Hydrogeochemistry and Groundwater Quality Assessment of Rapur Area, Andhra Pradesh, South India

The assessment of the quality of groundwater in Rapur area of Nellore District has been carried out with an objective to determine the hydrogeochemical validity. A total of 30 samples of groundwater were collected from wells occurring in the study area. The analyzed physicochemical parameters such as pH, electrical conductivity, total dissolved solids, silica, calcium, magnesium, sodium, potassium, bicarbonate, carbonate, sulfate, and chloride are used to characterize the ground-water quality and its suitability for drinking and irrigational uses. Based on the analytical results, chemical indices like sodium absorption ratio (SAR), adjusted SAR, percent sodium (Na %), potential salinity, residual sodium carbonate (RSC), permeability index (PI), chloroalkaline indices, Kelly’s ratio, magnesium ratio and Gibbs ratios have been calculated. Chadha rectangular and diagram for geochemical classification and hydrochemical processes of groundwater indicated that most of the waters are Na-Cl and Ca-Mg-Cl types. The Gibb’s plot indicates that the groundwater chemistry of the study area is mainly controlled by rock-water interaction.

Zr, Hf, U, Th and REE-Fertile Lower Proterozoic Potassic Granite from Parts of Andhra Pradesh, South India

The medium- to coarse-grained and porphyritic granitoid of Dharmawaram, Karimnagar district, Andhra Pradesh, south India is a biotite-hornblende granite with notable contents of rare metal (Zr, Hf, Th) and rare earth (including Y) minerals like zircon, thorite, allanite, monazite and xenotime. Chemically, it is metaluminous (average A/ C+N+K = 0.95)-type, potassic (av. 5% K2O) granite, with dominantly sub-alkaline characters. It shows up to 8 times enrichment of rare metals (Zr, Hf, U, Th) and rare earths (including Y, Sc), with reference to their abundances in normal unevolved granite, and hence, fertile for some of these elements. Field, petrological, geochemical and isotopic data of potassic granite (PG) indicate involvement of silica-rich metasedimentary-basic crustal rocks (amphibole-quartzite, amphibolite, hornblende-biotite gneiss, etc.) in its genesis, at a depth range of 30 km. Further, chondrite-normalized REE patterns demonstrate that low-degree partial melting of source rocks is the major controlling factor in the genesis of PG Mild negative Eu-anomaly (av. Eu/Eu* = 0.48), plots of Ba-Rb-Sr in the field of anomalous granite and K/Rb ratios (av. 239) in the range that is shown by normal unevolved granite together indicate less fractionated nature of the PG Limited fractionation of metalumination-type, involving hornblende, led to occasional weak alumina saturation. Interestingly, geochemical and petrogenetic features of the studied PG broadly match with those potassic granites which are already known to host anomalously high enrichment of rare metals and rare earths in other parts of Andhra Pradesh and adjoining Karnataka.

Role of Multi-Generation Dyke Emplacements in Moyar-Bhavani Shear Zone, South India

The Moyar-Bhavani Shear Zone(MBSZ)of the South Indian Granulite Terrain(SIGT),a complex continental block formed by the accretion of various crustal units during the Archaean to Neoproterozoic,bear evidences of

Clinical profile and outcomes of pediatric endogenous endophthalmitis: A report of 11 cases from South India

AIM To study the clinical profile and outcomes of pediatric endogenous endophthalmitis from a tertiary eye hospital in South India.METHODS A total of 13 eyes of 11 children presented to us with varied symptoms and presentations of endogenous endophthalmitis, over a five-year period from January 2010 to December 2015 were studied. Except for two eyes of a patient, vitreous aspirates were cultured from all 11 eyes to isolate the causative organism. These eleven eyes also received intravitreal injections. All patients were treated with systemic antibiotics. RESULTS Two cases had bilateral endophthalmitis. Ages ranged from 4 d to 11 years. Five cases were undiagnosed and treated, before being referred to our center. Ten of the 13 eyes underwent a core vitrectomy. The vitrectomy was done at an average on the second day after presenting(range 0-20 d). Five of the 11 vitreous aspirates showed isolates. The incriminating organisms were bacteria in three and fungus in two. An underlying predisposing factor was found in seven patients. At a mean follow-up 21.5 mo, outcome was good in 7 eyes of 6 cases(54%), five eyes of four cases(38%) ended up with phthisis bulbi while one child died of systemic complications. CONCLUSION Endogenous endophthalmitis is a challenge for ophtha-lmologists. Early diagnosis and intervention is the key for a better outcome.

