Japanese Encephalitis (JE) is a zoonotic mosquito-borne viral disease that primarily affects young children under the age of 15[1]. Annually, there are more than 50 000 clinical cases and JE causes over 10 000 fatalities globally[1]. In Japan, South Korea, China and Thailand, where it is now under control or almost entirely eradicated, the disease was initially noted to have a high incidence[1]. Later, it expanded to Nepal and India, becoming a serious public health issue in rural regions[1]. JE is a flavivirus-based neglected tropical disease that is spread by culicine mosquitoes of the Culex ( Cx.) tritaeniorhynchus and Cx. vishnui species[2]. It causes severe neurological symptoms that can occasionally be fatal. Another morbid consequence of this viral illness is chronic neurologic sequelae in the form of long-term impairment[3]. Pigs are considered as amplifying hosts and play a significant part in the general epidemiology of the disease, whereas humans are a dead-end host. Only three of the five genotypes that are known to be present in the global population are found to be common in India[3]. While JE is endemic in many areas of India, including Bihar, Kolkata, Andhra Pradesh, Tamil Nadu, Uttar Pradesh, Assam, and other regions, the eastern section of Uttar Pradesh is the region that is most severely afflicted, and children under the age of 15 are the main victims[3]. The Government of India and the Uttar Pradesh State Government's multifaceted approach, which includes vector control measures, strengthened surveillance programmes, JE immunisation campaigns in children, behavioural change and community-based awareness programmes, may have helped to significantly reduce JE cases in the last 10 years, after which incidence decreased to 0.07 in 2019[4]. In spite of the numerous control efforts outlined above, sporadic JE cases frequently appear in the eastern Uttar Pradesh region. Improved targeting of interventions will result from changes to the current strategies, which will help the JE curve continue to shorten. The natural transmission cycle of JE virus includes JE virus, mosquito vector, reservoir host pigs and birds and dead-end host human[3]. There is no human-to-human transmission of JE and current interventions are targeted to protect human from getting JE. Reservoir host and mosquito vectors play an important role in transmission of JE to newer areas. Increase in vector density is associated with agricultural practices in rural regions including paddy fields and irrigated crops[3]. In the current article, we are discussing the JE control strategies further needed to reduce the JE cases in eastern Uttar Pradesh to zero incidence by interrupting its natural cycle.

There is considerable evidence from a wide range of sources, including written texts, preserved monuments, and natural plant medicines, that demonstrate the long history of humankind's search for medicinal substances in the natural world. The purpose of this article was to compare the performance of medicinal plant Thuja ( T.) occidentalis in a variety of disease-relieving conditions. The current review draws on the work of nearly two hundred original research papers indexed in Google Scholar, ScienceDirect, and the NCBI Library. The authors gatherd all the accessible data on the therapeutic effects of T. occidentalis. Although there are no published randomized controlled trials of T. occidentalis alone so far, multiple clinical investigations have validated the therapeutic efficacy of a combination herbal medication including the extract of T. occidentalis and additional immune stimulants. T. occidentalis is a plant with great potential as it is widely used in both traditional homoeopathy and modern, evidence-based phytotherapy. In vitro and in vivo models have shown its immunopharmacological potential, including its immunostimulatory, anti-cancer, anti-bacterial, anti-fungal, and antiviral activities. More researches into these plants might be done to find out if any of them have the potential to be implemented as a novel drug to treat a wide range of conditions.

Malaria remains the most serious infectious disease and is one of the leading causes of death among children in malaria endemic areas. The development of malaria vaccines has been underway since 1960s. Significant progress in the development of vaccine has been made in the last decade. On 6 October 2021, World Health Organization recommended widespread use of the RTS, S/AS01 malaria vaccine. The level of acceptance of RTS, S/AS01 malaria vaccine is relatively low in middle-income countries. This might be because of lack of information regarding vaccine implementation in such countries. The proper and efficient execution of the malaria vaccination program necessitates careful consideration of each community's socio-cultural setting. The most prominent RTS, S/AS01 vaccine trial was conducted from 2009 to 2011 in which eleven sites in seven African countries participated. Results of the trial, published in 2015, provided a promising advance in the development of a malaria vaccine for African children. As of 2019, large-scale pilot studies of the vaccine have been conducted in Ghana, Kenya, and Malawi, involving several hundreds of thousands of infants. The RTS, S/AS01 vaccine shows modest efficacy against malaria and has a feasible mode of administration. Although there is increased risk of meningitis, cerebral malaria, pneumonia, anemia, febrile convulsions and gastroenteritis, the vaccine still has a feasible mode of administration and high cost effectiveness and can be easily implemented in resource-limited settings.

