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As the pandemic COVID-19 has severely affected the entire world, it became the utmost necessity of careful prioritization and utilization of limited medical resources, especially for the resource-constraint societies. This requirement along with the asymptomatic nature of COVID-19 in a significant proportion of the population, has prompted the need for a risk assessment tool-kit that can provide a rational behind prioritization and allocation of limited available medical resources. The purpose of this study is to compose a scientific-rationale-based ‘COVID-19-Self-Assessment-Test’ (C19SAT) framework, which helps develop a basis for measuring the risk of COVID-19 exposure with self-assessment. The study comprises of two major parts- (1) identification of key components of the C19SAT framework by studying various guidelines (WHO & CDC) and relevant literature, and (2) quantification of those components by assigning weight through the analysis of survey results and opinions from medical physicians and experts. A C19SAT framework is developed to measure the risk of covid-19 exposure, comprising a set of identified components (12 parameters and their corresponding attributes) and their corresponding weights. As the scientific rationale behind such assessment framework has not been reported to date in case of available mobile applications and web-based toolkit, the present study brings the novelty and reports the construction of such a framework. The study opens up untouched research and discussion on the composition of the COVID-19 exposure-measurement framework, which can help in vaccine prioritization and resource allocation. Further studies can be carried out on refining the framework for better understanding and effectiveness towards urban health governance.

Abstract Sanitation problems faced by the humanity are tightly coupled with the ever-growing water problems. Better sanitation infrastructures ensure sustainable solutions to the health and water issues faced by the majority of the urban population on the planet. In this study, we investigated sanitation status for squatter settlements in Mumbai, a major global megacity. We observe that capacity building in terms of adequate toilet infrastructure alone cannot eliminate open defecation. There is a huge need for more toilet blocks in Mumbai’s wards, even after considering unusable public and community toilets into account, since 71–99% out of 8417 toilets are not in good condition. We contend that the normal perception regarding more toilet infrastructures and its alleviating effect on open defecation is not always directly correlated and is an emerging as well as a complex urban issue. We corroborate the need for addressing associated governance issues along with capacity building, which will help stakeholders to identify the prevailing sanitation scenario towards further policy amendments. Further, effectively identifying the trends and processes entangled in the urban sanitation issues can ensure a more sustainable resource utilization situation and a better standard of living for the urban poor.

The shift towards capacity building and deteriorating governance, may lead to poor service delivery which is a prime challenge for governing agencies. Different countries follow their own sets of governance parameters and often assess the outcome of policies based on them. In order to compose a uniform good governance framework, we have conducted a comparative analysis among 22 existing governance frameworks across the globe and shortlisted 13 major criteria along with 74 sub-criteria. We explored the method to measure these governance components with the help of various indicators and took expert opinion to distribute weight among these indicators. Finally, the case of Mumbai city is discussed with the examples of direct indicators, which may be used to measure a sub-criteria of any specific criteria. The quantification process is also demonstrated with three specific representative indicators. For example- the contribution towards good-governance has been increased from 0.001218 in 2016 to 0.004466 in 2017, for the indicator “conviction percentage of corruption cases” of sub-criterion “active anti-corruption commission” of criterion “accountability”. Researchers as well as policymakers will be benefitted with the method demonstrated here, which can help in assessing governance of any public service towards further policy amendments. Keywords: Governance, Public, Urban Services, Management, Indicator

Introduction: Oral squamous cell carcinoma (OSCC) are amongst commonest cancer in the Indian sub-continent. After treatment, these patients require frequent followup to look for recurrences/second primary. Mouth Self Examination (MSE) has a great potential in all levels of prevention of oral cancer. However, the compliance to self-examination has been reported as poor. Mobile phone is a cheap and effective way to reach out to people. Short Message Service (SMS) is extremely popular can be a very effective motivational and interactive tool in health care setting. Methodology: We aimed to identify in adequately treated OSCC patients, the influence of health provider initiated SMS on the compliance to the MSE and to establish the efficacy of MSE by comparing patients' MSE interpretation via replies to the SMS with that of the experts' opinion on clinical examination status during follow up. Conclusion: We conclude that MSE can be very useful in adequately treated OSCC patients for evaluating disease status. All treated OSCC patients must be adequately educated for MSE as an integral part of treatment & follow-up protocol by the health provider facility. Health provider generated SMS reminders do improve motivation and compliance towards MSE but don't seem to reduce dropouts in follow up for large and diverse population like that in India.

