UNDERSTANDING THE VITAL DETERMINANTS SHAPING LEARNERS' PHYSICAL ACTIVITYAND PSYCHOEMOTIONAL WELLBEING IN THE COVID-19 PERIOD.

The Corona Virus (COV-19) epidemic significantly affected the educational environment, requiring a quick transition to distance and blended learning methods. This extraordinary disruption had an incredible impact on pupil's levels of physical activity (PA), psycho-emotional health (PEH) and engagement with academic material. The research aims to examine the vital determinants that influenced various areas of learners' lives during CoV-19. The purpose of this 600-person study was to collect data on the subjects' overall health and PA levels for the CoV-19 pandemic. The SPSS application was used to process the questionnaire's collected data. The information given reveals the respondents' degree of PA throughout the quarantine. According to the breakdown, 15% indicated low levels of PA, 39% reported medium levels and 46% reported high levels. The data show that, despite the respondents' different levels of PA, little PA predominated for most of them. The limitations of distance learning throughout quarantine and the prevalent recommendation of leaving residence for necessary reasons were blamed for this tendency. There were fewer prospects for higher-intensity PA due to these circumstances.

Impact of application of queuing theory on operational efficiency of patient registration.

Background: Hospital administrators are often challenged with overcrowding at hospitals. The study hospital receives referred patients; however, they have to wait in long queues even for getting registered. This was a cause of concern for hospital administrators. The study was undertaken to find an amicable solution to the queues at registration using Queuing Theory. Method: This observational and interventional study was carried out in a tertiary care ophthalmic hospital. In the first phase, data of service time and arrival rate was collected. The queuing model was built using the coefficient of variation (CoV) of the observed times. Server utilization for new patient registration was found to be 1.21 and was 0.63 for revisit patients. Scenario-based simulation carried out using free software for optimal utilization of both types of servers. Recommendations made to combine the registration process and to increase one server were implemented.In the second phase, after one year, patient registration data were collected and compared for the number of patients registered using SPSS 17. Results: Number of patients registered within the registration timings increased whereas the number of patients registered after the registration timings decreased significantly at 95% CI with a p-value of less than 0.001. Queues finished early and more number of patients were registered in the same time. Conclusion: Using queuing theory, the bottleneck of the systems can be identified. Scenario and software-based simulations provide solutions to the problem of queues. The study is an application of Queuing Theory with a focus on efficient resource utilization. It can be replicated in an organization with limited resources facing the challenge of queues.

Allocation scheduling leads to optimum utilization of operation theater time.

Background: Cancellation of surgeries is a regular phenomenon in any hospital, and reasons may vary from clinical to managerial ones. The aim of the study is to suggest scheduling to address the problem of time over run related cancellations. This is an observational and descriptive study conducted in a tertiary care hospital with ophthalmology facilities. The sample size is calculated with 95% confidence interval using Epi Info 6 from the total surgeries performed in the last 5 years (n = 380). Simple random sampling technique was used. Methods: Surgical time for all types of ophthalmic surgeries (n = 582) was observed. Allocation of listed cases to the available operating rooms (ORs) was carried out using the observed time using LEKIN software. Results: The time over-run of 2 h and 6 h was noted for two units, whereas idle OR time was observed in other units. An average idle time of 19% was noted on each day. Reallocation of the cases to the ORs was carried out taking all the planned cases (of both the operating units of the day) as the number of jobs and all the available ORs as parallel machines using LEKIN software. All the planned cases could be accommodated; still, an average of 17% of the total available operation theater (OT) time was found idle on each day. Conclusions: Planning of cases using procedure time and scheduling on a daily basis using allocation models with simple algorithms can provide optimal utilization of OTs and can address the time over-run and related cancellations.

Clinical Efficacy of Subgingivally Delivered Punica Granatum Chip and Gel in Management of Chronic Periodontitis Patients.

