IntroductionPretreatment loss to follow-up (PTLFU)—dropout of patients after diagnosis but before treatment registration—is a major gap in tuberculosis (TB) care in India and globally. Patient and healthcare worker (HCW) perspectives are critical for developing interventions to reduce PTLFU.MethodsWe tracked smear-positive TB patients diagnosed via sputum microscopy from 22 diagnostic centres in Chennai, one of India’s largest cities. Patients who did not start therapy within 14 days, or who died or were lost to follow-up before official treatment registration, were classified as PTLFU cases. We conducted qualitative interviews with trackable patients, or family members of patients who had died. We conducted focus group discussions (FGDs) with HCWs involved in TB care. Interview and FGD transcripts were coded and analysed with Dedoose software to identify key themes. We created categories into which themes clustered and identified relationships among thematic categories to develop an explanatory model for PTLFU.ResultsWe conducted six FGDs comprising 53 HCWs and 33 individual patient or family member interviews. Themes clustered into five categories. Examining relationships among categories revealed two pathways leading to PTLFU as part of an explanatory model. In the first pathway, administrative and organisational health system barriers—including the complexity of navigating the system, healthcare worker absenteeism and infrastructure failures—resulted in patients feeling frustration or resignation, leading to disengagement from care. In turn, HCWs faced work constraints that contributed to many of these health system barriers for patients. In the second pathway, negative HCW attitudes and behaviours contributed to patients distrusting the health system, resulting in refusal of care.ConclusionHealth system barriers contribute to PTLFU directly and by amplifying patient-related challenges to engaging in care. Interventions should focus on removing administrative hurdles patients face in the health system, improving quality of the HCW-patient interaction and alleviating constraints preventing HCWs from providing patient-centred care.

Introduction: Pretreatment loss to follow-up (PTLFU)--dropout of patients after diagnosis but before registration in treatment--is a major gap in TB care delivery in India and globally. Patient and healthcare worker (HCW) perspectives are critical for developing interventions to address this problem. Methods: We prospectively tracked newly diagnosed smear-positive TB patients from 22 TB diagnostic centers in Chennai, one of the largest cities in India. Patients who did not start therapy within 14 days, or who died or were lost to follow-up before official registration in treatment, were classified as PTLFU cases. We conducted qualitative interviews with all trackable PTLFU patients, or family members of patients who had died. We conducted focus group discussions (FGDs) with three types of HCWs involved in TB care. Interview and FGD recordings were transcribed, coded, and analyzed with the support of Dedoose 8.0.35 software to identify key themes. We created categories into which these themes clustered, identified relationships among thematic categories, and assembled findings into a broader explanatory model for PTLFU. Results: We conducted six FGDs comprising 53 HCWs and 33 individual patient or family member interviews. Themes clustered into five categories. Examining relationships among these categories revealed two pathways leading to PTLFU as part of a broader explanatory model. In the first pathway, administrative and organizational health system barriers--including the complexity of navigating the system, healthcare worker absenteeism, and infrastructure failures--resulted in patients feeling frustration or resignation, leading to disengagement from care. Health system barriers experienced by patients were in turn shaped by constraints that made it difficult for HCWs to do their jobs effectively. In the second pathway, negative or judgmental HCW attitudes and behaviors towards patients contributed to patient distrust of the health system, resulting in refusal of further care. Conclusion: Health system barriers contribute substantially to PTLFU directly and by amplifying patient-related challenges to engaging in care. Interventions should focus on removing administrative hurdles patients face in the health system, improving the quality of the HCW-patient interaction, and alleviating constraints HCWs face in being able to provide optimal patient-centered care.

Background: Dentists are the common preys for the transmission of pandemic disease because of the airborne spread via routine dental checkups. This study which is a cross-sectional one gives the idea about awareness and alertness of dentists about COVID-19 in Kerala, India. Materials and Methods: The survey comprised 25 closed-ended questions. The survey was separated into two sections. The initial segment of the poll was identified with the socio-segment qualities that were researched, while the subsequent part was worried about dental practitioners' perspectives toward the management of COVID-19 and the apparent danger of defilement in dental facilities. Results: Coronavirus management in dental clinics differs regarding adherence to the rules. An aggregate of 750 respondents finished the form, out of which 686 (91.46%) complete reactions were incorporated. The majority of the respondents concurred on inquiries regarding the knowledge, practice, and mentality of dental specialists toward the COVID-19 pandemic. Conclusion: The feedback of most dental specialists with respect to the readiness and view of disease control measures against the COVID-19 pandemic was positive. Dental facilities need to adhere more to the central and state government suggestions in alertness of their facilities or by tutoring their dental specialists and staff.

The aim of this study was to characterise the follicular dynamics in first two oestrous cycles of peripubertal Malabari goats. Transrectal ultrasonography was carried out on alternate days of oestrous cycles after first observed oestrus. Follicular studies revealed presence of two to five wave cycles with predominant three and four wave patterns. The interwave interval for ovulatory wave was longer than preceding waves in three and five wave cycles. The diameter of largest follicles in wave 1 was larger than follicles of subsequent waves of three, four and five wave cycles. The largest follicles in each wave could be observed from day 3 to day 13 of oestrous cycle. Majority of ovulations occurred on day 20 of oestrous cycles and short cycles were more in first oestrous cycle. The overall mean per cent of single and double ovulations were 56.3 and 43.8 and mean ovulatory follicle size was 6.59 ± 0.11 mm in peripubertal goats. The mean length of first and second oestrous cycle was observed as 17.72± 0.79 and 20.19± 0.43 days, respectively and mean duration of first and second oestrus was 36.88 ± 2.44 and 40.13 ± 1.84 h, respectively. The study revealed that predominant wave pattern was three and four waves in peripubertal Malabari breeds. The first oestrous cycle length was shorter and characterised by higher percentage of single ovulations with smaller periovulatory follicle size. Larger ovulatory follicles and double ovulations were observed in second oestrous cycle.

This study aimed to evaluate the Doppler ultrasonographic features of ventral perineal artery of bitches during different phases of oestrous cycle. Sixteen pluriparous bitches were subjected to transperineal Doppler ultrasonography during different stages of oestrous cycle by confirming the stage by exfoliative vaginal cytotlogy (EVC) and vaginoscopy. The resistivity index (RI), pulsatility index (PI), peak systolic velocity (PSV), end diastolic velocity (EDV) and systolic/ diastolic velocity (S/D) were analysed. No significant difference was found between the Doppler velocimetric parameters of ventral perineal artery during different phases of oestrous cycle by trasnperineal Doppler ultrasonography.