Background: Although most public services provide tests and TB drugs free of charge worldwide, opportunity costs pose barriers to accessing TB services and treatment. 'Kumar Raajratna Bhimrao Ambedkar Vaidakiya Sahay Yojana (KRBAVSY)' popularly known as Free Medical Aid Scheme is in operation in Gujarat since early 70s for SC and since 1991 for SEBC to provide monetary incentive. Primary objective: Evaluation of utilization and effectiveness of Financial incentives given under Free Medical Aids scheme on RNTCP in Gujarat. Methodology: A retrospective cohort study was undertaken in which all TB patients registered under RNTCP in Gandhinagar district were evaluated for their eligibility for KRBAVSY scheme, and whether eligible patients got benefit or not. Also, treatment outcome of patients were compared. Results: Out of total 1430 patients inquired, 896 (62.7%) patients were found eligible for the scheme, while only 87 (9.7%) patients confirmed that they had got the benefit of scheme. Eligible patients who got benefit under scheme had almost five times higher odds of successful outcome of TB treatment. Conclusion: The TB patients who got benefit of KRBAVSY scheme had significantly better successful treatment outcome in comparison to the TB patients who did not get benefit.

Occupational stress is a harmful response particularly physical and emotional, due to a mismatch between job requirements and the qualifications, resources, and worker’s needs; its chronic form is termed “Burnout.” Stress among health care workers is multifactorial. Its prevalence among healthcare professionals ranges from 27−87.4%. Occupational stress is a significant reason for physical and mental health, substance use, work-related delay, absenteeism, and emigration rate. Additionally, it can lead to patient safety concerns and poor quality of care. The mismatch between job requirements and the available resources, work overload, working environment, work experience, workplace conflict, gender discrimination, marital status, educational status, job satisfaction, and not being rewarded were some of the factors significantly associated with occupational stress among health care professionals. Moreover, the coronavirus disease 2019 (COVID-19) pandemic introduced additional stressors, such as staff redeployment and the fear of infection. WHO identified good primary health care as fundamental for achieving universal health coverage without financial hardship. Healthcare professionals’ physical and mental well-being is crucial for attaining this. Developing culturally and organizationally appropriate early interventions is the need of the hour to prevent a health care worker from entering a stress level that is non-adaptable beyond their coping abilities.

The enzyme cytochemistry and proportion of mononuclear cells exclusively present within degenerating muscle fibres of the soleus of rats 24 h after a single intraperitoneal injection of 5-hydroxytryptamine (5-HT) (10 mg/kg) were studied. The following enzymes displayed strong cytochemical activities within these cells: non-specific esterase (against naphthol AS-D acetate and alpha-naphthylacetate), aminopeptidase (against leucine-4-methoxy-2-naphthylamide) and dipeptidyl peptidase II. A peroxidatic activity was also present, but was found to arise from cytochrome oxidase in phagocytosed muscle mitochondria. The aminopeptidase activity in the monocytic cells increased by roughly 50% between 6 and 24 h after 5-HT administration. Dipeptidyl peptidase II was found, by the use of appropriate inhibitors, to be present in both mononuclear cells and muscle fibres and may be implicated in degrading the basal lamina of muscle fibres, thereby permitting access to the mononuclear cells. The morphological, enzyme histochemical and electron microscopical evidence suggest that the cells which invade muscle fibres in the early stages of a myopathy induced by 5-HT in rats are actively phagocytosing, mature macrophages.

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Introduction:All 26 antiretroviral treatment (ART) centers of Gujarat were monitored by Gujarat State AIDS Control Society under the National AIDS Control Program. A comprehensive tool is needed to identify gap in service delivery and to prioritize monitoring visits.Objectives:To supplement the existing monitoring system, identify strengths/weakness of ART centers, and give recommendations.Methodology:Scorecard was developed in spreadsheet format with 17 scoring indicators on monthly base from March 2014 onward. The centers were classified in three color zones: green (score ≥80%), yellow (score <80% and ≥50%), and red (score <50%). Visits were prioritized at centers with more indicators in yellow/red zone. The performance of centers was compared for March 2014 and March 2015.Results:The statistically significant improvement was observed in indicator “ART initiation within 2 months of eligibility,” while after removing red zone from analysis, four more indicators named “eligible patients transferred out before ART initiation, general clients started on ART, antenatal women started on ART, and pre-ART follow-up CD4 done” reflect statistically significant improvement. Quadrant analysis was done for some indicators, which provide insight that less number of eligible patients may be a reason for low initiation of ART at one center, and at four other centers, the possible reasons for low retention are high death rate and high lost to follow-up rate. Based on these findings, the recommendations were made to regular mentoring centers, improve coordination between ART center and care and support centers (CSCs), and conduct verbal autopsy.Conclusion:Scorecard is a simple and cost-effective tool for monitoring, and by highlighting low-performing indicators, it helps in improving quality of services provided at ART centers.