Formation and Evolution of Dharwar Craton in South India-Synthesis from Broadband Seismological Experiment

Understanding the structure,composition and survival of Archaean cratons over geological times is critical to model the process of crustal evolution.The South India Broadband Seismic Imaging Experiment was organized to answer fundamental questions of craton formation,with the principal objective of characterizing physico-chemical nature of the crust and mantle of Dharwar craton and adjoining terrains.

Petrography and stable isotopic variations in Dalmiapuram Formation of Cauvery Basin, South India: implication on OAE1d

Petrography, carbon and oxygen isotopic study was carried out to interpret isotopic variations on the predominant carbonate sequence of the Dalmiapuram Formation of the Cauvery Basin, South India. The common petrographic types identified in the Dalmiapuram Formation range from wackestone to boundstone. The gray shale and limestone members show large variations in d13 C and d18 O values(Gray shale member: +1.44 to +2.40 %VPDB,-3.05 to-5.92 % VPDB, respectively; Limestone member:-6.07 to +2.93 % VPDB;-7.08 to-0.39 %VPDB; respectively). In the present study, the carbon and oxygen values are not correlated, which supports the fact that these limestones retain their primary isotopic signatures. In carbon isotope curve, one negative shift is identified in the gray shale member and a positive isotopic excursion is detected in the coral algal limestone(CAL).The observed positive isotopic excursion in the lower part of the CAL correlates with OAE1 d and suggests the global nature of the late Albian OAE1 d in the Cauvery Basin.

External Quality Assurance Scheme in a National Reference Laboratory for HIV Testing in South India

Background: The Department of Experimental Medicine functions as the National Reference Laboratory (NRL) for HIV testing covering 11 Medical Colleges (State Reference Laboratories SRL) & 723 subcenters i.e. Integrated Counseling & Testing Centres and Blood Banks. The External Quality Assurance Scheme (EQAS) in NRL implements Quality Control (QC) Testing, Proficiency panel testing and training programs. Materials & Method: 9419 samples (4393 HIV negative/5026 HIV positive) were tested for QC. All the samples were tested using HIV rapid test (CombAids) and HIV positives alone were tested using Tridot and EIA Comb. The QC samples consisted of 20% negative and all positives. All the 723 subcenters were provided with 5 coded plasma samples (3 reactive & 2 negative) for proficiency testing using rapid tests. The aliquot panel (500 μl) were provided twice a year for testing to monitor the laboratory performance. Results: Out of 9419 samples tested for QC, 9371 (99.49%) reported correct results and 48 (0.50%) discordant results. Out of 48 samples 26 (0.27%) were false positives and 22 (0.23%) false negative. Mislabeling, sample contamination, leaking vials, transcriptional errors, tests that were not performed correctly were identified. For proficiency testing 91.8% reported test results. 645 (97.13%) reported correct results & 19 (2.86%) incorrect results. Out of 19 samples 7 (1.05%) were false positive & 12 (1.80%) were false negative. Hands on training were provided and the 19 discordant centers reported correct results on retesting. Conclusion: Significant progress in establishing a well coordinated HIV Laboratory network of NRL and SRLs had been developed. However the HIV testing and Quality Assurance needs to be strengthened towards certification.

Southern and Tropical Indian Ocean SST: A Possible Predictor of Winter Monsoon Rainfall over South India

The complexities in the relationship between winter monsoon rainfall (WMR) over South India and Sea Surface temperature (SST) variability in the southern and tropical Indian Ocean (STIO) are evaluated statistically. The data of the time period of our study (1950-2003) have been divided exactly in two halves to identify predictors. Correlation analysis is done to see the effect of STIO SST variability on winter monsoon rainfall index (WMRI) for South India with a lead-lag of 8 seasons (two years). The significant positive correlation is found between Southern Indian Ocean (SIO) SST and WMRI in July-August-September season having a lag of one season. The SST of the SIO, Bay of Bengal and North Equatorial Indian Ocean are negatively correlated with WMRI at five, six and seven seasons before the onset of winter monsoon. The maximum positive correlation of 0.61 is found from the region south of 500 S having a lag of one season and the negative correlations of 0.60, 0.53 and 0.57 are found with the SST of the regions SIO, Bay of Bengal and North Equatorial Ocean having lags of five, six and seven seasons respectively and these correlation coefficients have confidence level of 99%. Based on the correlation analysis, we defined Antarctic Circumpolar Current Index A and B (ACCIA (A) & ACCIB (B)), Bay of Bengal index (BOBI (C)) and North Equatorial Index (NEI (D)) by averageing SST for the regions having maximum correlation (positive or negative) with WMRI index. These SST indices are used to predict the WMRI using linear and multivariate linear regression models. In addition, we also attempted to detect a dynamic link for the predictability of WMRI using Nino 3.4 index. The predictive skill of these indices is tested by error analysis and Willmott’s index.

