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Background Antibiotic resistance presents a substantial threat to global public health. One of the primary contributors to antibiotic resistance is the irrational use of antibiotics. This study aimed to comprehensively assess the prevalence and associated factors of antibiotic self-medication (ASM) practices among the pediatric population in India. Methods A comprehensive search was conducted in PubMed, Embase, Scopus, and Google Scholar to identify relevant articles published up to December 2024. Inclusion criteria included studies reporting the prevalence rate of ASM practices among the pediatric population in India. Quality assessment of the included studies was conducted using the JBI tool for prevalence studies. Data were extracted using a standardized form and analyzed using R software with a random-effects model. Results Seventeen studies involving 7847 children were analyzed. The pooled prevalence of pediatric ASM in India was 19.8% (95% CI: 13.5; 28.2; I 2  = 98.2%; p  < 0.01). Regional disparities were observed ( p  < 0.01), with the northern region exhibiting the highest prevalence at 30.7%. No significant difference in prevalence was found between studies that recruited participants from hospital and community settings ( p  = 0.0552). Key factors associated with pediatric ASM included financial constraints, time constraints, perceptions of mild illness, and limited healthcare access. Common sources for procuring antibiotics were local pharmacies, leftover medications, and friends/family members. Information sources regarding the use of antibiotics included previous prescriptions, friends/family members, media, past experiences, and pharmacists. The mean duration of antibiotic consumption was 2.5 days. Conclusion Self-medication with antibiotics was prevalent among the pediatric population in India. Therefore, government and policymakers should take necessary measures to promote the responsible use of antibiotics. Highlights The prevalence of antibiotic self-medication among children in India was 19.8%. Significant regional differences were observed, with the highest prevalence in North region. Financial constraints, time limitations, and the perception of mild illness were main reasons. Antibiotics were mainly sourced from pharmacies, leftover medicines, and family/friends. Urgent measures are needed to promote the responsible use of antibiotics in children. Graphical Abstract

Lesishmaniasis is a neglected tropical disease endemic in Bihar, India. Inappropriate health seeking behaviour of post kala-azar dermal leishmaniasis (PKDL) patients may increase the disease duration, severity and transmissibility. Simultaneously, lack of knowledge and perceived stigma may also increase the length of delay in receiving treatment. This ultimately effects the kala-azar elimination program. A cross sectional study was conducted in 120 confirmed PKDL patients, aged 18 years and older. Data related to knowledge and health seeking behaviour was collected by a pre-tested questionnaire. EMIC stigma scale was used for assessing the perceived stigma. Patients were personally interviewed after taking informed consent. Data analysis was done by using SPSS 16 software. The time between appearance of symptoms and first medical consultation (patient delay) ranged from 15 days to 5475 days (15 years) with a median of 285 days. The time between first medical consultations to onset of specific treatment (system delay) ranged from 2 to 5475 days with a median of 365 days. Many patients approached first to quacks (8.4%), homeopathic and ayurvedic practitioners (25.8%) upon recognition of symptoms. Majority of the patients (68.3%) had poor knowledge about PKDL and its vector. Type of skin lesions and gender had significant association with patient delay and system delay respectively (p<0.05). Distance to primary health centre (PHC) had significant association with patients delay as well as system delay (p<0.05). Patients with younger age, unmarried and polymorphic lesions had higher stigma (p<0.05). Patients with PKDL feel stigmatized in different areas. PKDL treatment delays were unacceptably high and patients had poor knowledge compounded with feelings of stigmatization. To reduce the delay, a system may be evolved to establish some sort of public-private collaboration, besides awareness programs should be tailored, and implemented for improving the patient education regarding the disease and its linkage with VL.

The COVID-19 pandemic has underscored the critical need for rapid and accurate screening and diagnostic methods for potential respiratory viruses. Existing COVID-19 diagnostic approaches face limitations either in terms of turnaround time or accuracy. In this study, we present an electrochemical biosensor that offers nearly instantaneous and precise SARS-CoV-2 detection, suitable for point-of-care and environmental monitoring applications. The biosensor employs a stapled hACE-2 N-terminal alpha helix peptide to functionalize an in situ grown polypyrrole conductive polymer on a nitrocellulose membrane backbone through a chemical process. We assessed the biosensor’s analytical performance using heat-inactivated omicron and delta variants of the SARS-CoV-2 virus in artificial saliva (AS) and nasal swab (NS) samples diluted in a strong ionic solution, as well as clinical specimens with known Ct values. Virus identification was achieved through electrochemical impedance spectroscopy (EIS) and frequency analyses. The assay demonstrated a limit of detection (LoD) of 40 TCID50/mL, with 95% sensitivity and 100% specificity. Notably, the biosensor exhibited no cross-reactivity when tested against the influenza virus. The entire testing process using the biosensor takes less than a minute. In summary, our biosensor exhibits promising potential in the battle against pandemic respiratory viruses, offering a platform for the development of rapid, compact, portable, and point-of-care devices capable of multiplexing various viruses. The biosensor has the capacity to significantly bolster our readiness and response to future viral outbreaks.

