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Introduction Cervical cancer has been considered as one of the most common cancers in women (15–44 years) globally, but the advent of the human papilloma virus (HPV) vaccine has raised the anticipation that eradication of cervical carcinoma might be achieved in the near future as several prophylactic cervical carcinoma vaccines have already been currently licensed in various countries. Countries should devise strategies, practices and policies to attain and sustain higher levels of HPV immunization coverage as still 68% countries have introduced HPV vaccine in their national immunization programs even after 17 years following the licensure of the first prophylactic HPV vaccine. Methodology A comprehensive literature analysis was conducted using various databases and search engines, to include the most relevant research articles and data available and critically discussed the operational gaps that need to be answered to achieve adequate coverage of HPV vaccination. Results The present review highlights the existing HPV vaccination strategies, unmet needs and challenges needed to be addressed for proper implementation framework as well as the collaborations required to achieve decent vaccination coverage. Well‐coordinated vaccination strategy with focus on adolescent girls and if possible, boys can lead to dramatic impact on disease reduction around the world. Practices and policies related to human papilloma virus (HPV) vaccination need to be improved to achieve better vaccination coverage. The present review highlights the existing HPV vaccination strategies, unmet needs and challenges needed to be addressed for proper implementation framework as well as the collaborations required to achieve decent vaccination coverage.

Sheath blight (ShB) caused by Rhizoctonia solani is one of the serious constraints that hamper global rice production. It causes severe yield loss of up to 69% under favorable environmental conditions. The application of chemical fungicides remains the primary approach for the management of this disease. But, overuse of chemical fungicides causes potential health and environmental risk. The use of host plant resistance is a very effective, economic, and sustainable strategy to control sheath blight disease in rice. In this report, we have evaluated 405 accessions of Oryza rufipogon for four ShB-related traits i.e. lesion height (LH), plant height (PH), relative lesion length (RLH), and disease score (DS) during the years 2015, 2016, and 2017. A total of 44,109 high-quality SNP markers on 301 accessions were employed to identify significant marker-trait associations using a genome-wide association study (GWAS). The GWAS analysis revealed a total of 22 significant SNPs associated with the ShB-related traits distributed on all the rice chromosomes except 10 and 12. Among them, eleven were associated with RLH, seven with PH, and one each with LH and DS. The SNPs on chromosomes 3 and 9 were associated with multiple traits. Furthermore, seven ShB resistance loci were also found to be co-localized with previously reported ShB resistance genes/QTLs. These findings provide valuable information to identify key SNPs associated with ShB resistance. Significantly associated SNPs could be used for introgression of ShB resistance traits into rice cultivars using marker-assisted selection.

Background: The COVID-19 pandemic restricted movement, closed businesses, and economic activities which disproportionately affected people globally. This pandemic has resurfaced the existing cracks in the societal set-up and has pushed the vulnerable and marginalized communities like migrant workers, people with disabilities, geriatric population, and commercial sex workers (CSWs) to an edge for their existence. Materials and Methods: Due to the paucity of peer-reviewed research publications on CSWs, formative research was conducted to identify the determinants and attributes of the challenges faced by CSWs during COVID-19 situation in India. Media scanning approach was used to collate literature from newspaper and magazine reporting, and peer-reviewed articles were referred from research-based search engines. Results: In total, 31 articles were included for content analysis and four domains of issues i.e., economic, social, psychological and health related challenged faced by them were identified which are supported with the verbatims of the community members as reported in the data sources considered for this study. It was identified that the CSWs adopted several protective measures and coping strategies to deal with the pandemic situation. Conclusion: This research highlighted that there is a need for further exploration of issues among CSWs by conducting studies among the communities. Furthermore, this paper provides a scope for future implementation research by identifying the key priorities and determinants of the challenges among the personal livelihood of CSWs in the country.

