Experiential learnings from the Nipah virus outbreaks in Kerala towards containment of infectious public health emergencies in India.

Nipah virus (NiV) outbreak occurred in Kozhikode district, Kerala, India in 2018 with a case fatality rate of 91% (21/23). In 2019, a single case with full recovery occurred in Ernakulam district. We described the response and control measures by the Indian Council of Medical Research and Kerala State Government for the 2019 NiV outbreak.

The design and development of a multicentric protocol to investigate the impact of adjunctive doxycycline on the management of peripheral lymphoedema caused by lymphatic filariasis and podoconiosis.

Background: As new lymphatic filariasis infections are eliminated through mass chemotherapy, previously affected individuals are left with the sequellae, especially chronic progressive lymphoedema. Currently this is managed by careful attention to limb hygiene to prevent infection. Studies over the past 15 years have suggested that the incorporation of doxycycline treatment may arrest or even reverse progression of lymphoedema.

Why are people dying due to tuberculosis? A study from Alappuzha District, Kerala, India.

Background: Tuberculosis (TB)is a major killer disease worldwide. It is the ninth leading cause of death worldwide and the leading cause from a single infectious agent. In India also, TB kills about 480,000 persons every year and more than 1400 every day.

Pharmacovigilance of Cutaneous Adverse Drug Reactions among Patients Attending Dermatology Department at a Tertiary Care Hospital.

Context: Cutaneous adverse drug reactions (CADRs) are the most frequent of all manifestations of drug sensitivity that present with varied and diverse morphology and therefore, awareness about them is essential for diagnosis and prevention. Aims: To evaluate the clinical spectrum, morphology, causality, severity and preventability of cutaneous adverse drug reactions in a tertiary care hospital.

Setting And Design: Descriptive study for six months in the Dermatology Department of a tertiary care hospital in Kerala.

Community engaged breast cancer screening program in Kannur District, Kerala, India: A ray of hope for early diagnosis and treatment.

Introduction: Community based programs can assist in early detection and improved survival of breast cancer.

Aims: To assess the feasibility and explore challenges of a district-wide door-to-door breast cancer screening program "ASWAS" conducted in Kannur district, Kerala, India from 2011 to 2014. METHODS: Aggregate data from survey records were collected in terms of the population screened, referred, diagnosed, and treated.

Neurosurgery videos on online video sharing sites: The next best teacher?

Background: E-learning platforms, especially the online neurosurgical video sharing sites, are playing a key role in the dissemination of knowledge related to the essential steps of operative neurosurgery.

Aim: A national survey was undertaken to assess the utility of neurosurgical operative videos exhibited on the online video-sharing sites.

Materials And Methods: Resident trainees in neurosurgery, as well as junior and senior consultant neurosurgeons practicing in India were provided, on the Google platform, a questionnaire consisting of nine multiple-choice questions and a space for remarks.

"Small small interventions, big big roles"- a qualitative study of patient, care-giver and health-care worker experiences of a palliative care programme in Kerala, India.

Background: Home-based palliative care is an essential resource for many communities. We conducted a qualitative study to explore perceptions of a home-based palliative care programme in Kerala, India, from the perspective of patients, their care-givers and the doctors, nurses and volunteers running the intervention.

Methods: A descriptive qualitative study was carried out.

Elimination of lymphatic filariasis in South East Asia.

Expanding treatment options alongside ensuring high coverage of mass drug administration can accelerate progress in elimination of lymphatic filariasis, say

Remote ischemic preconditioning for prevention of contrast induced nephropathy-Insights from an Indian study.

Objectives: To study if four cycles of remote ischemic preconditioning (RIPC) could offer protection against contrast induced nephropathy (CIN) and post procedural renal dysfunction in high risk patients undergoing percutaneous coronary intervention (PCI).

Methods: This was a prospective single blind randomized sham controlled trial where patients undergoing coronary angioplasty with stage III chronic kidney disease were randomized into sham preconditioning and remote ischemic preconditioning. The primary outcome was the reduction in the incidence of CIN.