Background Periodontitis has a multifactorial etiology, and the pathogenic bacteria that reside in the subgingival area are the primary etiologic agent. Objective The study aimed to evaluate the clinical efficacy and benefits of herbal chip and gel made from extracts of Punica granatum as a subgingival adjunct to scaling and root planing (SRP). Method A randomized control clinical trial was conducted on 30 systemically healthy patient's sites having chronic periodontitis, and they were randomly allocated to into three treatment groups followed by Scaling and Root Planing in all patients. Group 1 - Ten patients received Scaling and Root Planing and Punica granatum chip at selected sites. Group 2 - Ten patients received Scaling and Root Planing and punica granatum gel at selected sites. Group 3 - Ten patients with Scaling and Root Planing alone. Clinical parameters were recorded at baseline, 21 days and at 45 days which included plaque index (PI), gingival index (GI), probing pocket depth (PPD) and relative attachment level (RAL). Result Plaque Index and Gingival index showed better reduction in group I compared to group II and group III at 21st day 45th day follow up. Analysing Pocket Probing Depth the intergroup comparison revealed similar results with maximum reduction being seen in group I from baseline to 21 and baseline to 45 days (p < 0.001). On analysing Relative Attachment Loss revealed reduction in all three groups with maximum reduction in group I from baseline to 45 days and reduction in group III was not statistically significant (p < 0.090). Conclusion The study concluded that Punica granatum chip as an adjunct to Scaling and Root Planing was more effective than Punica granatum gel and scaling and root planing alone.

Effect of surface modification and laser repetition rate on growth, structural, electronic and optical properties of GaN nanorods on flexible Ti metal foil.

The effect of flexible Ti metal foil surface modification and laser repetition rate in laser molecular beam epitaxy growth process on the evolution of GaN nanorods and their structural, electronic and optical properties has been investigated. The GaN nanostructures were grown on bare- and pre-nitridated Ti foil substrates at 700 °C for different laser repetition rates (10-30 Hz). It is found that the low repetition rate (10 Hz) promotes sparse growth of three-dimensional inverted-cone like GaN nanostructures on pre-nitridated Ti surface whereas the entire Ti foil substrate is nearly covered with film-like GaN consisting of large-sized grains for 30 Hz growth. In case of the GaN growth at 20 Hz, uniformly-aligned, dense (∼8 × 109 cm-2) GaN nanorods are successfully grown on pre-nitridated Ti foil whereas sparse vertical GaN nanorods have been obtained on bare Ti foil under similar growth conditions for both 20 and 30 Hz. X-ray photoemission spectroscopy (XPS) has been utilized to elucidate the electronic structure of GaN nanorods grown under various experimental conditions on Ti foil. It confirms Ga-N bonding in the grown structures, and the calculated chemical composition turns out to be Ga rich for the GaN nanorods grown on pre-nitridated Ti foil. For bare Ti substrates, a preferred reaction between Ti and N is noticed as compared to Ga and N leading to sparse growth of GaN nanorods. Hence, the nitridation of Ti foil is a prerequisite to achieve the growth of dense and aligned GaN nanorod arrays. The X-ray diffraction, high resolution transmission electron microscopy and Raman studies revealed the c-axis growth of wurtzite GaN nanorods on Ti metal foil with good crystallinity and structural quality. The photoluminescence spectroscopy showed that the dense GaN nanorod possesses a near band edge emission at 3.42 eV with a full width at half maximum of 98 meV at room temperature. The density-controlled growth of GaN nanorods on a flexible substrate with high structural and optical quality holds promise for potential applications in futuristic flexible GaN based optoelectronics and sensor devices.

Structural and Optical Properties of Self-Assembled Epitaxially Grown GaN Nanorods and Nanoporous Film on Sapphire (0001) Using Laser Molecular Beam Epitaxy.

The GaN nanoporous-film (NPF) and nanorods (NRs) were grown on sapphire (0001) using laserassisted molecular beam epitaxy (LMBE) technique by laser ablating solid GaN target at different laser energy density. The interconnected GaN NPF was grown at low laser energy density of ˜4 J/cm² whereas vertically aligned GaN NRs was obtained at high laser energy density of ˜7 J/cm². The pore size of the GaN NPF structure is in range of 40-120 nm. The GaN NRs possess hexagonal shape with six sidewall facets and truncated top facet. The length, width and density of GaN NRs are 600-900 nm, 150-250 nm and ˜2.5×107 cm-2, respectively. The X-ray rocking curve full width at half maximum values along GaN (0002) and (1012) planes for GaN NRs obtained to be 0.41 and 0.53°, respectively. The biaxial stress in hetero-epitaxially grown GaN was investigated with Raman spectroscopy and it was found that GaN NRs possesses a very low in-plane compressive biaxial stress of 0.09 GPa. The photoluminescence study exhibits a sharp band-to-band emission at 3.4 eV with a peak line width of 140 meV, signifying the good optical quality of the LMBE grown GaN NRs on sapphire (0001).

