Regional Medical Research Center

BackgroundTo ensure a substantial impact and prevent the resurgence of the epidemic, the HIV programmes should effectively reach hidden key populations (KPs). A qualitative study was conducted to understand hidden men who have sex with men (MSM), and their needs and identify outreach strategies for those who were still unreached.MethodsBetween 17 March 2019 and 26 July 2019, 42 In-depth Interviews (IDIs), 40 Key Informant Interviews (KIIs), and 16 Focus Group Discussions (FGDs) were conducted covering 170 participants across four states of India. Data were audio recorded, transcribed, translated and analyzed using NVivo software employing a grounded theory approach.ResultsA diverse spectrum of unreached men were reportedly practicing same-sex behaviors and new hidden MSM categories have been identified. These hidden MSM demonstrated denial, lack of awareness, and a history of forced sexual experiences. Being elusive, hence no access to healthcare services and education resulted in condom-less sex. The very young adolescent MSM were unaware of the risks and perceived risky practices as the norm. Both at urban and rural settings, MSM respondents shared about sexual abuse by a male while studying in 2nd standard to 6th standard. The ‘sugar daddies/ older MSM’ who were >50 years old get disengage from the programme, preferentially practice high-risk behaviors, abusing young boys and men who fall prey for money or easy fun. Peers were the most acceptable persons to reach ‘hidden’ MSM.ConclusionA peer-driven approach based on the inbuilt trust of the community and leveraging networks might be a vital outreach strategy to engage this elusive, vulnerable hidden MSM. The vulnerability of young boys and men calls for an urgent need for fostering safer environment for minor male children in the context of this study and strong integration of POCSO Act in the programme. Additionally, there is an urgent need to revisit strategies for engaging middle-aged MSM, the ‘sugar daddies’ or ‘uncles’ in preventing spread of HIV. Policymakers and educational institutions may prioritize comprehensive sex and sexuality education to challenge and transform prevailing social norms affecting young boys in India. It is important for parents and carers to be alert about how these abuse happen, and how to help prevent it.

ABSTRACTBackground:Multi-morbidity poses complex challenges associated with more complex clinical management, poor treatment outcomes, longer hospital stays, and increased healthcare costs. In this context, nurses serve as crucial agents in delivering holistic patient-centered care among multimorbidity patients but there exists a noticeable gap in their curriculum which needs to be modified. Nursing faculty plays a vital role in advancing the nursing profession and nursing curriculum modification and development is one of the most important roles of nursing faculty. This study explores the perspectives of nurses and nursing faculties regarding the integration of multimorbidity into nursing curricula.Methods:Using a phenomenological approach, the study conducted 25 in-depth interviews have been conducted among nursing teachers, nursing officers, and community health officers across various nursing colleges and health centers in Odisha, India. Open-ended questions and probes were employed to elicit rich insights. The digitally recorded interviews were transcribed, translated into English, and then thematically analyzed.Findings:Thematic analysis of the in-depth interview transcripts revealed two overarching themes: “Patient with multimorbidity requires evidence-based, patient-centered care” “mitigating challenges faced by patient, Nurse and health sector.” Participants enunciated the importance of integration of multimorbidity management in nursing curricula. They highlighted the challenges faced by nurses/nurse educators due to knowledge gaps of nursing personnel on multimorbidity and have suggested to inculcate the management of multimorbidity in the nursing curriculum.Conclusion:The nurses occupy a unique position as frontline healthcare providers, both within hospital settings as nursing officers and in community setups as community health officers. This study explores the perspectives of nurses and nursing faculties to integrate the management of multimorbidity in the nursing curriculum. This study revealed the significance of integration of multimorbidity in the nursing curriculum and advocate to add this.

Assessment of relationship between polar symptoms (PS), such as weather, activity or food, and homeopathic medicines in chronic cough has produced some confusing outcomes. Statistical variation in the data partly explains the seemingly conflicting outcomes in prognostic factor research (PFR) of PS. Classification of statistical probability and selection of statistically reliable data can reduce conflicting outcomes.To make an inventory of statistically reliable PS and their relationship with homeopathic medicines in chronic cough.A prospective observational cohort study was conducted at 10 outpatient centers of the Central Council for Research in Homoeopathy, India. Patients with chronic cough were followed for 12 months. Effect of treatment was assessed using the ORIDL (Outcome in Relation to Impact on Daily Living) instrument, with symptom severity and health status evaluated respectively via the Cough Severity Index and EuroQoL 5D-5L. Prevalence and likelihood ratios (LRs) of PS were calculated for general and medicine-specific populations. Cumulative binomial probability (CBP) was used to determine whether symptom prevalence among good responders to specific medicines significantly differed from that of the general population.Some LRs were unexpectedly low, which could be explained by asymmetry of frequency distributions, resulting in high prevalence of one symptom pole. CBP for homeopathic medicines was subsequently performed, with 131 symptoms classified as 'certain' or 'probable': 21 symptoms for Arsenicum album, 23 for Bryonia, 11 for Calcarea carbonica, 3 for Lycopodium, 15 for Natrium muriaticum, 5 for Nux vomica, 17 for Phosphorus, 13 for Pulsatilla, 10 for Silicea, and 13 for Sulphur.Conflicting outcomes in PFR of PS can partly be explained by statistical variation. A classification of reliability was not feasible when expressed using the classical 95% confidence interval but could be achieved by CBP, resulting in certain and probable PS for 10 medicines. We still need clinical expertise and corroboration for future research. Practitioners need scientific training to prevent bias and use research instruments such as Likert scales and questionnaires.

