Impact of dehydration on the physiochemical properties of Nostoc calcicola BOT1 and its untargeted metabolic profiling through UHPLC-HRMS.

The global population growth has led to a higher demand for food production, necessitating improvements in agricultural productivity. However, abiotic and biotic stresses pose significant challenges, reducing crop yields and impacting economic and social welfare. Drought, in particular, severely constrains agriculture, resulting in unproductive soil, reduced farmland, and jeopardized food security. Recently, the role of cyanobacteria from soil biocrusts in rehabilitating degraded land has gained attention due to their ability to enhance soil fertility and prevent erosion. The present study focused on Nostoc calcicola BOT1, an aquatic, diazotrophic cyanobacterial strain collected from an agricultural field at Banaras Hindu University, Varanasi, India. The aim was to investigate the effects of different dehydration treatments, specifically air drying (AD) and desiccator drying (DD) at various time intervals, on the physicochemical properties of N. calcicola BOT1. The impact of dehydration was assessed by analyzing the photosynthetic efficiency, pigments, biomolecules (carbohydrates, lipids, proteins, osmoprotectants), stress biomarkers, and non-enzymatic antioxidants. Furthermore, an analysis of the metabolic profiles of 96-hour DD and control mats was conducted using UHPLC-HRMS. Notably, there was a significant decrease in amino acid levels, while phenolic content, fatty acids, and lipids increased. These changes in metabolic activity during dehydration highlighted the presence of metabolite pools that contribute to the physiological and biochemical adjustments of N. calcicola BOT1, mitigating the impact of dehydration to some extent. Overall, present study demonstrated the accumulation of biochemical and non-enzymatic antioxidants in dehydrated mats, which could be utilized to stabilize unfavorable environmental conditions. Additionally, the strain N. calcicola BOT1 holds promise as a biofertilizer for semi-arid regions.

Assessment of anti-psoriatic activity of bakuchiol-loaded solid lipid nanoparticles-based gel: design, characterization, and mechanistic insight via NF-kB signaling pathway.

The aim of the current study is to evaluate the anti-psoriatic potential of bakuchiol (Bak) loaded solid lipid nanoparticles (SLNs) via modulating inflammatory and oxidative pathways. Bak-loaded SLNs were prepared using hot homogenization method and characterized by various spectroscopic techniques. Bak-SLNs suspension was formulated into gel using Carbopol. Different in vivo assays were executed to explore the role of inflammatory markers and oxidative enzymes in psoriasis. DLS (dynamic light scattering) analysis showed suitable particle size, zeta potential, and polydispersity index (PDI) of developed formulation. TEM (transmission electron microscopy) reveal the spherical shape of Bak-SLNs particles. The release studies confirmed the sustained release of Bak-SLNs-based gel. UV-B-induced psoriatic Wistar rat model showed significant anti-psoriatic effect of Bak via regulating inflammatory markers (NF-kB, IL-6, IL-4, and IL-10) and levels of anti-oxidant enzymes, superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), and glutathione-S-transferase (GST). Furthermore, RT-qPCR analysis confirms that Bak downregulates the expression of inflammatory markers, while histology and immunohistology results also confirm the anti-psoriatic effect of Bak. The study indicates that Bak-loaded SLNs-based gel significantly downregulates the level of cytokines and interleukins involve in NF-kB signaling cascade; hence, it can prove to be a novel therapeutic approach to cure psoriasis.

Assessment of radon, thoron, and their progeny concentrations in the dwellings of Shivalik hills of Jammu and Kashmir, India.

