Background: Tuberculosis is still an endemic disease and a global health problem, especially in developing countries. Puskesmas Babakansari is a Puskesmas located in Kiaracondong District of Bandung City. In 2019, there were 80 people with tuberculosis. Aim: The purpose of the study was to analyze the relationship of environmental factors to the incidence of tuberculosis. Method: The types of research used are observational analytics and Cross Sectional design. The population in this study was suspected tuberculosis who conducted laboratory examinations as many as 368 people. The study sample of 98 respondents was taken at a simple random. The instruments used are questionnaires, thermo hygrometer observation sheets and lux meters. The statistical test used is chi square. Results: The results showed that environmental factors associated with the incidence of pulmonary tuberculosis were temperature (p = 0.004), humidity (p = 0.031), and lighting (p = 0.012). Conclusion: This study proves that the environmental factors associated with the incidence of tuberculosis are temperature, humidity and lighting. It is recommended to health workers to educate the public to pay attention to the physical environmental factors of the house as an effort to prevent the transmission of pulmonary tuberculosis.

Background: The city of Bandung is an endemic area of dengue fever. An increase in the number of dengue cases has an impact on the increase in deaths. Purpose: This study aims to analyze the epidemiological determinants of dengue hemorrhagic fever incidence. Method: This study uses a case-control design. The case population is those who suffer from dengue hemorrhagic fever, while the control population is those who do not suffer from dengue hemorrhagic fever. The sample in this study amounted to 510 respondents. Samples were taken using a simple random technique. Epidemiological determinants were analyzed using chi-square tests. Results: Related research results are education (p = 0.036), the presence of mosquito flicks (p = 0,000), container materials (p = 0.002), water reservoirs (p = 0.025), mosquito wire (p = 0.010), the presence of solid waste (p = 0.002), mosquito repellent plants (p = 0.041), mobility (p = 0.004). Conclusion: Epidemiological determinants that have been proven to be associated with DHF incidence are education, the presence of mosquito larvae, container materials, water reservoir objects, mosquito wire, the presence of solid waste, and mosquito repellent plants. Age, gender, occupation, and income cannot be proven.

Corona virus disease-2019 (COVID-19) pandemic continue to affect many countries across the globe for the past one year. This is mostly respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Spike protein on SARS-CoV-2 helps in binding the virus to the host cell. Spike protein consists of S1 and S2 domain. S1 domain further consists of the RBD domain, which can exist in an open or closed state. Open conformation is responsible for binding to the host cell and thus is a significant determinant of SARS-CoV-2 infectivity. The dominant variants, D614G and G614 of SARS-CoV-2 were identified early in the pandemic. These have mutations outside the RBD of the spike protein. N501Y, E484K and newly emerging Indian double mutant strain with two mutation E484Q and L452R are the recent variants in India, UK, South Africa. These variants have mutations in the RBD region of spike proteins. The variants carrying different mutations in their spike proteins have demonstrated a different level of infectivity. Owing to the lack of any specific treatment forSARS-CoV-2, the clinicians and researchers primary focus lies in vaccine development. The mutations in spike proteins may have a bearing on antibody response to vaccines. Different mutations in spike protein may affect not only the protective immune response to vaccines but also antibody-dependent enhancement of virus. Studies on the serum of patients for neutralizing antibodies to vaccines have shown conflicting results, particularly in the variants harboring mutations in the RBD domain. The focus of this article is to discuss the structural aspects of spike protein, structural-functional implications, infectivity potential and susceptibility to neutralization by vaccines of earlier and newer variants of SARS-CoV-2.

Public Health Emergency of International Concern (PHEIC) is defined in the International Health Regulations (IHR) as an extraordinary event that is determined to “constitute a public health risk to other states through the international spread of disease and to potentially require a coordinated international response”. (1) IHR algorithm helps and assists WHO member states to arrive at a conclusion that whether a PHEIC exists or not and thereafter the WHO is notified. Since 2009 there have been six declarations, H₁N₁Pandemic (swine flu) in 2009, Polio declaration in 2014, Ebola in western Africa in 2014, Zika virus in 2015-16, Kivu Ebola virus in 2018-20 and the recent ongoing COVID-19.

Government nowadays focuses on resolving problems in medical institutions and workers due to covid19. Covid19 is an infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The support of government revolves around the medical institutions disregarding that there is also the impact of covid19 in non-medical institutions, which is also part of government and delivering public services amidst the time of Covid19. A response of government revolves in the “community quarantine" which consisted of physical distancing, suspension of classes and work and introduction of work from home, prohibition of mass gatherings and non-essential public events. Upon continuation of regular operations to continue public services amidst the pandemic, regular work flow sustained following health and safety protocols and alternative working arrangements which is a completely different setting compared to what it used to be before. Working-from-home was the most used alternative working arrangement adopted by most organizations. Fostered by this pandemic, people have realized that working from home may be a long-term trend in the post-COVID-19 era. However, there are risks in working from home arrangement for the employees that are working outdoors or in the field. Most agencies adopted work from home not noticing that it may not be suitable for field workers. Insufficiency of plans supporting the different work settings was found out in this research. The post COVID-19 pandemic era will challenge many of our existing conventional practices across workplaces and between workers in different occupations or services. Therefore, the researcher recommends having potential sustainable strategies to support different kinds of work settings in public services. Different potential plans and programs identified in this literature review may be used in future research relative hereto. More so, this study can provide a backbone for other studies that deal with similar topics.

