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Background: Slum communities face health risks influenced by environmental, human, and animal health factors, particularly antimicrobial resistance (AMR). Tailored, community-driven solutions are needed to address these multifactorial health determinants. This study explores One Health challenges in urban slums using a Patient and Public Involvement (PPI) approach. Objectives: This study aims to use qualitative methods within a PPI framework to examine the social, environmental, and animal health factors contributing to AMR and other health challenges in urban slums. Focusing on One Health, we engaged slum residents in Jaipur, Jakarta, Antofagasta, and Istanbul through participatory approaches like social mapping and transect walks to identify health risks and develop intervention strategies. Methods: A PPI approach was employed to involve communities in the research process, ensuring culturally relevant insights. Data collection included social mapping, transect walks, and key informant interviews in the four cities, highlighting critical health determinants such as environmental contamination, healthcare access, and animal-related risks. Thematic analysis identified common challenges and intervention opportunities within the One Health framework. Conclusion: The study underscores the importance of PPI in addressing One Health challenges in urban slums and reveals interconnected human, environmental, and animal health risks. Engaging communities fostered trust and provided locally relevant solutions to complex health issues like AMR. Future interventions should be co-designed with communities to address social determinants like sanitation and healthcare access for sustainable outcomes.

Objectives Homelessness among families with children under 5 residing in temporary accommodation is a growing global concern, especially in high-income countries (HICs). Despite significant impacts on health and development, these ‘invisible’ children often fall through the gaps in policy and services. The study’s primary objective is to map the content and delivery methods of culturally sensitive interventions for children under 5 experiencing homelessness in HICs.Design A scoping review guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.Data sources Databases include PubMed, Medline, SCOPUS, The Cochrane Library and Google Scholar were searched up to 24 March 2022.Eligibility criteria This scoping review includes studies that describe, measure or evaluate intervention strategies aimed at improving child health programmes, specifically those yielding positive outcomes in key areas like feeding, nutrition, care practices and parenting.Data extraction and synthesis Articles were selected and evaluated by two independent reviewers, with a dispute resolution system involving a third reviewer for contested selections. The methodological quality of the studies was assessed using various tools including the Risk of Bias (RoB) tool, Cochrane RoB V.2.0, the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), each selected according to the type of article.Results The database search yielded 951 results. After deduplication, abstract screening and full review, 13 articles met the inclusion criteria. Two predominant categories of intervention delivery methods were identified in this research: group-based interventions (educational sessions) and individual-based interventions (home visits).Conclusion This review highlights effective interventions for promoting the health and well-being of children under 5 experiencing homelessness, including educational sessions and home visits. Research has supported the importance of home visiting to be instrumental in breaking down language, cultural and health literacy barriers.

Introduction: Patients suffering from stricture urethra and deranged renal function have poor quality of life. The incidence of urethral stricture co-existing with renal failure is comparatively small and cause may be multifactorial. There is paucity of literature on management of urethral stricture associated with deranged renal function. We present our experience of managing stricture urethra associated with chronic renal failure. Materials and Methods: This was a retrospective study conducted from 2010 to 2019. Patients with stricture urethra and deranged renal function (serum creatinine >1.5 mg/dl) who underwent urethroplasty or perineal urethrostomy were included in our study. A total of 47 patients met the inclusion criteria and were included in this study. Patients were followed every 3 months in their 1st year of surgery and 6 monthly thereafter. Statistical analysis was done using SPSS version 16. Results: There was a significant increase in the mean postopérative maximum and average urinary flow rates when compared to the preoperative values. The overall success rate was 76.59%. Out of 47 patients, 10 had wound infection and delayed wound healing, 2 patients developed ventricular arrhythmias, 6 patients developed fluid and electrolyte imbalance, 2 patients developed seizures, and 1 patient developed septicemia in the postoperative period. Conclusion: Prevalence of patients with chronic renal failure associated with stricture urethra was 4.58% and features suggestive of deranged renal function at presentation were present in 1.81% patients. In the present study, complications related with chronic renal failure occurred in 17 (36.17%) patients. Multidisciplinary care of the patient along with appropriate surgical management is a viable option in this sub-group of patients.