Mineralogy and geochemistry of siliciclastic Miocene Cuddalore Formation,Cauvery Basin,South India:Implications for provenance and paleoclimate

The Cuddalore Formation of the Cauvery Basin received siliciclastic detritus from inland areas of the Southern Granulite Terrain(SGT).It represented continental-fluvial sedimentation in the eastern continental margin of South India during the Miocene.Indian Summer Monsoon was thought to be initiated in the early Miocene and intensified during the middle Miocene causing major climatic shifts in the Indian subcontinent.In the present work,detailed mineralogical and geochemical studies on the siliciclastic Cuddalore Formation have been carried out to understand the provenance and paleoclimatic conditions during the Miocene.The paleocurrent direction,textural immaturity and framework detrital modes of sandstones suggest rapid uplift of basement and sediment source from nearby Madras Block of SGT.Various diagnostic immobile trace element ratios such as Th/Sc,Co/Th,La/Sc,La/Co suggest a tonalite-trondhjemite-granodiorite-charnockite provenance,and somewhat more felsic composition of source area compared to the present upper continental crust(UCC).Rare earth element mixed model suggests that sediments were dominantly(80%)sourced from felsic charnockite,with a minor contribution(20%)from mafic granulites.Higher abundance of advanced-weathering products like kaolinite,very high(>98)chemical index of alteration(CIA)values,severe depletion of mobile elements(Ca,Na,K,Mg,Ba,Rb)in comparison to UCC,significantly higher a Mg,a Ca,a Na,a K,a Sr and a Ba values(higher than the unity),all suggest the extreme chemical weathering in source terrain and/or in the sedimentary basin.Calculations based on CIA show high average surface temperature between 29.3℃and 29.5℃and high mean annual precipitation ranging from 2339 mm/yr to 2467 mm/yr.The geochemical data are consistent with the paleogeographic position of the depositional basin(Cauvery Basin)and suggest the deposition of Cuddalore sediments(the Cuddalore Formation)in a nearequatorial location under a warm climate condition with abundant monsoonal precipitation.

A potent fish pathogenic bacterial killer Streptomyces sp.isolated from the soils of east coast region,South India

Objective:To investigate the potentiality of the marine actinobacteria isolated from marine soil against fish pathogenic bacteria.Methods:east coast region(ECR)of Tamilnadu,South India.Then they were used for the isolation of actinobacteria by using conventional serial dilution technique on starch casein agar medium.The antibacterial activities of the actinobacteria were screened primarily by using cross streak plate method against fish pathogenic bacteria namely Vibrio alginolyticus,Vibrio parahaemolyticus,Vibrio cholera,Aeromonas sp.and Pseudomonas sp.The antimicrobial efficacy of the selected isolates was carried out with various organic solvents,and finally the active compound was subjected to chromatographic techniques including TLC and GC-MS.Results:In the present study,a total of 33 soil samples were collected from the Bay of Bengal,against fish pathogenic bacteria.Out of 21 antibacterial isolates,the isolate ECR77 was selected for further study based on its potential activity against fish pathogenic bacteria.Of the various solvents tested,the ethyl acetate extract had good antibacterial activity against the tested bacterial pathogens.The isolate ECR77 grew well on oat meal agar medium with 2%salt level at 35°C.GC-MS study found that the presence of bioactive compounds namely tetradecanoic acid,n-hexadecanoic acid and octadecanoic acid.The morphological,physiological,biochemical and cultural characteristics of the potential isolate were supported the identity up to generic level asStreptomyces sp.ECR77.Conclusions:The results obtained from this study concludes that the ECR soils of South India is a hot spot of novel bioactive compound producing marine actinobacteria with great pharmaceutical values.Of the 82 actinobacteria isolated,21(26%)isolates were possessed antibacterial activity.