Herpes Simplex Virus 1 and 2 in Herpes Genitalis: A Polymerase Chain Reaction-Based Study from Kerala.

Background: Herpes genitalis is an ulcerating sexually transmitted infection, the clinical importance of which lies in its ability to produce painful and recurrent disease in addition to its potential role as a cofactor in acquisition and transmission of human immunodeficiency virus. In recent years, there are increasing reports of genital herpes due to herpes simplex virus (HSV)-1 from various parts of the world. Molecular diagnostic methods such as polymerase chain reaction (PCR) have got both diagnostic and prognostic significance in genital herpes.

Population-based cancer screening through community participation: Outcome of a district wide oral cancer screening program from rural Kannur, Kerala, India.

Background: Oral cancer is a major public health challenge, and about one-fifth of all oral cancer cases reported globally are from India. In spite of the potential for early detection by simple visual examination, the majority of patients report in later stages of the disease, especially in low and middle-income countries. We report the results from a district level population-based oral cancer screening program.

Bilateral renal cortical necrosis following acute pancreatitis - A rare complication of a common disease.

Acute renal cortical necrosis is a rare cause of intrinsic acute kidney injury (AKI) which is commonly associated with obstetric complications such as placental abruption and some serious systemic disorders such as hemolytic-uremic syndrome, sepsis, severe burns, and snake bite. Acute pancreatitis is an extremely rare cause of renal cortical necrosis, and only less than 10 cases are reported in the literature. Here, we present a 24-year-old male presented with features of acute pancreatitis and oliguric AKI.

Study on Clinical Profile and Predictors of Mortality in Poisoning.

Context: is a tree native to South Asia. It belongs to the poisonous Apocynaceae family. Deliberate self-harm with fruit of this plant is a major clinical problem in the developing world.

Predictors of contrast induced nephropathy and the applicability of the Mehran risk score in high risk patients undergoing coronary angioplasty-A study from a tertiary care center in South India.

Objective: To study the incidence and predictors of Contrast induced nephropathy (CIN) in high risk patients undergoing coronary angioplasty. To study the applicability of the Mehran Risk Score (MRS) in the prediction of CIN in our population.

Methods: This was a prospective observational study where patients with an estimated glomerular filtration rate (eGFR) between 30 and 60ml/mt undergoing elective percutaneous coronary intervention (PCI) over a period of 15 months were evaluated prospectively for the development of CIN.

Imidazole bearing chalcones as a new class of monoamine oxidase inhibitors.

In the present study, series of eleven (2E)-1-[4-(1H-imidazol-1-yl)substituted phenyl]-3-phenylprop-2-en-1-one (IM1-IM11) derivatives were synthesized and evaluated as inhibitors of recombinant human monoamine oxidase (MAO) A and B. The results indicate that (2E)-3-[4-(dimethylamino) phenyl]-1-[4-(1H-imidazol-1-yl) phenyl] prop-2-en-1-one (IM5) is a nonselective and reversible competitive inhibitor of MAO-A and MAO-B with IC values of 0.30 ± 0.

Study of S100 Immunostaining in Demonstrating Neural Granulomas in Paucibacillary Leprosy.

Context: Neural granulomas are hallmark of leprosy. Challenges faced in diagnosing paucibacillary leprosy include: (i) Difficult visualization of nerve twigs on hematoxylin and eosin (H and E) sections due to their small size and (ii) Paucity of organisms on acid-fast bacilli stain.

Aims: (1) This study aimed to test the role of S100 immunostain in demonstrating neural granulomas in skin biopsies of paucibacillary leprosy, (2) to compare morphology of S100 staining of nerves inside granulomas among clinicohistologically defined different types of leprosy, and (3) to test whether the pattern of S100 immunostaining can distinguish nerve fragmentation/destruction from a normal intact nerve in skin biopsy.

