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Aquaculture is the fastest growing food sector round the globe, with huge potential for expansion. The objectives of United Nations Sustainable Development Goals (SDGs) can be met with concerted efforts of stakeholders for circular economy. It plays a critical role in global food production and over half of the aquatic foods for human consumption are farmed. According to several studies bacteria, fungi, viruses, and parasites are the main causative agents of aquaculture diseases. Antibiotics and synthetic chemicals are typically used by fish farmers to overcome these infections and reducing the mortality rate. Medicinal herbs have been used for thousands of years, as immunostimulants. The use of medicinal herbs as natural, risk-free substitutes for antibiotics and immunoprophylactics in aquaculture may prove to be advantageous. In this study, scholarly data was retrieved using Scopus database and were manually curated and approximately 150 scholarly articles were obtained using customized keyword search to be used for citation network analysis. There are a total of 5 clusters based on the relevant keywords consisting of 87 items and 2195 links amongst them. The work related to dietary supplements, immunology and fish foods have gained more relevance since 2016, as revealed by its interactions with relevant terms. In this research article, we aim to provide an overview of current research in this field, identify research hotspots, project future development prospects, and make recommendations for further research in aquaculture using sustainable approaches by exploiting the natural herbs and plants as immunostimulants. This work is related to the sustainable approach exploring medicinal plants as immunostimulants and will definitely find new promising avenues in this area.

The growth of the environment depends upon developing greener and ecological methods for managing pollutants and contamination from industrial wastewater, which causes significant effects on human health. The removal of these pollutants from wastewater using nanomaterials covers an ecological method that is free from expensive and secondary pollution. In this report, we developed magnetic iron nanoparticles from Chenopodium glaucum (CG), which showed excellent adsorption capacity at pH 5 for selective Hg2+ and Pb2+ metal ions among various heavy metal ions, with maximum adsorption capacities of 96.9 and 94.1%, respectively. These metals’ adsorption process conforms to the Langmuir model, which suggests that monolayer adsorption transpires on CG–Fe2O3 nanoparticles. CG–Fe2O3 nanoparticles also act as an efficient and recyclable heterogeneous catalyst for one-pot synthesis of xanthene derivatives, yielding products with high yields (up to 97%) and excellent purity (crystalline form) within a short timeframe (6 min) using microwave irradiations (at 120 W).

The Laplace distribution, also known as the double exponential distribution, is a continuous probability distribution that is often used for modelling the data having heavy tails. In this paper, we proposed the Neutrosophic Laplace distribution which is the extension of the classical Laplace Distribution. We derived various statistical properties of the Neutrosophic Laplace Distribution such as mean, variance, skewness, rth moment, quartiles, and moment-generating function. The expressions for the estimation of the parameters are also derived using the maximum likelihood function of the distribution. A simulation study has been done to evaluate the performance of estimates. An application of the Neutrosophic Laplace Distribution is discussed to study the daily return of the NIFTY50 from Indian Stock Market. The analysis shows that the neutrosophic Laplace Model is acceptable, effective, and adequate for dealing with uncertainty in an unpredictable context.

Abstract Background People living with HIV (PLHIV) are at higher risk for human papillomavirus (HPV)-related oropharyngeal cancers compared to the general population. Xpert HPV test is a polymerase chain reaction (PCR) assay capable of rapid HPV detection. Performing the assay requires minimal intervention by laboratory personnel. Its use could improve oropharyngeal cancer screening among PLHIV living in low-and middle-income countries (LMICs) with limited diagnostic capacities. However, Xpert HPV performance for oral samples has not been evaluated. Here, we describe our experience with Xpert HPV and compare its results with traditional PCR, for oral samples. Methods Oral samples from 429 PLHIV receiving care at a tertiary care hospital affiliated antiretroviral therapy center in Pune, India were used. Samples were collected either after a 30s oral rinse and gargle (n = 335) or in combination with cytobrush scraping of the oral mucosa (n = 91). Unsuccessful tests were those that generated an invalid or error result on Xpert HPV. Successful tests were those that generated a positive or negative result. Kappa statistic was used to compare concordance between Xpert HPV and traditional real-time PCR results. Results There were 29.8% (n = 127) unsuccessful tests, of which 78.7% (n = 100) were invalid and 21.3% (n = 27) were error results. Adding cytobrush scraping to oral rinse as a collection procedure did not significantly reduce the proportion of unsuccessful tests (p = 0.9). For successful tests, HPV positivity on Xpert was 0.3% (n = 1/299). Kappa statistic was 0.11, indicating poor agreement between Xpert HPV and traditional PCR results. Conclusions Presently, Xpert HPV appears to have limited use for oral HPV detection among PLHIV using oral samples. More research to improve the diagnostic capabilities of Xpert HPV for oral samples among PLHIV is needed.