Clinical profile of brucellosis from a tertiary care center in southern India

Objective:To highlight the spectrum of clinical manifestations,labs,complications,treatment and outcome of brucellosis.Methods:Retrospective study was conducted in Kasturba Medical College,Manipal University,Karnataka,India which included 68 confirmed cases of brucellosis from January 2006- April 2010.Diagnosis of brucellosis was made by culturing the sera/body fluids by standard BACTEC method(or) by testing the sera for Brucella agglutinins using the standard agglutination test(SAT).A titer of 1:320 or more was considered as significant.SPSS 16 was used for statistical analysis and Microsoft Excel for graphical representation.Results:Of the 68 patients,46(68%) were male and 22(32%) were female patients with age distribution of 9-75 years.Forty four(64.7%) had history of contact with unpasteurized dairy products or infected animals.Symptoms included fever(68,100%),myalgia(21,31%),musculoskeletal symptoms (23,34%),headache(16,24%),gastrointestinal symptoms(19,28%) and altered sensorium(3, 4%).Co-morbidities and associations included HIV positivity(2,3%),type 2 diabetes mellitus (13,19%),steroid therapy(3,4%) and HBsAg positivity(8,12%).Ten(15%) patients had cervical lymphadenopathy,4(6%) had splenic enlargement,6(7%) had hepatomegaly,19(28%) had hepatosplenomegaly and 2(3%) got meningeal signs.Anaemia was observed in 39(57.3%) cases,high erythrocyte sedimentation rate(ESR) was present in 55(80.8%) cases,leucocytosis in 10(14.7%),leucopenia in 10(14.7%),thrombocytopenia in 23(33.82%) and thrombocytosis in 2(2.94%) cases.Conclusions:In countries like India,where brucellosis and tuberculosis are endemic;rapid,sensitive and highly specific diagnostic methods are required to make early diagnosis and prevent resistance as there is an overlap in therapy.

The epidemiology and prevalence of Ulcerative colitis in the South of India

Ulcerative colitis is considered frequent in majority of European and North American population and exceptional in most of the developing Asian countries. There is a dearth of reported data from South India on the incidence of the disease and its prevalence. Hence the present study was designed to estimate the prevalence of ulcerative colitis in a tertiary care hospital of Hyderabad, South India. The study population consisted of 157 Ulcerative colitis and 204 healthy subjects. All subjects were interviewed by means of a questionnaire for general demographical details and socioeconomic conditions, health related quality of life and history of UC. Patients were categorized based on disease severity;moderate: 95, and severe: 62 and disease manifestation: 73 (46.5%) pancolitis, 60 (38.2%) left-sided colitis and 24 (15.3%) had proctosigmoiditits. Disease prevalence was high in patients

Factors Associated with Mental Depression among Men Who Have Sex with Men in Southern India

Background: Mental health has been a largely neglected issue among Men Who Have Sex with Men (MSM) across the world. This study examines the prevalence and correlates of depression among MSM. Data and Methods: Data for this study are used from a cross-sectional Behavioral Tracking Survey—2012 conducted among 1176 MSM from Andhra Pradesh (undivided), a southern state of India. Depression of MSM was assessed using Patient Health Questionnaire-2 scale. Descriptive statistics, bivariate and multivariate logistic regression techniques were used for analysis. Results: More than one-third of MSMs (35%) in the survey reported to have depression. The likelihood of experiencing depression was 5 times higher among MSM who were mobile for sex work outside their place of residence (55% vs 17%, AOR: 5.2, 95% CI: 3.7 - 7.3) and had experienced physical or sexual violence (82% vs 33%, AOR: 6.0, 95% CI: 2.1 - 17.4) than their respective counterparts. Rates of depression were significantly higher among MSM who had experienced Sexually Transmitted Infections symptoms;knowledge of their HIV positivity;who didn’t use condoms during anal sex with any clients/partners;those who consumed alcohol and were in financial debt at the time of survey than others. Those who were associated with any community groups have significantly less chances of reporting depression. Discussion: The study certainly highlighted that the HIV prevention efforts with MSM in India require an integrated approach on addressing the mental health issues. To support this, programs and research-based evidence will be highly needed to ensure that mental health issues are properly addressed among MSM and other high risk groups.