The magnetocaloric effect (MCE) in iron (Fe) nanoparticles incorporated within a titanium nitride (TiN) thin-film matrix grown using pulsed laser deposition (PLD) is investigated in this study. The study demonstrates the ability to control the entropy change across the magnetic phase transition by varying the size of the Fe nanoparticles. The structural characterization carried out using X-ray diffraction (XRD), scanning electron microscopy (SEM), atomic force microscopy (AFM), and scanning transmission electron (TEM) showed that TiN films are (111) textured, while the Fe-particles are mostly spherical in shapes, are single-crystalline, and have a coherent structure with the surrounding TiN thin-film matrix. The TiN thin-film matrix was chosen as a spacer layer since it is nonmagnetic, is highly corrosion-resistive, and can serve as an excellent conduit for extracting heat due to its high thermal conductivity (11 W/m K). The magnetic properties of Fe–TiN systems were investigated using a superconducting quantum interference device (SQUID) magnetometer. In-plane magnetic fields were applied to record magnetization versus field (M–H) and magnetization versus temperature (M–T) curves. The results showed that the Fe–TiN heterostructure system exhibits a substantial isothermal entropy change (ΔS) over a wide temperature range, encompassing room temperature to the blocking temperature of the Fe nanoparticles. Using Maxwell’s relation and analyzing magnetization–temperature data under different magnetic fields, quantitative insights into the isothermal entropy change (ΔS) and magnetocaloric effect (MCE) were obtained for the Fe–TiN heterostructure system. The study points out a considerable negative change in ΔS that reaches up to 0.2 J/kg K at 0.2 T and 300 K for the samples with a nanoparticle size on the order of 7 nm. Comparative analysis revealed that Fe nanoparticle samples demonstrate higher refrigeration capacity (RC) in comparison to Fe thin-film multilayer samples, with the RC increasing as the Fe particle size decreases. These findings provide valuable insights into the potential application of Fe–TiN heterostructures in solid-state cooling technologies, highlighting their enhanced magnetocaloric properties.

Introduction: Globally, every year, more than 6 million people die because of tobacco use. 20% of all global deaths attributed to tobacco occur in India. The behavioral difference in the rural and urban communities is an important aspect of tobacco problem in the country. In this context, we conducted a community-based cross-sectional study to determine the effect of area (rural-urban) in predicting tobacco consumption pattern. Materials and Methods: A community-based observational, cross-sectional study was conducted in a rural and an urban community of West Bengal from May 2014 to April 2015. A predesigned pretested schedule adapted from the Global Adult Tobacco Survey India Questionnaire was used for data collection. Males above 15 years of age, residing in the study areas, were interviewed during house-to-house visit. Results: Data obtained from the interview of 704 males (352 each from urban and rural area) above 15 years revealed that the prevalence of current tobacco use in any form is significantly higher in rural area (75.6%) than in urban area (67.6%). This was related to the fact that awareness and perception of the people in rural areas are significantly less than their urban counterparts. In bivariate analysis satisfactory consumption pattern was significantly more in urban area but when adjusted with all potentially explanatory variables, the odds of satisfactory consumption pattern in urban area was attenuated significantly. Conclusion: An appropriate intervention strategy, based on local area-wise behaviors of people to curb out the menace of tobacco use, is the need of the hour.

The low-and-middle-income country (LMIC) context is volatile, uncertain and resource-constrained. India, an LMIC, has put up a complex response to the COVID-19 pandemic. Using an analytic approach, we have described India’s response to combat the pandemic during the initial months (from 17 January to 20 April 2020). India issued travel advisories and implemented graded international border controls between January and March 2020. By early March, cases started to surge. States scaled up movement restrictions. On 25 March, India went into a nationwide lockdown to ramp up preparedness. The lockdown uncovered contextual vulnerabilities and stimulated countermeasures. India leveraged existing legal frameworks, institutional mechanisms and administrative provisions to respond to the pandemic. Nevertheless, the cross-sectoral impact of the initial combat was intense and is potentially long-lasting. The country could have further benefited from evidence-based policy and planning attuned to local needs and vulnerabilities. Experience from India offers insights to nations, especially LMICs, on the need to have contextualised pandemic response plans.

Hypospadias is a rare birth deformity characterised by shortening of urethra with dorsal ectopia of the urethral meatus. The occurrence of hypospadias in female patients is extremely rare. We present a young female complaining of recurrent urinary tract infection and voiding difficulty caused by hypospadias.

