareness of the principles of fluid balance, lack of formal procedures for enforcing hydration schemes, and lack of adequate training are most often barriers to the assessment of hydration status in hospital settings. Experts used hydration biomarkers, such as changes in body weight, serum, or plasma osmolality; fluid intake; and fluid balance charts; along with urine output, frequency, quantity, and color, to determine hydration status in hospital settings. Experts agreed that appropriate FEE supplementation in the form of ready-to-drink (RTD) fluids can restore FEE deficits and shorten the length of hospital stays in hospitalized patients at admission, during de-escalation from IV to oral therapy, and at discharge. RTD electrolyte solutions with known concentrations of electrolytes and energy are good choices to avoid taste fatigue and replenish FEE in hospitalized patients during transition care and at discharge., (© Journal of the Association of Physicians of India 2024.)

Equine piroplasmosis caused by Theileria equi is a febrile, tick-borne disease of equids. However, there is limited literature about the genotyping of T. equi in India. Blood samples were collected from 202 horses and subjected to microscopy and PCR to detect T. equi. Initially, a universal screening primer pair targeting 18S ribosomal RNA genes common for Babesia caballi and T. equi was employed to amplify the DNA of both parasites. Thereafter additional primers were employed for species-specific detection resulting in amplification of approximately 435 bp specific for T. equi. T.equi was detected in 9.9% and 20.79% of horses screened by microscopy and PCR, respectively. The representative samples confirmed positive by PCR were sequenced, submitted to NCBI (OR651254, OR687254, OR685656, OR650830, OR650834), and used for genotype characterization and phylogenetic analysis. Employing Genetool and MEGA X software, the T. equi Indian isolates and across the globe were compared, and the results demonstrated 99.05-100% and 95.86-100% homologies, respectively. All the T. equi Indian isolates belonged to genotype A. Phylogeny based on the EMA-1 gene of five isolates (OR731831, OR731833, OR731829, OR731830, OR731832) were also characterized by sequencing and support the previous findings. Genotypes C and D, as well as genotypes B and E, exhibited lower levels of evolutionary divergence compared to other genotypes. The EMA-1 gene exhibited limited diversity and might not be the most suitable target for assessing variability within T. equi populations. The findings also reveal a significant association (p < 0.01) between T. equi infection and the presence of ticks., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Approximately 16%-62% of patients undergoing non cardiac surgeries develop postoperative cognitive dysfunction. We compared the incidence of postoperative cognitive dysfunction in older adults aged 60-80 years who underwent open abdominal surgeries under general anaesthesia using isoflurane or desflurane and correlated it with the serum concentration of interleukin 1, interleukin 6, tumour necrosis factor alpha, amyloid β and S100 on postoperative day 3., Method: Forty American Association of Anesthesiologists Physical Classification I or II patients were included after acquiring institutional ethics committee approval, registering in the Clinical Trials Registry - India, and informed written consent. They underwent open abdominal surgery under general anaesthesia and epidurals between 2017 and 2019. Patients with substance abuse or any disorder affecting cognition were excluded. Postoperative cognitive dysfunction was assessed by Stroop test, Wisconsin Card Sorting Test, Trail making test - B, Porteus Maze test, PGI memory scale, mini-mental state examination, and Bender Gestalt test the day before surgery and on the third postoperative day along with blood samples., Results: Thirty-seven percent of the patients developed postoperative cognitive dysfunction. The risk was similar to isoflurane in comparison with desflurane (risk ratio: 0.65, 95% confidence interval: 0.30, 1.40). A significant percentage increase in reaction time for Porteus Maze test and Trail making test - B was noted with isoflurane (6.69 (4.20-8.94) and 8.01 (2.08-12.5), respectively) in comparison with desflurane group (13.01 (9.09-17.33), p = 0.003 and 11.62 (7.5-17.5), p = 0.017, respectively)., Conclusion: Isoflurane and desflurane had a similar impact on the elderly for developing postoperative cognitive dysfunction and no correlation with any of the biomarkers used in the study on postoperative day 3., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Background: Dehydration is a highly prevalent clinical challenge in adults which can go undetected. Although dehydration is commonly associated with an increased risk of hospitalization and mortality, only a few international guidelines provide recommendations regarding oral fluids, electrolytes, and energy (FEE) management in adults/geriatrics with dehydration due to nondiarrheal causes. Currently, there is a lack of comprehensive recommendations on the role of oral FEE in nondiarrheal dehydration in adult and geriatric Indian patients., Materials and Methods: A modified Delphi approach was designed using an online questionnaire-based