Excitation Density Dependent Photoluminescence Studies on Homo-Epitaxial GaN Nanowall Networks Grown by Laser Assisted Molecular Beam Epitaxy.

The optical properties of laser-assisted molecular beam epitaxy grown homo-epitaxialGaN nanowall networks (NWNs) were investigated using power dependent photoluminescence (PL) spectroscopy and compared with homo-epitaxial GaN thin film. The pore size and tip width of GaN NWN sample is ˜120-180 nm and 10-15 nm, respectively. The ultraviolet-visible spectroscopy study shows that the GaN NWNs have low optical light reflection and minimum Fabry-Perot cavity effect than GaN film. The room temperature PL spectroscopy reveals that the GaN NWNs possesses enhanced band gap of 3.51 eV with blue shift of 90 meV than the GaN film (3.42 eV). The excitation density dependent PL spectroscopy measurements reveal that the GaN NWNs nanowall and near band emission (NBE) peak position and its linewidth invariant. The intensity of NBE peak for GaN film and nanowalls varies linearly whereas NBE to defect related yellow luminescence peak intensity ratio shows a non-linear variation on the excitation density. The excitation density in PL measurements plays a key role when the sample quality compared on the basis of PL data.

Structural and Optical Properties of GaN Film on Copper and Graphene/Copper Metal Foils Grown by Laser Molecular Beam Epitaxy.

We report the direct growth of crystalline GaN on bare copper (Cu) and monolayer-graphene/Cu metal foils using laser molecular beam epitaxy technique at growth temperature of 700 °C. The surface morphology investigated with field emission scanning electron microscopy revealed that the size of GaN grains for film grown on bare Cu falls in range of 90 to 160 nm whereas large grains with size of ˜200 to 600 nm was obtained for GaN grown on graphene/Cu foil under similar growth condition. The transverse optical mode of cubic GaN and E2 (high) phonon mode for wurtzite GaN phases were obtained on the GaN film grown on Cu and graphene/Cu metal foils as deduced by Raman spectroscopy. The photoluminescence (PL) spectroscopy studies showed that the near band edge emission peaks for GaN on Cu and graphene/Cu consist two major peaks at 3.26 and 3.4 eV, corresponding to cubic and wurtzite GaN, respectively. The Raman and PL studies disclosed that the mixed phase growth of GaN occurs on these foils and better structural and optical quality for GaN on graphene/Cu foil. The direct growth of GaN on two dimensional graphene on polycrystalline metal foils is beneficial various transferrable and flexible opto-electronics device applications.

Effects of herpes simplex virus vectors encoding poreless TRPV1 or protein phosphatase 1α in a rat cystitis model induced by hydrogen peroxide.

Enhanced afferent excitability is considered to be an important pathophysiological basis of interstitial cystitis/bladder pain syndrome (IC/BPS). In addition, transient receptor potential vanilloid-1 (TRPV1) receptors are known to be involved in afferent sensitization. Animals with hydrogen peroxide (HP)-induced cystitis have been used as a model exhibiting pathologic characteristics of chronic inflammatory condition of the bladder. This study investigated the effect of gene therapy with replication-defective herpes simplex virus (HSV) vectors encoding poreless TRPV1 (PL) or protein phosphatase 1 α (PP1α), a negative regulator of TRPV1, using a HP-induced rat model of cystitis. HSV vectors encoding green fluorescent protein, PL or PP1α were inoculated into the bladder wall of female rats. After 1 week, 1% HP or normal saline was administered into the bladder, and the evaluations were performed 2 weeks after viral inoculation. In HP-induced cystitis rats, gene delivery of PL or PP1α decreased pain behavior as well as a reduction in the intercontraction interval. Also, both treatments reduced nerve growth factor expression in the bladder mucosa, reduced bladder inflammation characterized by infiltration of inflammatory cells and increased bladder weight. Taken together, HSV-mediated gene therapy targeting TRPV1 receptors could be effective for the treatment of IC/BPS.

Zoonotic surveillance for rickettsiae in rodents and mapping of vectors of rickettsial diseases in India: A multi-centric study.

