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The prescription of antibiotics empirically without confirmation of an infective etiology is on the rise. Administration of appropriate antibiotics can be guided by real‑time fluorescence imaging using a point‑of‑care device. These composite images show the presence, type and the burden of infection. The time saved by this method over microbiological testing, especially in resource‑poor settings, can lead to a paradigm shift in treatment by facilitating prompt and adequate antimicrobial therapy, surgical debridement as well as follow‑up. Thumbnail sketches of a series of four cases highlighting different scenarios in which a fluorescent imaging device utilizing artificial intelligence and machine learning was found useful is presented in this report. [ABSTRACT FROM AUTHOR]

Purpose: To estimate the prevalence of blindness and severe visual impairment (SVI) by using a door-to-door screening and vision center (VC) examination strategy in an urban area in western Maharashtra (Pune), India and repeat the exercise after 4 years to study its impact.Methods: Four trained community health workers measured the visual acuity and performed an external ocular examination in patients' homes. People with vision <6/18 were requested to visit the VC for a comprehensive eye examination by an optometrist. An ophthalmologist examined people whose vision did not improve to 6/12. A home examination was done for people who did not visit the VC despite two requests. The same population was examined twice in an interval of 4 years.Results: In the study, 44,535 people in 2015-16 and 98.14% (n = 43,708) of them in 2018-19 were examined. Blindness (vision < 3/60 in better eye), and moderate-to-severe visual impairment (MSVI, vision 6/18-6/60 in better eye) were 0.26% and 1.3%, respectively, in the first cohort, and 0.16% and 1.1%, respectively, in the second cohort (P < 0.001). When the worse eye was considered, the prevalence of blindness reduced from 0.72% to 0.44%, SVI reduced from 0.1% to 0.07%, and MVI decreased from 1.7% to 1.49% between 2015 and 2019 (P < 0.001). Females (P < 0.001) and older individuals (P < 0.001) were more likely to have blindness or SVI. In the VC, 8211 people were examined in 4 years.Conclusion: The reduction of blindness and MSVI in the urban area of Pune can be partly ascribed to the presence of a VC and attendant screening in this locality. [ABSTRACT FROM AUTHOR]

Background: WHO declared SARS‑CoV‑2 infection as pandemic on March 11, 2020. As cases recovered, it became important to know the rate of re‑infection from the same virus and its severity. Therefore, the study was done to find out re‑infection rate among the previously infected individuals. Aim: To find out re‑infection rate among already exposed and nonexposed individuals. Materials and Methods: A cohort study was done over 5000 previously serosurveyed individual. They were followed up via telephone. Data was collected using a questionnaire with questions regarding infection postserosurvey, severity of infection among relatives and vaccination status. Thus information collected was uploaded in Google form. Results: Re‑infection rate among previously exposed individuals was 1.2%; at the same time period, 6% of nonexposed individuals got infected. All the re‑infection cases were mild, whereas 80.74% of individuals who got infected for the first time had mild symptoms. Exposure to SARS-CoV-2 in relatives who were staying with participants was found to be 3.23% and 4.22% among previously exposed and non-exposed individuals respectively. 17% of previously nonexposed individuals were fully vaccinated, whereas 0.65% of exposed individual got fully vaccinated. Conclusion: Re‑infection rate in the study was less and mild on the basis of severity. Infection rate among the nonexposed was at a higher side stating that chances of getting re‑infected are much lesser. Previously exposed individuals did not show the same type of interest for vaccination compared to previously nonexposed individuals. [ABSTRACT FROM AUTHOR]

Background: Aging has become greatest challenge globally. In developing countries including India elderly population (persons aged 60 years and above) is projected to outpace the rich world resulting in 50-80 percent of them expected to be staying in resource constraint countries. By 2050 of the total population more than 20 percent will be elderly. Depressive illness associated with dementia is one of the important problems in elderly. With increase in longevity there will be sharp rise in old age dependency ratio which can drain the resources in any country due to expenditure on health, social security and education. Aim & Objectives: The present study was carried out to assess the extent of degree of depression in elderly and study the associated factors like economic dependency. Material and Methods: Randomly selected subjects were administered the questionnaire of Geriatric Depression Scale (GDS), in the Geriatric Clinic of a tertiary care hospital, to categorize them based on the scores, into mild, moderate and severe. Some of the factors were studied and analysed to find out their association with depression like working status, socioeconomic status and economic dependency. Results: Proportion of elderly having depression was 52.4% with females outnumbering males. Depression seems to be more in those elderly who were not working, were from low socioeconomic status and not having pension as 38.6% who had no pension were depressed. Moderate to severe depression was more in economically dependent (20%) as compared to those who were independent financially. Conclusion: Economic dependency seems to be important associated factor responsible for depression in elderly along with other factors like socioeconomic status, pension status etc. Implementation of adequate health services and social security system is needed to prevent the marginalization of elderly. [ABSTRACT FROM AUTHOR]