Abstract In this work, we study a constant-roll inflationary model in the Palatini formalism using modified gravity. Here our action consists a non-minimal coupling of a scalar field $$\phi $$ ϕ with Ricci scalar R in a general form of $$f(R,\phi )$$ f ( R , ϕ ) . Using Palatini approach, we write its equivalent scalar-tensor form in the Einstein frame and then apply the constant-roll condition in the equation of motion for the inflaton field. Later the tensor-to-scalar ratio and the spectral index are calculated using the slow-roll parameters and the results obtained are matched with the Planck 2018 data. We found that the results agree nicely with the observations within the parameter regime under consideration.

DRAM scalability is becoming a limiting factor to the available memory capacity in consumer devices. As a potential solution, manufacturers have introduced emerging non-volatile memories (NVMs) into the market, which can be used to increase the memory capacity of consumer devices by augmenting or replacing DRAM. In this work, we provide the first analysis of the impact of extending the main memory space of consumer devices using off-the-shelf NVMs. We equip real web-based Chromebook computers with the Intel Optane solid-state drive (SSD), which contains state-of-the-art low-latency NVM, and use the NVM as swap space. We analyze the performance and energy consumption of the Optane-equipped Chromebooks, and compare this with (i) a baseline system with double the amount of DRAM than the system with the NVM-based swap space; and (ii) a system where the Intel Optane SSD is naively replaced with a state-of-the-art NAND-flash-based SSD. Our experimental analysis reveals that while Optane-based swap space provides a cost-effective way to alleviate the DRAM capacity bottleneck in consumer devices, naive integration of the Optane SSD leads to several system-level overheads, mostly related to (1) the Linux block I/O layer, which can negatively impact overall performance; and (2) the off-chip traffic to the swap space, which can negatively impact energy consumption. To reduce the Linux block I/O layer overheads, we tailor several system-level mechanisms (i.e., the I/O scheduler and the I/O request completion mechanism) to the currently-running application’s access pattern. To reduce the off-chip traffic overhead, we leverage an operating system feature (called Zswap) that allocates some DRAM space to be used as a compressed in-DRAM cache for data swapped between DRAM and the Intel Optane SSD, significantly reducing energy consumption caused by the off-chip traffic to the swap space. We conclude that emerging NVMs are a cost-effective solution to alleviate the DRAM capacity bottleneck in consumer devices, which can be further enhanced by tailoring system-level mechanisms to better leverage the characteristics of our workloads and the NVM.

The purpose of the study was to determine the effects of starch-natural deep eutectic solvents (NADES) coating on the physicochemical characteristics of strawberries during storage. The samples were stored at room temperature (20 °C) and coated with lactic acid: fructose (5:1) NADES with different starch percentages. Significant (p ≤ 0.05) differences between coated and control strawberry fruits were observed, and all the coated fruits delayed the ripening process, which was characterized by a reduction in firmness, weight loss, total soluble solid, ascorbic acid, and microbial load as compared to the uncoated sample. The formulations containing 10% starch-NADES were found to be the most effective, followed by lower starch concentration. The reduction behavior of firmness, weight loss, total soluble solid, and ascorbic acid of the coated and uncoated fruits followed first-order kinetics. When compared to the uncoated sample, the coated sample shows a lower reaction rate constant. The findings indicated that starch-NADES would be a promising coating substance for perishable fruit, such as strawberries, as it could prolong the ripening process by up to 18 days when stored at 20 °C.

Multifunctional plant growth-promoting bioinoculants are used to enhance growth, harvest yields, and add economic value to agricultural crops. In this study, such bioinoculant, BC-II-20 (Pseudomonas sp.), was isolated from the rhizospheric soil of a medicinal plant Bergenia ciliata from the Garhwal Himalayas, Uttarakhand, India. After characterization, supplementation with Pseudomonas sp. was used to study growth stimulation in a commercially important medicinal plant, Andrographis paniculata (Kalmegh), and it depicted enhanced physiological growth parameters under controlled conditions. Bacterial seed priming and also supplementation led to early and increased germination and plants displayed better vegetative growth during the entire growth stages. Early initiation of flowers and the appearance of pods occurred in inoculated plants, ultimately leading to the reduction in the life cycle of the plant. At the time of harvesting, there was an increase in the physiological parameters such as shoot length (38%), root length (14%), fresh weight (57%), dry weight (60%), number of panicles, and root branching. Photosynthetic efficiency was also higher, and ultimately, overall plant growth was improved by bacterial inoculation. The eco-friendly and sustainable use of this bioinoculant will provide an alternative to harmful chemical fertilizers and has become increasingly important. In conclusion, we reported a promising bioinoculant having plant growth-promoting traits, which promotes growth and development in A. paniculata and may be applied to other plants also.