Spirituality, religiousness and coping in patients with schizophrenia: A cross sectional study in a tertiary care hospital.

Religion is a form of coping that helps individuals to deal with a wide variety of difficult life situations. But most of the research in this field has been in acute patients of schizophrenia. Also, most of the research on religion and schizophrenia has focused on religion and spirituality as coping mechanisms, and research evaluating the relationship between spirituality/religiousness and repertoire of other coping skills is sparse.

Management of Chronic Subdural Hematoma: Burr Hole versus Twist Drill - A Prospective Study.

Introduction: Incidence of chronic subdural hematoma (CSDH) is about 5/100,000/year in the general population and still rising. Two surgical techniques, namely, burr-hole evacuation (BHE) versus twist-drill evacuation (TDE) are commonly used to manage such patients but the preferred surgical method continues to attract debate, and the time for an evidence-based approach is now overdue. In vogue with recent trends, a minimally invasive surgical approach is considered as best; therefore, we tried to establish the hypothesis that TDE is as safe and as effective as BHE for CSDH treatment.

Twenty years of home-based palliative care in Malappuram, Kerala, India: a descriptive study of patients and their care-givers.

Background: The well lauded community-based palliative care programme of Kerala, India provides medical and social support, through home-based care, for patients with terminal illness and diseases requiring long-term support. There is, however, limited information on patient characteristics, caregivers and programme performance. This study was carried out to describe: i) the patients enrolled in the programme from 1996 to 2016 and their diagnosis, and ii) the care-giver characteristics and palliative care support from nurses and doctors in a cohort of patients registered during 2013-2015.

Why don't key populations access HIV testing and counselling centres in Nepal? Findings based on national surveillance survey.

Objectives: To assess the demographic, behavioural, psychosocial and structural factors associated with non-utilisation of HIV testing and counselling (HTC) services by female sex workers (FSWs) and men who have sex with men/transgender (MSM/TG).

Methods: This study involved a cross-sectional design. We used the national surveillance survey data of 2012, which included 610 FSWs and 400 MSM/TG recruited randomly from 22 and three districts of Nepal, respectively.

Seroprevalence of Japanese encephalitis virus & West Nile virus in Alappuzha district, Kerala.

Background & Objectives: Several outbreaks of acute encephalitis syndrome (AES) have been reported in Alappuzha district, Kerala State, India, in the past. The aetiology of these outbreaks was either inconclusive or concluded as probable Japanese encephalitis virus (JEV) infection based on clinical presentation. The role of West Nile virus (WNV) in AES outbreaks was also determined.

Factors associated with long turnaround time for early infant diagnosis of HIV in Myanmar.

Background: A previous review of early infant diagnosis (EID) using polymerase chain reaction technology (PCR) under integrated HIV care (IHC) program in Myanmar revealed a low uptake of timely (within 6 to 8 weeks of babies' age) EID and a long turnaround time (TAT) of receiving results.

Objective: This study aimed to determine the proportion and factors associated with the composite outcome of a long TAT (≥7 weeks; from sample collection to receipt of result by mother) or nonreceipt of result among HIV-exposed babies whose blood samples were collected for PCR at <9 months of age under the IHC program, Myanmar (2013-15).

Methods: Cohort study involving record review of routinely collected data.

Prevalence of depression among middle aged women in the rural area of Kerala.

Aims: The aim of this study was to determine the prevalence of Depression among women aged 40-60 years in the rural area of Kerala using Patient Health Questionnaire 9 (PHQ-9).

Settings And Design: Ambalappuzha is an area of rural background under the District of Alappuzha. The study was conducted by Preventive and Social Medicine department of Govt.

Autoimmune Thyroiditis Presenting as Psychosis.

Hashimoto's thyroiditis is a rare condition associated mainly with neurological symptoms. It contains an abundant amount of auto-antibodies in the blood. Only a few cases of behavioral symptoms without significant neurological disturbances have been recorded in the literature.