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Introduction: Rabies, though endemic in India, has been a disease of low public health priority throughout the years. Being a non-notifiable disease together with limited diagnostic facilities, it often ends up in under-reporting of cases, especially atypical rabies. Failure of complete rabies Post Exposure Prophylaxis (PEP) with Immunoglobulin has been rarely reported. Case: We report a case of atypical rabies in a 60-year-old man from a rural village in Kerala, who presented with fever, paralysis of limbs, fluctuating consciousness, phonophobia and without classical signs of hydrophobia and aerophobia 22 days after dog bite. The case is supplemented with supportive Magnetic Resonance Imaging (MRI) findings and corneal imprint smear Fluorescent Antibody Test (FAT). The death of the patient on the 28th day of exposure despite early PEP with rabies vaccine and immunoglobulin is suggestive of PEP failure. Conclusion: The case study stresses on the need in making rabies a notifiable disease in the study setting, encouraging disease specific investigation, ensuring availability of vaccine and immunoglobulins with adherence to standardized treatment protocols. Key Messages: Deviations from the recommended protocol for Animal bite management, such as delay in seeking PEP, lack of or improper administration of rabies immunoglobulin (e.g. missing out bite sites), lack of or improper primary wound care, and/or poor-quality rabies vaccine, may lead to death. Keywords: Atypical rabies, Death, Post exposure prophylaxis failure, Zoonosis

The SARS-CoV-2 Variant of Concern, Delta (B.1.617.2) was first reported in December 2020 in India and has spread colossally throughout the globe. Owing to factors like increased transmissibility, immune escape, and virulence, the delta variant has been considered as a potential public health threat apart from other variants of concern like alpha, beta and gamma. Kerala was one of the first states in India to enroll in the systematic genomic surveillance. In the present report, vaccine breakthrough infections were followed up in 147 patients including 55 healthcare workers who had been vaccinated with ChAdOx1 nCoV- 19/BBV152 across eleven districts from the state of Kerala. The timeline of samples analysed were from April 2021 till June 2021. Severity of the infections reported in the enrolled patients found to be mildly symptomatic, majorly with only 0.7% (n=1) of the cohort to be asymptomatic. Genomic analysis of the samples revealed the Delta variant (B.1.617.2) to constitute about 81.6% (n=120) in the studied cohort. This was followed by the Kappa variant B.1.617.1 (8.35%, n=9), AY.1 (0.6%, n= 1), AY.12 (0.6%, n= 1), AY.4 (1.2%, n= 2), AY.9 (1.2%, n= 2) and Eta variant, B.1.525 (0.6%, n= 1). 11 samples were not assigned any lineage. Evidence from this study suggests the preponderance of the Delta variant in the samples analysed.

Truncated octahedral gold (Au) nanoparticles (NPs), Au nanocubes (NCs)-, and silver (Ag) NCs are used to study the effect of NPs shape, material and incorporation location on the performance of poly(3-hexylthiophene):[6,6]-phenyl-C71-butyric acid methyl ester (P3HT:PC71BM) based inverted bulk heterojunction (BHJ) organic solar cells (OSCs). Plasmonic OSCs (POSCs) with NPs incorporated as an interfacial layer between zinc oxide (ZnO) and active layer showed highest power conversion efficiency (PCE) and short circuit current density (Jsc) values for all kind of shapes and material compared to POSCs with NPs blended into the active layer. Near-field enhancement as well as enhanced forward scattering cross section is attributed for POSC performance improvement. Among the NPs with two shapes, POSCs with truncated octahedral Au NPs exceeded the photovoltaic performance compared to those of POSCs with Au and Ag NCs. Large number of antennas in truncated octahedral Au NPs compared to NC is reasoned to be the cause for this improvement. Even though Ag has better localised surface plasmon resoanance (LSPR) properties compared to Au, the POSCs with Ag NCs showed lower Jsc value and is due to reduced number of photons at the blue shifted LSPR wavelength of Ag NCs. The improvement in Jsc values of POSCs is confirmed by enhancement in absorption, external quantum efficiency (EQE), exciton generation and exciton dissociation probability measurements and is due to improved LSPR coupling of the NPs with the active layer. The surface enhanced Raman scattering (SERS) and photoluminescence (PL) studies confirm the absorption enhancement in the active layer by NP LSPR coupling and further confirm the enhancement in the photovoltaic performance of POSCs.