The present work determines the contents of active and passive indoor 222Rn, 220Rn, and their daughter in the 32 houses of the Reasi district of J&K, India. The passive 222Rn and 220Rn concentration was measured by dosimeters, whereas the active content was measured by active radon monitor. Progeny sensors and integrated samplers were operated for the evaluation of passive and active daughter contents of 222Rn and 220Rn. The measured averaged values of indoor 220Rn and 222Rn were 73 ± 40 and 22 ± 8 Bqm-3, respectively. The radon and thoron equilibrium factor has varied from 0.3 to 1.7 and from 0.006 to 0.6. The fine fraction of the above-mentioned gases was also calculated. The results of Mann-Whitney test statistically demonstrated significant differences between the content of indoor 222Rn, 220Rn, and their daughter for different seasons. The values of 222Rn, 220Rn, and their daughter content were appeared to be elevated in set of mud houses among all sets of houses. The values of all daughter concentration and indoor 222Rn were appeared to lie within the limit proposed by various agencies. The total doses were detected less than range commended by ICRP that suggested the district is safe as a health hazard point of view.

Quality, Equity and Partnerships in Mixed Methods and Qualitative Research during Seven Years of Implementing the Structured Operational Research and Training Initiative in 18 Countries.

Introduction: Qualitative studies are often inadequately reported, making it difficult to judge their appropriateness for decision making in public health. We assessed the publication characteristics and quality of reporting of qualitative and mixed-method studies from the Structured Operational Research and Training Initiative (SORT IT), a global partnership for operational research capacity building. Methods: A cross-sectional analysis of publications to assess the qualitative component using an adapted version of the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results: In 67 publications involving 18 countries, 32 journals and 13 public health themes, 55 were mixed-methods studies and 12 were qualitative studies. First authorship from low-and-middle-income (LMIC) countries was present in 64 (96%), LMIC last authorship in 55 (82%), and female first authorship in 30 (45%). The mean LMIC institutions represented per publication was five (range 1-11). Sixty-three (94%) publications were open access. Reporting quality was graded as 'good' to 'excellent' in 60 (89%) publications, 'fair' in five (8%) and 'poor' in two (3%). Conclusion: Most SORT IT publications adhered to COREQ standards, while supporting gender equity in authorship and the promotion of LMIC research leadership. SORT IT plays an important role in ensuring quality of evidence for decision making to improve public health.

Comprehensive Power Gain Assessment of GaN-SOI-FinFET for Improved RF/Wireless Performance Using TCAD.

In this work, we present a radio frequency (RF) assessment of the nanoscale gallium nitride-silicon-on-insulator fin field-effect transistor (GaN-SOI-FinFET). All the performances of the device were compared with GaN-FinFET and conventional FinFET (Conv. FinFET) simultaneously. All the results show that the power gains significantly improved in terms of Gma, Gms, Stern stability factor (SS), GMT, and intrinsic delay in comparison with conventional FinFET. Current gain and unilateral power gain were also evaluated for the extraction of fT (cut-off frequency) and fMAX, respectively. fT and fMAX were enhanced by 88.8% and 94.6%, respectively. This analysis was performed at several THz frequencies. Further, the parametric assessment was also performed in terms of gate length and oxide thickness to find the optimized value of gate length and oxide thickness. The implementation of GaN in the channel reduces the parasitic capacitance and paves the way for high-performance RF applications.

Assessment of Delirium as an Independent Predictor of Outcome among Critically Ill Patients in Intensive Care Unit: A Prospective Study.

