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This paper proposes a miniaturization method for conventional Wilkinson Power Divider(WPD) by replacing the quarter wave sections with the help of fractals. The performance degradation is compensated by using Defected Ground Structure (DGS). The resultant device occupies 56% of the area in comparison to the conventional WPD. The simulation results show a reflection coefficient of -66:98 dB and isolation of 24.1021 dB at the centre frequency of 1.8 GHz. Finally a prototype model is developed on a low cost FR4 Glass Epoxy substrate and tested. The experimental results show a good agreement with the simulation results. [ABSTRACT FROM AUTHOR]

Background: Reliable and recent data of human rabies deaths and animal bites are not available in India, where a third of global cases occur. Since there is a global target of eliminating dog-mediated human rabies by 2030, understanding whether the country is on track is essential. We aimed to estimate the animal-bite burden and the number of human rabies deaths in India., Methods: We conducted a community-based nationwide cross-sectional survey with a multistage cluster-sampling design from March 2, 2022 to Aug 26, 2023, covering 60 districts in 15 Indian states. The head of the household or an adult family member was interviewed to collect information about animal-bite history in family members, receipt of anti-rabies vaccination (ARV), and death following animal bite in the family. Annual animal-bite incidence along with 95% CIs were estimated after applying the sampling weights and adjusting for clustering. We estimated annual human rabies deaths using a decision-tree probability model with parameters from the community survey and laboratory data on rabies positivity among suspected rabid dogs., Findings: Of the 337 808 individuals residing in the 78 807 households surveyed, 2052 gave a history of animal bite, mostly (1576 [76·8%]) due to dogs in the past 1 year. The weighted and adjusted annual incidence of animal bite was 6·6 (95% CI 5·7-7·6) per 1000 population, translating into 9·1 million bites nationally. Annual dog-bite incidence was 5·6 (4·8-6·6) per 1000. Among people who had been bitten by a dog, 323 (20·5%) did not receive ARV, and 1043 (66·2%) received at least three doses. Nearly half (615 [49·1%]) of the 1253 individuals who received one dose did not complete their full course of vaccination. We estimated 5726 (95% uncertainty interval 3967-7350) human rabies deaths occurring annually in India., Interpretation: Although there was a substantial decline in human rabies deaths over the past two decades, to eliminate dog-mediated human rabies by 2030, India needs to fast-track its actions by adopting a focused one-health approach. Integrating human and animal surveillance, ensuring timely administration of full course of post-exposure prophylaxis, and accelerating dog vaccination across the country are crucial steps towards this goal., Funding: Indian Council of Medical Research., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

Background: The National TB elimination programme (NTEP) is facilitating sub-national certification of "TB Free" status with benchmarks at every 20% reduction in incidence from the baseline of 2015. Drug consumption/sale is essential criteria to claim for the award. During the certification process in 10 districts of Madhya Pradesh in 2022, it was found that Nikshay Aushadhi (a web-based supply chain management portal) entries were incomplete or vacant in most of the districts and it was observed that quarterly drug requests were not sent using Nikshay Aushadhi. Hence, present study was planned to explore the perceived challenges and suggested solutions from provider perspective, pertaining to Nikshay Aushadhi portal., Methods: A descriptive qualitative study with two distinct but interrelated phases. Free listing to identify the perceived challenges and suggested solutions pertaining to Nikshay Aushadhi followed with key informant interviews to explore in detail. Finally, the findings obtained were triangulated to increase the heterogeneity and validity of the results., Result: Major perceived challenges identified were i) interrupted internet accessibility ii) frequent changes in portal iii) inadequate testing of portal before deployment/updates iii) excess, unutilized field in the portal iv & v) lack of frequent and effective training vi) quarterly drug request is not felt need vii) increased workload viii) lack of lack of human resource ix) lack of job actualization, and x) lack of digital literacy. Four major themes for suggested solutions were: i) improve the internet accessibility ii) frequent and effective training iii) job actualization and iv) improve the portal interface., Conclusion: If the internet and portal related issues are sorted out, the health care workers should be able to run this portal smoothly. Capacity building of the NTEP staff is of utmost importance., (Copyright © 2023. Published by Elsevier B.V.)

Background: The term mucormycosis refers to any fungal infection caused by fungi belonging to the Mucorales order. The disease often manifests in the skin and also affects the lungs and the brain. A large number of Mucormycosis cases were detected in Delhi, Maharashtra and Gujarat, and Madhya Pradesh., Objectives: (1) To describe the epidemiology, management, and outcome of individuals with mucormycosis. (2) To evaluate the risk factors associated with cases and control., Methodology: A case-control study, conducted in Hamidia Hospital, Bhopal, for 5 weeks. One hundred and sixty-eight patients diagnosed clinically with radiological or pathological findings was considered a case of Mucormycosis. Control was taken from March 2020 to May 28, 2021, the list of COVID-19-positive patients obtained from IDSP, MP., Results: Majority of the study participants were among the age group of 51-60 years and comprising 69.6% of males. Diabetes mellitus is the major comorbidity found in both cases (87.58%) and in controls (20.0%)., Conclusion: There is a need to stress to control hyperglycemia, and monitor blood glucose levels after discharge following COVID-19 treatment., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Indian Journal of Community Medicine.)

Competing Interests: There are no conflicts of interest.