Drones have many applications in our daily lives and can be employed for agricultural, military, commercial, disaster relief, research and development, and many other purposes. There has been a significant increase in the usage of small drones/unmanned aerial vehicles in recent years. Consequently, there is a rising potential for small drones to be misused for illegal activities, such as terrorism and drug smuggling. Hence, there is a need for accurate and reliable UAV identification that can be used in various environments. In this paper, different versions of the current state-of-the-art object detection model, i.e., YOLO models, are used, by working on the principles of computer vision and deep learning to detect small UAVs. To improve the accuracy of small UAV detection, this paper proposes the application of various image-processing techniques to the current detection model, which has resulted in a significant performance increase. In this study, a mAP score of 96.7% was obtained for an IoU threshold of 50% along with a precision value of 95% and a recall of 95.6%. Distance-wise analysis of drones (i.e., for close, mid, and far ranges) was also performed to measure distance-wise accuracies.

IntroductionIn India, smokeless tobacco (SLT) is a predominant form of tobacco used among people living with HIV (PLHIV). Despite SLT being a risk factor for oral potentially malignant disorders (OPMDs), no prior studies have quantified the association of OPMDs with SLT use among PLHIV. This limits the planning of preventive and control strategies for oral cancer among PLHIV, who are at higher risk for the disease.MethodsWe enrolled 601 PLHIV and 633 HIV-uninfected individuals in an oral cancer screening study at BJ Government Medical College, Pune, India. Oral cavity images were collected using an m-Health application and reviewed by three clinicians. Participants with two clinician positive diagnoses were deemed to have suspected OPMDs. Prevalence ratios (PRs) were used to quantify the association between suspected OPMDs and SLT use among PLHIV. PRs for current SLT users, across HIV status and use duration were also estimated. Corrected PRs were obtained by modifying the maximum likelihood estimation. Models were adjusted for age, smoking, alcohol use and CD4 counts.ResultsOf those enrolled, 61% were men, median age was 36 years (IQR: 28-44), and 33% currently use SLT. Proportion of current SLT users was similar across PLHIV and HIV-uninfected groups but use duration for current SLT use was higher among PLHIV(pConclusionPLHIV that are current SLT users are at high risk of OPMDs and potentially oral cancer. The development of strategies for screening, early detection, and management of OPMDs must be considered for this group.

Odontogenic tumors are rare entities, often derived from epithelial remnants in the gnathic bones following odontogenesis. Ameloblastoma is benign locally invasive accounting for 1% of tumors of jaws. Among the various ameloblastoma, solid multicystic ameloblastoma is believed to be locally aggressive lesion that has the tendency for recurrence. In this report, we present a large aggressive solid multicystic ameloblastoma in a 33-year-old male patient diagnosed by computed tomography and successfully managed by hemimandibulectomy with simultaneous reconstruction using fibula. We have also briefly discussed the molecular pathogenesis and new treatment aspects of ameloblastoma.

Introduction: Knee is the largest joint in the human body with a very complex anatomy. It is a mobile trochoginglymus (i.e. a pivotal hinge joint), which permits flexion and extension as well as a slight medial and lateral rotation. Since the knee supports nearly the whole weight of the body, it is vulnerable to both acute injury and the development of osteoarthritis. The anterior cruciate ligament (ACL) is an important ligament for the proper movement of knee joint. ACL injury commonly causes knee instability than injury to other knee ligaments. Conclusion: In our study, we found the following: 1. Patients suffering from road traffic accidents have the highest rate of development of ACL injury department of Jawaharlal Nehru medical collage sawangi. 2. Twisting injuries/trivial fall injuries/injuries from fall on ground give the second highest numbers of ACL injuries in rural population. 3. Men are more prone to have ACL injury than women in rural population. 4. Patients falling in the age group of 16-25 years of age are more prone to have ACL injuries in rural population.