Background: Delirium is frequently observed among critically ill patients in the intensive care unit. Although a preventable and reversible process, it is associated with greater morbidity and mortality. Early recognition and interpreting the predisposing and precipitating risk factors for delirium can improve outcomes among these patients. Objective: A prospective observational study was conducted with the primary objective to evaluate the incidence of delirium in a mixed adult intensive care unit. The secondary objectives were the evaluation of risk factors and outcomes of delirium. Methods: All patients who were more than 18 years of age and with an ICU stay of more than 24 hours were included in the study. Patients with prior history of neurological disorders, psychosis, and who were deaf were excluded. Eligible patients were evaluated by the residents to detect delirium using confusion assessment method for the intensive care unit (CAM-ICU) as a tool. Results: A total of 110 patients were included, and delirium was detected in 41 patients (37.3%). Among the predisposing risk factors, only hypertension was significantly associated with delirium. Among precipitating factors, mechanical ventilation, use of physical restraints and presence of window/natural light exposure, high Acute Physiology and Chronic Health Evaluation II scores, use of opioids, and benzodiazepines were associated with delirium. In multivariate risk regression analysis, presence of window/natural light exposure [odds ratio (OR), 55.52; 95% CI (8.887-346.904)]; (p <0.001) and duration of stay in ICU OR (1.145); 95% CI (1.058-1.238) (p = 0.001) were independent risk factors of delirium. Also, high mortality (53.7%) was observed among the delirious group of patients. Conclusion: Delirium is a common problem in the ICU and is associated with poor outcomes. Various risk factors are linked to ICU environment. How to cite this article: Junior MM, Kumar A, Kumar P, Gupta P. Assessment of Delirium as an Independent Predictor of Outcome among Critically Ill Patients in Intensive Care Unit: A Prospective Study. Indian J Crit Care Med 2022;26(6):676-681.

Assessment of Biological Activities of Fungal Endophytes Derived Bioactive Compounds Isolated from Amoora rohituka.

Fungal endophytes have remarkable potential to produce bioactive compounds with numerous pharmacological significance that are used in various disease management and human welfare. In the current study, a total of eight fungal endophytes were isolated from the leaf tissue of Amoora rohituka, and out of which ethyl acetate (EA) extract of Penicillium oxalicum was found to exhibit potential antioxidant activity against DPPH, nitric oxide, superoxide anion and hydroxyl free radicals with EC50 values of 178.30 ± 1.446, 75.79 ± 0.692, 169.28 ± 0.402 and 126.12 ± 0.636 µg/mL, respectively. The significant antioxidant activity of EA extract of P. oxalicum is validated through highest phenolic and flavonoid content, and the presence of unique bioactive components observed through high-performance thin layer chromatography (HPTLC) fingerprinting. Moreover, EA extract of P. oxalicum also displayed substantial anti-proliferative activity with IC50 values of 56.81 ± 0.617, 37.24 ± 1.26 and 260.627 ± 5.415 µg/mL against three cancer cells HuT-78, MDA-MB-231 and MCF-7, respectively. Furthermore, comparative HPTLC fingerprint analysis and antioxidant activity of P. oxalicum revealed that fungal endophyte P. oxalicum produces bioactive compounds in a host-dependent manner. Therefore, the present study signifies that fungal endophyte P. oxalicum associated with the leaf of A. rohituka could be a potential source of bioactive compounds with antioxidant and anticancer activity.

Normative values of skeletal muscle indices for nutritional assessment and implications on definition of sarcopenia in Indian adult population.

INTRODUCTION: Sarcopenia is defined as both low muscle function (performance or strength) and low muscle mass. Although aging is the main cause of sarcopenia, it can also occur due to poor nutrition and chronic diseases like liver cirrhosis, chronic kidney disease, and diabetes. OBJECTIVE: To do the quantitative analysis of various normative skeletal muscle indices (to define sarcopenia) in the Indian population. METHODS: Sex-specific means, standard deviations (SD), and sarcopenia cutoffs (mean-2SD) of psoas muscle thickness (PMTH), psoas muscle area (PMA), psoas muscle index (PMI), erector spinae muscle area (ESMA), skeletal muscle radiation attenuation (SMRA), total skeletal muscle area (SMA), and total skeletal muscle index (SMI) were computed. RESULTS: A total of 2002 individuals (1308 males and 694 females) underwent CT evaluation. PMTH (mm/m) was observed to be 15.87±2.67 in males vs. 12.61±2.46 in females (p=0.0001); PMA (cm2) was 18.55±3.45 in males vs.13.52±2.80 in females (p=0.0001); PMI (cm2/m2) was 6.69±1.40 in males vs. 5.57±1.18 in females (p=0.0001); ESMA (cm2) was 45.74±6.01 in males vs. 35.37±5.63 in females (p=0.0001); ESMI (cm2/m2) was 16.5±2.55 in males vs. 14.62±2.6 in females (p=0.0001); SMRA was 55.80±3.91 Hounsfield unit (HU) in males vs. 52.36±3.67 HU in females (p=0.0001); SMA (cm2) was 147.73±11.77 in males vs. 106.33±12.00 in females (p=0.0001); and SMI (cm2/m2) was estimated to be 51.00±5.70 in males vs. 43.93±6.05 in females (p=0.0001). PMTH, PMI, ESMI, SMI, and SMRA cutoffs for sarcopenia at L3 were observed to be 10.53 mm/m, 3.89 cm2/m2, 11.40 cm2/m2, 39.59 cm2/m2, and 47.98 HU among males and 7.69, 3.20, 9.42, 31.83, and 45.01 among females, respectively; these values were consistent with previously reported cutoffs in Indian studies but not consistent with the cutoffs reported in other countries. CONCLUSION: Normative values of skeletal muscle indices for either sex among the Indian adult population would enable future studies on sarcopenia in various medical conditions.

