BJGMC

Byramjee Jeejeebhoy Government Medical College (BJGMC), and Sassoon General Hospitals (SGH)
Jai Prakash Narayan Road, Near Pune Railway Station
Pune, India 411001
www.bjmcpune.org    

 

About:

  • Among the top 10 medical schools in India
  • 200 medical students, 130 residents per year; 50 nursing students per year
  • SGH: State-funded 1500-bed tertiary-care public hospital, 21 outpatient clinics, and links to multiple NGOs in the community
  • CCGHE partnership established in 1999 for HIV studies; now investigates other infectious diseases, noncommunicable diseases, and comorbidities 
  • In 2011, JHU field office established at BJGMC Clinical Research Site: 3 full time Hopkins faculty and 20 staff; 150 BJGMC clinical research staff.
  • Clinical research as well as leadership and oversight for clinical rotations and field studies

 

Field Study Administrators:

ACTIV-2/A5401: Adaptive Platform Treatment for Outpatients with COVID-19 (Adapt Out COVID)

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2021-07-21
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Rationale: There is an urgent need for a platform to rapidly evaluate therapies in the outpatient setting, to prevent disease progression, and reduce serious complications of COVID-19 and transmission [10]. ACTIV-2/A5401 is a phase II/III randomized, blinded, controlled adaptive platform trial to...

P2026: Pharmacokinetic Properties of Antiretroviral and Anti-Tuberculosis Drugs during Pregnancy and Postpartum

Post Date: 
2021-05-18
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IMPAACT P1026s, the predecessor of this study, was first approved in 2003. P1026s enrolled over 1000 pregnant/postpartum women, studied the PK of more than 25 HIV and TB drugs in these women and published 27 manuscripts presenting these data. P1026s data was cited in 32% of the 76 perinatal...

The Pharmacokinetics, Safety and Acceptability of New Child-Friendly Formulations of Clofazimine and Moxifloxacin in Children Routinely Treated for Rifampicin-Resistant Tuberculosis (CATALYST)

Post Date: 
2021-04-26
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PK, safety and acceptability data and practical guidance on the optimal dosing of new more child-friendly formulations of moxifloxacin and clofazimine in children are urgently needed to inform their current and future use in children with Rifampicin-Resistant TB (RR-TB). Both medications have a key...

Dynamics and immune mechanisms of QFT response in close contacts of TB cases

Post Date: 
2021-04-05
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Rationale: A vaccine that prevents infection with Mycobacterium tuberculosis (Mtb) (POI vaccine) is an ideal approach to TB control. As Mtb infection (MTBI) is measured indirectly (positive tuberculin skin test (TST) or interferon gamma release assay (IGRA), prevention of IGRA conversion is the...

A Nanopore Biosensor for Leveling MTB Antigens in Blood

Post Date: 
2021-04-01
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Purpose of the study: The inability to obtain diagnostically useful sputum specimens, or the inability to analyze non-sputum specimens, is a significant contributor to poor diagnostic sensitivity of current TB assays, leading to the WHO to call for the development of non-sputum-based biomarker or...

Effect of Neighborhoods and Peer Networks on substance use and violence among adolescents living with and without HIV in India

Post Date: 
2021-01-28
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Purpose of the study: A strong bidirectional association exists between substance use, various forms of violence and HIV. Substance use accounts for 0.8% of the burden of disease measured in disability adjusted life years (DALYs) among adolescents in South Asia. Violence among adolescents living...

Impact of Tuberculosis Infection on HIV-1 Antibody Response (NWCS501)

Post Date: 
2020-12-05
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Study Objective: Compare longitudinal HIV-1 antibody responses among HIV-1 infected participants that either did or did not develop active TB enrolled in ACTG 5274 and ACTG 5279 Study Design: Longitudinal antibody responses will be examined among select participants in A5274 who have plasma samples...

Identification of Biomarkers That Can Predict Progression from Latent Tuberculosis Infection to Active Tuberculosis Disease

Post Date: 
2020-08-23
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Purpose: The C-TRIUMPH study has identified 20 household contacts (HHC), who have progressed to active TB from its HHCs cohort (Cohort B). Immunological profiling of TB antigen induced biosignatures, profiling of transcriptional and proteomic biosignatures should provide novel insights into the...

