Managerial Challenges in Addressing HIV/AIDS: Gujarat State AIDS Control Society (GSACS)

The spread of HIV/AIDS is not merely a problem of public health; it is also an economic, political, and social challenge that threatens to hinder decades of progress in different parts of Gujarat. There is an urgent need to significantly scale-up public health interventions that work to make a meaningful impact. While NGOs and community based organizations have a critical role to play in implementing these interventions amongst the various population groups, the government must shoulder the overall responsibility for planning, coordinating, mobilizing, and facilitating the various HIV/AIDS prevention, care and treatment services in the state. Generally, the departments of HIV/AIDS are dominated by doctor-managers who lack training in management. This working paper was developed with objective of enhancing the skills of the program implementers. In this paper, in first three chapters we describe the overall situation of HIV/AIDS globally and nationally. Major challenges in managing sentinel surveillance, behavior surveillance, targeted interventions and its subcomponents have been described in chapter four. Issues related to integration of HIV/AIDS activities with reproductive health has also been discussed in the chapter. In chapter five, we present a few case studies from Gujarat State AIDS Control Society. These cases focus on the managerial issues in the following areas: Project Management, Blood Bank Management, VCTC/ICTC Management, Behavioral Surveillance and MIS for Targeted Interventions. These case studies bring out the ground level realities and can help participants develop insights for better management of the HIV/AIDS programme.

AstroSat view of the newly discovered X-ray transient MAXI~J1803--298 in the Hard-intermediate state

We perform comprehensive temporal and spectral analysis of the newly discovered X-ray transient MAXI~J1803--298 using an AstroSat target of opportunity observation on May 11, 2021 during its outburst. The source was found to be in the hard intermediate state. We detect type C quasi-periodic oscillations (QPOs) at the frequencies of $\sim5.4$ Hz and $\sim6.3$ Hz along with a sub-harmonic at $\sim2.8$ Hz in the $3-15$ keV band. The frequency and fractional rms amplitude of the QPO in the $15-30$ keV band are found to be higher than those in the $3-15$ keV band. We find soft lags of $\sim3.8$ ms and $\sim6.8$ ms for the respective QPOs at $\sim5.4$ Hz and $\sim6.3$ Hz, whereas soft lag of $\sim4.7$ ms is found at the sub-harmonic frequency. The increase in the soft lags at the QPO frequencies with energy is also observed in other black hole transients and is attributed to the inclination dependence of the lags. The rms-energy spectra indicate the power-law component to be more variable than the disk and the reflection components. We find a broad iron line with an equivalent width of $\sim0.17-0.19$ keV and a reflection hump above $\sim12$ keV in the energy spectrum. Based on the X-ray spectroscopy and considering the distance to the source as 8 kpc, the estimated mass ($\sim8.5-16$ M$_\odot$) and spin ($a\gtrsim0.7$) of the black hole suggest that the source is likely to be a stellar mass Kerr black hole X-ray binary.Comment: Accepted for publication in The Astrophysical Journal (ApJ). 17 pages and 9 figure

Stability Analysis of Twin Axial Groove Hybrid Journal Bearing

Stability of rigid rotor supported on hybrid journal bearing with twin axial groove has been investigated using stiffness and damping coefficients of the bearings. In this paper the stability analysis of twin axial groove bearing is determined in different fluid flow regime. Non linear journal centre trajectories are drawn for small amplitude oscillations of the journal centre about its steady state position. It was observed that turbulence decreases 10 to 12 percent the stability margin of twin grooved journal bearings

Dengue fever mimicking acute appendicitis: A case report

AbstractINTRODUCTIONDengue fever is an acute viral disease, which usually presents as a mild febrile illness. Patients with severe disease present with dengue haemorrhagic fever or dengue toxic shock syndrome. Rarely, it presents with abdominal symptoms mimicking acute appendicitis. We present a case of a male patient presenting with right iliac fossa pain and suspected acute appendicitis that was later diagnosed with dengue fever following a negative appendicectomy.PRESENTATION OF CASEA 13-year old male patient presented with fever, localized right-sided abdominal pain and vomiting. Abdominal ultrasound was not helpful and appendicectomy was performed due to worsening abdominal signs and an elevated temperature. A normal appendix with enlarged mesenteric nodes was found at surgery. Complete blood count showed thrombocytopenia with leucopenia. Dengue fever was now suspected and confirmed by IgM enzyme-linked immunosorbent assay against dengue virus.DISCUSSIONThis unusual presentation of dengue fever mimicking acute appendicitis should be suspected during viral outbreaks and in patients with atypical symptoms and cytopenias on blood evaluation in order to prevent unnecessary surgery.CONCLUSIONThis case highlights the occurrence of abdominal symptoms and complications that may accompany dengue fever. Early recognition of dengue fever mimicking acute appendicitis will avoid non-therapeutic operation and the diagnosis may be aided by blood investigations indicating a leucopenia, which is uncommon in patients with suppurative acute appendicitis

A Crash Injury Model Involving Autonomous Vehicle: Investigating of Crash and Disengagement Reports

Autonomous vehicles (AVs) are being extensively tested on public roads in several states in the USA, such as California, Florida, Nevada, and Texas. AV utilization is expected to increase into the future, given rapid advancement and development in sensing and navigation technologies. This will eventually lead to a decline in human driving. AVs are generally believed to mitigate crash frequency, although the repercussion of AVs on crash severity is ambiguous. For the data-driven and transparent deployment of AVs in California, the California Department of Motor Vehicles (CA DMV) commissioned AV manufacturers to draft and publish reports on disengagements and crashes. This study performed a comprehensive assessment of CA DMV data from 2014 to 2019 from a safety standpoint, and some trends were discerned. The results show that decrement in automated disengagements does not necessarily imply an improvement in AV technology. Contributing factors to the crash severity of an AV are not clearly defined. To further understand crash severity in AVs, the features and issues with data are identified and discussed using different machine learning techniques. The CA DMV accident report data were utilized to develop a variety of crash AV severity models focusing on the injury for all crash typologies. Performance metrics were discussed, and the bagging classifier model exhibited the best performance among different candidate models. Additionally, the study identified potential issues with the CA DMV data reporting protocol, which is imperative to share with the research community. Recommendations are provided to enhance the existing reports and append new domain

Percutaneous transolecranon pinning and lateral pinning Vs lateral pinning in displaced supracondylar fractures of humerus in children: an observative study

Background: Supracondylar fracture (humerus) is type of extra-articular fracture occurring in the distal metaphyseal site of humerus. It is almost exclusively a fracture of the immature skeleton, seen in children and young teenagers. Fractures around the elbow are a great challenge to orthopaedic surgeons. Clinical diagnosis may be difficult due to noncooperative patient and massive swelling around the elbow. Displaced type of supracondylar fractures poses problem not only in reduction but also in maintenance of reduced fracture   and   rapid   inclusion   of nerves and vessels.Methods: The present study was conducted on 30 cases of displaced supracondylar fracture humerus in children, aged 2-14 years, who were treated by CRPP with either lateral entry of k-wires or a lateral wire and a vertical wire through olecranon (transolecranon).Results: Both the Groups achieved 90% satisfactory results, but 10% unsatisfactory results recorded in Group A only rather than in Group B.Conclusions: Although the transolecranon wire has the disadvantage of limiting the flexion and extension of the elbow, this does not influence the final-outcome much as the elbow is fixed in a POP splint for minimum 3 weeks-in all patients in both groups