Hydro-geochemical analysis based on entropy and geostatistics model for delineation of anthropogenic ground water pollution for health risks assessment of Dhenkanal district, India.

Consumption of poor quality water causes serious human health hazards. Therefore, it is very crucial to investigate factors influencing the quality of groundwater and its suitability for drinking purpose. In the present study, groundwater quality of the Dhenkanal district of Odisha, India was characterized and the spatial distribution of different water quality parameters were analyzed using the multivariate statistics, entropy theory, and geostatistics techniques. In the present study 112 number of groundwater tube well samples were collected from the study area. The entropy theory revealed that SO42-, Mg+2 and Cl- were the most influencing parameters. A similar observation was also observed based on the correlation coefficient analysis. Groundwater quality index (GWQI) and entropy-weighted water quality index (EWQI) classifications indicated that 78.57 and 43.75% of the collected groundwater samples were categorized under excellent water quality, whereas, the rest of the samples were varying from good to medium drinking water quality. In addition, the result of EWQI classification offers more realistic assessment than that of GWQIs owing to its high precision, simplicity and without application of artificial weight. The correlation coefficient between Ca+2 and HCO3-, Mg+2 and PO4- were significantly high which might be due the presence of CaHCO3 and MgPO4 in the groundwater samples. The GWQI revealed a weak spatial dependence of groundwater quality.

Assessment of body weight from percutaneous widths of the bones and joints-Implications in forensic and clinical examinations.

BACKGROUND: Estimation of age, stature, sex, and ancestry contributes to the establishment of the biological profile of the deceased in forensic examinations. Assessment of the body weight aids in the approximation of the overall body size of the individual which may help in the forensic identification process. In clinical examinations, body weight assessment assumes importance in cases where body weight measurement is a challenging task due to illness and body deformity. OBJECTIVE: The present research was conducted to estimate the body weight from the percutaneous width of the bones and joints with the help of prediction equations. METHODS: The study was carried out on 344 adults (172 Females and 172 Males) aged between 18 and 25 years from the Himachal Pradesh State of North India. Eleven anthropometric measurements including height vertex, mid-arm circumference, humerus bicondylar width, transverse chest breadth, sagittal chest breadth, bi-iliac breadth, handbreadth, femur bicondylar breadth, ankle breadth, foot breadth, and body weight were taken on each individual. The sex differences were evaluated by using independent student t-test and Mann-Whitney U test and the correlation between the body weight and the anthropometric variables was investigated by using both Karl Pearson's correlation coefficient and Spearman's rank correlation coefficient depending upon the normality of the data. Regression models for the estimation of body weight were calculated. Further, a validation study was carried out to check the accuracy and utility of the derived regression models by calculating the mean absolute percent prediction error (MAPPE). RESULTS: Significant sex differences were observed among all the anthropometric variables. The transverse chest breadth and mid-arm circumference were strongly correlated with the body weight, whereas, a good correlation was also observed in other measurements except for the ankle breadth. The SEE (Standard error of estimate) of the derived linear regression models was compared, and it was found that multiple linear regression models show better accuracy than simple linear regression models. The MAPPE was found to be less in the case of multiple linear regression models than the linear ones. CONCLUSION: The present investigation concludes that regression models can be used in the estimation of body weight from the percutaneous measurements and joint widths with reasonable accuracy in an Indian population.

