Introduction HIV related deaths still continue to occur in large numbers in spite of good quality drugs being freely available in India. This study was therefore done to assess the prognostic factors of mortality among people living with HIV (PLHIV) on antiretroviral therapy (ART). This would help in planning strategies for further improving their survival. Materials and Methods Record based data from baseline and follow-up visits of a cohort of patients aged above 14 years on ART was retrospectively reviewed over a seven-year period. The Kaplan-Meier models were used to estimate life time survival probability, and Cox proportional hazard regression model was used to determine independent prognostic factors of death, among patients, after initiation of ART. Results Mean age of the total 285 patients enrolled in this study was 45.8±9.7 years. Mean duration of treatment on ART was 1127±611.8 days. During the follow-up period, 44/285(15.4%) patients died, resulting in incidence density of death rate as 3.12 per 100 person years. Good adherence with treatment was reported by 267(93.7%) patients. Nearly half of the deaths, i.e., 21(47.7%), occurred within three months of them starting ART. The mean survival time after initiation of ART was 2084.0±55.3 days (95% CI is 1975.5-2192.5). The presence of opportunistic infections (OIs) and tuberculosis before and poor/average adherence to ART and alcohol usage after starting ART were independent prognostic factors of mortality among patients. Conclusion Several prognostic factors influencing mortality among adult HIV patients receiving treatment were identified in this study. Screening efforts is essential in early detection and management of OIs among PLHIV. Good counselling and monitoring is recommended to improve adherence and also to prevent alcohol usage after initiation of ART. Such measures would help in further reducing mortality among HIV patients in the settings.

Asthma in childhood is a chronic disease and, when unadorned, often results in augmented morbidity for the enduring and indirect economic fatalities for the community. Geographical location, environmental, ethnicity, as well as dynamics related to behaviours and lifestyles are allied with the disease. 1 Asthma is a syndrome characterized by airflow obstruction that differs strikingly, both instinctively and with treatment. Asthmatics anchorages a distinct type of inflammation in the airways that makes them more receptive than nonasthmatics to a wide assortment of triggers, leading to excessive narrowing with consequent reduced airflow and symptomatic wheezing and dyspnea. 3-6 Narrowing of the airways is usually reversible, but in some patients with chronic asthma there may be an ABSTRACT Background: Asthma in childhood is a chronic disease and, when unadorned, often results in augmented morbidity for the enduring and indirect economic fatalities for the community. The predominance of childhood bronchial asthma being amplified in developing countries like India due to rapid urbanization is imposing a challenge to health sector. This study aims to determine the prevalence of bronchial asthma and socio-demographic factors influencing the bronchial asthma among the school children in the field practice area. Methods: A cross-sectional study was conducted in secondary schools in Davangere district, by utilizing International Study of Asthma and Allergies in Children (ISAAC) questionnaire tool for period of two months. Total of 550 school students were examined from the four schools of Davangere, two belonging to rural field practice area and two belonging to urban field practice area of J.J.M medical college, Davangere by using simple random selection. Results: On the basis of ISAAC scoring, 25 (4.5%) were found to be the cases of asthma. Boys had a higher prevalence (5.14%) than girls (3.77%). Maximum numbers of positive cases were found at the age of 15 years, 10 (5.37 %) cases. Out of the 25 positive cases, 8 (32%) had wheezing or whistling in the chest in the past 12 months. Among 25 positive cases, from last 12 months, 6 children (24%) had attack of wheezing, maximum number of children had 4-12 times (67%) attack of wheezing. Conclusions: Our data suggest that the actual prevalence of asthma and other 'wheezy' illnesses may be higher than that previously documented. Further studies are needed to confirm the difference in prevalence between urban and rural children and also to identify possible causes that could account for the higher urban prevalence in Davangere

Background: The COVID vaccination programme in conjunction with other control measures, are needed to control the COVID-19 pandemic. The mass vaccination with COVID vaccines, will help to increase the herd immunity. This study is an attempt to assess the knowledge and attitude of the adult population of a panchayat area of Thrissur district of Kerala towards COVID-19 vaccination and socio-demographic determinants associated with it.Methods: We have done a cross-sectional study among 350 study participants selected by cluster sampling technique from a panchayat area of Thrissur district of Kerala and the data was collected, using a pretested semi structured questionnaire. The knowledge and attitude were assessed by proportion and association of socio-demographic determinants was found out using ‘t’ test and ‘ANOVA’ test.Results: The result obtained, showed 94.3% of persons responded that there is a vaccine for preventing COVID and 85.2% were aware that Covishield and Covaxin were the vaccine freely available. The 78.3% respondents knew that there should be 84 days between the doses of Covishield and 77.1% knew that 28 days for Covaxin. The 100% respondents had attitude to take the vaccine and 99.1% were ready to continue COVID prevention measures even after vaccination. As per this study, younger age (p=0.04) and religion (0.000) had an association with knowledge.Conclusions: The high level of knowledge and a100% attitude towards COVID vaccination may be due to high political will and accountability of the governments towards it. The places with low acceptance rate can be able to model on it.

Background: Diabetes is rapidly emerging as a major health care problem, even in rural India. The earlier occurrence, delayed diagnosis and improper care leads to high complication rates, greater productivity loss and consequently higher costs. As the epidemiological burden of diabetes increases, the economic burden is expected to rise and the economically disadvantaged will be affected the most. Objectives: To assess the economic burden of diabetes among type 2 diabetic patients and to explore the factors associated with the economic burden of diabetes. Materials and Methods: Community based cross sectional study was carried out in rural field practice area of a medical college in Davangere for a period of six months during 2016-17 among 112 patients with type 2 diabetes mellitus. Information was collected using pretested predesigned questionnaire on socio-demographic details, health services utilization, expenditure incurred on diabetes care (both direct and indirect costs) in the past six months. Results: The direct cost accounted for 94.2% of the total cost of treatment, of which hospitalization for diabetes related complications and medications were major components. Source of health care significantly influenced the direct cost. About 8.9% of study subjects skipped medications at least once due to lack of money. Conclusions: Direct cost in the management of diabetes is major contributor to the expenditure. Availability of affordable essential quality diabetic medications and strengthening of public healthcare is crucial in reduction of these direct costs involved in diabetic management.