INTRODUCTION Rabies, an invariably fatal viral disease, is transmitted to humans through animal bites, most commonly dogs. Dog bites are the primary source of human infection in all rabies endemic countries and account for 96 % of rabies cases in South East Asia region. According to WHO, Each year, 23 000-25 000 people die in the SEA Region due to rabies. These accounts for approximately 45% human deaths due to rabies worldwide. 1 Of the estimated 25,000 deaths due to rabies in SEAR, a majority are in India (around 19,000) and Bangladesh (2000). More than 2.5 million people undergo post-exposure prophylaxis after being bitten by rabid or suspected rabid animals causing considerable morbidity and economic loss. 2 In spite of economic loss and sufferings, there is little information about the incidence of animal bites and rabies because of a lack of systematic reporting In India. As rabies is not a notifiable disease in India it is widely believed that this figure may be an underestimate. 3 Sporadic studies have been conducted indifferent parts of India but profile of bites not only varies from country to country but region to ABSTRACT Background: Rabies, an invariably fatal viral disease, is transmitted to humans through animal bites, mostly dogs. Of the estimated 25,000 deaths due to rabies in SEAR, a majority are in India and Bangladesh. Objective of the study was to study the epidemiological trend of animal bite by in central India. Methods: A cross sectional institutional study was conducted in 406 animal bite victims presenting to the tertiary care hospital and district hospital Rewa, Madhya Pradesh, India. Information collected with the pre tested structured questionnaire after obtaining informed verbal consent. Data pertaining to the socio demographic profile of victim, category of bite, provoked/ unprovoked time and place of bite, characteristic of animal was collected. Data was analysed using graph pad software. Results: Among 406 victims 76.3% were males, 56.7% belongs to 15-45 yrs, 61.6% were living in urban area, 31.3% and 21.7% of the victims were agriculture worker and laborers respectively. 95.8% victims bitten by dog of them 89% were stray, 89.4% had Category III bite, lower extremity was affected in 60.8%, 75.9% bites were unprovoked, fate of the animal was not known in 78.6% and 46% of the victims were affected during evening hours. Conclusions: Animal bites, especially dog bites still poses public health problem. Majority of the bites are attributed to stray dogs, unprovoked and category III bites. This indicates need of large amount of antirabies serum or HRIG thereby increasing the cost of management of animal bite cases. There is a need to control stray dog population and immunize pet dogs.

Corneal problems cause a significant proportion of blindness in India. Once corneal opacity is established, restoration of their vision is possible only through transplantation of cornea from donated eyes. Eye donations are dependent on people willing to pledge their eyes. PURPOSE: To determine "awareness of eye donation" and knowledge regarding eye donation and factors affecting in an adult population of northern India. METHODS: 550 Subjects who accompanied patients attending four ophthalmic clinics were interviewed using structured questionnaire. The information was collected about socio demographic profile, awareness of eye donation, knowledge about its various aspects and pledge to donate eye, reasons for donating or not donating eyes and sources of information. Data analyzed using SPSS software, Chi square test was used to test significance across category and p value <0.05 was considered statistically significant. RESULTS: Out 550 subjects 44.2% were in 18-35 years and 55.8 % were >35 yrs old. Majority was Hindu (76.73%) and males (71.64%). 78% subjects were aware of eye donation. The major source of awareness was AV aids (89%). Awareness was found to be high as age and education increases, in males, and in urban population. Significant difference (p<.05) was found between awareness and various variables except religion. 27% knew that relative can make pledge, only cornea is transplanted is known to 25.2%, 44.7% were aware about ideal time of eye removal and only 12 (2.8%) had pledged their eyes. 250(58.3%) subjects were aware but not willing to pledge their eyes or relatives eyes. Need more information to decide (79.2%), perceived objection by family members (52%) and religious reason (38.8%) were cited as major factors for not willing to pledge eyes. Nobility (76%) and pleasure (17.9%) was the main motivational force stated for willingness to donate eyes. CONCLUSION: There is good level of awareness in urban population still very less subjects is willing to pledge eyes major factor being insufficient knowledge. Targeting on aspects in which knowledge was found to be low might help to increase eye donation.