This work presents a photochemical and thermal treatment strategy to prepare in situ gold–platinum bimetallic nanoparticle-loaded titania photocatalysts with self-doped Ti3+ states (Au–Pt/Ti3+ nc-TiO2). In situ loading of Au–Pt bimetallic nanoparticles and Ti3+ self-doping in the TiO2 crystal lattice result in excellent solar light photocatalytic activity. The Au–Pt/Ti3+ nc-TiO2 displays an improved hydrogen evolution rate (98.53 mmol h–1 g–1) when compared to in situ gold-loaded and in situ platinum-loaded titania (Au/Ti3+ nc-TiO2 and Pt/Ti3+ nc-TiO2, respectively) photocatalysts. The Au–Pt/Ti3+ nc-TiO2 photocatalyst is further restructured into titania inverse opal (Au–Pt/Ti3+ io-TiO2) photocatalyst by a facile colloidal photonic crystal (CPC) infiltration method. The Au–Pt/Ti3+ io-TiO2 photocatalyst displays a superior solar hydrogen evolution profile (181.77 mmol h–1 g–1) compared to all the other photocatalysts investigated for hydrogen production experiments, which makes them potential candidates fo...

Exciton generation, dissociation, free carrier transport, and charge extraction play an important role in the short-circuit current (J(sc)) and power conversion efficiency of an organic bulk heterojunction (BHJ) solar cell (SC). Here we study the impact of band offset at the interfacial layer and the morphology of active layer on the extraction of free carriers. The effects are evaluated on an inverted BHJ SC using zinc oxide (ZnO) as a buffer layer, prepared via two different methods: ZnO nanoparticle dispersed in mixed solvents (ZnO A) and sol-gel method (ZnO B). The device with ZnO A buffer layer improves the charge extraction and J(sc),. The improvement is due to the better band offset and morphology of the blend near the ZnO A/active layer interface. Further, the numerical analysis of current-voltage characteristics illustrates that the morphology at the ZnO A/active layer interface has a more dominant role in improving the performance of the organic photovoltaic than the band offset.

ObjectivesTo assess the prevalence and factors associated with mild cognitive impairment (MCI) among older adults in an urban area of South India.SettingThe study was conducted in the capital city of Thiruvananthapuram in the South Indian state of Kerala.ParticipantsThe study participants were community-dwelling individuals aged 60 years and above.Primary outcome measureMCI was the primary outcome measure and was defined using the criteria by European Alzheimer’s Disease Consortium. Cognitive assessment was done using the Malayalam version of Addenbrooke’s Cognitive Examination tool. Data were also collected on sociodemographic variables, self-reported comorbidities like hypertension and diabetes, lifestyle factors, depression, anxiety and activities of daily living.ResultsThe prevalence of MCI was found to be 26.06% (95% CI of 22.12 to 30.43). History of imbalance on walking (adjusted OR 2.75; 95 % CI of 1.46 to 5.17), presence of depression (adjusted OR 2.17, 95 % CI of 1.21 to 3.89), anxiety (adjusted OR 2.22; 95 % CI of 1.21 to 4.05) and alcohol use (adjusted OR 1.99; 95 % CI of 1.02 to 3.86) were positively associated with MCI while leisure activities at home (adjusted OR 0.33; 95 % CI of 0.11 to 0.95) were negatively associated.ConclusionThe prevalence of MCI is high in Kerala. It is important that the health system and the government take up urgent measures to tackle this emerging public health issue.

