Inter-annual variability of urolithiasis epidemic from semi-arid part of Deccan Volcanic Province, India: climatic and hydrogeochemical perspectives.

Semi-arid Karha basin from Deccan Volcanic Province, India was investigated for inter-annual variability of urolithiasis epidemic. The number of reported urolith patient, weather station data and groundwater quality results was used to assess impact of geoenvironment on urolithiasis. Data of 7081 urolith patient were processed for epidemiological study. Gender class, age group, year-wise cases and urolith type were studied in epidemiology. Rainfall, temperature, pan evaporation and sunshine hours were used to correlate urolithiasis. Further, average values of groundwater parameters were correlated with the number of urolith episodes. A total of 52 urolith samples were collected from hospitals and analysed using FTIR technique to identify dominant urolith type in study area. Result shows that male population is more prone, age group of 20-40 is more susceptible and calcium oxalate uroliths are dominant in study area. Year-wise distribution revealed that there is steady increase in urolithiasis with inflation in drought years. In climatic parameters, hot days are significantly correlated with urolithiasis. In groundwater quality, EC, Na and F are convincingly correlated with urolith patients, which concludes the strong relation between geo-environment and urolithiasis.

Use of Smartphone-Based Video Directly Observed Therapy (vDOT) in Tuberculosis Care: Single-Arm, Prospective Feasibility Study.

BACKGROUND: India accounts for nearly one-quarter of the global tuberculosis (TB) burden. Directly observed treatment (DOT) through in-person observation is recommended in India, although implementation has been heterogeneous due largely to resource limitations. Video DOT (vDOT) is a novel, smartphone-based approach that allows for remote treatment monitoring through patient-recorded videos. Prior studies in high-income, low disease burden settings, such as the United States, have shown vDOT to be feasible, although little is known about the role it may play in resource-limited, high-burden settings. OBJECTIVE: The goal of the research was to assess the feasibility and acceptability of vDOT for adherence monitoring within a resource-limited, high TB burden setting of India. METHODS: We conducted a prospective, single-arm, pilot implementation of vDOT in Pune, India. Outcome measures included adherence (proportion of prescribed doses observed by video) and verifiable fraction (proportion of prescribed doses observed by video or verbally confirmed with the patient following an incomplete/unverifiable video submission). vDOT acceptability among patients was assessed using a posttreatment survey. RESULTS: A total of 25 patients enrolled. The median number of weeks on vDOT was 13 (interquartile range [IQR] 11-16). Median adherence was 74% (IQR 62%-84%), and median verifiable fraction was 86% (IQR 74%-98%). More than 90% of patients reported recording and uploading videos without difficulty. CONCLUSIONS: We have demonstrated that vDOT may be a feasible and acceptable approach to TB treatment monitoring in India. Our work expands the evidence base around vDOT by being one of the first efforts to evaluate vDOT within a resource-limited, high TB burden setting. To our knowledge, this is the first reported use of vDOT in India.