非对称性报偿结构如何影响地区合作——基于对南亚区域合作进程的分析

与世界其他地区相比,南亚区域主义的特点是进展缓慢、效率低下、合作机制经常性停摆,同时地区大国印度也未能在区域化过程中淡化与邻国间的敌意、构建区域信任。针对南亚区域主义相对失效的问题,本文尝试以非对称性报偿结构为分析视角,展现南亚区域主义中的三类行为体——地区大国印度、地区强国巴基斯坦和地区小国——在区域合作中的策略变化及其对区域合作的影响,以此解释停滞甚至是逆向的区域化进程是如何形成的。报偿结构决定了区域主义参与国初始策略的稳定性,而在区域化过程中,参与国报偿结构的不对称性影响了它们能否以及如何改变原有的策略选择。对于南亚的区域合作,印度、南亚小国和巴基斯坦分别怀有僵局、胆小鬼和相对弱势的僵局博弈参与者的偏好,它们的报偿结构呈现出了非对称的特点。在南亚区域化进程中,印度与南亚小国、印度与巴基斯坦分别形成了“恶棍博弈”和不对称状态下的“僵局博弈”。两个混合博弈组显示,区域主义不仅不必然改善各国在区域合作中的收益,策略的交叉也可能逐渐演化为所有参与国更加倾向不合作的僵局形式。因此,面对“重复的失败”和“争端的溢出”两个区域主义困局,只有各国重构报偿结构、突破安全主导型的合作逻辑,区域主义才能发挥促进区域稳定与繁荣的正向作用。

印度对外战略新动向——基于“全球南方”的视角

在大国竞争加剧的背景下,“全球南方”作为一支相对独立的政治力量活跃在世界舞台上,在全球治理、地区冲突中发挥重要作用。俄乌冲突爆发以来,印度将“全球南方”纳入对外战略布局,助力其大国战略,抬升国际威望。在政策层面,印度通过争做“全球南方”领袖、充当“西方”与“全球南方”的桥梁以及拓展“微型多边主义”的多项战略举措加强与“全球南方”的联系,将“全球南方”视为维护战略自主和对冲中国的重要手段。同时也应看到,印度的“全球南方”外交攻势仍面临诸多挑战:印度“全球南方”领袖合法性问题、印度与西方国家的深层矛盾问题、印度“全球南方”领袖角色面临激烈外部竞争。作为“全球南方”的当然成员,中国坚定维护“全球南方”的共同利益。在当下复杂严峻的国际形势下,中国在外交实践中应更加注重把“全球南方”国家作为优先方向,不断深挖合作潜力,培育合作动力,谋求共同发展,在高质量共建“一带一路”征程中推动“全球南方”在国际舞台上发挥更大作用。

边界争端、威胁认知与印越在南海的战略互动态势

面对实力强于自身的国家,选择与他国合作以制衡强国,是行为体的潜在反应之一。在边界争端形势较为严峻的背景下,印度和越南不断强化在南海战略互动和合作,加剧了南海争端的复杂态势。在影响印越南海战略合作的诸多因素中,边界争端和威胁认知是关键变量。边界争端框定两国南海合作政策变化的整体方向,威胁认知左右两国行动意愿强度。当中印和中越边界争端形势均较为严峻时,支撑印越南海靠近的条件较为充分,两国在该区域的战略互动就极易发生;当任意一国和中国边界争端局势有所缓和时,支撑两国南海频繁互动的条件会相应弱化,其在南海的战略合作强度就会有所减弱。通过对中越“中建南事件”和中印“洞朗事件”进行案例比较以及个案内的过程追踪分析,该论点得到了验证。尽管边界争端和共同对华威胁感知是驱使印越强化南海互动的动力源之一,但两国战略重点的不同和高度异质的威胁感知,会增强两国南海战略互动过程的复杂性及效果的不确定性。

印度地区领导力建构及其国际公共产品供给逻辑

国际领导力源自合法性认同,大国通过供给国际公共产品能够促进自我利益与集体利益的平衡统一。在相互依存的全球治理格局中,领导性大国依托广泛的社会关系网络,可以在共同体内外夯实领导力的社会基础。印度作为传统的南亚地区大国,冷战后在国际舞台上日趋活跃,推进区域政治领导力的意愿与能力均显著增强。在长期睦邻外交实践中,印度将自己置于南亚政治网络的中心位置,通过发起区域互联互通倡议、强化基础设施援助与供给区域公共产品,强化区域领导力的合法性基础。但在大国地缘政治竞争背景下,印度主导的区域互联互通项目存在与中国“一带一路”倡议重叠竞争的压力。在南亚区域一体化合作方面,南盟区域组织发展受制于印度偏好而进程缓慢。长期以来,南亚区域合作中的印式领导力面临巴基斯坦的尖锐质疑,而且尼泊尔、不丹、斯里兰卡的战略追随也时常摇摆不定。为进一步夯实领导力的合法性基础,印度需要供给更高质量的区域公共产品以争取追随者的政治认同,同时消解因大国竞争与区域冲突所引发的不确定挑战。