Colistin resistance, driven by chromosomal mutations and the spread of plasmid-mediated MCR genes, has emerged as a critical challenge in combating multidrug-resistant Gram-negative bacteria. This resistance compromises the efficacy of colistin, leading to higher treatment failure rates, prolonged hospitalizations, and increased mortality. Recent studies have highlighted key mechanisms, including lipid A modifications, that enable bacteria to evade colistin’s effects. The global spread of MCR genes exacerbates the issue, underlining the need for improved diagnostics and rapid detection of resistant strains to prevent adverse patient outcomes. To combat this growing threat, a multifaceted approach is essential, involving enhanced antimicrobial stewardship, stricter infection control measures, and continued research into alternative therapies and diagnostic methods. Collaborative efforts from researchers, healthcare providers, policymakers, and the pharmaceutical industry are crucial to preserving colistin’s effectiveness and mitigating the broader impact on public health.

Background: Dengue virus (DENV) infection triggers a wide spectrum of clinical outcomes, from mild febrile illness to severe dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). While environmental and virological factors contribute to disease severity, host genetic variability plays a crucial role in modulating immune responses. This review explores the genetic determinants influencing dengue outcomes, focusing on polymorphisms in cytokine genes, human leukocyte antigen (HLA) alleles, and FcγR variants. These genetic factors impact innate and adaptive immunity, shaping infants and the elderly to be generally more susceptible to severe manifestations, possibly due to underdeveloped or waning immune responses the balance between protective responses and immunopathology, such as antibody-dependent enhancement (ADE). We also reviewed how prior infections and host immunogenetics interact to influence cross-immunity and disease risk. Advances in genomics and systems biology have enabled the identification of risk-associated alleles and potential biomarkers for disease stratification. Personalized medicine approaches, including genetic risk profiling, targeted therapies, and genotype-informed vaccine strategies, hold promise for improving dengue prevention and treatment. However, challenges remain in implementing these strategies in low-resource settings. Expanding genomic studies across diverse populations and integrating multi-omics data are essential for translating genetic insights into clinical practice. Ultimately, understanding the genetic basis of dengue immunity could revolutionize public health interventions in endemic regions.

ABSTRACT This article reports the synthesis of (1‐vinyl‐3‐alkyl imidazolium‐styrene‐divinyl benzene) co‐polymers {alkyl = hexyl (A), octyl (B), and decyl(C)} using divinyl benzene as the cross‐linking agent and benzoin ethyl ether as photo‐initiator. The functional co‐polymeric ionic liquids (PILs) were treated with CuCl 2 and ZnCl 2 solution. To characterize the synthesized co‐polymers, characterizations including Fourier transform infrared (FTIR), Nuclear magnetic resonance (NMR), UV‐Visible diffuse reflectance spectroscopy (UVDRS), and X‐ray diffraction analysis (XRD) have been performed. In addition to this the thermal analysis have also been carried out using thermogravimetric analysis (TGA). Co‐polymers with longer alkyl chains exhibited lower MIC values (Cu chelated PIL copolymer C shows MIC at 360 µg mL −1 against (Staphylococcus aureus) S. aureus and 410 µg/mL against (Escherichia coli) E. coli ). The antibacterial and antibiofilm activities increased in the order PIL copolymers < Zn chelated PIL copolymers < Cu chelated PIL copolymers (against E. coli < S. aureus ). Further, the antibacterial efficacy of the metal chelated PIL co‐polymers have been tested by immersing them in deionized water for 30 days. From in silico analysis the docking energies for β‐lactamase‐Cu chelated PIL copolymers C was −6.2 kcal/mol ( E. coli ) and −4.7 kcal/mol for β‐lactamase‐Zn chelated PIL copolymers C ( S. aureus ). The docked complexes were further subjected to MD simulations.

