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BackgroundCOVID-19 was declared as a Public Health Emergency of International Concern on 30th January 2020. Compared to the general population, healthcare workers and their families have been identified to be at a higher risk of getting infected with COVID-19. Therefore, it is crucial to understand the risk factors responsible for the transmission of SARS-CoV-2 infection among health workers in different hospital settings and to describe the range of clinical presentations of SARS-CoV-2 infection among them.MethodologyA nested case–control study was conducted among healthcare workers who were involved in the care of COVID-19 cases for assessing the risk factors associated with it. To get a holistic perspective, the study was conducted in 19 different hospitals from across 7 states (Kerala, Tamil Nadu, Andhra Pradesh, Karnataka, Maharashtra, Gujarat, and Rajasthan) of India covering the major government and private hospitals that were actively involved in COVID-19 patient care. The study participants who were not vaccinated were enrolled using the incidence density sampling technique from December 2020 to December 2021.ResultsA total of 973 health workers consisting of 345 cases and 628 controls were recruited for the study. The mean age of the participants was observed to be 31.17 ± 8.5 years, with 56.3% of them being females. On multivariate analysis, the factors that were found to be significantly associated with SARS-CoV-2 were age of more than 31 years (adjusted odds ratio [aOR] 1.407 [95% CI 1.53–1.880]; p = 0.021), male gender (aOR 1.342 [95% CI 1.019–1.768]; p = 0.036), practical mode of IPC training on personal protective equipment (aOR 1. 1.935 [95% CI 1.148–3.260]; p = 0.013), direct exposure to COVID-19 patient (aOR 1.413 [95% CI 1.006–1.985]; p = 0.046), presence of diabetes mellitus (aOR 2.895 [95% CI 1.079–7.770]; p = 0.035) and those received prophylactic treatment for COVID-19 in the last 14 days (aOR 1.866 [95% CI 0.201–2.901]; p = 0.006).ConclusionThe study was able to highlight the need for having a separate hospital infection control department that implements IPC programs regularly. The study also emphasizes the need for developing policies that address the occupational hazards faced by health workers.

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Background: As tuberculosis is one of the most common causes of morbidity and mortality in HIV-infected individuals. The present study was planned with an objective to find out the socio-demographic profile of HIV-Tb co-infected cases. Methodology: This was a descriptive longitudinal study of HIV TB co-infected patients registered in Revised National Tuberculosis Control Programme (RNTCP) and Anti-retroviral Therapy (ART) centre. Results: Diagnosis of both HIV and tuberculosis at the same time was positive in 104 (51.0%) of the patients. Majority (77.0%) of the cases were having extra-pulmonary tuberculosis which includes abdominal, lymph node, inguinal nodes, etc. Sputum positivity was seen in 22 (34.4%) of the cases. Radiological findings were significant in 24.5% of the cases HIV Tb co-infected cases. It was found 146 (75.6%) of the cases had favourable outcome i.e., cure and treatment completed. Conclusion: It was observed that 75.6% of the cases of the HIV-TB co-infected cases had a favourable outcome (cured and treatment completed). Active case finding of Tuberculosis should be done in HIV cases as we observed 51% cases having TB and HIV diagnosed simultaneously.

Introduction: After starting free Anti Retroviral Therapy (ART) in India, challenge has changed from gaining access to taking the treatment correctly and consistently in order to realize the rewards of improved health status, and reduced morbidity and mortality from HIV. This study was aimed to identify of socio-demographic risk factors responsible for non-adherence to ART. Methodology: This Case Control Study was conducted at ART centre where all patients with poor adherence percentage i.e. ≤ 95% of Treatment Adherence were denoted as ‘Case’ and good adherence percentage i.e. > 95% of Treatment Adherence were denoted as ‘Control’. The ‘Pill Count method’ was used to measure the adherence level. Results: Mean age of 104 cases and 208 unmatched controls was 36.29 years and 39.21 years respectively (p