Lichens of the Sirumalai hills,Eastern Ghats with one genus and six species new to India

Lichens of Sirumalai hills are reported here for the first time.Lichen biota comprised of 95 species.The genus Japewiella is reported for the first time in India and is represented by J.tavaresiana(H.Magn.)Printzen.Furthermore,the following six taxa including one variety are new to India viz.Arthonia atra(Pers.)A.Schneid.,Graphis brevicarpa M.Nakan.,Kashiw.&K.H.Moon,Micarea erratica(Körb.)Hertel,Rambold&Pietschm.,Pertusaria cicatricosa var.deficiens A.W.Archer,Elix&Streimam,Porina subargillacea Müll Arg.,and Pyxine schmidtii Vain.Brief accounts for all the new records to India are provided to facilitate their identification.Arthonia redingeri Grube and Lepraria caesiella R.C.Harris are reported for the first time from south India.Besides all above,29 species are recorded for the first time from the state of Tamil Nadu.The lichen biota of the area is primarily corticolous in habitats and dominated by crustose form.

Assessment of Land Use Land Cover Change Detection Using Geospatial Techniques in Southeast Rajasthan

Change analysis acquires effective information in the form of maps and statistical data which becomes the central component in spatial planning, monitoring environmental changes, management and utilization of land. The present study makes an attempt to assess the changes in land use land cover using multi-temporal satellite data in south-east Rajasthan. These maps were derived from geocoded dia-positive False Color Composites (FCC’s) of IRS 1991, 2001, 2010 & 2018 using Arc GIS platform. The present study demonstrates the extension, approach and result of change analysis which might be helpful for decision making and sustainable growth. The landscape has been divided into 12 categories. Mining and its associated features were increased whereas forest and open scrub cover shows decreasing trend during the study period. The former increased by 23.82 km2 while the later shrunk by 26.08 km2. Most significant changes are also witnessed in settlement and industrial areas which shows increment by 8.8 km2 and 1.33 km2. Stone quarrying has destroyed arable land, natural vegetation cover, topsoil, subsoil and consequently the soil profile of the area. On the other hand cultivated land is increasing due to the conversion of uncultivated land and scrub cover with facilitation of irrigation and modern agricultural activities under different government schemes. The study shows that the area of 184.88 km2 has undergone significant spatial and temporal changes during the study period.

Unfolding of HIV Epidemic and Spectrum of AIDS in North India

The review traces the unfolding of HIV epidemic in North India. The first few cases were reported in 1989 in Indians returning from African countries like Uganda, Zambia and a trickle from USA. Subsequently the cases started pouring from coastal areas of Mumbai, Chennai and finally the virus spread all over through rail and road. In the North eastern region or the golden triangle, IV drug users formed a major group. Using a simple peptide ELISA, it was documented that the virus belonged to the NOF strain. This was much before clades were identified using molecular analysis. It appears that the HIV virus followed the drug (mandrax) route between Mumbai and South Africa. An alarming rise was observed among truck drivers fuelling HIV in Punjab villages who indulged in promiscuous behavior in road side making shift brothels near eating kiosks. Special customs in the state also flared the spread. During the early epidemic a very high prevalence was shown in blood transfused individuals (12.5%) which dropped to 2% -3% after aggressive measures taken by the NACO. While HIV positivity rates plateaued in some states by 2004, infection in Punjab continued to rise even after 2005. Kaposi sarcoma is almost unknown in Indian patients while TB and candida formed major co-infections. In one study, subtype V3 -V5 region chimeras of Indian clade C and clade B replicated freely in peripheral blood mononuclear cells (PBMC) and macrophages and showed higher HIV replication. Opt-out screening was started in an emergency setting in a tertiary care hospital. The positivity rate was 20/per thousand. Thus a large number of patients would have been missed if opt-out screening was not resorted to.