Background Visceral leishmaniasis–human immunodeficiency virus (VL-HIV) co-infection has emerged as a serious concern, which could adversely affect the VL elimination efforts of the country. These patients have a poor VL therapeutic success rate, more drug-related toxicity, and relapses resulting in high mortality. Despite the emerging pattern of VL-HIV co-infection, there have been limited studies analyzing the presentation of VL-HIV co-infection in Bihar, India. The present study investigated the clinico-epidemiological features, predictors of mortality, and quality of life for people living with VL-HIV co-infection. Methods A cross-sectional study was conducted, using retrospective data on VL-HIV cases from 2018 to 2020. A semi-structured questionnaire was used for data collection. Data analysis was done, using the IBM SPSS statistics v22. Results Our study included a large sample of 222 VL-HIV cases, of these one-fifth of the patients (47; 21%) had died. A highly statistically significant difference ( P  < 0.0001) in mortality was observed between males (38; 80.9%) and females (9; 19.1%). The death occurred rapidly within a mean duration of 6.7 months (95% CI: 5.4–8.1) after VL diagnosis. A highly statistically significant difference ( P  < 0.0001) was observed between individuals who had stopped anti-retroviral therapy (ART) (36; 76.6%) and those who were taking ART regularly (11; 23.4%) in terms of mortality. The primary predisposing factor observed was heterosexual behavior, which accounted for 113 cases (88.3%). In most of the cases (95.3%), the diagnosis was done at tertiary care centers and not in their home district. The majority of VL cases (101; 78.9%) were treated with multiple doses of liposomal amphotericin B. Out of 128 VL-HIV cases, 120 (93.7%) were declared cured of VL after completing treatment. Approximately 47 cases (36.7%) experienced more than two VL relapses. A significant difference was observed for gender and income per month in the environmental health domain specifically. Conclusion The present study documents a time gap between the initiation and cessation of ART, as well as the duration from VL treatment to death. It suggests that regular adherence to ART may have a significant impact on reducing mortality and relapses. Therefore, a comprehensive people-centric approach for specific groups must be adopted for VL-HIV patients. Additional epidemiological studies on VL-HIV co-infection are warranted.

Background This study was aimed to assess the impact of quality of life using WHOQOL-BREF in patients with Visceral leishmaniasis (VL). Methods A total of 95 VL cases and 95 healthy participants filled out the questionnaires. Data on socio-demographic aspects along with disease duration were collected. Data were compared using a t-test, analysis of variance and chi-square test. Results VL patients experienced very high impact on their quality of life. Study cohort had male preponderance (72.63%). Majority (64.21%) were aged < 40 years. Longer disease duration was found to have significantly poor quality of life ( p  < 0.05). The physical domain was found to be most affected domains of quality of life (QOL). QOL was affected most in illiterate, married, housewife, rural population and patients with longer disease duration ( p  < 0.05). The psychological and environmental domains were significantly affected in > 40 years of age group married patients ( p  < 0.05). Conclusions VL significantly impaired the patients’ (QOL) in all four domains (physical, psychological, social relationship and environmental). Physical domain was significantly the most affected domain.

Post kala-azar dermal leishmaniasis (PKDL) is a skin disorder that usually occurs among patients with a past history of visceral leishmaniasis (VL). Cases are also reported without a history of VL. There is no satisfactory treatment regimen available at present. We aimed to compare the efficacy and safety of amphotericin B in two different doses (0.5mg/kg vs 1mg/kg) in a prospective randomized trial in 50 PKDL patients. In this open label study 50 patients with PKDL, aged between 5-60 years were randomized in two groups. Group A received amphotericin B in the dose of 0.5 mg/kg in 5% dextrose, daily for 20 infusions for 3 courses at an interval of 15 days between each course and Group B received amphotericin B in the dose of 1mg/kg in 5% dextrose on alternate days, 20 infusions for 3 courses an interval of 15 days between each course and followed up for one year. A total of 50 patients were enrolled, 25 in each of group A and group B. Two patients lost to follow up and three patients withdrew consent due to adverse events. The initial cure rate was 92% in group A and 88% in group B by intention to treat analysis and final cure rate by per protocol analysis was 95.65% and 95.45% in group A and group B respectively. Two patients each from either group relapsed. Nephrotoxicity was the most common adverse event occurring in both the groups. The lower dose appears to have fewer adverse events however, nephrotoxicity remains a problem in both regimens. The 0.5mg/kg regimen may be considered instead of the higher dosage however safer treatments remain critical for PKDL treatment.