Fibromyalgia is a multi-symptomatic disorder characterized by generalized pain. The pathophysiology of fibromyalgia is supposedly an interplay between central nervous system hyper-responsiveness, autonomic dysfunction, and peripheral pain. In this cross-sectional study, the objective was to assess central sensitization and autonomic activity in patients with fibromyalgia compared with control. Fifty adults diagnosed with fibromyalgia by the modified American College of Rheumatology 2010 criteria and an equal number of age- and sex-matched controls participated in the study in an urban tertiary care hospital. Central sensitization was assessed by history and by evidence of increased prefrontal cortical activity as measured by cortical oxygenation using functional near-infrared spectroscopy. Autonomic activity was assessed by heart rate variability, electrodermal activity, and deep breathing test in three physiological states: rest, sympathetic stress (cold pressor test), and deep breathing. Mann–Whitney U-test, paired t-test, Wilcoxon test, and Friedman test with Bonferroni a priori were used to analyze the data. Cortical activity was significantly higher in the fibromyalgia group than control. There was no significant difference in autonomic activity between the fibromyalgia and control groups. In the fibromyalgia group, variable degrees of sympathetic hyperactivity and normal parasympathetic activity were observed. Central sensitization may be playing a primary role in the pathophysiology of generalized pain in fibromyalgia.

Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation.

Context: Maternal anxiety has an association with low birth weight. However, studies are scarce to determine any association between maternal anxiety and fetal growth. Aims: This study aims to determine the effect of maternal anxiety on fetal growth, measured by gestational age-dependent increase in fetal abdominal circumference (AC). The secondary objective is to determine the effect of maternal anxiety on other fetal parameters (biparietal diameter [BPD], head circumference [HC], femur length [FL]). Settings and Design: This cross-sectional study was conducted in a tertiary care hospital, Kolkata. Materials and Methods: Four hundred and ten pregnant mothers, between 14 and 40 weeks of gestation, were interviewed with socioeconomic and obstetric profile questionnaire and examined for anthropometric profile and presence and severity of pallor. Anxiety was assessed using Generalized Anxiety Disorder-7 (GAD) questionnaire. HC, AC, BPD, and FL were measured by ultrasound biometry. Analysis Used: A multivariable logistic regression analysis was done to determine the predictors of small-for-gestational-age (SGA). A robust mediation analysis was done to determine mediating effect of anxiety on gestational age-dependent increase in fetal AC. Results: Mild (odds ratio [OR]Adjusted = 6.23, [2.41, 16.15]) and moderate (ORAdjusted = 22.42, [5.00, 100.57]) anxiety was significantly associated with SGA fetus. Anxiety increased with the progression of gestation (βGAD: 0.011 [0.007–0.015]) and it had a negative effect on fetal growth (standardized indirect effect of gestational age-mediated by anxiety on AC: −0.037 [−0.059, −0.022]). Anxiety also attenuated gestational age-dependent increment of HC. Conclusion: Mother's anxiety has a gestational age-dependent temporally incremental negative effect on fetal growth and brain development.

Bisphenol S (BPS) is an industrial chemical which is recently used to replace the potentially toxic Bisphenol A (BPA) in making polycarbonate plastics, epoxy resins and thermal receipt papers. The probable toxic effects of BPS on the functions of haemopoietic and cardiovascular systems have not been reported till to date. We report here that BPS depresses haematological functions and induces cardiovascular risks in rat. Adult male albino rats of Sprague-Dawley strain were given BPS at a dose level of 30, 60 and 120 mg/kg BW/day respectively for 30 days. Red blood cell (RBC) count, white blood cell (WBC) count, Hb concentration, and clotting time have been shown to be significantly (*P

Context: Anemia is a major contributor to morbidity and mortality among women of reproductive age. Progress toward reducing the burden of anemia has been little despite efforts through decades. Aims: We conducted this study to unearth the microlevel determinants of anemia among women of reproductive age. Settings and Design: This qualitative study was conducted in Urban Health Centre (UHC), Chetla. Subjects and Methods: A focus group discussion was held among all the eight health staffs, who were involved in reproductive and child health-related service delivery under UHC, Chetla. Analysis Used: A thematic analysis of the transcript was performed. Results: We found that socioeconomic factors like poverty and social neglect, diet and nutrition related factors, lack of personal hygiene, and worm infestation contributed to the burden of anemia, and this was reinforced by factors related to service delivery, such as lack of supply of drugs and supplements, and inadequate training of health workers as well as poor media accountability. Conclusions: Because of easy reversibility and implementation, health service delivery-related issues should be addressed closely through monitoring and evaluation and appropriate and timely action should be taken to improve the effectiveness of the services.