Despite the significant success of India’s COVID-19 vaccination program, a sizeable proportion of the adult population remains unvaccinated or has received a single dose of the vaccine. Despite the recommendations of the Government of India for the two doses of the COVID-19 vaccine and the precautionary booster dose, many people were still hesitant towards the COVID-19 full vaccination. Hence, this study aimed to identify the primary behavioral and psychological factors contributing to vaccine hesitancy. Cross-sectional data was collected via a multi-stage sampling design by using a scheduled sample survey in the Gorakhpur district of Uttar Pradesh, India, between 15 July 2022 to 30 September 2022. This study has utilized three health behavior models—the Health Belief Model (HBM) , the Theory of Planned Behavior (TPB) , and the 5C Psychological Antecedents of vaccination, and employed bivariate and multivariable binary logistic regression model to assess the level of vaccine hesitancy and predictive health behavior of the respondents. Results indicate that among the constructs of the HBM and 5C Antecedents models, \"perceived benefits\", \"confidence\" and \"collective responsibility\" showed a lesser likelihood of COVID-19 vaccine hesitancy. However, in the TPB model constructs, a ‘negative attitude towards the vaccine’ showed a four times higher likelihood of COVID-19 vaccine hesitancy. From the future policy perspective, this study suggested that addressing the issue of ‘negative attitudes towards the vaccine’ and increasing the trust or confidence for the vaccine through increasing awareness about the benefits of the vaccination in India may reduce vaccine hesitancy.

The public health landscape in North-East India is marked by the foundational principle of equitable health care provision, a critical endeavor considering the region's intricate geography and proximity to international borders. Health care workers grapple with challenges, such as treacherous routes, limited infrastructure, and diverse cultural nuances, when delivering essential medical services. Despite improvements since the National Rural Health Mission in 2005, challenges persist, prompting a study to identify health care workers' challenges and alternative strategies in Manipur and Nagaland. This study aims to document the challenges experienced by health care workers during service delivery in the geographically challenging terrains of North-East India. This study is part of the i-DRONE (Indian Council of Medical Research's Drone Response and Outreach for North East) project, which aims to assess the feasibility of drone-mediated vaccine and medical delivery. This study addresses the secondary objective of the i-DRONE project. In-depth interviews of 29 health care workers were conducted using semistructured questionnaires in 5 districts (Mokokchung and Tuensang in Nagaland, and Imphal West, Bishnupur, and Churachandpur in Manipur). Nineteen health facilities, including primary health care centers, community health centers, and district hospitals, were selected. The study considered all levels of health care professionals who were in active employment for the past 6 months without a significant vacation and those who were engaged in ground-level implementation, policy, and maintenance activities. Data were recorded, transcribed, and translated, and subsequently, codes, themes, and subthemes were developed using NVivo 14 (QSR International) for thematic analysis. Five themes were generated from the data: (1) general challenges (challenges due to being an international borderline district, human resource constraints, logistical challenges for medical supply, infrastructural issues, and transportation challenges); (2) challenges during the COVID-19 pandemic (increased workload, lack of diagnostic centers, mental health challenges and family issues, routine health care facilities affected, stigma and fear of infection, and vaccine hesitancy and misinformation); (3) perception and awareness regarding COVID-19 vaccination; (4) alternative actions or strategies adopted by health care workers to address the challenges; and (5) suggestions provided by health care workers. Health care workers demonstrated adaptability by overcoming these challenges and provided suggestions for addressing these challenges in the future. Health care workers in Manipur and Nagaland have shown remarkable resilience in the face of numerous challenges exacerbated by the pandemic. Despite infrastructural limitations, communication barriers, and inadequate medical supply distribution in remote areas, they have demonstrated adaptability through innovative solutions like efficient data management, vaccination awareness campaigns, and leveraging technology for improved care delivery. The findings are pertinent for not only health care practitioners and policymakers but also the broader scientific and public health communities. However, the findings may have limited generalizability beyond Manipur and Nagaland.