Background: Mental disorders are common, affecting more than 25% of all people at some time during their lives. Worldwide literature has shown that onset of common mental disorders occurs in childhood and adolescence. Children with mental health problems are often first seen and first treated in the education, social justice, or juvenile justice systems. In India, according to Juvenile Justice Act, 2000, such children are institutionalized in children’s and observation homes under Social Justice Department. This study aims at assessing the mental health status and estimating the prevalence of mental health morbidity among these children and adolescents.Methods: This is a cross sectional study conducted among the inmates of childcare homes under the Social Justice Department, Government of Kerala. Each individual district in the state was fixed as clusters. Out of the 14 districts, five districts were randomly selected. The childcare homes in each cluster were included. All the eligible children in the cluster during the visit were studied.Results: The median SDQ total score of the study participants was 15 (11, 21). The prevalence of mental health morbidity was estimated as 33.3% (95% CI: 26.86% - 40.31%) in the study population. There were 32 (15.9%) study participants with borderline SDQ score.Conclusions: The prevalence in the current study was more than that found in the general child population children across the world as well as in India, which in turn suggests the need of special care needed for these children and adolescents, especially in mental health.

High figure-of-merit p-type transparent conducting Cu–Zn–S thin films with Zn doped CuS structure were successfully deposited by Successive Ionic Layer Adsorption and Reaction (SILAR) method at room temperature. Films were deposited with an optimal Cu:Zn:S ratio of 75:25:50 in the precursor solution. The thickness of the films was controlled by varying the number of deposition cycles. The composition, structure, morphology, electrical, electronic and optical properties of the as deposited films were studied in detail. All the films exhibited relatively high conductivity and transparency resulting in high figure-of-merit values. Overall, the hole concentration and conductivity are in the range of degenerately doped semiconductors. The Cu–Zn–S film deposited with 40 nm thickness has an electrical conductivity of more than 1000 S/cm and average optical transparency greater than 81% in the visible region. These values are higher than most of the other reported p-type transparent conducting materials, especially for room temperature deposition. Conventional bulk heterojunction organic solar cells were fabricated with structure ITO/Cu–Zn–S/P3HT:PC71BM/ZnO/Al, where Cu–Zn–S is the hole transport layer. The best configuration resulted in an efficiency of 1.87% suggests the suitability of Cu–Zn–S thin films as a hole transport layer in organic solar cells.

For the past few years, solar energy research witnessed a tremendous growth in the field of perovskite solar cells. Superior device performance and low cost are some of the aspects that ensure perovskite solar cell to be a promising technology in the global photovoltaic market. However, device stability and toxicity of lead used in the perovskite dye are of great concern. Life cycle assessment (LCA) in the early development stage of perovskite solar cell is used to design and fabricate efficient devices with minimal environmental impacts. Cradle-to-gate LCA studies conduct environmental assessment on various impact categories. These studies demonstrate that lead provides very low environmental impact (0.001%) in the manufacturing stages. Perovskite solar cells also exhibit the shortest energy payback time compared to the existing photovoltaic technologies. The positive feedback from all LCA studies promises a bright future for perovskite solar cells.

Background: Respiratory tract infections are the leading cause of infections and associated hospitalizations in India. Generally, there is little control on the use of antibiotics. Community awareness of the issues involved in antibiotic therapy is poor and this is compounded by over-the-counter availability. The main aim was to compare the resistance developed by respiratory microbes. Methods: A retrospective and prospective study was designed and conducted to compare the pattern of resistance developed by microorganisms affecting the respiratory tract. Results: The sensitivity of K. pneumoniae to cefepime/tazobactum has decreased from 91.9% to 47.6% and S. aureus to Linezolid has decreased from 93.4% to 80% and S. pyogenes to azithromycin from 51.4% to 24.8%. Whereas sensitivity pattern of S. pneumoniae to amoxicillin/clavulanate is increased from 65.6% to 82.3%. The prevalence of Klebsiella pneumoniae was increased 19% to 25.2% whereas the prevalence of S. pneumoniae was decreased from 66.8% to 65.2%. Our study suggests that all microorganisms isolated are susceptible to carbapenems and cefepime/tazobactum in the cephalosporin class. Conclusions: There is major shift in the sensitivity pattern of microorganisms towards antibiotics. Therefore, these results must be kept in mind by the practitioners in the study site, prior to making decisions over a medication regimen empirically for patients and also to maximize the output of medications by rational prescribing and dosing.