Background Post kala-azar dermal leishmaniasis (PKDL) is a dermatological disorder caused by protozoal parasite Leishmania donovani . PKDL cases are thought to be a reservoir of parasites and may increase cases of visceral leishmaniasis. The disease is not life threatening but cosmetic disfigurement associated with it may impair the patients’ quality of life. This study aimed to assess the health related quality of life in patients with post kalaazar dermal leishmanasis for the first time. Methods A total of 92 PKDL cases and 96 healthy participants filled out the questionnaires. The Dermatology Life Quality Index (DLQI) and SF 36 questionnaire were used to assess the quality of life. Data on socio-demographic and clinical features were also collected. The collected data were analyzed by using SPSS software (version 16), Student’s t-test, analysis of variance (ANOVA) was applied for comparison of means. Results PKDL patients experienced very large impact on their quality of life. The mean score of DLQI was 11.41. Highest impact was found in symptoms and feelings and lowest impact was observed for personal relationship domain. Patients below 20 years age group found to have lower quality of life. There was a significant difference in mean DLQI scores with regard to age and severity of lesions ( P  < 0.05). No significant difference was observed with respect to gender, duration and location of lesions ( p  > 0.05). Conclusion PKDL significantly impaired the patient’s quality of life. Further studies to assess the impact of treatment on quality of life in these patients are recommended.

Visceral leishmaniasis (VL), a fatal disease prevalent in more than 70 countries, poses significant health challenges, particularly in poor communities with limited access to healthcare. Vitamins and trace elements play a crucial role in immune function and may influence susceptibility to VL. This systematic review and meta-analysis aimed to assess the differences in serum vitamin and trace element levels in VL patients compared to healthy individuals. We conducted an extensive search of databases (PubMed, Embase, and Google Scholar) to identify potentially eligible articles published from inception to June 2023. Data extraction and quality assessment were carried out by two reviewers independently. RevMan software (version 5.4) was used for analysis. Standardized mean difference (SMD) with a confidence interval (CI) of 95% was used to summarize the findings. Ten studies comprising 546 VL patients and 535 controls were included in our study. The findings revealed significantly reduced serum retinol levels in VL patients in comparison to controls (SMD: − 0.67; 95% CI: [− 1.05, − 0.28]; p = 0.0008). Serum zinc levels were also substantially lower in VL patients, regardless of controls recruited from endemic (SMD: − 2.65; 95% CI: [− 3.86, − 1.44]; p < 0.0001) or non-endemic regions (SMD: − 1.99; 95% CI: [− 3.02, − 0.96]; p < 0.0002). However, VL patients exhibited significantly increased serum copper levels compared to controls (SMD: 2.51; 95% CI: [0.70, 4.32]; p = 0.007). Patients with VL had lower serum levels of zinc and retinol and higher levels of copper, indicating a possible role of these micronutrients in influencing VL susceptibility and progression.

We propose a simple model quantum network consisting of diamond-shaped plaquettes with deterministic distribution of magnetic and non-magnetic atoms in presence of a uniform external magnetic flux in each plaquette and predict that such a simple model can be a prospective candidate for spin filter as well as flux driven spintronic switch. The orientations and the amplitudes of the substrate magnetic moments play a crucial role in the energy band engineering of the two spin channels which essentially gives us a control over the spin transmission leading to a spin filtering effect. The externally tunable magnetic flux plays an important role in inducing a switch on-switch off effect for both the spin states indicating the behavior like a spintronic switch. Even a correlated disorder configuration in the on-site potentials and in the magnetic moments may lead to disorder-induced spin filtering phenomenon where one of the spin channel gets entirely blocked leaving the other one transmitting over the entire allowed energy regime. All these features are established by evaluating the density of states and the two terminal transmission probabilities using the transfer-matrix formalism within a tight-binding framework. Experimental realization of our theoretical study may be helpful in designing new spintronic devices.

Clenbuterol is a potent beta-2 agonist widely misused by professional athletes and bodybuilders. Information on clenbuterol associated adverse events is present in case reports and case series, though it may not be readily available. This systematic review aimed to critically evaluate the evidence of adverse events associated with clenbuterol among athletes. The search strategy was in accordance with PRISMA guidelines. Databases such as PubMed, Science Direct, Scopus, and Google Scholar were searched from 1990 to October 2021 to find out the relevant case reports and case series. There were 23 included studies. Using a suitable scale, the included studies’ methodological quality analysis was evaluated. In total, 24 athletes experienced adverse events. Oral ingestion of clenbuterol was the most preferred route among them. The daily administered dose of clenbuterol was ranging from 20 µg to 30 mg. Major adverse events experienced by athletes were supraventricular tachycardia, atrial fibrillation, hypotension, chest pain, myocardial injury, myocarditis, myocardial ischemia, myocardial infarction, cardiomyopathy, hepatomegaly, hyperglycemia, and death. The cardiac-related complications were the most commonly occurring adverse events. Clenbuterol is notorious to produce life-threatening adverse events including death. Lack of evidence regarding the performance-enhancing effects of clenbuterol combined with its serious toxicities questions the usefulness of this drug in athletes.