BackgroundA package of Maternal, Newborn and Child Health (MNCH) services are administered sequentially to mother–child dyads as Continuum of Care (CoC), but often each intervention is reviewed in silo in low-middle-income countries like India. Therefore, we aimed to examine the coverage of the entire package by computing composite CoC score of Indian mother–child dyads. We also aimed to estimate the effect of Indian states on CoC after adjusting for variations in socio-economic determinants; and then rank the Indian states based on their adjusted effects.MethodsWomen (15–49 years) with most recently-born child (in last 5 years) aged 12–23 months (n = 40,687) from National Family Health Survey-5 (2019–21) of India were analysed. Nineteen CoC interventions (Y/N) were added (equally-weighted) to construct a composite CoC score. Multi-level models were used to study the state effect on CoC score after adjusting for individual-level wealth, education, caste, urban/rural residence and fertility. Indian states were ranked by their CoC performance using adjusted state residuals from the model.ResultsOnly 3% dyads received all the 19 interventions, however, 50% received 14/19. Sterile delivery kit usage (94.4%), newborn weighing (92.4%) and skilled birth attendance (89.4%) were services with higher coverage, whereas early initiation of breastfeeding (43.7%) and appropriate iron-folate consumption (56.8%) had low coverage. The state factor explained 23% CoC score. Odisha, a comparatively less-developed state, was ranked first and also other less-developed states like Madhya Pradesh and Chhattisgarh outperformed richer counterparts. But many traditionally weaker Northern and North-Eastern states continued to lag behind.ConclusionOdisha and a few other less-developed Indian states demonstrated that good CoC coverage can be achieved even with restricted resources, perhaps through strengthening of public health system. Other states should emulate and help India as a nation achieve full CoC coverage of all its mother–child dyads and attain MNCH-related sustainable development goals.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-23697-x.

The Aedes (Stegomyia) albopictus (Skuse, 1985) (Diptera: Culicidae) is one of the major vectors for Dengue and Chikungunya. However, our study uncovered another mosquito species morphologically similar to Ae. albopictus but is genetically different. The male genitalia of this species possess minute differences in the IX tergum with Ae. albopictus. Nucleotide diversity and mean genetic distance analysis confirmed the genetic difference from Ae. albopictus and other Aedes species. However, this species has a significant degree of genetic similarity with the cryptic species of Ae. albopictus earlier reported from Vietnam and China. The time tree revealed the median divergence time of this species and Ae. albopictus species to be approximately 36.13 million years ago. This study marks the discovery of an Aedes nr. Albopictus species resembling Ae. albopictus in India and third in the world, also reports the distinct morphological feature of the male genitalia for the first time. Our study indicates the sympatric behavior of this species as it shares the breeding habitat of Ae. albopictus. The absence of endosymbiont Wolbachia in this species raises the possibility of reproductive isolation with Ae. albopictus leading to sympatric speciation and increasing virus-carrying capability for this species, having significant implications for vector-borne disease control.

BackgroundUndernutrition is a major public health challenge among Indian adolescents in India where 253 million of them are in the age group of 10–19 years. In spite of several intensive efforts through various program interventions and care, research studies find a less encouraging improvement in nutritional scenarios. The present systematic review aimed to determine the pooled prevalence and associated factors of undernutrition (stunting and underweight) among Indian adolescents.MethodsWe searched e-databases of MEDLINE/PubMed, EMBASE, Google Scholar, and Cochrane library for the period between the years 2000 and 2021. The peer-reviewed and empirical studies analyzing the prevalence of undernutrition among Indian adolescents and its associated factors were eligible for inclusion. The quality of the study reports included in the review was evaluated using the Newcastle–Ottawa Scale. The random-effect model with the Dersimonian and Laird method, at 95% confidence intervals, was used for estimating the overall effect. Subgroup analysis was conducted to investigate the possible sources of heterogeneity. Publication bias was assessed through visual examination of funnel plots and objectively by Egger’s regression test.ResultsA total of forty eligible studies with a pooled sample size of 67,865 adolescents were included to determine the prevalence of undernutrition among adolescents in India. The pooled prevalence of stunting and underweight in India was 41.1% (95% CI: 35.9, 46.0) and 32.6% (95% CI: 26.8, 37.1) respectively. It was also found that the rate of stunting prevalence was high among late adolescents and underweight was high among early adolescents. Age, gender, income, family size, caste, parental education, and occupation were the significant associated factors of the prevalence of stunting and underweight among adolescents in India.ConclusionThe prevalence of stunting and underweight among adolescents is still a high concern in India. The results of this review posit the need of an integrated effort to reduce undernutrition in India and identify research priorities in this field.