Background: A prescription by a doctor may be taken as a reflection of physician's attitude to the disease. Inappropriate prescription has always been a serious problem in developing countries., Objectives: The objective was to observe the current prescription practices for the management of diarrhea and pneumonia in Bhopal., Settings and Design: This was a cross-sectional study., Materials and Methods: The study was conducted at the clinics and hospitals of Bhopal over 4 months. The prescription of under-5 children with a diagnosis of acute respiratory tract infection and/or acute gastroenteritis attending the outpatient departments was included in the study. Data were recorded and analysis was done., Statistical Analysis Used: Epi Info was used for statistical analysis., Results: A total of 513 prescriptions of pneumonia and 417 of diarrhea were observed under the study. Among pneumonia, signs were mentioned on 15.6%, 74% as cold and cough with 95.5% prescriptions with antimicrobials. Seventy-three percent of diarrhea prescriptions did not mention any signs. Oral rehydration salt and zinc were prescribed in majority of the prescriptions along with around 64% use of antibiotics as well for the treatment of diarrhea., Conclusion: There is a huge need of improvement in prescribing patterns in areas of complete prescriptions with clinical features, follow-up advice along with rational choice of drugs with dose, and duration., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Indian Journal of Community Medicine.)

Competing Interests: There are no conflicts of interest.

Introduction: High-risk groups (HRGs) have limited access to appropriate information and sexual and reproductive health services. They are a highly marginalized subgroup and their social stigma is a barrier for the use of health care and treatment., Objectives: (1) To assess the knowledge regarding sexually transmitted infection (STI) infections among HRGs. (2) To identify the reasons and barriers associated with low utilization of services among HRGs., Materials and Methods: Qualitative study conducted in three HRGs of Bhopal for 3 months. Six focus group discussions were done among three HRGs namely intravenous drug users (IDUs), commercial sex workers (CSWs), and men having sex with men (MSM). Issues related to STIs were asked to all the respondents and detailed responses were recorded by the voice recorders and noted down. The audio recordings were translated and transcribed into English. Transcribed data content were analyzed manually in various themes., Results: Knowledge regarding STI/reproductive tract infection: The knowledge of HRGs regarding STDs was assessed. Almost all the CSWs of the group were having considerable knowledge regarding signs and symptoms about STI. MSM were having good knowledge about STIs. Most of the IDUs had a very limited and scarce knowledge about STI. Most of the CSWs shared their problems regarding STI with family members followed by doctor. Almost all the MSMs approached the counselor first before approaching a doctor and preferred to consult a doctor in a government hospital. Majority of IDUs said that they prefer to go to government hospital for getting treated for such conditions while a few prefer for private hospitals., Conclusion: Majority of HRGs are seeking health care from government health facilities while the MSMs and transgender faced discrimination at these facilities and nongovernmental organizations (NGOs) played a major role in promoting better health-seeking behavior among them. The HRGs freely discussed their problems with the NGOs., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Indian Journal of Sexually Transmitted Diseases and AIDS.)

Background: Maternal mortality is an indicator of state of maternal health services, status of women, women's health, and above all developments of nation., Objectives: The objectives of the study were to identify the patterns and causes, medical as well as sociocultural, of maternal death as well as consider and list out the rights realization perspective of the mothers, their immediate families and the community at large., Materials and Methods: A cross-sectional study was conducted in three districts of Madhya Pradesh, India, for 1 year. One hundred and two maternal deaths were covered, and verbal autopsy was conducted. Human right perspective was assessed using questionnaire., Results: Majority (64.7%) of maternal deaths occurred between 18 and 25 years of age. About 50.9% were primigravida, and postpartum hemorrhage was the most common cause. Nearly 53.9% had visited more than one facility before death., Conclusion: Poor antenatal care and lack of human resources posed major reasons for death in all facilities. Rights realization among the beneficiaries was found to be very poor., Competing Interests: There are no conflicts of interest.

Context: There is a need for a simple screening method for the detection of anemia that can be used by public health workers in the field., Aims: The aim of this study was to compare two methods for hemoglobin estimation, i.e., automated hematology analyzer and Digital Hemoglobinometer, and to find out the sensitivity and specificity of Digital Hemoglobinometer for the estimation of hemoglobin., Subjects and Methods: A hospital-based cross-sectional study was carried out for 6 months from April to September 2017 in a District Hospital of five High Priority Districts of Madhya Pradesh. Two hundred and sixty antenatal females per district were selected for the study., Results: The mean hemoglobin by autoanalyzer is 10.19, and that by Digital Hemoglobinometer device is 9.89. Overall, sensitivity of Digital Hemoglobinometer for hemoglobin estimation was calculated to be 89.4% and specificity was calculated to be 63.6%. Positive predictive value was found to be 82.6% and negative predictive value was 75.8% compared against AutoAnalyser (gold standard)., Conclusions: As the Digital Hemoglobinometer device has high sensitivity and specificity and good diagnostic accuracy, it must be used at the community level in resource-poor setting for hemoglobin estimation. In primary health-care conditions, Digital Hemoglobinometer can significantly reduce misdiagnosis of anemia compared with clinical assessment alone., Competing Interests: There are no conflicts of interest.

Objectives: To study the functioning of District Programme Management Units in the delivery of health services in various districts of Madhya Pradesh., Methodology: A cross-sectional descriptive study was conducted in seven districts of Madhya Pradesh selected randomly. The study subjects were Chief Medical and Health Officers, programme managers, assistant managers and data officers at state and district levels. Datawas collected from the respondents in a pre-designed, pre-tested in-depth interview schedule., Results: Around 70% of districts submitted their Programme Implementation Plan (PIP) on time, 30% were unable to do so because of inadequate staff and frequent changing of the reporting format. The District Programme Managers (DPMs) were not satisfied with their fixed salary. But they were satisfied with their job. In some districts the space available for the functioning of District Programme Management Unit (DPMU) are rather too small., Conclusion: Standardized uniform formats and guidelines should be made available to all DPMUs at the beginning of planning process. A comprehensive pre-service training for the DPMU staff including practical sessions, field exposure on district health planning, financial management, technical and administrative issues needs to be ensured.