Nitin Kumar Joshi

Background: Oral cancer is a significant health issue in the country, accounting for one-fourth of all cases worldwide. A shortage of specialized healthcare, limited access to screening tools, and diagnostic facilities are key contributors to delayed diagnosis. Artificial Intelligence can be a promising tool for the early screening of oral cancer. However, its application in India remains underexplored and lacks systematic evaluation. Methods: A scoping review was conducted using the Arksey and O’Malley (2005) framework and the approach by Peters et al. (2015). The PRISMA framework was adopted for selecting relevant studies on AI applications for oral cancer screening in India. Studies were systematically searched in PubMed, CINAHL, Scopus, and Google Scholar. Reviewers extracted relevant data and systematically mapped them to identify strengths, weaknesses, opportunities, and threats of AI applications in oral cancer screening within India. Results: Of the 265 identified studies, 33 were selected for final review. Various designs were used, including cross-sectional field evaluations, pilot and prospective studies, scoping and systematic reviews, narrative reviews, and experimental studies. AI methodologies demonstrated high diagnostic accuracy, with strengths in portability, scalability, and affordability in low-resource settings. Weaknesses reported were a lack of standardized data, limited digital literacy, and infrastructural gaps. AI models offer opportunities to enhance screening coverage, integrate multimodal datasets, and support personalized treatment planning. Key threats observed were data variability, lack of regulatory and ethical frameworks, and data privacy concerns. Conclusion: AI offers strengths in improving oral cancer screening in India through early detection and reducing inequities. Despite its promising strengths, AI faces challenges such as scalability, infrastructure gaps, and ethical issues when implemented for oral cancer screening in the Indian context. For the successful integration of AI, technological innovation, robust digital infrastructure, adequate workforce training, and regulatory guidelines are required.

Introduction: Breast cancer is the most common cancer among women worldwide and an increasing concern in India, with incidence rates rising particularly among women under 50 years old. In India, delayed diagnosis and limited access to health care often lead to mastectomy, leaving many women to face complex physical, emotional, and social challenges afterward. External breast prostheses (EBPs) are a cost-effective option for post-mastectomy recovery, but there is limited research on the long-term experiences of Indian women using EBPs. Methods: This qualitative study employed a phenomenological approach to explore the lived experiences of 35 women in Gujarat who had undergone mastectomy and used EBPs for at least 5 years. Participants were purposively chosen and interviewed using a semi-structured guide that addressed satisfaction, challenges, user needs, and suggestions for improvement. Thematic analysis was performed to identify key patterns and insights. Results: Most women reported high satisfaction with the adaptability, comfort, and positive impact of EBPs on self-confidence, especially when using silicone prostheses. However, challenges such as heat and perspiration, weight imbalance, durability concerns, limited product awareness, and affordability issues were noted. Participants suggested improvements including lighter, more breathable, and adjustable materials, longer warranties, enhanced counseling, and better financial access. Discussion and conclusion: Findings reveal both the psychosocial benefits and practical challenges of long-term EBP use among Indian women, aligning with global literature and emphasizing the need for patient-centered rehabilitation solutions. Although EBPs improve confidence and daily function, enhancements in design, cost, and awareness are needed. Addressing these could significantly improve life quality and rehabilitation for postmastectomy women in India.

A BSTRACT: Introduction: A groundbreaking Round Table Discussion took place on October 9, 2023, at the Indian Institute of Public Health, Gandhinagar, which gathered leaders from the public health institutions in India. The event’s main goal was to discuss the changing terrain of public health education in India by emphasizing reforms in the curriculum, promoting partnerships, and embracing advancements. Methodology: The methodology adopted for the Round Table was participatory, with three thematic sessions: (1) Historical Foundations and Present Challenges, (2) Opportunities for Domestic and Global Collaboration, and (3) The Role of Innovative Technologies in Shaping Future Educational Paradigms. The event emphasized inclusive communication, collective intelligence, and strategic planning. Interactive presentations and group discussions promoted diverse viewpoints, creating the collaborative atmosphere conducive to innovation in public health education. Results: Discussions emphasized the development of public health education in India, shifting from a medical-centric model to an interdisciplinary approach. Challenges encompassed were lack of uniform accreditation, fragmented curricula, and inadequate global health exposure. The deliberation also pointed to opportunities such as creating competency-based curricula, leveraging digital tools, and nurturing international collaborations. Delegates highlighted the need to integrate social sciences and technology into public health programs and enhance faculty development. Conclusion: The Round Table concluded that India’s present public health education system needs significant improvement to realize global standards. Digital innovation, interdisciplinary education, and more rigorous systems of accreditation were identified among the factors facilitating this change. Establishing a national public health education consortium was proposed to promote collaboration and resource sharing, positioning India as the global public health education leader.