IntroductionUnmanned aerial vehicles, or drones, have emerged as versatile tools across various sectors, including defence, agriculture, surveillance, mining, infrastructure, emergency response, transportation, geospatial mapping and notably medical supply delivery to challenging terrains. This study aims to investigate the feasibility of using drones for delivering essential medical supplies in Keylong, Himachal Pradesh, situated amidst the Middle Himalayan Range, where heavy snowfall during peak winter restricts access to remote regions, posing logistical hurdles for healthcare provision.MethodsThis cross-sectional used a mixed-method approach alongside assessing the drone-based medical delivery. Insights from healthcare workers were documented on sociodemographic characteristics, local healthcare facilities and challenges encountered during drone operations.ResultsA total of 15 sorties were conducted, efficiently transporting 1000 units of medicines and 20 clinical samples. Throughout the drone operation, various technological and health-related challenges were encountered due to the high altitude and the cold weather conditions. Additionally, it has been observed that drones could play a pivotal role in supplementing traditional medical supplies. Particularly, the transportation of the medical supplies in emergency situations and delivery of diagnostic samples from peripheral villages.ConclusionThe study observed that drones present a viable solution for enhancing healthcare accessibility in hard-to-reach regions, particularly for expeditiously delivering diagnostic samples and essential medications during emergencies. The findings underscore the potential of drones to complement existing healthcare systems, providing an efficient means to address logistical challenges in remote areas.

BackgroundType 2 diabetes mellitus presents a major public health challenge globally, with India bearing a disproportionate burden. Early detection and management at the primary healthcare (PHC) level are critical but remain underexplored in rural contexts.MethodsWe conducted a phenomenological qualitative study in Akola district from western Vidarbha region of India. Data were collected through 15 key informant interviews with healthcare providers, 11 interviews with patients and 13 focus group discussions with community health workers. Thematic analysis was performed following Braun and Clarke’s framework, and intercoder reliability was established (Cohen’s Kappa=0.85).ResultsBarriers included limited provider knowledge, patient health literacy gaps, fragmented referral systems and resource shortages. Facilitators encompassed training initiatives, home-based screening innovations, community awareness programmes and integration of specialist support. A conceptual framework was developed mapping systemic, provider and community-level determinants influencing diabetes outcomes.ConclusionStrengthening early diabetes screening and management at the PHC level requires multifaceted interventions encompassing workforce capacity development, supply chain improvements and community engagement. The findings offer a scalable model for integrating diabetes care into primary health systems in resource-constrained settings, contributing to global efforts to address the rising non-communicable disease burden.

COVID-19 has inundated the entire world disrupting the lives of millions of people. The pandemic has stressed the healthcare system of India impacting the psychological status and functioning of health care workers. The aim of this study is to determine the burnout levels and factors associated with the risk of psychological distress among healthcare workers (HCW) engaged in the management of COVID 19 in India. A cross-sectional study was conducted from 1 September 2020 to 30 November 2020 by telephonic interviews using a web-based Google form. Health facilities and community centres from 12 cities located in 10 states were selected for data collection. Data on socio-demographic and occupation-related variables like age, sex, type of family, income, type of occupation, hours of work and income were obtained was obtained from 967 participants, including doctors, nurses, ambulance drivers, emergency response teams, lab personnel, and others directly involved in COVID 19 patient care. Levels of psychological distress was assessed by the General health Questionnaire -GHQ-5 and levels of burnout was assessed using the ICMR-NIOH Burnout questionnaire. Multivariable logistic regression analysis was performed to identify factors associated with the risk of psychological distress. The third quartile values of the three subscales of burnout viz EE, DP and PA were used to identify burnout profiles of the healthcare workers. Overall, 52.9% of the participants had the risk of psychological distress that needed further evaluation. Risk of psychological distress was significantly associated with longer hours of work (≥ 8 hours a day) (AOR = 2.38, 95% CI(1.66-3.41), income≥20000(AOR = 1.74, 95% CI, (1.16-2.6); screening of COVID-19 patients (AOR = 1.63 95% CI (1.09-2.46), contact tracing (AOR = 2.05, 95% CI (1.1-3.81), High Emotional exhaustion score (EE ≥16) (AOR = 4.41 95% CI (3.14-6.28) and High Depersonalisation score (DP≥7) (AOR = 1.79, 95% CI (1.28-2.51)). About 4.7% of the HCWs were overextended (EE>18); 6.5% were disengaged (DP>8) and 9.7% HCWs were showing signs of burnout (high on all three dimensions). The study has identified key factors that could have been likely triggers for psychological distress among healthcare workers who were engaged in management of COVID cases in India. The study also demonstrates the use of GHQ-5 and ICMR-NIOH Burnout questionnaire as important tools to identify persons at risk of psychological distress and occurrence of burnout symptoms respectively. The findings provide useful guide to planning interventions to mitigate mental health problems among HCW in future epidemic/pandemic scenarios in the country.