survey followed by a virtual meeting, and another round of online surveys was used to develop this consensus recommendation. In round one, 130 statements, including 21 open-ended questions, were circulated among ten national experts who were asked to either strongly agree, agree, disagree, or strongly disagree with statements and provide responses to open-ended questions. The consensus was predefined at 75% agreement (pooling "strongly agree" and "agree" responses). Presentation of relevant literature was done during a virtual discussion, and some statements (the ones that did not achieve predefined agreement) were actively discussed and deliberately debated to arrive at conclusive statements. Those statements that did not reach consensus were revised and recirculated during round two., Results: Consensus was achieved for 130/130 statements covering various domains such as assessment of dehydration, dehydration in geriatrics, energy requirement, impact of oral FEE on patient outcome, and fluid recommendations in acute and chronic nondiarrheal illness. However, one statement was not added as a recommendation in the final consensus (129/130) as further literature review did not find any supporting data. Oral FEE should be recommended as part of core treatment from day 1 of acute nondiarrheal illness and started at the earliest feasibility in chronic illnesses for improved patient outcomes. Appropriately formulated fluids with known electrolyte and energy content, quality standards, and improved palatability may further impact patient compliance and could be a good option., Conclusion: These consensus recommendations provide guidance for oral FEE recommendations in Indian adult/geriatric patients with various nondiarrheal illnesses., (© Journal of the Association of Physicians of India 2024.)

Executing global clinical trials for cancer is a long, expensive, and complex undertaking. While selecting countries global studies, sponsors must consider several aspects including patient pool, quality of trained investigators, competing trials, availability of infrastructure, and financial investment versus returns. With a large, often treatment-naïve, and diverse patient pool, relatively low cost, good quality health care facilities in urban areas, and a robust and well-trained workforce, India offers several advantages for conducting oncology clinical trials. However, there remains challenges, including a shifting regulatory environment in recent decades. With the implementation of the New Drugs and Clinical Trial Rules in 2019, India's regulatory atmosphere seems to have stabilized. In this article, we present a review of the evolving clinical trial landscape in India, highlight the current regulatory scenario, and discuss the advantages and challenges of selecting India as a potential location for conducting global oncology clinical trials.

Background: Dehydration due to reduced intake or increased losses including insensible losses in patients with acute nondiarrheal diseases may lead to fluid, electrolytes, and energy (FEE) deficits. The impact of oral FEE supplementation adjuvant to standard of care (SOC) treatment on recovery in patients with acute nondiarrheal diseases is yet to be evaluated., Aim: To determine the effectiveness of ORSL® variants (ORSL® Apple Drink and ORSL® PLUS Orange Drink), fruit juice-based electrolyte drinks as an adjuvant along with SOC in the restoration of oral FEE in patients with acute nondiarrheal disease with fever and/or general weakness who attended an outpatient department (OPD)., Materials and Methods: This was a prospective, interventional, open-label, multicenter, real-world, study conducted at eight sites across India. Patients with fever and/or general weakness due to an acute nondiarrheal illness were given either ORSL® Apple Drink or ORSL® PLUS Orange Drink as an adjuvant along with SOC treatment per physician's discretion. The primary endpoint of the study was to assess improvement from baseline in energy or hydration levels after ORSL® variants consumption at 6, 24, and 48 hours measured by a new aided recovery scale (ARS). Secondary endpoints were to assess the improvement in energy and hydration levels at 20, 40, and 60 minutes, as well as energy levels and hydration levels at 20, 40, and 60 minutes, 6, 24, and 48 hours after the consumption of ORSL® Apple Drink or ORSL® PLUS Orange Drink. The patient's consumption of ORSL® variants and treatment experience, physician's experience of recommending ORSL® variants, and product safety were evaluated., Results: In total, 612 patients were enrolled with mean age 38.3 years, of whom 62.9% were male. The mean baseline level of energy and hydration was 1.59 (range 1.0-2.0) on ARS. Statistically significant ( p < 0.0001) improvements were observed in energy or hydration 6 hours after first consumption of ORSL formulations. Furthermore, improvement was observed from 40 minutes, and in levels of energy, hydration, and both energy and hydration from 60 minutes. Patients and physicians reported a positive experience with ORSL® variants., Conclusion: ORSL® Apple Drink and ORSL® PLUS Orange Drink are clinically proven to provide hydration and/or energy to patients with fever and/or general weakness., (© Journal of the Association of Physicians of India 2024.)