Supply chain vulnerability assessment for manufacturing industry.

In today's business, environment natural and manmade disasters like recent event (Covid 19) have increased the attention of practitioners and researchers to Supply chain vulnerability. Purpose of this paper is to investigate and prioritize the factors that are responsible for supply chain vulnerability. Extant literature review and interviews with the experts helped to extract 26 supply chain vulnerability factors. Further, the relative criticality of vulnerability factors is assessed by analytical hierarchy process (AHP). Critical part supplier; location of supplier; long supply chain lead times; Fixing process owners and mis-aligned incentives in supply chain are identified as the most critical factors among twenty-six vulnerability factors. Research concludes that not only long and complex supply chain but supply chain practices adopted by firms also increase supply chain vulnerability. Relative assessment of vulnerability factors enables professionals to take appropriate mitigation strategies to make the supply chains more robust. This research adds in building a model for vulnerability factors that are internal to supply chain & controllable.

Improving lung health in low-income and middle-income countries: from challenges to solutions.

Low-income and middle-income countries (LMICs) bear a disproportionately high burden of the global morbidity and mortality caused by chronic respiratory diseases (CRDs), including asthma, chronic obstructive pulmonary disease, bronchiectasis, and post-tuberculosis lung disease. CRDs are strongly associated with poverty, infectious diseases, and other non-communicable diseases (NCDs), and contribute to complex multi-morbidity, with major consequences for the lives and livelihoods of those affected. The relevance of CRDs to health and socioeconomic wellbeing is expected to increase in the decades ahead, as life expectancies rise and the competing risks of early childhood mortality and infectious diseases plateau. As such, the World Health Organization has identified the prevention and control of NCDs as an urgent development issue and essential to the achievement of the Sustainable Development Goals by 2030. In this Review, we focus on CRDs in LMICs. We discuss the early life origins of CRDs; challenges in their prevention, diagnosis, and management in LMICs; and pathways to solutions to achieve true universal health coverage.

The Impact of Vitiligo on Quality of Life and Psychosocial Well-Being in a Nepalese Population.

The authors collected demographics and assessed the impact of vitiligo using Vitiligo Quality of Life (VitiQoL) and Vitiligo Impact Scale (VIS), followed by a focused survey and semistructured interviews with 22 participants in midwestern Nepal. VitiQoL and VIS scales did not indicate a large impact on quality of life; however, through interviews/focused surveys, participants expressed unhappiness/worry, problems in finding partners, securing employment, and social discrimination due to their skin lesions. These stressors are highlighted along with lack of proper physician counseling and vitiligo-related myths, which create psychosocial distress that may not be given priority in underdeveloped countries like Nepal.

Assessment of Impairment of Quality of Life in Foot Eczema and Correlation thereof with Epidemiological Data of its Patients: A Cross-Sectional Study.