BACKGROUND: The global resurgence of rickettsial diseases and their potential to impact the fitness of military personnel and inflict widespread casualties amongst civil populations has emerged as a major cause of public health concern. Absence of surveillance system, lack of awareness amongst medical fraternity to rickettsial activity along with the difficulty in diagnosis because of their protean clinical manifestations are reasons for the outbreaks of these diseases. OBJECTIVES: To determine rickettsial activity amongst rodents and study vector diversity, abundance and their distribution to enable mapping of rickettsial hotspots. METHODS: Zoonotic surveillance was undertaken in six selected study areas in India - Jammu, Akhnoor, Rajouri-Poonch, Udhampur-Nagrota, Dehradun and Pune. Weil-Felix test was used for rickettsial sero-surveillance amongst rodents and standard identification keys were used for mapping vector diversity and database preparation. RESULTS: Serological findings revealed positivity to all the three rickettsial antigens (OXK, OX19 and OX2) in Jammu, OX19 in Dehradun and OXK and OX2 positivity in Udhampur-Nagrota belt. The vector database records presence of 16 species of trombiculid mites from three important genera - Leptotrombidium, Schoengastiella and Gahrliepia with ticks from five genera and 8 species of fleas from four genera. Mite fauna of study sites has been enriched with addition of new records of mite species (five mite species at Pune, two at Akhnoor with one mite species each at Jammu and Dehradun). CONCLUSION: The study reveals rickettsial activity amongst rodents at Jammu, Dehradun and Udhampur-Nagrota belt. The results correlate well with the presence of vectors of scrub and tick typhus and corroborate the occurrence of outbreaks of these diseases in the respective areas.

Prevalence of enteric bacterial parasites with respect to anthropogenic factors among commensal rhesus macaques in Dehradun, India.

There has been a recent surge in research on primate infectious disease ecology. Two major areas remain relatively unaddressed to date-the prevalence of enteric bacterial parasites and the role of anthropogenic environmental factors in parasite acquisition in commensally living primate populations. In this preliminary assessment, we address both these gaps by assessing the prevalence, and the role of anthropogenic factors in shaping this prevalence, of three enteric bacterial parasites-E . coli O157:H7, Salmonella sp., Shigella sp.-across populations of rhesus macaques (M. mulatta) that live commensally with humans in Dehradun, northern India. Across 10-week study period, we collected data on (1) human-macaque behavioral interactions, (2) macaque and human demographic and activity scans, and (3) macaque fecal samples from the environment at four different locations in Dehradun. Biochemical tests and morphology-based confirmations clearly established the presence of all three enteric bacterial parasites in rhesus macaques. Overall prevalence ranged from 2 to 5 %, with Shigella sp. being the most prevalent. Regression analyses linking anthropogenic factors to bacterial prevalence showed a positive association between rates of macaques eating human garbage and E. coli O157:H7 (ß = 0.23, p = 0.083), but a negative association with Salmonella sp. (ß = -0.17, p = 0.026). Rather, the prevalence of Salmonella sp. was positively linked to rates of macaque eating provisioned food (ß = 0.0012, p = 0.058). Finally, we found no relationship between anthropogenic factors and the prevalence of Shigella sp. Our findings establish the prevalence of enteric bacterial parasites in commensal populations of primates and suggest that although anthropogenic factors are linked to bacterial prevalence, the nature of the relationships may depend on the socioecological/foraging strategies of macaques and the food sources that facilitate the environmental survival of particular types of enteric bacteria over others.

Monitoring artemisinin resistance in Plasmodium falciparum: comparison of parasite clearance time by microscopy and real-time PCR and evaluation of mutations in Pfatpase6 gene in Odisha state of India.

Antimalarial drug resistance including artemisinin resistance in Plasmodium falciparum malaria is a major concern in combating malaria throughout the world. Delayed parasite clearance time (PCT) is indicative of emergence of artemisinin resistance. Herein, PCT has been monitored with the help of gold standard technique microscopy accompanied by a more sensitive real-time assay for academic purpose. After the administration of artemisinin based combination therapy, artesunate + sulfadoxine pyrimethamine (AS + SP), all the subjects were followed up to day 42 for monitoring the therapeutic efficacy of AS + SP in Bisra Community Health Centre (CHC), Sundergarh district in the state of Odisha in India. Further, representative samples were analyzed for L263E, E431K, A623E and S769N SNPs in Pfatpase6 gene and copy number polymorphisms in Pfmdr1 gene. Though all the samples were found parasite negative according to microscopy by the end of day 3 and attained adequate clinical and parasitological response (ACPR) at the end of day 42, real-time PCR showed day 3 positivity in 12 of the total analyzed samples (n = 43). This was further validated by end-point diagnostic PCR and correlated with high initial parasite load. E431K mutation was observed in 2 of the 12 samples (16.7 %) while the controls (n = 18) were all wild. L263E, A623E and S769N were wild in all the analyzed samples (n = 30). Pfmdr1 copy number analysis showed no change in the said trait. Conclusively, real-time PCR could support microscopy for better monitoring of PCT and may provide as an additional but useful research tool for artemisinin resistance studies.