Introduction: Venous thromboembolism (VTE) is a multifactorial condition and one of the leading causes of mortality and disability. The present study explores the factors associated with hospitalization duration among different types of venous thromboembolism diagnoses, such as deep vein thrombosis (DVT), pulmonary embolism (PE), and other forms of thrombosis. Methods: The data included participants with VTE admitted to 13 hospitals within pan-India from June 2022 to December 2023 to the i-RegVed registry, where socio-demographic data, clinical history, and various factors associated with hospital length of stay (LOS) were included for analyses. Multilinear regression was performed to explore the factors associated with hospital LOS among VTE conditions such as DVT, PE, forms of thrombosis other than PE and DVT, and all VTE diagnoses. Results: A total of 633 participants were included in the study, with 55% being males, and 28.9% being homemakers. Longer hospital LOS was significantly associated with age (β = −.09, P < .05), sex (β = 3.21, P < .05), and non-communicable diseases (β = 3.51, P < .05) among participants with DVT and among participants with at least one of the VTE diagnoses, age (β = −.12, P < .001) and anticoagulant use (β = −2.49, P < .05) was significantly associated. Conclusion: The findings provide insights into the factors influencing hospital outcomes among participants with different types of VTE, highlighting the importance of age and comorbidities in predicting the hospital LOS.

Toll-like receptors (TLRs) play an important role in the innate immune response to HIV infection. Single nucleotide polymorphism (SNP) in TLR7 (Gln11Leu) gene has been associated with a rapid decline of CD4T cell count. Hence, we assessed the TLR7 (rs179008, Gln11Leu (A/T) and rs179009, IVS2-151 (A/G)) polymorphism in 150 HIV-infected individuals naïve to ART and 158 healthy controls. The genotyping of TLR7 Gln11Leu (A/T) and IVS2-151 (A/G) polymorphisms was done using the PCR-RFLP method. In univariate analysis, none of the genotype and haplotype of TLR7 Gln11Leu (A/T) and IVS2-151 (A/G) polymorphism differed significantly between HIV-infected individuals and healthy controls. The occurrence of TLR7 rs179009AG genotype in the codominant model and rs179009 AG-GG genotype in the dominant model was significantly reduced in HIV-infected individuals as compared to healthy controls (18.0% vs. 29.1%, OR=0.42, P=0.016; 26.7% vs. 36.7%, OR=0.52, P=0.016). TLR7 rs179009AG genotype was significantly underrepresented in the intermediate HIV disease stage compared with healthy controls (OR=0.03, P=0.04). TLR7 rs179009AG genotype expressed higher in tobacco-consuming HIV-infected individuals compared with nonusers (OR=1.71, P=0.47). In conclusion, rs179009 AG-GG and AG genotypes were found reduced in HIV-infected individuals as compared to healthy controls; their higher prevalence in health individuals clearly support that they are associated with reduced risk of acquisition of HIV-1 infection.