Background: The relationship between becoming a smoker and having smoker parents, siblings, and relatives is still uncovered in India. The influences of a smoking role model in a family on smoking habits of individuals are yet to be revealed. This study aimed to understand the relationship of smoking abuse of a person with smoking of their family members. Methods: This community-based cross-sectional study was conducted in the slums of 20 urban health centers (UHCs) of Surat city (India). A pretested semi-structured questionnaire was used to collect data. The data was analyzed using Epi-Info software. Findings: Among 281 smoker participants, 168 (59.8%), 55 (19.6%), 95 (33.8%), and 50 (17.8%) had smoking fathers, grandparents, siblings, and other relatives, respectively. While 131 participants (44.6%) had correct information about the law of banned smoking, 249 participants (88.6%) were in favor of this law. The association of smoking abuse in fathers with smoking abuse in siblings came out to be odds ratio (OR) = 3.75 (95% CI: 2.11-6.63) and grandparents to be odds ratio 16.43 (95% CI: 4.98-54.17), respectively. The association between education and following the law of banned smoking was statistically significant OR = 2.98 (95% CI: 1.43-6.00).Conclusion: Substance abuse in parents, siblings, and other relatives is likely to influence the behavior of the person towards it. Persons living in the same vicinity may also greatly influence the behavior of an individual.Keywords: Smoking, Smoker, India.

Background: Microbial keratitis is common potentially sight threatening ocular infection that may be caused by bacteria, fungi or virus. Epidemiological and microbiological profile of corneal ulceration have been found vary with patient population, health of cornea, geographical location and climate tends to vary over times. Methods: The present cross-sectional study was conducted 3 on patients having microbial keratitis. Detailed history taking include duration of symptoms, predisposing factors, history of trauma, traumatic agents, associated ocular conditions, other systemic disease, treatment received prior to presentation, visual acuity at the time of presentation and all clinical findings were collected. Detailed ocular examination, using standard technique, corneal scraping were also taken under aseptic conditions from each ulcer. Results: In our study, 51 cases belonged to low socio-economic group of which 21 cases (41%) of bacterial keratitis, 15 cases (29%) of fungal keratitis , 11 cases (21%) of viral keratitis and 4 cases (8%) of Mixed (bacterial + fungal ) keratitis. A total 15 bacterial pathogens were isolated from the 64 eyes which yielded only bacterial growth in culture. Out of which 4(16%) were staphylococcus aureus, 4(16%) pseudomonas,3(12%) were streptococcus,2(8%) were staphylococcus epidermis. A total of 17 viral keratitis 9(53%) were recurrent cases. Conclusion: Trauma is most common predisposing factor responsible for microbial keratitis. Direct microscopic examination of corneal scraping is key tool for rapid diagnosing and institution of antimicrobial therapy.

Introduction: Leptospirosis is a globally important bacterial zoonotic disease occurring in rural areas of South Gujarat. Primary prevention of Leptospirosis is very difficult. This study was planned for early detection and timely referral of cases; increase awareness in high risk population regarding primary prevention and early treatment seeking; and establish and strengthen case suspicion and referral network in the community itself. Methodology: This intervention study was conducted in villages of Surat district with main focus on early recognition of symptoms of Leptospirosis and timely health care seeking. Multipronged approach including meeting with villages, local leader and local health functionaries were used as an intervention. Results: Mass campaign resulted in early health seeking behavior for suspected symptoms which is evident from gross increase in case reporting compare to previous year. These cases were reported early in their clinical course and timely treatment resulted in decreased case fatality rate from 24% in year 2012 to 9.5% in 2013. Conclusion: The comprehensive effort involving every strata of the community from health staff to Sarpanchs/local leaders to local community under one roof has desirable and positive impact on the implementation of leptospirosis control in form of early treatment seeking and timely referral.