BACKGROUND: Eczema of foot adversely impacts daily activities, work productivity, and interpersonal relationships. MATERIALS AND METHODS: This cross-sectional, questionnaire-based study collated epidemiological data of 70 outpatients of foot eczema, evaluated their quality of life by 10-item dermatology life quality index (DLQI) questionnaire, and undertook the correlation thereof. RESULTS: Cases were predominantly males (48; 68.5%); 26 (37.1%) belonged to fifth decade of life and 47 (67%) presented within 12 months of onset. Dorsa of feet was involved in most (59; 84.2%) cases. Itching was a universal complaint followed by scaling (51; 72.9%), dryness (22; 31.4%), and oozing (21; 30%). History of atopy was reported by 15 (21.4%) patients; tobacco and/or alcohol abuse 32 (45.7%) patients; past treatment was received by 37 (52.9%) patients; and winter aggravation in 9 (12.3%) patients. Mean DLQI score was 13.64; with very large effect (11-20) on QoL in 38 (54.3%) patients; moderate (6-10) in 15 (21.4%) patients; extremely large (21-30) in 9 (12.9%) patients; and small (2-5) in 8 (11.4%) patients. Mean scores of questions of DLQI tool were 2.46 in first question (symptoms), 1.99 in fifth (social activities); 1.81 in seventh (working/studying); and 0.17 in fourth (clothes) question. Significant (P < 0.05) impairment of quality of life emerged with respect of burning, scaling, oozing, history of atopy, seasonal variation, and past treatment. CONCLUSION: Our study reports significant association of atopy, winter aggravation, past treatment, burning, scaling, and oozing with adverse quality of life in our study on cases of foot eczema and appears to be first study from India.

Quality, Equity and Utility of Observational Studies during 10 Years of Implementing the Structured Operational Research and Training Initiative in 72 Countries.

Introduction: Observational studies are often inadequately reported, making it difficult to assess their validity and generalizability and judge whether they can be included in systematic reviews. We assessed the publication characteristics and quality of reporting of observational studies generated by the Structured Operational Research and Training Initiative (SORT IT). Methods: A cross-sectional analysis of original publications from SORT IT courses. SORT IT is a global partnership-based initiative aimed at building sustainable capacity for conducting operational research according to country priorities and using the generated evidence for informed decision-making to improve public health. Reporting quality was independently assessed using an adapted version of 'Strengthening the Reporting of Observational Studies in Epidemiology' (STROBE) checklist. Results: In 392 publications, involving 72 countries, 50 journals, 28 publishers and 24 disease domains, low- and middle-income countries (LMICs) first authorship was seen in 370 (94%) and LMIC last authorship in 214 (55%). Publications involved LMIC-LMIC collaboration in 90% and high-income-country-LMIC collaboration in 87%. The majority (89%) of publications were in immediate open access journals. A total of 346 (88.3%) publications achieved a STROBE reporting quality score of >85% (excellent), 41 (10.4%) achieved a score of 76-85% (good) and 5 (1.3%) a score of 65-75% (fair). Conclusion: The majority of publications from SORT IT adhere to STROBE guidelines, while also ensuring LMIC equity and collaborative partnerships. SORT IT is, thus, playing an important role in ensuring high-quality reporting of evidence for informed decision-making in public health.

Chemical, biological and in silico assessment of Ocimum viride essential oil.

AIMS: Ocimum viride Willd. (family: Lamiaceae) is a member of the genus Ocimum, an aromatic annual and perennial herb with numerous culinary, horticultural and ethno-medicinal benefits. This study aims to explore the chemical properties of leaf essential oil (EO) from Ocimum viride and to evaluate its antimicrobial and anticancer potential. MAIN METHODS: Characterization of essential oil was done by GCMS, antimicrobial by agar well diffusion methods, in vitro cytotoxicity evaluation by MTT assay, cell death analysis was done by DNA fragmentation, cell cycle analysis, nuclear morphology analysis and molecular docking studies were also conducted. KEY FINDINGS: Essential oil from aerial parts (leaf) of Ocimum viride revealed high content of oxygenated monoterpenes, notably thymol (~50%) and γ-terpinene (~18%). Further, antibacterial analysis showed that among all the evaluated bacterial species EO showed highest sensitivity against the Bacillus subtilis and was also found most effective against HT-29 colon cancer cell line with IC50 value of ~0.034 ± 0.001µL/mL. Mechanistic studies revealed that EO inhibits the growth of HT-29 colon cancer cells probably through induction of irreparable DNA damage leading to subsequent cell death in apoptotic manner. Molecular docking analysis also supports the in vitro studies conducted by indicating the interaction of thymol with Sec A protein of Bacillus subtilis cell wall as well as with Beclin protein responsible for apoptotic corpse clearance. SIGNIFICANCE: Taken together, our results indicate that EO possesses potent antimicrobial and anticancer properties, and may find applications as effective antibacterial and in cancer therapeutics.