P3HT:PCBM is one of the most studied polymer-fullerene system. However the reported power conversion efficiency (PCE) values falls within the range of 4% to 5%. The thin film architecture in OPVs exhibits low PCE compared to inorganic photovoltaic cells. This is mainly due to the low exciton diffusion length that limits the active layer thickness which in turn reduces the absorption of incident light. Several strategies are adapted in order to increase the absorption in the active layer without increasing the film thickness. Inclusion of metal nanoparticles into the polymer layer of bulk heterojunction (BHJ) solar cells is one of the promising methods. Incorporation of metal nanostructures increases the absorption of organic materials due to the high electromagnetic field strength in the vicinity of the excited surface plasmons. In this work, we used ~ 60 nm Au plasmonic structures to improve the efficiency of organic solar cell. The prepared metal nano structures were characterized through scanning electron microscopy (SEM), and UV-Visible spectroscopy techniques. These prepared metallic nanoparticles can be incorporated either into the electron transport layer (ETL) or into the active P3HT:PC71BM layer. The effect of incorporation of plasmonic gold (Au) nanoparticle in the inverted bulk heterojunction organic photovoltaic cells (OPVs) of P3HT:PC71BM fabricated in ambient air condition is in progress. Initial studies shows an 8.5% enhancement in the PCE with the incorporation of Au nanoparticles under AM1.5G light of intensity 1 Sun.

We investigate the role of cathode interfacial layer thickness in tuning the barrier height and charge transport in inverted bulk heterojunction organic solar cells (BHJ OSCs). The variation of cathode layer thickness significantly changed the cell parameters like open-circuit voltage (Voc) and short-circuit current density (Jsc). For better understanding of the charge transport properties in the device, photoinduced capacitance spectroscopic studies and temperature dependent studies were carried out in polythieno[3,4-b]thio phene/benzodithiophene : [6,6]-phenyl-C71-butyric acid methyl ester (PTB7:PC71BM) based inverted BHJ OSC with ZnO as the cathode interfacial layer. These studies gave insight into the charge accumulation and barrier height at the active layer/ZnO interface. Due to the presence of trap states in the ZnO layer, charges can accumulate at the interface creating a barrier for the smooth extraction of charge carriers. The barrier height is found to increase from 0.05 to 0.13 eV as the ZnO thickness is varied from 30 to 250 nm that can be attributed to the increase in the density of trap states in the ZnO layer. Intensity-dependent studies were also performed to analyze the recombination processes in the device.

Background: This study is based on the tragic firework accident, with the highest death toll in India, that occurred in Puttingal Devi Temple, Kollam District, Kerala, at 3.30 am on 10/04/2016. Around 1500 people were injured. On the spot death toll was 109 and 12 others died in hospitals later. 1039 were treated as OP case and 410 as inpatients in various secondary and tertiary care hospitals in Kollam and Thiruvananthapuram with the help of the team of experts from AIIMS, Delhi. The aim was to study the clinical profile of inpatients admitted with trauma and/or burns following the incident and to formulate a Medical action- plan of in such eventualities.Methods: The present study is descriptive in nature with study setting in secondary and tertiary care hospitals in Kollam and Thiruvananthapuram districts. The study subjects were all the inpatient victims of the firework tragedy. The study method used analysis of relevant patient details collected from hospitals records. Results: 410 inpatients of various hospitals were analysed. Majority of the victims were males. (95.6%) Major age group affected is 20-50 years (66.1%). 79.5% of patients were treated in wards and 20.5% in various ICUs. 54.4% in secondary care centres and 45.6% in tertiary care centres. 78.2% of patients had traumatic injuries alone, 19.8% had trauma and burn injuries and 2% had burn injuries alone. 37.3% had major injuries, 21.5% had multiple fractures and 39.1% had minor injuries. 29% of patients had to undergo various surgeries. Hospital stay -76.4% of patients