Further research specifically in terms of intensity and duration of TIG may inform whether physical activity may be improved. Enhancing the Indigenous cultural features of the existing TIG kit might positively influence Indigenous cultural connectedness.

Background: The NRHM has identified Mobile Medical Units (MMUs) as a strategy for improving access. The principle behind MMUs is to reach underserved areas by taking healthcare to the doorstep of the people. The study aims and objectives are to assess the function of Mobile Medical Units in Jharkhand and to identify the factors influencing the utilization of MMU. Methods: Three districts were selected based on geographical distribution with Ranchi as central district; Khunti was nearby district, and Garhwa as far of district. In each district two MMUs were selected for assessment. From each district two blocks and from each block one campsite was randomly selected. From each Campsite five beneficiaries were randomly selected. Every third beneficiary who had availed services of MMU was interviewed. The exit interview of beneficiaries was undertaken at the site of MMU. The data were analyzed by using SPSS Software. Results: Frequency of MMU visit at 04 campsites in Khunti, 02 in Garhwa & 01 in Ranchi were once in a month. Sahiya (ASHA) & NGOs were the main source of information about schedule of MMU visit. Medicines were available at all the campsites of all study districts. Laboratory test facility was available at 04 campsites in Garhwa, 03 in Khunti and 02 in Ranchi district. X-ray facility was not available in all MMUs. Conclusions: Easy accessibility and free services were the main factors that influence the MMU utilization.

Background Severe acute malnutrition (SAM) is a major underlying cause of mortality among children. Around one third of the world’s acutely malnourished children live in India. The WHO recommends community-based management of acute malnutrition (CMAM) for managing children with SAM. In India, different states are implementing community-based SAM treatment programme, hereinafter called CSAM, using varieties of locally produced nutrient dense food items with different nutrient compositions. The study will assess the effectiveness of these state specific CSAM interventions. Methods The longitudinal quasi-experimental study will be undertaken in two purposively selected blocks of one district each in the four intervention states and one comparison state. From each state, 200 SAM children identified using weight-for-length/height z-score (WHZ) < − 3 criteria will be enrolled in the study. Their anthropometric data and skinfold thickness will be taken on admission, at sixth week and at discharge by trained field investigators. Other child details, incidence of morbidity and socio-economic details will be collected on admission. To assess food consumption pattern including consumption of locally produced nutrient dense food supplements, dietary assessment, using 24-h dietary recall will be conducted on admission, at sixth week and at discharge. In addition, body composition parameters will be assessed for a sub-set of children using bio-electrical impedance analysis on admission and at discharge to analyse changes in total body water, fat-free mass, and fat mass. Post discharge, all study participants will be followed up monthly until 6 months. Atleast 10% of the sample will be checked for quality assessment. The study’s primary outcome is cure rate defined as children attaining WHZ ≥ -2. Secondary outcomes include mean weight gain, mean length of stay, body composition parameters, relapse and mortality rates. Additionally, process evaluation and cost effectiveness analysis will be conducted. Discussion There is a shortage of robust evidence regarding the effectiveness of locally produced nutrient dense food supplements provided as part of the CSAM intervention in India. This study will contribute to evidence on effective strategies to manage children with uncomplicated SAM in India. The study protocol has all necessary ethical approvals. Written informed consent will be obtained from caregivers of the children. Trial registration The study is registered with Clinical Trial Registration of India (Registration No.: CTRI/2020/09/028013) Date of registration 24/09/2020.

Background: Apparently healthy blood donors may carry double viral co-infections that might be more fatal than viral mono-infection for the donor himself as well as recipient later on.Methods: All blood samples were screened for HIV-I and II (4th generation kit), HBV and HCV (3rd generation kit) by using chemiluminescence technique (Manufacturer- Abbott, Model-Architect i 1000SR).Results: On screening of 41307 blood units, 829 (2.0%) donors were found positive for one of the viral infection (HBV, HCV and HIV). Highest prevalence was for HBV (417 donors- 1.0%) followed by HCV (324 donors- 0.78 %) and HIV (88 donors- 0.21 %).Conclusions: Apparently healthy blood donors might carry, life threatening, double viral co-infections in their blood. Failure to diagnose and treat co-infection at an early stage results in serious complications and sequelae. For safe blood transfusion all blood units should be tested for compatibility and TTI’s with reduction in unnecessary blood transfusion.

A multicentric study is being conducted in which children with severe acute malnutrition (SAM) aged 6–59 months are identified with only weight-for-height z-score (WHZ) < − 3 criteria. The present study aimed to assess associations of anthropometric parameters and body composition parameters, to improve treatment of SAM. We conducted a cross-section assessment using the enrolment data of children who participated in a multi-centric longitudinal controlled study from five Indian states. Fat-free mass (FFM) and fat mass (FM) were determined by bio-electrical impedance analysis (BIA). Six hundred fifty-nine children were enrolled in the study using WHZ < -3 criteria. Available data shows that WHZ, WAZ and BMIZ were significantly associated with FFMI while MUACZ was significantly associated with both FMI and FFMI. Children with both severe wasting and severe stunting had significantly lower FFMI compared to those who were only severely wasted. All forms of anthropometric deficits appear to adversely impact FFM and FM.Trial registrationThe study is registered with Clinical Trial Registration of India (Registration No.: CTRI/2020/09/028013 dated 24/09/2020).