Survival data is a special form of time to event data that is often encountered while modelling risk. The classical Cox proportional hazard model, that is popularly used to analyse survival data, cannot be used for modelling risk when the proportional hazard assumption is violated or when there is recurrent time to event data. In this context we conducted this narrative review to develop an algorithm for selection of advanced methods of analysing survival data in the above-mentioned situations. Findings were synthesized from literature retrieved from searches of Pubmed, Embase, and Google Scholar. Existing literature suggest that for non-proportionality, especially due to categorical predictors stratified Cox model may be useful. An accelerated failure time model is applicable in case of different follow-up time among different experimental groups and the median time to event is the outcome of interest instead of hazard. Extended Cox models and marginal models are used in case of multivariate ordered failure events and the type of model depends upon the presence of clustering and nature of ordering. In the presence of heterogeneity, a shared frailty model is used that is analogous to mixed models. More advanced models, including competing risk and multistate models are required for modelling competing risk, multiple states and multiple transitions. Joint models are used for multiple time dependent outcomes with different attributes. We have developed an algorithm based on the review for appropriate model selection to curb the challenge of modeling survival data and the algorithm is expected to help the naïve researchers in analysing survival data.

Introduction: Hypertension is one of the major public health problem affecting the whole world so its accurate measurement is of utmost importance for its early diagnosis and management. Concerns related to the potential ill effects of mercury on health and environment, has led to the widespread use of non-mercury sphygmomanometers. Aim: A study was conducted to compare the accuracy of readings of aneroid and digital sphygmomanometers in reference to mercury sphygmomanometers and determine the hypertensive classification agreement between the mercury and non-mercury devices. Materials and Methods: The study was conducted in an OPD of a health centre in a rural community of West Bengal which is the rural field practice area of our institute. An aneroid and a digital sphygmomanometer were compared to a properly calibrated mercury sphygmomanometer. All the subjects above the age of 25 years, in two days per week, selected randomly from five working days per week in a period of one month were selected. Two blood pressure readings of each of 218 study subjects was recorded with each pretested sphygmomanometer. Paired t-test, Kappa coefficients, sensitivity and specificity tests were done. Receiver Operating Characteristics curve analysis was done and Youden index was estimated to detect the optimal cut off point for the diagnosis of hypertension by non-mercury sphygmomanometers. Results: Data analysis of 218 study subjects showed the mean difference of the mercury reading and the test device was much less for aneroid than that of the digital device for both systolic and diastolic blood pressure. More than 89% of aneroid readings and less than 44% of the readings by digital device had absolute difference of 5mm Hg. when compared with the mercury readings for both systolic and diastolic blood pressure. Sensitivity and specificity of aneroid device was higher (86.7% and 98.7%) than digital device (80% and 67.7%). Receiver Operating Characteristic curve had larger area under the curve for aneroid device than digital device for both SBP and DBP. Conclusion: The aneroid device had better accuracy than the digital device as compared to mercury sphygmomanometer and should be used for proper and better management.

We identify influential early adopters in a social network, where individuals are resource constrained, to maximize the spread of multiple, costly behaviors. A solution to this problem is especially important for viral marketing. The problem of maximizing influence in a social network is challenging since it is computationally intractable. We make three contributions. First, we propose a new model of collective behavior that incorporates individual intent, knowledge of neighbors actions and resource constraints. Second, we show that the multiple behavior influence maximization is NP-hard. Furthermore, we show that the problem is submodular, implying the existence of a greedy solution that approximates the optimal solution to within a constant. However, since the greedy algorithm is expensive for large networks, we propose efficient heuristics to identify the influential individuals, including heuristics to assign behaviors to the different early adopters. We test our approach on synthetic and real-world topologies with excellent results. We evaluate the effectiveness under three metrics: unique number of participants, total number of active behaviors and network resource utilization. Our heuristics produce 15-51% increase in expected resource utilization over the naïve approach.