We describe a new species of dragonfly Macromia kannharaiensis sp. nov., based on a male and a female specimens collected from Dodamarg taluka, Sindhudurg district, Maharashtra. The new species belongs to the calliope-group (species group initially discussed by Laidlaw 1922), and it can be distinguished by its congeners on the bases of specific colour pattern on postclypeus, markings on S2 and S8, shape and structure of caudal appendages and accessory genitalia.

Theileria orientalis, the causal agent of oriental theileriosis, is known to cause mild disease in cattle and buffalo across the world. Recently, different genotypes of T. orientalis have emerged as pathogenic, causing high reported morbidity in cattle. This study focuses on investigating three suspected outbreaks of oriental theileriosis that resulted in fatalities among crossbred and indigenous bulls in Karnataka, India. Examination of blood smears revealed the presence of T. orientalis piroplasms within erythrocytes. The genetic characterization of T. orientalis was conducted by targeting specific markers, including the mpsp gene, p23 gene, and ribosomal DNA markers (18S rRNA gene, ITS-1, and ITS-2). Analysis based on the 18S rRNA gene unveiled the presence of both Type A and Type E genotypes of T. orientalis in the outbreaks. The mpsp gene-based analysis identified genotype 7 of T. orientalis in crossbred cows, whereas genotype 1 (Chitose B) was found to be present in indigenous bulls. Haplotype network analysis based on the mpsp gene revealed the presence of 39 distinct haplotypes within the 12 defined genotypes of T. orientalis with a high haplotype diversity of 0.9545 ± 0.017. Hematological and biochemical analysis revealed a decrease in calcium, hemoglobin levels, red blood cell counts, and phosphorus. This study constitutes the initial documentation of a clinical outbreak of oriental theileriosis in indigenous bulls with genotype 1 (Chitose 1B). Substantial epidemiological investigations are imperative to gain a comprehensive understanding of the geographical distribution of distinct genotypes and the diverse clinical manifestations of the disease across various hosts., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Estuaries function as temporary storage sites for plastic debris, influencing the distribution of microplastics (MPs) across ecosystems. This research delves into the presence of MPs in the water, sediment, fish, and shellfish of Ashtamudi Lake, a Ramsar wetland with brackish water located on the southwest coast of India. Given the lake's significance in supporting the livelihoods of numerous fishers and acting as a vital source of fishery resources for both local consumption and export, examining the contamination of the system by MPs becomes particularly pertinent. The highest percentage composition of MPs was found in macrofauna at 60.6% (with fish at 19.6% and shellfish at 40.9%), followed by sediment (22.8%) and water (16.7%). The primary types of MPs identified in all samples were fibers (35.6%), fragments (33.3%), and films (28%), with beads being the least represented at 3.03%. ATR-FTIR and Raman spectra analysis identified five polymers from shellfish (polypropylene, polyethylene, polystyrene, nylon, and polyvinyl chloride), five from fish guts (nylon, polypropylene, polyethylene, polyurethane, and polysiloxane), four in sediment (polypropylene, polyethylene, nylon, rayon), and four in water samples (polypropylene, polyethylene, nylon, and polystyrene). SEM-EDAX analysis of MPs obtained from the samples revealed degradation and the presence of inorganic elements such as Na, Mg, Al, Si, S, K, Cl, P, and Ca, as well as heavy metals like Pb, Mo, Rh, Pd, Ti, and Fe. The existence of these plastic polymers and heavy metals in microplastic samples poses a threat to vulnerable biota; people consume contaminated fish and shellfish, underscoring the importance of monitoring MPs in lake water. This investigation of MPs in Ashtamudi Lake highlights the system's susceptibility to plastic pollution and the bioavailability of smaller MPs to aquatic organisms. Identified sources of MPs in the lake include fishing and aquaculture activities, sewage pollution, improper solid waste management in lake watersheds, and unsustainable tourism. Upstream and downstream management interventions are recommended to address MP pollution in Ashtamudi Lake., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

To effectively control and eradicate PPR, the comprehensive understanding of risk factors associated with PPR exposure is vital. Hence, this study investigated socioeconomic and other associated risk determinants for PPR exposure at flock level in sheep and goats in a non-vaccination programme implemented Madhya Pradesh state India. A total of 410 sheep and goat flocks, comprised mostly of goats but also some mixed flocks, were surveyed during 2016 using a multistage random sampling procedure. Further, 230 blood samples were also collected from the farmers-reported PPR affected flocks and sera were tested using c-ELISA to confirm PPR exposure. The primary data on socioeconomic factors, farm management factors, health status, vaccination details and other epidemiological risk factors