Epidemiology and Clinical Outcomes of COVID-19 in India (ECO-19)

Post Date: 
2020-07-09
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This study was terminated May 25, 2021 This is a prospective cohort study of adults with suspected COVID-19 to address key knowledge gaps in the epidemiology of disease severity and poor clinical outcomes in India. Results from this study may help clinicians in India focus limited health resources...

Mental Health Outcomes among Health Care Professionals Involved in the Treatment and Care of COVID 19 Patients in India

Post Date: 
2020-06-01
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Drs. Nikhil Gupta and Nishi Suryavanshi are leading this survey project. This study is investigating the immediate impact of the COVID-19 pandemic on mental health outcomes and overall quality of life and what are the factors associated with it among Indian Health care workers. Among health care...

Prevalence of Risk Factors for Lung Cancer and Facilitators and Barriers for Tobacco Cessation among People Living with HIV

Post Date: 
2020-04-01
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India has the world’s third largest HIV epidemic, with 2.1 million people currently living with HIV and an additional 90,000 new infections each year.[29] At the same time, expansion of the HIV response under India’s premier governmental agency - the National AIDS Control Organization (NACO), has...

The Sentinel Research Network of IeDEA: A Prospective Cohort among People Living with HIV

Post Date: 
2020-03-12
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This study is nested within the TREAT Asia HIV Observational Database initiative. The global scale up of antiretroviral therapy (ART) has significantly improved the immune recovery and life expectancy of people living with HIV (PLHIV). However, PLHIV on long-term ART now face health challenges...

Hybrid Trial for Alcohol Reduction among People with TB and HIV in India

Post Date: 
2020-02-12
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Dr. Geetanjali Chander is PI and Dr. Kakrani is local site PI at DY Patil Medical College for this study. The highest incidence of tuberculosis disease (TB) in the world is in India, accounting for 27% of all new cases globally, with approximately 86,000 among persons with HIV (PWH). Unhealthy...

Pregnancy Associated Immune Responses to Tuberculosis and HIV in India and South Africa (PARTHISA)

Post Date: 
2020-01-14
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Dr. Jyoti Mathad is Co-PI of this study. Purpose: Tuberculosis (TB) is a leading cause of maternal mortality, especially among HIV-infected women. Women are most likely to develop active TB during and immediately after pregnancy. The immunologic conditions responsible for this phenomenon are not...

Increasing Market and Public Health Outcomes Through Scaling Up Affordable Access Models of Short Course Preventive Therapy for TB (IMPAACT4TB)

Post Date: 
2019-12-17
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Primary Objective: This study is being conducted in Brazil, Cambodia, China, Ethiopia, Ghana, Haiti, India, Indonesia, Kenya, Malawi, Mozambique, South Africa, Tanzania, and Zimbabwe. The overall goal is to reduce TB incidence among (1) people living with HIV who are on antiretroviral therapy, and...

Markers of Lung Impairment in HIV-TB Coinfected Indian Adults

Post Date: 
2019-12-11
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Objectives/Aims We will compare the degree of lung impairment between HIV-TB co-infected adults (HIV-TB group) and TB cases without HIV co-infection (TB group) who successfully complete TB therapy. We hypothesize that the HIV-TB group will have a greater degree of lung impairment compared to the TB...

T Cell Biomarkers and T-regulatory Responses to Pediatric TB

Post Date: 
2019-11-21
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The goals of this study are to: Validate host T cell biomarkers for diagnosis of pediatric TB Investigate the phenotype and functions of T-regulatory cells in pediatric TB We will use cryopreserved PBMC samples from CTRIUMPH cohorts: Pediatric unconfirmed TB, confirmed TB, latest Tb, and no TB...

Inflammasome Genetics and Tuberculosis Treatment Outcomes

Post Date: 
2019-11-07
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Dr. Amita Gupta is a Co-PI on this study. STUDY DESIGN We will conduct a retrospective case-cohort study nested within the CTRIUMPH and EDOTS cohorts to address our study objectives. This will enable us to measure the association of polymorphisms with multiple clinical outcomes simultaneously and...

A Phase 2a, Double-Blind, Placebo-Controlled, Randomized Clinical Trial to Evaluate the Safety and Immunogenicity of ID93 + GLA-SE Vaccine Administered to HIV-Negative Patients at 3 Time Points During Multidrug Therapy for Drug Susceptible Pulmonary TB

Post Date: 
2019-10-28
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This study was terminated in April 2020. Vidya Mave was PI of this HIV vaccine trial. BACKGOUND: Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis (Mtb). TB is one of the leading causes of morbidity and mortality around the world with an estimated 10...

