Essential health services during COVID-19: an unidentified lead

The struggle against COVID-19, which once started as an amicable endeavor with an anticipated climax has now turned into an unending, mysterious puzzle with lesser hope. What impacts more is the deficiency of financial backups in the health sector, for such an unexpectedly long duration. All these are pointing us towards a more sustainable, cost-effective method to fight against COVID-19, where the daily health and lifestyle of people are also considered. Maintenance of provision of essential health care services is important and urgent since this is the only way to decrease the indirect morbidity and mortality from other health conditions, thereby preventing the health system from collapse. Various new reforms have been made in health policies of different vulnerable groups including, people living with chronic diseases, the elderly, children and mothers, and pregnant women. To avoid the re-emergence of vaccine-preventable diseases and also future similar contagious diseases, reforms are also made in immunization services. Implementation of these amendments in the health care sector is a need of the hour and it demands a broader perspective with a long-term goal. Further, identifying gaps for innovative initiatives in the same direction are also to be welcomed, for a sustainable post-COVID-19 phase

Social marketing: a commercial marketing strategy for understanding and improving health

Disease prevention and health promotion is now looking forward to newer innovative platforms to bring social change. Social marketing is a process that applies marketing principles and techniques to create, communicate, and deliver value in order to influence target audience behaviours that benefit society (public health, safety, the environment and communities) as well as the target audience. There are many challenges of marketing approach in India like financial cost, non-availability of audience data, difficulty in measuring marketing efforts, negative demand benefit to third party etc. These challenges can be dealt with 8 benchmark of social marketing which includes exchange, self-interest, behaviour change, competition, audience segmentation, consumer orientation, formative research and marketing mix (4 ‘P’s). Currently in India, condoms are social marketed under NACP-IV which can be extended to OCPs, Injectable contraceptives, ORS, Mosquito nets etc. For success of social marketing incorporation of consumers as partners into the planning process is must along with training of health professionals to enable them to imbue public health organizations with a marketing mind-set. Grantees should be given sufficient time and resources to conduct formative research, develop evidence-based marketing strategies, pretest program interventions, and monitor program activities

Surgical Management of an Indian Spotted Eagle with Compound Fracture of Humerus

An adult Indian Spotted Eagle (Aquila hastata) was presented with a history of being unable to fly. Clinical examination and radiography revealed a compound oblique fracture in the distal humerus of the right wing. The fracture site was grossly contaminated and the fragments were necrosed. Hence, to save the life of the bird, the wing was amputated under general anaesthesia, induced and maintained with ketamine. The surgical intervention led to uncomplicated recovery of an eagle

Integration of emerging PCMs and nano-enhanced PCMs with different solar water heating systems for sustainable energy future: A systematic review

Solar water heaters (SWHs) are primarily used to generate hot water to meet daily needs in domestic and industrial applications. Due to its technical and economic practicality, solar water heating has been widely exploited for use of solar energy. However, the inconsistent availability of solar radiation and lack of energy storage facilities restrict its utilization. Thermal energy storage materials (Phase change materials and nano-enhanced phase change materials) are key solutions for effectively harvesting thermal energy from solar radiation. Integrating phase-change materials (PCMs) and nano-enhanced phase-change materials (NE-PCMs) with SWHs overcome the constraint of only being used during the daytime and making them more efficient. The main aim of this systematic review article is to summarize and highlights the key results of recent studies on SWHs integrated with PCMs and NE-PCMs for domestic and industrial water heating applications. This study also highlights the technical issues associated with SWH systems. In addition, the perspectives, recommendations, and future improvements of the SWH systems integrated with PCMs and NE-PCMs are explored to overcome the technical barriers to their practical use. In conclusion, the thermal performance of SWHs with the help of PCMs and NE-PCMs increased significantly, and the cost of the system was reduced, resulting in a shorter payback period compared to conventional SWHs. Also, there is a considerable reduction in CO2 emissions from an environmental perspective. It is intended that this study will provide new insights to the researchers to design and develop highly efficient SWH systems

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Understanding the metrics used to assess the quality of journals

Various databases offer access to thousands of academic journals. A miscellaneous picture with respect to quality, scientific influence and prestige is presented by umpteen numbers of journals present. Authors wishing to publish their research aim to publish in journals with the highest ratings and are ultimately in no man’s land

Tribal population in India: A public health challenge and road to future

India with 8.6% of tribal population is finding it difficult to bridge the gap that exists between tribal and non-tribal population in regards to healthcare. Tribal population suffers triple burden of disease; in fact it is quadruple, namely, communicable diseases, non-communicable diseases, malnutrition, mental health, and addictions complicated by poor health seeking behavior. With increasing needs, an Expert committee on Tribal health has given recommendations with the goal to bridge the current gap in the health status of tribal people latest by the year 2027. An entirely parallel health system has been proposed with key focus areas, governance, and financing. To summarize and report the present scenario in terms of disease burden, health-seeking behavior, healthcare delivery system, and a roadmap for the future along the importance of primary healthcare in achieving it. Mere establishment of more health facilities cannot overcome the poor health of tribal population and so the role of trained manpower to deliver quality healthcare, in which case the role of traditional healers, local Tribal boys and girls comes in handy. It is high time and states should act swiftly to assess the needs, priorities of their own tribal population and set goals, targets to achieve the same through proven public health strategies

Decoding mystery disease “litchi as idiopathic triggering cause of hypoglycemia-induced (LITCHI) encephalitic syndrome” – Are the evidence of association adequate?

There has been an increase in reports of outbreak of encephalopathy in children presenting with a syndrome of sudden onset of high fever and altered sensorium in and around the peak of Indian summer months in geographical regions that flourish in Litchi plantation. In the light of the increased mortality and morbidity due to the mystery disease and the speculations surrounding litchi consumptions, a study was conducted in the litchi production hub of Muzaffarpur district Bihar in India by the NCDC in technical collaboration with US CDC. The variables that were significantly associated were litchi consumption (OR: 9.6 [3.8-24.1]), visiting a fruit orchard (OR: 6 [2.7-13.4]), and absence of an evening meal (OR: 2.2 [1.2-4.3]) in the 24-h preceding illness onset. The recommendations that have been advocated are to avoid eating unripe litchi or its seed and always preferring fresh and ripe ones, children should not to go to sleep without a proper dinner meal during the litchi season and cases of altered sensorium should be always be checked for blood glucose levels and prompt correction should be done if levels suggest hypoglycemia in hospitals

Vaccination coverage and vaccine hesitancy among vulnerable population of India

Vaccination coverage in India has improved from 44% to 62%, an increase of 19% over a span of 10 y (2006–2016), the inequity continues among the vulnerable people belonging to tribal groups and migrant population. In order to leave no one behind strategy, their vaccination coverage, reasons for low coverage were analyzed from available literary sources through this review article. A systematic search for relevant articles was conducted and articles published in various journals over the past 5 y were included. The vaccine coverage among the vulnerable population ranged from 31% to 89% from various studies. It was found that parents’ education status, income of the family and lack of awareness of the schedule were the most important reasons for vaccine hesitancy. Introduction of cash assistance integrated into other national program, digitalizing vaccination cards, involvement of local healers are few strategies suggested in this article