were collected from flock owners and descriptive statistics, chi-square analysis and logistic regression models were fitted to identify the significant risk factors for PPR incidence. The farmer's education, flock size, rearing pattern, and awareness of PPR vaccination were found to be significant pre-disposing risk factors for PPR exposure in the flocks. Hence, the control and eradication strategy need to be designed comprehensively considering the key social factors like education and vaccination awareness along with other flock level risk factors to eradicate PPR by 2030 in consonance with the global plan., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Asian countries are facing difficulties in attaining sustainable development goals (SDGs), and India is not an exception to it, with environmental degradation being one of the primary issues. Therefore, a policy-level reorientation may be required to address it. From this standpoint, fiscal policy instruments may come in handy towards fully integrating the SDGs into its agenda. The present investigation designs an SDG framework for India that could serve as an example for other Asian nations. This study introduces a new investigation exploring the relationship between fiscal policy instruments and environmental quality in India by examining the environmental Kuznets curve (EKC) hypothesis from 1990 to 2021. A nonlinear autoregressive distributed lag (NARDL) model is applied for empirical examination. The findings indicate that positive and negative shocks in fiscal policy instruments have significant impact on carbon emissions in both the long and short run. The study has also found evidence of an "inverted U-shape" EKC for India. These results are valuable from a policy perspective for India and other Asian countries to address environmental issues. The study has also outlined potential outcomes that may benefit India's fiscal policy in resolving environmental issues and attaining better economic growth. In the end, the study proposes a policy framework that supports SDG 7, SDG 8, SDG 12, SDG 13, and SDG 17 objectives., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Malaria remains a public health problem in regions of Northeastern India because of favourable bio-geographic transmission conditions, poor access to routine healthcare, and inadequate infrastructure for public health and disease prevention. This study was undertaken to better understand community members' and health workers' perceptions of malaria, as well as their knowledge, attitudes, and prevention practices related to the disease in Meghalaya state., Methods: The study included participants from three malaria endemic districts: West Khasi Hills, West Jaiñtia Hills, and South Garo Hills from 2019 to 2021. A total of 82 focus group discussions (FGD) involving 694 community members and 63 in-depth interviews (IDI) with health personnel and traditional healers residing within the three districts were conducted. A thematic content analysis approach was employed, using NVivo12 software for data management., Results: Most participants reported a perceived reduction in malaria during recent years, attributing this to changes in attitudes and behaviours in health seeking, and to more effective government interventions. Local availability of testing and treatment, and an improved, more responsive health system contributed to changing attitudes. Long-lasting insecticidal nets (LLINs) were largely preferred over indoor residual spraying (IRS), as LLINs were perceived to be effective and more durable. Community members also reported using personal protective measures such as applying repellents, burning neem tree leaves, straw/egg trays, wearing long sleeve clothes, and applying ointments or oils to protect themselves from mosquito bites. While most participants acknowledged the role of mosquitoes in malaria transmission, other conditions that are not mosquito-borne were also attributed to mosquitoes by some participants. The communities surveyed have largely shifted from seeking treatment for malaria from traditional healers to using public facilities, although some participants reported switching between the two or using both simultaneously. Improved understanding of cerebral malaria, which some participants previously attributed to mental illness due to 'bad spirits', is an example of how cultural and ritualistic practices have changed., Conclusion: The findings reveal diverse perceptions among community members regarding malaria, its prevention, practices to prevent mosquito-transmitted diseases, and their opinions about the healthcare system. A key finding was the shift in malaria treatment-seeking preferences of community members from traditional healers to the public sector. This shift highlights the changing dynamics and increasing acceptance of modern healthcare practices for malaria treatment and prevention within tribal and/or indigenous communities. By recognizing these evolving attitudes, policymakers and healthcare providers can better tailor their interventions and communication strategies to more effectively address ongoing needs and concerns as India faces the 'last mile' in malaria elimination., (© 2024. The Author(s).)