Evaluation of a Urinary Biomarker Assay for Diagnosis and Test of Cure for Tuberculosis

Post Date: 
2019-09-09
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Dr. Jeff Tornheim is PI of this study. METHODS This study will make use of biorepository samples from the Cohort for TB Research by the Indo-US Medical Partnership (CTRIUMPh). CTRIUMPh, funded by the US NIH and Indian Department of Biotechnology, is an academic collaboration between Johns Hopkins...

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Unhealthy alcohol use independently associated with unfavorable TB treatment outcomes among Indian men

Post Date: 
2021-03-10
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Publication: 
International Journal of Tuberculosis and Lung Disease
This study by Samyra Cox and colleagues highlights the need for integrating effective alcohol interventions into TB care.

Detection of genital tuberculosis among women with infertility using best clinical practices in India: An implementation study

Post Date: 
2021-01-15
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Indian Journal of Tuberculosis
Background Diagnosis of genital tuberculosis (TB) as a cause of infertility still remains a diagnostic dilemma for clinicians, as no standard guidelines exist. The recently proposed best practices for genital TB diagnosis have not been evaluated yet in India. Objectives To implement best practices...

Tuberculosis preventive treatment should be considered for all household contacts of pulmonary tuberculosis patients in India

Post Date: 
2020-07-29
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PLoS One
PLoS One: Dr. Mandar Paradkar and colleagues conducted a CTRIUMPH study that supports TB preventive therapy for all household contacts of pulmonary TB patients in India

Impact of the Fogarty Training Program on Trainee and Institutional Research Capacity Building at a Government Medical College in India

Post Date: 
2020-07-27
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Publication: 
Annals of Global Health
Gauri Dumal and colleagues assess the impact of the 5-year HIV-TB research training program on building individual research capacity at BJGMC.

A mobile health-facilitated behavioral intervention for community health workers improves exclusive breastfeeding and early infant HIV diagnosis in India: A cluster randomized trial

Post Date: 
2020-07-02
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Publication: 
Journal of the International AIDS Society
When community health workers used a mobile health intervention with HIV+ women to deliver care, there was a higher uptake of exclusive breastfeeding at two months and early infant HIV diagnosis at six weeks

Intensified short symptom screening program for Dengue infection during pregnancy, India

Post Date: 
2020-04-15
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Publication: 
Emerging Infectious Diseases
Mosquitoborne diseases (e.g., malaria, dengue, and chikungunya) are endemic to India and pose diagnostic challenges during pregnancy. We evaluated an intensified short symptom screening program in India to diagnose dengue during pregnancy. During October 2017-January 2018, we screened pregnant...

High prevalence of late presentation of ART-naïve perinatally infected children for care in Pune, India

Post Date: 
2020-02-19
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Publication: 
AIDS Care
AIDS Care : There is an urgent need to identify strategies that improve linkage of perinatally infected ART-naïve children to care, and earlier than what is currently observed.

Assessment of the Xpert assay among new pulmonary tuberculosis suspects with and without diabetes mellitus

Post Date: 
2020-01-01
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Publication: 
International Journal of Tuberculosis and Lung Disease
IJTLD: Deshmukh and colleagues: High sensitivity and specificity of Xpert underscores need for rapid scale up for early detection of TB in settings with a high dual burden of TB and DM

Transcriptomic profiles of confirmed pediatric tuberculosis patients and household contacts identifies active tuberculosis, infection, and treatment response among Indian children

Post Date: 
2019-12-04
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Publication: 
Journal of Infectious Diseases
Journal of Infectious Diseases: Gene expression profiles among Indian children with confirmed TB were distinct from those of adults, highlighting the importance of including distinct populations in differential gene expression models

MAL adaptor (TIRAP) S180L polymorphism and severity of disease among tuberculosis patients

Post Date: 
2019-10-31
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Infection, Genetics, and Evolution
Infection, Genetics, and Evolution : We investigated the association of TIRAP variants with severity of TB disease and IP-10 production in humans, which may be useful in predicting poor clinical outcome

Incidence of tuberculosis in HIV-infected adults on first- and second-line antiretroviral therapy in India

Post Date: 
2019-10-29
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Publication: 
BMC Infectious Diseases
In this study among people living with HIV, Akshay Gupte and colleagues found that the risk of acquiring tuberculosis was higher in those receiving first-line antiretrovial therapy versus those receiving second-line medications.

