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Background: Gold standard treatment for chronic anal fissure is lateral internal sphincterotomy. Bilateral internal sphincterotomy (BIS) as a treatment option for chronic anal fissure has not been evaluated. Aims and Objectives: The aims and objectives of the study are to compare the efficacy of unilateral versus bilateral internal anal sphincterotomy in treatment of chronic anal fissure. Materials and Methods: Study design: A prospective randomized comparative study. Study area: Patients coming to General Surgery outpatient department at College of Medicine and Sagore Dutta Hospital with chronic anal fissure. Study period: July 2022 to December 2023 (18 months). Sample Size: 100 patients. Study Group: Group A=Patients who had undergone unilateral internal sphincterotomy (UIS)=50 patients and Group B=Patients who had undergone BIS=50 patients. Results: 2 (4%) patients in Group A and 3 (6%) patients in Group B developed incontinence for flatus postoperatively. No patients in either group developed incontinence for stools. The Mean Fissure Healing Time (Mean±SD) (Weeks) post-sphincterotomy was 4.32±0.91339 in Group A and 2.66±0.65807 in Group B. There were 6 cases of recurrence in the unilateral sphincterotomy group. Second surgery was needed in 4 patients who underwent unilateral sphincterotomy. Conclusion: As compared to UIS, BIS results in a faster healing of chronic anal fissure, with no increase in incontinence, decreased pain score, and less recurrence rates. [ABSTRACT FROM AUTHOR]

Background & objectives: To support recent political commitments to end tuberculosis (TB) in the World Health Organization South-East Asian Region (SEAR), there is a need to understand by what measures, and with what investment, these goals could be reached. These questions were addressed by using mathematical models of TB transmission by doing the analysis on a country-by-country basis in SEAR. Methods: A dynamical model of TB transmission was developed, in consultation with each of the 11 countries in the SEAR. Three intervention scenarios were examined: (i) strengthening basic TB services (including private sector engagement), (ii) accelerating TB case-finding and notification, and (iii) deployment of a prognostic biomarker test by 2025, to guide mass preventive therapy of latent TB infection. Each scenario was built on the preceding ones, in successive combination. Results: Comprehensive improvements in basic TB services by 2020, in combination with accelerated case-finding to increase TB detection by at least two-fold by 2020, could lead to a reduction in TB incidence rates in SEAR by 67.3 per cent [95% credible intervals (CrI) 65.3-69.8] and TB deaths by 80.9 per cent (95% CrI 77.9-84.7) in 2035, relative to 2015. These interventions alone would require an additional investment of at least US$ 25 billion. However, their combined effect is insufficient to reach the end TB targets of 80 per cent by 2030 and 90 per cent by 2035. Model projections show how additionally, deployment of a biomarker test by 2025 could end TB in the region by 2035. Targeting specific risk groups, such as slum dwellers, could mitigate the coverage needed in the general population, to end TB in the Region. Interpretation & conclusions: While the scale-up of currently available strategies may play an important role in averting TB cases and deaths in the Region, there will ultimately be a need for novel, mass preventive measures, to meet the end TB goals. Achieving these impacts will require a substantial escalation in funding for TB control in the Region. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic challenged the Global Outbreak Alert and Response Network's (GOARN) mechanism used to rapidly deploy technical support for international responses and highlighted areas that require strengthened capacity within the Network. GOARN's partners in the World Health Organization's (WHO) South-East Asia and Western Pacific regions were engaged to explore their levels of preparedness, readiness and ability to respond to international public health emergencies., Methods: Consultative discussions were held and a survey was conducted with GOARN's partners from the two WHO regions. Discussion topics included partners' capacity to support and participate in a GOARN deployment, training, research and collaboration. Descriptive and content analyses were conducted., Results: Barriers to engaging in GOARN's international outbreak response efforts included limited numbers of personnel trained to respond to outbreaks; institutional, financial and administrative hurdles; and limited collaboration opportunities. Partners identified innovative solutions that could strengthen their engagement with deployment, such as financial subsidies, mentorship for less experienced staff, and the ability to provide remote support., Discussion: GOARN plays an important role in enabling WHO to fulfil its international alert and response duties during disease outbreaks and humanitarian crises that have the potential to spark disease outbreaks. Yet without systematic improvement to strengthen national outbreak capacity and regional connectedness, support for international outbreak responses may remain limited. Thus, it is necessary to integrate novel approaches to support international deployments, as identified in this study., Competing Interests: AEP and SS are associate editors of the Western Pacific Surveillance and Response journal. They had no role in the decision to publish this manuscript. The other authors have no conflicts of interest to declare., ((c) 2024 The authors; licensee World Health Organization.)

In 1998, the resurgence of Plasmodium vivax malaria in the Democratic People's Republic of Korea quickly increased to an epidemic, with 601 013 cases reported I during 1999-2001. The introduction of mass primaquine preventive treatment (MPPT) in 2002 was followed by a rapid reduction of malaria disease burden. The intervention has been well accepted by the community. Doctors were part of a strong functional health system with the ability to deliver interventions at the household J level. MPPT was considered for control of malaria after a study conducted in two J neighbouring endemic villages (ris) involving 320 healthy adults demonstrated that presence of parasitaemia was significantly lower among those receiving MPPT than those who did not. Similarly, in a mass blood survey conducted in the study sites during May, 2002 involving 5138 persons in study and 4215 in comparison areas, the total positive results were 7-10 times rarer in the treatment group both before and after the malaria transmission season. In addition, the number of malaria cases in the MPPT treatment ris was strikingly lower than control ris in every month during the malaria transmission season of 2002. The prevalence of G6PDD deficiency in DPR Korea is low, haemolytic events are rare and deaths due to MPPT have not been reported. MPPT in itself is a powerful intervention and the decision to deploy it depends on the epidemiology of malaria, urgency of malaria control and resources available in the country.