BACKGROUND:A critical challenge in providing TB care to People Living with HIV (PLHIV) is establishing an accurate bacteriological diagnosis. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents results from PLHIV taking part in a large demonstration study across India wherein upfront Xpert MTB/RIF testing was offered to all presumptive PTB cases in public health facilities. METHOD:The study covered a population of 8.8 million across 18 sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each TU. All HIV-infected patients suspected of TB (both TB and Drug Resistant TB (DR-TB)) accessing public health facilities in study area were prospectively enrolled and provided upfront Xpert MTB/RIF testing. RESULT:2,787 HIV-infected presumptive pulmonary TB cases were enrolled and 867 (31.1%, 95% Confidence Interval (CI) 29.4‒32.8) HIV-infected TB cases were diagnosed under the study. Overall 27.6% (CI 25.9-29.3) of HIV-infected presumptive PTB cases were positive by Xpert MTB/RIF, compared with 12.9% (CI 11.6-14.1) who had positive sputum smears. Upfront Xpert MTB/RIF testing of presumptive PTB and DR-TB cases resulted in diagnosis of 73 (9.5%, CI 7.6‒11.8) and 16 (11.2%, CI 6.7‒17.1) rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high 97.7% (CI 89.3‒99.8), with no significant difference with or without prior history of TB treatment. CONCLUSION:The study results strongly demonstrate limitations of using smear microscopy for TB diagnosis in PLHIV, leading to low TB and DR-TB detection which can potentially lead to either delayed or sub-optimal TB treatment. Our findings demonstrate the usefulness and feasibility of addressing this diagnostic gap with upfront of Xpert MTB/RIF testing, leading to overall strengthening of care and support package for PLHIV.

BACKGROUND:Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. METHODS:This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. RESULTS:In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. CONCLUSION:Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased case-notification rates of all bacteriologically confirmed TB by 39% and rifampicin-resistant TB case notification by fivefold.

In India as elsewhere, multi-drug resistance (MDR) poses a serious challenge in the control of tuberculosis (TB). The End TB strategy, recently approved by the world health assembly, aims to reduce TB deaths by 95% and new cases by 90% between 2015 and 2035. A key pillar of this approach is early diagnosis of tuberculosis, including use of higher-sensitivity diagnostic testing and universal rapid drug susceptibility testing (DST). Despite limitations of current laboratory assays, universal access to rapid DST could become more feasible with the advent of new and emerging technologies. Here we use a mathematical model of TB transmission, calibrated to the TB epidemic in India, to explore the potential impact of a major national scale-up of rapid DST. To inform key parameters in a clinical setting, we take GeneXpert as an example of a technology that could enable such scale-up. We draw from a recent multi-centric demonstration study conducted in India that involved upfront Xpert MTB/RIF testing of all TB suspects.We find that widespread, public-sector deployment of high-sensitivity diagnostic testing and universal DST appropriately linked with treatment could substantially impact MDR-TB in India. Achieving 75% access over 3 years amongst all cases being diagnosed for TB in the public sector alone could avert over 180,000 cases of MDR-TB (95% CI 44187 - 317077 cases) between 2015 and 2025. Sufficiently wide deployment of Xpert could, moreover, turn an increasing MDR epidemic into a diminishing one. Synergistic effects were observed with assumptions of simultaneously improving MDR-TB treatment outcomes. Our results illustrate the potential impact of new and emerging technologies that enable widespread, timely DST, and the important effect that universal rapid DST in the public sector can have on the MDR-TB epidemic in India.

BackgroundXpert MTB/RIF is an automated cartridge-based nucleic acid amplification test that has demonstrated its potential to detect tuberculosis and rifampicin resistance with high accuracy. To assist scale-up decisions in India, a feasibility assessment of Xpert MTB/RIF implementation was conducted within microscopy centres of 18 RNTCP TB units.MethodsAs part of programme-based demonstration of Xpert MTB/RIF implementation, we recorded and analysed association between key implementation factors and the ability of test to produce valid results. Factors contributing to test failures were analysed from GeneXpert software data which provides 'failure codes' and causes for test failures.ResultsFrom March'12 to January'13, total 40,035 suspects were tested by Xpert MTB/RIF, and 39,680 (99.1%) received valid results (Cumulative: 37157 (92.8%) on first attempt, 39410 (98.4%) on second attempt, 39637 (99.0%) on third attempt and 39680 (99.1%) on more attempts). Overall initial test failure was 2,878 (7.2% (4%-17%)); of these, 2,594 (90.1%) were re-tested and produced valid results. Most frequent reason of test failure was inadequate sample processing or equipment malfunction (3.9%). Other reasons included power failure (1.1%), cartridge integrity/component failure (0.8%), device-computer communication error (0.5%), and temperature-related errors (0.08%). Significant variation was observed in failure rates both across instruments and over time; furthermore, substantial variation was observed in failure rate in two cartridges lots.ConclusionInstallation required minimal infrastructure modifications and concerns about adequacy of human resources under public sector facilities and temperature extremes proved unfounded. Under routine conditions, Xpert MTB/RIF provided 99.1% valid results in TB suspects with low overall failure rates (7.2% initial failure, 0.9% final failure); devices provided valuable real-time feedback on reasons for test failure, which were used for rapid corrective action. High modular replacement (32%) and inter-lot cartridge performance variation remain sources of concern, and warrant close monitoring of failure rates as a key quality indicator.