Isoniazid preventive therapy in HIV-infected pregnant and postpartum women

Post Date: 
2019-10-03
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Publication: 
New England Journal of Medicine
New England Journal of Medicine: Dr. Amita Gupta and colleagues found that the current standard of care given to HIV+ pregnant women to prevent TB should wait until 12 weeks after delivery. The study underscores the need to include pregnant women in clinical trials.

Challenges in conducting trials for pediatric tuberculosis meningitis: lessons learned in the field

Post Date: 
2019-10-01
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Publication: 
International Journal of Tuberculosis and Lung Disease
International Journal of Tuberculosis and Lung Disease: Researchers describe the challenges associated with conducting the first randomized clinical trial of antimicrobial agents in pediatric tuberculosis meningitis.

Inclusion of key populations in clinical trials of new antituberculosis treatments: Current barriers and recommendations for pregnant and lactating women, children, and HIV-infected persons

Post Date: 
2019-08-15
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PLOS Medicine
PLOS Medicine: Dr. Amita Gupta and colleagues discuss the scientific and ethical basis for including pregnant and lactation women, children, and HIV+ patients in tuberculosis therapeutic clinical trials.

Smoking, alcohol use disorder and tuberculosis treatment outcomes: A dual co-morbidity burden that cannot be ignored

Post Date: 
2019-07-31
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PLoS One
BACKGROUND: More than 20% of tuberculosis (TB) disease worldwide may be attributable to smoking and alcohol abuse. India is the second largest consumer of tobacco products, a major consumer of alcohol particularly among males, and has the highest burden of TB globally. The impact of...

Third-line antiretroviral therapy in low-income and middle-income countries (ACTG A5288): a prospective strategy study

Post Date: 
2019-07-29
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Publication: 
Lancet HIV
BACKGROUND: Antiretroviral therapy (ART) management is challenging for individuals in resource-limited settings presenting for third-line treatment because of complex resistance patterns, partly due to reduced access to viral load monitoring. We aimed to evaluate use of newer...

Infection free "resisters" among household contacts of adult pulmonary tuberculosis

Post Date: 
2019-07-18
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PLoS One
Despite substantial exposure to infectious pulmonary tuberculosis (TB) cases, some household contacts (HHC) never acquire latent TB infection (LTBI). Characterizing these "resisters" can inform who to study immunologically for the development of TB vaccines. We enrolled HHCs of culture-confirmed...

Advancing the development of new tuberculosis treatment regimens: The essential role of translational and clinical pharmacology and microbiology

Post Date: 
2019-07-15
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PLoS Medicine
Summary points Translational and clinical pharmacology are the state-of-the-art tools used by drug developers to efficiently move compounds and regimens through all drug development phases. Tuberculosis drug and regimen development, though, has traditionally underutilized these modern, model-based...

High risk for latent tuberculosis infection among medical residents and nursing students in India

Post Date: 
2019-07-07
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PLoS One
PLoS ONE: Self-reported TB exposure is underreported, and uptake of LTBI prevention therapy remains low

Mobile phone access and comfort: implications for HIV and tuberculosis care in India and South Africa.

Post Date: 
2019-07-01
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Publication: 
International Journal of Tuberculosis and Lung Disease
SETTING: India and South Africa shoulder the greatest burden of tuberculosis (TB) and human immunodeficiency virus (HIV) infection respectively, but care retention is suboptimal. OBJECTIVE: We conducted a study in Pune, India, and Matlosana, South Africa ...

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COVID-19 Lessons Learned

Post Date: 
2021-04-27
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Bollinger R. Speaker. COVIS-19 Lessons Learned. 47th Annual Annual Conference of Research Society, BJGMC and Sassoon General Hospital. Virtual confernece, based in Pune, India. Apri 28-29, 2021.