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mately 6.8 million people have been estimated to have vision less than 6/60 in at least one eye due to corneal diseases; of these, about a million have bilateral involvement. [3,4] The burden of corneal disease in our country is reflected by the fact that 90% global cases of ocular trauma and corneal ulceration leading to corneal blindness occur in developing countries. [5] The prevalence of corneal blindness varies from country to country and even from one population to another. Its epidemiology is complicated and encompasses a wide variety of infectious and inflammatory eye diseases. As trachoma and vitamin A deficiency become less common, suppurative keratitis is becoming the major cause of corneal blindness in the developing world. [6] Whereas contact lens use is a major risk factor for corneal ulceration in the developed world, a high prevalence of fungal infections, agriculture-related trauma, and use of traditional eye medicines (TEMs) is unique to the developing world. [7,8] Background: Instillation of traditional eye medicines (TEMs) into the eye is one of the causes associated with poor visual outcome and corneal blindness. Objective: To determine the use of TEM and factors for its use in patients with corneal ulcer. Materials and Methods: This prospective study was conducted on 189 new patients with corneal ulcer attending cornea clinic of Gandhi Memorial Hospital, Rewa, Madhya Pradesh (India). After complete eye examination, information was collected for use of TEM, sociodemographic profile, symptoms necessitating its use, and complication. Necessary treatment was given and final visual outcome was noted. Lab investigations were performed to identify organism. Result: TEM was used by 38% subjects, especially females and subjects residing in rural areas were found to be significantly associated with its use. Majority of TEM users were farmers (51.4%). The most common symptom was poor vision (66.7%) for use of TEM. Breast milk (40%) and plant products (29%) were most commonly applied TEMs. Central and entire corneal involvement was found to be significantly high among TEM users. Scarring and perforation occurred in 70.8% and 31.9% TEM users, respectively. No significant difference was found between organism identified and the use of TEM. Visual acuity up to 6/18 was found to be higher among non-TEM users (23.9%) as compared to TEM users (9.7%). At presentation, 38.9% TEM users had already lost their vision. Significant difference was found between presenting visual acuity and final visual acuity achieved in both groups. Conclusion: Intensive health education is needed for encouraging the uptake of eye care services, particularly in rural areas.

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BACKGROUND Dog bites account for tens of millions of injuries annually with children being at the highest risk. Dog bite fatality rates are higher in low-and middle-income countries due to prevalent rabies virus, lack of post-exposure treatment and appropriate access to health care. Between 30% and 60% of the victims of dog bites are children under the age of 15 in countries where rabies is endemic. The objectives of this study were-1. to assess the sociodemographic profile of animal bite victims who are < 15 years old, 2. To evaluate parents' knowledge and practices for prevention and control of rabies. MATERIALS AND METHODS This is institutional based cross-sectional observational study carried out among animal bite victims attending OPD of GMH, SGMH and District Hospital of Rewa city from February 2014 to February 2015. Out of 406 victims interviewed, 72 were <15 years of age (17.7%). Data was analysed using Graph Pad software. Percentage and proportion were used for data analysis. RESULTS 17.7% (n=72) of cases were aged < 15 years. 73.6% were males and 59.7% were urban residents. 61.1% victims belonged to below poverty line families. 94.4% victims sustained dog bites. Most common site of bite was lower extremity (38.9%), followed by head and neck (30.6%). Majority of the victims 84.7% had Category III bites. Almost half were bitten by pet animal/ or animal in vicinity of their home. 100% parents knew that animal bite would lead to rabies. Three fourths of them knew about washing the wound with soap and water. Availability of ARV Injection free of cost was known to almost 60 % of them. Almost 60% of the victims after animal bite consulted to health personal. Wound washing was done in 62.5% of cases. Many (45.8%) victims had taken advice from pharmacist. 55.6% victims washed the wound within 1 hour and 51.4% victims were administered ARV within 24 hours. CONCLUSION The adoption of PEP was below par in spite of having adequate knowledge of PEP. A delay in accessing PEP was noted. Present study revealed most victims approached health care personnel or pharmacist for advice. They can be utilized for sensitization of community emphasizing early initiation of post exposure prophylaxis measures. Time interval between animal bite and early initiation of PEP is crucial for prevention of rabies. Health educational program for community and pet owners focusing on vaccination of pets, supervision of children while playing with pets can be developed and implemented through grass root leve l workers and community leaders.