BACKGROUND:Diagnosis of pulmonary tuberculosis (PTB) in children is challenging due to difficulties in obtaining good quality sputum specimens as well as the paucibacillary nature of disease. Globally a large proportion of pediatric tuberculosis (TB) cases are diagnosed based only on clinical findings. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents the results from pediatric groups taking part in a large demonstration study wherein Xpert MTB/RIF testing replaced smear microscopy for all presumptive PTB cases in public health facilities across India. METHODS:The study covered a population of 8.8 million across 18 programmatic sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each study TU. Pediatric presumptive PTB cases (both TB and Drug Resistant TB (DR-TB)) accessing any public health facilities in study area were prospectively enrolled and tested on Xpert MTB/RIF following a standardized diagnostic algorithm. RESULTS:4,600 pediatric presumptive pulmonary TB cases were enrolled. 590 (12.8%, CI 11.8-13.8) pediatric PTB were diagnosed. Overall 10.4% (CI 9.5-11.2) of presumptive PTB cases had positive results by Xpert MTB/RIF, compared with 4.8% (CI 4.2-5.4) who had smear-positive results. Upfront Xpert MTB/RIF testing of presumptive PTB and presumptive DR-TB cases resulted in diagnosis of 79 and 12 rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high (98%, CI 90.1-99.9), with no statistically significant variation with respect to past history of treatment. CONCLUSION:Upfront access to Xpert MTB/RIF testing in pediatric presumptive PTB cases was associated with a two-fold increase in bacteriologically-confirmed PTB, and increased detection of rifampicin-resistant TB cases under routine operational conditions across India. These results suggest that routine Xpert MTB/RIF testing is a promising solution to present-day challenges in the diagnosis of PTB in pediatric patients.

The objectives of the study were to compare the performance of line probe assay (GenoType MTBDRplus) with solid culture method for an early diagnosis of multidrug resistant tuberculosis (MDR-TB), and to study the mutation patterns associated with rpoB, katG and inhA genes at a tertiary care centre in north India.In this cross-sectional study, 269 previously treated sputum-smear acid-fast bacilli (AFB) positive MDR-TB suspects were enrolled from January to September 2012 at the All India Institute of Medical Sciences hospital, New Delhi. Line probe assay (LPA) was performed directly on the sputum specimens and the results were compared with that of conventional drug susceptibility testing (DST) on solid media [Lowenstein Jensen (LJ) method].DST results by LPA and LJ methods were compared in 242 MDR-TB suspects. The LPA detected rifampicin (RIF) resistance in 70 of 71 cases, isoniazid (INH) resistance in 86 of 93 cases, and MDR-TB in 66 of 68 cases as compared to the conventional method. Overall (rifampicin, isoniazid and MDR-TB) concordance of the LPA with the conventional DST was 96%. Sensitivity and specificity were 98% and 99% respectively for detection of RIF resistance; 92% and 99% respectively for detection of INH resistance; 97% and 100% respectively for detection of MDR-TB. Frequencies of katG gene, inhA gene and combined katG and inhA gene mutations conferring all INH resistance were 72/87 (83%), 10/87 (11%) and 5/87 (6%) respectively. The turnaround time of the LPA test was 48 hours.The LPA test provides an early diagnosis of monoresistance to isoniazid and rifampicin and is highly sensitive and specific for an early diagnosis of MDR-TB. Based on these findings, it is concluded that the LPA test can be useful in early diagnosis of drug resistant TB in high TB burden countries.