Objectives: The wastage of blood components results in significant direct costs to health care organizations. Previous education-based efforts to reduce blood component wastage were unsuccessful at our institution. We hypothesized that a quality and process improvement approach would result in sustained reductions to less than 5 percent, as recommended by World Health Organization. Methods: A retrospective study was conducted on the data retrieved from laboratory blood banking information system, on usage and wastage of blood products, for the period Jan 2018 to October 2020. Interventions were taken and post intervention wastage analyzed. Results: A total of 19279 units of blood were issued from the blood bank during the period of study. The most frequently requested blood component was packed cells [9423 Unit, 48.87 %] followed by fresh frozen plasma (FFP) [4160 units, 21.57%], platelet [2240 units, 11.61%], and whole blood [810 units, 4.20 %] respectively. Data indicated that 184 units out of 939 prepared units (19.5%) of blood were wasted due to various reasons. Three commonest causes for wastage were leakage, expiry and return from ward. The wastage of blood components over two years was reduced from 19.5% to 2.75% by various interventions, like placing appropriate request, staff training, proper documentation, improved communication. Wastage reduction was maximum in platelet component and most effective intervention was limiting number of platelet preparation by strict monitoring. Comprehensive policies have been formulated to ensure better quality control in collection, storage, testing, and distribution of blood and its components for the identified major factors affecting blood product wastage. Conclusions: Thus, our team focused on raising awareness among medical staff in reducing blood wastage and improving the process of blood product ordering, transport, and storage was able to significantly reduce blood component wastage associated costs using quality and process improvement methods.

Enteropathy-associated T cell lymphoma [EATL] is a rare but aggressive malignancy in patients with celiac disease. Delayed diagnosis of celiac disease and poor adherence to a gluten-free diet are risk factors for malignant evolution of celiac disease. Here the author presents such a rare case of EATL with obstructive renal failure, who after diagnosis was managed symptomatically and started on chemotherapy.

We present a 32 year old male with ocular trauma by sharp object resulting in corneal laceration and iris prolapse. This case shows importance of early diagnosis, proper wound repair and value of early postoperative visual rehabilitation.

In this world of technology the smartphones are now no longer a mode of communication or entertainment but can be used as an easy tool for data collection.[1] The process is easy, time saving and decreases the errors done during data collection with pen and paper. Epicollect5 is one such application that is available free of cost. This application is both mobile and web based and was developed by Imperial College, London.[2] The authors used epicollect5 as a tool to increase the pace of COVID19 vaccination in a hilly district of North India.

Pulmonary aspergillosis is clinical spectrum of lung diseases caused by several species of the genus Aspergillus. It presents with a variety of clinical forms including invasive pulmonary aspergillosis, allergic bronchopulmonary aspergillosis, chronic necrotizing aspergillosis, aspergilloma and chronic cavitary pulmonary aspergillosis. Haemoptysis is a devastating complication of pulmonary aspergillosis and a common indication for surgery. The authors present a case of aspergillosis presenting with prolonged fever and haemoptysis.

Hypogonadism is one of the most common endocrinopathy in HIV infected patients. Hypogonadotropic hypogonadism due to hypothalamic-pituitary dysfunction is more frequent than hypergonadotropic hypogonadism in HIV infected men. The pathogenesis of hypogonadism in HIV-infected men remains unclear. Hypothesis on the underlying causes and mechanisms have been provided based on some well recognized pathophysiologic phenomena, but their cause-effect relationships need to be substantiated by further evidence. Through this article, we try to explain the pathophysiology of hypogonadism in HIV infected men.

Malaria is a complex and daunting problem with an intricate life cycle and nuanced interplay of agent, host, vector, and environment that is further complicated by challenging political, eco- nomic, and social factors. This article provides an overview of the relevant aspects of malaria focusing principally on the key public health-related issues including estimates of the current burden, description of the agent, life cycle, modes of transmission and vector aspects, discussion of epidemiological factors, basic information on clinical manifestations, diagnostic testing, treatment and chemoprophylaxis approaches.

Acute onset of fever, chills, myalgia, and fatigue are common features of many infections that are endemic in India. In many areas of developing countries, where diagnostic facilities are limited, etiologies of acute undifferentiated febrile illness (AUFI) remain largely unknown. Physicians often diagnose patients presumptively based on clinical features and assumptions regarding circulating pathogens. These AUFI that includes scrub typhus, dengue fever, malaria, enteric fever, and leptospirosis among others cause significant mortality and morbidity. Through this article we wish to focus on the differential diagnosis of Acute Undifferentiated Febrile Illness.

It has been hypothesised that various factors can lead to this diversity like age, sex, baseline liver function tests, underlying liver diseases, malnutrition and severity of tuberculosis disease. Also, genetic susceptibility of the patients to drug liver injury has been identified such as NAT2 polymorphism.  We conducted a cross-sectional study to estimate the baseline liver injury in newly diagnosed tuberculosis patients before the initiation of anti-tubercular drugs. There was a total of 312 participants in our study. The mean age of all patients was 40.26±17.82 years. All patients had normal liver function tests before the initiation of therapy. Liver function tests were monitored at initiation, 2^ndand 4^th week of the treatment to note the elevation in serum bilirubin and liver transaminase levels which indicate the anti-tuberculosis treatment induced hepatotoxicity.

Tuberculosis was considered to be among the top ten causes of global mortality and morbidity. The highest incidence of TB was found in developing countries. Estimates suggest that 32% of the world’s population was infected with TB.As per global TB report of 2018, in India, there were nearly 2.7 million new cases of tuberculosis and 4.1 lakh TB related deaths in India. This is despite the availability of treatment that will cure most cases of TB. The first line drugs used for the treatment of tuberculosis include Isoniazid, Rifampicin and Pyrazinamide all of which are hepatotoxic. Incidence of Anti- tuberculosis Drug induced Hepatitis varies from 3 -28% in various studies with higher incidence in Asian countries. In this article, we discuss the adverse effects of drugs used for the treatment of tuberculosis.