Reservoirs of transmission of resistant Gram-negative pathogens responsible for neonatal sepsis among hospitalized neonates in Pune, India

Post Date: 
2020-10-21
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Johnson J, Robinson ML, Naik S, Patil S, Kulkarni R, Kinikar A, Dohe V, Mudshinkar S, Kagal A, Smith RM, Westercamp M, Randive B, Kadam A, Kulkarni V, Mave V, Gupta A, Milstone AM, Manabe YC, for the CDC SHEPheRD India Study Team. Reservoirs of transmission of resistant Gram-negative pathogens...

Screening for Tuberculosis (TB) in pregnant and non-pregnant women of reproductive age: Findings from an observational study in Pune, India

Post Date: 
2020-10-20
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Alexander M, Bhosale R, Naik S, Kulkarni V, Mave V, Suryavanshi N, Gupte N, Gupta A, Mathad J. Screening for Tuberculosis (TB) in pregnant and non-pregnant women of reproductive age: Findings from an observational study in Pune, India. Poster Presentation. 51st Union World Conference on Lung Health...

An RNA signature for TB risk in pregnant women: A prospective cohort study from India

Post Date: 
2020-10-20
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Mathad J, Bhosale R, Barreto-Duarte B, Alexander M, Kulkarni V, Nathella PK, Andrade B, Gupta A. Polyfunctional T-cells and IL-2 production decrease in pregnant women with latent TB. TB Science 2020. Virtual. October 20, 2020.

Systemic inflammation in pregnant women with and without latent tuberculosis infection

Post Date: 
2020-10-20
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Naik S, Alexander M, Kumar P, Kulkarni V, Yadana S, Bhosale R, Babu S, Gupta A, Mathad J and Shivakoti R. Systemic inflammation in pregnant women with and without latent tuberculosis infection. Poster Presentation. 51st Union World Conference on Lung Health. Virtual Conference. October 20-24, 2020.

Polyfunctional T-cells and IL-2 production decrease in pregnant women with latent TB

Post Date: 
2020-10-20
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Mathad J, Bhosale R, Barreto-Duarte B, Alexander M, Kulkarni V, Nathella PK, Andrade B, Gupta A. Polyfunctional T-cells and IL-2 production decrease in pregnant women with latent TB. TB Science 2020. Virtual. October 20, 2020.

Comparison of neurocognitive assessment in children with TB Meningitis and healthy controls in Pune, India

Post Date: 
2020-10-20
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Nimkar S, Joshi S, Kinikar A, Valvi C, Gupte N, Thakur KT, Suryavanshi N, Mave V, Dooley KE, Arenivas A. Comparison of neurocognitive assessment in children with TB Meningitis and healthy controls in Pune, India. Poster Presentation. 51st Union World Conference on Lung Health. Virtual Conference...

Blood-based biomarkers of tuberculosis in children integrating metabolomic and transcriptomic data

Post Date: 
2020-10-20
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Tornheim JA, Paradkar M, Fukutani KF, Kinikar A, Mave V, Andrade BB, Gupta A, Karakousis PC. Blood-based biomarkers of tuberculosis in children integrating metabolomic and transcriptomic data. TB Science 2020. Virtual. October 20, 2020.

Factors associated with gestational diabetes in HIV+ and HIV- women in Pune, India

Post Date: 
2020-03-09
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Chebrolu P , Alexander M, Bhosale R, Naik S, Patil N, Gupta A, Mathad J. Factors associated with gestational diabetes in HIV+ and HIV- women in Pune, India. Presented at: CROI 2020. Boston, Massachusetts. March 8-11, 2020.

Geographic and Individual Risk Factors for TB or Death in the Brief-TB Trial (A5279)

Post Date: 
2020-03-09
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Riviere C , Juste MAJ, Ramchandani R, Gupta A, Benson CA, Masheto G, Supparatpinyo K, Mohapi L, da Silva Escada RO, Mngqibisa R, Kanyama C, Langat D, Swindells S, Chaisson RE, for the A5279/BRIEF TB Study Team. Geographic and Individual Risk Factors for TB or Death in the Brief-TB Trial (A5279)...

Adjusted analysis of effect of IPT on adverse pregnancy outcomes in women with HIV

Post Date: 
2020-03-09
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Clinical Sites: 
Theron G , Chakhtoura N, Montepiedra G, Aaron L, Jean-Phillipe P, Weinberg A, McCarthy K, Nematadzira T, Masheto G, Chipato T, Onyango-Makumbi C, Gupta A, the IMPAACTP1078 Team. Adjusted analysis of effect of IPT on adverse pregnancy outcomes in women with HIV. Presented at: CROI 2020. Boston,...