Background: Baby-friendly Hospital Initiative (BFHI) is a vital intervention supported by World Health Organization and UNICEF to reduce infant mortality and has been included as a part of the curriculum in nursing and medical courses. To know the extent of knowledge of students about BFHI along with its understanding and to find out the gap in their knowledge about BFHI steps. Methods: A descriptive cross sectional study was carried out among the nursing (4th year) and medical students (3rd year MBBS) about ten steps of BFHI by a pretested and predesigned questionnaire. After ethical clearance, information was collected about their awareness and correct understanding concerning ten steps. Results: A total of 102 (51.6%) medical and 96 (48.4%) nursing students comprising of 57 (28.8%) males and 141 (71.2%) females were interviewed, had similar mean score about the ten steps of BFHI. Female respondents 82.3% had best understood the step 2 (training), as compared to males 80.7%. About step 6 (no supplements) 94.3% females and 86% males had well understood the step. Step 7 (rooming in) was known to 85.8% females and 54.4% males respectively. Step 9 (no pacifiers) was known to 80.1% females while among males 56.1% were aware. There was statistically significant difference in their knowledge about the steps 2 and 4 (skin to skin), 5 (counseling), 7, and 9 as females were more aware about these steps than males. The least understood steps in medical and nursing students were step 1 (written policy) (15.7%, 15.6%), step 3 (prenatal education) (27.5%, 29.2%), step 8 (cues) (10.8%, 24%) and step ten (community support) (8.8%, 11.5%) respectively. Conclusions: BFHI is one of the successful international efforts undertaken to promote, protect and support breast feeding. Acquiring knowledge about the same by medical and nursing students is most crucial tool for better practices by them in the future. Continued medical education, workshops and seminars by lactation specialists in addition to the regular teaching about BFHI as part of the curriculum may be considered to ensure and update their knowledge about BFHI. [ABSTRACT FROM AUTHOR]

Background: Tobacco use in different forms has become a growing public health problem. It contributes to increased non communicable disease burden. Females tend to use smokeless tobacco in various forms. Material and methods: It was a cross sectional study conducted in the fi eld practice area of Rural Health Training Centre of Dr. D Y Patil Medical College, Pimpri, Pune. Pretested, semistructured proforma was used to collect the information regarding the age of initiation and reasons for its use and other parameters of mishri use after taking informed consent from women >10 years of age . At the end of the study all the subjects were given active education in group setting. Results: Total 256 rural women were studied. 59.8% were <45 yrs, majority were Hindu, married and housewives. 50.4% belonged to joint families, 46.1% from nuclear families. Majority (55%) were from socioeconomic class II and III. 38% initiated its use from 11 to 20 yrs, 49% left it on teeth for a duration of less than 5 minutes, 38% of them used the amount as 1 tsf per day while another 37% used the amount as 1-2 tsf of mishri per day. 45.3% gave reasons for initiation of mishri as to clean teeth. Reasons for continuing use were noted as experienced a kick, gave energy, relieved tension, etc. Positive correlation was observed between quantity of mishri used at a single time and age as well as with duration of use (r = 0.258, P < 0.001 and r = 0.335, P < 0.001 respectively). Conclusion: There is a need to make the rural women aware about hazardous effects of use of mishri through health education sessions to wean them out of this addiction. [ABSTRACT FROM AUTHOR]

Background: The nutritional status of under five children in urban slums is an important health indicator for assessing the health status of entire population and one of the major predictors of child survival. Objective: A nutritional survey was carried out in September- October 2012 in the field practice area of a medical college in Pimpri, Pune area with an objective to assess the nutritional status of under-five children. Materials and Methods: All the under five students in the field practice area of the medical college were examined. A total of 658 children were examined. Results and Conclusion: It was observed that the prevalence of under weight 34.3% (226/654) (30.7 to 38.0 C.I.), stunting 58.7% (386/654) (54.9 to 62.4 C.I.) and wasting was 16.9%(109/654) (14.0 to 19.7 95% C.I.). The prevalence of under weight 37.6% (114/303) and stunting 61.4% (186/303) was more in girls whereas wasting was more in boys 18%.(64/355) [ABSTRACT FROM AUTHOR]