Objective: To evaluate early efficacy of sputum conversion within 6 months of individual regimens containing bedaquiline in patients with drug resistant tuberculosis. Methods: We conducted a retrospective study among patients with drug resistant tuberculosis who were receiving individual regimens containing bedaquiline. The primary outcome was sputum conversion of both smear and culture within 6 months of treatment. We used medical records of drug resistant tuberculosis patients from January 2020 to December 2021. The study was conducted at Dr. Soetomo Hospital, Indonesia from August to October 2022. Results: In this study, 44 eligible drug resistant tuberculosis patients were initiated on regimens containing bedaquiline. There were 52.3% males and the median age was 45.5 years. The rates of previous treatment (70.5%) and lung cavity (36.4%) were high. The most common companion drugs included clofazimine, cycloserine, levofloxacin, and linezolid. Sputum smear and culture conversion was seen in 79.4% and 82.1% at the 2nd month, respectively. More than 97% patients had smear and culture conversion at the end of 6 months. Conclusions: Among drug resistant tuberculosis patients, individual regimens containing bedaquiline were associated with high rates of smear and culture conversion at the end of 6 months. Early efficacy of regimens containing bedaquiline can be used to predict cure rate at the end of treatment.

Objective: To examine COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China. Methods: An online cross-sectional study was conducted among parents of teenagers in Zhejiang, China from May 1 to 31, 2022. Data were interpreted via univariate and multivariate analyses using the statistical package for the social sciences (SPSS) program. Results: A total of 11 115 (96.11%) participants and 11 449 (99.00%) of their children in Zhejiang, China had been vaccinated against COVID-19. Children whose parents did not receive COVID-19 vaccination were 19 times (aOR 18.96, 95%CI 12.36-29.08) more likely to be unvaccinated than their counterparts. In addition, children with no previous influenza vaccination, those whose parents doubted the COVID-19 vaccine’s safety or effectiveness, were 6.11 times (aOR 6.11, 95%CI 2.80-13.34), 8.27 times (aOR 8.27, 95%CI 5.33-12.83), and 2.69 times (aOR 2.69, 95%CI 1.11-6.50) more likely to be unvaccinated than their counterparts, respectively. COVID-19 vaccine uptake varied between different sociodemographic groups. However, the odds of receiving the COVID-19 vaccine decreased as age and education level increased. The main refusal reasons claimed by participants were that they had medical conditions that may not qualify them for vaccination (53.78%), followed by safety concerns about the vaccine (13.56%), not knowing where to get vaccinated (6.44%), and concerns about fertility issues (5.56%). Conclusions: Despite a highly encouraging level of COVID-19 vaccine uptake in Zhejiang, China, the elderly and highly educated people had lower COVID-19 vaccine uptake. It is suggested that tailored health education strategies should be taken to increase the COVID-19 vaccine uptake in such groups. Furthermore, with vaccination rates at such a high level, the pandemic is still ongoing, and public confidence in vaccines may decline. Thus, sufficient evidence-based information regarding COVID-19 vaccines should be provided to the public.

Rationale: Fever with myositis and rhabdomyolysis is a medical emergency requiring prompt diagnosis and management. Scrub typhus associated myositis with rhabdomyolysis is rare. Patient concerns: A 36-year-old female presented with intermittent fever up to 38.6 ℃, jaundice and progressive weakness of all four limbs. Diagnosis: Scrub typhus associated myositis and rhabdomyolysis. Intervention: Doxycycline 100 mg twice daily and injection of ceftriaxone 1 gm twice daily along with continuous intravenous fluids. Outcome: Fever resolved with normalization of liver function and recovery of muscle power. Lessons: Presence of myositis and rhabdomyolysis is uncommon in scrub typhus; high clinical suspicion should be kept in patients with atypical manifestations of scrub typhus.