Context: Pressure swing adsorption (PSA) is a gas separation technique that separates some gas species from a mixture of gases under pressure based on the species’ molecular characteristics and affinity for an adsorbent material. During the peak of the coronavirus pandemic, the need for medical oxygen was critical due to the overwhelming surge in respiratory-related cases. The establishment of PSA plants across the country was a strategic move to ensure a continuous and reliable supply of oxygen to healthcare facilities. Objectives: The objective of this review was to systematically collect and assess evidence regarding the effectiveness of PSA. Design: A scoping review was carried out using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. Study Selection: Studies, reports, review articles, and gray literature that addressed the economic viability, ease of operation, overall feasibility, and reliability of PSA plants in the Indian context were particularly considered for inclusion. Main Outcome Measures: This review aims to assess the effectiveness of PSA technology, focusing on its cost efficiency, user-friendliness, overall feasibility, and reliability. The goal is to offer a clear understanding of the practical implications and outcomes related to the adoption of PSA plants in the Indian context. Results: Sixty-four relevant records were reviewed and analyzed. After considering all the eligibility criteria 33 records were included. The scoping review revealed the different characteristics of PSA plant. A total of six studies from the reviewed literature collectively state that this advancement marks a significant progress toward establishing a dependable and renewable supply of medical-grade oxygen, eliminating the dependency on external sources, and thereby enhancing hospital security. Conclusion: This review showed that properly maintained, and operated, PSA oxygen plants can be highly effective in providing a reliable source of medical-grade oxygen, especially in higher level of health facility where patient load is more.

India is experiencing demographic changes, with the aged population projected to rise from 153 million to 347 million by 2050. This unprecedented phase calls for urgent attention to geriatric home care, especially with the growing prevalence of chronic diseases and dependence on untrained informal caregivers. A trained workforce with expertise in psychological support, preventive and rehabilitative care, digital literacy, and communication is urgently needed. From a demand perspective, systemic constraints inhibit quality care, including limited training, inadequate financial support, social stigma, and caregiver burnout. Frameworks like NITI Aayog's Senior Care Reforms and WHO's Integrated Care for Older People (ICOPE) offer pragmatic strategies focusing on holistic person-centred care, digital enablement, and caregiver support. This piece identifies critical gaps in competencies and advocates for a professional geriatric home care curriculum aligned with national and global priorities. Integrating these measures with supportive policies, financial incentives, and infrastructure will improve accessibility and caregiver retention. Strengthening the geriatric care platform requires collaboration among policymakers, providers, and educators to ensure equitable, compassionate care for India’s aging population while empowering caregivers to deliver sustained support.

Background India is undergoing a significant demographic shift with a growing older population, leading to an anticipated increase in people with dementia. Family caregivers, who are predominantly informal, carry the burden of care within households, facing numerous challenges that impact their well-being. Despite the cultural emphasis on family support, there is a lack of targeted interventions for caregivers in India. The WHO emphasises the importance of caregiver support, and recent advancements in information and communication technology, particularly mobile health (mHealth), offer promising avenues to address this need. This study protocol outlines an Indo-Sweden collaborative effort, funded by Indian Council of Medical Research (ICMR) Forte, to develop and assess the effectiveness of a mHealth application designed to improve caregiving skills, reduce caregiver burden and support family caregivers of persons with dementia. Methods and analysis The study will be conducted through a community-based cluster randomised controlled trial in Jodhpur, Rajasthan, with Accredited Social Health Activists (ASHAs) serving as the unit of randomisation. The methodology includes several key phases: a needs assessment to understand caregiver requirements, the development of the mHealth application, comprehensive training for ASHAs and a thorough evaluation of the intervention’s impact. The effectiveness of the intervention will be measured through quantitative assessments of stress reduction, depressive symptoms and quality of life improvements, alongside qualitative insights from stakeholders. Additionally, usability and cost analyses will be conducted to evaluate the practicality and economic feasibility of the intervention. The expected outcomes of this study include the creation of a scalable mHealth platform that facilitates remote support, bridges geographical gaps and enhances the well-being of caregivers in India’s evolving healthcare landscape. Ethics and dissemination Ethical approval has been obtained from the Institutional Ethical Committee of AIIMS Jodhpur (AIIMS/IEC/2022/4245). Trial registration number Clinical Trials Registry: CTRI/2022/12/048320.