The most common measures of childhood undernutrition are based on anthropometric measures such as height-for-age (stunting/chronic undernutrition) and weight-for-height (wasting/acute undernutrition). It is well recognised that the determinants of undernutrition are multiple, including food intake, dietary diversity, health, sanitation and women's status. Currently, most countries across the world including India use the globally accepted WHO-Multicentre Growth Reference Study (MGRS) growth standards (2006) for the purposes of measurement as well as for evaluating progress on these metrics. However, there is some discussion on the universal relevance of these standards, and in the Indian context, whether these standards overestimate the prevalence of stunting, considering differences in genetic potential for growth. This is especially relevant in the context of increasing burden of obesity and non-communicable diseases in India. Based on a detailed review of literature, policy documents and expert inputs, this review paper discusses the relevance of the WHO growth standards for height/stunting, in the context of India. Issues discussed related to the MGRS methodology include pooling of data and intersite and intrasite variability, opting for standards as opposed to references, and external validity. Other issues related to plasticity of stunting and the influence of maternal heights are also discussed, in the context of analysing the appropriateness of using universal growth standards. Based on the review, it is recommended that the current standards may continue to be used until a newer global standard is established through a similar study., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Lumpy skin disease (LSD) is a disease of cattle that is also known to cause mild infection in buffaloes. To date, there have been no reports of LSD in mithun (Bos frontalis), a bovine species distributed in Northeast India, Bangladesh, Myanmar, and parts of China. In the present study, the presence of typical clinical signs, virus isolation, PCR amplification, sequence analysis, and the demonstration of antibodies in serum by indirect enzyme-linked immunosorbent assay and serum neutralization test, confirmed the occurrence of LSD in mithun for the first time in India. Phylogenetic analysis based on the full-length RPO30 and P32 genes of LSD virus from mithun and cattle revealed 100% sequence identity, indicating circulation of the same strain in both species in India and the possibility of spillover between species., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Despite advancements in using multi-temporal satellite data to assess long-term changes in Northeast India's tea plantations, a research gap exists in understanding the intricate interplay between biophysical and biochemical characteristics. Further exploration is crucial for precise, sustainable monitoring and management. In this study, satellite-derived vegetation indices and near-proximal sensor data were deployed to deduce various physico-chemical characteristics and to evaluate the health conditions of tea plantations in northeast India. The districts, such as Sonitpur, Jorhat, Sibsagar, Dibrugarh, and Tinsukia in Assam were selected, which are the major contributors to the tea industry in India. The Sentinel-2A (2022) data was processed in the Google Earth Engine (GEE) cloud platform and utilized for analyzing tea plantations biochemical and biophysical properties. Leaf chlorophyll (C ab ) and nitrogen contents are determined using the Normalized Area Over Reflectance Curve (NAOC) index and flavanol contents, respectively. Biophysical and biochemical parameters of the tea assessed during the spring season (March-April) 2022 revealed that tea plantations located in Tinsukia and Dibrugarh were much healthier than the other districts in Assam which are evident from satellite-derived Enhanced Vegetation Index (EVI), Modified Soil Adjusted Vegetation Index (MSAVI), Leaf Area Index (LAI), and Fraction of Absorbed Photosynthetically Active Radiation (fPAR), including the C ab and nitrogen contents. The C ab of healthy tea plants varied from 25 to 35 µg/cm 2 . Pearson correlation among satellite-derived C ab and nitrogen with field measurements showed R 2 of 0.61-0.62 (p-value < 0.001). This study offered vital information about land alternations and tea health conditions, which can be crucial for conservation, monitoring, and management practices., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Peste des petits ruminants (PPR) presents economic challenges in enzootic countries impacting small ruminant productivity. The state of Karnataka, India, implemented a mass vaccination campaign in alignment with the PPR-Global Eradication Programme (GEP) and the National Strategic Plan for PPR eradication. This study was conducted from January to March 2023 to assess seroconversion in post-vaccinated goats and sheep at the epidemiological unit (epi-unit) level, aligning with the World Organisation for Animal Health (WOAH) and