Objective: A cluster of leptospirosis and brucellosis cases in a semi-nomadic, pastoral community was reported in October 2023 from Village A, Uttarakhand State, India. This cluster was investigated to describe the epidemiology and potential exposures. Methods: Suspected cases were residents with sudden-onset fever or myalgia occurring from 1 August 2023 to 7 January 2024; confirmed cases were suspected cases with laboratory confirmation. Suspected cases were identified through a house-to-house case search and were interviewed regarding sociodemographic variables, symptoms and exposures. Those who consented were tested. Data were cleaned and analysed in Microsoft Excel. Results: Fifty suspected cases were identified among a total of 300 residents across 85 households. Among these, 27 agreed to be tested, and 25 were confirmed (13 with leptospirosis, 7 with brucellosis and 5 with both leptospirosis and brucellosis). The cases began in September 2023 following flooding and continued until January 2024, with no deaths. The median age (range) of cases was 30 (17–82) years for leptospirosis, 39 (25–56) years for brucellosis and 39 (22–50) years for coinfection. Altogether, females accounted for 92% (12/13) of leptospirosis cases, 57% (4/7) of brucellosis cases and 80% (4/5) of coinfections. Symptoms included fever, myalgia and arthralgia. All cases reported contact with floodwater and animal abortus. Discussion: This was a laboratory-confirmed co-occurring cluster of leptospirosis and brucellosis, including five cases of coinfection, following flooding, predominantly affecting female Van Gujjar dairy farmers. Education was provided to the community about the hygienic disposal of animal waste.

Objective: To investigate the effect of acupressure therapy as an adjunctive therapy to pharmacological treatment on pain and health-related quality of life (QOL) among knee osteoarthritis (KOA) patients.Methods: One hundred KOA patients were recruited from the orthopedic out-patient clinic of the institute. The patients were allocated randomly (flipping-coin simple randomization method) into an intervention group (n=50) and a control group (n=50). Patients in the intervention group received acupressure therapy along with pharmacological treatment. Patients in the control group did not receive acupressure therapy but continued their pharmacological treatment. Changes in pain (visual analog scale, VAS) and QOL (short-form 36-item health survey, SF-36) scores at baseline (A0), during training session (A1), follow-up at the 3rd month after training (A2) and follow-up at the 6th month after training session (A3) were collected and examined. Multiple regression analysis was used to check the relationship between pain and SF-36 domains. Results: The VAS score of participants in the intervention group decreased at A3 (P=0.001). Scores of physical functioning (PF), role limitations due to emotional problems (RE) and mental health (MH) of SF-36 in the intervention group improved more as compared with the control group. Patients in the intervention group with improvement in VAS (pain) score showed greater changes in mean scores of all domains of SF-36 from baseline (all P?0.05). Except bodily pain (BP), the other domains of SF-36 were negatively correlated with pain score. Conclusion: Acupressure therapy with pharmacological treatment can improve health-related QOL and pain among KOA patients.