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Objective To more accurately define the annual incidence of cholera in India, believed to be higher than reported to the World Health Organization (WHO). Methods We searched the biomedical literature to extract data on the cases of cholera reported in India from 1997 to 2006 and compared the numbers found to those reported annually to WHO over the same period. The latter were obtained from WHO's annual summaries of reported cholera cases and National health profile 2006, published by India's Central Bureau of Health Intelligence. Findings Of India's 35 states or union territories, 21 reported cholera cases during at least one year between 1997 and 2006. The state of West Bengal reported cases during all 10 years, while the state of Maharashtra and the union territory of Delhi reported cases during nine, and Orissa during seven. There were 68 outbreaks in 18 states, and 222 038 cases were detected overall. This figure is about six times higher than the number reported to WHO (37 783) over the same period. The states of Orissa, West Bengal, Andaman and Nicobar Islands, Assam and Chhattisgarh accounted for 91% of all outbreak-related cases. Conclusion The reporting of cholera cases in India is incomplete and the methods used to keep statistics on cholera incidence are inadequate. Although the data are sparse and heterogeneous, cholera notification in India is highly deficient. [ABSTRACT FROM AUTHOR]

Background Online education has gained popularity in various fields, including medicine, owing to its flexibility and time-saving advantages. The COVID-19 pandemic has further accelerated its adoption as an alternative to traditional in-person learning. Medical students appreciate the ability to study at their own pace, access resources remotely, and engage in virtual collaboration and networking. Objective The objective of this study was to determine the perception of online education among medical students. Method A cross-sectional descriptive study was conducted at Kathmandu University School of Medical Sciences (KUSMS), Nepal, comprising 332 participants. A Google Form questionnaire was used to assess their perceptions and responses deliberated on a three-point Likert scale. Descriptive analysis was used to determine the respondents' views. Result The results showed that a significant majority (64.8%) of the respondents agreed that accessing the internet for online education was easy. However, only 35.5% felt comfortable attending online lectures at home. Regarding the effectiveness of online learning, the majority (66.3%) disagreed that it was similar to traditional classroom lectures. More than half (51.5%) of the respondents agreed that online classes were time-consuming and (71%) required breaks during sessions. Surprisingly, only 27% expressed a preference for online education. Additionally, a notable proportion (87%) disagreed that online education could provide similar real-world skills. Moreover, the majority (85%) disagreed that conducting exams for theoretical and practical/clinical courses virtually was possible. Conclusion Despite the availability of internet access for the majority of students, a significant proportion expressed discomfort with online education. Only a quarter preferred it, and many disagreed that it could replicate the traditional classroom experience or provide comparable skills. Training all faculties, providing high-speed internet, improving student interaction, and giving online demonstrations can enhance student preferences and online quality.

Background: Many areas with endemic and epidemic cholera report significant levels of HIV transmission. According to the World Health Organization (WHO), over 95% of reported cholera cases occur in Africa, which also accounts for nearly 70% of people living with HIV/AIDS globally. Peru-15, a promising single dose live attenuated oral cholera vaccine (LA-OCV), was previously found to be safe and immunogenic in cholera endemic areas. However, no data on the vaccine's safety among HIV-seropositive adults had been collected., Methods: This study was a double-blinded, individually randomized, placebo-controlled trial enrolling HIV-seropositive adults, 18-45 years of age, conducted in Bangkok, Thailand, to assess the safety of Peru-15 in a HIV-seropositive cohort., Results: 32 HIV infected subjects were randomized to receive either a single oral dose of the Peru-15 vaccine with a buffer or a placebo (buffer only). No serious adverse events were reported during the follow-up period in either group. The geometric mean fold (GMF) rise in V. cholerae O1 El Tor specific antibody titers between baseline and 7 days after dosing was 32.0 (p<0.001) in the vaccine group compared to 1.6 (p<0.14) in the placebo group. Among the 16 vaccinees,14 vaccinees (87.5%) had seroconversion compared to 1 of 16 placebo recipients (6.3%). V. cholerae was isolated from the stool of one vaccinee, and found to be genetically identical to the Peru-15 vaccine strain. There were no significant changes in HIV viral load or CD4 T-cell counts between vaccine and placebo groups., Conclusion: Peru-15 was shown to be safe and immunogenic in HIV-seropositive Thai adults., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background/aims: To evaluate early surgical outcome and analyze postoperative complications of gastric cancer surgery, on the basis of standard auditing system., Methodology: 357 patients who underwent operations for gastric cancer were included in this study. We applied POSSUM (Physiological and Operative Severity Score for the enumeration of Morbidity and mortality) system to predict morbidity. The observed to estimated morbidity ratio (O: E) was calculated to give risk adjusted morbidity. All the complications were stratified according to its severity and analyzed separately., Results: Observed morbidity was not significantly different from predicted value, the O: E ratio was 1.01. Overall, 137 patients were observed to have postop complications (including 5 death); infection was the main complication which complicated about 17 per cent patients and occupying 44 per cent of all complications. Pulmonary infection rate was on the top., Conclusions: Post operative complication is higher in gastric cancer surgery. POSSUM system along with stratification of complications is a reliable algorithm in surgical audit to analyze various complications. Postoperative infection is the culprit of various complications. Postoperative infection especially the pulmo-nary infection stands on the top of all complications. More prospective study including basic researches is necessary to explore the etiology of different compilations.