Background: India's Revised National Tuberculosis Control Programme (RNTCP) has made significant progress in TB control through countrywide DOTS implementation. This also includes efforts to engage the private medical sector in TB care and control through various published schemes. Objective: To assess the knowledge of tuberculosis among the general practitioners in Surat. Methodology: It was cross-sectional conducted among general practitioner of Surat city by interview using a pretested semi-structured questionnaire during March-April 2010. Results: Out of the 28 participating general practitioners, only 8 (28.6%) claimed to be using the drugs of alternative medicine for TB treatment. 64.3%, 25% and 10% believed that TB should be diagnosed by sputum microscopy, X-ray findings and sputum culture respectively. Conclusion: Health policy managers and DOTS implementers should encourage all doctors, particularly private sector doctors, to receive RNTCP training and follow DOTS methodology. Improvement is needed in RNTCP training, and emphasis needs to be given to correct diagnosis, management and follow-up of TB patients.

Background: Healthcare workers in developing countries inconsistently practice universal precautions and are commonly exposed to blood in the course of their work via needle-stick injuries and direct contact. Aims and Objective: The present study was carried out to provide comprehensive data from assessment of injection practices in a Surat city with an overall aim to compare the differences between knowledge and practices among health care providers. Methodology: Qualitative study design, consisted of assessing the knowledge of staff nurses and observation during injection procedure, took place over a 2 month period during June-July 2011 in 20 health centres of Surat Municipal Corporation area. A semi-structured questionnaire regarding their views and experiences related to injection practices, awareness about the different diseases spread by faulty injection technique and disposal of biomedical waste was asked. Results: The total of 40 staff nurses was involved in the study. All of them knew that gloves should be wore during injection procedure but only 14 (35 %) were actually wearing it. Only 6 (15 %) of participants knew that gloves should be wore for both personal and patient safety. Around 65 % of the participants felt that needle should not be recapped after giving injection but 50 % were actually found to be recapping it. The percentage of needle stick injury among nurses came to be 65 %. Around 90 %, 80 % and 30 % of the participants feels that hospital staff can acquire HIV/AIDS, Hepatitis B and Hepatitis C infection respectively but 10 (25 %) don’t know anything about how this disease can contract to the health staff. Conclusion: There was a great disparity between knowledge and practice of health care workers regarding injection practices. Efforts are needed to be done in this regard for the benefit of both health care worker and patients.

Background: Surveillance is the ongoing systematic collection, collation, analysis and interpretation of data so that appropriate action can be taken within time. Aims and Objective: The present annual HIV sentinel surveillance (HSS) was carried out for monitoring trends of HIV epidemic in high risk group populations in selected sites of Gujarat state.. Methodology: The HSS was carried out in representative populations from High Risk Group (HRG) like Female Sex Workers (FSW), Man having Sex with Man (MSM) and Single Male Migrant. Target sample size was 250 at each HRG site (Female Sex Worker, Male Sex Male & SMM). Consecutive sampling was done at designated sentinel site for selecting the survey participants. Results: Overall 3726 samples (1494 FSWs, 1732 MSMs & 500 SMM) were tested in the High risk group of HSS 2008. The overall sero-positivity in samples from FSWs, MSMs sites was 4.5%. Sero-positivity was more or less high (≥ 5%) among FSWs as well as MSMs irrespective of age, place of residence, literacy level, occupation; and migration status. Conclusion: The overall trend of sero-positivity in High risk groups shows decreasing trend of HIV in the state from 2004 to 2008.

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The breast feeding practices adopted in terms of duration, frequency and exclusiveness of breast feeding and weaning have great impact on complete physical, mental and psycho-social development of the child. The objective of conducting the study is to evaluate the breast feeding practices adopted by women in urban community, and s to study factors affecting time of initiation of breast feeding, age of weaning, and food given to the baby other than breast milk. The current cross sectional study conducted among 200 women reveal that 70% of mothers were able to start breast feeding within first hour of life after normal delivery. Out of 26 complicated deliveries, 6 mothers were able to start breast feeding within 4 hours of life. The major reasons for delay in starting of breast feeding were uneasiness to mother and not having adequate breast milk. Exclusive breast feeding was practiced by 50% of the mothers for first six month of life. The common reason given by mother for not giving exclusive breast feeding were no knowledge of exclusive breast feeding (40%) and not having adequate breast milk(35%). This study emphasizes the need of breast feeding education programme regarding the duration of exclusive breast feeding and the age of weaning.