Tuberculosis preventive therapy should be considered for all household contacts of pulmonary TB patients in India

Post Date: 
2020-02-07
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Paradkar M, Chandrasekara P, Jain D, Shivakumar SVBY, Thiruvengadan K, Gupte AN, Thomas B, Kinikar A, Sekar K, Bharadwaj R, Dolla CK, Gaikwad S, Elilarasi S, Lokhande R, Reddy D, Murali L, Kulkarni V, Pradhan N, Hanna LE, Pattabiraman S, Kohli R, Nayagam R, Suryavanshi N, Shrinivasa BM, Cox SR,...

Female tuberculosis (TB) patients with stigma are at increased risk of persistent depression: time to integrate mental health screening into TB care

Post Date: 
2019-11-20
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Suryavanshi N . Female tuberculosis (TB) patients with stigma are at increased risk of persistent depression: time to integrate mental health screening into TB care. Poster presentation. 50th Union World Conference on Lung Health. Hyderabad, India. October 30-November 2, 2019.

The crisis in maternal TB: a case-based discussion of research gaps

Post Date: 
2019-11-02
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Naik SN . The crisis in maternal TB: a case-based discussion of research gaps. Speaker. Confronting the crisis: emerging research in maternal-child TB Symposium. 50th Union World Conference on Lung Health. Hyderabad, India. October 30-November 2, 2019.

Is there a connection between gestational diabetes and TB?

Post Date: 
2019-11-02
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Alexander M . Is there a connection between gestational diabetes and TB? Speaker. Confronting the crisis: emerging research in maternal-child TB Symposium.50th Union World Conference on Lung Health. Hyderabad, India. October 30-November 2, 2019.

Performance of QuantiFERON-TB Gold in Tube (QFT-GIT) and QuantiFERON-TB Gold Plus (QFT-Plus) for detection of Mycobacterium tuberculosis infection in pregnant women in India

Post Date: 
2019-11-01
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Kulkarni V , Bhosale R, Jain D, Deshpande P, Naik N, Alexander M, Patil N, Gupte N, Gupta A, Mathad J. Performance of QuantiFERON-TB Gold in Tube (QFT-GIT) and QuantiFERON-TB Gold Plus (QFT-Plus) for detection of Mycobacterium tuberculosis infection in pregnant women in India. Poster presentation...

Six-week culture conversion predicts tuberculosis treatment outcomes

Post Date: 
2019-11-01
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Pradhan N , Kagal A, Gupte N, Gaikwad S, Barthwa M, Gupta A, Golub JE, Mave V. Six-week culture conversion predicts tuberculosis treatment outcomes. Poster presentation. 50th Union World Conference on Lung Health. Hyderabad, India. October 30-November 2, 2019.

Association of latent TB infection in pregnancy with perinatal health outcomes in an Indian cohort

Post Date: 
2019-11-01
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Clinical Sites: 
Graham H , Bhosale R, Alexander M, Kinikar A, Khwaja S, Patil N, Mathad J, Shivakoti S, Gupta A. Association of latent TB infection in pregnancy with perinatal health outcomes in an Indian cohort. Poster presentation. 50th Union World Conference on Lung Health. Hyderabad, India. October 30-November...

Inappropriate postpartum weight loss may predict development of active TB: Findings from a cohort study in Pune, India

Post Date: 
2019-11-01
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Countries: 
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Clinical Sites: 
Alexander M , Bhosale R, Naik S, Gupte N, Jain D, Patil N, Pradhan N, Mave V, Gupta A, Mathad J. Inappropriate postpartum weight loss may predict development of active TB: Findings from a cohort study in Pune, India. Poster presentation. 50th Union World Conference on Lung Health. Hyderabad, India...

Does treatment of infertile women with probable genital tuberculosis improve fertility outcome?

Post Date: 
2019-11-01
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Countries: 
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Clinical Sites: 
Naik SN , Chandanwale A, Kadam D, Sambarey PW, Dhumal G, DeLuca A, Jain D, Gupta A, Bollinger R, Mave V. Does treatment of infertile women with probable genital tuberculosis improve fertility outcome? Poster presentation. 50th Union World Conference on Lung Health. Hyderabad, India. October 30-...

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