Pelvic organ cross-sensitization to enhance bladder and urethral pain behaviors in rats with experimental colitis.

Neural cross-sensitization has been postulated as a mechanism underlying overlaps of chronic pelvic pain disorders such as bladder pain syndrome/interstitial cystitis (BPS/IC) and irritable bowel syndrome (IBS). Animals with experimental colitis have been used to study the underlying mechanisms for overlapped pelvic pain symptoms, and shown to exhibit bladder overactivity evidenced by frequent voiding; however, it has not directly been evaluated whether pain sensation derived from the lower urinary tract is enhanced in colitis models. Also, the cross-sensitization between the colon and urethra has not been studied previously. In the present study, we therefore investigated pain behaviors induced by nociceptive stimuli in the lower urinary tract and the involvement of C-fiber afferent pathways using rats with colitis induced by intracolonic application of 2,4,6-trinitrobenzenesulfonic acid (TNBS). In TNBS-induced colitis rats at 10 days, intravesical application of resiniferatoxin (RTx) induced a significantly greater number of episodes of both licking and freezing behaviors, which were reduced by capsaicin-sensitive C-fiber afferent desensitization. Histochemical studies using fluorescent dye tracers injected into the colon, bladder or urethra showed that dichotomized afferent neurons comprised 6.9-14.5% of L1, L6 and S1 dorsal root ganglion (DRG) neurons innervating the colon or the lower urinary tract. Transient receptor potential vanilloid 1 (TRPV1) mRNA expression was significantly increased in, the bladder, urethra and S1 DRG in colitis rats. An increase in myeloperoxidase (MPO) activity was found in the colon, but not in the bladder or urethra after intracolonic TNBS treatment. These results indicate that TNBS-induced colitis increased pain sensitivity in the bladder and urethra via activation of C-fiber afferent pathways due to colon-to-bladder and colon-to-urethral cross-sensitization, suggesting the contribution of pelvic organ cross-sensitization mechanisms to overlapped pain symptoms in BPS/IC and IBS.

Mechanisms inducing autonomic dysreflexia during urinary bladder distention in rats with spinal cord injury.

OBJECTIVES: This study investigated the mechanisms inducing autonomic dysreflexia due to enhanced bladder-to-vascular reflexes in rats with spinal cord injury (SCI). METHODS: SCI was produced by the transection of the Th4-5 spinal cord in female Sprague-Dawley rats. At 4 weeks after SCI, changes in blood pressure during graded increases in intravesical pressure (20-60 cm H2O) were measured in spinal-intact (SI) and SCI rats under urethane anesthesia. In five animals, effects of C-fiber desensitization induced by intravesical application of resiniferatoxin (RTX), a TRPV1 agonist, on the bladder-to-vascular reflex were also examined. Nerve growth factor (NGF) levels of mucosa and detrusor muscle layers of the bladder were measured by enzyme-linked immunosorbent assay. The expression levels of TRPV1 and TRPA1 channels were also examined in laser captured bladder afferent neurons obtained from L6 DRG, which were labeled by DiI injected into the bladder wall. RESULTS: In SI and SCI rats, systemic arterial blood pressure was increased in a pressure-dependent manner during increases in the intravesical pressure, with significantly higher blood pressure elevation at the intravesical pressure of 20 cm H2O in SCI rats vs SI rats. The arterial blood pressure responses to bladder distention were significantly reduced by RTX-induced desensitization of C-fiber bladder afferent pathways. SCI rats had higher NGF protein levels in the bladder and higher TRPV1 and TRPA1 mRNA levels in bladder afferent neurons compared with SI rats. CONCLUSIONS: The bladder-to-vascular reflex induced by TRPV1-expressing C-fiber afferents during bladder distention is enhanced after SCI in association with increased expression of NGF in the bladder and TRP channels in bladder afferent neurons.

Liposomal inhibition of acrolein-induced injury in rat cultured urothelial cells.