An Opportunity to END TB: Using the Sustainable Development Goals for Action on Socio-Economic Determinants of TB in High Burden Countries in WHO South-East Asia and the Western Pacific Regions.

The progress towards ending tuberculosis (TB) by 2035 is less than expected in 11 high TB burden countries in the World Health Organization South-East Asia and Western Pacific regions. Along with enhancing measures aimed at achieving universal access to quality-assured diagnosis, treatment and prevention services, massive efforts are needed to mitigate the prevalence of health-related risk factors, preferably through broader actions on the determinants of the "exposure-infection-disease-adverse outcome" spectrum. The aim of this manuscript is to describe the major socio-economic determinants of TB and to discuss how there are opportunities to address these determinants in an englobing manner under the United Nations Sustainable Development Goals (SDGs) framework. The national TB programs must identify stakeholders working on the other SDGs, develop mechanisms to collaborate with them and facilitate action on social-economic determinants in high TB burden geographical areas. Research (to determine the optimal mechanisms and impact of such collaborations) must be an integral part of this effort. We call upon stakeholders involved in achieving the SDGs and End TB targets to recognize that all goals are highly interlinked, and they need to combine and complement each other's efforts to end TB and the determinants behind this disease.

Does peer education go beyond giving reproductive health information? Cohort study in Bulawayo and Mount Darwin, Zimbabwe.

OBJECTIVE: Peer education is an intervention within the voluntary medical male circumcision (VMMC)-adolescent sexual reproductive health (ASRH) linkages project in Bulawayo and Mount Darwin, Zimbabwe since 2016. Little is known if results extend beyond increasing knowledge. We therefore assessed the extent of and factors affecting referral by peer educators and receipt of HIV testing services (HTS), contraception, management of sexually transmitted infections (STIs) and VMMC services by young people (10-24 years) counselled. DESIGN: A cohort study involving all young people counselled by 95 peer educators during October-December 2018, through secondary analysis of routinely collected data. SETTING: All ASRH and VMMC sites in Mt Darwin and Bulawayo. PARTICIPANTS: All young people counselled by 95 peer educators. OUTCOME MEASURES: Censor date for assessing receipt of services was 31 January 2019. Factors (clients' age, gender, marital and schooling status, counselling type, location, and peer educators' age and gender) affecting non-referral and non-receipt of services (dependent variables) were assessed by log-binomial regression. Adjusted relative risks (aRRs) were calculated. RESULTS: Of the 3370 counselled (66% men), 65% were referred for at least one service. 58% of men were referred for VMMC. Other services had 5%-13% referrals. Non-referral for HTS decreased with clients' age (aRR: ~0.9) but was higher among group-counselled (aRR: 1.16). Counselling by men (aRR: 0.77) and rural location (aRR: 0.61) reduced risks of non-referral for VMMC, while age increased it (aRR ≥1.59). Receipt of services was high (64%-80%) except for STI referrals (39%). Group counselling and rural location (aRR: ~0.52) and male peer educators (aRR: 0.76) reduced the risk of non-receipt of VMMC. Rural location increased the risk of non-receipt of contraception (aRR: 3.18) while marriage reduced it (aRR: 0.20). CONCLUSION: We found varying levels of referral ranging from 5.1% (STIs) to 58.3% (VMMC) but high levels of receipt of services. Type of counselling, peer educators' gender and location affected receipt of services. We recommend qualitative approaches to further understand reasons for non-referrals and non-receipt of services.