the Food and Agriculture Organization (FAO) guidelines in the PPR Global Control and Eradication Strategy (GCES). Before vaccination, 3466 random serum samples were collected from small ruminants of three age groups (6-12 months, 1-2 years, and >2 years) across 116 epi-units, spanning 82 taluks in 28 districts. Post-vaccination sero-monitoring included 1102 serum samples collected from small ruminants of the 6-12-month age group only, across 111 epi-units covering 64 taluks in 23 districts. The PPRV antibody status was determined using an indigenous hemagglutinin (H) protein monoclonal antibody-based competitive ELISA kit. Pre-vaccination, the PPR seropositivity rates were 55%, 62%, and 66% in the age groups of 6-12 months, 1-2 years, and >2 years, respectively, with a 61% PPRV antibody prevalence across all the age groups. Notably, 41% of the epi-units exhibited antibody prevalence rates of ≥70%, indicating a substantial population immunity, possibly attributed to the previous vaccination program in the state since 2011. In contrast, only 17% of the epi-units had below 30% seroprevalence rates, emphasizing the need for intensified vaccination. Statistical analysis of the data revealed significant correlations ( p < 0.05) between the presence of PPRV antibodies and host factors such as species, breed, and sex. Post-vaccination seroprevalence in the 6-12 months age group was found to be 73.4%, indicating the use of an efficacious vaccine. On the evaluation of vaccination immunity in the 6-12 months age group, it was revealed that over 69% of the epi-units achieved a response surpassing ≥70%, indicating a significant improvement from 42% of the epi-units in pre-vaccination. For active PPR eradication, a mass vaccination campaign (>95% coverage) targeting small ruminant populations aged >4 months is advocated, aiming to achieve the desired herd immunity of >80%. This study offers crucial insights into PPR baseline seroprevalence/immunity status and vaccine efficacy, guiding national strategies towards a PPR-free India and further supporting the global eradication initiative.

The present study investigates the ability of five boosting algorithms, namely Adaptive Boosting (AdaBoost), Categorical Boosting (CatBoost), Light Gradient Boosting (LGBoost), Natural Gradient Boosting (NGBoost), and eXtreme Gradient Boosting (XGBoost) for simulating streamflow in the Lower Godavari Basin, India. Monthly rainfall, temperatures, and streamflow from 1982 to 2020 were used for training and testing. Kling Gupta Efficiency (KGE) was deployed to assess the ability of the boosting algorithms. It was observed that all the boosting algorithms had shown good simulating ability, having KGE values of AdaBoost (0.87, 0.85), CatBoost (0.90, 0.78), LGBoost (0.95, 0.93), NGBoost (0.95, 0.95), and XGBoost (0.91, 0.90), respectively, in training and testing. Thus, all the algorithms were used for projecting streamflow in a climate change perspective for the short-term projections (2025-2050) and long-term projections (2051-2075) for four Shared Socioeconomic Pathways (SSPs). The highest streamflow for all four SSPs in the case of NGBoost is more than the historical scenario (9382 m 3 /s), whereas vice-versa for the remaining four. The effect of ensembling the outputs of five algorithms is also studied and compared with that of individual algorithms.

The construction industry plays a vital role in the economic development of any country. Concurrently, the sector also generates enormous quantities of construction and demolition waste (CDW) that damages the ecology causing environmental pollution and deteriorating human health. Recently, various governments and other organizations realized the importance of implementing construction waste management (CWM) practices to attain sustainability in construction. The current decade can be called a pathway for achieving the 2030 agenda for sustainable development goals in which CWM plays an inevitable role. However, accurately quantifying construction waste is necessary to successfully implement any CDW management plan. A detailed literature review for the current research revealed that limited information on the magnitude of construction waste is available in India. Therefore, the current paper proposes a practically viable model to estimate the waste generation index (construction waste generated per total floor area) of high-rise residential buildings in India. The waste quantification is being done based on the project documents and expert interviews. The methodology is later validated through a high-rise building with G + 18 stories located in Kerala, India. The study indicated that a high-rise concrete framed structure generates 122.3 kg m -2 of waste during construction. It was also noted that, concrete, aggregates and blocks constitute 92% of the total waste generated in the project. The developed model can also be used as a cornerstone for establishing a construction waste database at the regional level., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.