Background: The TB Mukt Gram Panchayat program was launched by the National Health Mission in Rajasthan on August 15, 2022 to engage Panchayati Raj Institutions at the grass-root level to strengthen the fight against tuberculosis (TB). This study was conducted to assess the progress and achievements of this program in Rajasthan. Methodology: The methodology involved the collaborative development of assessment criteria by expert stakeholders to assess the TB-free status of Gram Panchayats (GPs)/Wards (WAs) in Rajasthan. Two stages were conducted: shortlisting based on specific criteria, including active case finding and treatment linkage, and final assessment using a standardized questionnaire. Indicators assessed included program delivery, active case finding, community awareness, community support, district capacity, and TB burden, each with defined qualifying criteria and achievement scores, yielding final scores for each GP. Results: In the context of the GP/WA TB-Free Declaration Status, the results depict a mix of statuses, including “Progress toward TB-free status” and “Achieved TB-free status.” Out of 51 GPs/WAs, 29 achieved TB-free status, 13 were in progress toward TB-free status, and the rest were not qualified, having incomplete coverage. Conclusion: This study highlights the progress in Rajasthan’s TB Mukt Gram Panchayat program and exemplifies stakeholder collaboration across sectors in developing a verification framework for TB Mukt Gram Panchayat claims. Moreover, this novel assessment framework offers a valuable tool for other states to monitor their progress toward TB elimination.

Tobacco, being an established risk factor for significant mortality and morbidity, causes over 7 million annual deaths globally. India is a country with over 270 million active tobacco users. On the one hand, although the willingness to quit amongst tobacco users is as high as 55.4%, the actual quit rates translate to less than 20%. Taking a cue from the economic principle of commitment and consistency, paying a nominal fee can serve as a form of public commitment and motivation to decrease the dropout rate amongst those committed to quitting. This study uses contingent valuation assessment to determine the willingness to pay (WTP) values for an effective tobacco cessation service across individuals with different socio-demographic characteristics. A cross-sectional observational study with multistage cluster sampling in Rajasthan was conducted to recruit 360 active tobacco users from 8 districts. Q-Q plots were used to determine the non-parametric distribution, and statistical differences between median WTP values were compared using Mann-Whitney U and Kruskal-Wallis H tests, considering a p-value less than 0.05 to be statistically significant. The majority of participants were males (57.78%) between the ages of 26 and 35 (40.28%), married (82.50%), and with children (65.83%), with an annual income between $7500-10,000 (23.61%) and graduate-level education (40.56%). Exclusive smokers formed the majority of the cohort (48.06%), and 50.83% were willing to quit as well as willing to pay for cessation. Median WTP values were maximum for males ($54.05; p<0.05), age group 26-35 years ($54.05; p<0.05), post-graduates ($81.08; p<0.05), and annual income above $20,000 ($121.62; p<0.05). Weak positive and significant correlations were observed between WTP and annual spending on tobacco, annual spending on health, and annual income. The study emphasizes the critical importance of early-age interventions for effective tobacco cessation prior to transitioning into dependency, resulting in reduced financial parity for availing health services. These are the first such WTP values from the Southeast Asian region, tailored for different population subsets, specifically for tobacco cessation. Our findings contribute to the growing body of evidence to support innovative approaches to enhance tobacco cessation efforts through financial commitments.

India is currently experiencing a significant demographic transition characterized by a remarkable increase in its elderly population, particularly in rural areas.(1) The country’s aged population is expected to grow by 279% between 2022 and 2050, with the expectation that by 2046 they will outnumber children aged 0-15 years (2,3). This demographic change comes with a range of challenges including poverty, gender inequality, social isolation and limited access to quality healthcare (4). There are complex and varied healthcare needs of elderly people in rural India, with declining physical and mental health, vulnerability to multiple health problems such as chronic diseases, mobility difficulties and cognitive decline (4). During this period of life, access to quality healthcare becomes very essential but many aged individuals in India do not have the means or support required to maintain their wellness (1).