Background: It is believed that all suffer from chickenpox infection in their childhood. Many studies abroad and some in India clearly indicate that many individuals escape the infection in childhood, and thus, remain susceptible in adulthood. Adulthood chickenpox is a more serious infection than childhood. Prior screening of health care workers for the presence of IgG antibodies against Varicella will not only prevent hospital outbreaks but also economic and academic loss faced by the students. This will also have an important implication in terms of patient care as there is a threat of spreading Varicella to immuno-compromised patients. Definite history of prior infection of chickenpox is considered as an indicator for immunity towards the same. However, the reliability of this needs to be tested. Aim: A study to assess the susceptibility of nursing and medical students towards Varicella infection by screening for IgG antibodies against Varicella virus and to identify any risk factors for the same. Settings and design: A hospital-based cross-sectional study in nursing and medical students. Materials and Methods: Total 78 nursing and medical students participated in the study. They were given prestructured and pretested questionnaires. After obtaining informed consent, blood sample was collected and screened for the presence of IgG antibodies against Varicella by Enzyme Linked Immunosorbent Assay (ELISA) by using a commercial kit. Statistical analysis: Epi_info 2002 was used for analysis. Age of the study subjects were summarized as mean age and standard deviation. Susceptibility was analyzed as percentage with 95% confidence interval and Chi Square test was used to find association of susceptibility status with sex and region of residence in childhood. Relevance of definite history as an indicator for immunity was assessed by calculating sensitivity, specificity, positive and negative predictive values with 95% confidence interval. Results: Twenty males (25.6%) and 58 females (74.4%) participated in the study from medical and nursing students. The mean age ± standard deviation of mean was 19.4 ± 1.42 years for female students and 20.8 ± 2.13 years for male students. Total 20 (25.6%) students were found to be susceptible to Varicella with the confidence interval ranging from 15.8% to 35.4%. With respect to the gender of the students, the difference between the susceptibility percentage in female students (32%) and in male students (14.3%) was only a numerical difference and not statistically significant (χ2 = 2.098, P=0.147, d.f. = 2). Also, the susceptibility was seen significantly more among Keralite students (Pearson Chi-Square=16.736, d.f=6, P=0.008; Likelihood Ratio=15.086, d.f=6, P=0.035; Fisher's Exact Test=13.569, p=0.022). The sensitivity of definite history of prior chickenpox infection as an indicator of immunity was only 55.17%, with C.I ranging from 43.9% to 66.4%, specificity was 80%, with C.I. ranging from 70.9% to 86%, and positive predictive value was 88.8% with C.I of 81.7% to 89% and negative predictive value of history of 66.6% with C.I. of 56% to 77.2%. Conclusion: Total 20 (25.6%) students were found to be susceptible to Varicella with the confidence interval ranging from 15.8% to 35.4%. Thus, there is a need for vaccination of all susceptible individuals. Definite history of prior chickenpox infection is not a reliable indicator of immunity against the same. The investigators recommend screening for IgG antibodies against Varicella of all students selected for the M.B.B.S. (Bachelor of Medicine and Bachelor of Surgery) and nursing course, and vaccination for susceptible individuals to prevent institutional outbreak and academic loss. [ABSTRACT FROM AUTHOR]

Pemphigus vulgaris (PV) is a chronically relapsing intraepidermal immunobullous dermatosis characterized by the presence of painful oral lesions and flaccid blisters in a seborrheic distribution (Zakka, Shetty, & Ahmed, [7]). The scalp lesions of PV can be particularly recalcitrant to treatment, probably due to the presence of abundant desmogleins 1,3 and their pathogenetic antibodies within the hair follicles (Sar-Pomian, Rudnicka, & Olszewska, [4]). [Extracted from the article]

Background: Treatment delays increase adverse treatment outcome of tuberculosis (TB). It is necessary to identify reasons behind such delays in different phases of anti-TB treatment (ATT). Objective: To study treatment seeking behavior (TSB) and risk factors for treatment delays among TB patients. Materials and Methods: New smear positive (NSP) pulmonary TB patients initiated on category one regimen of directly observed treatment short course (DOTS) at 24 DOTS centers (N = 156) in E-ward of Mumbai Municipal Corporation (MMC) were interviewed using pre-tested semi-structured schedule, which was designed to elicit the TSB and factors associated with treatment delays. Results: Median duration of cough with expectoration before consulting a provider was 8 weeks (min = 1, max = 96 weeks). Risk factors for patient delay were age <45 years, living without family. Mean provider delay was 17.91 (SD = 18.026, range = 7-99 days). First approach to the private sector for the treatment was associated with provider delay. Mean delay to start continuation phase (CP) was 18.46 days (SD = 16.292) (min = 4 days, max = 67 days). Delay to go for sputum microscopy, to collect reports, delay in reporting, supposed that treatment is completed as felt better were the reasons to delay to start CP. It was associated with migration, smoking, alcoholism, living away from family, social stigma involving hiding the disease from spouse and relatives. Conclusion: Risk factors identified for treatment delays were age <45 years, lack of family support, first approach to the private sector, migration, addictions and social stigma. Strengthening Revised National TB Control Program by operational research to involve the private sector, improving transfer procedures for migrants, creating public awareness to remove stigma and transport of patients and/or their sputum samples from DOTS centers to microscopy centers may be considered to decrease treatment delays. [ABSTRACT FROM AUTHOR]