BACKGROUND:HIV-infected persons suffering from tuberculosis experience high mortality. No programmatic studies from India have documented the delivery of mortality-reducing interventions, such as cotrimoxazole prophylactic treatment (CPT) and antiretroviral treatment (ART). To guide TB-HIV policy in India we studied the effectiveness of delivering CPT and ART to HIV-infected persons treated for tuberculosis in three districts in Andhra Pradesh, India, and evaluated factors associated with death. METHODS AND FINDINGS:We retrospectively abstracted data for all HIV-infected tuberculosis patients diagnosed from March 2007 through August 2007 using standard treatment outcome definitions. 734 HIV-infected tuberculosis patients were identified; 493 (67%) were males and 569 (80%) were between the ages of 24-44 years. 710 (97%) initiated CPT, and 351 (50%) collected >60% of their monthly cotrimoxazole pouches provided throughout TB treatment. Access to ART was documented in 380 (51%) patients. Overall 130 (17%) patients died during TB treatment. Patients receiving ART were less likely to die (adjusted hazard ratio [HR] 0.4, 95% confidence interval [CI] 0.3-0.6), while males and those with pulmonary TB were more likely to die (HR 1.7, 95% CI 1.1-2.7, and HR 1.9, 95% CI 1.1-3.2 respectively). CONCLUSIONS:Among HIV-infected TB patients in India death was common despite the availability of free cotrimoxazole locally and ART from referral centres. Death was strongly associated with the absence of ART during TB treatment. To minimize death, programmes should promote high levels of ART uptake and closely monitor progress in implementation.

BACKGROUND: Little information exists regarding the burden of HIV among tuberculosis patients in India, and no population-based surveys have been previously reported. A community-based HIV prevalence survey was conducted among tuberculosis patients treated by the national tuberculosis control programme to evaluate the HIV prevalence among tuberculosis patients in India. METHODOLOGY/PRINCIPAL FINDINGS: Fifteen districts (total population: 40.2 million) across 8 states were stratified by HIV prevalence in antenatal clinic HIV surveillance sites and randomly selected. From December 2006 to May 2007, remnant serum was collected from patients' clinical specimens taken after 2 months of anti-tuberculosis treatment and subjected to anonymous, unlinked HIV testing. Specimens were obtained and successfully tested for 5,995 (73%) of 8,217 tuberculosis patients eligible for the survey. HIV prevalence ranged widely among the 15 surveyed districts, from 1% in Koch Bihar, West Bengal, to 13.8% in Guntur, Andhra Pradesh. HIV infection was 1.3 times more likely among male TB patients than among female patients. Relative to smear-positive tuberculosis, HIV infection was 1.4 times more likely among smear-negative patients and 1.3 times more likely among extrapulmonary patients. In 4 higher-HIV prevalence districts, which had been previously surveyed in 2005-2006, no significant change in HIV prevalence was detected. CONCLUSIONS: The burden of HIV among tuberculosis patients varies widely in India. Programme efforts to implement comprehensive TB-HIV services should be targeted to areas with the highest HIV burden. Surveillance through routine reporting or special surveys is necessary to detect areas requiring intensification of TB-HIV collaborative activities.

Background: People living with HIV (PLHIV) are at an increased risk of human papillomavirus (HPV)-related head and neck cancers (HNCs). However, there is little data on the prevalence of oral HPV among PLHIV in India, limiting the planning of oral HPV preventive strategies. Methods: We used cross-sectional data from an oral cancer screening study conducted at the antiretroviral therapy (ART) centre of Byramjee-Jeejeebhoy Government Medical College-Sassoon General Hospitals (BJGMC-SGH). PLHIV ≥21 years of age with no prior history of HNCs were enrolled. We determined the prevalence of high-risk oncogenic HPV (hrHPV) and low-risk non-oncogenic HPV (lrHPV) using real-time PCR and Next-Generation Sequencing. We used multinomial logistic regression to determine the prevalence ratios (PRs) of different sociodemographic, clinical, and behavioural predictors with hrHPV and lrHPV. Multivariable models were adjusted for age, sex, CD4 count and duration on ART. Results: Of the 582 PLHIV enrolled, the median age was 40 years (IQR: 34–46) and 54% were male. More than a fourth (25.8%) had multiple sexual partners and 11% had given oral sex. Median CD4 counts were 510 cells/mm 3 (IQR: 338–700). The prevalence of hrHPV was 4.5% and lrHPV was 3.4%. Of those with hrHPV, 77% had HPV16. There were no significant associations with any predictors for both lrHPV and hrHPV in adjusted analyses. Conclusions: We found the prevalence of any oral HPV (hrHPV and lrHPV) to be 7.9% among PLHIV in India. Larger studies are required to better understand risk factors for oral HPV among Indian PLHIV.