Background:Measles is a major cause of childhood morbidity and mortality, accounting for nearly half of the morbidity associated with global vaccine preventable diseases. Regular outbreaks of Measles are reported in India, of which only a few are investigated. This study was conducted in the Shivpuri District of Madhya Pradesh (India) to investigate and asses various epidemiological factors associated with measles outbreak.Materials and Methods:A cross-sectional study was carried out in 30 randomly selected sub-centers in 8 blocks of the Shivpuri District of Madhya Pradesh, covering 212 villages, selected by cluster sampling. The villages, which had reported measles cases, were extensively investigated by the field teams through extensive house-to-house surveys during 12-19 May 2004.Results:A total of 1204 cases with 14 deaths were reported with an attack rate of 6.2% and a case fatality rate of 1.2%. In this study, 17.7% of the cases reported post-measles complications with diarrhea as the most common post measles complication. The routine measles vaccine and Vitamin A supplementation in the area was also less than 30%.Conclusions:The majority of the cases had occurred in the unvaccinated children and in under 5 year old population. There are repeated outbreaks and a long delay in reporting of the cases. The occurrence of cases, in a reasonable proportion of the vaccinated population, points toward the fact that there is a possibility of a vaccine failure in older children. This study calls for an improved surveillance system, an improvement in the cold chain, and enhancements for measles vaccination if India is to achieve the goal of measles elimination.

BACKGROUND The clinical spectrum of SARS–CoV-2 infection encompasses asymptomatic infection, mild upper respiratory tract infection, and severe viral pneumonia with respiratory failure and even death. This study attempts to estimate the time interval between symptoms onset to severity, time taken for hospitalization, length of stay in hospital along with demographic and clinical characteristics of deceased patients infected with Covid-19. METHODS This retrospective study was conducted in SSMC associated Dedicated Covid Hospital, Rewa district, India. Covid-19 positive deaths (112) that occurred from May 2020 to January 2021 in this institute were considered for this study. Information regarding socio-demographic profile, systemic diseases / underlying medical conditions, signs and symptoms of the disease, clinical course, and investigations were collected and analysed. Time duration variables included were time from the initial symptom to breathlessness, time taken to seek treatment, delay in hospitalization, and length of stay in the hospital. RESULTS Elderly males with 2 or more comorbid conditions were found to be at higher risk of mortality. Median duration from onset of initial symptom to treatment seeking / hospitalization in DCH was 5 days. While mean duration from onset of initial symptoms to onset of breathlessness was 2 days 6 hrs. There was a delay of 3 days in hospitalization after experiencing breathlessness. 90 % patients had bilateral lung involvement at the time of admission. More than half of the patients had multiple organ involvement. Positive correlation was observed in delay in hospitalization, with syndrome severity at the time of admission and negative correlation with length of stay in hospital. CONCLUSIONS Delay in hospitalization is observed as an important factor which affects clinical course. Disease severity increases and length of stay decreases with delayed presentation at the time of admission. It should be addressed with awareness generation activities in community and self-assessment tool appropriate and suitable for implementing in general population. KEYWORDS Covid 19, Covid Infection, Mortality, Time Delay, Length of Stay (LoS)