PURPOSE: To study the protection offered by empty liposomes (LPs) alone against acrolein-induced changes in urothelial cell viability and explored uptake of LPs by primary (rat) urothelial cells. METHODS: Acrolein was used as a means to induce cellular damage and reduce urothelial cellular viability. The effect of acrolein or liposomal treatment on cellular proliferation was studied using 5-bromo-2'-deoxy-uridine assay. Cytokine release was measured after urothelial cells were exposed to acrolein. Temperature-dependent uptake study was carried out for fluorescent-labeled LPs using confocal microscopy. RESULTS: Liposome pretreatment protected against acrolein-induced decrease in urothelial cell proliferation. LPs also significantly affected the acrolein-induced cytokine (interferon-gamma) release offering protection to the urothelial cells against acrolein damage. We also observed a temperature-dependent urothelial uptake of fluorescent-labeled LPs occurred at 37 °C (but not at 4 °C). CONCLUSIONS: Empty LPs alone provide a therapeutic efficacy against acrolein-induced changes in urothelial cell viability and may be a promising local therapy for bladder diseases. Hence, our preliminary evidence provides support for liposome-therapy for urothelial protection and possible repair.

Sedative effects of oral midazolam, intravenous midazolam and oral diazepam in the dental treatment of children.

OBJECTIVE: To evaluate and compare the behavioral changes and effect of sedative techniques in pediatric dental patients using Oral Midazolam, Intravenous Midazolam and Oral Diazepam as sedative agents. METHOD: Triple blind randomized control trial with 40 patients aged between 2-10 years, exhibiting definitely negative behavior was considered. Patients were randomly assigned to one of the four treatment groups. Group I received midazolam 0.5 mg/kg orally, Group II received 0.5 mg/kg diazepam orally, Group III received 0.06 mg/kg midazolam intravenously and Group IV received oral placebo. Behavioral changes (sleep, crying, movement, and overall behavior) and effect of sedative techniques on pediatric patients were assessed. RESULTS: All the patients in group 3 were significantly better in post administrative behavior viz. sleep, crying and movement. Over all behavior scores for group 3 patients were significantly better than other three groups (p < 0.001). Positive behavior of patients in group 2 and 3 did not show significant difference but positive behavior in group 3 was significantly (p < 0.05) more than group 2. Placebo group showed the highest negative behavior CONCLUSION: Sedative effects of oral midazolam and oral diazepam were comparable, where as intravenous midazolam produced more sedation. Anxiolysis was found to be more in both the midazolam groups than the diazepam group. Most number of positive changes were observed in midazolam groups as compared to diazepam group.

Arterolane maleate plus piperaquine phosphate for treatment of uncomplicated Plasmodium falciparum malaria: a comparative, multicenter, randomized clinical trial.

BACKGROUND: Artemisinin-based combination therapy is the first-line treatment for uncomplicated falciparum malaria. This study assessed the antimalarial efficacy and safety of a combination of 150 mg of arterolane maleate and 750 mg of piperaquine phosphate (AM-PQP) in comparison to Coartem (artemether and lumefantrine) in patients with acute uncomplicated P. falciparum malaria. METHODS: In this open-label, randomized, multicentric, parallel group clinical trial, 240 patients were randomized to receive AM-PQP (160 patients) or Coartem (80 patients). Patients with P. falciparum monoinfection and initial parasite densities ranging from 1000 to 100 000 asexual parasites/µL of blood were followed for 28 days. Polymerase chain reaction-corrected adequate clinical and parasitologic response on day 28, parasite clearance time, and fever clearance time were evaluated. RESULTS: A total of 151 (94.4%) of 160 patients in the AM-PQP group completed the trial, while 77 (96.3%) of 80 patients in the Coartem group completed the trial. No treatment failure was noted in the AM-PQP group, while one patient receiving Coartem failed treatment on day 28. There was no difference in the median parasite clearance time (30 hours in both groups) or median fever clearance time (24 hours in both groups) after administration of the 2 study treatments. CONCLUSIONS: The available data support the evaluation of a drug combination in a larger population as a fixed-dose combination. Clinical Trials Registration. CTRI/2007/091/000031.

Approach to chronic hepatitis B virus infection.

Hepatitis B virus (HBV) infection constitutes one of the major global public health problems. Not only India and Nepal, East Asia is fighting with the same. About 30 percent of the world's population has serological evidence of current or past infection with HBV. By virtue of its different stage of presentation in different age groups of patients and the rapid mutation in the virus, the treatment of HBV requires thorough work-up and regular monitoring. Many new concepts have evolved in last decade in managing these patients, such as HBV Genotype, HBV DNA quantification and mutation analysis. The introduction of oral antivirals in the treatment of HBV infection has revolutionized the treatment.