Transfusion-transmitted infections (TTIs) impose meticulous screening protocols in blood banks. Emerging or re-emerging viruses with altered pathogenicity remains debatable whether or not to include those in TTI screening panel. Dengue infection is known to transmit via Aedes aegypti mosquito; however, the route of infection through blood transfusion is recently of greater importance. India with hyper-endemic and endemic dengue regions must guarantee the safety in transfusion-related products. The donor with asymptomatic dengue infection during viremic phase can act as a reservoir for transmission. The acute infection in dengue is ascertained by detecting either nonstructural-1 protein (NS1) or IgM antibody whereas the prevalence of dengue can be monitored by the presence of IgG. The presence of viremia in blood related products need to be assessed. However, reports on transfusion transmissible dengue infection are still lacking in this part of India. Therefore, the present study aims to determine the dengue NS1 protein and IgM status among blood donors collected at a tertiary care hospital in Southern India. Fortunately, we receive samples for routine dengue testing from patients residing in and around camp area. Hence, the latter part of this study is designed to substantiate the active circulation of dengue virus in and around camp area during camp period. A single blinded randomized pilot study was designed for which serum samples those were negative to TTIs were collected from Department of Transfusion Medicine. The remaining serum of non-reactive samples collected during blood donation camp organized at Surulipatti village (9.7059°N, 77.3016°E) of Theni district on 30th September 2017 was taken for this study. The samples were de-identified and assigned a donor number from one to 95. Once collected, the samples were aliquoted into small vials and kept in deep freezers at −20 ℃. NS1 protein and dengue specific IgM detection was carried out by Panbio™ Dengue Early ELISA (Abbott Diagnostics, Korea) and IgM capture ELISA (National Institute of Virology, India) respectively. Samples positive to either one of the above tests were subjected to Panbio™ IgG ELISA (Abbott Diagnostics, Korea). All the tests were performed and the interpretation of results was done as per the manufacturer’s instructions provided in the kit. Appropriate controls from the kits and the in-house controls prepared from positive samples were added in each run. The active circulation of the dengue virus in and around the study area was evidenced by two factors: duration and location. Villages near the blood camp were identified by point-radius method using Maptive software (www.maptive.com)[1]. The duration for data stratification was calculated on the basis of maximum incubation period of dengue virus (i.e) 10 days. The data pertaining to hospitalized dengue cases were downloaded in the form of Microsoft Excel sheet from NIE server (http://112.133.207.124:82/vdln/) maintained by National Institute of Epidemiology, Chennai, Tamilnadu. The sorting was done based on the closest villages identified earlier and the date on which the sample was tested. Furthermore, the resultant samples those were tested only for IgM was retrospectively tested for NS1 antigen using stored serum. Once dengue testing was completed, the positive and negative status of individual donor for each assay was represented as D (donor number) followed by NS1+/-/IgM+/e/-/IgG+/-. The positivity was expressed in percentage and their combinations were depicted in proportional Venn diagram using Biovenn online software with some modifications[2]. The dengue cases filtered from hospital-based data were tabulated with their respective positives. We tested 95 blood donor samples for dengue infection. Of these, 8 (8.4%) samples were positive to NS1 (2, 2.1%) and/or IgM (6, 6.3%) as per kit cut off values (Table 1). Our study revealed that all NS1 positive samples (D25/NS1+/IgM-/IgG- and D50/NS1+/IgMe/IgG-) were IgG negative. Out of six IgM positives, two donor samples (D46 and D81) turned out to be IgG negative (Figure 1). A total of 293 records were downloaded between 20th September and 10th October 2017. Point radius method found that four villages were close to the camp area. Using this, filter applied to ‘village column’ sorted 16 dengue suspected cases, of which, seven (43.7%) had dengue infection. Two positive NS1 cases were identified and one belonged to the village of Surulipatti.