Introduction: Different techniques of radiation therapy have been studied to reduce the cardiac dose in left breast cancer. Aim: In this prospective dosimetric study, the doses to heart as well as other organs at risk (OAR) were compared between free-breathing (FB) and deep inspiratory breath hold (DIBH) techniques in intensity modulated radiotherapy (IMRT) and opposed-tangent three-dimensional radiotherapy (3DCRT) plans. Materials and Methods: Fifteen patients with left-sided breast cancer underwent computed tomography simulation and images were obtained in both FB and DIBH. Radiotherapy plans were generated with 3DCRT and IMRT techniques in FB and DIBH images in each patient. Target coverage, conformity index, homogeneity index , and mean dose to heart (Heart Dmean), left lung, left anterior descending artery (LAD) and right breast were compared between the four plans using the Wilcoxon signed rank test. Results: Target coverage was adequate with both 3DCRT and IMRT plans, but IMRT plans showed better conformity and homogeneity. A statistically significant dose reduction of all OARs was found with DIBH. 3DCRTDIBHdecreased the Heart Dmeanby 53.5% (7.1 vs. 3.3 Gy) and mean dose to LAD by 28% compared to 3DCRTFB. IMRT further lowered mean LAD dose by 18%. Heart Dmeanwas lower with 3DCRTDIBHover IMRTDIBH (3.3 vs. 10.2 Gy). Mean dose to the contralateral breast was also lower with 3DCRT over IMRT (0.32 vs. 3.35 Gy). Mean dose and the V20of ipsilateral lung were lower with 3DCRTDIBHover IMRTDIBH (13.78 vs. 18.9 Gy) and (25.16 vs. 32.95%), respectively. Conclusions: 3DCRTDIBHprovided excellent dosimetric results in patients with left-sided breast cancer without the need for IMRT.

Purpose: To describe the Quality Assurance (QA) methods of modern Three-dimensional conformal radiotherapy (3DCRT) treatments such as image guided Intensity-modulated radiation therapy (IMRT), RapidArc, Stereotactic radiosurgery (SRS)/ Stereotactic fractionated radiation (SRT) to ensure quality of treatments delivered to cancer patients. Materials and methods: 3D-RFA and Ionisation chambers were used for the machine specific QA. Imatrixx-2D array with locally fabricated phantom and another locally fabricated spherical phantom with ionization chambers is used for relative and absolute QA respectively. Electronic Portal Imaging Devices and Epiqa software is used for the QA with portal dosimetry. Varians Eclipse and Brainlab’s Iplan treatment planning systems were used for treatment plans and dose calculations. For relative dosimetry the planar dose matrices are analysed using global Gamma Index criteria of 3mm distance to agreement (DTA) and 3% dose difference. The QA of Machines and patient treatments were carried out using national and international protocols. Results: The maximum deviations of percentage of dose points in which γ>1 are 1.98 in relative dosimetric QA and 1.5 for absolute QA in the delivery of IMRT, RapidArc and SRS/SRT treatments. The mean deviations and Standard deviation (SD) values are less in portal dosimetry than that of phantom studies in relative dosimetry and all the absolute dose deviations are less than that of relative dose deviations. Conclusion: The results of machine specific QA as well as relative and absolute dosimetric QA of patient treatments are well within the acceptable limits of values mentioned in the national and international protocols. The study ensures the accuracy and quality of the treatments delivered to the patients at our oncology center.

This exploratory study aimed to assess a range of sexual behaviors, relationships and related factors among a sample of bisexual men in Mumbai, India. Data collection occurred in two separate phases: 1. focus group discussions were facilitated with local community members in order to finalize an interviewer-administered questionnaire, and 2. structured interviews were conducted with a sample of 50 bisexual men using this questionnaire. Participants self-reported a wide range of sexual behaviors and relationships. Findings have implications for future research and practice focusing on bisexual men in India, as well as their partners of all genders.

Background: Men who have sex with men and transgenders are an important risk group for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). They have risky sexual behaviors but low risk perception., Objectives: To assess the sexual behavior, STIs, HIV and identify factors associated with HIV in men who have sex with men (MSM) and transgenders (TGs) in Mumbai., Methods: Participants were enrolled from two clinics in Mumbai. They completed an interviewer-administered questionnaire and were evaluated for STIs and HIV infection., Results: A total of 150 participants, 122 MSM and 28 TGs were evaluated; 17% of MSM and 68% of the TGs were HIV infected. HIV infection in MSM was associated with serological positivity for HSV2 IgG [adjusted odds ratio (aOR), 95% confidence interval (CI): 9.0 (2.2-36.9)], a positive Treponema pallidum hemagglutination assay (TPHA) [aOR (95% CI): 6.0 (1.5-24.0)], greater than five acts of receptive anal sex in the past six months [aOR (95% CI): 4.3 (1.2-15.0)] and per category increase in age (18-24 yrs, 25-29 yrs, > 30 yrs) [aOR (95% CI): 3.1 (1.3-7.1)] in multivariate analysis. Consistent condom use during receptive anal sex in the past six months was low (27%). Many MSM were married (22%) or had sex with females and may act as a 'bridge population'. HIV infection in TGs was associated with a positive TPHA [OR (95% CI): 9.8 (1.5-63.9)] and HSV 2 IgG [OR (95% CI): 6.7 (1.1-40.4)] in univariate analysis., Conclusion: Prior STIs were strongly associated with HIV infection in MSM and TGs. These groups should be the focus of intensive intervention programs aimed at STI screening and treatment, reduction of risky sexual behavior and promotion of HIV counseling and testing.

Beneath the surface of the Bollywood cinema is a percolating gay culture trying to break free, waiting for the moment to emerge from subtext into text. For now, in what we might now call a period of transition, the Bollywood hero has been (particularly in the past three decades) the focus of increased homoeroticization, with his body becoming a spectacle at every turn. Unfortunately, what has facilitated this is a veiled (and sometimes not-so-veiled) form of misogyny, in which the heroine's role is minimized such that, rather than another filmic character falling in love with the hero, the audience itself is invited to see the macho (and perhaps narcissistic) hero as unattached and therefore available for homoerotic desire.